Disorders of bladder function in spinal cord disease.

Successful management of bladder function mandates a thorough knowledge of the neuroanatomy and physiology of micturition. Accurate urodynamic diagnosis of the exact vesicourethral dysfunction is a key to successful management. The primary concern for the urologist is preservation of renal function, taking into account the social needs of the patient.

Occupational therapy in the Department of Veterans Affairs: focus on health care of the elderly veteran.

The Department of Veteran Affairs (VA) operates the largest integrated health care system in the world (VA, 1989), with designated departments and programs designed to meet the long-term care needs of the aging veteran. Occupational therapy is an important intervention to maximize the quality of life of older persons. Because of the increasing number of aging veterans and the national shortage of occupational therapists, the VA has been devising programs to recruit and retain occupational therapists in VA medical centers.

Evaluation of the causes and severity of geriatric incontinence. A critical appraisal.

The evaluation of urinary incontinence in the elderly differs from that in younger patients because of altered or nonspecific disease presentation, the different spectrum of pathophysiology, greater variation between individuals and, in some cases or settings, variable treatment goals. Evaluation must be multifactorial and extend beyond the genitourinary system, because many age-related conditions and the drugs used to treat them can cause or exacerbate urinary incontinence. Voiding records are a reliable measure of severity, although studies of their validity are still lacking.

Neuroleptic-associated autoantibodies. A prevalence study.

Antinuclear antibodies (ANA), antiphospholipid antibodies (APA), rheumatoid factor (RF), and immunoglobulin (Ig) M levels were determined in 184 male chronic psychiatric patients on long-term therapy with neuroleptics, and in 35 age-matched normal male controls. The prevalence of one or more of these autoantibodies was 70% in the neuroleptic-treated patients and 9% in the normal controls. Polyclonal IgM elevation was frequently seen among patients treated with phenothiazines.