The efficacy of an enuresis alarm in monosymptomatic nocturnal enuresis.
ABSTRACT Monosymptomatic nocturnal enuresis (MNE) is a frequent problem in children older than five years of age. Of the various treatment options, the enuresis alarm has been widely advocated for treating nocturnal enuresis. This study was designed to evaluate the success rates of the enuretic alarm device in patients with MNE.
40 patients who had significant MNE (three or more wet nights per week) were included. They used an enuretic alarm for 12 weeks initially. If a relapse was observed, reusage of the device was provided. A success criterion was defined as "14 consecutive dry nights" and a relapse criterion was "more than one wet night a week".
The patients' mean age was 8.1 (range 6-16) years and the mean follow-up time was 10.2 (range 6-19) months. 27 patients became dry at night at the end of three months. In the follow-up period, a relapse was observed in 66.7 percent of the initial responders. For recovery, 14 patients started to reuse the device, and seven of them responded positively. At the end of the treatment, a total of 13 of the patients had benefited from the enuretic alarm.
During the follow-up, the enuretic alarm device provided acceptable initial and long-term complete dryness in patients with primary nocturnal enuresis. Without the need for expensive pharmacological intervention, the alarm treatment is an effective choice for children with nocturnal enuresis.
Full-textDOI: · Available from: Vehbi Dogan, Jul 02, 2015
Click to see the full-text of:
Article: The efficacy of an enuresis alarm in monosymptomatic nocturnal enuresis.
- SourceAvailable from: ssl1571.websiteseguro.com[Show abstract] [Hide abstract]
ABSTRACT: Introdução O propósito deste capítulo, como o título sugere, é, primariamente, discutir a im portância de se tratar a enurese (infantil e adolescente), independentemente da faixa etária em que ela seja diagnosticada, levando o portador à condição de controle vesical. Inicialmente apresentaremos a epidemiologia, etiologia e patogenia dessa condição para combater argumentos contrários às concepções errôneas que jus-tificariam o adiamento e/ou a indefinição terapêutica no tratamento da enu-rese. Em seguida, veremos os principais fatores responsáveis pela omissão do tratamento por parte dos pais e profissionais, bem como o impacto positivo decorrente do tratamento específico, destacando a necessidade de uma avaliação compreensiva e encaminhamento adequados do problema, sem negligenciá-lo. A evolução do conhecimento científico relativo à eficácia do tratamento da enurese (muitas vezes chamada de enurese noturna ou mais especificamente da enurese noturna monossintomática – MNE) é crescente. Essa condição, das muito frequentes na infância (Özgür, Özgür e Örün, 2009), é entendida aqui, em conformidade com um dos documentos de estandardização, promovido em 2006, pela Sociedade Internacional de Continência em Crianças – International Children´s Continence Society – ICCS (Nevéus et al., 2006) como incontinência urinária, durante o sono de uma criança com pelo menos 5 anos, sendo que essa condição não é causada por outros fatores, como diabetes ou malformação do sistema nervoso central (SNC). É importante, ainda, descrever a classificação da enurese: ela é considerada primária quando a criança nunca teve controle da uri-na durante o sono, ou secundária, quando o controle existiu por pelo menos seis meses consecutivos e foi pedido. A enurese também pode ser monossintomática, Silvares.indd 15 24/7/2012 08:15:19 16 Silvares & Pereira (orgs.) quando não existem outros sintomas do trato urinário inferior, ou não monos-sintomática, quando tais sintomas estão presentes. É de se esperar que, em função dos progressos na área, algumas ideias sem base empírica sobre o tratamento dessa condição devam ser deixadas de lado, na medida em que o conhecimento construído for mais amplamente difundido. Essas concepções errô-neas variam ao longo de dois extremos, indo desde o ponto de vista de que não haveria um tratamen-to específico para essa condição particular até a cren-ça de que não haveria nenhuma necessidade de trata-mento para enurese uma vez que, com o decorrer do tempo, essa condição se dissiparia, ou seja, o controle vesical, nunca antes alcan-çado desde o nascimento da pessoa, seria obtido de forma natural sem necessi-dade de nenhuma intervenção.
