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Biomedical subjects

A L Nelson

Publications and source records attributed to A L Nelson.

31 records · Page 2Linked to original sources
PubMed1991

Stress incontinence in women. Psychological status before and after treatment.

Sixty-three women with clinical and urodynamic evidence of stress incontinence were evaluated before and after incontinence surgery for symptoms of depression, nervousness, tension, sleep disturbances, decreased appetite, somatic weakness and headaches. Women treated successfully with surgery demonstrated a statistically significant improvement in their subjective psychologic status (P less than .05). Unsuccessful treatment, however, was not associated with a significant change in or deterioration of their symptoms. All the symptoms were evaluated individually to ascertain the specific effects of treatment. Sleep disturbances were significantly improved with successful treatment and worsened with unsuccessful treatment (P less than .05). Tension was significantly improved with successful therapy (P less than .05) but was unchanged if surgery was unsuccessful. Depression became worse with subjectively unsuccessful surgery. Headaches and appetite were not affected by the therapeutic outcome. Therapy can be instrumental in affecting the psychologic status of women with stress incontinence. If the psychologic disability continues after therapy and/or treatment is unsuccessful, a referral for psychologic evaluation should be considered.

Adult↗
PubMed1990

Patients' perspectives of a spinal cord injury unit.

The purpose of this study is to provide an ethnographic description of the subculture of a spinal cord injury (SCI) unit. The research method was qualitative, combining ethnographic interviews, participant observation, and document review. A 30 bed SCI facility on the west coast was selected as the setting for this ethnographic description. The developmental research sequence model (Spradley, 1980) and grounded theory (Glaser & Strauss, 1967) were used for data analysis. Findings indicate optimal rehabilitation is a creative and individualized process of reintegration. Reintegration prepares the individual for coping with physical limitations, architectural barriers, and societal prejudices while simultaneously making the person feel intact and valued. Successful reintegration promotes a "fit" between the newly injured spinal cord patient and the home environment. The patient learns to compensate for the physical limitations of the spinal cord injury in a manner that promotes safety, comfort, and personal worth. Successful reintegration assures the newly injured SCI patient returns to a viable occupation, feels physically attractive, participates in a rich, full social life, and maintains family ties. Four phases of reintegration emerged: buffering, transcending, toughening, and launching. Buffering is the nurturing and protective process of lessening, absorbing, or protecting the newly injured SCI patient against the shock of multiple ramifications of the injury and the indignities of being a patient; Transcending is the process of helping SCI patients recognize and rise above culturally imposed limitations and negative beliefs about people with disabilities. The "toughening up" process focuses on compensating for physical limitations, gaining independence, and maintaining social interactions without "using the disability." Launching is the process of (1) exposing rehabilitation patients to the real world, (2) exploring the range of options for living in the community, (3) promoting patient autonomy and decision making, and (4) facilitating the ejection of the patient from the rehabilitation program. The study is significant because it offers a new perspective for viewing a spinal cord injury unit. The proposed theoretical model explains patients' attitudes, beliefs, and behavior on SCI units. This model provides a framework for designing a prototype therapeutic milieu in SCI.

Adaptation, Psychological↗
PubMed1986

Attenuation of protection with repeated cromolyn dosing before exercise challenge in subjects with asthma.

Though cromolyn sodium exhibits tachyphylaxis in laboratory models of allergy, this pattern has not been identified in clinical use or in human asthma provocation models. We looked for it using a treadmill exercise challenge scheme that had previously confirmed cromolyn's protective effect. Twelve exercise-sensitive asthmatic volunteers received in random order, 12 20-mg cromolyn inhalations, 12 placebo inhalations, and 11 placebo inhalations with a final 20-mg dose of cromolyn. Each regimen was given over a three-day period, with the final dose administered 30 minutes before exercise. Subjects' respiratory functions were measured before and repeatedly after exercise with body plethysmography and peak flow rates. Beginning six minutes after the end of exercise, parameters measured after single-dose cromolyn and placebo administration differed in all endpoints at most of the measurement intervals. Results with 12-dose cromolyn pretreatment were significantly different from those seen with placebo only at 40 minutes after exercise, whereas single- and multiple-dose cromolyn results differed at 20 and 30 minutes. Cromolyn accelerated recovery from exercise-induced falls in lung function; this effect was attenuated with multiple dosing. These results are consistent with development of tachyphylaxis.

Aged↗
PubMed1985

Treatment of ragweed hay fever with flurbiprofen, a cyclooxygenase-inhibiting drug.

Sixty-two volunteer hay fever patients participated in a 2-week trial which examined the protective effect of the cyclooxygenase-inhibiting drug flurbiprofen. The drug suppressed symptom severity significantly, though it was not as protective as the antihistamine also employed in the trial. Flurbiprofen's effects suggests that prostaglandin release may contribute to the symptoms of allergic rhinitis.

Adolescent↗
PubMed1984

Effect of flurbiprofen, a cyclooxygenase inhibiting drug, on induced allergic rhinitis.

