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PubMedDate not supplied

Selecting the correct incontinence pad in nursing home patients by pad weighing.

The aim of this study was to identify which types of absorbent pads were being used by the inhabitants of two nursing home wards and to determine to what extent the pads were adapted to the patient's leakage volume. An objective assessment of urinary leakage was performed in all the men (age 80.2 +/- 8.0 years) and women (age 84.8 +/- 6.5 years), from the two wards, who used incontinent aids (n=41). Subjects were assessed by weighing all incontinence aids on a precision weight scale before and after use during a period of 7 days. The number of patients experiencing wetting of external clothing or bedding was recorded. During the assessment period 1146 pads were used and the mean urinary leakage per patient during the day was 260 +/- 212 ml and during the night 413 +/- 230 ml. Wetting of external clothing or bedding occurred during the day time in 16% and in 40% at night time despite the use of pads. Only 22% of the pads were adapted to the patients degree of urinary incontinence. Many of the nursing home inhabitants were using larger pads than necessary. If the pads had been adapted to the patient's urinary leakage volume, costs for incontinence aids would have been reduced by 31%.

Journal Article↗
PubMed2005

[Diagnostic algorithms in female urinary incontinence].

Urinary incontinence is frequent problem with significantly negative impact on the quality of life. The correct plan of examination leads to the proposal of the appropriate treatment. The history, correct judgment of symptoms of incontinence and detailed gynaecological examination are important at the beginning of the diagnostic process. Negative urine cultivation is necessary condition for the invasive investigation of the urinary tract. Special questionnaires, micturition diary and clinical tests belong to the physical examination. The pad-weight test is based on the measurement of weight gain of absorbent pads during a test period under standardised conditions. Q-tip test (cotton swab test) measures the degree of mobility of urethra and bladder neck. Most of the clinical tests can be replaced by the ultrasound examination (introital or perineal approach), which helps to appreciate the vigour of urethra, bladder neck and vagina during the resting period and at stress. Urodynamic examination records pressure changes during the bladder filling, pressure gradients in urethra and the velocity of the urinary flow. It should be carried out when antiincontinence surgery is planned or when conservative therapy failed. Urodynamic examination helps to distinguish between stress and urge type of incontinence. Urethrocystoscopy is indicated for the diagnosis of the recurrent urinary infections, urge incontinence when structural pathologies of the urinary bladder are suspected, iatrogenic incontinence or postoperative complications.

Algorithms↗
PubMed1986

Evaluation of the Du Pont Pro-Tek Formaldehyde Badge and the 3M Formaldehyde Monitor.

The 3M Formaldehyde Monitor and the DuPont Pro-Tek Formaldehyde Badge were evaluated for performance and reliability. This evaluation revealed that the 3M monitor results were variable and lower than reference concentrations determined independently. When the monitors were humidified before use and then exposed in humid (ca. 80% RH) formaldehyde-containing atmosphere, the monitors did give accurate results. Results of additional experiments led to the conclusion that quantitative reaction between formaldehyde generated in our chamber and the absorbent pad in the 3M monitor required the presence of a minimum level of absorbed water. The DuPont badges gave good agreement with the reference concentrations determined independently under the following conditions: sampling period of 1 to 12 hr with a minimum integrated sample loading of 4 ppm-hr; at least 3 m/min (10 ft/min) face velocity; correction for blank badges; and correction for loss of reagent from the samples. The evaluation indicated that the DuPont badge was not well suited to short term sampling and was subject to evaporation of liquid from the absorbing liquid blister. Blank values also were found to be variable, necessitating the analysis of several blanks to be used for blank correction with each set of samples. This blank variability also contributed to high variability found when short term measurements were made. The badge also had a negative interference from phenol at high phenol-to-formaldehyde ratios. Some of the major problems observed with both passive monitors were found only after devices which had been aged under storage conditions were analyzed and these results interpreted. If all testing had been done with fresh sampling devices, many of the problems would not have been noticed. Based on the results of this study, this factor of diffusive monitor aging needs to be addressed in any further work on passive monitor evaluation.

Air Pollutants, Occupational↗
PubMed2006

Development of an immunochromatographic lateral flow test strip for detection of beta-adrenergic agonist Clenbuterol residues.

