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Biomedical subjects

R D Jeffs

Publications and source records attributed to R D Jeffs.

149 records · Page 9Linked to original sources
PubMed1975

Ileal conduit urinary diversion in children: computer analysis of followup from 2 to 16 years.

A 2 to 16-year followup of 96 ileal conduit urinary diversions in children is discussed. To assess the effect of time on renal function and structure we divided the patients into recent and remote operative groups. Patients with a longer followup (average 11.3 years) had a significantly greater incidence of pyelographic deterioration, particularly from preoperative normal status, compared to patients in the short followup group (average 4.5 years). Preoperative pyelonephritis was associated with a small but significant percentage of patients who progressed to poor renal function. Three potentially preventable and correctable late complications--stomal stenosis, excessive conduit length and ureteroileal obstruction--were associated with significant long-term deterioration in either renal function or pyelographic appearance. By using ileal conduit urinary diversion in children we attempt to provide a lifelong solution to urologic and social problems. The pyelographic deterioration rates would suggest that the solution is not perfect. Alternative forms of treatment need similar assessment for comparison. Patients who have ileal conduit urinary diversion need vigilant lifelong followup with accurate assessment of renal function, infection and pyelographic status to prevent or arrest renal deterioration.

Blood Urea Nitrogen↗
PubMed1972

Enuresis.

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Adolescent↗
PubMed1972

Enuresis treated by an improved waking apparatus.

One hundred and sixty children with enuresis were treated by the use of an improved waking apparatus which combines a buzzer and a battery-energized electrical stimulus. The over-all cure rate was 72%. Ninety-five patients were followed up for one year or more after treatment. When patients with organic, psychological and psychiatric problems were excluded the cure rate for the children with essential enuresis was 83%.

Adolescent↗
PubMed1968

Experimental pyelonephritis in dogs.

Both E. coli and S. aureus were simultaneously injected into the left renal arteries of 55 female dogs. The arteries were occluded for 10 minutes prior to the injection and 10 minutes after. The renal veins were occluded during the injection and for 10 minutes after. Ten animals did not survive longer than 24 hours. Ten of 45 developed neither renal lesions nor bacteriuria; of the remaining 35 which did, five were killed on each of the second, seventh and fourteenth days, and their renal lesions were assessed. Eighteen of the remaining 2 which developed bacteriuria were killed 3 to 12 weeks following surgery when bacteria could no longer be recovered from the urine. Only two dogs had persistent bacteriuria 12 weeks after surgery. All animals which developed bacteriuria had gross lesions in the left kidney but not the right. Naturally occurring renal lesions were found in 17 of 78 random-source dogs at laparotomy. E. coli was cultured from the urine of five of these dogs but not from the kidneys. These lesions were morphologically similar to experimental ones. It is concluded that with this method renal lesions similar to spontaneous ones can be produced, but care must be taken to exclude the relatively large percentage of random-source dogs with naturally occurring lesions from any study. Various forms of infectious nephritis have been reported to be among the commonest diseases of dogs (1, 2). The successful production of chronic pyelonephritis in dogs depends on a variety of factors in addition to injecting bacteria into either the renal artery or ureter. Thus, ureteral obstruction, renal anoxia and reduced pulse pressure increased the susceptibility to renal infection (3, 4, 6, 7, 8). Our laboratory has been concerned with the production of experimental pyelonephritis in dogs so that the efficacy of various treatments could be studied. The present work was undertaken to standardize methods of producing the disease and to compare experimental renal lesions with naturally occurring ones.

Animals↗