ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1992.tb01875.x

年代:1992

数据来源: WILEY

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1992.tb01877.x

年代:1992

数据来源: WILEY

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1992.tb01878.x

年代:1992

数据来源: WILEY

摘要:

ObjectivesTo test the effectiveness of electrical stimulation in the treatment of urinary incontinence in female nursing home patients.SettingA community long term care facility.ParticipantsNine unselected female nursing home patients with urinary incontinence. All patients were moderately to severely cognitively impaired. By bedside cystometry, six patients had involuntary detrusor contractions while two had inconclusive results.InterventionParticipants were treated with electrical stimulation for 8 weeks using the Microgyn II device. A current with a frequency of 20 hertz and a pulse width of 1 millisecond was delivered repeatedly for 2 seconds on, 4 seconds off for 15 minutes twice a week.MeasurementsThe number of every‐2‐hour wet episodes during a 48‐hour period (Wet) was recorded by a blinded observer at baseline and after 4 and 8 weeks of treatment. We evaluated the overall effect of electrical stimulation by averaging the Wet at 4 and 8 weeks for each patient and comparing it to Wet at baseline.Main ResultsThe mean ± standard deviation of intensity of electrical stimulation was 12 ± 5 milliamps. Mean Wet at baseline was 11.8 ± 4.2. For all patients mean Wet increased by 2.3 ± 3.2,P= 0.07. Analysis of patients with documented involuntary detrusor contractions showed a mean increase in Wet of 2.6 ± 3.6,P= 0.16. The volume of fluid at which an involuntary contraction occurred during cystometry showed a mean increase of 48.3 ± 52.6 mL,P= 0.07 after 8 weeks of treatment.ConclusionsElectrical stimulation is well tolerated in elderly nursing home patients. However, it was ineffective in improving urinary incontinence. In fact, there was a tendency for the treatment to worsen the i

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1992.tb01828.x

年代:1992

数据来源: WILEY

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1992.tb01879.x

年代:1992

数据来源: WILEY

摘要:

ObjectiveThis study documents the patient characteristics associated with prescribed medications on entry to a nursing home and the change in prescribing patterns after 3 months.DesignOne‐year admission cohort.SettingThree university‐affiliated community nursing homes in Albuquerque, NM.PatientsAll new admissions (n= 81) to a University geriatrics team, covering intermediate and skilled levels of care during 1 year (July 1, 1988–July 1, 1989).MethodsOutcome measures were scheduled and as‐needed (PRN) medications prescribed at entry and 3 months. Data collected at entry included patient demographics, activities of daily living index, mental status score, and medical diagnoses.ResultsOlder persons were prescribed fewer scheduled medications than younger ones, and women fewer than men. There was a positive association between the number of diagnoses and the number of scheduled medications (r= 0.25,P= 0.02). No associations were found between medications prescribed and mental status or functional level. There were no associations between as‐needed (PRN) medications and any of the variables studied. Overall, there was a significant increase in the average total number of medications prescribed between admission (4.7) and 3 months (6.2). This was due to an increase in the number of PRN medications from 1.3 at admission to 3.0 at 3 months (P<0.001).ConclusionsMeasuring medications at consistent points in a person's nursing home stay may be more informative than using cross‐sectional sampling. Future studies on medications in nursing home populations should distinguish between PRN and scheduled medications because medication prescribing patterns may be different in these

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1992.tb01829.x

年代:1992

数据来源: WILEY

摘要:

ObjectiveTo assess the long‐term evolution of elderly patients with large or impacted bile duct stones, treated by an endoscopic biliary endoprosthesis.DesignCase series.SettingTertiary care center.PatientsTwenty‐three patients with a mean (± SD) age of 86 ± 5 years (range, 77–97 years). On admission, 96% were highly symptomatic. These patients represent 8.4% of a group of 273 elderly patients (≧70 years old) with choledocholithiasis treated by endoscopic sphincterotomy between November 1984 and May 1989.InterventionEndoscopic insertion of a biliary endoprosthesis.ResultsEighty‐seven percent (20/23) remained completely free of biliary symptoms and died of unrelated illness (48%) after a mean follow‐up of 23 months or are still alive (39%) with a mean follow‐up of 52 months. In four cases, this asymptomatic evolution now extends for more than 5 years.ConclusionInsertion of a biliary endoprosthesis offers an effective method for long‐term treatment of non‐extractable biliary stones

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1992.tb01830.x

年代:1992

数据来源: WILEY

摘要:

PurposeTo evaluate the use of a vacuum tumescence device in the treatment of impotence in couples wishing to restore coital function, whose male partners had unsatisfactory results from penile implants or in whom the man was impotent following treatment for prostate or colon carcinoma.SubjectsConvenience sample of seventeen couples seeking treatment of male factor sexual dysfunction.MethodsAfter completion of a comprehensive diagnostic evaluation of the male partner, couples who expressed a wish to restore coital function were instructed in the use of the vacuum tumescence device. Partners each filled out and initialled a daily diary of sexual activity and returned to clinic for followup at 3 and 6 months.ResultsSixteen patients were able to obtain firm to hard erections lasting an average of 14.9 minutes and had satisfactory coitus with vaginal ejaculation an average of 3.9 times per month. There were no significant complications.ConclusionThe vacuum tumescence device can be effective in the treatment of impotence after penile prosthesis explantation, in enhancement of inadequate erections with a prosthesis in place, and after surgical or radiation therapy for prostate or colon carcinoma.

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1992.tb01831.x

年代:1992

数据来源: WILEY

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1992.tb01832.x

年代:1992

数据来源: WILEY

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1992.tb01833.x

年代:1992

数据来源: WILEY