Effects of Crede's method on urine voiding within the first 8 h after surgery among post‐haemorrhoidectomy patients: a comparison study

Urinary retention is a common complication among patients after haemorrhoidectomy. Although Crede's method is recommended for urinary retention in nursing practice textbooks, its effects require further examination. The purpose of this study was to investigate the rate of urine voiding within the first 8 h following haemorrhoidectomy and to examine the effects of Crede's method on this postoperative outcome. A two‐group comparison study was conducted. All participants were over 20 years of age, and each had undergone haemorrhoidectomy. Outcome measurements included patients' self‐reported urine voiding within 8 h of surgery, personal demographics and disease‐related data. Before the surgical procedure, participants were divided into Crede's group and non‐Crede's group, and written educational materials were given. Patients in the Crede's group were taught Crede's method for application in the event that they were unable to void urine after haemorrhoidectomy. The non‐Crede's group patients were taught traditional methods without Crede's method. We examined urine voiding within the first 8 h after haemorrhoidectomy. The mean rate of urine voiding within 8 h of surgery was 60·9% overall, with 91·3% (21/23) in the Crede's group and 30·4% (7/23) in the non‐Crede's group reporting successful voiding. After controlling for the two groups' personal characteristics and disease‐related variables, age, educational level and perioperative fluid administration were treated as covariates and included in the multinomial logistic regression model. The odds ratio of urine voiding within the first 8 h after surgery was 52·70‐fold higher in the Crede's group than in the non‐Crede's group (p < 0·01). This study shows that Crede's method is an effective strategy to aid in urine voiding within the first eight postsurgical hours among patients following haemorrhoidectomy. Clear and concise information about urinary retention and related management strategies should be given to patients before haemorrhoidectomy.     

Self‐reported quantity of daily water intake and urine output in healthy young

Water is an essential nutrient and adequate intake and output of water is required for health maintenance. Water homeostasis is vital for life and optimal function and considerable interest surrounds the issue of recommendations for water consumption in healthy individuals. Few studies are available about self‐reported water intake and urine output. The aim of this study was to assess the quantity of water intake and urine output in 24‐h period in healthy young individuals. This prospective study was carried out on 31 students aged 18–24 years undergoing nursing education in a University during January 2011 in Sakarya, Turkey. Healthy young individuals were recruited for determination of the quantity of water taken in and urine excretion along 24 h; they recorded fluid input and urine output. The students collected the data during weekend break. In our study, the total daily fluid intake (mL) for females was 2082·6 ± 687·1 and the total daily fluid intake (mL) for males was 2720·8 ± 717·4. The total daily quantity of urine (mL) for females was 1623·4 ± 602·4 and the total daily quantity of urine (mL) for males was 1818·3 ± 420·6. This research may be the source for similar studies that could include seasonal changes, climates, cultures and different age groups.     

Titanium and polyether ether ketone (PEEK) patient-specific sub-periosteal implants: two novel approaches for rehabilitation of the severely atrophic anterior maxillary ridge

The aim of this study was to assess two new protocols for single-stage rehabilitation of the severely atrophic maxillary ridge using customized porous titanium or polyether ether ketone (PEEK) sub-periosteal implants. Ten patients with a severely atrophic anterior maxillary alveolar ridge were divided randomly into two groups (five patients in each) to receive customized sub-periosteal implants fabricated via CAD/CAM technology: group 1, porous titanium implants; group 2, PEEK implants. Prosthetic loading with fixed acrylic bridges was performed 1 month postoperative. The implants were followed-up for 12 months and evaluated for the presence of any sign of radiographic bone resorption, mobility, infection, prosthetic fracture, or implant exposure. The immediate postoperative period was uneventful except for one case complicated by wound dehiscence in group 1. At 12 months, all implants were functionally stable and the patients were comfortable with the prostheses. No signs of radiographic bone resorption, mobility, infection, or prosthetic fracture were observed. Within the limitations of this study, the application of customized porous titanium and PEEK sub-periosteal implants produced through CAD/CAM technology appears to be an acceptable method for single-stage prosthetic rehabilitation of the severely atrophic edentulous anterior maxilla.This study was awarded the best case study at the academy of osseintegration annual meeting 2017, Orlando, Florida.     

Phthalate metabolites and bisphenol A in urines from German school-aged children: Results of the Duisburg Birth Cohort and Bochum Cohort Studies

