Excess passing of URINE during the night. Among its many causes are glomerulonephritis (see under KIDNEY, DISEASES OF) and enlargement of the PROSTATE GLAND.... nocturia
The involuntary passing of URINE during sleep. It is a condition predominantly of childhood, and usually genetically determined. Sometimes, however, it is a symptom of anxiety in a child, especially if there has been over-rigorous attempts at toilet-training or hostile or unloving behaviour by a parent. It can also be provoked by apparently unimportant changes in a child’s life – for example, moving house. In a small minority of cases it is due to some organic cause such as infection of the genitourinary tract.
The age at which a child achieves full control of bladder function varies considerably. Such control is sometimes achieved in the second year, but much more commonly not until 2–3 years old. Some children do not normally achieve such control until the fourth, or even ?fth, year, so that paediatricians are reluctant to make this diagnosis before a child is aged six.
The approach consists essentially of reassurance and ?rm but kindly and understanding training. In most cases the use of a ‘star chart’ and a buzzer alarm which wakens the child should he or she start passing urine is helpful. Where there are relationship or social problems, these need to be considered in treating the child. The few who have urinary infection or irritable bladders may respond to drug tretament.
Those who do not respond may be helped by DDAVP, an analogue of a pituitary hormone, which reduces the amount of urine produced overnight. It is licensed for use for three months at a time. Some children prefer to reserve it for occasions such as sleeping away from home. The antidepressant imipramine can help some children but has to be used cautiously because of side-effects.
For help, contact www.eric.org.uk... nocturnal enuresis
A very common jellyfish known as the little mauve stinger, which has occurred in severe `swarms’ in the Mediterranean Sea. The sting causes moderate skin pain, but may also cause systemic symptoms such as cough, sneezing, painful breathing and nasal catarrh. It has not caused death, but one severe case of potentially-fatal anaphylaxis occurred in the wife of the then Greek Prime Minister.... pelagia noctiluca
(PNH) a type of acquired haemolytic *anaemia that results from an abnormality of the red blood cell membrane. It is due to a defect in the formation of glycosylphosphatidylinositol (GPI), whose role is to anchor proteins to the lipid framework of the membrane. This leads to increased *complement-mediated destruction of red blood cells, which results in the release of haemoglobin in the circulation and then in the urine, giving the latter a reddish colour. Some patients may develop blood clots.... paroxysmal nocturnal haemoglobinuria
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