@article {10492, title = {ISL1 is a major susceptibility gene for classic bladder exstrophy and a regulator of urinary tract development.}, journal = {Sci Rep}, volume = {7}, year = {2017}, month = {2017 02 08}, pages = {42170}, abstract = {

Previously genome-wide association methods in patients with classic bladder exstrophy (CBE) found association with ISL1, a master control gene expressed in pericloacal mesenchyme. This study sought to further explore the genetics in a larger set of patients following-up on the most promising genomic regions previously reported. Genotypes of 12 markers obtained from 268 CBE patients of Australian, British, German Italian, Spanish and Swedish origin and 1,354 ethnically matched controls and from 92 CBE case-parent trios from North America were analysed. Only marker rs6874700 at the ISL1 locus showed association (p = 2.22 {\texttimes} 10). A meta-analysis of rs6874700 of our previous and present study showed a p value of 9.2 {\texttimes} 10. Developmental biology models were used to clarify the location of ISL1 activity in the forming urinary tract. Genetic lineage analysis of Isl1-expressing cells by the lineage tracer mouse model showed Isl1-expressing cells in the urinary tract of mouse embryos at E10.5 and distributed in the bladder at E15.5. Expression of isl1 in zebrafish larvae staged 48 hpf was detected in a small region of the developing pronephros. Our study supports ISL1 as a major susceptibility gene for CBE and as a regulator of urinary tract development.

}, keywords = {Animals, Bladder Exstrophy, Embryo, Mammalian, Female, Gene Expression Regulation, Developmental, Genetic Predisposition to Disease, Humans, Larva, LIM-Homeodomain Proteins, Mesoderm, Mice, Organogenesis, Polymorphism, Single Nucleotide, Pronephros, Protein Isoforms, Transcription Factors, Urinary Tract, Zebrafish}, issn = {2045-2322}, doi = {10.1038/srep42170}, author = {Zhang, Rong and Knapp, Michael and Suzuki, Kentaro and Kajioka, Daiki and Schmidt, Johanna M and Winkler, Jonas and Yilmaz, {\"O}znur and Pleschka, Michael and Cao, Jia and Kockum, Christina Clementson and Barker, Gillian and Holmdahl, Gundela and Beaman, Glenda and Keene, David and Woolf, Adrian S and Cervellione, Raimondo M and Cheng, Wei and Wilkins, Simon and Gearhart, John P and Sirchia, Fabio and Di Grazia, Massimo and Ebert, Anne-Karolin and R{\"o}sch, Wolfgang and Ellinger, J{\"o}rg and Jenetzky, Ekkehart and Zwink, Nadine and Feitz, Wout F and Marcelis, Carlo and Schumacher, Johannes and Martin{\'o}n-Torres, Federico and Hibberd, Martin Lloyd and Khor, Chiea Chuen and Heilmann-Heimbach, Stefanie and Barth, Sandra and Boyadjiev, Simeon A and Brusco, Alfredo and Ludwig, Michael and Newman, William and Nordenskj{\"o}ld, Agneta and Yamada, Gen and Odermatt, Benjamin and Reutter, Heiko} } @article {10472, title = {Qualitative questionnaire on the psychosocial wellbeing of mothers of~children with BEEC.}, journal = {J Pediatr Urol}, volume = {13}, year = {2017}, month = {2017 Feb}, pages = {55.e1-55.e6}, abstract = {

INTRODUCTION: The bladder exstrophy-epispadias complex (BEEC) represents a spectrum of malformations that affect the anatomical and functional structure of the urogenital system. The parents of patients affected by this condition are subject to particularly stressful situations, such as worrying about their child{\textquoteright}s health, long hospital stays, concerns about the health and constant need for personal care for their children, that can profoundly compromise the quality of family life.

OBJECTIVE: The objective of this explorative qualitative study is to evaluate the social situation and the psychological strategies implemented by the mothers of children between 6 and 10 years of age who are affected by BEEC.

STUDY DESIGN: Fourteen mothers of children aged 6-10 years and affected by BEEC (9 boys and 5 girls) were interviewed. Data on the mothers{\textquoteright} experiences were collected through semi-structured interviews (Table).

RESULTS: The qualitative analysis of the interviews showed that participants described experiences that were characterised by emotions such as fear and anger. Each mother had implemented a different and, sometimes, dysfunctional strategy in order to cope with the complex situation of the son/daughter. The aspects that most clearly emerged from mothers{\textquoteright} descriptions were (1) the traumatic situation at the birth of the baby, (2) the sense of embarrassment concerning the pathological condition as the child was growing and the consequent sense of isolation of the mother, and (3) the fluctuation of feelings towards the multidisciplinary staff, which was sometimes seen as an important source of help and some other times as too destabilising and not helpful at all.

DISCUSSION: The study provided some insight into the psychological and social conditions experienced by mothers of children with BEEC, which could serve as a basis for developing multidisciplinary teams with greater awareness about families living with this condition and better timing in addressing their needs.

CONCLUSIONS: Mothers of children with BEEC show emotional and social difficulties. This is a crucial aspect to consider when planning a multidisciplinary approach to the treatment/therapy, especially considering that children examined in this study are approaching adolescence.

