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Biomedical subjects

L J Donaldson

Publications and source records attributed to L J Donaldson.

At least 73 records · Page 4Linked to original sources
PubMed1984

Longitudinal changes in functional capacity among surviving old people continuously resident in hospitals and homes.

A group of surviving, continuously resident elderly people was identified through linkage of data from two cross sectional studies (three years apart) of all types of hospital and homes provided within a defined geographical area. Although 60-70% were unchanged in their ability to perform basic activities of daily living, any change was most often deterioration: between three and four to one. The exception was for faecal incontinence: a higher proportion remained unchanged but of those who changed, more deteriorated than was so for other activities. Change was greater when all aspects of functional capacity were considered, though the extent of deterioration was similar. Greater change and greater deterioration were associated with increasing age, the male sex, shorter initial duration of stay, and residence in a geriatric ward. After adjustment for differences in such factors, patients in geriatric and psychiatric wards deteriorated to a similar extent but significantly more than residents of homes for the elderly. Few such data are available, yet they are necessary for assessing the impact of different institutional regimens and formulating rehabilitation strategies.

Activities of Daily Living↗
PubMed1984

Review of an orthopaedic in-patient waiting list.

A review of 950 patients who had waited for more than one year for orthopaedic treatment at a large District General Hospital was undertaken. Searches of medical records eliminated 193 patients who had already had operations, but, whose names had not been removed from the list. Of the remaining 757 patients, 48% indicated their wish to remain on the list. This proportion was lowest for: the under 45 year old age group (43%), the over 75s (36%), patients awaiting less complex procedures (35%) and those with waiting times longer than five years (31%).

Appointments and Schedules↗
PubMed1983

Patterns of Asian and non-Asian morbidity in hospitals.

On the basis of surname, 6418 Asians were identified out of a total of 109 187 deaths and discharges of Leicestershire residents who had been treated in hospitals in the Trent Regional Health Authority over two years. After linkage to Hospital Activity Analysis computerised records, hospital morbidity in Asians and non-Asians was compared. Asian patients in certain age groups were more likely than non-Asian patients to be diagnosed as having asthma; leukaemia; diabetes mellitus; blood, thyroid, and eye disorders; certain forms of heart disease; and spontaneous and other types of abortion (excluding therapeutic abortion). The well recognised excess of cases of tuberculosis among Asians was also confirmed. Conversely, for some age groups, Asians were less likely than non-Asians to fall into particular diagnostic categories. Exploring such apparent differences can serve as the basis for aetiological inquiry and service planning. The patient's name is now probably the most reliable indicator of Asian ethnic origin in health records.

Adolescent↗
PubMed1983

Survival and functional capacity: three year follow up of an elderly population in hospitals and homes.

A three year mortality study was undertaken of a population of 4490 people aged 65 and over in all types of hospitals and homes provided within a defined geographical area. The rate of survival consistently fell with increasing incapacity in mobility, incontinence, washing/dressing, and feeding. The effect was independent of differences in age, sex, and duration of stay. Differences in survival between patients and residents of National Health Service hospitals (geriatric, psychiatric, acute) and homes for the elderly did not persist after adjustment for variations between populations in level of incapacity, age, and sex. An assessment based on ability to perform basic items of self care is easily undertaken and understood by staff in different settings. It allows homogeneous groups of elderly people to be identified despite a diverse range of underlying diseases and could provide the basis for planning and evaluating services and rehabilitation regimens.

Activities of Daily Living↗
PubMed1983

Institutional care for the elderly: the impact and implications of the ageing population.

Two cross-sectional studies three years apart assessed functional capacity in everyone aged 65 years and over in any ward, hospital, home or hostel in a defined geographical area. Comparison of the proportion of patients aged 65-74 years, 75-84 years and 85 years and over within these institutions showed that a higher proportion of the very elderly were in homes for the elderly and a lower proportion in National Health Service (NHS) geriatric hospital beds in the later time period. Greater proportions of all age groups of the elderly were in NHS acute hospital beds. Levels of incapacity in these people had increased between 1976 and 1979. In continuously resident people the proportion remaining unchanged fell and the extent of deterioration increased with greater age: among recent admissions significant increases in incapacity were only seen in patients in NHS geriatric hospitals. At present the demands of the ageing population are such that old people will be admitted where places are available even if the setting is not entirely appropriate to their needs. Restrictive admission policies on the part of residential homes will not reduce levels of incapacity if they continue to admit older residents.

Activities of Daily Living↗
PubMed1981

The use of topical thrombin to reduce wound haematoma in patients receiving low-dose heparin.

The efficacy of topical thrombin in prevention of wound haematoma in patients receiving subcutaneous low-dose heparin was studied in a randomized, controlled trial. One hundred and two patients undergoing elective abdominal surgery were included in the trial. Haematological studies were carried out in the last 42 patients to determine whether introduction of thrombin into the wound resulted in any systemic effect via the coagulation pathways. The frequency of post-operative wound haematoma was significantly lower in the thrombin-treated group as compared to the control group and its action appeared to be independent of any change in coagulation parameters.

Abdomen↗
PubMed1980

The elderly in residential care: mortality in relation to functional capacity.

