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Biomedical subjects

E J O'Shaughnessy

Publications and source records attributed to E J O'Shaughnessy.

12 recordsLinked to original sources
PubMed1988

Carbon dioxide cystometry and postural changes in patients with multiple sclerosis.

Ninety-one subjects with multiple sclerosis were evaluated by carbon dioxide cystometry in the supine, sitting, and standing positions, and by water cystometry in the supine position. Detrusor responses in supine studies were characterized as normal, hyperreflexic, or areflexic. Carbon dioxide and water cystometry were without difference in determining types of detrusor responses. Positional changes (particularly standing) resulted in reassessing of normal supine bladder responses as hyperreflexic. Hyperreflexia was aggravated with sitting and standing. Positional changes did not demonstrate conversion of areflexia to hyperreflexia. The relatively small proportion of dyssynergic sphincter responses probably represents a population of patients with early stage multiple sclerosis. Carbon dioxide cystometry, with positional changes, is relatively safe, easily performed, and an accurate method of evaluating detrusor response in patients with multiple sclerosis who have a changing clinical course or unresponsiveness to treatment.

Adult↗
PubMed1985

Urodynamic evaluation of voluntary detrusor response in healthy subjects.

The ability of healthy subjects to voluntarily inhibit a bladder detrusor contraction was evaluated using standard urodynamic techniques. Ten healthy subjects (five men and five women) were appraised using trichannel techniques which included measuring bladder volume, bladder pressure, intraabdominal pressure, and electromyographic activity of the anal or external urethral sphincter. Each subject was first evaluated to determine normalcy of urine flow rate. All subjects were assessed in three positions: supine, sitting, and standing. All ten subjects were able to inhibit their detrusor responses without increasing external urethral or anal sphincter activity or raising the tonus pressure limb of the bladder. Three of the subjects were unable to void during any part of the urodynamic evaluation. In one subject, voiding was accomplished by Valsalva maneuver which mimicked detrusor contraction. At least two subjects did not demonstrate their first urge to void until 300 to 400 cc, and one of these individuals was unable to void until his bladder capacity reached 600cc. These results indicated that normal subjects can inhibit their detrusor response during urodynamic studies. Inability to inhibit this response would therefore appear to be an abnormal pattern. Conversely, inability to produce a detrusor response cannot be called an abnormal retention pattern. Bladder volumes in healthy subjects may be higher than the traditional norms, and this must be taken into account during urodynamic evaluations.

Adult↗
PubMed1984

Localization of urinary tract infection in patients with spinal cord injury.

The site of urinary tract infection (UTI) was localized in asymptomatic bacteriuric patients with spinal cord injury who underwent intermittent bladder catheterization by the bladder washout (BWO) test, antibody-coated bacteria (ACB) test, quantitative urinary leukocyte count, ultrasonography, and excretory urography. Thirty-two (43%) of 74 UTIs were localized by BWO to the upper tract and 42 (57%) to the lower tract. Sensitivity of the ACB test in detecting upper UTI as defined by BWO was 0.28, and specificity was 0.86. The median urinary leukocyte count in 22 BWO-positive infections tested was 420 vs. 94 in 24 BWO-negative infections (P = .01). Patients with polymicrobic infections or with upper tract abnormalities, as detected by ultrasound or excretory urography, were more likely to have BWO-positive infections. We conclude that negative BWOs are usually associated with negative ACB tests in this population, but further comparisons of both tests with ureteral catheterization are needed to clarify the meaning of results in either assay.

Antibody-Coated Bacteria Test, Urinary↗
PubMed1984

Sequelae of mild closed head injuries.

Thirty-nine minimal to mild closed head injuries without neurological signs were evaluated by a series of clinically available psychometric tests to determine the presence of identifiable intellectual deficits, rate of recovery, and personality or occupational changes. Even minimally head-injured patients suffer measurable cognitive deficits and occupational and behavioral changes.

Adolescent↗
PubMed1983

Bladder dysfunction: a remedial social problem.

Urinary bladder dysfunction is a leading disability of persons with multiple sclerosis. The study reported here demonstrates that the critical management of this neurologic deficit can improve the patient's quality of life in terms of personal, social, and occupational activities. The urodynamic studies of urinary flow rate, voiding cystourethrography, and positional cystometrography were used to establish the type of neurogenic bladder (areflexic, uninhibited, or mixed). Management regimens were individualized using a combination of anticholinergic or cholinergic drugs, intermittent self-catheterization, and managed fluid intake and voiding.

Adult↗
PubMed1983

Micturition monitor as an aid to management of neurogenic bladder.

A portable, battery-operated micturition monitor has been developed for use by patients with spinal cord injuries. The monitor, when integrated into the external urinary collection device for a male with a spinal cord injury, provides an accurate measure of the elapsed time in minutes since the patient last voided. This measure greatly reduces the efforts required by the medical staff to obtain a reliable residual urine volume measurement.

Humans↗
PubMed1982

Urinary bladder dysfunction as a remedial disability in multiple sclerosis: a sociologic perspective.

Forty-two patients formed the sample for this study. They represented a self-selected subset of 115 patients who complained of bladder dysfunction as a disability secondary to multiple sclerosis. The study generated data on previous management and results, subjects' desired current intervention goals, urodynamic evaluation, and current intervention outcomes. Results indicated that bladder dysfunction disabilities are either ignored or mismanaged and that the disability can be reduced to the patient's satisfaction using clinically available diagnostic methods and indicated management.

Adult↗
PubMed1981

Detrusor reflex contraction inhibited by anal stretch.

Anal stretch has been advocated as a method to overcome detrusor-sphincter dyssynergia. In evaluating candidates for this technique, it has been observed that in some cases the detrusor reflex and the external sphincter contraction is inhibited. The detrusor-sphincter unit then assumes a lower motor neuron pattern. This explains the need of the Valsalva and Credé maneuver that had been incorporated in the anal stretch technique to allow dyssynergic patients to void.

Adult↗