LIVIVO - The Search Portal for Life Sciences

zur deutschen Oberfläche wechseln
Back to previous search Search history
Advanced search

Your last searches

  1. AU=Holzman Sarah A
  2. AU="Sun, Xuefeng"

Search results

Result 1 - 10 of total 46

Search options

  1. Article ; Online: Perinatal HIV exposure and infection and caregiver depressive symptoms.

    Brewer, Sarah K / Talge, Nicole / Holzman, Claudia / Sikorskii, Alla / Ezeamama, Amara

    AIDS care

    2023  Volume 36, Issue 2, Page(s) 280–290

    Abstract: Survival is possible for children perinatally exposed to or infected by HIV in the post-combined antiretroviral therapy era and identifying factors affecting children's ability to thrive has public health significance. Caregiver mental health is one such ...

    Abstract Survival is possible for children perinatally exposed to or infected by HIV in the post-combined antiretroviral therapy era and identifying factors affecting children's ability to thrive has public health significance. Caregiver mental health is one such factor to consider given its impact on child development, but previous work has not included a full complement of HIV exposure/infection groups within HIV-endemic settings. We compared depressive symptoms among caregivers of 3 groups of 6-10-year-olds in Uganda: children with perinatally acquired HIV infection (CPHIV,
    MeSH term(s) Child ; Female ; Pregnancy ; Humans ; HIV Infections/epidemiology ; HIV Infections/psychology ; Depression/psychology ; Caregivers/psychology ; Mental Health ; Mothers
    Language English
    Publishing date 2023-06-23
    Publishing country England
    Document type Journal Article
    ZDB-ID 1012651-x
    ISSN 1360-0451 ; 0954-0121
    ISSN (online) 1360-0451
    ISSN 0954-0121
    DOI 10.1080/09540121.2023.2214865
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Zs.A 2799: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  2. Article ; Online: Papers presented at the fall 2020 Pediatric Urologic Oncology Work Group of the Societies of Pediatric Urology meetingPrenatally Diagnosed Solid Renal Mass.

    Holzman, Sarah A / HaDuong, Josephine / Khoury, Antoine E

    Urology

    2020  Volume 153, Page(s) 317–319

    Abstract: Congenital mesoblastic nephroma is the most common renal neoplasm diagnosed in the first month of life of which 15% occur prenatally. We present a prenatal diagnosis of a 5.8 cm solid renal mass identified on the 36-week ultrasound. Labor was induced at ... ...

    Abstract Congenital mesoblastic nephroma is the most common renal neoplasm diagnosed in the first month of life of which 15% occur prenatally. We present a prenatal diagnosis of a 5.8 cm solid renal mass identified on the 36-week ultrasound. Labor was induced at 38 weeks and a female infant was delivered vaginally without complications. The postnatal ultrasound demonstrated a 6.3 cm heterogeneous mass nearly replacing the kidney. The infant underwent a radical nephrectomy on the first day of life and pathology confirmed stage II classic CMN with negative margins and nodes. She is otherwise healthy at follow-up of 1 year with no evidence of recurrence.
    MeSH term(s) Congresses as Topic ; Female ; Humans ; Infant, Newborn ; Medical Oncology ; Nephroma, Mesoblastic/congenital ; Nephroma, Mesoblastic/diagnostic imaging ; Pediatrics ; Societies, Medical ; Ultrasonography, Prenatal ; Urology ; Writing
    Language English
    Publishing date 2020-11-13
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 192062-5
    ISSN 1527-9995 ; 0090-4295
    ISSN (online) 1527-9995
    ISSN 0090-4295
    DOI 10.1016/j.urology.2020.11.005
    Database MEDical Literature Analysis and Retrieval System OnLINE

    Full text online

    More links

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Zs.A 1142: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)
    Zs.MO 275: Show issues

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  3. Article ; Online: Taking "Trans-ano-rectal" out of ASTRA: An anterior sagittal approach without splitting the rectum.

