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Biomedical subjects

C R Nyman

Publications and source records attributed to C R Nyman.

At least 37 records · Page 2Linked to original sources
PubMed1990

Urostomy appliances and stoma care routines. The relation to peristomal skin complications.

The aim of the study was to describe types of appliances and stoma care routines and evaluate their relation to peristomal skin complications. Sixty-six patients with a cutaneous uretero-ileostomy were interviewed and the peristomal skin was assessed according to Classification of Peristomal Skin (CPS). The results show a conservatism regarding the types of appliance and the stoma care routines. More than half of the patients used the same product at follow-up as they were initially fitted with three to 14 years earlier. The routines adopted by the patients were often inadequate, resulting in skin complications. Continuous exposure of the skin to urine by creation of a too wide opening in the face-plate and infrequent changing of the appliance resulted in development of pseudoverrucose skin lesions.

Adult↗
PubMed1990

The impact on work ability of ileal conduit urinary diversion.

The purpose of the study was to investigate to what extent ileal conduit urinary diversion influenced patients' capacity to work. Sixty-sex urostomy patients were interviewed. Forty-seven of those were employed before surgery. Sixteen of 47 patients (34%) made permanent changes in their working conditions immediately after surgery, i.e. they did not resume work or they changed from full-time to part-time work. The working conditions changed in similar ways for another 15 patients who initially had been able to resume. Bladder cancer patients were more likely to work less than patients with incontinence/bladder dysfunction. Nineteen patients obtained disability pension either immediately after surgery or later. Eight of those considered stoma related problems, mainly leakage, as the main reason for inability to work. Diagnosis, gender, and type of work did not seem to affect the frequency of disability pension.

Adult↗
PubMed1990

Local status of the urinary stoma--the relation to peristomal skin complications.

Sixty-six patients with uretero-ileostomy were investigated with special regards to local status of the urinary stoma, i.e. stomal site, length, size/shape, and peristomal skin. Each variable was defined. In reports from other centres there has been a lack of definitions making it difficult to compare results from different studies. One fifth of our patients had inadequately located stomas and 85% had stomas shorter than 1 cm. The peristomal skin status was assessed according to CPS, Classification of Peristomal Skin. Eight per cent of the patients exhibited severe erythematous/erosive lesions and one fifth pseudoverrucose lesions. The relation between skin lesions and local status of the urinary stoma was analyzed. Patients with inadequately located stomas were more likely to show severe erythematous/erosive lesions and there was a tendency towards patients with stomas shorter than 1 cm, more frequently exhibiting pseudoverrucose lesions.

Adult↗
PubMed1990

Blood coagulation alterations after embolic occlusion of the renal circulation.

Alterations in blood coagulation and fibrinolysis after embolic occlusion of renal adenocarcinoma were investigated in 11 patients. Peripheral vein blood was collected before, 2 hours after and on the first, third and fifth to seventh day after embolization. Five patients had renal vein blood sampling before and 2 hours after embolization. Increased levels of fibrinogen, plasminogen and antiplasmin were found on days 1-3. Antithrombin III showed a slight decrease between days 1 and 3 after embolization. All measured variables were lower in renal vein compared with simultaneous samples from peripheral vein. In renal vein samples, consumption of antiplasmin and antikallikrein was indicated. Fibrinopeptide A (FPA) was increased, with a mean maximum 2 hours after embolization. The findings seemed mainly to monitor acute phase reaction but also activation of blood coagulation and fibrinolysis. Embolization might be used as a human model of coagulation activation and acute phase reaction.

Acute-Phase Reaction↗
PubMed1990

Complications following combined transrectal aspiration and core biopsy of the prostate.

Ultrasound guided biopsy of the prostate with fine needle (22G) as well as trucut needle (18G) was performed in 145 patients with a suspicion of prostate cancer. After three weeks all patients were interviewed about complications associated with the biopsy. Hematuria and/or hemospermia occurred in 2/3 of the patients. None of the hemorrhages was severe and all ceased spontaneously. E. coli infection of the urinary tract occurred in 9 cases (6.2%). Five of the infections caused high fever and necessitated hospital care with parenteral antibiotics for 1 to 8 days. The patients with infection had no signs of immunological defects by which they might have been identified before the biopsy. As a consequence of these observations we now use prophylactic antibiotics when core biopsy of the prostate is performed transrectally.

Aged↗
PubMed1989

Comparative flow cytometric deoxyribonucleic acid studies on exophytic tumor and random mucosal biopsies in untreated carcinoma of the bladder.

In 290 patients with untreated carcinoma of the bladder the deoxyribonucleic acid properties, as measured by flow cytometry, of 3 random mucosal biopsies were studied and compared to those of the exophytic tumors. Mucosal aneuploidy was found with few exceptions in aneuploid tumors only, and in a significantly lower frequency in aneuploid tumors of grade 2 than grade 3. The individual specificity of bladder tumors is emphasized by the observation that the level of ploidy was mostly the same in aneuploid mucosal biopsies as in the exophytic tumor. This is underlined further by the occurrence of cell populations of the same ploidy in different parts of the bladder mucosa. However, S-phase values of the concomitant intraurothelial lesions were significantly lower than those of the exophytic tumors. Therefore, we concluded that the process of evolution from malignantly transformed lesions, confined to the urothelium, to an exophytic or invasive tumor is dependent on a further elevated proliferation of the urothelial lesions.

Adult↗
PubMed1988

Classification of peristomal skin changes in patients with urostomy.

