Suppose that the recurrence in pediatric urolithiasis has a close relationship with metabolic abnormalities and is affected by residual burden and prophylaxis. If so, the recurrence rates could be reduced with effective surgery and appropriate prophylaxis. Here we retrospectively evaluate the metabolic risk factors data of 148 children who were operated on between January 2005 and March 2013 due to kidney stones. All patients underwent percutaneous nephrolithotomy (PCNL), and all were children. Thirteen children had a history of surgery performed to treat urological anomalies. Twenty-four-hour urine analysis, the residual status of surgery, BMI levels, and the number of metabolic abnormalities were noted. Only 18 (15%) of 122 patients without residual stones after PCNL had recurrence at follow-up whereas; nine (26%) of 26 patients with residual stones developed recurrence (p = 0.017). Recurrence was observed in 14 (16%) of 89 patients with a metabolic abnormality, and 13 (30%) of 44 patients with two or more metabolic abnormalities had recurrence at follow-up (p = 0.024). Those patients with no metabolic abnormalities did not develop recurrence. Stone recurrence was seen in six (8%) of 78 children who were given metabolic prophylaxis, compared to 21 (30%) of 70 patients who did not receive metabolic prophylaxis (p = 0.02). No stone recurrence was seen in nine children who were given Shohl’s, whereas four (67%) of six patients who did not take Shohl’s had recurrence (p = 0.022). Complete removal of stones by a suitable surgical method is essential to avoid recurrences. Detailed clinical and laboratory evaluations should be performed in children with urolithiasis. Appropriate specific prophylactic treatment (e.g., potassium citrate and Shohl’s) and non-specific prophylactic treatment (e.g., avoiding animal proteins, salt, simple sugars, and increased water intake) should be given to prevent reformation of stones in patients with pediatric urolithiasis.

One-third of adult patients presenting for the repair of persistent penile defects after failing multiple hypospadias repair attempts during childhood will complain of erectile dysfunction (ED). The goal of this paper is to identify possible etiological causes of its onset.

Five selection criteria were used for entrance into the study 1) Patients had to have failed≥three prior hypospadias repair attempts. 2) Present for evaluation between 18 and 40 years of age. 3) No known congenital or medical anomaly could be present that could have predisposed to erectile dysfunction. 4) Sexual history inventory for men (SHIM-5 score) completed. 5) All patients with moderate to severe ED (SHIM scores≤16) underwent psychological screening; individuals with good quality spontaneous or self-stimulated erections, experiencing major life events, or had documented psychological problems were excluded from the study. One hundred consecutive patients meeting these criteria were assessed. We evaluated multiple factors to discet of a ventral corporal graft, 24% (8/33) vs 1.5% (1/67), p=0.0003 or had undergone repetitive DVIU’s to manage urethral stricture disease, median number 4 (range 0-15) vs 0 (range 0-6), p<0.0001, see table.

The early onset of ED in patients that failed multiple attempts at hypospadias repair in childhood is associated with advancing age, division of the urethral plate, and prior ventral corporal grafting. Especially significant is the association of ED to the use of repetitive internal urethrotomy to manage urethral stricture disease.

The early onset of ED in patients that failed multiple attempts at hypospadias repair in childhood is associated with advancing age, division of the urethral plate, and prior ventral corporal grafting. Especially significant is the association of ED to the use of repetitive internal urethrotomy to manage urethral stricture disease.

Patients with neurogenic bladder (NGB) and urinary incontinence (UI) due to low bladder outlet resistance may require bladder neck procedures (BNPs) to achieve continence. These patients may also have reduced bladder capacity and or elevated detrusor storage pressures that require augmentation cystoplasty (AC). AC is not without complications that include risks for bladder rupture, urolithiasis, urinary tract infections and metabolic issues. Avoidance of AC would be helpful in patients with neurogenic urinary incontinence that have safe bladder parameters in the setting of low bladder outlet resistance.

To determine if pre-operative urodynamics could select children with NGBs and UI for isolated BNPs without AC. Additionally we sought to determine the safety of BNPs without AC and future need of AC with long-term follow-up.

This is an IRB-approved retrospective analysis of all patients undergoing BNPs for management of neurogenic UI over a 17-year period. We separated these BNP patients into two groups enerally in the first 2 years. Since there are no apparent reliable pre-operative variables predicting the need for subsequent AC, parents should be counseled regarding vigilant post-operative follow-up.

BNP without AC is safe in only a few selected patients with NGB. Despite preoperative selection, there are significant changes in bladder dynamics and 40% required subsequent augmentation. Bladder deterioration occurs early and generally in the first 2 years. Since there are no apparent reliable pre-operative variables predicting the need for subsequent AC, parents should be counseled regarding vigilant post-operative follow-up.This article has been withdrawn at the request of the author(s) and/or editor. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at https//www.elsevier.com/about/our-business/policies/article-withdrawal.We call on geriatric brain health care providers, executives and entrepreneurs to embrace our Brain Health Living Lab model-a user-centered, iterative ecosystem, integrating concurrent clinical care, research and innovation processes.

