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Biomedical subjects

W Doherty

Publications and source records attributed to W Doherty.

17 recordsLinked to original sources
PubMed2001

Promoting planned care for patients with indwelling catheters.

Indwelling urinary catheters are common among patients in the community. Use of a catheter entails a significant lifestyle adjustment on the part of the patient, who must learn a new regime of self-care. In order to help patients to cope with the new device, it is essential that nurses play an active role in educating patients and involving them in the decision-making process. By empowering patients through knowledge of their condition and care, nurses can encourage greater compliance with care plans and reduce the risk of potentially distressing complications that can arise from indwelling catheters.

Catheters, Indwelling↗
PubMed2001

Urinary sheaths: assessment, prescription and evaluation.

Urinary sheaths are a common solution to male urinary incontinence, but can be a source of much anxiety and discomfort if incorrectly fitted. This article discusses the process of assessment that must precede the prescription of a urinary sheath system. Assessment of bladder function and correct fitting and sizing are essential. The article also discusses the range of urinary sheath systems available, some of the problems that may arise in their use, and the processes of evaluation that should accompany use.

Aged↗
PubMed1996

Internal fixation of oblique metacarpal fractures. A biomechanical evaluation by impact loading.

Internal fixation of oblique metacarpal fractures was studied in a cadaver model by impact loading. One hundred twenty fresh-frozen human metacarpals underwent compressive and bending impacts after oblique osteotomy and internal fixation. Dorsal plating with lag screws, 2 dorsal lag screws (2-screws), crossed Kirschner wire tension band (crossed K-wire), 5 stacked intramedullary Kirschner wire (5-rod), and paired intramedullary Kirschner wire (2-rod) were used. The failure occurred within 6 msec in the compressive impact and was almost immediate in the bending impact. The dorsal plate and the intramedullary rod fixations were the strongest and were not significantly different from the intact specimens in compressive impact; they were, however, 19% weaker in bending impact. The 2-screws was the weakest fixation in this group. This fixation was 59% weaker in compressive impact and 47% weaker in bending impact compared with the dorsal plating.

Biomechanical Phenomena↗
PubMed1993

Scapholunate advanced collapse pattern of arthritis in calcium pyrophosphate deposition disease of the wrist.

Chondrocalcinosis is a well-described radiographic finding in patients with calcium pyrophosphate dihydrate deposition disease of the wrist and other joints. The medical records and x-ray films of 12 patients evaluated over an 18-month period for chondrocalcinosis of the wrist were examined for symptoms and physical and x-ray film findings. Thirteen wrists were affected. All wrists were noted to have calcification of the triangular fibrocartilage complex. Twelve of 13 wrists had the characteristic features of the scapholunate advanced collapse pattern of arthritis. In addition, there was a correlation in our series between chondrocalcinosis and carpal tunnel syndrome. Destruction of the interosseous soft tissues caused by crystalline deposition could alter the biomechanics of the wrist in a similar fashion to that of the post-traumatic scapholunate advanced collapse wrist leading to arthritic symptoms.

Aged↗
PubMed1988

Costs and consequences of drug use: a comparison of health care utilization and social-psychological consequences for clinical and nonclinical adolescents and their families.

A retrospective (case control) design was used to compare adolescents in treatment for alcohol and drug problems and their families with adolescents and families not in treatment to determine: (1) the extent to which adolescents' drug-using behavior was associated with greater physical and mental health services utilized by the adolescent and his/her family members over a period of 3 years; and (2) costs incurred for a health maintenance organization and social-psychological consequences for the individuals and their families. On the average, those families with an adolescent with alcohol and/or drug problems use more health services, resulting in greater costs to the prepaid health plan than the costs for families with adolescents not in treatment or not using drugs. For both the adolescents and other family members, significant differences between groups were found for utilization of mental health services, but not for services for physical health. Consequences of drug use--relational, health related, and social/legal--were greatest for adolescents in treatment. Adolescents whose drug use was similar to those in treatment, but who were not in treatment, also experienced drug-related consequences; this group can be considered at high risk for alcohol and drug problems that, in the future, may require treatment.

