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Biomedical subjects

M Gray

Publications and source records attributed to M Gray.

At least 109 records · Page 6Linked to original sources
PubMed1996

Continence management.

The elderly, critically ill patient is particularly prone to transient and established fecal or urinary incontinence. With proper management, these devastating problems can be managed, alleviated, or prevented promptly. Care of incontinence is not simply a hygienic consideration. Elderly persons who experience loss of bladder or bowel control frequently are depressed, isolated, and fearful of discovery. Left untreated, these individuals are prone to mental and social deterioration that may lead to social isolation or institutionalization. With adequate awareness and prompt management, however, the critical care nurse can prevent transient incontinence from becoming an established pattern, and he or she can serve as a resource for the elderly patient who seeks care and understanding for this significant condition.

Age Factors↗
PubMed1995

Collagen injections for intrinsic sphincter deficiency in the neuropathic urethra.

Twelve subjects experiencing stress urinary incontinence caused by spinal injury or myelomeningocele were treated by periurethral injection of a bulking agent, glutaraldehyde cross-linked (GAX) collagen. Of the 11 subjects who completed the program, seven were either cured or improved and four were only slightly improved or no better following injection. The valsalva (abdominal) leak point pressure (LPP) rose an average of 57 cm H2O (pre-treatment mean of 60 cm H2O versus post-treatment mean of 117 cm H2O) and none of the patients experienced significant complications during the mean follow-up period of 24 months. Every subject injected was able to maintain an intermittent catheterization program after treatment. These data support the use of GAX collagen as an alternative or adjunct therapy to pharmacotherapy, surgical reconstruction or implantation of a prosthesis in the management of stress urinary incontinence in the neuropathic urethra.

Adult↗
PubMed1995

Evaluation and validation of a monoclonal immunofluorescent reagent for direct detection of Bordetella pertussis.

An outbreak of pertussis in Manitoba, Canada, provided an opportunity to evaluate the recently developed monoclonal antibody (MAb) BL-5 for the direct detection of Bordetella pertussis. The MAb recognizes a lipooligosaccharide epitope. A total of 1,507 consecutive nasopharyngeal swabs for culture and companion smears for direct fluorescent-antibody (DFA) detection were evaluated at Cadham Provincial Laboratory between September and November 1994. The cutoff for DFA positivity was four fluorescing organisms with morphology characteristic of B. pertussis. PCR analysis for B. pertussis DNA was performed on a subset of 100 smears by eluting material from the slides after DFA examination. In comparison with culture, the sensitivity, specificity, and positive and negative predictive values of BL-5 were 65.1% (41 of 63 samples), 99.6% (1,438 of 1,444 samples), 87.2% (41 of 47 samples), and 98.5% (1,438 of 1,460 samples), respectively. The sensitivity of culture compared with PCR was 45.5% (10 of 22 samples) for the subset of 100 specimens tested by both procedures. An expanded "gold standard" of positivity by culture or PCR for these 100 specimens resulted in DFA sensitivity, specificity, and positive and negative predictive values of 32.3, 97.1, 83.3, and 76.1%, respectively. The utility of MAb BL-5 for direct detection of B. pertussis in a clinical laboratory setting has been demonstrated by this investigation.

Adult↗
PubMed1995

Mass versus activity: validation of an immunometric assay for bone alkaline phosphatase in serum.

A detailed investigation of the performance of an immunometric assay for the quantitation of bone alkaline phosphatase (ALP) in serum showed that precision of this assay was similar to that of lectin precipitation and electrophoretic methods. Relationships for mass and activity measurements of the bone isoform using samples from children and patients with Paget's disease were similar for lectin and electrophoretic methods. Purified liver enzyme showed 100% cross reactivity in the immunometric assay. However, comparison of the slopes between bone ALP mass and total ALP activity using only samples with predominantly liver or bone isoforms showed that the cross reactivity of the liver isoform in serum was 18.3%. Experiments in which increasing amounts of a sample containing 90% of liver isoform adding to a serum sample from a patient with Paget's disease showed a cross reactivity of 16.5%. The reference range for bone ALP mass was 7-28 micrograms/L for men (n = 77) and 5-20 micrograms/L for women (n = 110) in the age group 20-50 years. In women over 50 years bone ALP was 28% higher. Increased bone ALP mass was also demonstrated in patients with Paget's disease (n = 59), liver disease (n = 95), chronic renal failure (n = 41) and hyperthyroidism (n = 17).

Adolescent↗
PubMed1995

Incontinence and clean intermittent catheterization following spinal cord injury.

Clean intermittent catheterization (CIC) is commonly used by individuals with neuropathic bladder dysfunction caused by spinal injury. Although the incidence of urologic complications such as infection, calculi, and urethral erosion have been documented for patients managed by CIC, little is known about the incidence or characteristics of urinary incontinence among these patients. One hundred and fifty patients who had been discharged on CIC were investigated via a structured interview. Contrary to speculations in the literature, only 54% of those individuals who performed CIC experienced any incontinent episodes and 53% of those noted only episodic incontinence, with minimal or moderate volume leakage. A variety of strategies were used to attempt to prevent urinary leakage. Generally, patients demonstrated a lack of knowledge concerning nonpharmacological strategies to alleviate incontinence. This research provides a basis for nursing management strategies to reduce the incidence and severity or urinary leakage among spinal injured patients managed by intermittent catheterization.

Adolescent↗
PubMed1995

The urethral sphincter: an update.

The urethral sphincter is a single mechanism capable of forming a watertight barrier to urinary leakage during bladder filling while changing its shape to serve as an effective conduit for bladder emptying during micturition. By abandoning traditional concepts of the two muscular sphincters, urologic clinicians are better able to assess and manage sphincter dysfunction causing SUI or bladder outlet obstruction.

Female↗