}, keywords = {Adaptation, Psychological, Adolescent, Bladder Exstrophy, Child, Epispadias, Female, Humans, Long-Term Care, Male, Mother-Child Relations, Mothers, Qualitative Research, Quality of Life, Stress, Psychological, Surveys and Questionnaires, Treatment Outcome}, issn = {1873-4898}, doi = {10.1016/j.jpurol.2016.07.015}, author = {Di Grazia, Massimo and Pellizzoni, Sandra and Tonegatti, Luca Giacomo and Rigamonti, Waifro} } @article {10580, title = {Surgery for distal hypospadias: what about the catheter?}, journal = {Pediatr Med Chir}, volume = {39}, year = {2017}, month = {2017 Sep 28}, pages = {145}, abstract = {

No agreed recommendations exist for timing of urethral stent removal, after distal hypospadias surgery. We compared our preliminary case series with outcomes from literature: 18/44 patients were treated with catheter and 26/44 without it. The surgical outcome was comparable in the two groups. After hypospadias surgery, the main advantage of the immediate postoperative catheter removal was the shorter hospital stay without negatively affecting the care and home management.

}, keywords = {Child, Child, Preschool, Device Removal, Humans, Hypospadias, Infant, Length of Stay, Male, Retrospective Studies, Stents, Treatment Outcome, Urinary Catheterization}, issn = {2420-7748}, doi = {10.4081/pmc.2017.145}, author = {Scarpa, Maria-Grazia and Perin, Giordano and Di Grazia, Massimo and Codrich, Daniela and Pederiva, Federica and Guida, Edoardo and Lembo, Maria Antonietta and Giannotta, Antonio and Schleef, Jurgen} } @article {8352, title = {CNV analysis in 169 patients with bladder exstrophy-epispadias complex.}, journal = {BMC Med Genet}, volume = {17}, year = {2016}, month = {2016}, pages = {35}, abstract = {

BACKGROUND: The bladder exstrophy-epispadias complex (BEEC) represents the severe end of the congenital uro-rectal malformation spectrum. Initial studies have implicated rare copy number variations (CNVs), including recurrent duplications of chromosomal region 22q11.21, in BEEC etiology.

METHODS: To detect further CNVs, array analysis was performed in 169 BEEC patients. Prior to inclusion, 22q11.21 duplications were excluded using multiplex ligation-dependent probe amplification.

RESULTS: Following the application of stringent filter criteria, seven rare CNVs were identified: n = 4, not present in 1307 in-house controls; n = 3, frequency of <0.002 in controls. These CNVs ranged from 1 to 6.08~Mb in size. To identify smaller CNVs, relaxed filter criteria used in the detection of previously reported BEEC associated chromosomal regions were applied. This resulted in the identification of six additional rare CNVs: n = 4, not present in 1307 in-house controls; n = 2, frequency <0.0008 in controls. These CNVs ranged from 0.03-0.08~Mb in size. For 10 of these 13 CNVs, confirmation and segregation analyses were performed (5 of maternal origin; 5 of paternal origin). Interestingly, one female with classic bladder extrophy carried a 1.18~Mb duplication of 22q11.1, a chromosomal region that is associated with cat eye syndrome.

CONCLUSIONS: A number of rare CNVs were identified in BEEC patients, and these represent candidates for further evaluation. Rare inherited CNVs may constitute modifiers of, or contributors to, multifactorial BEEC phenotypes.

}, issn = {1471-2350}, doi = {10.1186/s12881-016-0299-x}, author = {von Lowtzow, Catharina and Hofmann, Andrea and Zhang, Rong and Marsch, Florian and Ebert, Anne-Karoline and R{\"o}sch, Wolfgang and Stein, Raimund and Boemers, Thomas M and Hirsch, Karin and Marcelis, Carlo and Feitz, Wouter F J and Brusco, Alfredo and Migone, Nicola and Di Grazia, Massimo and Moebus, Susanne and N{\"o}then, Markus M and Reutter, Heiko and Ludwig, Michael and Draaken, Markus} } @article {8498, title = {When a lymphatic malformation determines a bowel volvulus: Are clinical status and images always reliable?}, journal = {Int J Surg Case Rep}, volume = {25}, year = {2016}, month = {2016}, pages = {192-5}, abstract = {

INTRODUCTION: An acute abdomen in the form of small-bowel volvulus could be a presentation of a lymphatic malformation in childhood.

CASE PRESENTATION: A 5year old male was admitted to our Institute for an acute abdomen. Clinical aspects and radiological images were not specific for a certain diagnosis. Laparotomy revealed a big soft mass, with a milky content, completely involving about 50cm of ileus with a partial volvulus of the intestinal loop. A complete mass excision and also a bowel involved resection were performed. After a histological examination, a lymphatic malformation was diagnosed.

DISCUSSION: The diagnosis of a mesenteric lymphatic malformation could be intraoperative and a complete resection should be the treatment of choice. Sometimes it could be necessary to perform an involved bowel tract resection in the case of volvolus with ischemia.

CONCLUSIONS: Paediatricians and surgeons should bare in mind that an intrabdominal lymphatic malformation may present as a nonspecific an acute abdomen caused by a bowel volvolus and diagnosis may not be so simple preoperatively.

}, issn = {2210-2612}, doi = {10.1016/j.ijscr.2016.06.030}, author = {Guida, Edoardo and Di Grazia, Massimo and Cattaruzzi, Elisabetta and Bussani, Rossana and Rigamonti, Waifro and Lembo, Maria Antonietta} }