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Dysuria in Children

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181. Milnacipran Pierre Fabre Medicament

studies have not been performed. The use of milnacipran in children is therefore not supported by any juvenile toxicity studies. • Toxicokinetic data Toxicokinetic data for milnacipran racemate are available for all animal species investigated. Toxicokinetic studies differentiating between the single enantiomers have only been performed for the rat. Milnacipran did not accumulate following repeated oral administration in animal species investigated. No clear gender effect was observed in nonclinical

2010 European Medicines Agency - EPARs

182. Impulsor - milnacipran

fertility of F 1 females. The results of the pre-/postnatal development studies did not yield a clear indication as to whether reduced pup viability was directly due to treatment or was just secondary to impaired maternal care during lactation. Juvenile toxicity studies have not been performed. The use of milnacipran in children is therefore not supported by any juvenile toxicity studies. • Toxicokinetic data Toxicokinetic data for milnacipran racemate are available for all animal species investigated

2010 European Medicines Agency - EPARs

183. Glycopyrrolate oral solution

/5ml, indicated for treatment of chronic severe drooling in children 3-16 years of age with cerebral palsy (CP), or other neurologic conditions associated with problem drooling. 1.2 Risk Benefit Assessment In this current NDA, the applicant proposes the use of glycopyrrolate in a flavored oral solution to help control severe drooling in children 3-16 years of age with CP and/or related medical conditions. The applicant conducted one pharmacokinetic study, one placebo-controlled pivotal trial (...) for treatment of drooling in children. In addition, a mortality rate was calculated for children with cerebral palsy who matched the demographics of the enrolled subjects to help make an assessment of three deaths that occurred in the open label study. Therapeutic Benefit The results of the placebo-controlled trial demonstrated that 78% of subjects on drug reached the prespecified definition of clinical improvement in drooling compared to 19% of those on placebo (p = 0.0016). The open label trial

2010 FDA - Drug Approval Package

184. Clinical Applications of Contrast-Enhanced Ultrasonography in Pediatric Population

years. No adverse events were reported at 1 hour after exam. Follow-up phone interviews revealed no adverse events in the majority (973 of 1,010). The remaining 37 children experienced mild symptoms including dysuria (n=26) and urinary retention (n=2) which may have been related to catheterization rather than the contrast agent. A recent European survey at 29 centers evaluating the use of ultrasound contrast agent in 4,131 children for pediatric reflux diagnosis reported no adverse events (Riccabona (...) Last Update Posted : January 25, 2018 Sponsor: Johns Hopkins University Information provided by (Responsible Party): Johns Hopkins University Study Details Study Description Go to Brief Summary: In children, specifically the intravesicle administration to study vesicoureteral reflux in children already catheterized and scheduled for voiding cystourethrogram (VCUG). Contrast-enhanced ultrasonography is a tremendous advancement from conventional B-mode and color Doppler ultrasonography, as it permits

2016 Clinical Trials

185. What is the outcome of paediatric gastrocystoplasty when the patients reach adulthood? (PubMed)

What is the outcome of paediatric gastrocystoplasty when the patients reach adulthood? To document the long-term outcomes of paediatric augmentation gastrocystoplasty (AGC) in terms of preservation of renal function and maintenance of dryness, and to analyse the rate of complications.The medical records of children who had undergone AGC between 1992 and 2000 (minimum time interval of 15 years) were reviewed retrospectively. The following data were collected: age at surgery, the cause of bladder (...) -19.5) years. Renal function was preserved or improved in seven of the 11 patients and nine patients were dry after AGC. Seven of the 11 patients reported symptoms linked to haematuria-dysuria syndrome, which was resistant to treatment in one case and requiring excision of the gastric patch. Three of the 11 patients developed a tumour on the gastric graft after a median (range) delay of 20 (11-22) years after the initial procedure. All had gastric adenocarcinoma of which two were metastatic

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2016 BJU international

186. Composite Paraganglioma and Neuroblastoma of the Urinary Bladder: A Rare Histopathological Entity (PubMed)

Composite Paraganglioma and Neuroblastoma of the Urinary Bladder: A Rare Histopathological Entity Paraganglioma of the urinary bladder is an uncommon clinical entity. Neuroblastoma of the urinary bladder is another rare tumor with only 7 reported cases, all in children. This report presents the case of a composite paraganglioma and neuroblastoma in a 45 year-old male who presented with dysuria and flank pain. On the computerized tomography scan, the bladder wall overlying the tumor was smooth

