A Possible Pathogenic Linkage Among Headache, Migraine, and Nocturnal Enuresis in Children

Innocent heart murmurs and enuresis: Examining a possible link

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.

Medical Comorbidity of Nocturnal Enuresis in Children

Introduction:

The purpose of this study was to evaluate the characteristics of patients with nocturnal enuresis (NE).

Methods:

We enrolled 403 children with NE referred to the Services of Pediatrics, Campus Bio-Medico University Hospital of Rome between June 2013 and July 2018. We excluded 2 children, respectively, with renal agenesis and chromosomopathy.

Results:

Of the 401 patients, 101 girls (25.2%) and 300 boys (74.8%), aged 5–16 years; mean age at first visit 8.8 ± 2.44 years. During the physical examination, we asked the patients and their parents specific questions to identify signs and symptoms of voiding disorders and comorbid conditions. In addition, we evaluated family history and behavioral characteristics of patients. In this study, NE was heredity in the 31.2% of cases. We found urogenital abnormalities in 15.7% of cases, constipation in 14.5% of cases, innocence heart murmur in 21.4% of cases and parasomnias in a good percentage of cases, especially snoring (13.7%), restless sleep (5.7%), somniloquy (23.7%) and bruxism (14.7%).

Conclusions:

Our experience demonstrates that there are a lot of comorbidities that are associated with NE and can influence the prognosis and the response to the therapy in these children.

Oral Desmopressin Lyophilisate Formulation (MELT): Efficacy and Safety in Children and Adults

Nocturnal enuresis (NE) is a common disorder in childhood and desmopressin is one of the most widely and well-tolerated medications for NE. The recent oral lyophilisate formulation of desmopressin (MELT) is effective in the treatment of NE in children and nocturia in adults. A MEDLINE literature search MEDLINE (2000-July 2017) was performed using the search terms MELT enuresis, MELT desmopressin, sublingual desmopressin, lyophilisate desmopressin. Twenty articles were analyzed with a number of patients of 3448. In 12 articles were reported 1275 pediatric patients (<18 years old), and in 8 articles 2213 adult patients. In pediatric population the indication was enuresis in 1269 patients and central diabetes insipidus in 6 patients. In adult population the indication was nocturia in 1941 patients, renal colic in 259 patients, healthy volunteers 13 patients. In 17 studies desmopressin was administered alone while in 3 studies in association respectively with Tolterodina, Ketorolac and Tamsulosin. In 7 studies were reported side effects in only 81 patients, 60 in pediatric population and 21 in adult population. The reported side effects in pediatric population were nausea, lethargy, lower limb weakness, headache, diarrhea, viral gastroenteritis. The reported side effects in adult population were asymptomatic hyponatriemia, nausea, diarrhea, dizziness, symptomatic hyponatriemia. Our review confirm that the MELT formulation of desmopressin guarantee the same response of other formulations with a lower doses and a lowest number of side effects. We believe according with the literature that this formulation is actually the first line and safety treatment for nocturnal enuresis and nocturia.