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Biomedical subjects

R J Millard

Publications and source records attributed to R J Millard.

34 records · Page 2Linked to original sources
PubMed1986

Predictors of long term outcome following a bladder re-training programme.

A total of fifty-three female patients suffering from urinary urgency and urge incontinence completed a bladder re-training programme which comprised behavioural and biofeedback treatment components. The psychological status of patients prior to treatment and at eighteen-month follow-up was compared. The role of clinical and psychological factors was examined in relation to treatment outcome (immediately following treatment and at eighteen-month follow-up). Compared to pre-treatment, patients at the eighteen-month follow-up were experiencing fewer psychological symptoms and were more internal with respect to their locus of control, irrespective of urological response to the programme. Poor treatment compliance predicted a poor treatment response both in the short- and long-term. Excessive worrying about, and preoccupation with, the urinary symptoms, previous surgery, and chronic urinary symptoms were all good predictors of a poor treatment response in the long term.

Adolescent↗
PubMed1984

The clinical significance of bladder speed.

By calculation of a notional maximum possible flow rate (Qm) from the pressure-flow parameters of clinical urodynamic studies, a variable is obtained which relates to the speed of shortening of the muscle fibres and hence to detrusor contractility. Bladder outlet obstruction causes a reduction in detrusor contractility. After the satisfactory relief of outflow obstruction, the clinical results are related to the degree of recovery of detrusor contractility.

Adolescent↗
PubMed1984

Urodynamic evaluation of bladder neck obstruction in chronic prostatitis.

Urodynamic assessment was performed in 50 patients with symptoms which supported a diagnosis of chronic prostatitis and commonly suggested outflow obstruction. Twenty-three patients had bladder instability with an equal incidence with or without obstruction; this was demonstrated in 30 patients and was localised to the bladder neck in 24 and to the prostate in 6. A sensory problem presented on urodynamic testing in 26 patients (52% of the entire series), with a lower incidence (43%) in the obstructed group. Posterior urethritis was found in 28 (78%) of 36 patients subjected to cystourethroscopy. Endoscopic findings were suggestive of obstruction in 20 (95%) of 21 patients with urodynamic evidence of outflow obstruction and the sites of obstruction generally corresponded. The studies have provided urodynamic evidence that bladder neck obstruction could be a significant though not a predominant factor in the aetiology of the clinical syndrome of chronic prostatitis.

Adult↗
PubMed1983

The symptomatic, urodynamic and psychodynamic results of bladder re-education programs.

Bladder training and/or biofeedback techniques were used to treat 75 patients with frequency, urgency, nocturia and urge incontinence. Significant improvement or cure was obtained in 70 per cent of enuretic children, and 66 per cent of men and 74 per cent of women with unstable detrusor function. The clinical results correlated with cystometric reversion to stable bladder function. Patients who obtained good results showed improvement in the tested level of psychological adjustment, suggesting that psychological factors are not causes of the urological problem.

Adolescent↗
PubMed1981

Busulfan-induced hemorrhagic cystitis.

A case of a busulfan-induced hemorrhage cystitis is reported. Spontaneous resolution occurred following cessation of the drug. The similarity between the histologic appearances of busulfan cystitis and both radiation and cyclophosphamide-induced cystitis is discussed and the world literature reviewed. In view of the known tendency of busulfan to induce cellular atypia and carcinoma in other sites, periodic urinary cytology is suggested in patients on long-term therapy.

Busulfan↗
PubMed1980

Experimental evaluation of the urethral response to section of the spinal cord or cauda equina and to the electrostimulation of the bladder in non-human primates.

Studies of urethral function in 32 female monkeys indicate a dual innervation of the mid-urethra from sympathetic and somatic supply. The resting urethral pressure profiles were preserved after low level section of the spinal cord or division of the cauda equina. They had lowered amplitude after overstretch or electrostimulation of the autonomous bladder.

Animals↗
PubMed1980

Controlled clinical trial comparing intra-incisional cephaloridine and Polybactrin Spray.

300 patients undergoing various operations were randomly allocated to receive, intra-incisionally, just before skin suture, either a solution of 1 g cephaloridine or Polybactrin aerosol. An equal number of patients were allocated to each group, and various factors likely to influence the incidence of wound infections were evenly distributed. 13 wound infections (9.8%) developed in the cephaloridine group and 28 (20.1%) in the Polybactrin group (p less than 0.02). In the former group, the infections were milder and there were 44 fewer patient-days of hospitalisation. The difference in infection rates for 'potentially contaminated and contaminated' operations was greater (p less than 0.01), in favour of cephaloridine. Other differences are discussed and some reasons for the superiority of cephaloridine over other agents (e.g., povidone-iodine, ampicillin) are advanced.

Adolescent↗
PubMed1979

Experimental neurogenic disorders of the bladder after section of cauda equina.

Changes in the cystometric pattern and urethral pressure profile after surgical section of the cauda equina have been studied in a group of 20 monkeys (Macaca nemestrinal). The experimental autonomous bladder was characterised by tonic response to filling and with variable urethral dribbling incontinence but without co-ordinated detrusor activity. This pattern developed despite previous urinary diversion to prevent inadvertent overstretch of the bladder. Deliberate "overstretch" of the autonomous bladder was not followed by loss of tonus but was associated with the development of high amplitude regular detrusor contractions which were superimposed upon a steep rising filling cystometrogram. With urinary diversion the resting urethral pressure profiles were preserved after division of the cauda equina but were lower in amplitude after overstretch of the autonomous bladder.

Animals↗