The endocrinology of the urinary bladder.

The urinary bladder primarily functions as a reservoir for urine. Apparently, it serves only a mechanical and passive role in the urinary tract, but closer scrutiny reveals that it has several meaningful endocrine interactions. This vital organ has an intricate plexus of neurons that release neurohormones concerned with the functioning of the bladder.

Fitterfly Diabetes CGM Digital Therapeutics Program for Glycemic Control and Weight Management in People With Type 2 Diabetes Mellitus: Real-world Effectiveness Evaluation.

Background: Digital therapeutic platforms facilitate health care through patient-centered strategies based on multidisciplinary teams and shared decision-making. Such platforms can be used for developing a dynamic model of diabetes care delivery, which can help in improving glycemic control by promoting long-term behavior changes in people with diabetes.

Objective: This study aims to evaluate the real-world effectiveness of the Fitterfly Diabetes CGM digital therapeutics program for improving glycemic control in people with type 2 diabetes mellitus (T2DM) after the completion of 90 days in the program.

Personalized glycemic response led digital therapeutics program improves time in range in a period of 14 days.

Background: Lifestyle modification is an integral aspect for the management of type 2 diabetes (T2D). However, it is difficult to ensure the accuracy of personalized lifestyle advice. The study aims to analyse the real-world effectiveness of personalized glycemic response based Diabefly-Pro digital therapeutics for better glycemic control.

Video Call-based Fitness Assessment shows Poor Fitness in People with Type II Diabetes: Findings from Diabefly Digital Therapeutics Program.

Objective: Exercise and physical activity are integral aspects for the effective management of diabetes. Unsupervised home exercise although very accessible is limited by poor adherence, risk of injury, and a higher dropout rate of participants. A fitness assessment by a qualified physiotherapist can help in understanding the baseline fitness of individuals and thus generating appropriate exercise prescriptions.

Prediabetes: A Pragmatic approach to counselling and coaching.

Prediabetes is often considered as the link between normoglycaemia and diabetes. Though a lot of emphasis is given to an individual after the development of diabetes, pre-diabetes is often not adequately addressed in clinical practice. Given a distinct diagnostic criterion, its association with metabolic complications, an opportunity to prevent further progression to diabetes and the large number of people affected with it, makes it a subject of great importance and opportunity.

What's in a Name? Redefining Type 2 Diabetes Remission.

Diabetes remission is a concept that is marked by ample attention, but lack of unanimity. This opinion piece explores existing definitions of diabetes remission and proposes a contemporary and comprehensive framework to help define this clinical state. Type 2 diabetes remission is defined as a healthy clinical state characterized by achievement of HBA1c below the targeted level, maintained for at least 6 months, with or without continued use of lifestyle modification and/or metformin, provided that this is not due to complications, comorbid conditions or concomitant therapy.

Abdominoscrotal Lymphangioma Masquerading as a Communicating Hydrocele: A Case Report.

A 5-year old boy presented with a picture of communicating hydrocele and was discovered to have an abdominoscrotal lymphangioma after undergoing hydrocele surgery. Upon initial presentation the lymphangioma was missed and the child underwent inguinal approach surgery for hydrocele. The lymphangioma was then noticed as an abdominal lump due to a rapid increase in size within 1 week following the hydrocele surgery.

Stage 4S Neuroblastoma: A Report of Two Cases Presenting with Extremes of Biological Behavior.

Neuroblastoma is the most common extracranial solid tumor in childhood. Stage 4S is a special stage of neuroblastoma in which majority of cases may have spontaneous regression; however, in some cases the tumor is rapidly progressive with poor prognosis and thus requires aggressive therapy. Dilemmas in its management and therapy will be discussed.

Anogenital distance is determined during early gestation in humans.

Study Question: Does cord blood androgen level obtained at birth affect the AGD in human newborns?

Summary Answer: In human newborns, though males have a significantly longer AGD compared to females (as early as 22 weeks of gestation) the AGD is not affected by androgen levels at birth in both the sexes.

What Is Known Already: Animal studies have reported a critical time period in early fetal life, termed the masculinization programming window (MPW) during which AGD is fixed by in utero androgen action and is unaffected by testosterone levels later during gestation. Thus, AGD may serve as a lifelong biomarker of androgen exposure during this window.

Shorter anogenital distance correlates with the severity of hypospadias in pre-pubertal boys.

Study Question: Do pre-pubertal boys with hypospadias have a shorter anogenital distance (AGD) than boys with normal genitalia?

Summary Answer: AGD is significantly shorter in boys with hypospadias and decreases with the severity of hypospadias.

