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Biomedical subjects

J Lapides

Publications and source records attributed to J Lapides.

At least 19 recordsLinked to original sources
PubMed1979

Mechanisms of urinary tract infection.

Most urinary tract infections begin as a cystitis secondary to decreased host resistance brought on by disruption of tissue integrity or a decrease in blood supply to the bladder. In the female, infrequent voiding and the uninhibited bladder are the most common causes of urinary tract infection and are best treated by healthy voiding regimens; while in the male, structural and functional obstructive uropathy are most often associated with urinary tract infection and are alleviated by lowering the high intravesical pressures via surgical or medical measures. The concept that host resistance is the determinant of infection rather than the organism has permitted the use of clean, intermittent self-catheterization; clean intermittent self-dilatation; and transurethral diverticulectomy in the therapy of a host of urologic disease syndromes.

Animals↗
PubMed1979

Association of urinary tract infection and reflux with uninhibited bladder contractions and voluntary sphincteric obstruction.

We studied 53 neurologically normal children with recurrent urinary tract infection who were found to have bladder-sphincter incoordination characterized by voluntary sphincteric constriction during involuntary uninhibited bladder contraction. Increased intravesical pressure was documented during these events and was associated with vesicoureteral reflux in nearly 50 per cent of the children and with abnormalities of the ureteral orifice in 30 per cent of those without reflux. We hypothesize that increased intravesical pressure causes urinary infection in these children and produces a spectrum of intravesical anatomic distortion that predisposes to vesicoureteral reflux. In a prospective uncontrolled study treatment of the uninhibited bladder contractions allowed 58 per cent of the patients to maintain sterile urine without subsequent antimicrobial therapy after cure of the initial infection.

Adolescent↗
PubMed1979

Transurethral treatment of urethral diverticula in women.

Six women with urethral diverticulitis and a history of having had previous operations for diverticula were subjected to transurethral diverticulotomy with a knife electrode. Each patient had multiple diverticula, some compartmented, located in the mid or most proximal segments of the urethra. All patients have been relieved of the symptoms and infection during the postoperative period, varying from 1 1/2 to 7 years.

Adult↗
PubMed1979

Neurogenic bladder dysfunction.

The combined use of cystometry and perineal electromyography permits the physician to detect abnormalities in the synchronization of bladder contraction and urinary sphincter relaxation. With each pattern of neurogenic bladder disease, the coordination between bladder and sphincter determines whether urinary tract problems will develop. Treatment is tailored to specific bladder and sphincter defects.

Humans↗
PubMed1978

The anticholinergic effects of dicyclomine hydrochloride in uninhibited neurogenic bladder dysfunction.

A preliminary study to assess objectively the effects of dicyclomine upon uncontrolled detrusor contractions and bladder capacity was undertaken in 14 patients with a cystometric diagnosis of uninhibited neurogenic bladder. Response was measured by cystometry performed 1, 2 and 4 hours after a 20 mg. oral dose. Of the 14 patients 11 had significant blockade of uninhibited contractions and a concomitant increase in bladder capacity. Similar but less dramatic changes were noted in the remaining 3 patients. Dicyclomine seems to have effective anticholinergic properties. No remarkable side effects were observed.

Adult↗
PubMed1978

Followup of abdominal neourethra.

Abdominal neuroethrostomy is a highly satisfactory form of urinary diversion for patients with irreparable urethral stricture or destruction. Normal renal function, structure and urinary continence have been observed in 7 patients for as long as 17 years.

Abdomen↗
PubMed1978

Transurethral treatment of urethral diverticula in women.

Six women with urethral diverticulitis and a history of having had previous operations for diverticula were subjected to transurethral diverticulotomy with a knife electrode. Each patient had multiple diverticula, some compartmented, located in the mid or most proximal segments of the urethra. All patients have been releived of the symptoms and infection during the postoperative period, varying from 1 1/2 to 7 years.

Adult↗
PubMed1977

Action of oral and parenteral bethanechol on decompensated bladder.

A double blind balanced Latin-square study was conducted on 20 adult patients with decompensated bladders to determine the relative effectiveness of oral and parenteral bethanechol chloride (Urecholine) on the stretch response of bladder muscle. Detrusor reaction was measured by modified cystometry. Five mg. of subcutaneous bethanechol chloride produced a significant increase in intravesical pressure which was more rapid in onset, of larger magnitude, and of shorter duration than oral doses of 100 and 200 mg.

Administration, Oral↗
PubMed1977

Altered bladder function in staghorn calculus disease.

Disorders of the lower urinary tract that predispose to urinary infection were identified in 69 per cent of 62 patients with branched renal calculi. Within an average followup of 6.3 years control of these disorders was observed to reduce the rate of reinfection and the frequency of complications after operative stone removal.

Adolescent↗
PubMed1977

Followup of abdominal neourethra.

Abdominal neourethrostomy is a highly satisfactory form of urinary diversion for patients with irreparable urethral stricture or destruction. Normal renal function, structure and urinary continence have been observed in 7 patients for as long as 17 years.

Abdominal Muscles↗
PubMed1976

Further observations on self-catheterization.

A non-sterile technique of intermittent self-catheterization was used for 218 patients with an inability to void in a normal fashion because of obstructive uropathy, decompensated detrusor or neurogenic bladder. Marked improvement was noted in urinary continence, urinary infection, renal function, bladder emptying and, perhaps most important, the mental and emotional status of the patient and/or parents. The extremely low incidence of complications and its therapeutic efficacy clearly make clean, intermittent self-catheterization an outstanding weapon in the urological armamentarium and a most persuasive reminder that host resistance is still the primary factor in the occurrence of infection.

Adolescent↗
PubMed1976

New approach to myelodysplasia.

Data from 60 patients with myelodysplasia are presented. Electromyography of the periurethral striated muscle in conjunction with simultaneous cystometry allows prediction of those patients at risk from urinary tract infection in 100 per cent of the cases. Intermittent self-catheterization is an effective form of therapy for bladder dysfunction in patients with myelodysplasia. An orderly approach to the evaluation and management of bladder dysfunction is outlined.

Adolescent↗
PubMed1976

Prostatitis.

Explore the source record for details and available documents.

Adult↗
PubMed1976

Comparison of rapid versus slow decompression of the distended urinary bladder.

Experiments are described showing that urinary retention with its associated increased intravesical pressure and overstretching of the bladder wall can lead to loss of capillary and tissue integrity. Our findings indicate that the severity of damage to the bladder wall prior to catheterization determines the degree of hemorrhage after bladder decompression and not the rate of emptying.

Animals↗