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Evidence-based medicine V: how to use in clinical practice
In this penultimate installment in the educational series on evidence-based medicine, the Research Committee of the European Society of Pediatric Urology will focus on clinical application. In previous communications, optimizing medical decisions was focused on through the use of well-conducted research publications, and the topics of background, hierarchy of evidence, information acquisition, and critical appraisal tools were covered. The goal is to guide the clinician in using evidentiary tools for setting up a clinical question, finding appropriate information, searching appropriate databases, and evaluating the results...
Source: Journal of Pediatric Urology - August 8, 2019 Category: Urology & Nephrology Authors: Magdalena Fossum, Kathrine W. Herbst, Martin Kaefer, Luke Harper, Marco Castagnetti, Goedele Beckers, Nicolas Kalfa, Darius Bagli, the ESPU research committee Tags: Educational Article Source Type: research

Peritoneal Dialysis in Critically Ill Patients: Time for a Critical Reevaluation?
Clin J Am Soc Nephrol. 2023 Jan 13. doi: 10.2215/CJN.0000000000000059. Online ahead of print.ABSTRACTPeritoneal dialysis (PD) as an AKI treatment in adults was widely accepted in critical care settings well into the 1980s. The advent of extracorporeal continuous KRT led to widespread decline in the use of PD for AKI across high-income countries. The lack of familiarity and comfort with the use of PD in critical care settings has also led to lack of use even among those receiving maintenance PD. Many critical care units reflexively convert patients receiving maintenance PD to alternative dialysis therapies at admission. Ren...
Source: Clinical Journal of the American Society of Nephrology : CJASN - February 8, 2023 Category: Urology & Nephrology Authors: Muthana Al Sahlawi Daniela Ponce David M Charytan Brett Cullis Jeffrey Perl Source Type: research

Further medical experience will be required to validate these results: How experience -based medicine shapes the validity of medical evidence
This communication contextualizes the importance of clinical experience or experience-based medicine within the current paradigm of evidence-based medicine, complementing our previously published series of five short educational articles on evidence-based medicine.Previously we focused on optimizing medical decisions using publications of well-conducted research. Previous commentaries included a backgrounder, the hierarchy of evidence, data acquisition, tools for critical appraisal, and clinical use of evidence based medicine.
Source: Journal of Pediatric Urology - November 13, 2019 Category: Urology & Nephrology Authors: Darius Bagli, Katherine W. Herbst, Luke Harper, Goedele Beckers, Martin Kaefer, Nicolas Kalfa, Magdalena Fossum, ESPU research committee Tags: Educational Article Source Type: research

Ramping up Telemedicine in Pediatric Urology- Tips for Using a New Modality
The COVID pandemic has incited the rapid implementation of telehealth services. Through telemedicine, pediatric urologists can counsel children and their families about genitourinary tract conditions, while adhering to social distancing requirements and keeping families safe at home. With the accelerated use of telemedicine, it is crucial to maintain standards of providing high-quality and secure urologic care. Clinicians must practice effective virtual communication or ‘webside’ manner. While research may not be a priority, collecting data on telemedicine efforts will be critical in bringing about both payer-based and...
Source: Journal of Pediatric Urology - April 15, 2020 Category: Urology & Nephrology Authors: Julia B. Finkelstein, Caleb P. Nelson, Carlos R. Estrada Tags: How I do it Source Type: research

“Ramping up telemedicine in pediatric urology- Tips for using a new modality”
The COVID pandemic has incited the rapid implementation of telehealth services. Through telemedicine, pediatric urologists can counsel children and their families about genitourinary tract conditions, while adhering to social distancing requirements and keeping families safe at home. With the accelerated use of telemedicine, it is crucial to maintain standards of providing high-quality and secure urologic care. Clinicians must practice effective virtual communication or ‘webside’ manner. While research may not be a priority, collecting data on telemedicine efforts will be critical in bringing about both payer-based and...
Source: Journal of Pediatric Urology - April 15, 2020 Category: Urology & Nephrology Authors: Julia B. Finkelstein, Caleb P. Nelson, Carlos R. Estrada Tags: How I do it Source Type: research

Pediatric Onco-Nephrology: Time to Spread the Word-Part II: Long-Term Kidney Outcomes in Survivors of Childhood Malignancy and Malignancy after Kidney Transplant
AbstractOnco-nephrology is a recent and evolving medical subspecialty devoted to the care of patients with kidney disease and unique kidney-related complications in the context of cancer and its treatments, recognizing that management of kidney disease as well as the cancer itself will improve survival and quality of life. While this area has received much attention in the adult medicine sphere, similar emphasis in the pediatric realm has not yet been realized. As in adults, kidney involvement in children with cancer extends beyond the time of initial diagnosis and treatment. Many interventions, such as chemotherapy, stem ...
Source: Pediatric Nephrology - September 6, 2021 Category: Urology & Nephrology Source Type: research

Quality Improvement, Pediatric Urology, and You
Finally, we hope that reader can appreciate the value of both efforts in stabilizing complex health care systems, or at least specific aspects of such systems. One could imagine further QI work building off of these stabilized systems, leveraging standardization to improve onboarding of new operating room staff, for instance. As QI continues to permeate throughout pediatric urology, critical attention to rigorous QI methodology will be necessary to interpret, contextualize, and benefit from the experiences of our colleagues.
Source: Journal of Pediatric Urology - September 7, 2022 Category: Urology & Nephrology Authors: Jonathan S. Ellison, Martin A. Koyle Source Type: research

