Henoch-Schonlein purpura is the most common childhood vasculitis, but may also affect adults. This article reviews the literature since 2011 on advances in diagnosis, clinical disease manifestations, pathophysiology and treatment of Henoch-Schonlein purpura. The clinical manifestations are thought to arise from IgA depositions in blood vessel walls in the affected organs, mostly skin, gastrointestinal tract, joints and kidneys. Corticosteroids may be effective in rapid resolution of renal manifestations and treating joint and abdominal pain, but they are not proven effective for treating organ manifestations and complications, such as glomerulonephritis, bowel infarction or intussusception. Mycophenolate mofetil or cyclosporine A may be better treatment choices in case of renal involvement. Other immunosuppressive and immunomodulating drugs, such as rituximab and dapsone, are promising, but larger studies are needed to confirm these findings. Cancer screening should be considered in older males diagnosed with Henoch-Schonlein purpura.

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Henoch-Schönlein Purpura: A Literature Review.

PURPOSE\nAlthough caffeine consumption is common and generally believed to affect bladder function, little is known about caffeine intake and incident urinary incontinence.\n\n\nMATERIALS AND METHODS\nWe performed a prospective cohort study in 65,176 women 37 to 79 years old without incontinence in the Nurses' Health Study and the Nurses' Health Study II. Incident incontinence was identified from questionnaires during 4 years of followup. Caffeine intake was measured using food frequency questionnaires administered before incontinence development. The multivariate adjusted relative risk of the relation between caffeine intake and incontinence risk as well as attributable risk were calculated.\n\n\nRESULTS\nCaffeine was not associated with incontinence monthly or more. However, there was a modest, significantly increased risk of incontinence at least weekly in women with the highest (greater than 450 mg) vs the lowest (less than 150 mg) daily intake (RR 1.19, 95% CI 1.06-1.34) and a significant trend of increasing risk with increasing intake (p for trend = 0.01). This risk appeared focused on incident urgency incontinence (greater than 450 vs less than 150 mg daily, RR 1.34, 95% CI 1.00-1.80, p for trend = 0.05) but not on stress or mixed incontinence (p for trend = 0.75 and 0.19, respectively). The attributable risk of urgency incontinence associated with high caffeine intake was 25%.\n\n\nCONCLUSIONS\nFindings suggest that high but not lower caffeine intake is associated with a modest increase in the incidence of frequent urgency incontinence. A fourth of the cases with the highest caffeine consumption would be eliminated if high caffeine intake were eliminated. Confirmation of these findings in other studies is needed before recommendations can be made.

Caffeine Intake and Risk of Stress, Urgency, and Mixed Urinary Incontinence

The detailed anatomy of the paraurethral ducts in the adult human female

Pilot randomized controlled trial of foster parent training: A mixed-methods evaluation of parent and child outcomes

This article gives an overview of female urinary incontinence including the symptoms, diagnosis and treatment of stress urinary incontinence and overactive bladder syndrome. It summarises recent guidelines, the role of the nurse in conservative management and when a referral for specialist care is required. It aims to encourage nurses to use all opportunities to identify women who have urinary incontinence then to assess and treat urinary incontinence effectively. All patients should receive a full continence assessment. National Institute for Health and Care Excellence guidelines recommend conservative treatments including lifestyle advice, pelvic floor exercises and bladder retraining. Nurses may need to access training from their local specialist continence nurse service to enable them to provide evidence-based care. This article concludes that equitable, integrated continence services are essential to improve the quality of care for people with continence problems.

Assessment, diagnosis and treatment of urinary incontinence in women

Henoch-Schonlein purpura (HSP) is an immune-mediated systemic vasculitis generally found in children. The standard manifestations of HSP are palpable purpura, arthritis, abdominal pain, and renal complications. Although less common, there are significant urological manifestations associated with HSP. The primary objective of this review is to encourage better understanding and management of HSP by emphasizing the common and rare manifestations of HSP, how they are diagnosed, and the latest treatment options for mild to severe complications. Medline searches of HSP and its urological manifestations were conducted along with searches on current diagnostic and treatment methods. Urological manifestations of HSP involve the kidney, ureter, bladder, prostate, scrotum, testicle, and penis. Diagnosis and management of HSP are not always clear due to differential diagnosis and diversity of symptom presentation. Treatment for HSP is mainly supportive and includes use of nonsteroidal anti-inflammatory drugs for pain relief. In more severe cases, glucocorticoids, methylprednisolone, plasmapheresis, and peritoneal and hemodialysis are reported successful. It is important to note different symptoms of HSP in order to distinguish HSP from other diseases. Early diagnosis may prevent severe complications. Treatment options vary from conservative to invasive depending on the severity of the disease and time frame of diagnosis.

