1
|
Rodrigues Pereira RP, Mazzali Pessoa Martins AM, Mendes de Carvalho IT, Kel de Souza LD, Francao P, Gomes CM, Bernardes RDP, Meyer KF, Fonseca EMGOD, Machado MG, Tanaka C. Clinical phenotyping of children with nocturnal enuresis: A key classification to improve the approach. J Pediatr Urol 2024; 20:384.e1-384.e9. [PMID: 38508980 DOI: 10.1016/j.jpurol.2024.01.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 12/01/2023] [Accepted: 01/19/2024] [Indexed: 03/22/2024]
Abstract
INTRODUCTION The literature shows that nocturnal enuresis is not an isolated phenomenon of urinary loss during sleep, but encompasses a set of systemic clinical manifestations that significantly influence children's quality of life and development. However, the understanding of the clinical and physiological relationship of these systemic manifestations remains a clinical challenge. The recognition of these manifestations and their subsequent categorisation, may provide better insights into integrated clinical manifestations, facilitating the understanding of pathophysiological mechanisms, and promote increased assertiveness in the assessment and the selection of appropriate therapies. OBJECTIVE The aim of this study is to develop a phenotyping model for children with nocturnal enuresis based on evidence. METHODS This study presents a clinical phenotyping model for children with nocturnal enuresis based on an analytical and methodological review of the literature, about nocturnal enuresis and its associated clinical manifestations. There was a bibliometric analysis carried out to better analyse outcomes. After reading and analysing the literature, the clinical manifestations were categorised into domains and submitted to the validation of an expert committee with extensive experience in their specific area of expertise. A visual representation of the categorised model was developed to make the phenotyping concept easily understandable to all professionals. RESULTS The clinical manifestations related to nocturnal enuresis have been categorised according to frequency and relation found in the literature and validation by an expert committee and the development of the phenotyping model for children with nocturnal enuresis was completed. CONCLUSION The present study developed an evidence-based phenotyping model for children with nocturnal enuresis.
Collapse
Affiliation(s)
- Rita Pavione Rodrigues Pereira
- Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional da Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, SP, Brazil; LIM 54 - Laboratório de Investigação em Fisioterapia, Hospital das Clínicas da Faculdade de Medicina da Universidade De São Paulo, Sao Paulo, SP, Brazil.
| | - Aline Mari Mazzali Pessoa Martins
- Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional da Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, SP, Brazil; LIM 54 - Laboratório de Investigação em Fisioterapia, Hospital das Clínicas da Faculdade de Medicina da Universidade De São Paulo, Sao Paulo, SP, Brazil.
| | - Isabela Teixeira Mendes de Carvalho
- Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional da Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, SP, Brazil; LIM 54 - Laboratório de Investigação em Fisioterapia, Hospital das Clínicas da Faculdade de Medicina da Universidade De São Paulo, Sao Paulo, SP, Brazil.
| | - Luana Daniele Kel de Souza
- Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional da Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, SP, Brazil; LIM 54 - Laboratório de Investigação em Fisioterapia, Hospital das Clínicas da Faculdade de Medicina da Universidade De São Paulo, Sao Paulo, SP, Brazil.
| | - Patricia Francao
- Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional da Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, SP, Brazil; LIM 54 - Laboratório de Investigação em Fisioterapia, Hospital das Clínicas da Faculdade de Medicina da Universidade De São Paulo, Sao Paulo, SP, Brazil.
| | - Cristiano Mendes Gomes
- Divisão de Urologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, SP, Brazil.
| | | | | | - Eliane Maria Garcez Oliveira da Fonseca
- Departamento de Pediatria, Núcleo de Disfunção Miccional, Faculdade de Ciências Médicas da Universidade Estadual do Rio de Janeiro, Rio de Janeiro, Brazil; Departamento de Pediatria da Escola de Medicina Souza Marques, Rio de Janeiro, Brazil.
| | - Marcos Giannetti Machado
- Divisão de Urologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, SP, Brazil.
| | - Clarice Tanaka
- Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional da Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, SP, Brazil; LIM 54 - Laboratório de Investigação em Fisioterapia, Hospital das Clínicas da Faculdade de Medicina da Universidade De São Paulo, Sao Paulo, SP, Brazil.
