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Vesicoureteral Reflux is a Phenotype, Not a Disease: Population Health and the Pediatric Urologist

In this presentation, Dr. Steven Docimo reviews the different ways of diagnosing and managing reflux and urinary tract infection.

Educational objectives:

Upon completion of this activity, participants should be able to:

  • Explain the difference between a phenotype and a disease, and that a phenotype can complicate a disease, but is not the disease itself.
  • Become familiar with the findings of the RIVUR and CUTIE studies, and be able to express alternative ways of interpreting those findings and applying them to clinical strategies.
  • Differentiate between decisions made on the basis of infinite possible outcomes for an individual patient vs. those made on the basis of population-wide occurrence rates.

Reading Resources:

  1. Shaikh N, Mattoo TK, Keren R, Ivanova A, Cui G, Moxey-Mims M, Majd M, Ziessman HA, Hoberman A. Early Antibiotic Treatment for Pediatric Febrile Urinary Tract Infection and Renal Scarring. JAMA Pediatr. 2016 Sep 1;170(9):848-54. doi: 10.1001/jamapediatrics.2016.1181. PubMed PMID: 27455161.
  2. Shaikh N, Hoberman A, Keren R, Gotman N, Docimo SG, Mathews R, Bhatnagar S, Ivanova A, Mattoo TK, Moxey-Mims M, Carpenter MA, Pohl HG, Greenfield S. Recurrent Urinary Tract Infections in Children With Bladder and Bowel Dysfunction. Pediatrics. 2016 Jan;137(1). doi: 10.1542/peds.2015-2982. PubMed PMID: 26647376; PubMed Central PMCID: PMC4702025.
  3. Keren R, Shaikh N, Pohl H, Gravens-Mueller L, Ivanova A, Zaoutis L, Patel M, deBerardinis R, Parker A, Bhatnagar S, Haralam MA, Pope M, Kearney D, Sprague B, Barrera R, Viteri B, Egigueron M, Shah N, Hoberman A. Risk Factors for Recurrent Urinary Tract Infection and Renal Scarring. Pediatrics. 2015 Jul;136(1):e13-21. doi: 10.1542/peds.2015-0409. PubMed PMID: 26055855; PubMed Central PMCID: PMC4485012.
  4. RIVUR Trial Investigators., Hoberman A, Greenfield SP, Mattoo TK, Keren R, Mathews R, Pohl HG, Kropp BP, Skoog SJ, Nelson CP, Moxey-Mims M, Chesney RW, Carpenter MA. Antimicrobial prophylaxis for children with vesicoureteral reflux. N Engl J Med. 2014 Jun 19;370(25):2367-76. doi: 10.1056/NEJMoa1401811. PubMed PMID: 24795142; PubMed Central PMCID: PMC4137319.

Disclosures:

Dr. Docimo has reported no relevant relationships with proprietary entities producing health care goods or services.

All presenters disclosure of relevant financial relationships with any entity producing, marketing, re-selling, or distributing health care goods or services, used on, or consumed by, patients is listed above.  No other planners, members of the planning committee, speakers, presenters, authors, content reviewers and/or anyone else in a position to control the content of this education activity have relevant financial relationships to disclose.

Accreditation Statement:

The University of Pittsburgh School of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The University of Pittsburgh School of Medicine designates this enduring material for a maximum of .75 AMA PRA Category 1 Credits™. Each physician should only claim credit commensurate with the extent of their participation in the activity. Other health care professionals are awarded (0.075) continuing education units (CEU) which are equivalent to .75 contact hour.

For your credit transcript, please access our website 4 weeks post-completion at http://ccehs.upmc.edu and follow the link to the Credit Transcript page. If you do not provide the last 5 digits of your SSN on the next page you will not be able to access a CME credit transcript. Providing your SSN is voluntary.

Release Date: 1/12/2017 | Last Modified On: 1/12/2017 | Expires: 1/12/2018

TRANSCRIPT

Presenter

Steven Docimo, MD

Steven Docimo, MD Chief Medical Officer, Children’s Hospital of Pittsburgh of UPMC President, Children’s Community Pediatrics Professor of Urology, University of Pittsburgh School of Medicine
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