Peristomal skin lesions in patients with ileal conduit urinary diversion have been reported in frequencies ranging from none to occurrence in 100% of patients. In previous studies skin lesions often are referred to in unspecific terms, which has made it impossible to compare results with those of other studies. Thus a classification of peristomal skin (CPS) has been developed on the basis of macroscopic peristomal findings. It defines what can be accepted as ordinary findings, as well as two different types of skin lesions, erythematous-erosive and pseudoverrucous. Each of these is divided into two subgroups. Such a classification is a prerequisite for a meaningful comparison of the type, incidence, and severity of skin lesions in different groups; it also may allow a more reliable clinical evaluation of new ostomy appliances and skin care products. In addition, CPS may also facilitate communication among professionals who are responsible for the care of ostomy patients.

Adult↗
PubMed1985

Haematological and biochemical observations during a 750 mile relay.

During a marathon relay from John O'Groats to Lands End (JOGLE) various blood and urine parameters were measured in the runners. Samples of blood and urine were taken from each runner immediately prior to the event and on two occasions during it. Subsequently a three point plot was made for each parameter measured. No special diet was taken. Food and liquid refreshment was provided during the run, the first two days of which came from the organisers. The total distance covered was 870 miles and the time taken one hundred hours and thirty-two minutes. Although the results do not approach statistical significance a trend has been shown suggesting that even with the modern running shoe injury may still occur.

Adolescent↗
PubMed1982

Hydrodynamics of micturition in stress-incontinent women. Comparisons of pressure and flow at different micturition volumes in stress-incontinent and continent women.

The urethral flow, resistance and closure pressure and bladder pressures in 19 stress-incontinent but otherwise healthy women were compared with the same parameters in 19 healthy, continent women. The micturition studies were performed at three predetermined levels of bladder filling. The urethral closure pressure, the premicturition intravesical pressure and detrusor pressure at micturition were significantly lower in the stress-incontinent women than in the continent group. The intravesical opening pressure showed no intergroup difference. The urethral and bladder pressure measurements in the incontinent women indicated musculo-elastic tissue with greater compliance and less contractility than in normal women.

Adult↗
PubMed1981

Hydrodynamics of micturition in healthy females: pressure and flow at different micturition volumes.

A new urodynamic technique, in which detrusor and bladder pressures are recorded with suprapubic percutaneous catheters, was used for investigation of 19 healthy female volunteers to obtain urodynamic reference values. The investigation was made in parous as well as in nulliparous women of varying ages. Apart from a significantly elevated premicturition pressure in the elderly women, neither age nor parity seemed to change urodynamic parameters. Voidings with three different, defined bladder volumes in each volunteer indicated that flow increased with a larger volume up to a certain limit (400 ml) but further increase of volume did not raise the flow. All total bladder pressures, maximum detrusor pressures, and detrusor pressures at maximum flow at micturitions were independent of bladder volumes. Micturitions were made as detrusor micturitions as all volunteers were requested not to strain at voiding. It is considered that detrusor micturitions must be the best way to obtain comparable parameters from different urodynamic investigations.

Adult↗
PubMed1981

Urodynamic effects of oral benzilonium bromide in healthy subjects.

Benzilonium bromide (Ulcoban) has been tried in oral administration in 10 healthy volunteers, 5 of whom got the substance in a fast-release form and 5 in a combination of fast- and slow-release preparation. Serum concentration analyses show that the subject after 1 week of treatment has a certain amount of active substance in blood 12 h after the last administration. There is an increase in serum concentration during the morning hours after administration of another dose at least 1 h before breakfast. The serum concentration is higher when the fast-release form is used. We found in the urodynamic investigation, after 1 week of treatment, an effect on detrusor pressures and urinary flow. In micturitions with a large initial bladder volume, when the patient more easily can initiate a micturition, the difference is not statistically significant. When the initial bladder filling is small, it is more difficult to initiate a micturition, and at an initial bladder volume of 200 ml the difference between micturition with and without benzilonium bromide is more marked, especially in urinary flow and detrusor pressures where the differences are statistically significant.

Administration, Oral↗
PubMed1981

Clinical experiences of direct transmural measurement of the detrusor pressure.

The clinical value of a technique using suprapubic catheters prevesically and intravesically for detrusor pressure recordings is analysed. The method has been used in 143 investigations including both males and females. The complication rate is low, 2.8%, and the advantages of a well defined measuring level and identical measuring systems for all pressure recordings are stressed. It is also concluded that there seems to be no risk of infection. For repeated investigations, such as when, for instance a second postoperative urodynamic check is wanted, this technique does not involve any drawbacks due to surgical trauma. The technique with two suprapubic catheters is well accepted by the patients and is preferred to rectal catheters by volunteers who have tried both types.

Adult↗
PubMed1981

Direct transmural measurement of the detrusor pressure. A technique of detrusor pressure recording in micturition with intravesical and prevesical suprapubic catheters compared with recordings using a rectal balloon and rectal open-end catheters.

A technique of suprapubic recording of intravesical and prevesical pressure is presented. We conclude that rapid intraabdominal pressure changes (cough) and slow and sustained pressure changes (long strain) are equally transmitted to the bladder and to the prevesical space. When intraabdominal pressure is increased, the prevesical route of recording gives more uniform values of intraabdominal pressure elevations than do recordings from the rectum via rectal balloon and rectal open-end catheters. In micturitions with an initial bladder volume of 400 ml the suprapubic prevesical catheter functions well and the pressure recorded is not significantly different when compared with rectal recordings of extravesical pressure. The advantages associated with the use of suprapubic catheters are that identical recording systems with open-end catheters are used for both intravesical and extravesical recordings and that detrusor pressure is recorded directly as the transmural pressure difference.

Adult↗