| |
Collapse
|
2
|
Dahan P, de Oliveira PMN, Brum AR, Ribeiro ACP, Figueiredo AA, de Bessa J, Murillo B. J. Treating asthma in patients with enuresis: repercussions on urinary symptoms. Int Braz J Urol 2023; 49:590-598. [PMID: 37450772 PMCID: PMC10482458 DOI: 10.1590/s1677-5538.ibju.2023.0101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 07/07/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND Children presenting enuresis are more likely to be asthmatics. The association between enuresis and sleep-disordered breathing has already been demonstrated and several studies have shown at least partial improvement of two thirds or more of the cases of enuresis adenoidectomy. Studies have already described associations between enuresis and allergies but do not assess the repercussions of allergy treatment in enuretics. OBJECTIVE This study aims to evaluated whether asthma treatment alters the course of enuresis and whether there is any predictive factor associated with this improvement. MATERIALS AND METHODS Twenty patients (5 - 12 years old) with uncontrolled enuresis and asthma, received treatment for asthma. Children were also assessed for the presence of rhinitis and other allergies. The control of asthma was confirmed by a validated questionnaire and primary enuresis by clinical history and wet night diaries. Patients received only asthma treatment. RESULTS At least partial improvement of enuresis was observed in 55% of the patients with an increase in 64.4% in the number of dry nights at the end of the study (p=0.01). The "presence of other allergies" and "obstruction seen in nasal endoscopy" positively influenced the improvement of urinary symptoms (OR = 3.350; CI 0.844-13.306) and (OR=1.272; CI 0.480-3.370), respectively. DISCUSSION Until now, only patients presenting upper airway obstruction were known to benefit from the improvement of urinary symptoms when undergoing treatment for their respiratory problems. In our study, we found at least partial improvement in enuresis in 55% of our patients, with only clinical asthma treatment. CONCLUSION Controlling asthma in children with primary enuresis resulted in a significant increase in dry nights.
Collapse
Affiliation(s)
- Patricia Dahan
- Faculdade de Medicina da Faculdade de Ciências Médicas e da Saúde de Juiz de ForaDepartamento de PediatriaJuiz de ForaMGBrasilDepartamento de Pediatria, Faculdade de Medicina da Faculdade de Ciências Médicas e da Saúde de Juiz de Fora (SUPREMA), Juiz de Fora, MG, Brasil
| | - Pricila Mara Novais de Oliveira
- Universidade Federal de Juiz de ForaHospital UniversitárioDepartamento de Fisioterapia PediátricaJuiz de ForaMGBrasilDepartamento de Fisioterapia Pediátrica do Hospital Universitário da Universidade Federal de Juiz de Fora (UFJF), Juiz de Fora, MG, Brasil
| | - Aparecida Regina Brum
- Hospital Evandro RibeiroJuiz de ForaMGBrasilServiço de Otorrinolaringologia do Hospital Evandro Ribeiro, Juiz de Fora, MG, Brasil
| | - André Costa Pinto Ribeiro
- Universidade Federal de Juiz de ForaDepartamento de Cirurgia do Hospital UniversitárioDepartamento de OtorrinolaringologiaJuiz de ForaMGBrasilDepartamento de Otorrinolaringologia, Departamento de Cirurgia do Hospital Universitário da Universidade Federal de Juiz de Fora (UFJF), Juiz de Fora, MG, Brasil
| | - André Avarese Figueiredo
- Universidade Federal de Juiz de ForaDepartamento de CirurgiaDivisão de UrologiaJuiz de ForaMGBrasilDepartamento de Cirurgia- Divisão de Urologia, Universidade Federal de Juiz de Fora (UFJF), Juiz de Fora, MG, Brasil
| | - José de Bessa
- Universidade Estadual de Feira de SantanaDepartamento de CirurgiaDivisão de UrologiaFeira de SantanaBahiaBrasilDepartamento de Cirurgia - Divisão de Urologia, Universidade Estadual de Feira de Santana, Feira de Santana, Bahia, Brasil
| | - José Murillo B.
