The South African guidelines on enuresis-2017

Introduction: Enuresis (or Nocturnal Enuresis) is defined as discreet episodes of urinary incontinence during sleep in children over 5 years of age in the absence of congenital or acquired neurological disorders. Recommendations: Suggestions and recommendations are made on the various therapeutic options available within a South African context. These therapeutic options include; behavioural modification, pharmaceutical therapy [Desmospressin (DDAVP), Anticholinergic (ACh) Agents, Mirabegron (beta 3-adrenoreceptor agonists), and Tricyclic Antidepressants (TCA)], alternative treatments, complementary therapies, urotherapy, alarm therapy, psychological therapy and biofeedback. The role of the Bladder Diary, additional investigations and Mobile Phone Applications (Apps) in enuresis is also explored. Standardised definitions are also outlined within this document. Conclusion: An independent, unbiased, national evaluation and treatment guideline based on the pathophysiological subcategory is proposed using an updated, evidence based approach. This Guideline has received endorsement from the South African Urological Association, Enuresis Academy of South Africa and further input from international experts within the field

Risks and benefits of ChatGPT in informing patients and families with rare kidney diseases:an explorative assessment by the European Rare Kidney Disease Reference Network (ERKNet)

Background: Rare diseases affect fewer than 1 in 2000 individuals, but approximately 150 rare kidney diseases account for about 10% of the chronic kidney disease (CKD) population, impacting millions across Europe and globally. The scarcity of medical experts for these conditions results in an unmet need for accurate and helpful patient information. Large language models like ChatGPT may offer a technological solution to assist medical professionals in educating patients and improving doctor-patient communication. We hypothesized that ChatGPT could provide accurate responses to frequently asked basic questions from patients with rare kidney diseases. Methods: Medical professionals and members of European Patient Advocacy Groups (ePAGs) affiliated with the European Rare Kidney Disease Reference Network (ERKNet) simulated patient-ChatGPT interactions using a Microsoft forms questionnaire and ChatGPT 3.5 and 4.0. Participants selected any rare kidney disease for a structured conversation with ChatGPT 3.5 or 4.0. Responses were evaluated for accuracy and helpfulness. Results: Forty-six ERKNet experts and 12 ePAGs from 13 European countries participated in this study. ChatGPT provided scientifically accurate and helpful information on 28 randomly selected rare kidney diseases, including prognostic information and genetic testing guidance. Participants expressed neutral positions regarding ChatGPT’s recommendations on alternative treatments, second opinions, and other information sources. While ChatGPT generally was perceived as helpful and empathetic, concerns about patient safety persisted. Conclusions: ChatGPT exhibited substantial potential in addressing patient inquiries regarding rare kidney diseases in a real-world context. While it demonstrated resilience against misinformation in this application, careful human oversight remains essential and indispensable.</p

A randomized clinical trial indicates that levamisole increases the time to relapse in children with steroid-sensitive idiopathic nephrotic syndrome

Levamisole has been considered the least toxic and least expensive steroid-sparing drug for preventing relapses of steroid-sensitive idiopathic nephrotic syndrome (SSINS). However, evidence for this is limited as previous randomized clinical trials were found to have methodological limitations. Therefore, we conducted an international multicenter, placebo-controlled, double-blind, randomized clinical trial to reassess its usefulness in prevention of relapses in children with SSINS. The efficacy and safety of one year of levamisole treatment in children with SSINS and frequent relapses were evaluated. The primary analysis cohort consisted of 99 patients from 6 countries. Between 100 days and 12 months after the start of study medication, the time to relapse (primary endpoint) was significantly increased in the levamisole compared to the placebo group (hazard ratio 0.22 [95% confidence interval 0.11-0.43]). Significantly, after 12 months of treatment, six percent of placebo patients versus 26 percent of levamisole patients were still in remission. During this period, the most frequent serious adverse event (four of 50 patients) possibly related to levamisole was asymptomatic moderate neutropenia, which was reversible spontaneously or after treatment discontinuation. Thus, in children with SSINS and frequent relapses, levamisole prolonged the time to relapse and also prevented recurrence during one year of treatment compared to prednisone alone. However, regular blood controls are necessary for safety issues

Children with monosymptomatic primary nocturnal enuresis - the clinical profile of patients during the first nephrological consultation

