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Dysuria in Children

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301. Reactive Arthritis (Overview)

of Poncet's disease. From the description of 198 cases found in the literature. Clin Rheumatol . 2013 Jul. 32(7):929-35. . Prati C, Bertolini E, Toussirot E, Wendling D. Reactive arthritis due to Clostridium difficile. Joint Bone Spine . 2010 Mar. 77(2):190-2. . Durand CL, Miller PF. Severe Clostridium difficile colitis and reactive arthritis in a ten-year-old child. Pediatr Infect Dis J . 2009 Aug. 28(8):750-1. . Macía Villa C, Sifuentes Giraldo W, Boteanu A, González Lanza M, Bachiller Corral J (...) (2):121-3. . Simonini G, Taddio A, Cimaz R. No evidence yet to change American Heart Association recommendations for poststreptococcal reactive arthritis: comment on the article by van Bemmel et al. Arthritis Rheum . 2009 Nov. 60(11):3516-8; author reply 3518-9. . Moorthy LN, Gaur S, Peterson MG, Landa YF, Tandon M, Lehman TJ. Poststreptococcal reactive arthritis in children: a retrospective study. Clin Pediatr (Phila) . 2009 Mar. 48(2):174-82. . Siala M, Gdoura R, Younes M, Fourati H, Cheour I

2014 eMedicine.com

302. Reactive Arthritis (Overview)

of Poncet's disease. From the description of 198 cases found in the literature. Clin Rheumatol . 2013 Jul. 32(7):929-35. . Prati C, Bertolini E, Toussirot E, Wendling D. Reactive arthritis due to Clostridium difficile. Joint Bone Spine . 2010 Mar. 77(2):190-2. . Durand CL, Miller PF. Severe Clostridium difficile colitis and reactive arthritis in a ten-year-old child. Pediatr Infect Dis J . 2009 Aug. 28(8):750-1. . Macía Villa C, Sifuentes Giraldo W, Boteanu A, González Lanza M, Bachiller Corral J (...) (2):121-3. . Simonini G, Taddio A, Cimaz R. No evidence yet to change American Heart Association recommendations for poststreptococcal reactive arthritis: comment on the article by van Bemmel et al. Arthritis Rheum . 2009 Nov. 60(11):3516-8; author reply 3518-9. . Moorthy LN, Gaur S, Peterson MG, Landa YF, Tandon M, Lehman TJ. Poststreptococcal reactive arthritis in children: a retrospective study. Clin Pediatr (Phila) . 2009 Mar. 48(2):174-82. . Siala M, Gdoura R, Younes M, Fourati H, Cheour I

2014 eMedicine.com

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

(UTI). Reprinted with permission from Elsevier. of 3 Tables Contributor Information and Disclosures Author Pamela I Ellsworth, MD Chief, Division of Pediatric Urology, Nemours Children's Hospital; Professor of Urology, University of Central Florida College of Medicine Pamela I Ellsworth, MD is a member of the following medical societies: , , , Disclosure: Nothing to disclose. Coauthor(s) Wellman W Cheung, MD, FACS Clinical Professor, Department of Urology and Department of Obstetrics and Gynecology (...) 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

2014 eMedicine.com

304. Papillomavirus (Treatment)

. In more than one half of children with anogenital warts, the lesions are a manifestation either of viral inoculation at birth or of incidental spread of cutaneous warts. Such cases often are caused by nongenital HPV types. The diagnosis of genital warts in a child requires that the clinician report suspected abuse to begin an evaluation process that may or may not confirm sexual abuse. [ , ] Neonates and infants with laryngeal papillomatosis Pregnant women with genital warts can transmit the virus (...) . Patients with perianal warts, those who are HIV positive, and those with a history of receptive anal intercourse are at increased risk for anal HGSIL. There is no direct evidence to suggest that this would progress to invasive anal cancer, as lesions of the cervix are capable of doing. Nonetheless, penile, vulvar, vaginal, anal carcinomas, and head and neck cancers have been linked to HPV infection. [ ] Children with anogenital warts Anogenital warts are rare in the general pediatric population