    Huen, Kathy H / Holzman, Sarah A / Davis-Dao, Carol A / Wehbi, Elias J / Khoury, Antoine E

    Journal of pediatric urology

    2021  Volume 18, Issue 1, Page(s) 96–97

    Abstract: The anterior sagittal trans-ano-rectal approach (ASTRA) provides excellent exposure to the urethra and vagina for partial or total urogenital sinus mobilization and subsequent reconstruction for patients with urogenital sinus anomalies. It is a frequent ... ...

    Abstract The anterior sagittal trans-ano-rectal approach (ASTRA) provides excellent exposure to the urethra and vagina for partial or total urogenital sinus mobilization and subsequent reconstruction for patients with urogenital sinus anomalies. It is a frequent approach to reconstruction for children with a high confluence. However, the division of the anterior anal external sphincter and the rectal wall in the ASTRA incurs morbidity, which include fecal incontinence if one veers from the midline, and increased risk of wound infection due to fecal soilage. We demonstrate a modified technique to the ASTRA without dividing the anterior anal sphincter and rectal wall, with achievement of comparable exposure and excellent vaginal mobilization and length.
    MeSH term(s) Anal Canal/surgery ; Animals ; Child ; Cloaca ; Female ; Humans ; Male ; Rectum/abnormalities ; Rectum/surgery ; Urethra/abnormalities ; Urethra/surgery ; Vagina/abnormalities ; Vagina/surgery
    Language English
    Publishing date 2021-12-22
    Publishing country England
    Document type Journal Article
    ZDB-ID 2237683-5
    ISSN 1873-4898 ; 1477-5131
    ISSN (online) 1873-4898
    ISSN 1477-5131
    DOI 10.1016/j.jpurol.2021.12.007
    Database MEDical Literature Analysis and Retrieval System OnLINE

    Full text online

    More links

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Zs.A 6387: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  4. Article ; Online: Telemedicine and patient satisfaction during the COVID-19 pandemic: A case-control study of outpatient pediatric urology patients.

    Holzman, Sarah A / Davis-Dao, Carol A / Khoury, Antoine E / Fortier, Michelle A / N Kain, Zeev

    Journal of child health care : for professionals working with children in the hospital and community

    2021  Volume 27, Issue 3, Page(s) 351–359

    Abstract: Telemedicine has increased during the coronavirus disease 2019 pandemic. Our objective was to determine if patient satisfaction with telemedicine differed from in-person visits in an academic pediatric urology clinic. Following outpatient telemedicine ... ...

    Abstract Telemedicine has increased during the coronavirus disease 2019 pandemic. Our objective was to determine if patient satisfaction with telemedicine differed from in-person visits in an academic pediatric urology clinic. Following outpatient telemedicine and in-person pediatric urology visits, the validated NRC Health© Patient Survey was used to assess patient experience. Patient satisfaction was assessed on a 10-point scale with scores of 9-10 considered "satisfied" and 1-8 considered "not satisfied." Satisfaction scores between telemedicine and in-person groups were compared using McNemar's test, Wilcoxon signed rank test, and conditional logistic regression. Fifty-one patients had urology telemedicine visits during April-August 2020 and completed the NRC Health© Patient Survey. Propensity score matching was used to identify 102 in-person controls between January 2019 and March 2020. Ninety-two percent of telemedicine patients were satisfied compared to 87% of in-person patients (OR 1.7 95% CI [0.53-5.6]). Regression analysis adjusting for matching variables demonstrated that patient satisfaction was higher for telemedicine compared to in-person visits but was not statistically significant (OR 1.5 95% CI [0.43-5.6]). Patient satisfaction with telemedicine was similar to in-person visits in the pediatric urology clinic. Reduced waiting time and convenience associated with telemedicine visits provide an opportunity for telemedicine as a useful modality for pediatric urology.
    MeSH term(s) Child ; Humans ; COVID-19/epidemiology ; Pandemics ; Case-Control Studies ; Outpatients ; Patient Satisfaction ; Urology ; Telemedicine
    Language English
    Publishing date 2021-12-06
    Publishing country England
    Document type Journal Article
    ZDB-ID 2299167-0
    ISSN 1741-2889 ; 1367-4935
    ISSN (online) 1741-2889
    ISSN 1367-4935
    DOI 10.1177/13674935211058272
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Zs.A 6662: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  5. Article ; Online: Crizotinib-associated Renal Cyst Formation in a Pediatric Patient With ALK+ Epithelioid Inflammatory Myofibroblastic Sarcoma.

