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Biomedical subjects

J G Barone

Publications and source records attributed to J G Barone.

At least 19 recordsLinked to original sources
PubMed2001

Utility of biofeedback for the daytime syndrome of urinary frequency and urgency of childhood.

OBJECTIVES: To evaluate in a preliminary study the utility of biofeedback for the treatment of the daytime syndrome of urinary frequency and urgency of childhood, a benign, self-limited condition with symptoms that can last for months or years. Observation is a commonly recommended approach to this syndrome because medications and other forms of therapy are often not effective. METHODS: During a 2-year period, 89 children (34 boys and 55 girls) presented with this syndrome. Patient age ranged from 4 to 11 years, and duration of symptoms ranged from 1 to 38 months. All children were evaluated with a history, physical examination, urinalysis and culture, and renal and bladder ultrasound scanning. After the evaluation, the parents were offered either observation or surface patch electromyography biofeedback for the problem. RESULTS: Overall, 84 parents (94.3%) selected biofeedback for their child. After 1 month of biofeedback, 34.5% of children were able to achieve a 2 to 4-hour voiding interval. After 2 to 4 months of biofeedback, another 51.2% of patients experienced the same improvement. Overall, 85.7% of children who underwent biofeedback had symptom improvement. In 14.3% of children, no symptom improvement was noted after 4 months of biofeedback and these children were considered nonresponders. CONCLUSIONS: The results of this study suggest that biofeedback may be a treatment option for this disorder and warrants further investigation.

Activities of Daily Living↗
PubMed2001

Use of cyanoacrylate tissue adhesive under a diaper.

OBJECTIVE: To examine the utility of cyanoacrylate tissue adhesive (Dermabond, Ethicon, Somerville, NJ, USA; an effective means of epithelial skin closure) under a diaper (i.e. constantly exposed to bodily fluids) in 25 children (not toilet-trained) undergoing inguinal surgery. PATIENTS AND METHODS: A retrospective review of charts between July 1998 and July 2000 was used to identify children who were not toilet-trained and who had undergone inguinal surgery (e.g. orchidopexy, hernia and hydrocele repair). In addition to the type of surgery, the method of closure was also assessed; in all cases reported the subcutaneous tissues were approximated with 4/0 polyglactin suture. From July 1998 to October 1999 all epithelial skin was closed with 5/0 poliglecaprone, benzoin, sterile strips and collodion; from October 1999 to July 2000 all skin was closed with cyanoacrylate tissue adhesive. RESULTS: The chart review identified 45 boys (mean age 15.3 months, range 1-26) of whom 26 (57%) had undergone either inguinal hernia or hydrocele repair, and 19 (42%) who had undergone orchidopexy. These procedures resulted in a total of 52 incisions in the 45 children. Of the 52 incisions, 27 were closed with suture and 25 with cyanoacrylate adhesive. All patients were followed up at 2 weeks; there were no instances of infection or wound dehiscence in either group. The incisions were cosmetically identical at 3 months of follow-up. CONCLUSION: Cyanoacrylate adhesive is a safe and effective method of skin closure that can be used under a diaper.

Child↗
PubMed2000

DNA organization in patients with a history of cryptorchidism.

OBJECTIVES: Cryptorchidism is associated with infertility, even in those patients with unilateral undescended testes. The mechanism for this infertility is not understood. We demonstrated recently that in mice, a stable nuclear matrix, a structural component of the nucleus that organizes DNA, is necessary for proper embryogenesis. We tested the hypothesis that spermatozoa from cryptorchid patients had unstable nuclear matrices. METHODS: Semen samples from 7 patients with a history of undescended testes and decreased fertility were tested for sperm nuclear matrix stability using our halo assay. RESULTS: All 7 patients were found to have unstable nuclear matrices, as compared with controls. CONCLUSIONS: This preliminary study suggests that one factor in the decreased fertility of cryptorchid patients may be unstable sperm nuclear matrices.

Adult↗
PubMed2000

Lesch-Nyhan syndrome presenting as acute renal failure secondary to obstructive uropathy.

Lesch-Nyhan syndrome is a rare genetic disorder characterized by mental retardation, self-mutilation, choreoathetosis, and hyperuricemia. The disease is caused by a mutation in the hypoxanthine-guanine phosphoribosyltransferase gene and is transmitted as a sex-linked recessive disorder. Since hyperuricemia is the primary metabolic problem caused by a hypoxanthine-guanine phosphoribosyltransferase mutation, urologic evaluation and treatment is often necessary for children with this disease. We report a 3-year-old boy who presented with anuric renal failure secondary to bilateral obstructing uric acid calculi. The evaluation of T lymphocytes revealed a hypoxanthine-guanine phosphoribosyltransferase mutation consistent with Lesch-Nyhan syndrome. The diagnosis and urologic management of this disorder is discussed.

