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Objectives: To analyze the utility of assessing degree of constipation by abdominal radiograph (KUB) in relation to symptoms and urodynamic data in children with dysfunctional elimination. Methods: A retrospective review of children with concomitant constipation and daytime incontinence was performed. Inclusion required at least two consecutive visits with KUB and noninvasive uroflowmetry. Patients were excluded for anticholinergic medication use or neurogenic or anatomic abnormalities. Rectal fecal quantification and presence of stool throughout the colon was assessed on KUB and categorized as "empty," "normal amount of stool," or "fecal distention of rectum (FDR)." Results: Twenty-six patients met inclusion requirements (6 boys, 20 girls; average age, 7.7 +/- 2.2 years). The average time between the initial and subsequent visit was 12.5 +/- 7.8 weeks. Initial KUB revealed FDR in 17. No statistical significance was found between FDR on initial or final KUB and outcome of wetting symptoms, nor could a relationship between FDR uroflow parameters at either visit be demonstrated. Conclusions: No correlation between any uroflowmetry parameter and the presence of FDR at the initial or final visits could be demonstrated. Similarly, no statistical significance between FDR on final or initial KUB and outcome of wetting symptoms was established. [ABSTRACT FROM AUTHOR]

Objectives: To analyze the relationship between potential prognostic factors and early success after treatment of childhood daytime urinary incontinence without anticholinergic medication. Methods: A total of 63 patients with daytime urinary incontinence met the inclusion criteria for a retrospective review of the effect of a timed voiding regimen. The severity, duration, and frequency of wetting, along with age, sex, and uroflow parameters, were recorded. Statistical analysis was used to determine the factors predictive of improvement in wetting without anticholinergic treatment. Results: Of 315 children evaluated with daytime incontinence, only 24% were treated with nonanticholinergic methods. At the first follow-up visit, 6.3% of patients treated without anticholinergics became dry, 38.1% showed significant improvement, 36.5% were slightly improved, and 19.0% were unchanged. Age, sex, duration or severity of wetting, constipation, bladder capacity, and uroflow pattern and parameters were not predictive of early improvement with timed voiding. Patients with good compliance with timed voiding were significantly more likely to improve than those with poor compliance (P = 0.014). Conclusions: The results of our study have indicated that anticholinergic therapy appears to be overused as a first-line treatment for children with daytime urinary incontinence in our clinic population. The lack of reliable predictive factors regarding the response to nonanticholinergic treatment suggests a trial of timed voiding should be used as an initial treatment for all children with daytime urinary incontinence. Almost 45% of our patients had significant improvement in the frequency of wetting within 4 months without anticholinergics. [Copyright &y& Elsevier]

Late Devonian mass extinctions attributed to extensive anoxia and/or euxinia of the oceans are associated with widespread deposition of organic-rich shales. Also in the epeiric waters of the Canning Basin (Western Australia), photic zone euxinia (PZE) prevailed during the Givetian–Frasnian, with geochemical evidence for PZE on the northern (Lennard Shelf)–, and southern (Barbwire Terrace) margins of the Fitzroy Trough. On the Lennard Shelf, shales record episodic pulses of PZE associated with high algal activity due to enhanced nutrient supply, whereas a restricted marine setting on the Barbwire Terrace is thought to be the main driver for the development of persistent PZE and associated bacterial predominance. Structural evidence indicates that the Fitzroy Trough was a confined basin during the Late Devonian with the possibility of limited ocean circulation. Widespread PZE is expected to have developed in the poorly mixed water column, if the basin received sufficient nutrient supply for enhanced primary production. Notwithstanding the presence of anoxia during deposition of potential source rocks, only two small Devonian-sourced oil fields and numerous oil shows have been found in the Canning Basin. Biomarker assemblages show that the oils produced from the Lennard Shelf fields (i.e. Blina-1, Blina-4 and Janpam North-1) have substantially different molecular compositions to the minor oil recovered from Mirbelia-1 on the Barbwire Terrace. A correlation was established between the Lennard Shelf oils and rock extracts from the Gogo Formation at Blina-1 and McWhae Ridge-1 based on their hopane, sterane and carotenoids abundances. A definitive source correlation was not obtained for the Mirbelia-1 oil, but it did show some genetic affinity to the Givetian–Frasnian extracts from the Barbwire Terrace, suggesting that local source rocks are developed in the region. [ABSTRACT FROM AUTHOR]