A rapid immunochromatographic lateral flow test strip was developed in a competitive format with the gold-conjugated monoclonal antibody to specifically determine the residues of Clenbuterol (CL), a beta-adrenergic agonist. The test strip is made up of a sample pad, a conjugate reagent pad, a test membrane containing a control line and a test line, and an absorbent pad. CL standard samples of 0, 0.1, 0.3, 0.9, 2.7, 8.1 ng/ml in swine urine were determined by the test strip. It was shown that detection limit of the test strip was as low as 0.1 ng/ml of CL and that the half of maximal inhibition concentration (IC50) in relative optical density was calculated to be 1.78+/-0.17 ng/ml under an optical density scanner. The sensitivity by eye measurement was 1.0 ng/ml. It takes 10 min to accomplish a test. Parallel analysis of urine samples from pigs fed with CL showed comparable results obtained from the test strip and GC-MS. Therefore, the test strip is very useful as a screening method for quantitative, semi-quantitative or qualitative detection of CL residues in swine urine.

Adrenergic beta-Agonists↗
PubMed1999

Use and costs of incontinence pads in female study volunteers. Continence Program for Women Research Group.

OBJECTIVES: We examined the use and cost of incontinence pads and the relationship to factors such as age, duration of incontinence, diurnal frequency, incontinence severity indices, urodynamic diagnosis, and quality of life. SUBJECTS AND SETTING: Three hundred fifteen women with urinary incontinence who volunteered to participate in 1 of 3 incontinence studies (behavioral intervention, estrogen supplementation, or surgery) were analyzed. Subjects were community-dwelling women aged 45 years and older living in 3 cities in the southeastern United States. METHODS: Pad use was recorded on a daily diary. The type of pads used was reported on the history. Average price of pad types was assessed at local stores and reported in 1995 dollars. Statistical comparisons used nonparametric methods. MAIN OUTCOME MEASURES: The number of pads used per week and annual cost of pads in 1995 dollars. RESULTS: Seventy-seven percent of subjects used pads at baseline. Median cost per year for the entire cohort was $46 (interquartile range $3-$138). For pad users, median annual cost was $76 (interquartile range $36-$177), with costs being greater for women with detrusor instability than those with pure genuine stress incontinence (median $135-$138 versus $63). This increased cost was likely associated with the greater use of special incontinence products among women with detrusor instability. For the entire cohort, cost and usage did not differ by urodynamic diagnosis. Cost and pad usage were significantly associated with number of incontinent episodes and quality of life, but not with age, pad weight, or duration of incontinence. CONCLUSIONS: The majority of incontinent women who sought treatment used absorbent pads at least once per week, with menstrual pads being the most common type of pad. The annual cost of pad usage was not as high as in previous estimates.

Aged↗
PubMed2002

Biomechanical analysis of padding in child seats and head injury.

Head injury is a common finding for infants and young children involved in automobile accidents. Although the child restraint seats have increased the level of safety for the pediatric population, skull fracture and/or brain injury occur during the interaction between the child's head and interior of the car seats with no padding. The introduction of effective and sufficient padding may significantly reduce the head injury. The present study was designed to evaluate the biomechanical effects of padding in child seats to reduce the potential for head injury. A head drop test of a six-month old anthropomorphic dummy was conducted. The side of the dummy head impacted the interior wing of child car seats of relatively soft and stiff materials, and a rigid metal plate at velocities of 2.2, 4.5 and 6.7 m/s. In all tests, three types of padding environments were used (no padding, comfort foam, 16 to 19 mm polypropylene padding). All data were collected at 10 kHz and filtered. A total of 39 tests were conducted. The head injury criteria (HIC), and head acceleration, and head angular acceleration were obtained. The HIC was calculated over a 36 ms interval from the resultant tri-axial acceleration. The angular accelerations were derived from the angular velocity data. The head injury biomechanical parameters decreased with the addition of padding. The HIC, peak acceleration, and angular acceleration were reduced up to 91%, 80%, and 61% respectively. The present results emphasize the importance of energy absorbing padding to provide an improved safety environment in child car seats.

Biomechanical Phenomena↗
PubMed1987

Injectable-antineoplastic-drug practices in Michigan hospitals.

Practices related to parenteral (injectable) antineoplastic drugs (PADs) in Michigan hospitals were surveyed. All hospitals in Michigan were surveyed to assess compliance with American Society of Hospital Pharmacists (ASHP) and Occupational Safety and Health Administration (OSHA) recommendations related to PADs. Other PAD-related practice issues not covered within those guidelines were also studied. Surveys were mailed to the pharmacy directors of the state's 192 acute-care hospitals. Included were questions concerning policies and procedures for ordering, storing, preparing, handling, labeling, transporting, administering, and disposing of PADs. Questions concerning staff education, spill cleanup, and personnel issues were also included. A total of 169 questionnaires were returned, yielding a response rate of 88%. Of those respondents, 132 indicated that they prepare PAD doses for inpatients. Adherence rates were high for several of the PAD-preparation recommendations, including handwashing (97%) and gloving (98.5%). Rates for gowning (71.2%), labeling of PAD doses as biohazards (chemical hazards) (73.5%), and use of Class II biological-safety cabinets (71.2%) were less favorable. Practice areas with relatively poor adherence rates included use of plastic-backed absorbent pads under PAD preparation areas (53.8%), storing PADs separately from other drugs (48.5%), informing prospective employees of potential risks of handling PADs (36.4%), availability of spill kits (36.4%), and attaching and priming i.v. tubing before adding PADs to i.v. containers (5.4%). Many pharmacy departments in Michigan hospitals can substantially improve their adherence to ASHP and OSHA recommendations related to PADs.

