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Archivos Argentinos de Pediatria Apr 2023Introduction. Usually, during anorectal manometry, only the presence or absence of rectoanal inhibitory reflex (RAIR) is investigated. Studies have reported that a... (Comparative Study)
Comparative Study Observational Study
Introduction. Usually, during anorectal manometry, only the presence or absence of rectoanal inhibitory reflex (RAIR) is investigated. Studies have reported that a detailed analysis may provide data of interest. Our hypothesis is that RAIR measurement may provide information to detect organic causes (tethered cord, lipoma, etc.) in patients in whom a functional cause had been previously considered. Objectives. To compare RAIR duration in anorectal manometry between patients with refractory functional constipation (RFC) and myelomeningocele (MMC). Population and methods. Observational, analytical, cross-sectional study (2004-2019). Patients with chronic constipation and functional and organic fecal incontinence (myelomeningocele). The anorectal manometry was performed with a water-perfused system, and the duration of RAIR was measured with different volumes (20, 40, and 60 cc). Group 1 (G1): 81 RFC. Group 2 (G2): 54 MMC. Patients with developmental delay, compliant anal sphincter, sacral agenesis and non-cooperative patients were excluded. Results. A total of 135 individuals were included (62 were male). Their median age was 9.57 years in G1 and 9.63 years in G2. Average duration in G1 versus G2 with 20 cc: 8.89 versus 15.21 seconds; 40 cc: 11.41 versus 21.12 seconds; 60 cc: 14.15 versus 26.02 seconds. The difference in RAIR duration with the varying volumes was statistically significant (p = 0.0001). Conclusion. RAIR duration was longer with increasing balloon inflation volumes in both populations. RAIR duration was longer in patients with MMC than in those with RFC. Spinal injury should be ruled out in patients with prolonged RAIR.
Topics: Constipation; Meningomyelocele; Humans; Manometry; Anal Canal; Rectum; Male; Female; Child, Preschool; Child; Adolescent; Prevalence; Reflex
PubMed: 36413143
DOI: 10.5546/aap.2022-02598.eng -
Neurology India 2022In this report, we describe a 6-month-old child having Type I split cord malformation (SCM), associated with meningomyelocele of one hemicord and lipomeningomyelocele of...
In this report, we describe a 6-month-old child having Type I split cord malformation (SCM), associated with meningomyelocele of one hemicord and lipomeningomyelocele of other hemicord at the same level along with Type II Chiari malformation. The classical embryological theories on split cord malformation and neurulation defect do not clearly explain such a complex entity at one level. The new research on the genetic association of posterior neuropore defect opens a new horizon of research on such genesis.
Topics: Humans; Infant; Arnold-Chiari Malformation; Magnetic Resonance Imaging; Meningomyelocele; Neural Tube Defects; Spinal Dysraphism
PubMed: 36412390
DOI: 10.4103/0028-3886.360939 -
The Pan African Medical Journal 2022
Topics: Humans; Meningocele; Meningomyelocele; Spinal Dysraphism
PubMed: 36405669
DOI: 10.11604/pamj.2022.42.288.36209 -
The Pan African Medical Journal 2022
Topics: Humans; Meningomyelocele; Spinal Dysraphism
PubMed: 36405667
DOI: 10.11604/pamj.2022.42.281.36395 -
Developmental Medicine and Child... Jun 2023To describe the education and employment transition experience of young adults with spina bifida (YASB) and investigate factors associated with employment.
AIM
To describe the education and employment transition experience of young adults with spina bifida (YASB) and investigate factors associated with employment.
METHOD
We queried education and employment data from the US National Spina Bifida Patient Registry from 2009 to 2019. We applied generalized estimating equations models to analyze sociodemographic and disease-related factors associated with employment.
RESULTS
A total of 1909 participants (850 males, 1059 females) aged 18 to 26 years contributed 4379 annual visits. Nearly 84% had myelomeningocele and, at last visit, the median age was 21 years (mean 21 years 5 months, SD 2 years 10 months). A total of 41.8% had at least some post-high school education, and 23.9% were employed. In a multivariable regression model, employment was significantly associated with education level, lower extremity functional level, bowel continence, insurance, and history of non-shunt surgery. This large, national sample of YASB demonstrated low rates of post-secondary education attainment and employment and several potentially modifiable factors associated with employment.