Some phthalates and also bisphenol A (BPA) interfere with the human endocrine system and are labelled as reproductive toxicants. Children's exposure to these contaminants is suspected to be associated with developmental disorders and other health impairments.We provide biomonitoring data on 21 urinary phthalate metabolite and BPA levels in first morning urine of 8–10 year old children. Participants were children born between 1999 and 2002 of the Duisburg birth cohort (8–9 years, N = 113) and of the Bochum cohort study (8–10 years, N = 352). Additionally, for the Duisburg birth cohort we compare current data of children from Duisburg (8–9 years) with data from 2 years earlier when the children were 6–7 years old. We analyzed influences of important covariates on exposure levels by multiple regression analysis and those from two sampling time points by generalized equation estimation models adjusted for important covariates. Compared to recently published studies the phthalate metabolite and BPA concentrations were within the range of background levels. There were no significant differences between children from Bochum and Duisburg. Comparison between the two Duisburg birth cohort data sets (2007–2008 and 2009–2010) showed significant correlations for most of the phthalate metabolites (r_Spearman between 0.25 and 0.51; p ≤ 0.05) but not for BPA (r_Spearman= 0.162; p = 0.143). Most of the phthalate metabolites in the groups of the 6–7 and 8–9 years old Duisburg children were negatively associated with higher age, except for BPA concentrations with nearly constant levels. Exposure levels may be influenced by changes in child specific exposure patterns with age but also by the rapidly changing phthalate market.     

小儿泌尿感染50例临床分析

目的：对小儿泌尿系统感染的临床特征、致病细菌分布以及耐药情况进行深入分析。方法：选取本院2009年7月-2012年7月确诊为泌尿感染的患儿50例，对其临床特征、实验室检查以及病情治疗等临床资料进行回顾总结。结果：小儿泌尿感染多发生于婴幼儿以及女童这一群体，其临床表现缺少典型性，尿培养是此病重要的诊断依据。尿培养之前未使用抗生素的患者其尿培养的阳性率明显比使用了抗生素者高。尿培养产生的细菌主要是大肠埃希菌，对此病菌敏感的药物主要包括哌拉西林他唑巴坦、丁胺卡那霉素、头孢他啶、亚胺培南、以及环丙氟哌酸等。结论：小儿泌尿感染其症状通常缺乏特殊性，因此，儿科医生要注重对患者原因不详的血尿、少尿、遗尿、尿道口红肿、腰痛、腹痛以及顽固性质的尿布皮炎等患者进行尿常规等检查。一旦发现异常情况，尽量在抗生素使用前进行尿培养，并及时使用抗菌敏感类药物治疗。此外，还要注意检查泌尿的畸形以及包茎等潜在的因素，提高临床的诊断准确性和治愈率。     

Evaluation of plasma 3,4-dihydroxyphenylacetic acid (DOPAC) and plasma 3,4-dihydroxyphenylalanine (DOPA) as tumor markers in children with neuroblastoma

Catecholamines and their metabolites are important in the diagnosis of neuroblastoma (NB). Plasma (p-) levels of 3,4-dihydroxyphenylalanine (DOPA) are increased in most NB, probably reflecting decreased DOPA decarboxylase activity. Urine (u-) homovanillic acid (HVA), a DOPA and dopamine (DA) metabolite, is also increased in most NB. DOPAC (3,4-dihydroxyphenylacetic acid) is an important metabolite of DA in tissues with monoamine oxidase (MAO) activity. Because MAO is expressed in NB tumor cells, we studied the importance of measuring p-DOPAC and p-DOPA as compared to u-HVA and u-vanillylmandelic acid (VMA) in the diagnosis and follow-up of NB. DOPAC, DOPA, dopamine, noradrenaline, adrenaline, VMA and HVA were measured by reverse-phase HPLC with electrochemical detection in 106 children (28 with NB (13 newly diagnosed), 25 with other solid tumors, 28 hospitalized for nonneoplastic diseases, and 25 healthy children). P-DOPAC or p-DOPA concentrations were above the upper normal range in 92% of untreated NB patients, as were u-HVA or u-VMA levels. None of these tumor markers was correlated to tumor stage or survival. P-DOPA but not p-DOPAC was correlated to age in NB children. Increased values of p-DOPAC and p-DOPA were found in one patient surviving NB for 10 years. Plasma DOPAC concentrations were decreased in children hospitalized for non-NB diseases, probably reflecting reduced food intake. Plasma analyses of DOPA and DOPAC seem to be useful alternatives in the diagnosis and follow-up of NB if urine sampling is to be avoided. Plasma DOPAC may be an index of nutritional status in various diseases.     

Transcatheter Hepatic Arterial Drug Infusion Therapy for Hepatocellular Carcinoma: Effect on the Arterial Ketone Body Ratio

The arterial ketone body ratio (acetoacetate to β-hydroxybutyrate) was measured in 15 patients with chronic liver disease before and after the infusion of anticancer drugs or embolic agents (gelatin sponge or iodized oil) into the hepatic artery. The arterial ketone body ratio decreased after hepatic angiography and decreased further at 15 min after infusion therapy. When the arterial ketone body ratio decreased to 1.0 or less on at least one occasion after infusion therapy, the ratio after hepatic angiography was always 1.35 or less. Such patients developed marked systemic symptoms like fever and severe liver dysfunction. Ascites also developed in three patients in whom the arterial ketone body ratio was reduced to 0.7 or less at 24 h after infusion therapy. The arterial ketone body ratios improved at 3–7 days after infusion therapy. In the seven patients treated with gelatin sponge embolization, the ratio at 3–7 days after therapy was actually higher than that before angiography.