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Biomedical subjects

D Fonda

Publications and source records attributed to D Fonda.

35 records · Page 2Linked to original sources
PubMed1993

Simple screening for urinary incontinence in the elderly: comparison of simple and multichannel cystometry.

Urinary incontinence is a major cause of suffering and disability especially in the elderly. Accurate diagnosis is important to optimize treatment and multichannel cystometry is regarded as the gold standard. Simple cystometry is a technique of bedside cystometry using a single lumen catheter and filling syringe. Simple cystometry was compared with multichannel cystometry in 83 patients (mean age 73.5 years) and was found to have a specificity of 75 percent and a sensitivity of 88 percent for the diagnosis of detrusor instability. Simple cystometry is a quick, easy, and useful test which can be readily performed in the elderly by a doctor or trained nurse. Residual urine measurement, testing for stress incontinence, and estimation of flow rate can be performed at the same time. It can enable the most appropriate treatment to be initiated by improving the diagnostic accuracy of the clinical assessment when more complex resources and expertise is not available. In a proportion of patients further referral and investigation may be necessary.

Aged↗
PubMed1990

Improving management of urinary incontinence in geriatric centres and nursing homes. Victorian Geriatricians Peer Review Group.

OBJECTIVE: To study prevalence and management of urinary incontinence in institutes and to recommend improved strategies of managing this problem. METHOD: A one-day census of ten geriatric assessment and rehabilitation services and nursing homes was undertaken to estimate the extent and management of urinary incontinence in Victoria. The definition of incontinence was extended to include patients with 'dependent continence', i.e. being dry of urine only as a result of being reminded or physically assisted. RESULTS: A total of 1659 patients, comprising 333 short-stay and 1326 nursing home type patients, was surveyed. The mean age was 77 and 81 years respectively. Only 43% and 23% of these patients respectively were independently continent, whilst 26% and 11% respectively of all patients were dependent continent. Incontinence occurred once or more per day in 85% of these patients and had usually been present for at least one month. There was a high association between incontinence and physical and mental infirmity. Dependent continent patients were as physically handicapped as their wet counterparts. A diverse range of management strategies, including various toileting programmes, was employed to deal with the incontinence. It is concluded that urinary incontinence is more common than reported in previous studies, largely as a result of the additional group of patients with dependent continence, a condition that often can be achieved. Proposed management protocols are outlined which aim to define different population subgroups that might respond more effectively to the various interventions available. The need for follow-up appraisal of these interventions is emphasized.

Activities of Daily Living↗
PubMed1988

A prospective study of the incidence of urinary incontinence in an acute care teaching hospital and its implications on future service development.

OBJECTIVE: To assess the incidence of urinary incontinence and indwelling catheter use. METHOD: A prospective study of 627 consecutive admissions to an acute care teaching hospital over a 4-week period. RESULTS: At least one episode of urinary incontinence was experienced by 145 patients (23.4 per cent of all admissions) with 28 per cent of these having urinary incontinence lasting more than 10 days. Patients with urinary incontinence had a significantly greater age, mean length of stay and overall mortality compared with the total hospital inpatient population. During this survey, 7 per cent of all inpatients suffered from at least one episode of faecal incontinence, with the mean duration of faecal incontinence being 5.4 days. The major discriminating findings were from the data of patients with urinary incontinence for longer than 10 days. These patients had a longer length of stay (47 days compared with 17 days for patients with urinary incontinence 10 days) and poorer outcome (28 per cent went to nursing homes and 50% returned home compared with 7 per cent and 81 per cent respectively for pts with incontinence less than 10 days). Patients on medical wards and those with confusion or poor mobility fared disproportionately worse. After 10 days of incontinence, only 59 per cent of these patients had a rectal examination; and 90 per cent a urine specimen for culture. The interpretation and implication of these findings will be discussed particularly as it related to future planning for continence services and the development of clinical nurses with knowledge of urinary incontinence.

Adult↗
PubMed1987

Multiple sites of alternative splicing of the rat fibronectin gene transcript.

We describe analyses of the structure and expression of the rat fibronectin gene with particular attention to the 40-kb stretch from the center of the gene which encodes 17 type-III repeating units. Each repeat is precisely separated from its neighbors by introns and most are encoded by pairs of exons. Three repeats are encoded precisely by single exons and two of these (EIIIA and EIIIB) are alternatively spliced in a cell type-specific fashion. A third site of alternative splicing (EIIIB) reported here is similar in expression to the previously described EIIIA segment. Both are excluded from mRNA in liver cells and are, therefore, absent from plasma fibronectin. These two alternative splices, plus a third one (V) reported previously, can occur in all possible combinations giving 12 fibronectin mRNAs from a single gene. These splicing variations account for most but not all of the known fibronectin subunit variants. We report investigations designed to detect other regions of alternative splicing. We also show that the pattern of alternative splicing is somewhat altered on oncogenic transformation.