    Kopelevich, Alexei / Holzman, Sarah A / La, Justin / Lai, Hollie A / Torno, Lilibeth / Stephany, Heidi A

    Urology

    2020  Volume 149, Page(s) 222–224

    Abstract: Background: Crizotinib is a first-generation tyrosine kinase inhibitor used for anaplastic lymphoma kinase (ALK) positive cancers. Simple and complex renal cyst formation is a rare complication of crizotinib use that has been reported previously in the ... ...

    Abstract Background: Crizotinib is a first-generation tyrosine kinase inhibitor used for anaplastic lymphoma kinase (ALK) positive cancers. Simple and complex renal cyst formation is a rare complication of crizotinib use that has been reported previously in the adult population.
    Case: We report a case of a right renal mass in a 17-year-old with ALK-positive epithelioid inflammatory myofibroblastic sarcoma treated with Crizotinib. After cessation of Crizotinib and initiating Alectenib, a second generation ALK inhibitor, the mass decreased in size and the patient remained asymptomatic without evidence of recurrence at three months of follow-up.
    MeSH term(s) Adolescent ; Antineoplastic Agents/adverse effects ; Antineoplastic Agents/therapeutic use ; Crizotinib/adverse effects ; Crizotinib/therapeutic use ; Humans ; Kidney Diseases, Cystic/chemically induced ; Male ; Neoplasms, Muscle Tissue/chemistry ; Neoplasms, Muscle Tissue/drug therapy ; Receptor Protein-Tyrosine Kinases/analysis ; Sarcoma/chemistry ; Sarcoma/drug therapy
    Chemical Substances Antineoplastic Agents ; Crizotinib (53AH36668S) ; Receptor Protein-Tyrosine Kinases (EC 2.7.10.1)
    Language English
    Publishing date 2020-09-01
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 192062-5
    ISSN 1527-9995 ; 0090-4295
    ISSN (online) 1527-9995
    ISSN 0090-4295
    DOI 10.1016/j.urology.2020.08.032
    Database MEDical Literature Analysis and Retrieval System OnLINE

    Full text online

    More links

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Zs.A 1142: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)
    Zs.MO 275: Show issues

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  6. Article: Evaluation of Bi-Layer Silk Fibroin Grafts for Penile Tunica Albuginea Repair in a Rabbit Corporoplasty Model.

    Gundogdu, Gokhan / Okhunov, Zhamshid / Starek, Stephanie / Veneri, Faith / Orabi, Hazem / Holzman, Sarah A / Sullivan, Maryrose P / Khoury, Antoine E / Mauney, Joshua R

    Frontiers in bioengineering and biotechnology

    2021  Volume 9, Page(s) 791119

    Abstract: The use of autologous tissue grafts for tunica albuginea repair in Peyronie's disease and congenital chordee is often restricted by limited tissue availability and donor site morbidity, therefore new biomaterial options are needed. In this study, bi- ... ...

    Abstract The use of autologous tissue grafts for tunica albuginea repair in Peyronie's disease and congenital chordee is often restricted by limited tissue availability and donor site morbidity, therefore new biomaterial options are needed. In this study, bi-layer silk fibroin (BLSF) scaffolds were investigated to support functional tissue regeneration of tunica albuginea in a rabbit corporoplasty model. Eighteen adult male, New Zealand white rabbits were randomized to nonsurgical controls (NSC,
    Language English
    Publishing date 2021-12-07
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2719493-0
    ISSN 2296-4185
    ISSN 2296-4185
    DOI 10.3389/fbioe.2021.791119
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  7. Article ; Online: Identifying variability in surgical practices and instrumentation for hypospadias repair across the Western Pediatric Urology Consortium (WPUC) network.

