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Biomedical subjects

S Walter

Publications and source records attributed to S Walter.

At least 235 records · Page 13Linked to original sources
PubMed1985

Ileal conduit urinary diversion--early and late complications.

110 adult patients with benign and malignant conditions subjected to an ileal conduit urinary diversion were followed from 1 to 8 years after the operation. 62 patients (59 with a malignant disease) died in the follow-up period. The patients were divided into 3 groups according to their primary diseases: (1) benign, (2) malignant without irradiation, and (3) malignant with irradiation. Early complication rates were 22% in group 1, 33% in group 2, and 29% in group 3. In addition, the complications were more serious in the group with malignant diseases. Late complication rates were 70% in group 1, 80% in group 2, and 54% in group 3, possibly due to a shorter time of observation in group 3. Renal function deteriorated in 18% of the patients but only 3% became uremic. When urinary diversion is inevitable we find this method acceptable, at least until the long-term results of newer methods are known.

Adult↗
PubMed1985

Changes in the diagnoses of the functional psychoses associated with the introduction of lithium.

Diagnostic patterns for schizophrenia and affective psychosis were examined for all admissions to psychiatric facilities in New South Wales over a ten-year (1967-1977) period, before, during, and after lithium carbonate had been established as an accepted treatment. While the proportion of functional psychoses to total admissions remained relatively constant over the study, there was a relative decrease in schizophrenia, and a relative increase in the affective psychosis group. Analyses of sub-groups suggested, after controlling for the effects of time, that the introduction of lithium has been associated with an increase in diagnoses of mania and a decrease in diagnoses of paranoid schizophrenia, both for first admissions and for readmissions.

Affective Disorders, Psychotic↗
PubMed1984

Effect of cimetidine on upper gastrointestinal bleeding after renal transplantation: a prospective study.

In 97 consecutive patients undergoing renal transplantation the incidence of upper gastrointestinal bleeding was registered over 180 days after allocation to treatment with either cimetidine or placebo. Bleeding episodes occurred in 12 patients, 11 of whom were receiving placebo and only one cimetidine (p less than 0.01). All bleeding episodes occurred during the first month after allotransplantation. Treatment with cimetidine did not lead to an increased incidence of rejection of the allograft. It is concluded that cimetidine is effective and safe in protecting against upper gastrointestinal bleeding after renal transplantation.

Cimetidine↗
PubMed1984

Prolonged application of pressure in transluminal coronary angioplasty.

We investigated the morphologic structure and fluid content of atherosclerotic specimens of fresh human postmortem artery segments before and after application of a pressure of 5 atmospheres simulated by a weight of 5 kg per 1 cm2. After applying pressure in nonorganized atheromata, we noticed a marked reduction in thickness while in fibrotic atheromata we observed only smaller differences in thickness. Reduction in fluid content was significantly more pronounced in nonorganized atheromatous tissue. Reduction in thickness was closely related to reduction in weight (i e, fluid content). The time of pressure application necessary to achieve the optimal result averaged 60 sec. The conclusions drawn from these experiments were incorporated into clinical application of coronary angioplasty. Prolonged balloon inflation was applied to the last 400 out of a total of 600 coronary angioplasty procedures, performed between October 1977 and October 1983. Stenoses not sufficiently responsive to balloon inflation periods of 5-10 sec were exposed to periods of 60 sec (30-120 sec). The number of "non dilatable" stenoses was 15% with the standard short pressure procedure, but only 5% with the prolonged pressure application. No serious complications related to prolonged pressure application were observed. Thus, from experimental data and clinical experience the application of longer pressure periods appears justified and beneficial.

Angioplasty, Balloon↗
PubMed1984

Urinary incontinence in the female. A long-term study of the effect of anticholinergics on overactive detrusor function.

The long-term effect of anticholinergic medication in female patients with overactive detrusor function was studied in a group of 73 patients. The definition of overactive detrusor function is in accordance with the terminology and definition of the International Continence Society. The patients were mailed a questionnaire about the medication, its effect on the continence situation, the side effects, and whether they still used the drugs. The duration of observation was more than 12 months. A satisfactory effect of the treatment was found in 43% while 50% reported no effect or severe side effect. Only 5% stopped the medication because of side effects, 18% because of lack of effect, while 42% had resigned themselves to their voiding disorders. Twenty-nine claimed to be cured or were still using the drug with beneficial effect. Nevertheless the treatment had continued for 6 months in both the group with no effect and in the group with good effect. The anticholinergic medication is of some value because it helps the patient to accept the bladder dysfunction, to alter the micturition habits and to assist in re-establishing inhibition of the micturition reflex.

Adult↗
PubMed1984

[Behavior of atheromatous vessel segments during pressure application of 5 kg/cm2 for various periods of time].

In this study changes in weight and thickness of atheromatous vessel wall segments in relation to a varying duration (2-60 sec.) of a constant pressure application (5 kg/cm2) were investigated. Vessel wall segments were taken shortly postmortem from human femoral and external iliacal arteries. According to the type of atherosclerotic changes the samples were divided into 2 types (lipoidosis/sclerosis) before the experiments. As standard served non-atheromatous segments. During pressure application all specimens showed rapid decrease in weight and thickness within the first 40 seconds. After 50 seconds no further change could be seen. Atheromata predominantly containing lipids and few collagen fibres showed higher decrease in weight and thickness than those predominantly containing collagen and the control group. A positive correlation was shown between decrease in weight and thickness of the specimens. Is is concluded that squeezing out tissue fluid by pressure application may lead to a decrease in thickness of the atheromata; the enlargement of the luminal diameter achieved by balloon catheters may be attributed to this mechanism.