2014 eMedicine.com

305. Reactive Arthritis (Treatment)

of Poncet's disease. From the description of 198 cases found in the literature. Clin Rheumatol . 2013 Jul. 32(7):929-35. . Prati C, Bertolini E, Toussirot E, Wendling D. Reactive arthritis due to Clostridium difficile. Joint Bone Spine . 2010 Mar. 77(2):190-2. . Durand CL, Miller PF. Severe Clostridium difficile colitis and reactive arthritis in a ten-year-old child. Pediatr Infect Dis J . 2009 Aug. 28(8):750-1. . Macía Villa C, Sifuentes Giraldo W, Boteanu A, González Lanza M, Bachiller Corral J (...) (2):121-3. . Simonini G, Taddio A, Cimaz R. No evidence yet to change American Heart Association recommendations for poststreptococcal reactive arthritis: comment on the article by van Bemmel et al. Arthritis Rheum . 2009 Nov. 60(11):3516-8; author reply 3518-9. . Moorthy LN, Gaur S, Peterson MG, Landa YF, Tandon M, Lehman TJ. Poststreptococcal reactive arthritis in children: a retrospective study. Clin Pediatr (Phila) . 2009 Mar. 48(2):174-82. . Siala M, Gdoura R, Younes M, Fourati H, Cheour I

2014 eMedicine.com

306. Reactive Arthritis (Treatment)

of Poncet's disease. From the description of 198 cases found in the literature. Clin Rheumatol . 2013 Jul. 32(7):929-35. . Prati C, Bertolini E, Toussirot E, Wendling D. Reactive arthritis due to Clostridium difficile. Joint Bone Spine . 2010 Mar. 77(2):190-2. . Durand CL, Miller PF. Severe Clostridium difficile colitis and reactive arthritis in a ten-year-old child. Pediatr Infect Dis J . 2009 Aug. 28(8):750-1. . Macía Villa C, Sifuentes Giraldo W, Boteanu A, González Lanza M, Bachiller Corral J (...) (2):121-3. . Simonini G, Taddio A, Cimaz R. No evidence yet to change American Heart Association recommendations for poststreptococcal reactive arthritis: comment on the article by van Bemmel et al. Arthritis Rheum . 2009 Nov. 60(11):3516-8; author reply 3518-9. . Moorthy LN, Gaur S, Peterson MG, Landa YF, Tandon M, Lehman TJ. Poststreptococcal reactive arthritis in children: a retrospective study. Clin Pediatr (Phila) . 2009 Mar. 48(2):174-82. . Siala M, Gdoura R, Younes M, Fourati H, Cheour I

2014 eMedicine.com

307. Genital Herpes in Pregnancy (Overview)

of Obstetrics and Gynecologists (Washington, DC) for speaking and teaching; Received honoraria from National Institute of Child Health and Human Development Pediatric and Adolescent Gynecology Research Thi. Chief Editor Ronald M Ramus, MD Professor of Obstetrics and Gynecology, Director, Division of Maternal-Fetal Medicine, Virginia Commonwealth University School of Medicine Ronald M Ramus, MD is a member of the following medical societies: , , , Disclosure: Nothing to disclose. Additional Contributors (...) to herpes simplex virus 2 (HSV-2). Approximately 22% of pregnant women are infected with HSV-2 and 2% of women acquire genital herpes in pregnancy. Approximately 1500-2000 new cases of neonatal HSV infection are diagnosed each year. The incidence of neonatal herpes varies considerably in international studies (about 1:3,200 births in the US and 1:60,000 in the UK). Approximately 80% of infected infants are born to mothers with no reported history of HSV infection. [ ] Untreated neonatal HSV infection

2014 eMedicine.com

308. Gonococcus (Overview)

partners frequently enough to sustain the infection in a community are defined as core transmitters. Neonatal and pediatric gonococcal infection Neonatal gonococcal infection may follow conjunctival infection, which is obtained during passage through the birth canal. In addition, direct infection may occur through the scalp at the sites of fetal monitoring electrodes. In children, infection may occur from sexual abuse by an infected individual or possibly nonsexual contact in the child's household (...) of reported gonorrhea cases by age group and sex, United States, 2016. Courtesy of the Centers for Disease Control and Prevention (CDC). Infection in children is a marker for child sexual abuse and should be reported as such, although a 2007 review provided some support for nonsexual transmission between children and for transmission from adults to children related to poor hand hygiene. [ , ] Gonococcemia remains an important disease in the adolescent and young adult population, with a peak incidence

2014 eMedicine.com

309. Gonococcemia (Overview)

partners frequently enough to sustain the infection in a community are defined as core transmitters. Neonatal and pediatric gonococcal infection Neonatal gonococcal infection may follow conjunctival infection, which is obtained during passage through the birth canal. In addition, direct infection may occur through the scalp at the sites of fetal monitoring electrodes. In children, infection may occur from sexual abuse by an infected individual or possibly nonsexual contact in the child's household (...) of reported gonorrhea cases by age group and sex, United States, 2016. Courtesy of the Centers for Disease Control and Prevention (CDC). Infection in children is a marker for child sexual abuse and should be reported as such, although a 2007 review provided some support for nonsexual transmission between children and for transmission from adults to children related to poor hand hygiene. [ , ] Gonococcemia remains an important disease in the adolescent and young adult population, with a peak incidence