    Yamashiro, Justine R / Austin, J Christopher / Braga, Luis H / Chuang, Kai-Wen / Davis-Dao, Carol A / Hecht, Sarah / Holzman, Sarah A / Khoury, Antoine E / Kurzrock, Eric A / Lerman, Steven E / McGrath, Melissa / Merguerian, Paul A / Saltzman, Amanda F / Schaeffer, Anthony J / Seideman, Casey / Singer, Jennifer S / Wang, Peter / Wehbi, Elias J / Wu, Hsi-Yang /
    Sturm, Renea M

    Journal of pediatric urology

    2023  Volume 19, Issue 3, Page(s) 277–283

    Abstract: Background: Although hypospadias outcomes studies typically report a level or type of repair performed, these studies often lack applicability to each surgical practice due to technical variability that is not fully delineated. An example is the ... ...

    Abstract Background: Although hypospadias outcomes studies typically report a level or type of repair performed, these studies often lack applicability to each surgical practice due to technical variability that is not fully delineated. An example is the tubularized incised plate (TIP) urethroplasty procedure, for which modifications have been associated with significantly decreased complication rates in single center series. However, many studies fail to report specificity in techniques utilized, thereby limiting comparison between series.
    Objective: With the goal of developing a surgical atlas of hypospadias repair techniques, this study examined 1) current techniques used by surgeons in our network for recording operative notes and 2) operative technical details by surgeon for two common procedures, tubularized incised plate (TIP) distal and proximal hypospadias repairs across a multi-institutional surgical network.
    Study design: A two-part study was completed. First, a survey was distributed to the network to assess surgeon volume and methods of recording hypospadias repair operative notes. Subsequently, an operative template or a representative de-identified operative note describing a TIP and/or proximal repair with urethroplasty was obtained from participating surgeons. Each was analyzed by at least two individuals for natural language that signified specified portions of the procedure. Procedural details from each note were tabulated and confirmed with each surgeon, clarifying that the recorded findings reflected their current practice techniques and instrumentation.
    Results: Twenty-five surgeons from 12 institutions completed the survey. The number of primary distal hypospadias repairs performed per surgeon in the past year ranged from 1-10 to >50, with 40% performing 1-20. Primary proximal hypospadias repairs performed in the past year ranged from 1-30, with 60% performing 1-10. 96% of surgeons maintain operative notes within an electronic health record. Of these, 66.7% edited a template as their primary method of note entry; 76.5% of these surgeons reported that the template captures their operative techniques very or moderately well. Operative notes or templates from 16 surgeons at 10 institutions were analyzed. In 7 proximal and 14 distal repairs, parameters for chordee correction, urethroplasty suture selection and technique, tissue utilized, and catheter selection varied widely across surgeons.
    Conclusion: Wide variability in technical surgical details of categorically similar hypospadias repairs was demonstrated across a large surgical network. Surgeon-specific modifications of commonly described procedures are common, and further evaluation of short- and long-term outcomes accounting for these technical variations is needed to determine their relative influence.
    MeSH term(s) Child ; Male ; Humans ; Infant ; Hypospadias/surgery ; Urology ; Treatment Outcome ; Urethra/surgery ; Plastic Surgery Procedures ; Urologic Surgical Procedures, Male/methods ; Retrospective Studies
    Language English
    Publishing date 2023-01-11
    Publishing country England
    Document type Journal Article
    ZDB-ID 2237683-5
    ISSN 1873-4898 ; 1477-5131
    ISSN (online) 1873-4898
    ISSN 1477-5131
    DOI 10.1016/j.jpurol.2022.12.001
    Database MEDical Literature Analysis and Retrieval System OnLINE

    Full text online

    More links

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Zs.A 6387: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  8. Article ; Online: Parenting in a Pandemic: Preliminary Support for Delivering Brief Behavioral Parent Training Through Telehealth.

    Holzman, Jacob B W / Hawks, Jessica L / Kennedy, Sarah M / Anthony, Bruno J / Anthony, Laura G

    Behavior modification

    2022  Volume 47, Issue 1, Page(s) 128–153

    Abstract: Behavioral problems, such as noncompliance and aggression, are a common referral reason to mental health services for young children. Behavioral parent training (BPT) is the leading intervention for addressing behavioral problems and leads to benefits in ...