- Faculdade de Ciências Médicas e da Saúde de Juiz de ForaDepartamento de CirurgiaJuiz de ForaMGBrasilDepartamento de Cirurgia, Faculdade de Ciências Médicas e da Saúde de Juiz de Fora (SUPREMA), Juiz de Fora, MG, Brasil
| |
Collapse
|
3
|
Pereira RPR, Leitão AQ, Fotakos GS, Neves Dos Reis J, Rocha FET, Machado MG, Bower WF, Tanaka C. Pediatric incontinence questionnaire (PINQ): translation and transcultural adaptation to Brazilian Portuguese. J Pediatr (Rio J) 2023; 99:379-384. [PMID: 36731540 PMCID: PMC10373139 DOI: 10.1016/j.jped.2023.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 01/04/2023] [Accepted: 01/09/2023] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVE Lower urinary tract symptoms (LUTS) affect approximately 10% of children worldwide and are related to psychosocial manifestations and compromised quality of life, both for children and their families. The assessment of emotional conditions of LUTS in children is recommended by International Children's Continence Society; however, there is no specific instrument in the Brazilian Portuguese language. Therefore, the aim of this study was to translate, culturally adapt and assess the internal consistency of the Brazilian Portuguese version of the Pediatric Incontinence Questionnaire (PINQ). MATERIAL AND METHODS This cross-sectional study was performed at two referral centers for childhood voiding dysfunction. The 20-item PINQ was translated into Brazilian Portuguese and culturally adapted according to Beaton, 2000. His-standard methodology consists of 6 phases: translation, synthesis, back-translation, expert committee, and pre-test. The internal consistency was assessed using Cronbach's alpha. RESULTS The PINQ-br version was developed, validated by a committee of experts, and pre-tested on 44 children diagnosed with lower urinary tract symptoms, 23 boys and 21 girls (mean age: 9.7 and 9.6 years old respectively), as well as on their parents. The internal consistency was considered satisfactory, reaching Cronbach's alpha coefficient of 0.74 when applied to children and 0.82 when applied to parents. CONCLUSIONS The PINQ was translated and culturally adapted to Brazilian Portuguese to assess the impact of LUTS on the health-related quality of life in Brazilian children and adolescents.
Collapse
Affiliation(s)
- Rita Pavione Rodrigues Pereira
- Faculdade de Medicina, Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Universidade de São Paulo, São Paulo, SP, Brazil; LIM 54 - Laboratório de Investigação em Fisioterapia, São Paulo, SP, Brazil.
| | - Angélica Quintino Leitão
- Faculdade de Medicina, Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Gabriella Silva Fotakos
- Faculdade de Medicina, Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Universidade de São Paulo, São Paulo, SP, Brazil; LIM 54 - Laboratório de Investigação em Fisioterapia, São Paulo, SP, Brazil
| | | | - Flávio Eduardo Trigo Rocha
- Faculdade de Medicina, Hospital das Clínicas, Unidade de Urologia Pediátrica da Divisão de Urologia, Universidade de São Paulo, São Paulo, SP, Brazil; Hospital Municipal Infantil Menino Jesus, São Paulo, SP, Brazil
| | - Marcos Giannetti Machado
- Faculdade de Medicina, Hospital das Clínicas, Unidade de Urologia Pediátrica da Divisão de Urologia, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Wendy F Bower
- Dentistry and Health Sciences, Royal Melbourne Hospital and Faculty of Medicine, University of Melbourne, Melbourne, Australia
| | - Clarice Tanaka
- Faculdade de Medicina, Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Universidade de São Paulo, São Paulo, SP, Brazil; LIM 54 - Laboratório de Investigação em Fisioterapia, São Paulo, SP, Brazil
| |
Collapse
|
4
|
Ziaei E, Dorreh F, Yousefichaijan P, Sarmadian R, Sajjadi N, Kahbazi M. Evaluation of the association between asthma and non-neurogenic urinary incontinence in children; a case-control study. BMC Pediatr 2023; 23:141. [PMID: 36997891 PMCID: PMC10061945 DOI: 10.1186/s12887-023-03958-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 03/20/2023] [Indexed: 04/01/2023] Open
Abstract
BACKGROUND Asthma is the most common chronic disease in children. Asthma can lead to sleep disorders and psychiatric issues, which are often accompanied by urinary incontinence in children. Furthermore, several studies have shown a relationship between allergic diseases and urinary incontinence. This study aims to examine the association between asthma and non-neurogenic urinary incontinence. MATERIALS AND METHODS This case-control study included 314 children over three years old referred to Amir Kabir Hospital; 157 with asthma and 157 without asthma. After explaining each urinary disorder in accordace with the International Children's Continence Society's definitions, parents and children were asked about their presence. The disorders included monosymptomatic nocturnal enuresis(MNE), nonmonosymptomatic nocturnal enuresis (NMNE), vaginal reflux (VR), pollakiuria, infrequent voiding, giggle incontinence (GI), and overactive bladder (OAB). The analysis was performed using Stata 16. RESULTS The average age of the children was 8.19 ± 3.15 years. Patients with asthma (p = 0.0001) and GI (p = 0.027) had a considerably lower average age than patients without these disorders. Asthma and urinary incontinence, including NMNE, Infrequent voiding, and OAB, were significantly correlated (p = 0.017, 0.013, and 0.0001, respectively). Moreover, the association between MNE and asthma was significant in males (p = 0.047). CONCLUSION Due to the relationship between asthma and urinary incontinence, children with asthma must be evaluated for the presence of urinary disorders and, if present, receive the proper treatment in order to improve their quality of life.