To test whether prostaglandins contribute to the nasal allergic reaction, we subjected allergic rhinitis patients to nasal allergen challenge after treatment with flurbiprofen, a cyclooxygenase inhibitor. We challenged 18 patients after two pretreatment doses of flurbiprofen, 75 mg, chlorpheniramine, 6 mg, both drugs combined, and placebo. All patients received all treatments. None of the treatments affected measured nasal airway resistance. Nasal secretion weight, number of sneezes, and overall subjective severity scores for all active treatments differed significantly from placebo treatment. Flurbiprofen proved nearly as effective as chlorpheniramine in reducing severity of induced rhinitis. Some mechanism that can be influenced by flurbiprofen (possibly prostaglandin synthesis) contributes to the acute, induced allergic reaction.

Adult↗
PubMedDate not supplied

Evaluation of the efficacy of a polyurethane condom: results from a randomized, controlled clinical trial.

CONTEXT: Condoms made of latex are not comfortable or appropriate for all consumers. Polyurethane condoms may provide a needed alternative. METHODS: In a double-masked study, 805 monogamous couples were randomized to use either the polyurethane condom or the latex condom for six months. Couples recorded the frequency of intercourse, of condom use and of breakage and slippage throughout the trial in coital diaries and in detailed reports on the first five uses. Breakage and slippage rates were determined, and typical-use and consistent-use pregnancy rates were calculated using life-table analysis, adjusted for use of emergency contraception. RESULTS: The six-month pregnancy rate during typical use (adjusted for use of emergency contraception) was 4.8% for the polyurethane condom and 6.3% for the latex condom. Similarly adjusted pregnancy rates during consistent use over six completed menstrual cycles--2.4% for the polyurethane condom and 1.1% for the latex condom--did not differ significantly. Clinical failure rates (including breakage and slippage occurring during either intercourse or withdrawal) were 8.5% for the polyurethane condom and 1.6% for the latex condom. In general, male participants were more satisfied with the latex condom, and users of latex were significantly less likely to drop out of the study for condom-related reasons than were users of polyurethane. CONCLUSIONS: Although polyurethane and latex condoms provide equivalent levels of contraceptive protection, the polyurethane condom's higher frequency of breakage and slippage suggests that this condom may confer less protection from sexually transmitted infections than does the latex condom.

Condoms↗
PubMedDate not supplied

Design of the advanced commode-shower chair for spinal cord-injured individuals.

The purpose of this development project was to design a new commode-shower chair that can be safely used by individuals with spinal cord injuries (SCI) and their caregivers. The need for this new design was consumer-driven. Patients and caregivers identified the following fatal flaws in the commode-shower chairs used in Spinal Cord Injury (SCI) centers: 1) risk for patient falls during transfers, propelling, and while leaning over for showering; 2) risk for pressure ulcers due to inadequate padding and seat positioning for lengthy bowel care regimes; 3) inadequate caregiver access to the perianal area of the patient to perform bowel care procedures; and, 4) wheel-related inability to properly position the chair directly over the toilet. The new, self-propelled chair addresses each of these concerns. Lockable, swing-away, pivoting armrests and improved, lever-activated brakes were designed to facilitate safe transfers. An innovative foot-lift was invented to facilitate washing of feet. Larger handrims were designed to aid in propulsion in wet environments. To prevent pressure ulcers, a chair frame and padding combination was designed to facilitate a seating position that optimally distributes body weight to prevent the development of pressure ulcers in the sacral and ischial areas. To address the common risk of heel ulcers, footrests, featuring edgeless, rounded heel cups, were designed. A new tubular chair frame, a new seat and smaller wheels were designed to enhance caregiver access and ensure proper chair positioning over the toilet. Following its successful clinical evaluation at the Milwaukee and Tampa VA Medical SCI Centers, the Advanced commode-shower chair is being patented by the Department of Veterans Affairs (VA). The VA has partnered with Everest & Jennings, to make this chair available commercially.

Activities of Daily Living↗
PubMedDate not supplied

Breakage and acceptability of a polyurethane condom: a randomized, controlled study.

CONTEXT: Although the first commercial polyurethane condom was approved for use several years ago, no U.S. clinical trial has compared its performance to that of the latex condom. METHODS: In a masked crossover study, 360 couples were randomized to use three polyurethane condoms and three latex condoms. After each use, couples recorded condom breaks, condom slips and other aspects of performance. At completion of the study, couples compared the sensitivity, ease of use, fit and lubrication of the two types of condoms. RESULTS: The clinical breakage rate of the polyurethane condom was 7.2%, compared with 1.1% for the latex condom (relative risk of 6.6, 95% confidence interval of 3.5-12.3). The complete slippage rate (combining incidents during intercourse and withdrawal) of the polyurethane condom was 3.6%, compared with 0.6% for the latex condom (relative risk of 6.0, 95% confidence interval of 2.6-14.2). Most male users preferred the sensitivity provided by the polyurethane condom to that of the latex condom. CONCLUSIONS: The clinical breakage rate of the polyurethane condom is significantly higher than that of the latex condom. However, nearly half of the users preferred the polyurethane condom, which provides an option for couples who have rejected conventional condoms or who cannot use latex products.

Adolescent↗