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1.
World J Urol ; 33(1): 131-5, 2015 Jan.
Article in English | MEDLINE | ID: mdl-24573904

ABSTRACT

PURPOSE: To investigate whether ultrasonographic bladder wall thickness (BWT) correlates with urodynamic parameters in patients with spinal cord injury (SCI). METHODS: Two hundred and seventy-two patients with SCI were enrolled in the study. All of the patients underwent bladder ultrasonography and urodynamic study. The anterior bladder wall was measured and compared to urodynamic data. RESULTS: The mean age of the patients was 37.4 years. The mean BWT was 3.9 mm. BWT was significantly higher in the patients with neurogenic detrusor overactivity associated with detrusor sphincter dyssynergia (NDO/DSD) compared to those without sphincter dyssynergia (4.2 vs. 3.6 mm, respectively, p < 0.001) and in those with compliance <20 ml/cm H2O. Nevertheless, ROC curve analysis [ROC = 0.624, 95 % CI (0.530, 0.718), p = 0.011] showed that no meaningful BWT measurement cutoff could be made to predict an elevated detrusor pressure in the storage phase. CONCLUSIONS: Increased BWT was present in patients with low bladder compliance and NDO/DSD. No BWT cutoff value to predict an elevated detrusor pressure was found. Therefore, the measurement of BWT has no clinical role in patients with SCI and cannot replace urodynamic evaluation.


Subject(s)
Spinal Cord Injuries/complications , Urinary Bladder, Neurogenic/diagnostic imaging , Urinary Bladder, Neurogenic/physiopathology , Urinary Bladder, Overactive/diagnostic imaging , Urinary Bladder, Overactive/physiopathology , Urodynamics/physiology , Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Paraplegia/diagnostic imaging , Paraplegia/etiology , Paraplegia/physiopathology , Predictive Value of Tests , Quadriplegia/diagnostic imaging , Quadriplegia/etiology , Quadriplegia/physiopathology , ROC Curve , Spinal Cord Injuries/diagnostic imaging , Spinal Cord Injuries/physiopathology , Ultrasonography , Urinary Bladder, Neurogenic/etiology , Urinary Bladder, Overactive/etiology , Young Adult
2.
Urology ; 76(4): 942-5, 2010 Oct.
Article in English | MEDLINE | ID: mdl-20579700

ABSTRACT

OBJECTIVES: To evaluate lower urinary tract dysfunction (LUTD) based on questionnaire symptom scoring and ultrasound assessment of bladder wall thickness (BWT) in children with cerebral palsy (CP). METHODS: A total of 97 children with CP were enrolled in the study. The patients were either symptomatic or asymptomatic with respect to lower urinary tract symptoms. All children underwent a urinary questionnaire and renal ultrasonography. Ultrasound assessment of BWT was completed in 72 cases. RESULTS: A total of 47 patients were female and 50 were male. The mean age was 8 years 8 months (SD 3 years 1 month), with a range of 5-18 years. Urinary incontinence was present in 43 patients (44.3%). Based on the questionnaire, LUTD was found in 59 patients (60.8%). The mean BWT was 2.30 mm. There was no statistically significant difference between continent and incontinent children (2.46 vs 2.19 mm) or between children with and without LUTD (2.43 vs 2.12 mm). CONCLUSIONS: LUTD is common in children with CP and occurred in 60.8% of the patients assessed. BWT did not correlate with the presence of bladder dysfunction or incontinence. Ultrasound assessment of BWT was not relevant for diagnosis of lower urinary tract dysfunction.


Subject(s)
Cerebral Palsy/complications , Urinary Bladder/diagnostic imaging , Urination Disorders/etiology , Adolescent , Cerebral Palsy/pathology , Child , Child, Preschool , Constipation/etiology , Constipation/pathology , Female , Humans , Kidney/diagnostic imaging , Male , Paraplegia/etiology , Quadriplegia/etiology , Severity of Illness Index , Ultrasonography , Urinary Tract Infections/diagnostic imaging , Urinary Tract Infections/etiology , Urinary Tract Infections/pathology , Urination Disorders/diagnostic imaging , Urination Disorders/pathology
3.
Arq Neuropsiquiatr ; 65(1): 167-9, 2007 Mar.
Article in English | MEDLINE | ID: mdl-17420850

ABSTRACT

Congenital muscle dystrophy (CMD) is a heterogeneous group of autosomal recessive myopathies. It is known that CMD may affect the central nervous system (CNS). Some authors have shown that merosin-negative CMD patients may have encephalic metabolic disturbances. In order to study metabolic changes within the brain, the authors performed a magnetic resonance spectroscopy (MRS) study in a 1-year-old girl with merosin-positive CMD (MP-CMD). MRS of brain demonstrated that NAA/Cr ratio was decreased (1.52), while Cho/Cr ratio was increased (1.78). These findings suggest that metabolic changes in CNS can also be found in patients with MP-CMD.


Subject(s)
Brain/metabolism , Laminin/analysis , Muscular Dystrophies/metabolism , Muscular Dystrophies/pathology , Aspartic Acid/analogs & derivatives , Aspartic Acid/analysis , Choline/analysis , Creatine/analysis , Female , Humans , Infant , Magnetic Resonance Imaging , Magnetic Resonance Spectroscopy
4.
Arq. neuropsiquiatr ; 65(1): 167-169, mar. 2007. ilus
Article in English | LILACS | ID: lil-446703

ABSTRACT

Congenital muscle dystrophy (CMD) is a heterogeneous group of autosomal recessive myopathies. It is known that CMD may affect the central nervous system (CNS). Some authors have shown that merosin-negative CMD patients may have encephalic metabolic disturbances. In order to study metabolic changes within the brain, the authors performed a magnetic resonance spectroscopy (MRS) study in a 1-year-old girl with merosin-positive CMD (MP-CMD). MRS of brain demonstrated that NAA/Cr ratio was decreased (1.52), while Cho/Cr ratio was increased (1.78). These findings suggest that metabolic changes in CNS can also be found in patients with MP-CMD.


A distrofia muscular congênita (DMC) é um grupo heterogêneo de miopatias autossômicas recessivas que também podem afetar o sistema nervoso central (SNC). Alguns autores mostraram previamente que pacientes com DMC por deficiência da merosina podem apresentar alterações metabólicas no encéfalo. Com o objetivo de estudar as possíveis alterações metabólicas no SNC, os autores realizaram um estudo por ressonância magnética com espectroscopia em uma paciente de 1 ano com DMC sem deficiência da merosina. A razão NAA/Cr estava reduzida (1,52), enquanto que a razão Cho/Cr estava aumentada (1,78). Estes achados sugerem que alterações metabólicas no SNC também podem ser encontradas em pacientes com DMC merosina-positiva.


Subject(s)
Female , Humans , Infant , Brain/metabolism , Laminin/analysis , Muscular Dystrophies/metabolism , Muscular Dystrophies/pathology , Aspartic Acid/analysis , Aspartic Acid/analogs & derivatives , Choline/analysis , Creatine/analysis , Magnetic Resonance Imaging , Magnetic Resonance Spectroscopy
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