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Biomedical subjects

M S Pathy

Publications and source records attributed to M S Pathy.

At least 55 records · Page 3Linked to original sources
PubMed1983

Pharmacokinetic and pharmacodynamic characteristics of trazodone in the elderly.

The pharmacokinetic and some pharmacodynamic characteristics of a single oral dose of 100 mg trazodone were compared in young and elderly volunteers. The maximum plasma concentration of trazodone was similar in both age groups. The time to maximum concentration was apparently prolonged in four subjects who swallowed the capsule with a minimal volume of fluid. This may have been due to the capsule being retained in the oesophagus. The terminal phase half-life of trazodone was significantly prolonged (P less than 0.05) and area under the plasma concentration-time curve was significantly larger (P less than 0.01) in the elderly. Apparent oral clearance was significantly reduced (P less than 0.01) in the elderly. Measurement of critical flicker fusion threshold and subjective assessment of alertness using a visual analogue scale, confirmed the sedative effect of trazodone in both age groups. The elderly subjects were less alert for a longer period following drug administration than the young. The differing pharmacokinetic and pharmacodynamic characteristics of trazodone in the young and elderly may be due to an age-related reduction in hepatic drug-metabolising activity, a difference in regional distribution or a change in CNS sensitivity to the drug.

Adult↗
PubMed1983

An evaluation of the short-term hypnotic efficacy of loprazolam in comparison with nitrazepam in elderly patients.

A double-blind, parallel group, randomized trial was carried out to compare the hypnotic efficacy of 1.0 mg loprazolam and 5.0 mg nitrazepam in 40 elderly patients. All had disturbed sleep patterns, which were not the result of physical illness, and had been shown to be placebo non-responders during a 3-day placebo screening period. Patients received active medication for 7 nights. Both loprazolam and nitrazepam significantly improved sleep patterns, as measured by patient self-rating scales and night nurses' global assessments, in comparison with the placebo baseline screen (p less than 0.001). No significant differences in efficacy were shown between drug treatments and no untoward effects were recorded which could be attributed to either drug. The results suggest that 1.0 mg loprazolam is an effective and well-tolerated hypnotic in elderly patients suffering from insomnia.

Aged↗
PubMed1982

Attitudes towards the care of the aged and to a career with elderly patients among students attached to a geriatric and general medical firm.

Studies in the United States have suggested that medical students' bias against older patients is not influenced by ad hoc courses in geriatrics. If the suggestion is correct then there should be no difference between the attitudes towards the care of the aged and to a career with elderly patients among students attached to a geriatric and general medical firm. In order to examine the hypothesis, such attitudes were compared among students randomly allocated to geriatric and general medical firms. More of the geriatric firms' students held favourable attitudes towards the care of the aged and were prepared to consider a hospital career with elderly patients. The majority of students in both groups wanted to gain their pre-general practice experience of elderly patients on a geriatric ward. The geriatric firm's students also felt that their training had more adequately prepared them to deal with problems commonly encountered among the elderly in hospital.

Aged↗
PubMed1982

Osteoarthritis and non-steroidal and anti-inflammatory drugs: a multi-centre comparative study.

An open, multi-centre study was carried out in 239 elderly out-patients referred with symptomatic osteoarthritis of the hip and/or knee to assess the effectiveness of 200 mg sulindac twice daily compared with either 400 mg ibuprofen 3-times daily, 250 mg naproxen twice daily or 25 mg diclofenac 3-times daily. Assessments were made before and during the 12-week trial period of disease activity, weight-bearing pain, pain on active and passive movement, night pain, and inactivity stiffness. The results showed that there was significant improvement in all of the parameters with each of the treatments, and the difference between treatments was significant in favour of sulindac compared with ibuprofen in disease activity, weight-bearing pain and pain on active movement. In the overall assessment of response to treatment at the end of the trial it was the patients' opinion that the degree of improvement was better on sulindac than on the comparative drugs. The main side-effect leading to some patients withdrawing from the trial was abdominal pain.

Aged↗
PubMed1981

Change in disability status as a predictor of long-term survival after myocardial infarction in the elderly.

Seventy-five consecutive patients discharged from a geriatric medical ward after a proven myocardial infarction and still alive at three months were followed for three years. Twenty-two died. Sixty-five patients replied to a postal questionnaire designed to assess their degree of psychological impairment and disability sent at the end of the first and third month after discharge. The predictive value of an increased independency rating between the two administrations of the questionnaire for survival was 77%. The predictive value of a decreased independency rating for mortality was 52%. The only clinical feature noted on admission, whose frequency differed significantly between the group who died and those who survived, was a systolic blood pressure of 160 mmHg or more on admission but this was a less satisfactory predictor than change in disability status. Patients who improve their disability status in the few months after a myocardial infarction also have a low long-term mortality and can safely be excluded from out-patient follow-up.

Aged↗
PubMed1981

Follow-up study of disability among elderly patients discharged from hospital with exacerbations of chronic bronchitis.

Chronic bronchitis is a common reason for admitting an old person to hospital. Government statistics measure the impact of admission only in terms of mortality. A follow-up study of disability among the elderly admitted to hospital wih an exacerbation of chronic bronchitis is described. One month after discharge about 30% of patients were unable to walk as far on the flat or climb as many steps as they did before admission and 90% were unable to do all previous household chores or social activities. After a further two months, although the proportion of patients unable to do all previous household chores or social activities had decreased significantly the proportion with restricted ambulation or ability to climb stairs had not decreased. The proportion of patients admitting to anxiety or depression and being dissatisfied with their progress also remained high. We conclude that there is a need for graduated rehabilitation programmes, which have been shown to increase the walking distance of elderly bronchitics, to be extended to cover all aspects of disability and for home rehabilitation to become an integral part of the care of all elderly bronchitics discharged from hospital.