Pediatric urology fellowship training: Are we teaching what they need to learn?
Conclusion: It is reassuring that ACGME fellowship-trained pediatric urologists feel prepared in commonly performed procedures and perioperative care. Faculty supervision/feedback is highly valued.
Source: Journal of Pediatric Urology - April 26, 2012 Category: Urology & Nephrology Authors: Ming-Hsien Wang, Belinda Chen, David Kern, Susan Gearhart Tags: Research Articles Source Type: research

Dialysis in Children and Adolescents: The Pediatric Nephrology Perspective
Publication date: Available online 7 December 2016 Source:American Journal of Kidney Diseases Author(s): Deepa H. Chand, Sarah Swartz, Shamir Tuchman, Rudolph P. Valentini, Michael J.G. Somers The care of children with end-stage renal disease (ESRD) is highly specialized and often poorly understood by nonpediatric providers and facility/institution administrators. As such, this position paper has been created to offer provider, facility, and institutional guidance regarding the components of care necessary for children receiving dialysis. Key differences between adult and pediatric dialysis units are highlighted. Responsi...
Source: American Journal of Kidney Diseases - December 7, 2016 Category: Urology & Nephrology Source Type: research

A Cross-Sectional analysis of Paediatric Urologists ’ current practices, opinions and areas of perceived importance in the delivery of Adolescent & Transitional Care
Complex urological anomalies often require continued care as patients reach adulthood. Adequate transition for adolescents with ongoing urological care needs is critical to allow for seamless care in adult hospitals. Studies have shown that this can lead to improved patient and parental satisfaction, and lower utilisation of unplanned inpatient beds and emergency department visits. There is currently no ESPU-EAU consensus on the adequate mechanism and very few individual papers examining the role of urological transition for these patients in a European setting.
Source: Journal of Pediatric Urology - April 27, 2023 Category: Urology & Nephrology Authors: F. O ’Kelly, L.A. t’Hoen, B. Burgu, B. Banuelos Marco, R.J.M. Lammers, S. Sforza, M. Hiess, E. Bindi, N. Baydilli, M.I. Donmez, I. Paraboschi, A. Atwa, A.F. Spinoit, B. Haid, C. Radmayr, M.S. Silay, the EAU-YAU Paediatric Urology Group and the EAU-ESP Source Type: research

Fluid Management in Acute Kidney Injury.
Authors: Chuang CL Abstract The goal of fluid therapy in critical care medicine is to restore hemodynamic stability and vital organ perfusion while avoiding interstitial edema. Acute kidney injury (AKI) is a common complication in critically ill patients. Decisions regarding fluid management in critically ill patients with AKI are difficult, as these patients often have accompanying oliguria as well as body fluid overload. Both hypovolemia and volume overload are associated with increased morbidity and mortality in critical care patients; therefore, accurate assessment of the intravascular volume status as well as ...
Source: Contributions to Nephrology - February 18, 2016 Category: Urology & Nephrology Tags: Contrib Nephrol Source Type: research

Still ignoring human rights in intersex care
‘Surgery in disorders of sex development (DSD) with a gender issue: If (why), when, and how?’ reads like it was written 20 years ago. While the paper purports to address ‘unanswered questions’ regarding care for children born with atypical sex anatomies, most of these are the same questions that have prompted critical scrutiny of the standard of care since the mid 1990s. As the authors admit, there remains little ‘evidence of the answers’ that specialists provide to what they take to be an urgent problem presented by atypical sex anatomies in children [1].
Source: Journal of Pediatric Urology - June 2, 2016 Category: Urology & Nephrology Authors: Ellen K. Feder, Alice Dreger Source Type: research

The development and current status of Intensive Care Unit management of prospective organ donors
Conclusions: Management of deceased organ donors should focus first on maintaining adequate perfusion to all organ systems through adherence to standard critical care guidelines, early referral to OPOs, and family support. Furthermore, several specific DMGs and strategies have been recently shown to improve both the rates and outcomes of organ transplantation.
Source: Indian Journal of Urology - June 30, 2016 Category: Urology & Nephrology Authors: Margaret Kathleen Menzel EllisMitchell Brett SallyDarren Malinoski Source Type: research

Still ignoring human rights in intersex care
‘Surgery in disorders of sex development (DSD) with a gender issue: If (why), when, and how?’ reads like it was written 20 years ago. While the paper purports to address ‘unanswered questions’ regarding care for children born with atypical sex anatomies, most of these are the same questions that have prompted critical scrutiny of the standard of care since the mid 1990s. As the authors admit, there remains little ‘evidence of the answers’ that specialists provide to what they take to be an urgent problem presented by atypical sex anatomies in children [1].
Source: Journal of Pediatric Urology - June 2, 2016 Category: Urology & Nephrology Authors: Ellen K. Feder, Alice Dreger Source Type: research

Trends in pediatric urologic consultations in a tertiary care hospital setting
There is growing interest in the general activities of a pediatric urologist, whose specialty remains young in the spectrum of modern, organized medicine. Unplanned activities, which are more commonly referred to as consultations, can represent significant additional workload for the urologist seeing scheduled clinic patients or completing elective operative cases.
Source: Journal of Pediatric Urology - August 8, 2017 Category: Urology & Nephrology Authors: K.O. Rove, J.C. Warncke, V.M. Vemulakonda Source Type: research

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