Collapse
Affiliation(s)
- Elaheh Ziaei
- Faculty of medicine, Arak University of Medical Sciences, Arak, Iran
| | - Fatemeh Dorreh
- Department of Pediatrics, Arak university of medical sciences, Arak, Iran
| | | | - Roham Sarmadian
- Infectious disease research center(IDRC), Arak university of medical sciences, Arak, Iran.
| | - Nooshin Sajjadi
- Department of Pediatrics, Arak university of medical sciences, Arak, Iran
| | - Manijeh Kahbazi
- Department of Pediatrics, Arak university of medical sciences, Arak, Iran
| |
Collapse
|
5
|
Reiter J, Ramagopal M, Gileles-Hillel A, Forno E. Sleep disorders in children with asthma. Pediatr Pulmonol 2022; 57:1851-1859. [PMID: 33647191 PMCID: PMC8408281 DOI: 10.1002/ppul.25264] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 01/03/2021] [Accepted: 01/07/2021] [Indexed: 11/07/2022]
Abstract
Asthma and sleep disorders are both common in childhood, and often co-exist in the same child. Moreover, studies have shown that in many children the rate of one is influenced by the other. Sleep disorders can be classified into six different groups-insomnia, hypersomnia, parasomnia, movement disorders, circadian disorders, and sleep-related breathing disorders. Children with asthma often present with complaints of insomnia with poor sleep quality, difficulty falling asleep and sleep disruptions. These complains are often associated with asthma control. They may also complain of daytime sleepiness and have higher rates of parasomnias, such as night terrors and nocturnal enuresis when compared with their healthy peers. Whether movement and circadian disorders are also more prevalent in children with asthma is less clear. Finally, there is a complex bidirectional interaction between sleep-related breathing disorders and asthma: poor sleep and sleep disorders may worsen asthma, and asthma, particularly when it is poorly controlled, may impair sleep. In the current review we examine the association of each of the sleep disorders with asthma and review the common pathophysiological pathways. We hope to convince the reader that appropriate management of asthma must include inquiries into the patient's sleep, and vice versa.
Collapse
Affiliation(s)
- Joel Reiter
- Pediatric Pulmonary and Sleep Unit, Department of Pediatrics, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Maya Ramagopal
- Division of Pulmonary Medicine and Cystic Fibrosis Center, Rutgers-Robert Wood Johnson Medical School, New Brunswick, New-Jersey, USA
| | - Alex Gileles-Hillel
- Pediatric Pulmonary and Sleep Unit, Department of Pediatrics, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Erick Forno
- Division of Pulmonary Medicine, Department of Pediatrics, Children’s Hospital of Pittsburgh and University of Pittsburgh, PA
| |
Collapse
|
6
|
Chen Y, Zhao A, Lyu J, Hu Y, Yin Y, Qu J, Tong S, Li S. Association of Parasomnia Symptoms with Risk of Childhood Asthma and the Role of Preterm Birth. Nat Sci Sleep 2022; 14:1559-1573. [PMID: 36089999 PMCID: PMC9451036 DOI: 10.2147/nss.s356182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 06/20/2022] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To examine whether parasomnia symptoms are associated with increased odds of childhood asthma and wheeze, and the role of preterm birth. PATIENTS AND METHODS The Shanghai Children's Allergy Study was cross-sectionally conducted in 31 kindergartens and 17 primary schools in Shanghai, China. After excluding the missing data of gestational week and child's age, this study included a total of 16,487 individuals with a mean age of 7.74 years and 52.4% of males. The association between parasomnia symptoms and wheeze/asthma was assessed by univariate and multivariate analyses. The interaction effects of parasomnias and preterm birth were primarily evaluated by P for multiplicative interaction, and the relative excess risk due to interaction (RERI), attributable proportion due to interaction (AP), and synergy index (SI) were also measured. RESULTS Parasomnias, especially rapid eye movement (REM) parasomnia symptoms, were associated with an increased risk of childhood wheeze/asthma, and the interaction between parasomnia and preterm birth exhibited an excess risk of current wheeze (RERI, 1.43; 95% CI, 0.41-2.45) and ever asthma (RERI, 0.75; 95% CI, 0.01-1.50). In the stratification analyses, the combination of parasomnia symptoms and preterm birth had higher odds of wheeze/asthma. And the odds of current wheeze (OR, 4.55; 95% CI, 1.69-12.25; p=0.003) and ever asthma (OR, 6.17; 95% CI, 2.36-16.11; p<0.001) were much higher in cumulative parasomnia symptoms plus very preterm birth. And sensitive analyses were further conducted in populations without sleep disordered breathing (SDB), and an allergen test subgroup, yielding similar results. CONCLUSION Parasomnia symptoms are associated with increased odds of childhood wheeze/asthma, and the odds were even higher in premature population. The findings suggest that parasomnia symptoms, as a developmental sleep disorder, are supposed to be closely watched among children who have asthma or are at risk for asthma, and that preterm children deserve more attention.