Angioplasty, Balloon↗
PubMed1983

Adult enuresis and hyperthyroidism.

Two female patients with adult enuresis and enuretic syndrome were cured of their voiding disorders after treatment for hyperthyroidism. They were without symptoms at follow-up five and one-half and one and one-half years later. A relation between thyroid and bladder function is suggested which calls for further investigation in a controlled study.

Adult↗
PubMed1983

Incontinence surgery in female motor urge incontinence.

Conventional incontinence surgery was performed in 41 consecutive female patients despite the finding of motor urge incontinence. The patients were reinvestigated 6 months to more than 2 years after operation. Twenty-eight of the patients also had the symptom stress incontinence. Seventeen patients had coexisting symptomatic genital prolapse and were operated on without prior pharmacological treatment. The remaining 24 patients were all resistant to parasympatholytic treatment. The choice of operative procedure was based on vaginal examination as well as bladder suspension defect as demonstrated on voiding-colpo-cysto-urethrography. Subjective cure and improvement rate was 73%. At follow-up, 30% of the patients had normal detrusor reflex control, and a significant improvement in urge incontinence as well as frequency of micturition and nocturia was observed. Probably the primary treatment in females with motor urge incontinence should be pharmacological. However, in patients with symptomatic genital prolapse as well as in patients with ineffective medical treatment, conventional incontinence surgery seems to be well indicated in the absence of neurological disease-providing the patient has an associated bladder suspension defect.

Adult↗
PubMed1983

Follow-up of female patients complaining of urinary incontinence.

Sixty-three of 303 patients complaining of urinary incontinence and referred to hospital for examination were not treated, but followed for a median period of 33 months. Eighteen did not wish for treatment. The remaining were followed either because they had few subjective symptoms or because of concomitant bronchitis, or obesity, or owing to the fact that urinary incontinence could not be demonstrated during the objective examination. The patients were followed in order to offer treatment should this become necessary and to register the spontaneous progress of the condition. Fifteen of the 18 patients not wanting treatment were seen at follow-up and none had changed their minds with regard to treatment. In the other group, only 8 of 35 patients complaining of urinary incontinence without concomitant disease wished to have treatment and required re-evaluation. Urinary incontinence had been verified primarily in four only. The finding underlines the importance of a careful history and emphasizes the fact that patients with slight symptoms and no objective findings of urinary incontinence rarely develop more severe symptoms.

Female↗
PubMed1983

Chlamydia trachomatis in acute epididymitis.

The etiology of acute epididymitis was studied in 52 patients. Infection with Chlamydia trachomatis was demonstrated by culture or serology in 13 patients. In men under the age of 25 C. trachomatis was associated with 7 out of 9 cases of epididymitis, in contrast to none of the 19 cases in men above 35. Culture from the urethra is probably sufficient in diagnosing infection with C. trachomatis in patients with acute epididymitis, since only one patient with a negative urethral culture had a chlamydia-positive aspirate from the epididymis. Half of the cases of epididymitis in men above the age of 35 years were associated with urinary tract infection. One patient was infected with N. gonorrhoeae and one had tuberculosis of the epididymis.

Acute Disease↗
PubMed1983

A disposable uroflowmeter for recording of maximum flow rate. Accuracy and clinical acceptability.

A disposable urinary flowmeter (Peakometer) was evaluated in regard to accuracy of measurement and acceptability by patients. Laboratory tests of measurement accuracy were made with five Peakometers as recordings of maximum flow rate and voided volume. The accuracy was found to be acceptable. A minimum voided volume of 200 ml is recommended for a reasonably exact recording of maximum flow rate. Ten patients aged 28-86 years tested the acceptability of the Peakometer. All were able to use the apparatus correctly and to register maximum flow rate and voided volume of urine in accordance with written standardized instructions. The disposable flowmeter can be recommended for patients who live far from their hospital, thus saving time and transport costs. Clinics with relatively few patients requiring urinary flow studies may use the disposable flowmeters, instead of investing in relatively expensive electronic apparatus.

Adult↗
PubMed1983

Bone scintigraphy in Moore hemiarthroplasty with and without cement following femoral neck fractures. A controlled study.

In a controlled clinical trial patients with acute femoral neck fractures were allocated into two groups of treatment. One group (14 patients) had a Moore hemiarthroplasty cemented with methyl methacrylate, and the other (15 patients) a noncemented prosthesis. Bone scanning with 99m-Tc-MDP was performed 6 weeks, 3 months, 6 months and 12 months after the operation. Increased activity without time-trend was found at the operated side during the entire observation period in both groups. The activity was equally increased in the two groups. No correlation was found between the scintigraphic activity and the functional hip assessment according to Merle d'Aubigné. Bone scintigraphy is of no diagnostic value in the evaluation of a hemiarthroplasty, cemented or without cementation, during the first year postoperatively, as an increased activity might be expected through the entire period.

Aged↗