Pediatrics

Current lack of support may stem from misinterpretation of OIG guidelines

Inappropriate wetting and voiding habits are common in children, constituting 20% to 25% of new patients seen in the pediatric urology office setting.

Use of the popular seasonal allergy drug loratadine (Claritin) in early pregnancy does not influence the occurrence of hypospadias in infants, according to a report from the Centers for Disease Control and Prevention.

The endoscopic treatment of vesicoureteral reflux and the pathology oftestis tumors were the subject of both important new research and livelydiscussion during the 2003 American Academy of Pediatrics Section on Urologymeeting. Although many important topics were discussed at what is arguablythe finest annual meeting on pediatric urology in the world, these two subjectsdeserve particular attention and are the focus of articles in this issueof Urology Times.

Anthony Atala, MD, a pediatric urologist and internationally recognized leader in tissue engineering, has joined Wake Forest University Baptist Medical Center in Winston-Salem, NC.

The NIDDK-funded 'Urologic Diseases in America' is a broad-based, $6.9million project that will quantify the economic and human burden of urologicdiseases on the American population. In this exclusive Urology Times interview,Mark S. Litwin, MD, MPH, the study's principal investigator, outlines thescope of the project, its goals and objectives, and its relevance to practicingurologists. Dr. Litwin is professor of urology and public health at theDavid Geffen School of Medicine at UCLA and the UCLA School of Public Health.He is also a researcher at UCLA's Jonsson Comprehensive Cancer Center. Theinterview was conducted by UT Editorial Consultant Richard D. Williams,MD, professor and chairman of the department of urology at the Universityof Iowa, Iowa City.

Prostate cancer is the most common nonskin malignancy among men in Europe, North America, and Australia and, after lung cancer, represents the second leading cause of cancer-related death in men in these regions.4 Data from the Surveillance, Epidemiology, and End Results (SEER) program of the National Cancer Institute, which covers approximately 26% of the US population, show the rising incidence of cancer of the prostate (Figure 1).

Presented by Ronald Rabinowitz, MD, University of Rochester (NY) MedicalCenter.

Chicago-The cutting-edge field of angiogenesis is growing each year,according to M. Judah Folkman, MD, professor of pediatric surgery at Children'sHospital and Harvard Medical School, Boston, shown here. Dr. Folkman presentedthis year's John Duckett Memorial Lecture, "Angiogenesis in the genitourinarysystem," during the AUA meeting here yesterday.

Boston-Children with myelomeningocele and undescended testis face greaterrisk of infertility than patients with undescended testis alone, accordingto research presented at the American Academy of Pediatrics Section on Urologyannual meeting here. In a related study, researchers found that patientswith defective second step germ cell maturation due to cryptorchidism havea poor fertility prognosis.

Boston-Pregnant mice exposed to synthetic estrogens resulted in shorter urethras and disrupted urethral seam closures in their offspring, according to researchers from the University of California, San Francisco. They say their research supports previous cause-and-effect data regarding endocrine disruptors and genital tubercle anomalies.

Unknown deductibles, correction of human error, and value reassessmentcan all add upNow might be a good time for every urologist to take a look at the often-neglectedproperty or real estate tax on all the property owned by your practice.

Presented by Ricardo Gonzalez, MD, University of Miami Schoolof Medicine.

The incidence of hydronephrosis diagnosed in the neonatal period has increased dramatically with the routine use of ultrasound in obstetrical care. Prior to the mid-1980s, most children with obstructive uropathy secondary to ureteropelvic junction obstruction or ureterovesical junction obstruction were diagnosed after urinary tract infections had occurred or an abdominal mass was noted.

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With reports describing continued improvements in the success rates of hypospadias repair using contemporary one-stage techniques, only a minority of pediatric patients requires secondary urethroplasty to address significant complications. In the adult, the reconstructive urologic surgeon may similarly encounter the patient who requires extensive primary or secondary urethral reconstruction for stricture disease.

San Francisco - Researchers have successfully induced hypospadias in mice, an accomplishment that observers say provides more compelling evidence in support of the endocrine disruptor hypothesis as an explanation for the increase in hypospadias observed over the past 30 years.

San Francisco-Factors that may help to predict future infertilityin cryptorchid boys-enabling clinicians to intervene earlier-have emergedfrom two long-term studies of cryptorchidism and fertility presented atthe American Academy of Pediatrics Section on Urology annual meeting.

San Francisco-A modified Snodgrass hypospadias repair may allbut eliminate the problem of postoperative fistulas, while the originalSnodgrass procedure can be successful for proximal hypospadias reconstruction,according to two studies presented at the 2001 American Academy of PediatricsSection on Urology meeting.

San Francisco-Testis-sparing approaches are appropriate for many prepubertaltestis tumors, according to two decades of data from a tumor registry setup by the American Academy of Pediatrics Section on Urology. The registry,established in 1980, has enrolled 395 boys with primary testis tumors thatpresented before 12 years of age.

Section 530 of tax law allows relief from tax liability if two conditionsare satisfiedEmployment taxes paid on the "wages" of a urology practice'sprincipal may only be a matter of several hundred dollars each year, butover the course of a career, it can add up.

It's time to add electronic medical records, or EMR, to the list of buzzwordscommon in medical practices today. This new technology, although in itsinfancy, has the opportunity to facilitate many of the goals common to allpractices-efficiency, correct coding, Medicare and HIPAA compliance, andimproved outcomes. We are in a new age of medicine, and EMR technology willtransform the way you practice.

Canton, MA-Organogenesis Inc., has received FDA clearance to market its FortaPerm, a bioengineered surgical sling. The product, which uses the company's FortaFlex engineered collagen technology, is a natural collagen biomaterial indicated for urinary incontinence and vaginal prolapse. It is engineered to add long-term structural support to soft tissue where the patient's tissue is absent or inadequate, according to the company.

As laptop computers have become more reliable, less fragile, and less expensive, these machines have gone from being a luxury to an everyday business tool. Many physicians travel frequently and often have projects or correspondence to work on at home and at the office. All of this can be made much more practical with a laptop computer.

St. Petersburg, FL-A new peer-reviewed online medical reference covering all aspects of adult and pediatric urology is now available free of charge at www.emedicine.com. More than 200 separate chapters are written by physician experts and include multimedia presentations integrating photographs, tables, charts, drawings, anatomical illustrations, x-rays, and audio and video clips with each chapter. Authors are able to update their information at any time and are required to update their chapters at least once a year.

Washington-MDLinx now offers www.urologylinx.com, a web site featuring news about general urology and urologic subspecialties. The site's subspecialties include adrenal glands, erectile dysfunction, infertility, kidney, pediatric urology, penis, prostate, stones, testis/scrotum, ureter, urethra, urinary bladder, uroradiology, voiding dysfunction, basic science/genetics, economics of medicine, and popular press.

San Francisco-Non-myeloablative allogeneic stem cell transplantation for metastatic renal cell carcinoma appears feasible in a very select, younger, healthier patient population with slow-growing tumors and human leukocyte antigen (HLA)-matched siblings, said Brian I. Rini, MD. He reported results from a University of Chicago Hospital phase II trial at the 37th annual meeting of the American Society of Clinical Oncology here.

Palo Alto, CA-Urologists have heard more than once from detractors who have said that measuring PSA is not useful as a predictor for prostate cancer. You may now add Thomas A. Stamey, MD-the first investigator to show that the level of serum PSA was proportional to the volume of prostate cancer-to the list of naysayers.