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T J Wells

Publications and source records attributed to T J Wells.

At least 37 records · Page 2Linked to original sources
PubMed1987

Comparison of self-reported voided volume with cystometric bladder capacity.

We determined the validity of cystometric bladder capacity compared to self-reported voided urine volumes measured by the patient at home. The subjects included 200 ambulatory incontinent women 55 or more years old who were evaluated with a prospective protocol of home diaries, history, physical examination and urodynamic studies. The mean smallest and largest daily voided volumes, and the daily mean of all voided volumes were determined from the diary. Comparison of the cystometric bladder capacity with the daily voided volumes showed a significant positive correlation between cystometric bladder capacity and the largest voided volume (r equals 0.4938, p less than 0.01). Comparison of the mean daily and mean largest daily void, and the cystometric capacity with the different urodynamic diagnoses using analysis of variance revealed a statistical significance among the groups (p less than 0.01). We established the validity of cystometric bladder capacity in the measurement of functional bladder volume and that a home diary may be useful in clinical practice.

Aged↗
PubMed1987

Urinary incontinence in elderly women: clinical findings.

Two-hundred women self-described as having urinary incontinence, aged 55 to 90 years and living in the community completed a comprehensive history and physical examination. Initial presentation of urine loss was most commonly stress incontinence symptoms (35%). Scoring of peak response to volume lost and frequency revealed urine loss necessitating a clothing change for 78% and daily loss experienced by 73%. Over half had experienced a urine loss problem for more than five years. Most (65%) had sought treatment, but a minority reported current (11%) or previous (36%) treatment. Thirty-six percent were found to have severe atrophic vaginitis with severe urethocele (10%), cystocele (13%), rectocele (12%) less common. Pelvic floor strength by clinical scoring was weak (mean, 1.05 on a 5-point scale). The vaginal electromyograph first contraction peak mean was 5.94 microvolts sustained at 50% or better for 3.92 seconds. Clinical criteria established that 66% had stress, 27% a mixture of stress and urge, only 4% pure urge incontinence, and 4% other.

Aged↗
PubMed1987

Urinary incontinence in elderly women: urodynamic evaluation.

The objective of this study is to characterize urinary incontinence observed in elderly women and to assess the importance of various parameters used to evaluate urinary incontinence. Two hundred consecutive, ambulatory, outpatient, incontinent women 55 years of age and over who were seen at the Continence Program Clinic and completed a medical and urodynamic protocol are included in this paper. After a thorough medical history and a complete physical examination, urodynamic tests were performed. The urodynamic results showed that 77% of incontinent women had an incompetent urethra. Twenty-five percent had a hyperactive bladder, 8% had "other" types, and 7% had a normal study. Comparison of the clinical diagnosis with the actual urodynamic diagnosis for stress incontinence revealed a 78% accuracy and only a 6% false negative. In contrast, a similar comparison for urge incontinence found only 44% accurate and 45% false negative. Analysis of the urodynamic tests revealed that the simple provocative full-bladder stress test was as effective as the radiographic or electronic pressure measurement in detecting incompetent urethra producing stress urinary incontinence. Provocative upright cystometry was helpful in uncovering 33% of hyperactive bladders not provoked in the supine position. Complex urodynamic tests should be reserved for unexplained incontinence or when symptomatology is complex.

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PubMed1982

Effect of asphyxia on theophylline clearance in newborns.

The effect of asphyxia on theophylline clearance was studied in 30 newborns who were matched for gestational age, postnatal age, and the presence or absence of asphyxia. Asphyxiated newborns cleared theophylline at approximately half the rate of nonasphyxiated newborns. We found that, in order to achieve a steady-state plasma concentration of 8 mg/L of theophylline, asphyxiated neonates should receive 2.1 mg/kg/day, while nonasphyxiated neonates should receive 3.9 mg/kg/day.

Asphyxia Neonatorum↗
PubMed1982

Efficacy of phenobarbital monotherapy in treatment of neonatal seizures -- relationship to blood levels.

Seventy-one neonates were observed for the relationship between phenobarbital plasma concentrations and elimination of seizures. Sixty neonates (85%) had seizures controlled by phenobarbital alone. Effective plasma concentrations were 10.1 to 46.4 mg per liter. Although 36 neonates had seizures controlled by phenobarbital concentrations below 20 mg per liter, 7 neonates required levels above 30 mg per liter. We recommend that plasma phenobarbital concentrations should equal or surpass 40 mg per liter before additional anticonvulsants are used for neonates with seizures.

Humans↗
PubMed1976

A new concept in the control of acute gingival hemorrhage.

The topical application of epsilon-aminocaproic acid may be life-saving therapy for control of acute gingival hemorrhage in patients who are debilitated because of systemic diseases. When low doses were used, there have been no reports of adverse reactions.

Administration, Topical↗
PubMed1975

A new model for neonatal pulmonary hemorrhage research.

Hemorrhagic atelectasis was successfully produced in newborn rabbits by pharmacologically narrowing airways leading to alveoli ventilated with oxygen-enriched gas. Between 48% and 62% of alveoli filled with blood cells. Areas of lung with a tendency to collapse were measured by pressure volume studies. Animals given supplemental oxygen retained 56% of total lung volume compared with 79% in the pilocarpine group, which suggested increased effectiveness of anti-atelectasis factors in the latter. Less total lung gas was present in the pilocarpine group (4.0 plus or minus 0.4 cc/g) compared with oxygen controls (5.1 plus or minus 0.81 cc/g), which indicated more noninflatable lung. Neither surfactant deficiency nor heart failure needed to be present for pulmonary hemorrhage to occur.

Animals↗