- [Show abstract] [Hide abstract]
ABSTRACT: Background: Metabolic Syndrome (MS) increases the risk of developing type-2 diabetes (DM2) and cardiovascular diseases (CVD) and it is thought to be prevalent in Nigeria. This study aims at determining the prevalence of MS and its component risk factors among apparently healthy traders in a local market in Ibadan, Nigeria. Methods: 534 apparently healthy traders from a local market in Bodija, Ibadan, Nigeria aged (18–105) years with neither DM2 nor CVD were participants of a cohort study on risk assessment of type 2 diabetes and dementia in Nigerians with metabolic syndrome. The International Diabetes Federation (2005) and the World Health Organisation (1998) criteria were used for MS and BMI respectively. Anthropometric indices (weight, height, body mass index (BMI), percentage body fat (PBF), waist and hip circumferences (WC & HC) and their ratio (WHR), waist circumference to height ratio (WHT)) and blood pressure (BP) were obtained by standard methods. Blood samples (6 ml) were obtained for the determination of glucose (FPG), total cholesterol (TC), triglycerides (TG), high density lipoprotein cholesterol (HDL-C) by enzymatic methods while low density lipoprotein cholesterol (LDL-C) was calculated. Descriptive statistics, Chi-square test and ANOVA were among the analyses conducted. Results: 301 (56.4%) of traders studied were overweight (176, 33.0%) or obese (125, 23.4%) while 17 (3.4%) and 125 (40.4%) were underweight and normal weight respectively. The prevalence of MS and obesity were 87 (16.3%) and 125 (23.4%) respectively. There was significant association between obesity and MS (p < 0.05). Both MS and obesity were significantly associated with gender (p < 0.05). The prevalence of MS and obesity was higher in female (20.9%; 31.0%) than male traders (6.5%; 7.1%) respectively. The prevalence of MS increased from normal weight (8.3%) to overweight (18.8%) to obesity (28.8%). There were significantly higher differences in age, BP(systolic and diastolic), weight, BMI, WC, HC, WHT, WHR, and PBF but lower difference in height when overweight/obese groups were compared with normal weight group (p < 0.05). TC and LDL-C were significantly higher in only obese than normal weight traders. However, FPG, TG and HDL-C were similar in all groups (p > 0.05). Conclusion: There is high prevalence of MS and obesity among Nigerian traders. Female gender, hypercholesterolemia, hypertension, increasing age, general and abdominal obesity appear to be important metabolic risk factors of CVD and not DM2 among Nigerian traders. Health care strategies for effective modulation of diet and lifestyle are needed urgently. In addition, screening programs for indices of MS in all Nigerians irrespective of BMI could be considered.
- [Show abstract] [Hide abstract]
ABSTRACT: To explore the effectiveness of the enuresis alarm with overlearning for treatment of primary nocturnal enuresis (PNE). A key objective was to explore the effect of overlearning on treatment gains, and its impact on relapse. The RMIT University Psychology Clinic has been treating PNE in the community for more than 20 years following a standardized treatment protocol. The study analysed archival data of 126 participants, aged ≥5 years, presenting with PNE. A mean wetting frequency of 5.13 wet nights per week was observed at baseline. Treatment significantly reduced mean wetting from baseline levels during both treatment and overlearning phases, F(1.41, 176.10) = 588.54, p < 0.001, r(2) = 0.77, 95% CI (0.74-0.81). Wet nights per week reduced from a mean of 5.13 (SD = 1.77) during baseline to 1.88 (SD = 0.85) during treatment, and 0.64 (SD = 0.60) during overlearning. Alarm treatment with overlearning produced a treatment response of 87%, compared with 59% for alarm treatment only. Evidence of improved treatment response with the addition of overlearning suggests overlearning should be considered as a potentially useful adjunct to alarm treatment for PNE. Overlearning was not unreasonably onerous for participants. Further research is required to explore the impact overlearning has on reducing relapse rates.Journal of pediatric urology 09/2013; 10(2). DOI:10.1016/j.jpurol.2013.08.008 · 1.41 Impact Factor