2014 eMedicine.com

310. Gonococcal Infections (Overview)

unprotected intercourse with new partners frequently enough to sustain the infection in a community are defined as core transmitters. Neonatal and pediatric gonococcal infection Neonatal gonococcal infection may follow conjunctival infection, which is obtained during passage through the birth canal. In addition, direct infection may occur through the scalp at the sites of fetal monitoring electrodes. In children, infection may occur from sexual abuse by an infected individual or possibly nonsexual contact (...) contraceptives Rates of reported gonorrhea cases by age group and sex, United States, 2016. Courtesy of the Centers for Disease Control and Prevention (CDC). Infection in children is a marker for child sexual abuse and should be reported as such, although a 2007 review provided some support for nonsexual transmission between children and for transmission from adults to children related to poor hand hygiene. [ , ] Gonococcemia remains an important disease in the adolescent and young adult population

2014 eMedicine.com

311. Hematopoietic Stem Cell Transplantation (Overview)

hampered by small numbers. [ ] Patients treated with chemotherapy alone have achieved remission, but overall survival has been poor. [ , ] In a comparison allogeneic transplant versus chemotherapy in children with Phl + ALL (UK Medical Research Council trial for childhood ALL [MRC ALL 97] program from 1997-2002), 3-year survival was reported as 60% compared with 36%, respectively. [ ] Children with induction failure (M2 or M3 bone marrow status at the end of 1 mo of therapy) were found to have very (...) Leukocyte adhesion deficiency Indications for HSCT in specific diseases Acute myeloid leukemia Allogeneic HSCT is the treatment of choice for all children with acute myeloid leukemia (AML) with a human leukocyte antigen (HLA) ̶ matched sibling in their first complete remission (CR1). In adults, this is reserved for those with high-risk features in their CR1. In adults with standard or good risk features, stem cell transplantation is reserved for their second complete remission (CR2). HSCT is the only

2014 eMedicine.com

312. HLA-B27 Syndromes (Overview)

in the treatment of resistant chronic uveitis, including chronic anterior uveitis in children with juvenile rheumatoid uveitis and idiopathic uveitis. This allowed the reduction of both systemic corticosteroids and/or systemic methotrexate. Oral tolerance involves administering an antigen orally to induce a specific peripheral immune tolerance. The mechanisms of oral tolerance are unclear, but it is believed that it involves a specific antigen and the generation of active suppression or clonal anergy dependent (...) in individuals who are HLA-B27 positive; in fact, 60-85% of patients with reactive arthritis are HLA-B27 positive. The disease is most common in persons aged 18-40 years, but it has been known to occur in children and older adults. The sex ratio varies, depending on whether the infection is enteric or venereally acquired. The sex ratio following gastrointestinal infection is 1:1, whereas the genitourinary disease primarily affects males. Prevalence of the disease also is high in homosexual and bisexual men

2014 eMedicine.com

313. Hypercalciuria (Overview)

al. Prevalence and spot urine risk factors for renal stones in children taking topiramate. J Pediatr Urol . 2013 Jan 31. . . Vachvanichsanong P, Malagon M, Moore ES. Recurrent abdominal and flank pain in children with idiopathic hypercalciuria. Acta Paediatr . 2001 Jun. 90(6):643-8. . Alon US, Berenbom A. Idiopathic hypercalciuria of childhood: 4- to 11-year outcome. Pediatr Nephrol . 2000 Sep. 14(10-11):1011-5. . Escribano J, Balaguer A, Martin R, Feliu A, Espax R. Childhood idiopathic (...) degree of hematuria and back or abdominal pain and is also sometimes associated with voiding symptoms. Microcrystallization of calcium with urinary anions has been suggested to lead to injury of the uroepithelium in children with hypercalciuria. Consequently, when taking the history of the illness, attempt to identify symptoms relating to the urinary tract, paying special attention to the following signs and symptoms: Dysuria Abdominal pain Irritability (infants) Urinary frequency Urinary urgency

2014 eMedicine.com

314. Nonneoplastic Epithelial Disorders of the Vulva (Overview)

, diaphragms Fixed drug eruption A fixed drug eruption is a cell-mediated allergic drug reaction typically recurring in the same site upon reexposure. Common causative agents include oral drugs such as nonsteroidal anti-inflammatory agents, acetaminophen, sulfonamides, tetracycline, and barbiturates. Fluconazole as a possible causative agent has also been recently reported. [ ] Atopic dermatitis Atopic dermatitis usually occurs in patients with a personal or family history of asthma, hay fever, childhood (...) 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