INTERPRETATION
Specific sociodemographic, medical, and functional factors associated with employment are important for clinicians to consider when facilitating transition for YASB into adulthood. Additional research is needed to understand the impact of cognitive functioning and social determinants of health on transition success in YASB.
WHAT THIS PAPER ADDS
There were low education attainment and employment rates in a large sample of young adults with spina bifida. Specific sociodemographic, medical, and functional factors are associated with employment. Some employment-associated factors, such as continence and self-management skills, are modifiable.
Topics: Male; Female; Humans; Young Adult; Adult; Educational Status; Spinal Dysraphism; Meningomyelocele; Employment; Registries
PubMed: 36385606
DOI: 10.1111/dmcn.15456 -
Neurology India 2022
Topics: Child; Humans; Meningocele; Developmental Disabilities; Sacrum; Spinal Diseases; Meningomyelocele; Magnetic Resonance Imaging
PubMed: 36352675
DOI: 10.4103/0028-3886.359169 -
Asian Journal of Surgery Apr 2023
Successfully treatment of tethered-cord syndrome secondary to progressive-development giant myelomeningocele by surgical repair with intraoperative neurophysiological monitoring in an infant.
Topics: Infant; Humans; Meningomyelocele; Intraoperative Neurophysiological Monitoring; Neural Tube Defects; Neurosurgical Procedures
PubMed: 36347745
DOI: 10.1016/j.asjsur.2022.10.055 -
The Pan African Medical Journal 2022
Topics: Humans; Spinal Dysraphism; Meningomyelocele
PubMed: 36338552
DOI: 10.11604/pamj.2022.42.258.35894 -
Ultrasound in Obstetrics & Gynecology :... Feb 2023
Topics: Pregnancy; Female; Humans; Meningomyelocele; Fetus; Fetoscopy; Prenatal Care
PubMed: 36178849
DOI: 10.1002/uog.26081 -
Journal of Pediatric Urology Oct 2022Patients with myelomeningocele often use clean intermittent catheterization (CIC) for renal preservation and to promote urinary continence. While starting CIC at an...
INTRODUCTION
Patients with myelomeningocele often use clean intermittent catheterization (CIC) for renal preservation and to promote urinary continence. While starting CIC at an early age is associated with better renal outcomes, the impact of age of CIC initiation on continence outcomes has not been examined.
OBJECTIVE
To examine whether earlier CIC initiation is associated with higher likelihood of current urinary continence for patients with myelomeningocele.
STUDY DESIGN
Data of patients aged ≥5 years at last visit were obtained from 35 spina bifida clinics participating in the National Spina Bifida Patient Registry from 2013 to 2018. Sociodemographic characteristics, disease characteristics, and current bladder management strategies were collected. Via univariate and multiple logistic regression models, the latter conducted controlling for all variables associated with current continent status, associations between continence and sociodemographic factors, condition characteristics, and age CIC began (<3 years of age, 3-5 years, 6-11 years, ≥12 years) were analyzed.
RESULTS
Data from 3510 individuals were included (mean age at last visit = 17.0 years, range 5.0-88.7). The sample was evenly distributed by sex (52% female); most individuals were non-Hispanic White (62.6%). The majority of patients (55.2%) started CIC before age 3 years. Continence varied markedly across those who never started CIC (0.6% of patients were continent) and those who started at any age (range 35.3-38.5%). Among those who started CIC, the magnitude of the association was not proportional to age CIC was started. Compared with those who started CIC at age 12 or older, estimated adjusted odds ratio of being continent ranged from 1.04 (6-11 years, 95% CI, 0.72-1.52) to 1.25 (<3 years, 95% CI, 0.89-1.76).
DISCUSSION
Although CIC may be positively associated with achieving urinary continence in individuals with myelomeningocele, we could not demonstrate that younger age at CIC initiation increased the likelihood of achieving this goal. Limitations include lack of data on reason for starting CIC, urodynamic data, and the observational nature of data collection.
CONCLUSIONS
Further study is needed addressing limitations of the current investigation to determine if urinary continence outcomes are influenced by the age of starting CIC among patients with myelomeningocele.
Topics: Humans; Female; Child, Preschool; Child; Adolescent; Young Adult; Adult; Middle Aged; Aged; Aged, 80 and over; Infant; Male; Intermittent Urethral Catheterization; Meningomyelocele; Spinal Dysraphism; Urinary Bladder, Neurogenic; Urinary Bladder; Urinary Catheterization
PubMed: 36163222
DOI: 10.1016/j.jpurol.2022.08.022