Kelly Warren

Shaken Baby Syndrome: A Review

Shaken Baby Syndrome occurs in infants as a result of the brain pushing against the skull due to severe acceleration–deceleration forces. Symptoms of Shaken Baby Syndrome include subdural, subarachnoid, and retinal hemorrhages. MRI and ocular examinations are used to determine the extent of mental and visual damage and β-amyloid precursor protein immunohistochemical staining is used to detect axonal injuries. Surgeries such as Subdural hemorrhage (SDH) evacuation surgery and the Burr hole craniotomy are used to treat Shaken Baby Syndrome; however, the prognosis is poor in many cases. Because of the severity of Shaken Baby Syndrome and its traumatic and sometimes fatal effects, it is important to educate new parents, nurses, and doctors on the syndrome in order to prevent incidents.

Urological complications of uterine leiomyoma: a review of literature.

IntroductionUterine leiomyomas are common gynecologic tumor in reproductive-aged women, by age 50, diagnosis shared by urologist, gynecologists and radiologists.ObjectiveThe goal of this article is to review the current literature, study the impact of leiomyoma on female lower urinary tract, examine the cause female sexual dysfunction and provide a comprehensive review of current diagnostic, imaging studies, and current treatment of leiomyoma.MethodsClinical leiomyoma studies published from 1956 through 2015 were identified using the PubMed search engines and the key words leiomyoma, fibroid in the current literature. Impact of leiomyoma on the lower urinary tract including female sexual dysfunction was reviewed with terms of “urinary retention”, “bladder”, “urethra”, “dyspareunia”, “incontinence”, “incomplete bladder emptying”, “female sexual dysfunction”, and “lower urinary tract” to study the urological and sexual effects of leiomyoma. Literature related to leiomyoma was reviewed from 1965 to present.ResultsWomen with uterine leiomyomata complained of pelvic pain, menstrual irregularities, infertility, lower urinary tract symptoms and sexual dysfunction.ConclusionLeiomyoma is a common tumor of the uterus that often clinically impacts on the lower urinary tract and results in urological and sexual symptoms. Leiomyoma can compress and grow into and become adherent to the bladder and surrounding pelvic organs or metastasize into peritoneal organs. Leiomyoma can enlarge and compress the urinary bladder, urethra, and lower end of the ureters. Leiomyoma can cause embarrassing sexual dysfunction in females. Current literature of non-surgical and surgical therapy of leiomyoma is described.

Critical Manifestations of Pneumoscrotum

Introduction: Pneumoscrotum is a critical, physical finding that may indicate significant morbidity and mortality. Accumulation of gas in the scrotum can be primary or secondary. Objective: This paper discusses rapid diagnosis and treatment options. Material and Methods: PubMed searches for pneumoscrotum, etiology, diagnosis, and treatment. Results: We review the historical perspective, classification, etiology, diagnosis, and treatment options of pneumoscrotum, as well as the presentation of pneumoscrotum in neonates/infants. Conclusion: It is crucial to diagnose the etiology pneumoscrotum and designing a treatment option based off that.

The Role of Diabetes Mellitus in Sexual and Reproductive Health: An Overview of Pathogenesis, Evaluation, and Management

BACKGROUND Uncontrolled or long-term diabetes mellitus is conducive to vascular and oxidative stress disturbances that impede several physiological systems, which may in turn elicit psychological symptoms. OBJECTIVE We assess the sexual and hormonal complications of diabetes mellitus that impair reproductive function in males and females. METHODS A comprehensive MEDLINE® search was guided using key words relevant to diabetes mellitus and reproductive health. RESULTS We reviewed the pathogenesis, clinical manifestations, imaging modalities, pharmacological treatment, and intervention options for each diabetic reproductive complication in males and females. Erectile dysfunction secondary to angiopathic, neuropathic, and myopathic damage is a leading complication of diabetes in males. Other reproductive complications include ejaculatory dysfunction, hypogonadism, modified semen parameters, and delayed puberty. Specifics of reproductive dysfunction in diabetic women are less definite than in men due to the lack of standardized evaluation of sexual function in women as well as the increased role of psychological morbidity. Despite this, it is known to manifest as hypogonadism, hypoactive sexual desire disorder, dyspareunia, menstrual dysfunction, and polycystic ovarian syndrome. CONCLUSION Longitudinal studies with larger sample sizes are necessary to better comprehend the connection between diabetes and sexual dysfunction, chiefly in females. Understanding and dividing the role of fertility and sexual issues in reproductive dysfunction can help guide evaluation and management.

Effect of Diabetes Mellitus on Sexual Arousal and Intercourse

Diabetes mellitus, when producing hyperglycemia, as well as angiopathic, vasculopathic, and neuropathic complications, poses a threat to the function and viability of sexual arousal and intercourse at similar and different levels in males and females. Males are faced with hypogonadism, depression and anxiety, affecting their sexual arousal desire. Male intercourse may be impaired by erectile dysfunction, priapism, ejaculatory dysfunction, and/or benign prostatic hyperplasia. Female sexual arousal may be affected by depression, hormonal imbalance, and hypoactive sexual desire disorder. Female sexual intercourse may be disturbed by dyspareunia, vaginismus, and anorgasmia. Effects on sexual intercourse may also be seen at the gender neutral level due to cranial neuropathy and various autonomic neuropathies outside the genitourinary tract. Though specific treatments target most conditions, healthy diet and exercise are the best bets to avoid the long-term effects of diabetic complications on sexuality.

