Long-term efficacy of Mirabegron-anticholinergic combination in paediatric neurogenic bladder.

Introduction: The Mirabegron-anticholinergic (MAC) combination has proven effective as a step-up strategy in managing paediatric neurogenic bladder following anticholinergic medication and botulinum toxin (BTX) therapy. This study assesses the long-term efficacy of MAC in children with neurogenic bladder.

Patients And Methods: A retrospective chart review was conducted from 2015 to 2023, including consecutive paediatric patients receiving Mirabegron (25/50 mg) with an anticholinergic agent (solifenacin 16, tolterodine 7, oxybutynin 7, trospium 1).

The double barrel Impella exchange: A reliable method for uninterrupted mechanical circulatory support.

Classic Impella exchange interrupts flow when the old device is pulled into the aorta before advancing the new device across the aortic valve, threatening circulatory collapse and loss of left ventricular access. In "double barrel," uninterrupted Impella exchange, the new device is placed into the ventricle alongside the old, where flow is first transitioned completely. Of 31 consecutive patients undergoing this procedure, none experienced intraoperative cardiac arrest, and 96.

Four hour voiding observation study in infants with posterior urethral valves.

Introduction And Aim: Posterior urethral valves (PUV) are often associated with bladder dysfunction. Our primary aim was to investigate bladder status following primary valves resection to gather evidence of function and to guide early clinical management.

Patients And Methods: Between July 2015-2020, we prospectively evaluated bladder function of PUV infants.

Impella 5.5 Bridge to Heart Transplant: An Institutional Series and a Closer Look at Device Removal Technique.

Limited donor organ availability often necessitates mechanical circulatory support, and recently the Impella 5.5, as a bridge to heart transplant. Of 175 Impella 5.

Variability in cross-language and cross-dialect perception. How Irish and Chinese migrants process Australian English vowels.

We investigate how three adult groups - experienced L2 English listeners; experienced D2 (second dialect) listeners; and native L1/D1 listeners - categorise Australian English (AusE) lax front vowels /ɪ e æ/ in /hVt/, /hVl/ and /mVl/ environments in a forced-choice categorisation task of synthesised continua. In study 1, AusE listeners show predictable categorisations, with an effect of coarticulation raising the vowel in perception for nasal onset stimuli, and a following lateral lowering the vowel in perception. In study 2, Irish (D2) and Chinese listeners (L2) have different categorisations than AusE listeners, likely guided by their D1/L1.

Later Brain Death Declaration Correlates to Favorable Donor Characteristics but Decreased Heart Acceptance.

Background: With rates of potential donor heart discard as high as 66% nationally, quality improvement efforts must seek to optimize donor utilization. Whether the timing of donor brain death declaration (BDD) influences organ acceptance is understudied. The authors sought to characterize the impacts of time between donor hospital admission and BDD on heart utilization and posttransplant outcomes.

A consensus process to identify research priorities in paediatric urology in the United Kingdom.

Introduction: Paediatric urologists manage a spectrum of conditions, much of the evidence for relevant treatment pathways is of low quality. For many conditions treatment varies according to location and surgeon; children with the same condition might have surgery in one unit but watchful waiting in another. Underlying this variation are differences in opinion, and insufficient high-level evidence with few prospective randomized studies.

Lessons From an MD PhD - From SLC13A5 to Neurology.

The journey towards becoming a physician scientist is a long, arduous, and uncertain journey. Few medical students pursue a career as a physician scientist. Even those that do, the path towards maintaining a robust research career and clinical training can be difficult given the personal and social pressures to focus solely on research or clinical work.

Sociophonetic Variation in Vowel Categorization of Australian English.

This study involves a perceptual categorization task for Australian English, designed to investigate regional and social variation in category boundaries between close-front vowel contrasts. Data are from four locations in southeast Australia. A total of 81 listeners from two listener groups took part: (a) so-called mainstream Australian English listeners from all four locations, and (b) L1 Aboriginal English listeners from one of the locations.

Posterior Urethral Valves, Unilateral Vesicoureteral Reflux, and Renal Dysplasia (VURD) Syndrome: Long-Term Longitudinal Evaluation of the Kidney Function.

The presence of unilateral vesicoureteral reflux (VUR), and renal dysplasia associated with posterior urethral valves (PUV) (VURD syndrome) was believed to represent a pressure-released pop-off mechanism protecting kidney function. We aimed to investigate its role with respect to long-term kidney function in a cross-sectional and longitudinal analysis. We compared the iohexol glomerular filtration rate (GFR) measured at 5 (GFR) and 10 (GFR) years of age in children with (Group A) and without (Group B) VURD syndrome, who underwent PUV resection under 2 years of age.

Morbidity following suprapubic line insertion for videourodynamics in children.