Amino Acid Sequence↗
PubMed1987

Photodynamic therapy of spontaneous animal tumors using the active component of hematoporphyrin derivative (DHE) as photosensitizing drug: clinical results.

Photodynamic therapy was performed on 25 primary spontaneous tumors in dogs and cats. The animals were injected with 2.5 mg/kg body wt. of tumor localizing fraction of hematoporphyrin derivative and treated 48 h later with laser light at 631 nm. In 5 cases the treatment was performed on the tumor bed after surgical excision of the tumor mass. An evaluation of clinical results is presented and discussed. Complete remission was obtained in 19 cases and partial remission in 6 cases.

Animals↗
PubMed1986

Structure of integrin, a glycoprotein involved in the transmembrane linkage between fibronectin and actin.

We describe the isolation, characterization, and sequence of cDNA clones encoding one subunit of the complex of membrane glycoproteins that forms part of the transmembrane connection between the extracellular matrix and the cytoskeleton. The cDNA sequence encodes a polypeptide of 89 kd that has features strongly suggesting the presence of a large N-terminal extracellular domain, a single transmembrane segment, and a small C-terminal cytoplasmic domain. The extracellular domain contains a threefold repeat of a novel 40 residue cysteine-rich segment, and the cytoplasmic domain contains a tyrosine residue that is a potential site for phosphorylation by tyrosine kinases. We propose the name integrin for this protein complex to denote its role as an integral membrane complex involved in the transmembrane association between the extracellular matrix and the cytoskeleton.

Actins↗
PubMed1986

Telelink: the use of telephone conferences for multidisciplinary team meetings.

There are various circumstances where the traditional face to face setting for multidisciplinary meetings is not practical or possible. This includes departments which have a responsibility covering a large geographic region. This paper describes an inexpensive, cost-effective and novel way of conducting multidisciplinary meetings using the telephone conference facility. Team members based in the community are 'linked' by telephone to other members of the hospital-based Aged and Extended Care Department. These conferences led to a significant increase in the referral rate of community-based patients for fuller multidisciplinary geriatric assessment. It also provided a forum for education, exchange of ideas and development of new policy. Other uses for telelinking are highlighted, particularly its successful applications for linking together isolated and handicapped elderly people in the community.

Community Health Services↗
PubMed1985

Dynamic shape of the female urethra during micturition. Clinical methods.

Densitometry of the x-ray image provides a suitable technique for clinical quantification of the urethral shape during all stages of voiding. The technique of cystourethrographic densitometry is applied to determine the cross-sectional shape of the human female urethra during various phases of voiding. Errors that may occur because the x-rays are not perpendicularly incident to the urethral plane are considered and a method for their minimization is indicated.

Absorptiometry, Photon↗
PubMed1985

Parkinson's disease in the elderly: psychiatric manifestations.

Drug-induced psychiatric symptoms are usually reversible within days. However, if the patient also has cognitive impairment of a more permanent nature, improvement may not be seen for weeks or even months. During the year preceding the diagnosis of Parkinson's disease, the incidence of depression, hyperirritability, and instability of emotions is significant. After the onset of Parkinson's disease, depression is very common.

Aged↗
PubMed1984

Hematoporphyrin derivative photochemotherapy of spontaneous animal tumors: clinical results with optimized drug dose.

Hematoporphyrin derivative (HpD) photochemotherapy was performed on 13 primary spontaneous tumors in dog and cat. The animals received an optimized drug dose of 5 mg/kg body wt i.v. 48 h before the first treatment with laser light at 631 nm. An evaluation of the clinical results is presented and discussed. Complete disappearance of the primary tumors was obtained in all cases with one or more light irradiations. Five cases presented recurrences that were cured with a further treatment. In 4 cases treated after surgical exeresis of the primary tumors, this therapy resulted in complete cure.

Animals↗
PubMed1984

Algorithm for the determination of projected urethral lumen cross-sections and shape functions.

A method used to obtain computer graphic representations of projected urethral lumen cross-sections is described. The cross-sectional area of the lumen is measured accurately at all stages of voiding. Two methods of background subtraction are considered, direct subtraction from nonvoiding x-rays and subtraction from a least squares regression line. The projected cross-sections are described by simple shape functions. These shape descriptors increase the technique's potential application by providing a quantitative measure of the projected cross-sections.

Computers↗
PubMedDate not supplied

Urinary incontinence in the elderly.

Incontinence is a distressing, complex health problem which disproportionately affects older people. It is commonly endured silently, with many sufferers and carers not receiving appropriate support. In addition, incontinence is generally poorly managed both by families and health-care professionals, and is a major contributing factor in the institutionalization of the elderly. This paper argues that incontinence experienced in later life is often multifactorial in nature, thus health care professionals need to be cognizant of the many causes of incontinence, as well as the impact of lifestyle factors and 'normal' ageing processes. Incontinence in the community-based elderly can be cured or significantly improved in over 60% of cases with conservative management. Unfortunately community and professional attitudes and ignorance remain major barriers to continence.

Aged↗