Search PubMed⌕ Search

Biomedical subjects

R B Stewart

Publications and source records attributed to R B Stewart.

At least 145 records · Page 8Linked to original sources
PubMed1983

Haematological and biochemical laboratory values in an ambulatory elderly population: an analysis of the effects of age, sex and drugs.

Haematological and biochemical test results of 2242 ambulatory, elderly subjects in a health screening programme were used to study normal ranges for these values. A large percentage of leucocyte and erythrocyte counts and haemoglobin and haematocrit values were below the reference range of the laboratory performing the tests. Over 25% of erythrocyte counts were below the lower limit of normal, while in men 50% of mean corpuscular haemoglobin values were above the upper limit of normal. A large percentage of serum potassium concentrations were below the lower range of normal, while a high percentage of blood urea nitrogen, creatinine, triglycerides, and lactic dehydrogenase concentrations fell above the upper limit of normal. When subjects using drugs were compared to a nondrug-taking group, significant differences were found in serum potassium, chloride, carbon dioxide, creatinine, uric acid and serum glutamic oxaloacetic transaminase concentrations.

Age Factors↗
PubMed1983

Evaluation of hypertensive therapy in a skilled nursing facility.

Treatment of hypertension in the elderly has recently received increased attention. Both systolic and systolic plus diastolic hypertension are risk factors for cardiovascular and cerebrovascular diseases in patients older than age 65, but the value of antihypertensive therapy in reducing morbidity and mortality has not been adequately studied. The authors evaluated the appropriateness of antihypertensive therapy prescribed for elderly patients in a skilled nursing home and determined the effect reductions in antihypertensive therapy had upon the function and mental status of these patients. Of the 120 patients surveyed, 26.7 percent were found to have a diagnosis of hypertension, and 1/3 of these patients were not receiving any medications at the time of the study. Assessment of the remaining treated patients resulted in a recommendation to alter therapy in 43 percent of the cases. Results from this study suggest that periodic assessment of antihypertensive therapy in long-term care facilities should be considered.

Aged↗
PubMed1983

Pharmaceutical services in family practice medical residency training programs.

The extent and nature of pharmacists' involvement in family practice medical residency training programs was assessed using a national survey. Department chairmen of all 386 approved family practice residency training programs in the United States were contacted and asked to provide the names and addresses of pharmacists in charge of pharmaceutical services in the centers. A 46-item, six-page questionnaire was mailed to each pharmacist with a follow-up mailing, then a telephone call, to nonresponders. Department chairmen of 68 (18%) of the programs reported having at least one pharmacist in the center. Responses to the questionnaire were obtained from 53 (78%) of the pharmacists, four of whom were no longer involved with family practice centers. Most of the remaining 49 pharmacists were men (76%) between 30 and 40 years old (59%) with an academic appointment (67%) and a doctor of pharmacy degree or some type of postgraduate training. Drug-distribution services were provided in 37% of the centers. All pharmacies offered clinical services. Almost all pharmacies (92%) offered educational services to both medical and nursing staffs, and pharmacists in 74% of the centers were involved in research. Few family practice medical residency training centers have pharmaceutical services conducted by a pharmacist; centers with pharmacists have a wide variety of distributive and clinical services.

Family Practice↗
PubMed1983

Diuretic use in an ambulatory elderly population.

The nature and extent of diuretic use and the effect of diuretics on clinical laboratory values were studied in a retirement community. Study participants completed health questionnaires and provided information on all prescription and nonprescription medications regularly used. Subjects using diuretics were categorized according to product(s) used; a control group used no diuretics. Results for diuretic users who used potassium supplements were analyzed separately. Data were collected on 2009 women and 1183 men over 65 years old. At least one diuretic drug was used by 40.2% of the women and 29.5% of the men. In most cases, the diuretic was used daily (81.1%) and had been used for longer than two years (72.5%). Approximately one third of the subjects had hypertension. Serum potassium values for users of chlorthalidone and thiazide diuretics showed the greatest difference from the control group, while users of the combination of hydrochlorothiazide and spironolactone showed the greatest difference in serum sodium concentrations. Particularly in furosemide users, uric acid, BUN, and creatinine concentrations were significantly different from control. When serum potassium values of subjects using both diuretics and potassium supplements were analyzed, values were lower in participants using supplements. In many cases, significantly different laboratory values were still within normal limits. Long-term diuretic use in this ambulatory elderly population was high and was associated with numerous alterations in biochemical values.

Aged↗
PubMed1982

Prescribed and nonprescribed drug use in an ambulatory elderly population.

Drug usage was studied in an ambulatory geriatric population. Prescription and nonprescription drug use is described for 3,192 participants in a geriatric screening program (the Dunedin Program). Average drug use by these participants was found to be 3.2 medications. The use of both prescription and nonprescription drugs was higher for the women than for the men. In this population, drug use by both men and women increased with age, and this increase was mainly due to an increased use of prescription drugs. Participants were found to be taking numerous multiple-ingredient drug products.

