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Biomedical subjects

J Whyte

Publications and source records attributed to J Whyte.

23 records · Page 2Linked to original sources
PubMed1977

Drug usage and adverse drug reactions in paediatric patients.

The development of epidemiological methods for the study of adverse drug reactions is reviewed in connection with the presentation of data obtained by intensive monitoring of 1 000 admissions to a medical paediatric unit. Compared with adults and American children, the patients received fewer drugs and experienced fewer reactions while in hospital. The drug usage pattern was different from that of American paediatric practice and general practice in the United Kingdom. Fifty-one (6%) patients experienced 119 adverse drug reactions. These occurred more frequently in children suffering from serious disorders and in the majority of cases the basic therapy was continued regardless of the severity of the drug side-effects. Treatment was required for the effects of 66 (55%) adverse reactions. It appears that drug monitoring in paediatric practice may be of greater value if surveillance programmes are designed to provide a "therapeutic audit" and extended to include children receiving drugs in the community.

Child↗
PubMed1976

Pattern and quality of recording pre-admission drug treatment in paediatric patients.

The pattern and quality of recording drug use before admission was examined in children admitted to a paediatric unit over eight months. The preadmission drug intake (1-7 drugs/patient) was lower than that of adults. Antibiotics were the most frequently prescribed drugs, but mild analgesics and antihistamine preparations were commonly used, often without medical advice. The simultaneous administration of prescribed and non-prescribed drugs appeared to be as common in children as in adults. The number of drugs taken was related to the number of domicilary consultation received and the number of doctors seen as as to confirm that most doctors' visits result in the prescription of medicine. The transfer and recording of drug information was poor, owing principally to lack of communication between doctors and failure to detect self-medication, but the modern practices of self-referral to hospital and use of multiple prescribers have further reduced the information available. The use of a "current treatment card" is required if the full significance of iatrogenic disease in childhood is to be investigated.

Adolescent↗
PubMedDate not supplied

Carbamazepine replacement of phenytoin, phenobarbital and primidone in a rehabilitation setting: effects on seizure control.

Most patients who receive anticonvulsants after traumatic brain injury are treated with the sedative anticonvulsants phenytoin and/or phenobarbital, or perhaps primidone. However, there is considerable evidence demonstrating that these medications have a deleterious effect on cognitive function. Thus, in a rehabilitation setting, alternatives should be sought. Carbamazepine has been found to be relatively free of such effects, and would be an optimum alternative if seizure control were comparable. We have studied the effects of withdrawing phenytoin, phenobarbital and primidone, and using carbamazepine as the primary anticonvulsant in 27 patients at the Greenery Rehabilitation and Skilled Nursing Center for whom ongoing anticonvulsant treatment was considered to be necessary due to previous seizures or a high risk of the occurrence of seizure. We compared a 3 month baseline period (just prior to carbamazepine introduction or sedative anticonvulsant tapering), to a 3 month post-withdrawal period immediately following sedative anticonvulsant withdrawal, when carbamazepine was the sole anticonvulsant. In 20 out of 21 patients in whom carbamazepine replaced sedative anticonvulsants seizure control was essentially similar or somewhat improved. In only one patient did the substitution with carbamazepine result in a loss of seizure control. Six patients were initially receiving carbamazepine in combination with phenytoin and/or phenobarbital. The removal of phenytoin and phenobarbital, leaving carbamazepine as sole therapy, resulted in improved seizure control in three patients and no change in the other three. In the light of carbamazepine's reportedly less detrimental effects on cognitive function and behaviour in other patient populations, it should perhaps be considered as a first line anticonvulsant, especially for patients in rehabilitation settings.

Adult↗
PubMedDate not supplied

Arterial microanastomosis technique by using only one stitch.

The starting point of this work is the description of a microsurgical technique designed to carry out termino-terminal arterial anastomosis in rats. The technique is based on the intussusception of the afferent vessel of the anastomosis in the efferent vessel, both of which are fixed by a horizontal U-shaped stitch. Of the twelve cases which make up this series, haemorrhage appeared in two, and a postanastomotic aneurysm developed in one. The lack of complications both before and after operating, even in the long term, in the balance of the cases (75%), together with the simple and quick procedure of this kind of anastomosis, makes this technique a possible alternative to the classical techniques of vascular microanastomosis in experimental surgery.

Anastomosis, Surgical↗