Antineoplastic Agents↗
PubMed2002

A method comparison study to assess the reliability of urine collection pads as a means of obtaining urine specimens from non-toilet-trained children for microbiological examination.

BACKGROUND: In young, non-toilet-trained children, the collection of a urine sample for microbiology can be challenging, with the application of a urine bag being the main method of collection. However, recent research has shown that absorbent pads can be used yielding similar results to bag specimens. However, weaknesses in study design erode confidence in research findings. Therefore, improvements in research design are required to fully evaluate the reliability of pad collection. AIMS OF THE STUDY: This pilot study sought to test the feasibility of a technique for the collection of concurrent bag/pad urine samples from non-toilet-trained children, and to assess the reliability of urine pads over bags as a collection method for urine specimens for microbiological evaluation. DESIGN: A pilot, method comparison study. METHODS: Twenty concurrent bag and pad specimens were collected from non-toilet-trained children, following parental consent. Urine specimens were analysed for presence or absence of white cell count (WBC), and bacterial growth, using standard laboratory methods. DATA ANALYSIS: The Kappa (kappa) statistics and confidence interval (CI) estimation were used to assess agreement between the two collection methods. RESULTS: Despite concurrent samples there was a lack of agreement between bag and pad specimens on both main outcome measures. Agreement between bag and pad specimens for the presence of WBC yielded a kappa=0.10 (95% CI: 0.19, 0.39), indicating poor agreement, while a kappa of 0.5 (95% CI: 0.12, 0.88) was calculated for the degree of agreement in bacterial growth reflecting moderate agreement. Differences in proportions of the presence of WBC between bag and pad did not quite reach significance at the 5% level 0.2 (95% CI: 0.00, 0.42, P=0.062). For cultures the difference was calculated as 0.15 (95% CI: 0.05, 0.35, P=0.125). CONCLUSION: The pilot study demonstrates that concurrent urine samples can be obtained without difficulty. Despite poor to moderate agreement on outcome measures the level of agreement is greater than reported in those other studies, that use non-current methods of urine collection, suggesting an advantage of the concurrent technique. It is recommended that larger scale studies be undertaken using the concurrent collection technique to assess reliability of these findings.

Child, Preschool↗
PubMed2005

Improved protection for children in forward-facing restraints during side impacts.

OBJECTIVE: This study aims to determine the potential for improved child occupant protection in side impacts that can be obtained using rigid and semi-rigid anchorage systems and the addition of energy-absorbing padding in the side structures of child restraints. METHODS: This study uses a comprehensive set of simulated side impacts to evaluate the potential for improved side impact protection in forward-facing child restraints. Factors investigated included methods of anchoring the restraint to the vehicle, energy-absorbing materials in the side structure of restraints, and design features of the restraints such as side wing geometry and seat belt routing. RESULTS: The results show clearly that completely rigid lower attachment of restraints offers the potential for great reductions in head injury risk, which anchorage systems employing a combination of a rigid anchorage bar and webbing attached to a child restraint cannot match. The addition of energy absorbing material in the side structure of restraint systems is effective when the head is fully contained within an adequately designed side wing structure. For restraints anchored by seat belts and loop style semi rigid anchorage straps, belt routing has the potential to significantly affect occupant head excursion. CONCLUSIONS: The results suggest that current child restraint standards and consumer testing protocols do not adequately encourage best practice design of child restraints for side impact protection.

Accidents, Traffic↗
PubMedDate not supplied

Evaluation and treatment of urinary incontinence. Report of a physician survey.

