Search PubMed⌕ Search

Biomedical subjects

M E McMurdo

Publications and source records attributed to M E McMurdo.

At least 19 recordsLinked to original sources
PubMed2001

Falls prevention.

Explore the source record for details and available documents.

Accidental Falls↗
PubMed2001

Rediscovering the joy of food: the need for long-term review of swallowing ability in stroke patients.

Stroke is commonly associated with dysphagia, which may necessitate the use of enteral feeding best provided by a percutaneous endoscopic gastrostomy (PEG) tube. Resolution of dysphagia complicating stroke is observed in the days, weeks and months following the event. This may allow the resumption of a normal diet, and cessation of enteral feeding. However at the time dysphagia resolves many patients--with enteral feeding still in place--will have been discharged from facilities where expert speech and language therapy is available to assess recovery of swallow. We report three cases of patients with dysphagia following stroke who benefited from long term review of swallowing ability. We then discuss the benefits of such follow-up, and how it might best be achieved in the community.

Aged↗
PubMed2000

Adverse drug reactions.

Explore the source record for details and available documents.

Adverse Drug Reaction Reporting Systems↗
PubMed1999

A survey of attitudes and knowledge of geriatricians to driving in elderly patients.

OBJECTIVE: To assess the attitudes of consultant members of the British Geriatrics Society to elderly patients driving motor vehicles. DESIGN: An anonymous postal survey assessing knowledge and attitudes to driving in elderly people. A standardized questionnaire was used and five case histories were offered for interpretation. SETTING: The study was co-ordinated from a teaching hospital. SUBJECTS: The 709 consultant members of the British Geriatrics Society. Four hundred and eighteen responses were obtained, which represents a 59% response rate. RESULTS: 275 Respondents (68%) correctly realised that a person aged 70 had a duty to inform the Driving and Vehicle Licensing Authority (DVLA) about their eligibility to drive. The remainder did not. Most (315; 75%) believed that the overall responsibility for informing the DVLA was with the patient. If a patient was incapable of understanding advice on driving because of advanced dementia, 346 (83%) would breach patient confidentiality and inform the authority directly. Where a patient was fully capable of understanding medical advice but ignored it, 72% of geriatricians would have legitimately breached patient confidentiality and informed the DVLA. Most geriatricians (88%) saw their main role as one of providing advice on driving to patients and their families. Enforcing DVLA regulations was not seen as an appropriate function, unless the patient was a danger to themselves or other drivers. CONCLUSIONS: There is a wide variation in knowledge of driving regulations and attitudes to driving in elderly patients. Better education of geriatricians should improve awareness of when elderly drivers can safely continue to drive.

Aged↗
PubMed1998

Evaluation of peripheral dual energy X-ray absorptiometry: comparison with single photon absorptiometry of the forearm and dual energy X-ray absorptiometry of the spine or femur.

An evaluation of the Osteoscan peripheral dual energy X-ray absorptiometer (pDXA) was carried out to compare its performance with those of a single photon absorptiometer (SPA) (Molsgaard Medical ND1100A) and a dual energy X-ray absorptiometer (DXA) (Lunar DPX alpha) of the spine or femur. In 57 patients, correlation between bone mineral content (BMC) of the forearm at the ultradistal (UD) site by pDXA and by SPA was high (r = 0.94). Comparisons were also made with spine and femur bone mineral density (BMD) DXA measurements. The correlation of z-scores of UD BMD with z-scores for lumbar spine L2-L4 was r = 0.63 (n = 73 patients); and with z-scores for neck of femur was r = 0.72 (n = 33). With the Osteoscan the measurement error coefficient of variation in vivo was 2.6% for BMC, 1.8% for BMD at the ultradistal site; 2.1% for BMC and 1.9% for BMD at the mid-distal site. Repeat measurements were made of the European forearm phantom; precision for SPA was slightly better than either pDXA or Lunar DXA. The Osteoscan has the potential for a rapid throughput of patients and is not affected by calcification and degenerative changes that can corrupt DXA measurements on the anteroposterior spine in older women.

Absorptiometry, Photon↗
PubMed1997

Drug-related problems in elderly patients admitted to Tayside hospitals, methods for prevention and subsequent reassessment.

INTRODUCTION: although drug-related problems (DRPs) are known to be prevalent in elderly patients, the literature on prevention of iatrogenic disease is sparse. The present study addresses this requirement. OBJECTIVES: to assess the incidence of DRPs in elderly patients admitted to Tayside hospitals before (phase I) and after (phase II) implementation of preventive strategies. DESIGN: all elderly people admitted to hospital were screened by a pharmacist; individual case reviews were prepared for all those with a potential DRP and reviewed by a three-member panel which made a final decision on the presence of a DRP and its contribution to admission. SETTING: all hospital wards admitting elderly patients in the Tayside region of Scotland. SUBJECTS: 1011 elderly patient admissions over a 9-month period (phase I); 857 elderly patient admissions over an 8-month period (phase II). MAIN OUTCOME MEASURES: incidence of DRPs before and after targeted intervention strategies (information bulletin for general practitioners, patient information leaflet, oral presentation to trainee general practitioners). RESULTS: in phase I, the incidence of DRPs was 144/1011 (14.2%), with 54/1011 (5.3%) of the admissions identified as being definitely or probably drug-related. Non-steroidal anti-inflammatory drugs (NSAIDs) were the main drug group involved, being responsible for 15/54 (28%) of admissions primarily due to a DRP. Over 66% of admissions due to adverse effects of NSAIDs were considered to be definitely preventable. In phase II, after targeted intervention strategies, there was no significant reduction in total incidence of DRPs or incidence of DRPs related to NSAIDs. However, there appeared to be an improvement in the first 4 months, and a significant drop in NSAID prescribing in Tayside compared with the rest of Scotland was observed. CONCLUSION: DRPs remain a significant problem in elderly patients and NSAIDs are the major contributor. The intervention strategies used in the study were not demonstrably effective, but a continuous programme of education may be necessary to limit NSAID use.

Aged↗