[Function of the lower urinary tract. 4th report on the standardization of terminology: neuromuscular dysfunction (author's transl)].
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Humans↗
Biomedical subjects
M Torrens
Publications and source records attributed to M Torrens.
[Role of urodynamics in clinical practice].
These explanation should show, how the urodynamic examination may be involved in the clinical incontinence department, in which many clinical disciplines work together. One of the greatest advantages of urodynamics was the changed way of thinking of the physicians concerning the function of the lower urinary tract. It has, for instance, shown that trabeculation means hyperactivity of the vesical muscle and not simply obstruction of the flowing off tract. The value of the urodynamics corresponds to the experiences of the physician performing the urodynamic examination. This work must not be handed over to a younger unexperienced physician or technician. The best results will be achieved, when the physician performing the urodynamic examination is at the same time that physician who is in highest clinical charge of the patient. Altogether the introduction of the measuring technique into the urology has revolutionized the clinical treatment in the same way as in the other disciplines. The additional informations may be useful to the patient, provided that the clinician always thinks objectively and does not accept what other persons tell about the importance of the urodynamic observations.
Female↗
Bladder denervation procedures.
Bladder denervation can provide useful rehabilitation of bladder function when other measures have failed. Idiopathic hyperactivity may respond best to hyperbaric distension or bladder transection. Procedures performed close to the bladder seem, at present, to be more effective than those near the central nervous system. Procedures have little morbidity, apart from transection. On the average a 50 per cent improvement may be expected, but in all cases it is most important to consider the length of follow-up in reported series.
Denervation↗
Monitoring patterns of substance use in drug-dependent patients.
Drug-addicted patients (N = 435) admitted for treatment in different clinical settings were studied. Patients were classified according to their self-report of consumed drugs and to the results of urine screening tests. Of the patients, 77.8% were active consumers, 9.6% were included in a methadone maintenance program, and 12.6% were abstinent. In the active consumer patients, positive urine screening results surpassed by far the information provided in the self-reports. Most patients tested positive to several drugs, while only 8.7% tested negative to all screened drugs. These results indicate that the information provided by drug-dependent patients lacks reliability when an analytical screening method is used simultaneously.
Adolescent↗
[Differences in the subjective effects of drugs in patients with a first psychotic episode. Preliminary results].
INTRODUCTION: The study of the subjective effects of abuse substances may facilitate comprehension of the high prevalence of substance abuse in psychosis. OBJECTIVE: To assess the subjective effects of psychoactive substances in psychotic patients with substance use disorder in a prospective open study with a 6 month evaluation. METHODS: Thirty patients consecutively admitted for the first time to a psychiatric hospital because of a psychotic disorder (DSM-IV) were included. Sociodemographic data, substance use history, drug urine test, and severity of psychotic symptoms measured by BPRS, SANS and SAPS were evaluated. The subjective effects of drugs were assessed with the short form of the ARCI questionnaire. Patients were re-assessed at six months followup. RESULTS: Sixty-three percent of patients were male, mean age 29.2 years. A total of 46.6% presented at least one substance use disorder. Differences between substance users group and non-substance users group were only related to sex (more male in substance user group), and no other sociodemographic and clinical differences were found. The main abuse drugs found were: 86% cannabis, 17% cocaine, 17% alcohol, 3% heroin and 3% hypnosedatives. Fifty percent only consumed cannabis. The psychotic patients with substance use disorder showed higher punctuation in MBG scale (euphoria scale); no differences in other ARCI scales were found. At six months follow-up, 83.3% patients were re-assessed and no differences were found. CONCLUSIONS: The psychotic patients with substance use disorder showed a higher subjective effect of euphoria than non-substance user psychotics, suggesting that drug use is mainly related to obtaining euphoria-like effects than sedatives in this group.
Adult↗
[Use of the methylxanthines, caffeine and theophylline, in the treatment of extrapyramidal disorders caused by treatment with neuroleptics. Development of a therapeutic hypothesis].
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Antipsychotic Agents↗
The outcome of surgery of aneurysmal subarachnoid haemorrhage.
Aneurysmal subarachnoid haemorrhage is a challenging pathology which remains a cause of considerable mortality and morbidity. To demonstrate to general practitioners the results of surgery for this condition a retrospective study of 160 consecutive cases who had undergone aneurysmal surgery was carried out. On admission 57% of cases had a good Hunt and Hess grade (grades I and II) and 43% a poor grade (grades III, IV and V). Twelve per cent of cases had a pre-existing hypertension and 73% of cases were treated with nimodipine. Angiography was performed from 0 to 73 days (median 3 days) after the bleed. Early surgery (within the first three days after the bleed) was performed in 41% of cases. Twenty-two per cent of cases rebled before surgery from 1 to 69 days after initial presentation (median seven days). Delayed cerebral ischaemia was diagnosed in 38% of cases, but only 15% of cases had evidence of low density on the CT scan. The outcome was determined at six months using the 'Glasgow outcome scale'. Fifty-five per cent of cases made a good recovery (back to normality), 15% a fair recovery (moderately disabled but independent), 15% a poor recovery (severely disabled and dependent), and 15% died. The significant poor prognostic factors were: a poor pre-operative Hunt and Hess grade, the presence of an intracerebral haematoma or angiographic spasm, evidence of rebleeding and early surgery without treatment with nimodipine. Other factors which did not reach a statistical significance include: age, presence of subarachnoid and intraventricular blood on CT, timing of surgery, history of long-standing hypertension, intraoperative rupture, and the development of hydrocephalus or delayed ischaemia.
Adolescent↗