Adolescent↗
PubMed1988

Familial, interpersonal, and intrapersonal correlates of drug use: a longitudinal comparison of adolescents in treatment, drug-using adolescents not in treatment, and non-drug-using adolescents.

This study examined familial, interpersonal, and intrapersonal factors associated with adolescent drug use from both developmental and etiological perspectives. Retrospective case-control and prospective longitudinal designs were used. A multivariate analysis of variance with repeated measures design was conducted to examine changes over time and differences between groups of adolescents in treatment for alcohol and drug problems, drug-using adolescents not in treatment, and non-drug-using adolescents, on 16 measures of familial, interpersonal, and intrapersonal variables. Significant differences were found between adolescents using drugs (clinical or nonclinical) and those not using drugs and alcohol. No differences were found in any of the variables between clinical adolescents and those using drugs but not in treatment.

Adolescent↗
PubMedDate not supplied

The Clear Advantage urinary incontinence sheath for men.

All too often in the past urinary sheaths have been dismissed as having failed their user and carer simply because they have been poorly fitted or incorrectly measured. This article looks at the progressive development of the urinary incontinence sheath, from the various 'home-made' appliances that people with bladder problems conjured up, to today's more effective, more reliable products, such as the Clear Advantage all-silicone urinary incontinence sheath from Seton Continence Care.

Equipment Design↗
PubMedDate not supplied

The Aquacath hydrophilic coated single-use urinary catheter.

Single-use hydrophilic catheters are now being used widely throughout this country, Europe and America, for intermittent self-catheterization or carer-assisted intermittent catheterization, with considerable success. They are also reported to provide greater comfort for users. The latest catheter to become available on prescription is the Aquacath coated urinary catheter, produced by Seton Continence Care. This hydrophilic catheter performed very well in a trial comparing coating stability after wetting of various coated catheters (Jones, 1997). The teaching of intermittent self-catheterization must conform to local protocols and trust agreements. Nurses should find out about these and follow them. When teaching any procedure or technique to untrained carers, the nurse must always remember that he/she has overall responsibility for supervision and ensuring safe practice.

Equipment Reuse↗
PubMedDate not supplied

EasiCath: an advanced alternative to indwelling urethral catheters.

This article looks at EasiCath, the single-use hydrophilic catheter manufactured by Coloplast Ltd. EasiCath is now widely used throughout the UK and Europe. Since the launch of EasiCath, Coloplast has continued to develop its lubricated catheters and with the recent inclusion of the 30 cm EasiCath on the Drug Tariff, Coloplast now provides the most extensive range of lubricated catheters in the UK. In recent trials looking at the cell count on the surface of hydrophilic catheters following catheterisation, EasiCath performed well, indicating that it is a safe choice of lubricated catheter (Biering-Sorensen et al, 1999). This, combined with the benefits of the precoated, polished eyelets and the potential cost saving to the GP (4.60 Pounds per box of 25) over a number of other catheters available, means that EasiCath has become the first choice of hydrophilic catheter for many patients.

Disposable Equipment↗
PubMedDate not supplied

Instillagel: an anaesthetic antiseptic gel for use in catheterization.

Instillagel is a prefilled syringe containing lignocaine 2% and chlorhexidine 0.25% in a sterile lubricant gel. It is available in two sizes, 11 ml and 6 ml, for male and female catheterization respectively, and for intermittent self-catheterization. It has been used successfully for these purposes for many years, and its usage in the community setting is increasing. It is used for surface anaesthesia by many UK urologists. It is easily applied by both nurse and patient and remains the product of choice when performing indwelling catheterization. It also has an important role in stricture therapy where patients require extra lubrication for the passage of a catheter or an anaesthetic effect to provide patient comfort following the procedure. Instillagel has the added benefit of an antibacterial effect due to its chlorhexidine content.