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Urological Manifestations of Henoch-Schonlein Purpura: A Review

Overactive bladder (OAB) is a clinical diagnosis defined by the presence of urinary urgency with or without urgency urinary incontinence (UUI) and is often associated with frequency and nocturia. First-line treatment for OAB is behavioral and dietary modifications because they have minimal side effects and high potential benefits. There is evidence that diet can have a significant effect on the symptoms of OAB. This has led to increasing interest in characterizing the effect of specific dietary changes on OAB prevalence and severity. The aim of this paper is to review the specific nutritional factors that have been found to be associated with OAB and describe the relationship between OAB and diet-related medical conditions such as obesity and insulin resistance.

Diet Modification for Overactive Bladder: an Evidence-Based Review

Introduction The clinical and pathological aspects of the Skene's glands have not been addressed in the current scientific literature. Aim To review the current literature to focus on the clinical and pathological aspects of the Skene's glands. The historical perspective including embryology, anatomy, histology, and current role of prostatic specific antigen (PSA) as a tumor marker of lesions which develop from the Skene's glands, ‘female prostate.’ Material and methods Medline searches were performed to review the current literature regarding Skene's glands pathology, clinical manifestations, diagnosis, role of PSA, and its treatment options. Discussion Anatomical pathology including inflammatory, cystic, solid, benign, and malignant tumors of Skene's glands is emphasized. The unique role of PSA in these lesions is reviewed. Cognizance of periurethral, perimeatal and urethral masses is essential for anatomical pathologists, radiologists, urologists and gynecologists who encounter complex female urethral masses in their clinical practice. Imaging techniques of Skene's glands to diagnose urethral, perimeatal and periurethral masses in female are reviewed. Conclusions The literature of the interesting scientific concepts related to the Skene's glands are reviewed. The role of PSA in these lesions is expanded for diagnoses and treatment options of pathology of the Skene's glands. Methods of imaging are necessary for radiologist, pathologists, and clinicians alike, for the proper treatment of Skene's gland lesions.

http://www.paom.pl/pdf-119491-48211?filename=Clinical implications of.pdf

Clinical implications of the forgotten Skene's glands: A review of current literature

Prior work using nationally representative data of children in the child welfare system suggested that Latino foster parents were less likely to identify children in their care as having chronic conditions. Hispanics comprise over one-fifth of children in foster care, the majority of whom have special health care needs, and there is a growing need to recruit qualified Latino families into the child welfare system. Little is known about Latino parents’ health perceptions regarding chronic conditions, and potential reasons for differing identification rates of children with special health care needs. We conducted 17 home-based, in-depth interviews with Latino foster parents to explore health perceptions and cultural beliefs for children in their care around the concept of chronic illness. We found that Latino foster parents’ understanding of conditions that occurred “over and over again” related to emotional and behavioral health problems. In contrast, their perception of “chronic” was associated with terminal, biological conditions that had limited treatment options, such as cancer, HIV, and hepatitis. Latino foster parents did not interpret the survey question on chronic illness as it was intended, and their view of recurrent conditions did not reflect chronic health conditions. Developing survey questions that are culturally sensitive should improve accuracy in assessing chronic health conditions for this high-risk population. Sensitivity to cultural interpretation for this high-needs population is vital to enhancing communication between families and health providers caring for children in foster care.

Latino Foster Parent Health Perceptions of Chronic Conditions: A Qualitative Exploration

The objective of this study is to provide a comprehensive overview of the use of smartphone "apps" within the field of female pelvic medicine and reconstructive surgery (FPMRS) and the role they play in improving patient education. The authors conducted a keyword search using the search tab in the Apple App Store. The apps selected were ones that specifically pertained to female pelvic medicine. A total of 13 apps were found. The apps were separated into three categories: patient education (five apps), wellness (four apps), and reference (four apps). The majority of the patient education apps consisted of anatomical diagrams of the pelvis and anatomy videos to help explain the pathophysiology behind different pelvic and voiding disorders. Female pelvic medicine apps have a large focus on patient education, which can help patients achieve a greater understanding of female pelvic disorders and the treatment options that are available.

Jacquelyn Gonka

Papers

Urological Manifestations of Henoch-Schonlein Purpura: A Review

Diet Modification for Overactive Bladder: an Evidence-Based Review

Clinical implications of the forgotten Skene's glands: A review of current literature

Latino Foster Parent Health Perceptions of Chronic Conditions: A Qualitative Exploration

The Role of Information Technology (Apps) in FPMRS