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2015 Current urology

187. ESWL for Distal Ureteric Stone: Supine Versus Prone

reported using the supine approach of ESWL for treatment of distal ureter stones. No serious complications had developed in the patients who underwent supine approach. Only minor complications such as self-limiting blood in the urine, painful passage of urine, or local pain that had responded to oral painkillers. There were no serious complications encountered in children as well. In the most recent retrospective review by Tolley et al, they had revealed that patients who had underwent supine ESWL (...) /treatment Phase Urinary Tract Stones Urinary Stones Urinary Calculi Procedure: Supine ESWL Procedure: Prone ESWL Device: Extracorporeal Shockwave Lithotripsy (ESWL) Not Applicable Detailed Description: Previous authors have reported using the greater and lesser sciatic foramina as a pathway for the shockwaves to reach the distal ureter. No serious complications had developed in the patients who underwent transgluteal approach. Only minor complications such as self-limiting hematuria, dysuria, or pain

2014 Clinical Trials

188. A Phase I Clinical Pharmacology Study of TAK-233 in Healthy Subjects

regularly from the time of consent until 4 weeks after the end of the last assessment in the fourth treatment period Exclusion Criteria: Subjects who received TAK-233 within 16 weeks before the start of initial administration Subjects who have previously received TAK-233 during treatment or during participation in another clinical trial Employees of the medical institution conducting this clinical trial and their family/dependents (e.g., husband or wife, parents, children, and siblings), or subjects who (...) may be coerced to agree to participate in the clinical trial Subjects with poorly controlled and clinically significant neurological, cardiovascular, pulmonary, hepatic, renal, metabolic, gastrointestinal (including chronic costiveness), urological (including dysuria), autoimmune, endocrine, or psychiatric diseases or other abnormalities which may affect the subject's participation in the clinical trial or results of the clinical trial Subjects with hypersensitivity to TAK-233 related substances

2014 Clinical Trials

189. An unusual cause of terminal hematuria in a child: Eosinophilic cystitis (PubMed)

An unusual cause of terminal hematuria in a child: Eosinophilic cystitis Eosinophilic cystitis is a rare inflammatory disease of the bladder; it rarely occurs in children. Patients typically show irritative urination symptoms frequently, with a possible need for urgency, alongside dysuria, gross haematuria, suprapubic pain and painful urination. Sometimes bladder mass accumulation with the possibility of malignancy is also observed. We present an 8-year-old male patient who gained admission

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2014 Canadian Urological Association Journal

190. Late Effects of Treatment for Childhood Cancer

Late Effects of Treatment for Childhood Cancer Late Effects of Treatment for Childhood Cancer (PDQ®)—Health Professional Version - National Cancer Institute Menu Search Search Search General Information About Late Effects of Treatment for Childhood Cancer During the past five decades, dramatic progress has been made in the development of curative therapy for pediatric malignancies. Long-term survival into adulthood is the expectation for more than 80% of children with access to contemporary (...) , the Children’s Oncology Group (COG), and the Institute of Medicine. A risk-based medical follow-up is recommended, which includes a systematic plan for lifelong screening, surveillance, and prevention that incorporates risk estimates based on the following:[ ] Previous cancer. Cancer therapy. Genetic predisposition. Lifestyle behaviors. Comorbid conditions. Sex. Part of long-term follow-up is also focused on appropriate screening of educational and vocational progress. Specific treatments for childhood

2012 PDQ - NCI's Comprehensive Cancer Database

191. Labial adhesion and bacteriuria (PubMed)

Labial adhesion and bacteriuria The purpose of this study is to evaluate the clinical presentation, laboratory findings, and response to treatment in girls with labial adhesion younger than 23 months.A retrospective chart review of all girls younger than 23 months with the diagnosis of labial adhesion was referred to Dr Sheikh children's clinic in Mashhad in northeast Iran between 1998 and 2013.Sixty-three patients were diagnosed with labial adhesion during the review period. Most patients were (...) diagnosed by physicians during the physical examination or during the evaluation for their voiding problems. The most prevalent symptom among patients was dysuria and restlessness while voiding. Twenty-one (33.3%) patients had a history of urinary tract infection. 17 (26.9%) patients had sterile pyuria and 69.8% showed presence of bacteria in their urine samples.Physicians may frequently encounter pre-pubertal girls whose urinalysis may show sterile pyuria or presence of bacteria with colony counts <105

