1/11. Implementing an incontinence program in long-term care settings. A multidisciplinary approach.urinary incontinence is a prevalent and costly problem in long-term care settings. Impaired bladder function can cause many physical and social problems, such as impaired skin integrity, falls, and altered psychological well-being. Fortunately, there are several low-risk interventions that can cure or improve continence status in many individuals, regardless of cognitive status. Basic assessment of medical and environmental status, as outlined in this article, can assist staff in determining transient conditions which often alter bladder control. Because many interventions are dependent on mobility, dexterity, and diet, an interdisciplinary approach is ideal.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/11. Treatment of major depression complicated by bilateral foot drop and double incontinence with ECT.This report describes a 56-year-old man with severe depression who developed bilateral foot drop, dual incontinence, and swallowing difficulties, which required several physical investigations and consultations before an excellent response to electroconvulsive therapy occurred with reversal of all symptoms.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
3/11. The effects of a progressive exercise program with surface electromyographic biofeedback on an adult with fecal incontinence.BACKGROUND AND PURPOSE: fecal incontinence often compromises a person's ability to participate in work and recreational activities. Incontinence may also diminish a person's willingness to take part in social events, leading to feelings of isolation. This case report describes physical therapy designed to reduce a patient's pelvic-floor muscle dysfunction and fecal incontinence. CASE DESCRIPTION: The patient was a 30-year-old woman whose fecal incontinence began after the complicated vaginal birth of her first child that required a vacuum extraction and episiotomy. Intervention included soft tissue techniques, electromyographic biofeedback, strength training, relaxation training, patient education, and a home program. The patient completed a questionnaire at initial evaluation and at discharge to assess her perceived limitations in functional activities. Electromyographic analysis was used to measure changes in the patient's pelvic-floor muscle control. OUTCOMES: The social, occupational, and sexual domains, which the patient initially judged to be the most compromised, showed the greatest improvement. Electromyographic data for the final treatment session indicated improved strength, endurance, and control of her pelvic-floor muscles. The patient reported no episodes of fecal incontinence over the last month of the 3 months of therapy. DISCUSSION: The physical therapy program may have led to improved bowel continence and greater control of the pelvic-floor muscles, resulting in greater confidence and comfort in social and work situations and less restriction in the patient's physical relationship with her spouse.- - - - - - - - - - ranking = 3keywords = physical (Clic here for more details about this article) |
4/11. Surgically correctable fecal incontinence.A significant percentage of children who are fecally incontinent are so from improper operation or failure to recognize a surgically correctable problem. Over the past five years, we have managed ten children who had operations for anorectal problems and two with anterior anus. Seven were seen after poorly positioned pull-through procedures for imperforate anus and had anal repositioning, four successfully. Gracilis sling was successful in two of the other three. In two children overflow after a Duhamel operation for Hirschsprung's disease was corrected by division of a persistent anorectal septum. The third child with a disrupted Duhamel procedure was cured by anolevatorplasty. In two children an anterior ectopic anus was made continent by posterior anoplasty. Primary and secondary deviations from proper anatomy of the anorectal region will result in incontinence, which may be recognized by physical examination and defecograms. Proper operation usually produces acceptable continence.- - - - - - - - - - ranking = 3.141652931619keywords = physical examination, physical (Clic here for more details about this article) |
5/11. gallstones presenting as mental and physical debility in the elderly.Within 1 year six elderly patients (aged 80-89 years) were admitted because of non-specific deterioration in mental or physical well-being. In no instance was hepatobiliary disease suspected at the time of hospital admission. One patient presented with intermittent confusion only. The other five were referred with "falls" or having "gone off legs", with malaise, confusion, or incontinence. All had raised alkaline phosphatase levels of 159-1230 IU/l, which led to investigation of the biliary tree. At endoscopic retrograde cholangiopancreatography all were shown to have biliary disease (three common duct stones, one gallbladder calculus, one an abscess, and one a widely dilated common bileduct ). With appropriate treatment (endoscopic sphincterotomy for two, surgery for two, and antibiotics alone for two), all showed a gratifying return of mobility and mental function. Biliary disease is a treatable cause of chronic ill health in the elderly and should be excluded, even in the absence of "classical" symptoms, when there is abnormal liver function.- - - - - - - - - - ranking = 5keywords = physical (Clic here for more details about this article) |
6/11. Nursing management of the school-age child with bowel incontinence: utilizing Erikson's theory of psychosocial development.fecal incontinence due to physical and emotional factors can be devastating to the self-esteem of a child in the school setting. Approaches to the nursing management of a child with this condition are evaluated. Erikson's theory of psychosocial development is used to analyze compensatory behaviors in the child, and to plan a system of nursing care that will foster autonomy. Dorothea E. Orem's conceptual framework of nursing, a self-care model, is the base for developing a comprehensive plan of care for the child to normalize mastery of psychosocial tasks.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
7/11. The child with spina bifida. role of the pediatrician.Pediatricians commonly have patients with multiple physical and/or mental handicaps. Though many such children receive care at a multispecialty center, the role of the pediatrician is an important one, not only in providing primary care but also in helping to manage ongoing care of a multisystem disorder. Spina bifida is one such disorder, and children with this condition have many medical needs (pediatric, neurosurgical, orthopedic, urologic, gastrointestinal), as well as potential educational, emotional, and psychosocial problems. The pediatrician can effectively promote optimal interaction between patient, family, and community.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
8/11. Unwanted anal penetration as a physical cause of faecal incontinence.OBJECTIVE: To investigate sexual abuse as a cause of faecal incontinence. patients: Seven patients (two men and five women) with a history of sexual abuse, including anal penetration, and faecal incontinence. methods: Anorectal physiological techniques and anal endosonography were used for patient assessment. RESULTS: All seven patients had evidence of internal sphincter disruption and three had additional external anal sphincter dysfunction. CONCLUSION: Unwanted anal penetration can cause permanent structural anal sphincter damage.- - - - - - - - - - ranking = 4keywords = physical (Clic here for more details about this article) |
9/11. exercise-induced diarrhea: when to wonder.exercise-associated lower gastrointestinal symptoms seem to be a fairly common clinical finding occurring in anywhere from 10-50% of runners. However, it is unclear what percentage of those affected may have discrete medical conditions that are exacerbated by strenuous physical exertion. Perhaps, difficult physical training sessions function as a "stress test" for the colon. A case report of exercise induced diarrhea is presented with a discussion of the current medical literature and proposed management for the primary care sports physician.- - - - - - - - - - ranking = 2keywords = physical (Clic here for more details about this article) |
10/11. Faecal incontinence with transitory absence of anal contraction in two sexually or physically abused women.OBJECTIVE: To report two cases of faecal incontinence caused by transitory absence of anal voluntary contraction without anal anomalies. patients: Two women referred to our gastroenterology department with faecal incontinence. One patient had been sexually abused by her father; the other had been physically abused by her husband. RESULTS: Clinical and manometric anal contraction was absent despite normal anal endosonography and normal electrophysiological perineal study. Anal contraction was completely normalized after biofeedback, and the patients recovered from the faecal incontinence. CONCLUSION: Transitory absence of anal contraction is very uncommon as the origin of faecal incontinence. It was observed in two abused women.- - - - - - - - - - ranking = 5keywords = physical (Clic here for more details about this article) |
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