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Biomedical subjects

I Wandless

Publications and source records attributed to I Wandless.

18 recordsLinked to original sources
PubMed1981

Rotavirus infection in elderly patients.

In the course of an outbreak of non-bacterial diarrhoea in a group of elderly patients in a rehabilitation ward, rotavirus was detected by electron-microscopy in five of 11 stool specimens (45.5%) from symptomatic elderly patients. This suggests that although rotavirus is usually thought of as a cause of gastro-enteritis in children it should also be considered as a cause of non-bacterial diarrhoea in elderly patients and stool specimens examined for its presence. Rotavirus gastro-enteritis appears to be a highly contagious disease but appropriate measures can limit its spread.

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PubMed1981

The effect of counseling by a pharmacist on drug compliance in elderly patients.

The effect of counselling by a pharmacist on medication errors was assessed in fifty-three patients aged 65 years and over attending a day hospital. Despite random allocation to either the counselled or the uncounselled ('control') group, patients in the counselled group were making fewer errors than those in the control group even before they received instruction from the pharmacist. There was no evidence that those in the counselled group made fewer errors for complied better with their treatment as a result of counselling.

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PubMed1981

Transient global amnesia.

3 cases of transient global amnesia (TGA) are reported. Transient ischaemia is probably the cause of the condition in the majority of cases although other mechanisms, particularly epilepsy, may be responsible in some. TGA may not be reported by the patient and may be misdiagnosed as a psychiatric disturbance. An acute confusional or delirious state can also produce an episode of amnesia with inability to remember events which occurred during the period of cerebral dysfunction. In TGA, however, there is an acute and temporary failure to record events without the evidence of more generalised dysfunction which occurs in delirium. During the 3 episodes reported here the patients were able to carry on with their everyday activities and to complete structured tasks, such as the preparation of a meal. TGA appears, at least in some individuals, to carry the prognosis of transient cerebral ischaemia.

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PubMed1979

A prospective study of fractured proximal femur: factors predisposing to survival.

In a prospective study of patients with fractures of the proximal femur from a defined population it was found that age, mental test score, type of residence, place of injury and hospital of admission were all significantly associated with the likelihood of survival to six months. When these factors were taken into account no additional association between outcome and recorded associated disease, grade of surgeon operating, cigarette smoking, type of operation or social class was demonstrable. These findings have implications for the design of controlled trials of different types of treatment for fractures of the proximal femur.

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PubMed1979

Compliance with prescribed medicines: a study of elderly patients in the community.

Compliance with regular medicine taking has been assessed in 81 patients, aged 65 and over, living at home. Interview assessment, home tablet count, and retrospective review of general practice prescription record cards provided three indices of compliance.Deviation by more than 10 per cent from absolute adherence to the prescription was found in 53 per cent of all tablet counts and was significantly more common in women than in men. Errors were also more common when medicines were to be taken more than once daily.The compliance index obtained by inspection of prescription records correlated closely with the index calculated from tablet counts (r(s) = 0.68; p < 0.001) for 129 separate medicines taken regularly. Poor compliance with an individual medicine could be predicted accurately in 66 per cent of cases. A combination of prescription record inspection and interview assessment increased the accuracy of this prediction to 86 per cent.These findings suggest that, using simple methods, the level of compliance can be accurately predicted in a substantial number of elderly patients at home.

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PubMed1978

Computer-assisted review of digoxin therapy in the elderly.

Current practice with digoxin was assessed in a group of 42 elderly patients by comparing plasma digoxin concentrations attained on previously established maintenance doses with those generated by a computer programme designed to calculate dosage schedules to suit individual patients. Discrepancies between measured and computed plasma levels and between established and computed doses dictated withdrawal of the drug or revision of dosage in 26 patients (62%), with obvious clinical benefit. An important determinant of dosage was renal function; reduction in creatinine clearance provided good evidence for the loss of ability of the elderly kidney to eliminate digoxin. Simple bedside methods are available which permit a reliable estimate of creatinine clearance without a 24-hour urine collection, provoding a rational basis for the choice of digoxin dosage in the elderly.

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PubMed1977

Can drug compliance in the elderly be improved?

Three instruction schemes for self-medication in older patients were designed and compared to see whether they improved drug compliance. Forty-six patients in two rehabilitation units were divided into three different groups. Each group was instructed verbally on the nature and amount of their medication. One group was also given a tear-off calendar and a second group a tablet identification card as a memory aid. Patients were then responsible for taking their own medicine for 14 days. Those with calendars made fewer errors than those with cards, and those with either a card or a calendar made significantly fewer errors than those given only standard instructions.

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