Urological Manifestations of Obstructive Sleep Apnea Syndrome: A Review of Current Literature

Sleep apnea syndrome is a common health issue that is frequently found in patients with obesity associated cardiovascular and respiratory disorders. Patients with sleep apnea suffer from hypoxia during sleep, resulting in metabolic dysfunction of various organ specific symptoms. Obstructive sleep apnea syndrome results in critical psychological symptoms, which include depression and suicidal tendencies. Sleep apnea syndrome carries significant morbidity and mortality that is frequently ignored by healthcare providers. A high percentage of sleep apnea patients suffer from genitourinary symptoms, such as frequency, nocturia, erectile dysfunction, enuresis, and overactive bladder. Current concepts of sleep apnea, as related to urological health issues, are discussed to facilitate treatment options of sleep apnea syndrome. Current literature is reviewed related to genitourinary symptoms.

Neuro-urological manifestations of Parkinson's disease

This article highlights the urological manifestations of Parkinsons disease, the neurological pathways shared by Parkinsons and its urological diseases.

Chronic serotonin-norepinephrine reuptake transporter inhibition modifies basal respiratory output in adult mouse in vitro and in vivo.

Respiratory disturbances are a common feature of panic disorder and present as breathing irregularity, hyperventilation, and increased sensitivity to carbon dioxide. Common therapeutic interventions, such as tricyclic (TCA) and selective serotonin reuptake inhibitor (SSRI) antidepressants, have been shown to ameliorate not only the psychological components of panic disorder but also the respiratory disturbances. These drugs are also prescribed for generalized anxiety and depressive disorders, neither of which are characterized by respiratory disturbances, and previous studies have demonstrated that TCAs and SSRIs exert effects on basal respiratory activity in animal models without panic disorder symptoms. Whether serotonin-norepinephrine reuptake inhibitors (SNRIs) have similar effects on respiratory activity remains to be determined. Therefore, the current study was designed to investigate the effects of chronic administration of the SNRI antidepressant venlafaxine (VHCL) on basal respiratory output. For these experiments, we recorded phrenic nerve discharge in an in vitro arterially-perfused adult mouse preparation and diaphragm electromyogram (EMG) activity in an in vivo urethane-anesthetized adult mouse preparation. We found that following 28-d VHCL administration, basal respiratory burst frequency was markedly reduced due to an increase in expiratory duration (T(E)), and the inspiratory duty cycle (T(I)/T(tot)) was significantly shortened. In addition, post-inspiratory and spurious expiratory discharges were seen in vitro. Based on our observations, we suggest that drugs capable of simultaneously blocking both 5-HT and NE reuptake transporters have the potential to influence the respiratory control network in patients using SNRI therapy.

Genitourinary Complications of Diabetes Mellitus: An Overview of Pathogenesis, Evaluation, and Management.

BACKGROUND Diabetes mellitus is a vastly prevalent metabolic disorder with escalating global health concerns. Particularly when mismanaged, chronic micro- and macrovascular complications may highly impair physiological systems while immunodeficiency disposes us to infection. OBJECTIVE We investigate infections, localized complications, and neoplasms of the genitourinary system secondary to the chronic complications of diabetes mellitus in males and females. METHOD A comprehensive MEDLINE® search was guided using key words relevant to diabetes mellitus and the genitourinary system. RESULTS Pathogen-friendly environments may implicate the sequelae of urinary tract and genital mycotic infections, potentially generating necrosis, abscess, and other inflammatory complications, which may present concomitantly with neurogenic and/or vasculogenic dysfunction to further exacerbate an existing genitourinary condition. Manifestations of the adrenal, renal, and genital organs and tissues are discussed as they relate to vascular, immunodeficient, and other hyperglycemic complications of the diabetic state. Among those, chronic kidney disease and cystopathy are the most prevailing and detrimental. Though studies have connected diabetes to either an increased risk of developing or poor prognosis of bladder, renal, prostate, endometrial, and cervical cancers, the explicit biological relationships are as of yet inconclusive. CONCLUSION Despite the availability of precise treatments to ameliorate most presently reviewed conditions, particularly urinary tract and genital mycotic infection-related sequelae, reversing permanent vascular damage remains a great challenge. Leading a healthier lifestyle and managing diabetes mellitus with a patient-centric approach from the outset are the most putative methods for preventing critical long-term genitourinary manifestations of diabetes mellitus.

Diagnosis and Treatment of Prenatal Urogenital Anomalies: Review of Current Literature

With current advances in antenatal medicine it is feasible to diagnose prenatal anomalies earlier and potentially treat these anomalies before they become a significant postnatal problem. We discuss different methods and signs of urogenital anomalies and emphasize the use of telemedicine to assist patients and healthcare providers in remote healthcare facilities, in real time. We discuss prenatal urogenital anomalies that can be detected by antenatal ultrasound and fetal magnetic resonance imaging. Ultimately, we address the natural history of urogenital anomalies, which need surgical intervention, and emphasize ex-utero intrapartum treatment procedures and other common surgical techniques, which alter the natural history of urogenital anomalies.