A census in which 4514 people aged 65 and over had been enumerated in all types of institutional care both within and outside the National Health Service in Leicestershire was taken as a starting point for the present investigation. This entire population was followed up for one year to determine its mortality experience. Mortality was described by three measures: (a) the proportion surviving for one year from the date of the census, (b) the standardised mortality ratio (using the population of Leicestershire in 1977 as a standard), and (c) using a life-table analysis, the percentage survival to specified time periods after admission to institutional care. We discuss the relationship of these indices to functional capacity, indicated by the ability to undertake basic activities of daily living (ADL), and to type of institution.

Activities of Daily Living↗
PubMed1979

Leiomyoma of the duodenum presenting as a pyogenic liver abscess.

Leiomyoma of the duodenum is a rare condition which is most often diagnosed only as an incidental finding at post-mortem. It may present clinically with pain or haemorrhage. A case is described of degeneration of a leiomyoma of the fourth part of the duodenum giving rise to pyogenic liver abscess. There is no previous report of this association in the literature.

Duodenal Neoplasms↗
PubMed1978

Experience with the AO method in the treatment of 142 cases of fresh fracture of the tibial shaft treated in the UK.

A prospective study was carried out on 142 fresh fractures of the tibial shaft treated by internal fixation according to the AO principles, 99 fractures being closed and 43 open. A total of 140 cases was reviewed at 1 year and 125 cases at 2 years following injury, at which times a functional assessment score was awarded by the surgeon and the patient himself, and a precise measurement of ankle range was made. The time taken for the fracture to unite and the incidence of non-union was greater if the fracture was comminuted (whether open or closed) than if there was no comminution. For patients with closed fractures the minor infection rate (erythema and increased local temperature) was 4.1 per cent and the major infection rate (pus present) was 4.1 per cent, no infection being severe enough to warrant removal of the plate. In open fractures, the overall infection rate was 14 per cent, 7 per cent having major infection and only 1 case requiring removal of the plate. The functional results and complications are discussed.

Adolescent↗
PubMed1978

Mechanism of impaired glucose tolerance in patients with neoplasia.

The disappearance rate (k) of i.v. glucose was measured in cachectic and non-cachectic cancer patients and tumour-free controls. The respective k values were found to be 1.06 +/- 0.27 (mean +/- s.d.), 1.64 +/- 0.34 and 1.63 +/- 0.23. Of the other parameters measured, only plasma albumin level was found to vary significantly amongst the 3 categories, the mean level being the lowest in cachectic cancer patients. The means of total plasma protein, fasting blood glucose and plasma liver enzyme concentrations were similar in the 3 groups. Glucagon, a potent insulin secretogogue, failed to augment the fasting insulin level in cachectic but did so in non-cachectic cancer patients. Taken together, the findings suggest that the reduced glucose tolerance in patients with neoplasia is due to impairment of insulin release exhibited predominantly by ill-nourished advanced cancer patients having a moderate to sever degree of hypoalbuminemia.

Adult↗
PubMed1977

Topical thrombin and control of wound haematoma.

The frequency of wound haematoma was investigated in 45 prophylactically heparinised patients undergoing abdominal surgery. Thrombin was applied locally to the wound in 15 patients, and in these patients wound haematoma was significantly less common than in the controls.

Abdomen↗
PubMed1977

Deoxyribonucleic acid and polyamine synthesis in rat ventral prostrate. Effects of age of the intact rat and androgen stimulation of the castrated rat with testosterone, 5 alpha-dihydrotestosterone and 5 alpha-androstane-3 beta, 17 beta-diol.

The relationship between polyamine synthesis, growth and secretion in vivo was examined in ventral prostates from: (a) intact rats aged 3-60 weeks; (b) animals castrated for 7 days before injection with 5 alpha-dihydrotestosterone (17 beta-hydroxy-5-alpha-androstan-3-one), testosterone and 5 alpha-androstane-3 beta, 17 beta-diol for up to 10 days; (c) rats injected with the 3 beta, 17 beta-diol immediately after castration. Ornithine decarboxylase activity and the concentrations of putrescine, spermidine and spermine were measured. DNA-synthetic activity was monitored by measuring [125I]iododoxyuridine incorporation. An enhanced spermidine/spermine molar ratio reflected increased activity of the prostate. The ratio was higher (greater than 2) in prostates from sexually immature animals, than in the intact adult (1.5), suggesting that the ratio was indicative of the proliferative activity of the tissue. However, in the androgen-stimulated castrated rat, enhanced spermidine/spermine ratios tended to correlate with hypertrophy and secretion. In both sets of experiments there was a linear relationship between protein and spermidine content. High spermidine/spermine molar ratios were the consequence of a relatively low rate of accumulation of spermine relative to spermidine and protein. The relationship between polyamine synthesis and DNA-synthetic activity was investigated in cultured prostate. A combination of insulin (3 mug/ml) and testosterone (0.1 muM caused a stimulatory response in the incorporation of [125I]iododeoxyuridine and in cell division, despite a depleted polyamine content and low ornithine decarboxylase activity in the cultured tissue.

Age Factors↗