2014 eMedicine.com

315. 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 (...) by the ovaries is highly variable and is greatly influenced by breastfeeding the infant. The woman who breastfeeds her infant has a longer period of amenorrhea and anovulation than the mother who chooses to use formula. The mother who does not breastfeed may ovulate as early as 27 days after delivery. Most women have a menstrual period by 12 weeks; the mean time to first menses is 7-9 weeks. In the breastfeeding woman, the resumption of menses is highly variable and depends on a number of factors, including

2014 eMedicine.com

316. Nephrolithiasis: Acute Renal Colic (Overview)

in people aged 35-45 years, but the disease can affect anyone at any age. Patients in whom multiple recurrent stones form usually develop their first stones while in their second or third decade of life. An initial stone attack after age 50 years is relatively uncommon. Nephrolithiasis in children has historically been rare, with approximately 5-10 children aged 10 months to 16 years being seen annually for the condition at a typical US pediatric referral center. Over the last 25 years, however (...) . Pyonephrosis: diagnosis and treatment. Br J Urol . 1992 Oct. 70(4):360-3. . Jeffrey RB, Laing FC, Wing VW, Hoddick W. Sensitivity of sonography in pyonephrosis: a reevaluation. AJR Am J Roentgenol . 1985 Jan. 144(1):71-3. . Schneider K, Helmig FJ, Eife R, Belohradsky BH, Kohn MM, Devens K, et al. Pyonephrosis in childhood--is ultrasound sufficient for diagnosis?. Pediatr Radiol . 1989. 19(5):302-7. . Fultz PJ, Hampton WR, Totterman SM. Computed tomography of pyonephrosis. Abdom Imaging . 1993. 18(1):82-7

2014 eMedicine.com

317. Nephrolithiasis (Overview)

at any age. Patients in whom multiple recurrent stones form usually develop their first stones while in their second or third decade of life. An initial stone attack after age 50 years is relatively uncommon. Nephrolithiasis in children has historically been rare, with approximately 5-10 children aged 10 months to 16 years being seen annually for the condition at a typical US pediatric referral center. Over the last 25 years, however, the incidence of nephrolithiasis in children has increased (...) , Laing FC, Wing VW, Hoddick W. Sensitivity of sonography in pyonephrosis: a reevaluation. AJR Am J Roentgenol . 1985 Jan. 144(1):71-3. . Schneider K, Helmig FJ, Eife R, Belohradsky BH, Kohn MM, Devens K, et al. Pyonephrosis in childhood--is ultrasound sufficient for diagnosis?. Pediatr Radiol . 1989. 19(5):302-7. . Fultz PJ, Hampton WR, Totterman SM. Computed tomography of pyonephrosis. Abdom Imaging . 1993. 18(1):82-7. . Wu TT, Lee YH, Tzeng WS, Chen WC, Yu CC, Huang JK. The role of C-reactive

2014 eMedicine.com

318. Incontinence, Urinary: Nonsurgical Therapies (Overview)

. In addition, trauma can result in secondary structural incontinence. Neurogenic lesions make up the next category of pediatric incontinence disorders. These include spinal dysraphism, tethered spinal cord, and spinal cord tumors. Nonstructural causes account for most cases of pediatric incontinence. [ ] Infection and inflammation may be the source. Dysfunctional voiding habits can develop even at a young age. Some children may become so preoccupied with activities that voiding is delayed until capacity (...) , which may result from voiding with the legs held too tightly together. The impeded flow of urine may fill the vagina. The vagina empties when the child stands. Nocturnal enuresis is the most common pediatric incontinence disorder. For discussion of this topic, see . Previous Next: Etiology Even in an individual patient, urinary incontinence may have multiple etiologies, with varying degrees of contribution to the overall disorder. Structural and functional disorders involving the bladder, urethra

2014 eMedicine.com

319. Prostatitis, Tuberculous (Treatment)

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

320. Prostate Cancer: Brachytherapy (Radioactive Seed Implantation Therapy) (Treatment)

, acute urinary retention and dysuria were actually greater in the hormone ablation group. [ ] Clinicians often compromise and use a 5-alpha reductase inhibitor for downsizing instead of true androgen ablation. Nonetheless, brachytherapy is not advisable in patients with glands larger than 60 g. In morbidly obese patients, the equipment often cannot sustain the patient’s weight or is not long enough to reach the prostate. Previous Next: Outcomes When compared with historical series using classic EBRT (...) to treat prostate cancer, brachytherapy series appear to offer equivalent or better disease-specific survival as measured by biochemical failure rates. Patients must be appropriately selected and treated at an accredited institution. Although brachytherapy is still in its infancy, 5-, 7-, and 12-year follow-up studies suggest that brachytherapy is equal to surgery in terms of biochemical recurrence. A 12-year study by Ragde et al, which reported on patients treated with I-125 seeds with or without

2014 eMedicine.com

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