Introduction: Nocturnal enuresis can be diagnosed in a child older than 5 years of age who involuntarily discharges urine in the wrong time, i.e. at night, and in the wrong place, i.e. in bed. Aim: The aim of the study was to analyse the profile of patients who consult the specialist physician with monosymptomatic primary nocturnal enuresis. Material and methods: The data were collected from a questionnaire completed by guardians of children during the first nephrological consultation. The questions concerned the following: family history of nocturnal enuresis, bedwetting intensity, other urinary tract symptoms, a voiding chart and fluid intake record, number of nocturnal enuresis incidents in 14 days, episodes of nocturia, nocturnal diuresis volume, urinary urgency volume and constipation. Moreover, basic anthropometric measurements were taken. The data were analysed and the following values were calculated: average voided volumes, maximum voided volumes, voided volumes before 5 p.m. and 24-hour diuresis. An analogous analysis was conducted with respect to fluid intake. Results: Most patients were males. The family history of nocturnal enuresis was positive in ⅓ of patients. Approximately ⅓ of patients tended to drink fluids directly before bedtime. The number of patients with sporadic nocturnal enuresis (23–45%) was comparable to the number of patients with frequent nocturnal enuresis (28–55%). Nocturnal diuresis suggested nocturnal polyuria in 11 patients (21.6%). Decreased functional bladder capacity was found in almost ¼ of patients (12–23.5%). Conclusions: Monosymptomatic nocturnal enuresis is more common in boys. The family history was positive in ⅓ of patients. Patients and their guardians are not aware of fluid intake restrictions at bedtime. The frequency of nocturnal polyuria and decreased functional bladder capacity is comparable in the investigated patients

Poetic Rhythm and Meter in Tobias Picker's Suite for Cello and Piano

Electronic Thesis or DissertationThis manuscript uses musical principles, English phonetics, and English poetry structures to understand the works of the composer Tobias Picker. Additionally, the manuscript explores how, through the use of creative compositional approaches, music may speak. The process at the foundation of Picker's works is a unique approach to the relationship between words and music: songs without words. In this manuscript, I argue that the analytical tools of poetic scansion as well as the principles of English language literature can help us understand the musical rhythms which are based on the rhythms of poetry. The exploration of meter allows a performer to use the natural rhythm of words and speech to give audiences a physical experience of poetry, even without any words. This manuscript addresses how I explored the patterns, accents and tones within Tobias Picker's works and how the composer created a unique musical experience from the poetry

Translation or non-Translation? Borrowings from English in the Polish Language of Biotechnology

The paper deals with the impact of English on the Polish language of biotechnology on the basis of the analyzed linguistic material from academic course books, scientific articles, Internet publications, encyclopedias and dictionaries. About 220 terms from the field of biotechnology have been analyzed. The selected examples encompass calques, hybrids and exotics (direct borrowings) which squeeze the existing Polish terms out of usage. The authors put forward a thesis that the globalization of science results in the fact that English (which is a language of international communication, conference language and the language of scientific publications of worldwide importance) influences national languages of special purposes and contributes to the creation of Polish-English professional pidgin. The problem of meaning transfer in the process of English term borrowing has been discussed as well. In the majority of cases there is no expansion, restriction or any other change of meaning observed.utorki badają wpływ języka angielskiego na polski język biotechnologii na podstawie analizy materiału językowego zawartego w podręcznikach akademickich, artykułach naukowych, publikacjach internetowych, encyklopediach i słownikach. W wyniku analizy przygotowano listę ok. 220 terminów z zakresu biotechnologii. Wybrane przykłady obejmują kalki, hybrydy oraz egzotyki, które w wielu przypadkach wypierają wcześniej istniejące rodzime polskie terminy. Autorki wysuwają hipotezę, iż globalizacja nauki sprawia, że język angielski, który stał się językiem komunikacji międzynarodowej, językiem konferencyjnym, a także językiem publikacji naukowych o znaczeniu światowym, wywiera znaczący wpływ na języki specjalistyczne i przyczynia się do powstawania polsko-angielskiego pidginu zawodowego. Omówiono także problem przeniesienia znaczenia terminu angielskiego przy procesie zapożyczania przez język polski. W większości przypadków nie odnotowano sytuacji zawężenia, poszerzenia ani innego rodzaju zmiany znaczenia