Orme S.,Barnsley Hospital NHS Foundation Trust |
Morris V.,Musgrove Park Hospital Foundation Trust |
Gibson W.,University of Alberta |
Wagg A.,University of Alberta
Drugs and Aging | Year: 2015
Urinary incontinence and lower urinary tract symptoms are highly prevalent in late life and are strongly associated with dementia and frailty. Incontinence is extremely common among those living in long-term care and is most commonly due to urgency incontinence. Although national and international guidelines for continence care exist, they often fail to consider the complex comorbidity found in patients with dementia and are often not followed; continence practices in long-term care may promote rather than prevent incontinence. The majority of those with dementia living in the community can be managed successfully with standard treatments, both pharmacological and non-pharmacological; the expectations and aims of treatment of both the patient and their caregivers should be considered. A dementia diagnosis does not preclude management of incontinence, but treatment options may be more limited in those with advanced dementia who are unable to retain information and modify behaviors. High-quality data to guide the choice of pharmacological agent in those with dementia are lacking. Oxybutynin has been shown to have significant adverse cognitive effects, but data to support the use of trospium, solifenacin, darifenacin, and fesoterodine are limited. No data are available for mirabegron. Neither age, frailty, nor dementia should be considered a barrier to pharmacological management, but consideration should be given to the total anticholinergic load. Evidence to guide the treatment of incontinence in this vulnerable patient group is scarce, and available guidelines adapted for each individual’s situation should be applied. © 2015, Springer International Publishing Switzerland.
Padmakumar A.D.,St Jamess Hospital |
Wenham T.N.,Barnsley Hospital NHS Foundation Trust
Journal of the Intensive Care Society | Year: 2013
Critically ill patients do not sleep well. One of the major environmental factors influencing sleep is noise. We prospectively measured noise levels and their relation to the time of day and location in different parts of two separate intensive care units (ICUs). Maximum, minimum and average noise levels were collected over 24 hour periods on five random days in both ICUs using digital sound meters, measured by the A-weighted decibel scale (dB (A)). The World Health Organisation (WHO) recommends that the average background noise in hospitals should not exceed 35 dB (A), and that peaks during the night should be less than 40 dB (A). The measured noise levels in both ICUs were well above the WHO standards. We recommend that various aspects, including staff education and modification of ICU design, must be carefully considered to provide an optimum environment for critically ill patients. © The Intensive Care Society 2013.
Bennett A.,Barnsley Hospital NHS Foundation Trust
Nursing standard (Royal College of Nursing (Great Britain) : 1987) | Year: 2013
Lung cancer is the most common cancer worldwide and is associated with significant morbidity and mortality. In recent years, there have been important developments in the techniques used to diagnose lung cancer and in the treatment options available, allowing more people to be given anti-cancer treatment with the aim of increasing survival rates. This article provides an overview of lung cancer, including epidemiology, risk factors, diagnosis and treatment. It aims to provide healthcare professionals with information to improve care delivery and patients' quality of life.
Sabroe R.A.,Barnsley Hospital NHS Foundation Trust
Clinical and Experimental Dermatology | Year: 2010
Cholinergic urticaria is one of the more common physical urticarias. Although it is often fairly mild, severe treatment-resistant disease may occur, with significant associated disability. Omalizumab, a monoclonal IgG anti-IgE antibody licensed for use in severe asthma, has recently been used successfully in several types of urticaria, including in one case of cholinergic urticaria. This paper reports a patient with severe cholinergic urticaria, unresponsive to antihistamines and multiple other treatments, whose disease was also unresponsive to omalizumab. © 2009 British Association of Dermatologists.
Gray T.,Sheffield Teaching Hospitals NHS Foundation Trust |
Dass M.,Barnsley Hospital NHS Foundation Trust
British Journal of Hospital Medicine | Year: 2012
Ketamine abuse is increasingly common in the UK. Ketamine-induced cystitis can cause serious damage to the urinary tract. This emerging problem presents a new diagnostic challenge and is very likely to increase in incidence over the coming years.