Activities of Daily Living↗
PubMed1980

Papaverine and hepatotoxicity.

Six of 14 patients receiving a sustained release papaverine preparation developed abnormal liver function tests. One patient had jaundice and another abnormal liver histology on a biopsy specimen. This is only the third report of impaired liver function following the administration of papaverine--a drug which has been used in clinical medicine for over 100 years.

Aged↗
PubMed1980

Temporal variation of serum levels of vitamin B12, folate, iron and total iron-binding capacity.

The influence of food ingestion and time of day on the serum levels of B12, folate, iron and total iron-binding values was studied. Food intake had no influence on serum B12, serum iron and total iron-binding capacity (TIBC) levels, but serum folate rose rapidly. Serum B12 showed no change with time of day. Serum iron and TIBC fell significantly from 8 a.m. to 8 p.m. Folate initially rose significantly over 5 h then fell at 12 h, but this fall did not reach statistical significance. Over a period of 1 year serum iron fell, but TIBC showed no significant change. Subjects without pernicious anaemia but with low B12 levels showed no significant change in serum B12 over 4 years.

Aged↗
PubMed1979

Acute central chest pain in the elderly. A review of 296 consecutive hospital admissions during 1976 with particular reference to the possible role of beta-adrenergic blocking agents in inducing substernal pain.

Two hundred and ninety-six patients were admitted to geriatric medical beds in Cardiff in 1976 with acute central chest pain. One hundred and eighty-six (63 per cent) had a confirmed acute myocardial infarction. Of the 37 per cent without evidence of cardiac infarction, 32 per cent were on beta-blocking drugs. The possible role of adrenergic blocking agents in producing acute central chest pain is discussed.

Acute Disease↗
PubMed1979

Motor complications of herpes zoster.

Motor involvement is uncommon in herpes zoster. Of 14 subjects observed over an arbitrary period of five years, nine had flaccid limb paralyses, involving the upper limb in eight patients. Recovery was not always complete and occurred over a period of nine weeks to four years.

Aged↗
PubMed1979

Impaired plasms immunoreactive insulin response to glucose in elderly hypertensive patients with abnormal clucose tolerance.

Oral glucose tolerance and the plasma immunoreactive insulin response to oral glucose were measured in 42 elderly hypertensive patients. Twenty-four of these patients showed abnormal glucose tolerance curves an 18 had normal curves. Patients with abnormal glucose tolerance showed significantly lower plasms immunoreactive insulin concentrations at 30 min and 60 min after the glucose load compared with patients with normal glucose tolerance. The patients in the two groups did not appear to differ in any other clinical or biochemical characteristics.

Aged↗
PubMed1979

An evaluation of simultaneously administered free and intrinsic factor bound radioactive cyanocobalamin in the diagnosis of pernicious anaemia in the elderly.

The definitive diagnosis of pernicious anaemia (PA) in the elderly is by no means always straightforward, particularly when inappropriate medication has been introduced before the institution of specific investigatory procedures. A detailed haematological study was carried out on 301 patients aged 60-95 with a serum B(12) concentration at the laboratory's lower level of normal of 150 ng per litre (Euglena gracilis assay). The diagnosis of PA was based on strict predetermined haematological criteria. All patients were subsequently studied by the simultaneous oral administration of the dual isotopes (57)Co-labelled B(12) bound to intrinsic factor and free (58)Co-labelled B(12) (Dicopac test), and urine was collected over 24 hours after an intramuscular dose of 1 mg nonradioactive B(12) for estimation of the (57)Co/(58)Co B(12) ratio; 255 patients satisfied all criteria for final analysis. The Radiochemical Centre, Amersham suggests an upper limit of the normal range for the (57)Co/(58)Co ratio of 1.3 with a lower limit for PA of 2.0. We were unable to show a sharp borderline in the (57)Co/(58)Co B(12) ratio between those patients shown by other criteria to have PA and those who do not have PA; 34% of the 71 established patients had a ratio below 2.0. From our series a ratio borderline drawn at 1.4 gave only one false negative (1.4% of the PA group). Of the 175 non-PA cases, nine (5%) gave false positive results; four of these had (58)Co excretion levels high enough to make misdiagnosis unlikely. In a proportion of patients the (57)Co/(58)Co B(12) ratio was estimated at regular intervals for 36-hour periods. Maximum accuracy of isotope measurement on a single specimen was obtained 8-20 hours after isotope dosing. The Dicopac investigation is a useful simple screening test in the differential diagnosis of patients with a megaloblastic bone marrow and combined low serum B(12) and folate concentrations. When carried out by the standard technique, the degree of discrimination between normal and abnormal ratios is of limited diagnostic significance in one-third of patients.

Aged↗
PubMed1978

Defaecation syncope.

Defaecation syncope is recorded in seven female and two male patients aged between 63 and 78 years seen over a period of nine years. The tendency for defaecation syncope to occur at night contrasts with the rarity of nocturnal defaecation in most old people. The close similarity with micturition syncope is noted.

Aged↗