Acute Kidney Injury↗
PubMed1997

Evaluation of the utility of video-urodynamics in children with urinary tract infection and voiding dysfunction.

OBJECTIVE: To assess the use of video-urodynamic studies (VUDS) in children with urinary tract infection (UTI) and symptoms of voiding dysfunction (frequency, urgency, incontinence), to ascertain whether VUDS significantly assists in diagnosis and deciding treatment. PATIENTS AND METHODS: Over a 16-month period, all children seen at our centre with a UTI in conjunction with previous symptoms suggestive of voiding dysfunction underwent free and pressure-flow VUDS. Forty-two children underwent VUDS and 38 (mean age 9 years, range 4-16, 15 male, 23 female) had sufficient information to be included in the study. RESULTS: All children had a prior history of voiding dysfunction (mean 55 months). Only five patients were found to have reflux and three of these had associated detrusor instability. In addition, 24 of 33 patients who did not have reflux had abnormalities on urodynamic study, the most common problem being detrusor instability in 17 of 24 patients. Other abnormalities included sphincter dyssynergia (five patients), poor bladder compliance (two) and hypersensitivity on bladder filling (three). CONCLUSION: VUDS can provide information about the aetiology of UTI and voiding dysfunction in children that cannot be obtained from any other source. The results of VUDS can be used to select specific treatments, to avoid inappropriate therapy and to identify children who may benefit from follow-up studies despite normal findings on voiding cystourethrography. From these results, we believe that VUDS should be considered for children with UTI and voiding dysfunction.

Adolescent↗
PubMed1996

Cystic renal disease and tuberous sclerosis in infants.

We describe 2 infants who presented with autosomal dominant-like polycystic kidney disease. Evaluation revealed that both children had tuberous sclerosis, with resulting cystic kidney disease. This diagnosis should be suspected in infants who present with bilateral, large renal cysts, and no family history of autosomal dominant polycystic kidney disease.

Female↗
PubMed1996

Diagnosis and management of malignant perirenal schwannoma.

Malignant retroperitoneal schwannoma is an extremely rare tumor, with only six cases previously reported occurring in the perirenal space. We herein report the seventh case. A 50-year-old woman presented with an abdominal mass suggestive of renal cell carcinoma by standard preoperative evaluation. The tumor required surgical exploration and pathologic evaluation for diagnosis. The final histologic diagnosis was made with the aid of electron microscopy and immunohistochemical staining with antibodies for S-100 protein.

Basement Membrane↗
PubMed1995

Symptomatic tumors affecting the urinary tract in children with neurofibromatosis.

PURPOSE: We determined the need for urological screening in children with neurofibromatosis. MATERIALS AND METHODS: Of 96 children with neurofibromatosis treated at our institution 6 (6.2%) had a symptomatic tumor that affected the urinary tract. RESULTS: There were 5 plexiform neurofibromas and 1 prostatic rhabdomyosarcoma. Five children had a palpable abdominal mass and 3 required urinary diversion. CONCLUSIONS: Since most morbidity resulted because tumors were advanced by the time symptoms developed, we suggest that children with neurofibromatosis be screened annually with medical history, physical examination, urinalysis and serum chemistry studies for tumors that affect the urinary tract.

Adolescent↗
PubMed1995

Vena cava resection during post chemotherapy lymphadenectomy for testis tumor.

Two patients underwent retroperitoneal lymphadenectomy after chemotherapy for non-seminomatous germ cell testis tumor. A dense desmoplastic tissue reaction between the infrarenal vena cava and perivascular lymphatic tissue prohibited removal of the nodal packet from the vena cava in both cases. We herein discuss two techniques for vena cava resection in these difficult cases.

Adult↗
PubMed1994

Etiology of acute urinary retention following benign anorectal surgery.

The etiology of acute urinary retention following benign anorectal surgery is unknown. We performed bedside urodynamic evaluation on nine patients who developed acute urinary retention after benign anorectal surgery. A bladder contraction was demonstrated in all patients, which suggests that the retention is due to bladder outlet obstruction and not bladder acontractility. These findings have important implications for preventing and treating acute urinary retention following anorectal surgery for benign disease.

Acute Disease↗