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Biomedical subjects

F A Silverstone

Publications and source records attributed to F A Silverstone.

31 records · Page 2Linked to original sources
PubMed1983

The nonuse of urethral catheterization in the management of urinary incontinence in the teaching nursing home.

A survey of all patients in a 527-bed skilled nursing facility was carried out to determine the prevalence of bladder catheterization. The institution surveyed is a teaching nursing home and rehabilitation center comprising three intermediate-stay and rehabilitation units of 126 beds and nine long-term care units. The institutional prevalence of recurrent urinary incontinence was 46 per cent, or 243 patients. The prevalence of chronic indwelling urethral catheters was 2.5 per cent, or 13 patients. The prevalence of urethral catheterization was further reduced to 1.5 per cent on the long-term care units, where the rate of recurrent urinary incontinence exceeded 60 per cent. The results of our survey were then compared with similar surveys at the institution during the years 1975 through 1980. Despite a fluctuating but increasing prevalence of incontinence over the years studied, a favorable trend was shown toward a reduction in the number of patients with indwelling urethral catheters. This study indicates that unless specific complicating factors are present, urinary incontinence in all but a very few of the elderly can be successfully managed without chronic indwelling catheterization. The authors believe that the introduction and growth of an education and research program in the nursing home environment has led to improvement in the standards of medical and nursing care.

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PubMed1982

Simplifying the intravenous glucose tolerance test.

When used for classifying pregnant patients as normal or abnormal in terms of carbohydrate intolerance, the k value computed from a two-sample intravenous glucose tolerance test (IVGTT) (10 and 60 minutes) is reliable except in a zone of +/- 0.10 k points from the appropriate lower limit of normal. Retesting with six samples obtained in one hour may be required for patients with values within the doubtful range, +/- 0.10 of the lower limit of normal. Considerable savings can be realized nevertheless with the use of this test as compared with doing a full, seven-sample test on each subject. Our results suggest that the abbreviated IVGTT be used more widely as a routine screening procedure for diabetes rather than being restricted to use on suspect populations. One can make a direct conversion of blood sugar readings into k with the use of a table presented in the paper.

Adult↗
PubMed1975

Changes in carbohydrate tolerance during long-term oral contraception.

An intravenous glucose tolerance test (GTT) was given to 116 women--82 nondiabetic subjects (NDS) and 34 diabetes suspects--before they received Ovulen for oral contraception. Subjects were followed for 1 to 4 years during Ovulen therapy. Twenty women using an intrauterine device showed no changes in glucose tolerance. Prompt, significant decline in tolerance was noted in NDS, persisting for the duration of the study. At least one abnormal test, indicating chemical diabetes, was noted in 13 per cent of the NDS. Similarly, prompt decline in tolerance, although not statistically significant, was observed in the suspect group. Fifteen per cent of suspects had at least one abnormal test. Chemical diabetes persisted during Ovulen therapy in suspects but not in NDS. No overt diabetes occurred. Based on greater concern regarding suspects, a procedure for monitoring carbohydrate tolerance is proposed for this group.

Adult↗
PubMedDate not supplied

Energy requirements in Alzheimer's disease patients.

Weight loss in Alzheimer's patients has been observed by many clinicians and reported in the international geriatric literature. It represents a puzzling challenge for clinicians and researchers, and it is an important issue for caregivers and nursing home staff concerned with state and federal requirements for nutrition and weight monitoring. Using indirect calorimetry, we studied the resting energy expenditure of 21 elderly patients; 12 were residing in a community setting, and 9 were institutionalized. Of the 12 community-living patients studied, 5 had early to moderate Alzheimer's disease, and 7 were nondemented control subjects. Of the 9 institutionalized patients, all were severely demented, bedridden, and fed exclusively by gastric tube in a closely monitored clinical environment with daily bedside weighing. Four had Alzheimer's disease, and 5 had multi-infarct dementia (MID). Among the outpatients, the Alzheimer's group showed increased energy requirements (p = 0.028) and a significantly different pattern of fat-free mass compared with control subjects (p = 0.031). These observations on community-residing elderly were consistent with, and extended by our findings on energy requirements of, the demented institutionalized patients. The calorie intake necessary for weight maintenance of the bedridden institutionalized patients was determined during their prolonged institutionalization. The presumed maintenance level of calorie intake was then verified during a 10 wk study. During the 10 wk, we documented no significant change in weight with constant energy intake. Compared with MID patients, Alzheimer's patients tended to weigh less (52.84 vs 56.4 kg; p = 0.20) but actually required more calories (1626 vs 1341 kcal, p < 0.011).(ABSTRACT TRUNCATED AT 250 WORDS)

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