What Is Known Already: Animal studies have shown that androgen disruption and exposure to endocrine disrupting chemicals during a critical time period in early gestation, termed the male programming window (MPW), result in hypospadias and reduced AGD; and the severity of hypospadias correlates with the reduction in AGD. However, this correlation has not been established in humans.

Maternal and infant characteristics influencing the anogenital distance and penile length in newborns.

Recent studies have suggested that maternal characteristics can affect reproductive health of offspring, possibly through pre-natal hormonal influence. Anogenital distance (AGD) is an anthropometric measure which is a sensitive reproductive endpoint of masculinisation. It provides a read-out of pre-natal androgen exposure and has been associated with several reproductive health outcomes in humans.

Transverse preputial onlay island flap urethroplasty for single-stage correction of proximal hypospadias.

Aims And Objectives: Transverse preputial onlay island flap urethroplasty (TPOIF) was described initially for distal hypospadias, but has seen extended application for proximal hypospadias. We describe a set of modifications in the technique and results in a large series of proximal hypospadias.

Materials And Methods: All children who underwent TPOIF repair for proximal hypospadias (proximal penile, penoscrotal and scrotal) from June 2006 to June 2013 by a single surgeon were prospectively followed till June, 2014.

Shorter anogenital distance correlates with undescended testis: a detailed genital anthropometric analysis in human newborns.

Study Question: Are the anogenital distance (AGD) and stretched penile length (SPL) shorter in human newborn males with cryptorchidism?

Summary Answer: AGD is significantly shorter in boys with undescended testis (UDT) and this correlation may indicate that both have a common antecedent early in gestation.

What Is Known Already: Animal studies have reported a critical time period during early gestation termed the male programming window (MPW) where androgen deficiency results in reduced AGD and penile length, as well as cryptorchidism and hypospadias. Two pilot human studies have explored this association but these studies were small and heterogeneous with regard to age, race and had selection bias.

Undescended testis and torsion: is the risk understated?

Undescended testis (UDT) is seen in 3% to 5% of all newborn boys. Complications such as infertility and malignant transformation have been well documented in UDT. However, torsion of a UDT can also occur and the diagnosis is often missed or delayed, leading to loss of testis.

Local steroid therapy as the first-line treatment for boys with symptomatic phimosis - a long-term prospective study.

Aim: Phimosis is a common paediatric urological disorder and often necessitates circumcision. We prospectively evaluated local steroid therapy (LST) as the first choice therapy for such children.

Methods: Two hundred and sixty symptomatic boys up to 15 years of age (mean 34 months) with phimosis were started on betamethasone dipropionate (0.

3D multidetector CT angiographic evaluation of intralobular bronchopulmonary sequestration.

We report a case of intralobar pulmonary sequestration with special emphasis on computed tomography (CT) angiography in determining the arterial supply and venous drainage, thus providing a detailed knowledge of the vasculature, which is of vital importance in surgery. The 3D volume rendering technique and maximum intensity projection images provide the vascular road map for the surgeon.

Lower urinary tract obstruction secondary to congenital bladder diverticula in infants.

Purpose: Congenital primary bladder diverticulum is a rare condition and may present with urinary infection; other forms of presentation are rare. We present a series of infants who presented with urinary retention secondary to large primary bladder diverticulum.

Methods: Seven infants were evaluated for symptoms of lower urinary tract obstruction.

Preduodenal portal vein in association with midgut malrotation and duodenal web-triple anomaly?

Preduodenal portal vein (PDPV) is a rare anomaly in which the portal vein passes anterior to the duodenum rather than posteriorly. Generally asymptomatic, PDPV may rarely cause duodenal obstruction or may coexist with other anomalies. We report a neonate who presented with duodenal obstruction and was found out to have 3 coexisting anomalies, each of which can lead to duodenal obstruction independently-PDPV, midgut malrotation, and duodenal web.

Transmural intrathoracic lipoma with intraspinal extension.

A rare case of transmural dumbbell intrathoracic lipoma with intraspinal extension is reported. Preoperative diagnosis was possible with a computed tomographic scan and fine-needle aspiration cytology. Complete excision was curative.

Bilateral communicating bronchopulmonary foregut malformations in a child.

Communicating bronchopulmonary foregut malformations are rare anomalies. The complex anatomy requires innovative surgical techniques. We report a child with bilateral sequestrations communicating with the lower esophagus.

Oesophageal duplication cyst causing neonatal haemoptysis.

Duplication anomalies of the alimentary tract often present with myriad clinical symptoms and signs. There have been no reports of haemoptysis as the presenting feature and oesophageal duplication cyst is not considered as a cause for haemoptysis. An infant presented with this unusual manifestation.