Transition of urologic patients from pediatric to adult care: a preliminary assessment of readiness in spina bifida patients.

Objective: To assess the awareness and readiness of both spina bifida patients and parents regarding the transition process before transitioning, with a secondary aim that included identifying potential factors associated with successful transition.

Methods: All children aged ≥14 years requiring long-term care were prospectively enrolled. Questions designed by pediatric and adult urologists and an adolescent health specialist addressing the awareness of long-term follow-up and the desire to learn more about transitioning were administered by nursing staff at regularly scheduled clinic appointments.

Long-term urological impact of fetal myelomeningocele closure.

Purpose: Between 1997 and 2002 a large number of fetal myelomeningocele closures were performed at our institution. Previously early reports showed little improvement in neonatal bladder function after fetal back closure. We evaluated the long-term urological impact of this procedure.

Prospective evaluation of health related quality of life for pediatric patients with ureteropelvic junction obstruction.

Purpose: Clinical practices are increasingly proposing health related quality of life measures for informed treatment decisions. Dismembered pyeloplasty is an accepted standard therapy for ureteropelvic junction obstruction. This study evaluates health related quality of life in patients with ureteropelvic junction obstruction undergoing pyeloplasty.

Prospective, longitudinal evaluation of health related quality of life in the pediatric spina bifida population undergoing reconstructive urological surgery.

Purpose: Spina bifida, the most frequent permanently debilitating birth defect, results in major urological problems of voluntary bladder control and bowel function, which may impair quality of life. We prospectively assessed quality of life in patients with spina bifida using child and parent reports simultaneously. This study had 3 goals, that is to 1) document baseline health related quality of life in patients with spina bifida preoperatively, 2) study health related quality of life, reporting differences between parents and children, and 3) study changes in health related quality of life prospectively at preoperative and postoperative intervals.

High yield of urodynamics performed for refractory nonneurogenic dysfunctional voiding in the pediatric population.

Purpose: In the pediatric population urodynamic evaluation for nonneurological causes has been previously reported as a low yield endeavor when considering patients with a primary diagnosis of dysfunctional voiding. We evaluated the rate of clinically significant urodynamic findings that would drive therapeutic intervention for a spectrum of urological disorders in pediatric patients without neurological deficit in whom initial conventional management had failed.

Materials And Methods: We retrospectively reviewed the charts of patients who had undergone urodynamics in the last 7 years.

Continent catheterizable channels and the timing of their complications.

Purpose: We reviewed our experience with continent catheterizable channels with interest in the timing of conduit related complications.

Materials And Methods: A retrospective review was performed of the outcome of continent catheterizable channels in all patients between 1998 and 2003 who had undergone construction of an antegrade continence enema and/or a Mitrofanoff procedure using appendix, small bowel or continent cutaneous vesicostomy. We performed a total of 117 such stomas in 37 male and 41 female patients 2.

Potential risk factors associated with progressive renal damage in childhood urological diseases: the role of angiotensin-converting enzyme gene polymorphism.

Purpose: Experimental as well as human studies have established an important role for the renin-angiotensin system in the progressive deterioration of renal function. Recently genetic polymorphism in components of the renin-angiotensin system has been associated with several cardiovascular diseases, particularly variations in the angiotensin-converting enzyme gene that involve insertion (I) or deletion (D) of a 287 bp fragment. The D variant has been associated with myocardial infarction and cardiac hypertrophy.

Clinical care pathway for the management of ureteroneocystostomy in the pediatric urology population.

Purpose: The management of vesicoureteral reflux continues to evolve. Endoscopic and laparoscopic techniques have been reported as alternatives to standard surgical techniques. However, the newer modalities have no long-term track record and there is some question as to efficacy.

The natural history of nephrocalcinosis in premature infants treated with loop diuretics.

Purpose: We investigated the natural history of nephrocalcinosis in premature infants treated with furosemide and attempted to identify factors to predict infants most at risk.

Materials And Methods: We evaluated 13 preterm infants in this longitudinal pilot study. During hospitalization and while receiving a loop diuretic nephrocalcinosis developed in each patient.

Management of the patient receiving simultaneous kidney-pancreas transplantation.

For patients with severe diabetes complicated by renal failure, simultaneous kidney-pancreas transplantation offers some hope. The National Dialysis and Kidney Transplantation Study reports that transplant patients have a higher quality of life, higher employment, and higher perceived health beliefs than patients on dialysis. With this thought in mind, simultaneous kidney-pancreas transplantation can be seen as an appropriate and attractive alternative.

Simultaneous kidney-pancreas transplantation.

Simultaneous kidney-pancreas transplantation has emerged as a viable option for a select population of patients with type I diabetes mellitus and end stage renal disease. Nurses caring for this type of patient must be knowledgeable about the intricacies of the procedure. This article reviews indications for kidney-pancreas transplantation, selection criteria for both donors and recipients, organ procurement and transplant surgical procedures, potential postoperative complications, nursing considerations, and the impact this treatment modality has on the management of the patient with insulin-dependent diabetes mellitus.

OKT 3: nursing considerations for use in acute renal transplant rejection.

The development of monoclonal antibodies represents a significant biomedical advancement. The increasing use of muromonab-CD3 (Orthoclone OKT 3) for the treatment of acute rejection requires that the health care professional has a thorough understanding of its effects and regimen for proper and safe administration. This article reviews monoclonal antibody production and administration with an emphasis placed on the nursing implications associated with the use of OKT 3 in acute renal transplant rejection.