The aim of this pilot study was to evaluate the effect of the timing of postoperative orthodontic force application on bone remodeling during tooth movement into surgical alveolar defects with bone grafts in beagle dogs.

Six beagle dogs underwent surgery for buccal dehiscence-type defects (width, 5mm; height, 6mm) on the distal root of maxillary second premolars bilaterally for 12 defects. After 1-month healing, bone-augmentation procedures were undertaken at the dehiscence defects. The second premolars were protracted buccally for 6weeks into the surgical sites immediately (F-0), at 4weeks (F-4), or 8weeks (F-8) after grafting. Orthodontic tooth movement was monitored using digital models. Remodeling of alveolar bone was evaluated by histology, histomorphometry, immunohistochemistry, microcomputed tomography, and fluorescence microscopy.

Group F-0 showed significant expansion (mean, 2.42mm) and tipping (mean, 9.03°) after completing orthodontic tooth treatment. The vertical bone defect was significantlnd, eventually, promoted bone remodeling in the bone-grafted area.

This research aimed to analyze the prevalence of root dilaceration in buccally impacted canines (BICs) and palatally impacted canines (PICs) with their adjacent teeth based on a retrospective cone-beam computed tomography (CBCT) investigation.

Pretreatment CBCT images of 145 subjects with unilateral maxillary canine impaction and 145 age- and sex-matched subjects without impaction were used. Prevalence of dilaceration (subclassified to root curvature and apical hook based on severity) in canines and adjacent teeth was determined in CBCT records. The root length of maxillary impacted canines was measured for further morphologic evaluations.

Impacted canines had a significantly higher prevalence of root dilaceration than the control group and compared with the erupted contralateral canines in the experimental group (P<0.001 for both). A significantly higher prevalence of root dilaceration was found in adjacent lateral incisors of the PICs subgroup than that of the control group (P<0.001). Adjacent premolars had a higher prevalence of dilacerated roots in the PICs subgroup (P<0.001) than the control group, but not for the BICs subgroup. Significantly higher prevalence of curvature (P<0.001 for both) and hook (P=0.008 and P<0.001, respectively) were found in BICs and PICs roots compared with the control group. Both types of impacted canines had significantly shorter roots than the control group (P<0.001 for both).

BICs and PICs have a higher tendency to present root dilaceration and shorter roots. Unlike BICs, adjacent teethto PICs were more frequently observed to have root dilaceration.

BICs and PICs have a higher tendency to present root dilaceration and shorter roots. Unlike BICs, adjacent teeth to PICs were more frequently observed to have root dilaceration.

This study aimed to evaluate market trends on the demographics most likely to select direct to consumer orthodontics and the reasoning behind their decisions.

An internet-based cross-sectional survey was conducted. Data analysis was carried out using logistic regression models.

Total of 1573 surveys were completed. While 32.2% of those surveyed selected direct to consumer orthodontics over conventional orthodontics, 10.8% would select direct to consumer orthodontics for their children. Among parents who would seek direct to consumer orthodontics, only 27.8% would consider the same treatment for their children. The odds of seeking direct to consumer orthodontic treatment for divorced participants was 2.52 times higher than that for single participants, for participants with 4 children or more was 2 times higher than that for participant with no children, and in age group 46-59years was 2.23 times higher than that for age group 18-26years. Seventy three percent of consumers who selected direct to consumer orthodontics selected cost as an influencing factor. Convenience was also a major determining factor at 69.6%.

Cost, convenience, and perceived simplicity all appear to factor into a consumer’s consideration of direct to consumer orthodontics. As annual household income, age, and education increases consumers are more likely to consider direct to consumer orthodontic treatment.

Cost, convenience, and perceived simplicity all appear to factor into a consumer’s consideration of direct to consumer orthodontics. As annual household income, age, and education increases consumers are more likely to consider direct to consumer orthodontic treatment.

Health literacy affects how patients behave within the healthcare system. Overutilization of screening procedures inconsistent with the U.S. Preventive Services Task Force guidelines contributes to the high cost of health care. The authors hypothesize that higher health literacy supports guideline-concordant screening. This study assesses the effect of health literacy on nonrecommended prostate, breast, and cervical cancer screening in patients older than the recommended screening age limit.

The 2016 Behavioral Risk Factor Surveillance System included health literacy modules. Respondents self-reported their ability to obtain and understand health information, resulting in 4 health literacy rankings. The authors calculated the population-weighted proportion of respondents in each health literacy category who underwent screening past the Task Force‒recommended age limit. The ORs of nonrecommended screening for each malignancy were calculated, with low health literacy as the ref category.

Individuals with higher health literacy underwent more nonrecommended screening.