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Biomedical subjects

P V Knight

Publications and source records attributed to P V Knight.

12 recordsLinked to original sources
PubMed1997

Influenza vaccination of health care workers in long-term-care hospitals reduces the mortality of elderly patients.

Vaccination of health care workers (HCWs) is recommended as a strategy for preventing influenza in elderly patients in long-term care. However, there have been no controlled studies to show whether this approach is effective. During the winter of 1994-1995, 1059 patients in 12 geriatric medical long-term-care sites, randomized for vaccination of HCWs, were studied. In hospitals where HCWs were offered vaccination, 653 (61%) of 1078 were vaccinated. Vaccination of HCWs was associated with reductions in total patient mortality from 17% to 10% (odds ratio [OR], 0.56; 95% confidence interval [CI], 0.40-0.80) and in influenza-like illness (OR, 0.57; 95% CI, 0.34-0.94). Vaccination of patients was not associated with significant effects on mortality (OR, 1.15; 95% CI, 0.81-1.64). Results of this study support recommendations for vaccination against influenza of HCWs in long-term geriatric care. Vaccination of frail elderly long-term-care patients may not give clinically worthwhile benefits.

Aged↗
PubMed1995

An audit of clinical dependency in geriatric continuing care.

1,376 elderly patients in 16 separate geriatric medical continuing care facilities, in greater Glasgow, including an NHS funded partnership nursing home, were surveyed over a six month period. This provided a snapshot of physical and mental dependency, specialist medical and nursing requirements and suitability of placement. The survey confirmed an extremely dependent population, with 82% scoring eight or less on a modified Barthel scale (maximum score 20) and 79% thought to require ongoing consultant supervision. Not all of the latter group were in the most dependent category. Forty one per cent of patients received specialised pressure relieving equipment and 30% had had a major adverse medical event in the six months prior to survey. Eighty-eight per cent of cases had had formal consultant review in the previous month. Currently there is a small group of patients resident within NHS continuing care facilities who might be cared for elsewhere. There is a larger group who need specialised care, they are characterised by a need for specialised nursing skills, regular medical review and consultant supervision.

Activities of Daily Living↗
PubMed1991

Visitors' perceptions of continuing care.

One hundred and sixty-one replies (72% response rate) to a questionnaire sent to regular visitors of elderly continuing care patients showed that 73% of the visitors were first degree relatives. Sixty three per cent visited more than once per week, and were more likely to do so when the distance travelled was less than five miles (p less than 0.01) and the cost under pounds 2.00 (p less than 0.01). The physical surroundings and nursing care were rated as adequate or better by 80% and 92% respectively. Numbers of nurses were rated as inadequate by 44% and numbers of physiotherapists as inadequate by 46%. Increasing the numbers of nurses was suggested as the measure that would most improve the patients' quality of life. To facilitate visiting, continuing care units should be sited close to the community they serve.

Attitude to Health↗
PubMed1991

Continuing hospital care in Scotland: a survey of consultant geriatricians.

We report a survey of Consultant Geriatricians in Scotland with regard to the provision of continuing geriatric care. There are wide variations in the numbers of patients that individual consultants are responsible for, the type and geographical site on which a service is provided, and also in views on the adequacy of staffing levels. Quality of physical surroundings and nursing care are generally thought to be more than adequate. Consultants believed their main contribution was providing expert medical advice, and felt their patients' quality of life could most be improved by increased diversional therapy. There are wide geographical differences in the number of private nursing and residential homes in Scotland but they have had some influence on the criteria for placement of patients in continuing hospital care.

Aged↗
PubMed1987

Acute appendicitis in the elderly: a 5-year retrospective study.

Acute appendicitis in elderly patients has not been studied extensively in the United Kingdom. Studies were performed prior to the regular use of broad spectrum antibiotics and tended to include younger patients. We studied retrospectively all elderly patients (n = 30, mean age = 72 years) who presented in the years 1980-85 and a younger group (n = 30, mean age = 23 years) who had a confirmed pathological diagnosis of appendicitis. We found a significant reduction in accurate pre-operative diagnoses, a longer duration of hospital stay and increased complication and mortality rates in the elderly group. Our study suggests that diagnostic accuracy, mortality and morbidity have not improved in comparison to earlier overseas studies.

Acute Disease↗
PubMed1986

Echocardiographic diagnoses in elderly patients with systolic murmurs and cardiac disease.

M-mode and 'real-time' echocardiography was employed to study 100 elderly with systolic murmurs and cardiac disease. Technically adequate recordings were obtained in 89 patients. Independent assessment of the echocardiographs showed good reproducibility. Aortic sclerosis was the most prevalent lesion, but did not by itself impair left ventricular function. The echocardiographic diagnosis of mitral regurgitation was significantly related to heart failure and atrial fibrillation. A link between murmur and cardiac disease was postulated in 40% of cases.

Aged↗
PubMed1985

Systolic murmurs in pregnancy: value of echocardiographic assessment.

A systolic murmur discovered in antenatal care is the most common reason for cardiological assessment during pregnancy. We have assessed the value of clinical and echocardiographic assessment in 50 consecutive patients who were referred to our cardiac clinic following the discovery of a cardiac murmur at an antenatal clinic. Most of the murmurs occurred at 10-12 weeks gestation; 46 subjects had cardiac murmurs confirmed at the cardiac clinic, of whom 16 gave a history suggestive of a previous cardiovascular disorder. Of the 16 patients, 13 had been found to have a murmur earlier in life which was thought to be of no clinical significance. Complications during pregnancy were infrequent. The most frequent murmur discovered was a soft midsystolic murmur heard with greatest intensity at the left sternal edge. The results of electrocardiography and echocardiography were not helpful in assisting with the diagnosis or substantially altering antenatal management in these patients. We do not feel that echocardiography has an important role in the assessment of systolic murmurs in pregnancy in the absence of other clinical or ECG abnormalities.

Adolescent↗
PubMed1985

Are insulin dependent diabetics in the West of Scotland prone to nutritional deficiencies?

In a cross-sectional survey, the weight, vitamin and mineral status of 57 insulin dependent diabetics attending a clinic in Glasgow were studied. There were no significant differences in any of the measured parameters between poorly controlled and better controlled diabetics (as assessed by HbA1 status). No gross evidence of nutritional deficiency was found although serum magnesium levels tended to be low. This may be clinically relevant as hypomagnesaemia is associated with cardiac arrhythmias and ischaemic heart disease.

Adolescent↗