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Biomedical subjects

E Leahy

Publications and source records attributed to E Leahy.

9 recordsLinked to original sources
PubMed1998

An outbreak of Escherichia coli O157:H7 infections associated with leaf lettuce consumption.

In July 1995, 40 Montana residents were identified with laboratory-confirmed Escherichia coli O157:H7 infection; 52 residents had bloody diarrhea without laboratory confirmation. The median age of those with laboratory-confirmed cases was 42 years (range, 4- 86); 58% were female. Thirteen patients were hospitalized, and 1 developed hemolytic-uremic syndrome. A case-control study showed that 19 (70%) of 27 patients but only 8 (17%) of 46 controls reported eating purchased (not home-grown) leaf lettuce before illness (matched odds ratio, 25.3; 95% confidence interval, 3.9-1065.6). Pulsed-field gel electrophoresis identified a common strain among 22 of 23 isolates tested. Implicated lettuce was traced to two sources: a local Montana farm and six farms in Washington State that shipped under the same label. This outbreak highlights the increasing importance of fresh produce as a vehicle in foodborne illness. Sanitary growing and handling procedures are necessary to prevent these infections.

Adolescent↗
PubMed1994

The effects of changing prompted voiding schedules in the treatment of incontinence in nursing home residents.

OBJECTIVE: To determine the effects of different prompted voiding schedules on urinary incontinence on a continence unit (CU) and the maintenance of benefits on normal nursing units. DESIGN: Multiphase study with both intra- and inter-subject comparisons. PARTICIPANTS: Subjects were 41 consenting incontinent nursing home residents. Based on clinical criteria, subjects were assigned to one of four treatment groups that varied as to the schedule of prompted voiding received. MEASUREMENT: The study used chart review, Katz ADL, and MMSE. Urologic status, self-initiated toileting, urine volumes voided, and incontinence assessed by pad/pants checks were measured by research nurses. Baseline pad check data were collected on residents' normal nursing units. Residents were transferred to the CU where baseline measurement was repeated, and the effects of different prompted voiding schedules were then assessed. Indigenous staff were trained to use prompted voiding, and nurse supervisors were instructed in special procedures for enhancing maintenance of the intervention. Residents were returned to their normal units and the maintenance of improvements in continence status was assessed at 2 weeks and 3 months post-CU discharge. RESULTS: One of the four groups showed significant improvement on the CU in response to the 2-hour schedule; two groups improved on the less intensive 3-hour schedule (P < 0.05). Two groups maintained this improvement on their normal nursing units (P < 0.05); one group showed a non-significant trend toward improvement. Self-initiated toileting decreased (P < 0.05) and volume voids in an appropriate receptacle increased (P < 0.05) during training. CONCLUSIONS: Prompted voiding is an effective treatment for urinary incontinence, and a less intensive 3-hour schedule may be superior to the standard 2-hour schedule for some residents. These improvements in dryness can be maintained by normal nursing home staff if formal staff management procedures are utilized by nurse supervisors.

Aged↗
PubMed1992

Urinary incontinence: an augmented prompted void approach.

Continence improves from 44.7% dryness at baseline to 54.7% at the end of treatment, an improvement of 22%, or about one incontinent episode per day. Urinary incontinence is improved in cognitively impaired residents by augmenting the prompted voiding procedure with a bellpad. Bladder behavior changes with behavioral treatment strategies, because the volume voided into an appropriate receptacle increased an average of 26 mL per 2 hours. Reimbursement policies should not exclude treatment of the severely cognitively impaired nor the immobile in nursing homes.

Adult↗
PubMed1988

The effectiveness of the superiorly based pharyngeal flap in relation to the type of palatal defect and timing of the operation.

A 10-year review of 39 patients who underwent a superiorly based pharyngeal flap for severe velopharyngeal insufficiency was performed. The effectiveness of the operation, as scored by standardized preoperative and postoperative evaluations, was related to age at operation, type of defect, and duration of velopharyngeal inadequacy. There was no statistical difference between those who were under the age of 6 years (100 percent were improved) at the time of the operation versus those 6 years and older (74 percent improved). Likewise, there was no difference between those patients who received an early flap (92 percent were improved) versus those who received a flap 2 or more years after initial palatorrhaphy (90 percent were improved). The type of palatal defect also was not a significant factor, and none of the patients exhibited a postoperative decrease in function (p less than or equal to 0.001). The operation offered reliable salvage of velopharyngeal competency regardless of the above-mentioned factors.

Adolescent↗
PubMed1988

Nursing management of urinary incontinence in geriatric inpatients.

The management and treatment of incontinence represent two interrelated areas--providing enough providers of care and describing the types of management and treatment options available to the incontinent patient. This article has stressed that adequate staffing underlies any successful program of continence management and treatment. In addition, many options for the management and treatment of incontinence in the elderly have been presented. Of importance are the specific nursing implications that will make many continence protocols successful. These guidelines can provide the basis for planning patient care through the nursing process. This article has also addressed management and treatment strategies for incontinence that not only improve incontinence in patients but may cure it. These include behavioral management strategies which nurses should be encouraged to use in treating incontinent patients in the community. These same behavioral management strategies are being studied in inpatient settings, and the results indicate that nurses in inpatient settings and long-term care facilities should implement behavioral treatment programs for incontinent patients.

Aged↗