Aged↗
PubMed1982

Effects of nonsteroidal anti-inflammatory drugs on renal function in the elderly.

The effect of nonsteroidal anti-inflammatory drugs (NSAIDs) on estimated creatinine clearance (ECC) was studied in a large ambulatory elderly population. ECC of participants using eight different NSAIDs and that of a control group using no drugs were compared. With one exception, ECCs of subjects using NSAIDs were lower than those of subjects using no medications. Results of this study suggest that long-term treatment with NSAIDs results in a decrease in renal function, and the effect on renal function may not be the same with all agents.

Age Factors↗
PubMed1982

Use of nutritional supplements in an ambulatory elderly population.

The use of nutritional supplements by 3,192 ambulatory elderly participants in a health screening program is described. The 2,009 women used vitamin (45.5 per cent) and mineral (22.4 per cent) products with significantly greater frequencies than did the 1,183 men (34.0 per cent and 15.0 per cent, respectively); chi-square, P less than 0.01. The most commonly used vitamin products were multiple vitamins, multiple vitamins with minerals, vitamin E, and vitamin C; for minerals, the ranking was potassium chloride, calcium salts, and ferrous sulfate. Eighty-two participants (2.5 per cent) reported the use of four or more supplements. Many older Americans are spending a great deal of money for nutritional supplements, whereas it would seem that the money could be better spent to improve the quality of their diet.

Age Factors↗
PubMed1982

The effect of decomplementation on the infectious course of Sendai virus in mice.

The course of intranasal infection of Sendai virus in CBA and DBA mice was investigated in animals decomplemented with purified cobra venom factor. The mice were decomplemented either immediately before inoculation or at 4 days postinfection. Depletion of complement after the infection had been established had no apparent effect on the course of the viral infection in the two strains of mice. In contrast, both strains of mice were protected completely from the lethal effects of an infectious dose of 1 LD50 of virus when the serum C3 levels were depressed by more than 80% during the early stages of infection. The symptoms of morbidity were less pronounced in these animals and there was a delay in the production of hemagglutination-inhibiting antibody. There was no apparent effect on the growth of the virus in lung tissue. The results suggest that the complement system plays a significant pathogenic role during the course of Sendai virus infections in CBA and DBA mice.

Animals↗
PubMed1982

Psychotropic drug use in an ambulatory elderly population.

Medication histories were obtained from 3,192 ambulatory elderly persons participating in a health screening program. A total of 2,009 (63%) women and 1,183 (37%) men were included in the drug use study. Flurazepam, pentobarbital and the combination of amobarbital and secobarbital were used by 4.5, 0.6 and 0.4% of participants, respectively, and these three agents accounted for 87.6% of all prescribed hypnotic drugs. Diazepam, meprobamate and chlordiazepoxide were the most commonly used minor tranquilizers. Barbiturates were contained in nearly one fourth of minor tranquilizers used by these elderly subjects. Less than 1% (0.5%) of the participants in this program reported the use of a neuroleptic. Approximately 3% of the participants reported the use of an antidepressant drug. Nearly 90% of participants who reported the daily use of a hypnotic agent state they had been using the product on a daily basis for longer than 1 year.

Age Factors↗
PubMed1982

Analgesic drug use in an ambulatory elderly population.

Prescribed and nonprescribed analgesic use was studied in a population of 3192 elderly ambulatory subjects. Analgesic drugs were used by 44.3 percent of women and 32.6 percent of men. The most common analgesic products used were aspirin, buffered aspirin, acetaminophen, and ibuprofen. Numerous participants reported the use of multiple analgesic products. Alkaline phosphatase, lactic dehydrogenase, and blood urea nitrogen concentrations were higher in subjects reporting the use of analgesics, but total bilirubin and serum iron concentrations were lower.

Aged↗
PubMed1982

Toxic hepatitis and single daily dosage imipramine therapy.

Liver function abnormalities have occasionally been associated with imipramine since the drug was introduced in 1957. The mechanism by which the drug produces hepatotoxicity has not been determined but may involve a direct toxic effect or a hypersensitivity reaction. In this case, a patient receiving 6 mg/kg (300 mg) of imipramine daily developed elevated liver enzymes while the plasma imipramine concentration was found to be in a therapeutic range. This case suggests that single daily dosing of tricyclic antidepressants may be more hazardous to the liver than divided doses.

Adult↗
PubMed1981

Screening for hypertension in an elderly population: report from the Dunedin Program.

Hypertension detection and follow-up programs have recently received increased attention. The authors studied the effect of screening for hypertension in a geriatric screening program for a large ambulatory elderly population in Dunedin, Florida, over a three-year period. Of the 4,247 participants initially screened, 39 percent had some form of hypertension, and 15.6 percent of these had not received any form of treatment. At the time of the first year follow-up, the proportion of participants with treated, controlled hypertension had increased from 14.7 to 21 percent. These data lend support to the value of hypertension screening among persons over 65 years of age.

Aged↗