Biomedical subjects

B L Devine

Publications and source records attributed to B L Devine.

7 recordsLinked to original sources

PubMed1993

A busy urban geriatric day hospital: analysis of one year's activity.

Lightburn Geriatric Day Hospital is a 30-place unit sited adjacent to Geriatric Assessment and Rehabilitation wards and three miles from the local district general hospital in east Glasgow. The service serves an urban population of 25,000 persons aged 65 or more. During 1991 a data capture form was used to prospectively record Day Hospital referral patterns and activity. There were 731 new patient referrals, accounting for a total of 5,780 patient attendances. Thirty-eight per cent of new patients attended without prior screening (unscreened General Practitioner (GP) referrals). Booked occupancy was 85.5%, actual occupancy 76%. The average period of attendance was three weeks (median number of attendances: 7) and 18% of attenders required in-patient care. Specific after-care arrangements were made for 85% of patients on discharge from day hospital. Low rates for re-attendance (within three months of day hospital discharge) and chronic attendance (more than three months) as well as favourable responses from surveys of both GPs and patients suggest effective use of the Day Hospital resource, but more direct measures of Day Hospital effectiveness are required.

Aged↗

PubMed1990

Cardiac arrhythmias associated with upper gastrointestinal endoscopy in elderly subjects.

Continuous Holter monitoring was performed before, during and after upper gastrointestinal endoscopy in 50 unselected, consecutive elderly patients (median age 80 years: range 68-89). In contrast to other studies the patients received no atropine or opiate premedication and were monitored for a prolonged period usually 24 hours after endoscopy. Comparison of a control period when the patient was lying at rest before endoscopy with the period of endoscopy itself revealed an increased frequency of arrhythmias during endoscopy. Forty-eight per cent of patients developed a new arrhythmia or an increased frequency of existing arrhythmia during endoscopy. All arrhythmias were short and self-terminating. Evidence of cardiac disease conferred a significantly increased risk of developing an arrhythmia during endoscopy.

Aged↗

PubMed1988

Hypomagnesaemia in elderly digitalised patients.

Hypomagnesaemia and hypokalaemia are known to predispose to digoxin toxicity. Elderly patients receiving diuretics may be at special risk. A 12-month survey of all patients receiving digoxin at the time of admission to our Geriatric Assessment Unit revealed 16% were hypomagnesaemic, whereas no patient was hypokalaemic. There is a need for greater awareness of the risk of magnesium depletion in elderly patients receiving concurrent diuretic and digoxin therapy.

Aged↗

PubMed1978

Interrelation of age, obesity, cigarette smoking, and blood pressure in hypertensive patients.

The relations between age, obesity, cigarette smoking, and blood pressure were investigated in 637 men and 835 women who had attended the Glasgow Blood Pressure Clinic with untreated hypertension. In contrast to results of population surveys of mainly normotensive people no relation was found between cigarette consumption and either systolic or diastolic blood pressure. Moreover, contrary to results of epidemiological studies a relation between adiposity and blood pressure was found in only male non-smokers. Thus the relations established for largely normotensive populations do not apply to hypertensive patients.

Adult↗

PubMed1978

Relation between prognosis and the blood pressure before and during treatment of hypertensive patients.

1. A study was conducted amongst 1247 treated hypertensive patients to determine the predictive power of untreated baseline and achieved treated blood pressures in the development of the complications of hypertension. In addition the relative importance of systolic and diastolic pressures was calculated. 2. Statistical analysis was done by calculating univariate differences in blood pressure between cases with and without complications. The higher the univariate distance, the greater the predictive power. 3. Blood pressures achieved during treatment were more important than baseline pressures for predicting stroke in both men and women, confirming the benefits of antihypertensive therapy in preventing strokes. 4. There was some evidence of prevention of myocardial infarction in men and of angina in women as a result of therapy. 5. There was no evidence to suggest that any one group of drugs, including beta-adrenoreceptor-blocking drugs and thiazides, conferred any extra benefit in preventing coronary heart disease. 6. The systolic blood pressures achieved during treatment predicted stroke better than diastolic pressure, but no consistent trends were found for coronary heart disease.

Adolescent↗

PubMed1978

Cyclical release of vasoactive intestinal polypeptide (VIP) from a pancreatic islet cell apudoma.

A patient is described who presented with the classical symptomatology and profound electrolyte disturbance of the Verner-Morrison syndrome due to a pancreatic apudoma secreting vasoactive intestinal polypeptide (VIP). Diagnosis was confirmed by plasma VIP as measured by a radio-immunoassay technique now available. It is suggested that the cyclical nature of the symptoms in this case was due to cyclical release of VIP from the tumour in response to an unknown stimulus. Perfusion studies confirmed the excess secretory state of water, sodium and chloride in the small intestine. Symptoms were completely abolished by surgery and the progress is being monitored by means of serial plasma VIP estimations to detect any early recurrence of metastatic disease.

Adenoma, Islet Cell↗

PubMed1977

Minoxidil for severe hypertension after failure of other hypotensive drugs.

Forty-four patients with severe hypertension who were resistant to treatment with more conventional hypotensive drugs or could not tolerate the side effects were treated with minoxidil, a potent peripheral vasodilator. A beta-blocking drug and a diuretic were used routinely to control, respectively, the tachycardia and fluid retention caused by minoxidil. During treatment the outpatient supine blood pressure fell from a mean of 221/134 mm Hg to 162/98 mm Hg. Eleven patients required additional or alternative hypotensive agents before blood pressure was adequately controlled. Side effects were minor, although the invariable hirsuties caused by minoxidil was unacceptable to three women. The possibility of cardiotoxic effects, raised by early studies in dogs, has not been excluded, and therefore this drug should be used only in patients with severe hypertension. In such patients minoxidil appears to be most effective.

Adult↗