Reglamento Cgpa
Páginas: 17 (4101 palabras)
Publicado: 23 de octubre de 2012
Eur J Pediatr (2012) 171:971–983 DOI 10.1007/s00431-012-1687-7
ORIGINAL ARTICLE
Practical consensus guidelines for the management of enuresis
Johan Vande Walle & Soren Rittig & Stuart Bauer & Paul Eggert & Daniela Marschall-Kehrel & Serdar Tekgul
Received: 25 November 2011 / Accepted: 25 January 2012 / Published online: 24 February 2012 # The Author(s) 2012. This article is publishedwith open access at Springerlink.com
Abstract Despite the high prevalence of enuresis, the professional training of doctors in the evaluation and management of this condition is often minimal and/or inconsistent. Therefore, patient care is neither optimal nor efficient, which can have a profound impact on affected children and their families. Once comprehensive history taking and evaluation haseliminated daytime symptoms or comorbidities, monosymptomatic enuresis can be managed efficaciously in the majority of patients. Non-monosymptomatic enuresis is often a more complex condition; these patients may benefit from referral to specialty care centers. We outline two alternative strategies to determine the most appropriate course of care. The first is a basic assessment covering only theessential components of diagnostic investigation which can be carried out in one office visit. The second strategy includes several additional evaluations including completion of a voiding diary, which requires extra time during the initial consultation and two office visits
J. Vande Walle Pediatric Nephrology Unit, Ghent University Hospital, Ghent, Belgium S. Rittig Department of Pediatrics,Aarhus University Hospital, Skejby, Denmark e-mail: soren.rittig@skejby.rm.dk S. Bauer Department of Urology, Children’s Hospital, Harvard Medical School, Boston, MA, USA e-mail: stuart.bauer@childrens.harvard.edu P. Eggert University Children’s Hospital, Kiel, Germany e-mail: p.eggert@pediatrics.uni-kiel.de
before treatment or specialty referral is provided. This should yield greater success thanfirst-line treatment. Conclusion: This guideline, endorsed by major international pediatric urology and nephrology societies, aims to equip a general pediatric practice in both primary and secondary care with simple yet comprehensive guidelines and practical tools (i.e., checklists, diary templates, and quick-reference flowcharts) for complete evaluation and successful treatment of enuresis.Keywords Enuresis . Monosymptomatic . Consensus guidelines . Primary care . Management
Introduction Evaluation and management of enuresis, a common condition, is not a priority in training programs for medical
D. Marschall-Kehrel Urology Consultancy, Frankfurt/Main, Germany e-mail: kehrel.daniela@t-online.de
S. Tekgul Department of Urology, Hacettepe University School of Medicine, Ankara, Turkeye-mail: tekgul-k@tr.net
J. Vande Walle (*) Pediatric Nephrology UZ Ghent, De Pintelaan 185, 9000 Ghent, Belgium e-mail: johan.vandewalle@uzgent.be
972
Eur J Pediatr (2012) 171:971–983 Nocturnal polyuria (NP): Overproduction of urine at night, defined as nocturnal urine output exceeding 130% of EBC for age Non-monosymptomatic enuresis: Enuresis with other, mainly daytime, lower urinarytract symptoms Overactive bladder (OAB): all children with complaints of urgency and frequency with or without incontinence A full glossary of all relevant terminology and definitions can be found in the 2006 ICCS standardization paper [33]
doctors (MDs), despite being a common condition. Frequent bedwetting (defined as >3 wet nights per week) has an estimated prevalence of nearly 10% in childrenaged 7 years [9, 16, 17, 22, 57] and is associated with embarrassment and significant emotional and practical difficulties for affected children and their families. Information available to families on the internet is often inaccurate, while guidelines for doctors are often center- or subdiscipline-dependent and are published in highly specific specialty journals not available to the majority...
ORIGINAL ARTICLE
Practical consensus guidelines for the management of enuresis
Johan Vande Walle & Soren Rittig & Stuart Bauer & Paul Eggert & Daniela Marschall-Kehrel & Serdar Tekgul
Received: 25 November 2011 / Accepted: 25 January 2012 / Published online: 24 February 2012 # The Author(s) 2012. This article is publishedwith open access at Springerlink.com
Abstract Despite the high prevalence of enuresis, the professional training of doctors in the evaluation and management of this condition is often minimal and/or inconsistent. Therefore, patient care is neither optimal nor efficient, which can have a profound impact on affected children and their families. Once comprehensive history taking and evaluation haseliminated daytime symptoms or comorbidities, monosymptomatic enuresis can be managed efficaciously in the majority of patients. Non-monosymptomatic enuresis is often a more complex condition; these patients may benefit from referral to specialty care centers. We outline two alternative strategies to determine the most appropriate course of care. The first is a basic assessment covering only theessential components of diagnostic investigation which can be carried out in one office visit. The second strategy includes several additional evaluations including completion of a voiding diary, which requires extra time during the initial consultation and two office visits
J. Vande Walle Pediatric Nephrology Unit, Ghent University Hospital, Ghent, Belgium S. Rittig Department of Pediatrics,Aarhus University Hospital, Skejby, Denmark e-mail: soren.rittig@skejby.rm.dk S. Bauer Department of Urology, Children’s Hospital, Harvard Medical School, Boston, MA, USA e-mail: stuart.bauer@childrens.harvard.edu P. Eggert University Children’s Hospital, Kiel, Germany e-mail: p.eggert@pediatrics.uni-kiel.de
before treatment or specialty referral is provided. This should yield greater success thanfirst-line treatment. Conclusion: This guideline, endorsed by major international pediatric urology and nephrology societies, aims to equip a general pediatric practice in both primary and secondary care with simple yet comprehensive guidelines and practical tools (i.e., checklists, diary templates, and quick-reference flowcharts) for complete evaluation and successful treatment of enuresis.Keywords Enuresis . Monosymptomatic . Consensus guidelines . Primary care . Management
Introduction Evaluation and management of enuresis, a common condition, is not a priority in training programs for medical
D. Marschall-Kehrel Urology Consultancy, Frankfurt/Main, Germany e-mail: kehrel.daniela@t-online.de
S. Tekgul Department of Urology, Hacettepe University School of Medicine, Ankara, Turkeye-mail: tekgul-k@tr.net
J. Vande Walle (*) Pediatric Nephrology UZ Ghent, De Pintelaan 185, 9000 Ghent, Belgium e-mail: johan.vandewalle@uzgent.be
972
Eur J Pediatr (2012) 171:971–983 Nocturnal polyuria (NP): Overproduction of urine at night, defined as nocturnal urine output exceeding 130% of EBC for age Non-monosymptomatic enuresis: Enuresis with other, mainly daytime, lower urinarytract symptoms Overactive bladder (OAB): all children with complaints of urgency and frequency with or without incontinence A full glossary of all relevant terminology and definitions can be found in the 2006 ICCS standardization paper [33]
doctors (MDs), despite being a common condition. Frequent bedwetting (defined as >3 wet nights per week) has an estimated prevalence of nearly 10% in childrenaged 7 years [9, 16, 17, 22, 57] and is associated with embarrassment and significant emotional and practical difficulties for affected children and their families. Information available to families on the internet is often inaccurate, while guidelines for doctors are often center- or subdiscipline-dependent and are published in highly specific specialty journals not available to the majority...
Leer documento completo
Regístrate para leer el documento completo.