OBJECTIVE: To determine practice patterns related to the evaluation and treatment of urinary incontinence (UI). DESIGN: Stratified random sample of physicians surveyed initially by mail with telephone follow-up. SETTING: Four counties in Central Oklahoma. PARTICIPANTS: One hundred fifty-five physicians in 4 specialties: family practice, internal medicine, obstetrics/gynecology, and urology. MEASUREMENTS: Self-reported evaluation and treatment of UI and training in treatment of UI. The overall rate of response was 80%. RESULTS: Physicians miss opportunities to identify patients with UI. Despite substantial specialty variation, behavioral treatments and medications for UI, relative to the Agency for Health Care and Policy Research clinical guidelines, are underused. More than 40% of internists and family practitioners routinely recommended absorbent pads. Only 17% of physicians were aware of the clinical guidelines. CONCLUSIONS: Physicians identified deficiencies in their level of preparation to evaluate and treat UI. Reports of practice patterns also suggest deficiencies.

Adult↗
PubMed1976

Lipids in the skin of a cat-fish Heteropneustes fossilis (Bloch) (Heteropneustidae, Pisces). A histochemical investigation.

Localization and characterization of different lipids in the cellular constituents of the skin of Heteropneustes fossilis has been made using several histochemical techniques. High contents of cholesterol, its esters and phospholipids have been correlated with the metabolically active state of the basal cells undergoing cell proliferation and differentiation. The polygonal cells in the outermost layer of the epidermis, though rich in phospholipid contain small amounts of cholesterol and its esters. This has been correlated with the metabolically less active state of theses cells. Neutral lipids and phospholipids in the polygonal cells of the outermost layer may contribute to the contents of surface slime and act as an efficient barrier for the penetration of water through the skin. The deposits of neutral lipids in the subcutis may provide energy during the period of fasting, act as a barrier for water diffusion through the skin and serve as shock absorbing pads protecting the fish from mechanical injury.

Animals↗
PubMed2006

Prevalence of urinary incontinence in community dwelling men: a cross sectional nationwide epidemiological survey.

PURPOSE: Epidemiological studies on urinary incontinence (UI) in adult men of all ages are scarce. We aim to describe the UI phenomenon among community dwelling adult males in the United States (US). MATERIALS AND METHODS: We analyzed data from male respondents to a 14-item mailed UI symptoms questionnaire to the National Family Opinion (NFO) World Group Panel of 45,000 households matching the US 2000 census population on five key demographic elements. RESULTS: A total of 29,903 households responded, of which 21,590 were male heads of household (mean age 50 +/-15.2 years old). A total of 2,059 men (12.7%) reported symptoms of UI during the last 30 days. Symptoms of urge urinary incontinence (UUI), stress urinary incontinence (SUI), mixed urinary incontinence (MUI) symptoms, and other types of urinary incontinence (OUI) symptoms, were reported by 44.6%, 24.5%, 18.8%, and 12.3%, respectively. Among those with UI symptoms, the proportion of UUI and MUI symptoms increases with age while SUI symptoms decrease as age increases. Of those with UI symptoms, 44% consulted a physician of whom 57% did so within 6 months of the onset of symptoms. Treatments reported included absorbent pads (48%), prescription medication (30%), surgical procedure (18%), and intermittent catheterization (4%). CONCLUSIONS: Almost 1 in 10 males reported symptoms of UI. The UI prevalence rate increases with age and UUI symptoms is the most prevalent type reported. Less than half of men with UI symptoms sought professional help and half of them did so within 6 months of onset of UI symptoms.

Adolescent↗
PubMed1994

Functional urethral closure with pubovaginal sling for destroyed female urethra after long-term urethral catheterization.

OBJECTIVE: To assess the pubovaginal sling as therapy for correction of the destroyed female urethra secondary to long-term indwelling Foley catheter management of neurogenic vesical dysfunction. METHODS: Fourteen women with neurologic disease and a patulous and nonfunctioning urethra underwent pubovaginal sling functional urethral closure. The purpose of the procedure is to achieve a dry perineum. Greater tension is applied to the sling suspension for urethral closure than is normally used to ensure continence for patients exhibiting intrinsic sphincter dysfunction without neurogenic vesical dysfunction. RESULTS: Two patients with adequate bladder capacity and compliance underwent only a pubovaginal sling suspension. They were subsequently managed with intermittent catheterization. In 5 patients, a sling operation in conjunction with enterocystoplasty was accomplished. In 5 patients, a sling procedure with an ileocystostomy and a cutaneous urostomy (bladder chimney) was utilized. In 2 patients, suprapubic tube drainage was established at the time of pubovaginal sling placement. All patients have achieved continence, without the need for absorbent pads, with follow-up time of six to sixty months (mean, 24 months). Abdominal wall herniation has not developed in any patient. CONCLUSIONS: The pubovaginal sling cured incontinence and has resulted in a dry perineum with few problems. The sling procedure may be superior to transabdominal or transvaginal bladder neck closure without the risk of fistula formation.