    Abstract Behavioral problems, such as noncompliance and aggression, are a common referral reason to mental health services for young children. Behavioral parent training (BPT) is the leading intervention for addressing behavioral problems and leads to benefits in a variety of parental factors (e.g., parenting efficacy and parenting stress). While the COVID-19 pandemic dramatically shifted service delivery toward telehealth services, limited work has evaluated the effectiveness of BPT when delivered in a brief, group format through telehealth. The current retrospective chart review study evaluated the engagement to and preliminary effectiveness of a brief version of BPT delivered through telehealth to 64 families of 3- to 7-year-olds referred for behavioral problems. Families attended an average of 4.55 of 6 sessions and most families had two caregivers who engaged in the intervention. Significant reductions in caregivers' report of children's behavioral problems and improvements in parenting self-efficacy resulted. Future research and clinical implications are discussed.
    MeSH term(s) Child ; Humans ; Child, Preschool ; Parenting/psychology ; Pandemics ; Retrospective Studies ; Behavior Therapy/methods ; COVID-19 ; Parents/education ; Telemedicine
    Language English
    Publishing date 2022-06-15
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 432229-0
    ISSN 1552-4167 ; 0145-4455
    ISSN (online) 1552-4167
    ISSN 0145-4455
    DOI 10.1177/01454455221103226
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Zs.B 2195: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  9. Article ; Online: Associations between dispositional parental emotion regulation and youth mental health symptoms: A systematic review and meta-analysis.

    Holzman, Jacob B W / Kennedy, Sarah M / Grassie, Hannah L / Ehrenreich-May, Jill

    Clinical psychology review

    2022  Volume 95, Page(s) 102174

    Abstract: Theoretical perspectives propose that parents' dispositional emotion regulation (ER) tendencies are likely associated with youth mental health concerns. The aim of the current study was to conduct a systematic review and meta-analysis to evaluate the ... ...

    Abstract Theoretical perspectives propose that parents' dispositional emotion regulation (ER) tendencies are likely associated with youth mental health concerns. The aim of the current study was to conduct a systematic review and meta-analysis to evaluate the relationship between parental dispositional ER tendencies - both maladaptive and adaptive - and youth mental health symptoms. Regarding maladaptive parental ER, 32 unique studies (N = 6399) with 126 effects were included. A significant, small-to-moderate, effect was observed (r = 0.25) such that higher maladaptive parental ER was linked to heightened youth mental health symptoms. No differences were observed based on youth age or psychiatric risk status, yet effects were stronger when drawn from the same informant in contrast to different informants. Further, 12 studies (N = 4241) including 28 effects were identified and a significant, albeit small, relation (r = -0.16) between adaptive parental ER and youth mental health symptoms occurred. A narrative review of these studies evaluating adaptive parental ER and youth mental health symptoms was performed due to the limited number of effects found beyond parental dispositional mindfulness. These findings generally support the notion that parental dispositional ER tendencies are modestly associated with youth mental health concerns. Future directions and clinical implications are discussed.
    MeSH term(s) Adolescent ; Emotional Regulation ; Emotions/physiology ; Humans ; Mental Health ; Mindfulness ; Parents
    Language English
    Publishing date 2022-05-25
    Publishing country United States
    Document type Journal Article ; Meta-Analysis ; Review ; Systematic Review
    ZDB-ID 604577-7
    ISSN 1873-7811 ; 0272-7358
    ISSN (online) 1873-7811
    ISSN 0272-7358
    DOI 10.1016/j.cpr.2022.102174
    Database MEDical Literature Analysis and Retrieval System OnLINE

    Full text online

    More links

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Zs.A 1712: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  10. Article ; Online: High incidence of abnormal imaging findings in circumcised boys diagnosed with urinary tract infections.

