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Biomedical subjects

L Winter

Publications and source records attributed to L Winter.

14 recordsLinked to original sources
PubMed1992

Management of urinary retention after surgical repair of hip fracture.

OBJECTIVE: To compare the use of indwelling catheters and intermittent catheterization in the management of urinary retention after surgical repair of hip fractures. DESIGN: Randomized open trial. SETTING: Orthopedic unit in a general hospital. PATIENTS: Patients 60 years or more admitted to hospital for surgical repair of a hip fracture between November 1986 and December 1987. Of the 76 who were eligible and agreed to participate 5 became medically unstable, 2 died before surgery, and 2 did not have urinary retention after surgery. The remaining 55 women and 12 men were randomly assigned to one of two treatment groups. INTERVENTION: An indwelling catheter inserted preoperatively was removed 48 hours after surgery (group 1); the procedure was repeated if necessary after 24 hours. Intermittent catheterization was performed every 6 to 8 hours (group 2); the frequency was adjusted to avoid bladder distension. MAIN OUTCOME MEASURE: Pattern of return to satisfactory voiding within 5 postoperative days. RESULTS: Of the patients in group 1, 37% resumed voiding within the 5-day postoperative period, as compared with 66% in group 2 (p less than 0.025). The mean numbers of days for return to satisfactory voiding were 9.4 and 5.1 respectively (difference 4.3 days, p less than 0.01, 95% confidence interval 0.7 to 8.0 days). Urinary tract infections developed in 31% of those in group 1 and 38% of those in group 2; the difference was not significant. CONCLUSION: Satisfactory voiding resumes earlier with the use of intermittent catheterization, if begun at the onset of urinary retention and repeated at regular intervals, than with the use of an indwelling catheter in elderly patients who have undergone surgical repair of hip fractures.

Aged↗
PubMed1979

Analgesic combinations with orphenadrine in oral post-surgical pain.

Two hundred male and female patients underwent a variety of oral surgical procedures and were treated afterwards in four test groups. They took a combination of orphenadrine (25 mg) and acetaminophen (325 mg), either drug alone, or placebo. A double-blind study design was used. All patients had moderately severe baseline pain intensity; post-treatment pain relief was recorded at 30 minutes, one, two, four and six hours. A back-up analgesic (codeine-ASA) was made available if needed. Pain intensity difference (PID) and sums of pain intensity difference (SPID) were calculated using established analgesic study techniques. Statistical analyses indicated better analgesic efficacy in both PID and SPID scores for the orphenadrine-acetaminophen combination over the three other treatments. This was evident at 30 minutes and continued through the sixth hour. Each active drug, in turn, was also significantly better throughout than placebo for pain relief. Sub-groups in each treatment regimen required additional pain relief prior to six hours, with significantly more placebo than orphenadrine-acetaminophen patients needing remedication. Side-effect incidence was very low and randomly distributed among the four groups.

Acetaminophen↗
PubMed1978

Analgesic activity of ibuprofen (Motrin) in postoperative oral surgical pain.

The effectiveness of 400 and 800 mg. of ibuprofen was compared to that of 650 mg. of aspirin, 65 mg. of propoxyphene HCl, and placebo in 510 patients experiencing pain subsequent to oral surgical procedures. In double-blind study, patients were randomly assigned to one of five experimental groups and instructed to report the intensity of pain (complete, partial, or none) over a 3-hour period of evaluation. Ibuprofen, at both doses, was shown to be more effective for both degree and duration of relief from pain.

Adolescent↗
PubMed1975

Problems & solutions.

Explore the source record for details and available documents.

Patient Acceptance of Health Care↗
PubMedDate not supplied

Tailoring family planning services to the special needs of adolescents.

Experimental service protocols tailored to the needs of teenage family planning patients were developed that emphasized indepth counseling, education geared to an adolescent's level of development, and the provision of reassurance and social support. These protocols were tested against usual service delivery practices in a study involving 1,261 patients under 18 years of age at six nonmetropolitan family planning clinics. A comparison with teenagers obtaining services at control sites found that six months after their first clinic visit, patients at the experimental sites were more likely to be using a method, were less likely to experience difficulty in dealing with problems, were more likely to continue using their method despite problems and had learned more during the educational session. Teenage patients at the experimental clinics were also less likely to have become pregnant within one year than those who went to control clinics. Attrition during the year following the first study visit was similar among both groups; patient satisfaction was very high, and equivalent at experimental and control sites. The data show that the extra time and effort required to meet the special needs of teenagers is justified by their improved contraceptive use, greater knowledge and lower pregnancy rates.

Adolescent↗
PubMedDate not supplied

Prevalence and epidemiologic correlates of Chlamydia trachomatis in rural and urban populations.

In two rural and two urban family planning clinics in central Pennsylvania, the authors screened 889 women making routine visits for Chlamydia trachomatis using the Chlamydiazyme immunoassay method (Abbott Laboratories; North Chicago, IL). C. trachomatis antigens were detected in 11.2% of the women; they found no differences in prevalence between rural and urban clinics. Among 21 clinical characteristics and seven risk factors, younger age (younger than 25), oral contraceptive use, gonococcal infection, mucopurulent exudate, abnormal vaginal discharge, and cervical ectropion were associated with chlamydial infection. Logistic regression revealed that age alone was independently associated with infection. The authors found that screening criteria derived from other epidemiologic studies generally did not predict the presence of C. trachomatis in the present sample. In a follow-up study performed at least one year later, 169 patients were re-screened; 47 tested positive and 122 negatives for C. trachomatis. Overall, 11.8% were infected, which was 12.4% of those who originally tested negative and 10.6% of those who originally tested positive.

Chlamydia trachomatis↗