Adult↗
PubMed1984

Catheter-free geriatric care. Routines and consequences for clinical infection, care and economy.

In a geriatric hospital the routines of one ward were modified with the intention of removing indwelling catheters from all patients admitted to the ward. A continence training programme had been designed during the preceding 6 months. A total of 124 patients were admitted with indwelling catheters during a period of 18 months. It was possible to remove the catheters in 117 of these. Patients and their relatives reacted favourably to catheter-free care. The attitude of ward staff also was positive. The overall nursing requirements did not increase. Antibiotic prescription was 90 per cent less than in the control wards. This difference was accounted for not only by a reduction in drugs used against urinary tract infections, but also by a lower consumption of agents mainly used in the treatment of septicaemia, bronchopneumonia and wound infection. The cost of laundry and of hygiene and storage articles, including catheters, absorbing pads and other incontinence aids was 46 per cent of that in the control wards. Four years later, 65 per cent and 72 per cent of the patients from the test and control wards respectively, had died. Of the surviving patients from the test ward 78 per cent were still catheter-free.

Aged↗
PubMed2006

Inhibition of Escherichia coli O157:H7, Listeria monocytogenes and Staphylococcus aureus on sliced roast beef by cetylpyridinium chloride and acidified sodium chlorite.

The effects of 0.5% cetylpyridinium chloride (CPC), 0.12% acidified sodium chlorite (ASC) and a mix of equal volume of the two (0.25% CPC-0.06% ASC) on Escherichia coli O157:H7, Listeria monocytogenes and Staphylococcus aureus were evaluated on inoculated sliced roast beef. The antimicrobial agents were, respectively, sprayed on the beef surfaces and tray absorbent pads, and samples were stored at 4 degrees C for 10 days (d). At 0 d, L. monocytogenes and S. aureus were reduced to undetectable levels in 2 h after spraying with CPC. CPC-ASC treatment reduced E. coli O157:H7, L. monocytogenes and S. aureus by 4.07, 6.37 and 4.32 log cfu/cm2, respectively, at 0 d. ASC treatment reduced the population of E. coli O157:H7 by 6.09 log cfu/cm2 at 10 d. CPC treatment caused a slight discoloration and ASC-treated beef surfaces demonstrated the lowest redness and highest lightness. The grey colour and off-odour were significant in the ASC-treated beef samples, while CPC-treated samples demonstrated less off-odor and brown colour from 0 to 4 d. Based on our results, it appears that the application of CPC on sliced roast beef can extend the shelf-life of the product without impairing its quality.

Animals↗
PubMed1992

Simulation of blood flow in microgravity.

Knowledge of venous, capillary, and arterial blood flow in microgravity is required to modify hemostatic techniques for control of bleeding in traumatic injuries or surgical procedures in space. To simulate human arterial, venous, and capillary bleeding, fresh whole bovine blood was injected by two operators at calculated flow rates (3.5, 7, and 14 mL for venous and 14 and 28 mL for arterial) in 10 seconds with empirical controls in a lucent glove box during zero gravity parabolic flight on NASA's KC-135 aircraft. A pig's foot was used to mimic capillary bleeding. Hemostasis with sponges and laerdal suction was evaluated by video and still photography. Evaluations of the arterial and venous bleeding were conducted at 3 rates x 3 parabolas, and capillary bleeding was evaluated with 5 parabolas x 2 methods (pig's foot and sponge). Influenced by surface tension, the slow venous bleeding coated syringe surfaces and formed a dome over the skin laceration bleeding site. Arterial and venous bleeders broke into uniform spheres with low-velocity spheres bouncing off an absorbent pad and suction tip. Conventional dabbing with gauze fragmented blood into small spheres. Capillary oozing was better controlled by "wicking" up blood with gauze. Repeated arterial bleeding opacified the glove box wall. This stimulation demonstrated unique characteristics of extracorporeal blood flow and inadequacies of common methods of hemostasis in microgravity.

Animals↗
PubMed2006

[Treatment of severe chronic constipation through the antegrade continent enema procedure].

The antegrade continent enema procedure was first described in 1990 by Malone for the treatment of severe fecal neurogenic incontinence in children. Since then, this technique has been successfully carried out in adults, as well as in patients with refractory constipation. The procedure provides a continent and catheterizable channel, generally an appendicostomy, through which antegrade washouts are given to produce colonic emptying. We describe the case of a 23-year-old man with severe constipation and overflow fecal incontinence who underwent an appendicostomy. There were no immediate postoperative complications and saline washouts were started on the fourth day. Since then, the patient has had a bowel movement between 1 and 3 hours after each washout, has recovered continence, and no longer wears an absorbent pad.

Adult↗