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2015 Journal of the Turkish German Gynecological Association

192. Safety of Probiotics to Reduce Risk and Prevent or Treat Disease

use RCTs 76 Figure 22. RR Number of Children With Adverse Events 82 Figure 23. RR Number of Adults With Adverse Events 83 Figure 24. RR Number of Elderly Participants With Adverse Events 85 Figure 25. RR Number of Critically Ill or High-Risk Participants With Adverse Events 88 Figure 26. Number of Participants With Serious Adverse Events 94 Appendixes Appendix A. Exact Search Strings and List of Manufacturers Appendix B. Sample Data Abstraction Forms Appendix C. Evidence Tables Appendix D (...) no evidence that a particular mechanism or route of administration of probiotic organisms was associated with an increased risk of an adverse event in intervention participants relative to control group participants. Stratified analyses and meta-regressions showed no increased risk of adverse events for children (RR 0.96; 95% CI: 0.88, 1.04; p=0.296, 35 RCTs), adults (RR 0.97; 95% CI: 0.79, 1.19; p=0.745, 40 RCTs), or elderly (RR 0.94; 95% CI: 0.82, 1.08; p=0.367, 4 RCTs) participants compared

2011 EvidenceUpdates

193. Overactive Bladder: Etiology, Diagnosis, and Impact (Overview)

and Drug Administration (FDA) to expand the number and types of patients eligible for clinical trials. As noted, OAB may include not only urgency urinary incontinence but also urgency, frequency, dysuria, and nocturia. Other terms used include detrusor overactivity, detrusor instability, detrusor hyperreflexia, and involuntary bladder contractions. A preliminary diagnosis of OAB can be made on the basis of the history and physical examination (see ), in conjunction with a few simple office (...) modulators. [ ] These prospective therapies are currently at different stages of clinical development. Among other investigational therapies, neurokinin receptor antagonists, alpha-adrenoceptor antagonists, nerve growth factor inhibitors, gene therapy, and stem cell–based therapies are of considerable interest. The future development of new modalities in OAB treatment appears promising. OAB affects children as well as adults. For more information, see and . Previous Next: Anatomy A normal bladder

2014 eMedicine.com

194. Nephrolithiasis (Overview)

in nephrolithiasis include the following: Stones obstructing ureteropelvic junction: Mild to severe deep flank pain without radiation to the groin; irritative voiding symptoms (eg, frequency, dysuria); suprapubic pain, urinary frequency/urgency, dysuria, stranguria, bowel symptoms Stones within ureter: Abrupt, severe, colicky pain in the flank and ipsilateral lower abdomen; radiation to testicles or vulvar area; intense nausea with or without vomiting Upper ureteral stones: Radiate to flank or lumbar areas (...) surgery and in all children. [ ] Calcium stones Calcium stones account for 75% of renal calculi. Recent data suggest that a low-protein, low-salt diet may be preferable to a low-calcium diet in hypercalciuric stone formers for preventing stone recurrences. [ ] Epidemiological studies have shown that the incidence of stone disease is inversely related to the magnitude of dietary calcium intake in first-time stone formers. There is a trend in the urology community not to restrict dietary intake

2014 eMedicine.com

195. Nephrolithiasis: Acute Renal Colic (Overview)

and characteristics of pain in nephrolithiasis include the following: Stones obstructing ureteropelvic junction: Mild to severe deep flank pain without radiation to the groin; irritative voiding symptoms (eg, frequency, dysuria); suprapubic pain, urinary frequency/urgency, dysuria, stranguria, bowel symptoms Stones within ureter: Abrupt, severe, colicky pain in the flank and ipsilateral lower abdomen; radiation to testicles or vulvar area; intense nausea with or without vomiting Upper ureteral stones: Radiate (...) kidney or stone surgery and in all children. [ ] Calcium stones Calcium stones account for 75% of renal calculi. Recent data suggest that a low-protein, low-salt diet may be preferable to a low-calcium diet in hypercalciuric stone formers for preventing stone recurrences. [ ] Epidemiological studies have shown that the incidence of stone disease is inversely related to the magnitude of dietary calcium intake in first-time stone formers. There is a trend in the urology community not to restrict