Collapse
Affiliation(s)
- Yiting Chen
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Anda Zhao
- Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Jiajun Lyu
- Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China
| | - Yabin Hu
- Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Yong Yin
- Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Jiajie Qu
- Childcare Department, Shanghai Municipal Education Commission, Shanghai, People's Republic of China
| | - Shilu Tong
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.,Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.,School of Public Health, Institute of Environment and Population Health, Anhui Medical University, Hefei, People's Republic of China.,School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - Shenghui Li
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.,MOE-Shanghai Key Laboratory of Children's Environmental Health, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| |
Collapse
|
7
|
Ferrara P, Di Ruscio F, Zona M, Ruggiero A. Innocent heart murmurs and enuresis: Examining a possible link. Turk J Urol 2019; 45:312-315. [PMID: 30817273 DOI: 10.5152/tud.2019.16363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 12/26/2018] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the prevalence of innocent heart murmurs in children affected by nocturnal enuresis (NE). RESULTS The prevalence of innocent heart murmurs in G2 was 6.34%. This condition was significantly more frequent in children who suffered from NE. Indeed, in G1, the prevalence of innocent heart murmurs was 21.45%, although there were few differences between the children with monosymptomatic NE and non-monosymptomatic NE; moreover, this prevalence was higher in males. MATERIAL AND METHODS We enrolled a total of 401 children (G1), 300 males and 101 females, aged 5-15 years, affected by NE and referred to the Service of Pediatrics, "Campus Bio-Medico" University Hospital of Rome, from September 2013 to September 2018, into the study. The control group was composed of 394 children without NE (G2). The study was carried out in compliance with the Helsinki Declaration. CONCLUSION These findings made us aware of the presence of possible underlying mechanisms, which explain the association between a higher prevalence of innocent heart murmurs and enuresis, and further studies are required to explore this issue.
Collapse
Affiliation(s)
- Pietro Ferrara
- Institute of Pediatrics, Catholic University Medical School, Rome, Italy
| | | | - Margherita Zona
- Service of Pediatrics, Campus Bio-Medico University, Rome, Italy
| | - Antonio Ruggiero
- Institute of Pediatrics, Catholic University Medical School, Rome, Italy
| |
Collapse
|
8
|
Association between allergic disease, sleep-disordered breathing, and childhood nocturnal enuresis: a population-based case-control study. Pediatr Nephrol 2017; 32:2293-2301. [PMID: 28735503 DOI: 10.1007/s00467-017-3750-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 06/16/2017] [Accepted: 06/26/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND Little is known about the associations between allergic disease, sleep-disordered breathing (SDB), and childhood nocturnal enuresis (NE). We examined whether allergic disease and SDB were associated with childhood NE. METHODS Data were assessed from the 2007-2012 Taiwan National Health Insurance Research Database. We enrolled 4308 children aged 5-18 years having NE diagnosis and age- and sex-matched 4308 children as the control group. The odds ratios of NE were calculated to determine an association with preexisting allergic disease and SDB. RESULTS A total of 8616 children were included in the analysis. Prevalence of allergic diseases and SDB was significantly higher for the NE group than the control group (all p < 0.001). After adjusting odds ratios for potential confounding factors, except asthma, children with allergic rhinitis, atopic dermatitis, allergic conjunctivitis, and obstructive sleep apnea (OSA) had significantly higher odds of NE compared with children never diagnosed. With stratification for sex, girls with allergic rhinitis, atopic dermatitis, allergic conjunctivitis, OSA, and snoring had significantly higher odds of NE, compared with girls never diagnosed. Only boys with allergic rhinitis and OSA were associated with increased odds of NE. With stratification for age, children aged 5-12 years with allergic rhinitis, atopic dermatitis, allergic conjunctivitis, and OSA had significantly higher odds of NE compared with those never diagnosed. Odds of NE increased with the number of comorbid allergic diseases. CONCLUSIONS Allergic diseases and SDB are associated with increased odds of childhood NE. The odds of NE increased with the number of comorbid allergic diseases present.
Collapse
|