    Holzman, Sarah A / Grant, Campbell / Zee, Rebecca S / Rana, Md Sohel / Sprague, Bruce / Blum, Emily / Rushton, H Gil

    Journal of pediatric urology

    2020  Volume 16, Issue 5, Page(s) 560–565

    Abstract: Background: The American Academy of Pediatrics guidelines recommend delaying voiding cystourethrogram (VCUG) until the second febrile urinary tract infection (UTI). Similarly, the NICE Guidelines do not recommend VCUG after the first febrile UTI in ... ...

    Abstract Background: The American Academy of Pediatrics guidelines recommend delaying voiding cystourethrogram (VCUG) until the second febrile urinary tract infection (UTI). Similarly, the NICE Guidelines do not recommend VCUG after the first febrile UTI in infants and children under three years of age. Currently, there is no good clinical indicator to determine which patients would benefit from an earlier cystogram. Here, we sought to identify clinical and bacteriologic findings that are associated with an increased risk of urinary tract anatomic anomalies in pediatric males presenting to the Emergency Department with a UTI.
    Methods: A retrospective review was performed of all urine cultures from the Emergency Department at our institution between 2006 and 2015. Males under 18 years of age with ≥50,000 CFU/mL of Proteus, Klebsiella, Escherichia coli, Staphylococcus, Streptococcus and Enterococcus were included. Clean catch, catheterized and suprapubic aspiration specimens were included. Bagged specimens and specimens from patients on intermittent catheterization were excluded. Ultrasound and cystogram images were reviewed when available. Univariate and multivariable Poisson regression with robust variance was used to calculate and compare prevalence ratios. Statistical analysis was performed with Stata software, version 15.1 MP (Stata Corporation, College Station, Texas, USA).
    Results: We reviewed 1585 urine cultures, of which 812 met eligibility criteria including 619 (76.2%) E. coli, 84 (10.3%) Proteus, 55 (6.8%) Klebsiella, 29 (3.6%) Staphylococcus, 13 (1.6%) Enterococcus and 12 (1.5%) Streptococcus. Median age was six months (2.4-36 months IQR). After adjusting for age, ethnicity and bacterial species, the prevalence of dilating vesicoureteral reflux (VUR, defined as grades III-V) was 5.3 times higher in circumcised males compared to uncircumcised males (95% CI: 2.4-11.4, p = 0.001). Circumcised males had a 3.1 times increased prevalence of high-grade hydronephrosis (defined as SFU grades 3 and 4) compared to uncircumcised males (prevalence ratio: 3.1, 95% CI: 1.0-10.0, p = 0.05). Among bacterial pathogens, no patients with Proteus UTI had high-grade hydronephrosis or dilating VUR. In contrast, Staphylococcal infections were associated significantly with dilating VUR (prevalence ratio 10.1, 95% CI: 2.3, 44.8; p = 0.002) and high-grade hydronephrosis (prevalence ratio 8.1, 95% CI: 1.7, 39.7; p = 0.010).
    Conclusions: Circumcision status is an independent predictor of structural urinary anomalies of the bladder and upper tracts in pediatric males with UTI, therefore circumcised males should be considered for early imaging, including VCUG, after their first UTI. Furthermore, Staphylococcal infections were associated with an even higher prevalence of high-grade hydronephrosis and dilating VUR and therefore warrant early investigation with VCUG. In contrast, none of the Proteus infections, which were seen almost exclusively in uncircumcised males, were associated with dilating VUR or hydronephrosis, making initial observation more appropriate in these patients.
    MeSH term(s) Adolescent ; Child ; Child, Preschool ; Circumcision, Male ; Escherichia coli ; Humans ; Incidence ; Infant ; Male ; Retrospective Studies ; Texas ; Urinary Tract Infections/diagnosis ; Urinary Tract Infections/epidemiology ; Vesico-Ureteral Reflux
    Language English
    Publishing date 2020-07-25
    Publishing country England
    Document type Journal Article
    ZDB-ID 2237683-5
    ISSN 1873-4898 ; 1477-5131
    ISSN (online) 1873-4898
    ISSN 1477-5131
    DOI 10.1016/j.jpurol.2020.07.030
    Database MEDical Literature Analysis and Retrieval System OnLINE

    Full text online

    More links

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Zs.A 6387: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

To top