2014 eMedicine.com

196. Nonneoplastic Epithelial Disorders of the Vulva (Overview)

of 180 kd now thought to be collagen XVII), located in the basement membrane of the skin. [ ] Mucosal lesions of the vulva occur less frequently and are less severe than other blistering disorders. [ ] A juvenile localized subtype of immunoglobulin G (IgG)–mediated bullous pemphigoid occurring in children in the first year of life and characterized by a self-limited nonscarring bullous pemphigoid–like process involving only the vulva has been described. [ ] Cicatricial pemphigoid Cicatricial (...) , and irritation occur and may be responsible for dyspareunia and dysuria. [ ] The rare hypertrophic form, clinically resembling lichen sclerosus, manifests with extensive white scarring of the periclitoral area with variable degrees of hyperkeratosis. [ ] It may be very itchy. Extensive vaginal involvement may result in a malodorous discharge. Large denuded areas may become adherent, causing stenosis of the vaginal introitus and dyspareunia. Marked atrophy may develop with time. Malignancy is possible in long

2014 eMedicine.com

197. Normal and Abnormal Puerperium (Overview)

), the American College of Obstetricians and Gynecologists (ACOG), and the United States Preventive Services Task Force recommend exclusive breastfeeding for the first six months of life. In 1991 The World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) launched a global program called The Baby-Friendly Hospital Initiation (BFHI) that aims to increase the numbers of infants who are exclusively breastfed worldwide. The BFHI program developed “Ten Steps to Successful Breastfeeding (...) ) are options for those who are certain they do not desire more children. The CDC has published “The United Stated Medical Eligibility Criteria for Contraceptive Use (US MEC)” which are evidence-based guidelines that assist health care providers in recommending a safe of contraceptive method for an individual based on medical comorbidities [ ] Recommendations are provided using a 4-point categorical grading system which takes into account an individual’s risks of using certain contraceptive agents depending

2014 eMedicine.com

198. Epididymitis (Overview)

demonstrates increased blood flow in the epididymis resulting from the active inflammation. Signs and symptoms The following history findings are associated with acute epididymitis and orchitis: Gradual onset of scrotal pain and swelling, usually unilateral, often developing over several days (as opposed to hours for testicular torsion) Dysuria, frequency, or urgency Fever and chills (in only 25% of adults with acute epididymitis but in up to 71% of children with the condition) Usually, no nausea (...) prostatitis or seminal vesiculitis (in postpubertal individuals) With tuberculosis, focal epididymitis, a draining sinus, or beading of the vas deferens In children, an underlying congenital anomaly of the urogenital tract Findings associated with orchitis may include the following: Testicular enlargement, induration, and a reactive hydrocele (common) Nontender epididymis In 20-40% of cases, association with acute epididymitis See for more detail. Diagnosis The following laboratory studies may

2014 eMedicine.com

199. Epididymal Tuberculosis (Overview)

appearance) with . Severe cases involve the entire bladder wall, where deep layers of muscle are eventually replaced by fibrous tissue, thus producing a thick fibrous bladder. Tubercles are rare in the bladder; if present, they usually appear at the ureteral orifice. Malignancy should be considered with any isolated tubercles away from the ureteral orifices. Epididymal and testicular TB The higher frequency of isolated epididymal TB lesions in children favors the possibility of hematologic spread (...) increased frequency of urination (during the day initially but at night later in the disease course), dysuria, frank pain, suprapubic pain, blood or pus in the urine, and fever. Urinary urgency is relatively uncommon unless the bladder is extensively involved. Patients with GUTB may also present with a painful testicular swelling, perianal sinus, or genital ulcer. Unexplained infertility in both men and women is sometimes attributable to GUTB. [ ] Physicians have also diagnosed endometrial TB while

2014 eMedicine.com

200. Augmentation Cystoplasty (Follow-up)

Updated: Nov 23, 2016 Author: Pravin K Rao, MD; Chief Editor: Bradley Fields Schwartz, DO, FACS Share Email Print Feedback Close Sections Sections Augmentation Cystoplasty Overview Background Bladder augmentation, also called augmentation cystoplasty, is a surgical procedure used in adults and children who lack adequate bladder capacity or detrusor compliance. [ , , ] For many patients, augmentation cystoplasty can provide a safe, functional reservoir that allows for urinary continence and prevention (...) for an embryologic urinary defect as a child seek a healthier cosmetic and functional state. In other cases, adults have an acquired condition that is causing bladder dysfunction. Adults may present with symptoms very similar to those of children with congenital abnormalities. Again, surgery is indicated for adults with refractory symptoms and those with risk or progression of upper tract deterioration. Previous Next: Contraindications Patients who are unable or unwilling to perform life-long intermittent

2014 eMedicine.com

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