Introduction: Previously in our unit, urodynamics were delayed after insertion of suprapubic (SP) lines. We postulated that performing urodynamics on the same day as SP line insertion would not result in increased morbidity. We retrospectively compared complications in those having urodynamics on the same day against those who had delayed urodynamics.

Identification of DCAF1 by Clinical Exome Sequencing and Methylation Analysis as a Candidate Gene for Autism and Intellectual Disability: A Case Report.

Autism spectrum disorder (ASD) comprises a heterogeneous group of neurodevelopmental disorders and occurs in all racial, ethnic, and socioeconomic groups. Cutting-edge technologies are contributing to understanding genetic underpinnings in ASD. The reported patient is a 32-year-old male and as an infant was noted to have microcephaly, hypospadias, pulmonary vascular anomaly, and small stature.

Posterior urethral valves and urachal cyst: an unusual combination.

Combination of posterior urethral valves and urachus remnants has been described as rare occurrence. We report a case of a baby boy with normal antenatal scans, in whom the presence of large urachal cyst and posterior urethral valves causing high pressure bladder and chronic kidney disease was found. The patient underwent ablation of posterior urethral valves at 23 days of life and urachal cyst removal at age of 4 and a half months.

Perinatal Stress in Immature Foals May Lead to Subclinical Adrenocortical Dysregulation in Adult Horses: Pilot Study.

The persistent endocrinological effects of perinatal stress due to gestational immaturity in horses are unknown, although effects have been reported in other livestock species. This pilot study tested the hypothesis that persistent adrenocortical dysregulation is present in horses that were gestationally immature at birth by assessing the salivary cortisol response to exogenous ACTH. Case horses (n = 10) were recruited with histories of gestation length < 315 d or dysmaturity observable through neonatal signs.

Surgical Resection of a Symptomatic Ascending Aortic Mural Thrombus.

Aortic mural thrombus (AMT) is a rare disease with an unclear optimal treatment strategy. AMT in the ascending aorta is particularly uncommon and is associated with the additional risk of embolization to the brain. Resection of an ascending AMT is particularly challenging given the high risk of thrombus dislodgment during aortic cannulation and cross-clamp application.

Molecular Dysregulation in Autism Spectrum Disorder.

Autism Spectrum Disorder (ASD) comprises a heterogeneous group of neurodevelopmental disorders with a strong heritable genetic component. At present, ASD is diagnosed solely by behavioral criteria. Advances in genomic analysis have contributed to numerous candidate genes for the risk of ASD, where rare mutations and s common variants contribute to its susceptibility.

Urodynamic characterization of giggle incontinence in children.

Aims: Giggle incontinence is a rare condition resulting in excessive urinary incontinence with laughter, where bladder function is otherwise "normal." Urodynamic descriptions of the condition to date are limited. We believe that giggle incontinence has characteristic urodynamic findings.

Implementing Pharmacogenomics Testing: Single Center Experience at Arkansas Children's Hospital.

Pharmacogenomics (PGx) is a growing field within precision medicine. Testing can help predict adverse events and sub-therapeutic response risks of certain medications. To date, the US FDA lists over 280 drugs which provide biomarker-based dosing guidance for adults and children.

Native nephrectomy in the management of hypertension in children with kidney disease: a tool to improve blood pressure control.

Aim: Hypertension in children with abnormal kidneys often requires multiple antihypertensive agents (complex), or could present with complications (e.g. hypertensive encephalopathy).

Autism spectrum disorder and kidney disease.

Neurodevelopmental impairments have been recognised as a major association of paediatric kidney disease and bladder dysfunction, presenting challenges to clinicians and families to provide reasonable adjustments in order to allow access to investigations and treatments. Autism spectrum disorder (ASD) is a common neurodevelopmental disorder characterised by impairments in social interaction/communication and repetitive sensory-motor behaviours. Mental health, learning and physical co-morbidities are common.

Metformin, valproic acid, and starvation induce seizures in a patient with partial SLC13A5 deficiency: a case of pharmaco-synergistic heterozygosity.

SLC13A5/NaCT is a sodium-coupled citrate transporter expressed in the plasma membrane of the liver, testis, and brain. In these tissues, SLC13A5 has important functions in the synthesis of fatty acids, cholesterol, and neurotransmitters. In recent years, patients homozygous for recessive mutations in SLC13A5, known as SLC13A5 deficiency [early infantile epileptic encephalopathy-25 (EIEE-25)], exhibit severe global developmental delay, early-onset intractable seizures, spasticity, and amelogenesis imperfecta affecting tooth development.

Comparison of Objective Intermediate-Term Outcomes Between per-Oral Endoscopic Myotomy and Laparoscopic Heller Myotomy Show Equivalence.

Introduction: The surgical gold standard for esophageal motility disorders is laparoscopic Heller myotomy (LHM). Per-oral endoscopic myotomy (POEM) is a less invasive flexible endoscopic alternative. We compare their intermediate-term outcomes.