Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Bedwetting (nocturnal enuresis) is common. It occurs in up to 20% of 5 year olds and 10% of 10 year olds, with a spontaneous remission rate of 14% per year. Weekly daytime wetting occurs in 5% of children, most of whom (80%) also wet the bed. Bedwetting can have a considerable impact on children and families, affecting a child's self-esteem and interpersonal relationships, and his or her performance at school. Primary nocturnal enuresis (never consistently dry at night) should be distinguished from secondary nocturnal enuresis (previously dry for at least 6 months). Important risk factors for primary nocturnal enuresis include family history, nocturnal polyuria, impaired sleep arousal and bladder dysfunction. Secondary nocturnal enuresis is more likely to be caused by factors such as urinary tract infections, diabetes mellitus and emotional stress. The treatment for monosymptomatic nocturnal enuresis (bedwetting with no daytime symptoms) is an alarm device, with desmopressin as second-line therapy. Treatment for non-monosymptomatic nocturnal enuresis (bedwetting with daytime symptoms--urgency and frequency, with or without incontinence) should initially focus on the daytime symptoms.Bedwetting without daytime symptoms, the most common toileting problem, can be effectively treated with an alarm device.
 ...
PMID:4. Bedwetting and toileting problems in children. 1593 94

The prevalence of erectile dysfunction (ED) increases with age. ED has organic aetiologies and is associated with other clinical comorbidities. Men with ED are more likely to have: cardiac disease, diabetes, hypercholesterolaemia, angina, hypertension, prostate disease and depression. Similarly, men with these conditions are more likely to have ED. It is believed that vasculogenic ED shares a common aetiology with coronary artery disease, including hyperlipidaemia, diabetes and hypertension. Taking a careful history of onset, duration and associated symptoms may reveal possible causes of ED. Past medical history, disease control, trauma and medication use can provide vital information. ED patients with a sedentary lifestyle should be encouraged to exercise. In obese men, weight loss of 10% or more can improve IIEF score. Regular exercise, healthy diet, smoking cessation, limiting alcohol intake and avoiding recreational drugs can reduce the risk of, or improve, ED. It is important to differentiate between patients suffering from nocturnal frequency, enuresis or nocturnal polyuria as the causes and treatments for each of these conditions are different. Reducing fluid intake after 6 pm and avoiding alcohol and/or caffeine at night may reduce nocturnal voiding. Anticholinergics can decrease bladder overactivity. An improvement in nocturia and nocturia bother score have been shown after administration of oral melatonin. Nocturnal enuresis can often be the only symptom of high-pressure chronic retention which is prevalent in older men. It is important to recognise this condition as treatment can prevent further renal impairment. In nocturnal polyuria the urine output at night is more than a third of the total daily urine output. If conservative measures are not successful, in the absence of heart failure, a low-dose diuretic in the afternoon can help the kidneys get rid of the fluid before bedtime.
 ...
PMID:Diagnosing urological disorders in ageing men. 2030 27

Nocturnal enuresis is defined as involuntary wetting while asleep at least twice a week in children over the age of five. Primary nocturnal enuresis describes those children who have always been wet. Secondary nocturnal enuresis is defined as a relapse after a child has been completely dry for at least six months. Up to the age of nine years, nocturnal enuresis is twice as common in boys than girls but thereafter there is no sex difference in prevalence. At the age of five, 2% of children wet every night, and 1% are still wetting every night in their late teens. Bedwetting is not primarily caused by an underlying psychological disorder However, psychological problems and life events can exacerbate or precipitate bedwetting in susceptible children who have a genetic basis for their condition. The three systems approach to the management of the condition addresses: poor arousal from sleep, nocturnal polyuria and bladder dysfunction. Bedwetting is occasionally caused by underlying medical conditions; primarily urological, neurological, or metabolic. It can also be associated with obstructive sleep apnoea. However, these causes are uncommon in primary enuresis. A basic history and examination should exclude these conditions. If the bedwetting has started in the past few days or weeks, systemic illness should be considered e.g. UTI, diabetes mellitus. With secondary enuresis, symptoms or signs of medical and psychological conditions or life events may be elicited as possible causes, and may need separate treatment. Alarm treatment should be considered in any child over seven. The alarm takes several weeks to be effective and needs commitment from both child and carers. Desmopressin may be used as first-line treatment if rapid onset and/or short-term improvement is the priority of treatment or an alarm is inappropriate or undesirable.
 ...
PMID:Treating nocturnal enuresis in children in primary care. 2177 14

Enuresis is defined as intermittent urinary incontinence during sleep in a child at least five years of age. Approximately 5% to 10% of all seven-year-olds have enuresis, and an estimated 5 to 7 million children in the United States have enuresis. The pathophysiology of primary nocturnal enuresis involves the inability to awaken from sleep in response to a full bladder, coupled with excessive nighttime urine production or a decreased functional capacity of the bladder. Initial evaluation should include a history, physical examination, and urinalysis. Several conditions, such as constipation, obstructive sleep apnea, diabetes mellitus, diabetes insipidus, chronic kidney disease, and psychiatric disorders, are associated with enuresis. If identified, these conditions should be evaluated and treated. Treatment of primary monosymptomatic enuresis (i.e., the only symptom is nocturnal bed-wetting in a child who has never been dry) begins with counseling the child and parents on effective behavioral modifications. First-line treatments for enuresis include bed alarm therapy and desmopressin. The choice of therapy is based on the child's age and nighttime voiding patterns, and the desires of the child and family. Referral to a pediatric urologist is indicated for children with primary enuresis refractory to standard and combination therapies, and for children with some secondary causes of enuresis, including urinary tract malformations, recurrent urinary tract infections, or neurologic disorders.
...
PMID:Enuresis in children: a case based approach. 2536 44