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Biomedical subjects

B W Badley

Publications and source records attributed to B W Badley.

17 recordsLinked to original sources
PubMed1987

Effect of a geriatric consultation service on management of patients in an acute care hospital.

Elderly patients present particular management challenges. We conducted a randomized clinical trial of the effect of a geriatric consultation service on the management of elderly patients in an acute care hospital. A total of 113 patients aged 75 years or more who met certain criteria were assigned to either receive (57 patients) or not receive (56) care by the service. At the end of their hospital stay the patients were assessed with regard to predetermined outcomes. The patients were followed up for 1 year after discharge to determine death rates and direct health care expenditures. The intervention group showed significantly greater improvement in mental status (p less than 0.01), were receiving fewer medications at discharge (p less than 0.05) and had lower short-term death rates (p less than 0.05) than the control group. A geriatric consultation service can improve the hospital care and health of the elderly.

Aged↗
PubMed1982

Acute fatty liver of pregnancy.

Acute fatty liver of pregnancy (AFLP) is rare and is peculiar to the latter half of pregnancy. Despite the high rates of death among affected mothers and their fetuses, early recognition of the disease and immediate delivery of the infant may improve the chances of survival. This paper describes a case of AFLP, characterized by a rapid decrease in the size of the liver, a greatly prolonged prothrombin time and minimal increases in the serum transaminase levels, in which an immediate cesarean section followed by vigorous supportive care led to survival of both mother and infant. It is clear that guidelines on treatment are necessary if the management of such cases is to be successful.

Acute Disease↗
PubMed1978

Pseudomembranous colitis: isolation of two species of cytotoxic clostridia and successful treatment with vancomycin.

Lincomycin-resistant Clostridium sporogenes obtained from the stools of a patient with lincomycin-associated pseudomembranous colitis produced a heat-stable cytotoxin in low titre when grown in chopped meat medium. Vancomycin eradicated this strain and all other clostridia, and controlled the symptoms. When diarrhea recurred 7 days after treatment with vancomycin was stopped, clostridia including C. sporogenes and C. difficile were again isolated. The C. difficile produced a heat-labile cytotoxin in high titre that was unaffected by growth in various media and induced colitis in hamsters. Treatment with vancomycin, to which all the clostridia were sensitive, eradicated both toxic species and controlled the diarrhea. Antibiotic-induced pseudomembranous colitis may be associated with more than one species of toxin-producing clostridia. Vancomycin therapy should be continued for 10 days or more in patients with severe disease to eradicate the responsible organism.

Aged↗
PubMed1978

Symposium on intensive care: 3. Upper gastrointestinal bleeding in the intensive care unit.

Bleeding from hemorrhagic erosions in the stomach or duodenum of seriously ill patients is associated with a high mortality. While the pathogenesis of such lesions is by no means certain, it is known that they are universal after shock, sepsis or severe burns. Fiberoptic endoscopy has become the most valuable means of diagnosis. This should be preceded by gastric irrigaiton, which usually sufficies to control bleeding caused by acetylsalicylic acid or alcohol, or both. Neutralization of gastric acidity is essential. The histamine HI-receptor antagonist, cimetidine, was used in 27 patients with erosive gastritis, and bleeding ceased in 24. There is a prospect that sugh agents will obviate the necessity of total gastrectomy in the occasional resistant cases in favour of conservative surgery.

Antacids↗
PubMed1977

Current medical management of duodenal ulcer disease.

Each of three agents used in the treatment of duodenal ulcer--magnesium--aluminum antacids in high doses, cimetidine and carbenoxolone sodium--appears to enhance the rate at which ulcers heal, although their ability to control symptoms has been less clearly demonstrated. Since a large proportion of ulcers heal either without treatment or when the patient is given a placebo, a rational management plan should emphasize the removal of known irritants and the provision of symptomatic relief while spontaneous healing is allowed to occur. Lack of response to such a regimen warrants more specific investigation and therapy. On the basis of current evidence, cimetidine appears to be the preferred therapeutic agent.

Antacids↗
PubMed1977

A clinician's expectation of the radiologist.

This personal viewpoint emphasizes the importance of establishing a dialogue between the clinician and the radiologist. Such a dialogue must be characterized by specificity and objectivity, and should foster a critical appraisal of attempts to solve our patients' problems.

Attitude of Health Personnel↗
PubMed1976

A physiological approach to jaundice.

An understanding of the production, transport, hepatic uptake, biotransformation and excretion of bile pigments is necessary for the rational investigation of a patient presenting with jaundice. These aspects are reviewed, and at each step of bilirubin metabolism the clinical abnormalities giving rise to jaundice are indicated.

Adult↗
PubMed1975

Some aspects of medical management of gastrointestinal disease. I.

SUMMARY: Among drugs recently introduced into Canada for treatment of gastrointestinal disease are carbenoxolone sodium (used in treating gastric ulcer) and metoclopramide hydrochloride (which modifies upper gastrointestinal tract motility). A third drug, lactulose (useful in treating hepatic encephalopathy), will soon be available. Clinical experience with these drugs has been most extensive in Europe. In a new class of agents are histamine H2-receptor antagonists, which are currently under clinical trial. These drugs are the most potent inhibitors of gastric acid secretion yet investigated, and are potentially the most exciting agents to appear in many years. Part I of this paper is a review of the actions, clinical use, side effects, and dosage and administration of these new drugs.

Diarrhea↗
PubMed1971

Treatment of Salmonella enteritis and its effect on the carrier state.

During an outbreak of Salmonella enteritis, 113 symptomatic and asymptomatic patients were assigned to different treatment groups: 43 received ampicillin; 41 were given trimethoprim-sulfamethoxazole; and 29 received no specific therapy. During the four-week observation period no statistically significant benefit from treatment with either ampicillin or trimethoprim-sulfamethoxazole was apparent in relation to duration and severity of symptoms or duration of the carrier state. However, the impression that trimethoprim-sulfamethoxazole might have shortened the period of fecal Salmonella excretion in the few asymptomatic patients may warrant further controlled studies.There was no significant alteration in hematological or biochemical values, or urine constituents, in patients receiving trimethoprim-sulfamethoxazole. Side effects probably attributable to this drug developed in only 5% of the 41 patients.It is concluded that uncomplicated salmonellosis is best treated without using currently available chemotherapeutic agents.

Adolescent↗
PubMed1970

Bile salts.

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Bile Acids and Salts↗