Administration, Intravesical↗
PubMedDate not supplied

Indications for and principles of intermittent self-catheterization.

Intermittent self-catheterization (ISC) or carer/nurse assisted intermittent catheterization has developed over the past few years as a means of treating patients with bladder emptying problems. Initially the process was designed for patients with the dexterity to carry out the procedure; today, however, more nurses are trained in the technique and are therefore able to support people with coordination problems in carrying out the procedure. Education programmes on catheterization are becoming increasingly popular and many district nurses have become skilled in its practice. This article describes some of the conditions that may be associated with bladder dysfunction and which warrant ISC. The support required from nurses in the planning, implementing, intervention and evaluation of a package of care are discussed. Simple advice such as avoiding constipation, monitoring urine to identify infection and general measures to improve hygiene all play a role in maintaining good health.

Female↗
PubMedDate not supplied

The Sims Portex Catheter Valve: an alternative to the leg bag.

Any patients who would normally use a catheter and leg bag could benefit from exchanging their leg bag for a catheter valve, as long as they have the manual dexterity to open their valve at regular intervals and remember to do so. The Sims Portex Catheter Valve is a lightweight and compact catheter valve that is discrete and offers more comfort than a leg bag system, especially to the more mobile patient. This article examines this type of catheter valve and assesses its relevance for use in both the community and the acute sector.

Catheters, Indwelling↗
PubMedDate not supplied

Trident T2: a new development in urine bag tap design.

This article looks at Seton Scholl Continence Care's Simpla Trident T2 leg bag with the new advanced lever-action tap which has recently won the Independent Living Design Award. This easy-to-use lever-action tap has a simple, positive action which allows more independence and less intervention from carers. The lever-action tap enables the patient with limited hand coordination or poor finger/thumb dexterity to operate it effectively. The tap is smooth to the touch and the corners have been rounded to reduce any sharpness. The Simpla Trident T1 and T2 bags have the protected sample port to allow safe urine sampling without the need to break the system.

Drainage↗
PubMedDate not supplied

Indwelling catheters: practical guidelines for catheter blockage.

Catheterization is a medical decision and requires a team approach involving, where possible, the patient and carer, as well as those professionals administering care. Catheterization and subsequent effective catheter drainage is associated with many dangers and complications (Lowthian, 1998) and therefore the decision to catheterize someone should not be taken lightly. Catheterization should only be used in intractable incontinence when all other measures have been tried and proven to be ineffective. This article identifies some of the problems associated with the care of patients with indwelling catheters in the community setting, and examines the issues that can cause pain, distress and discomfort to patients. It looks at the various types of solutions to problems associated with catheterization. Case histories are used to illustrate the types of patients who may have been catheterized. It is hoped that nurses can learn from these examples, so that they will not only cope more effectively with these individuals, but also observe their own practice when initiating indwelling catheterization and developing care packages.

Aged↗
PubMedDate not supplied

Urinary sheaths and drainage bags available from Manfred Sauer.

This article looks at the wide range of sheaths, adhesives and leg bags manufactured and supplied by Manfred Sauer. The company designs from the user's perspective and has a unique range of products from condom-type drainage systems to leg bags. The company also markets URIbags which are reusable, pocket-sized urinals for men and women.

Female↗
PubMedDate not supplied

TENA flex: a new concept in disposable incontinence pads.

The development of adult or larger-sized all-in-one incontinence products continues to improve. The latest addition to the many products available for the management of moderate to heavy urinary incontinence is TENA flex, manufactured by SCA Hygiene Products. TENA flex is an all-in-one belt-style product, which does not require separate fixation as with a pad and pant system, and relies upon a different measurement process to ensure proper pad selection, fitting and positioning. The range of TENA flex features will be discussed in this article.

Adult↗