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Biomedical subjects

B N Panayiotou

Publications and source records attributed to B N Panayiotou.

12 recordsLinked to original sources
PubMed1996

Junior hospital doctors' views on their training in the UK.

To ascertain the views of senior house officers and registrars on the educational and training component of their posts, a questionnaire was sent to all full-time doctors working in training posts in general and/or geriatric medicine at three district general and three teaching hospitals. Completed questionnaires were received from 64 (61%) of 105 doctors who were contacted. Most had a careers counsellor or tutor, although less than two-thirds thought they had benefited from this arrangement. The majority of doctors attended at least two medical tutorials or meetings per week; most wanted to attend more but were unable to because of other work commitments. Supervision by more senior staff on the ward was deemed by most to be satisfactory, but less so in out-patient clinics. Overall, one-third of doctors thought that training was inadequate and three-quarters wanted a greater amount of formal education. The majority of junior doctors' time was spent on routine work and most considered :training' constituted less than 10% of their working time. Doctors in training require more sessions designated as educational, with protected time to attend these.

Attitude of Health Personnel↗
PubMed1994

Eligibility of acute stroke patients for pharmacological therapy.

The aims of this study were to analyse the characteristics of patients with acute stroke and to ascertain the number of patients meeting eligibility criteria commonly applied in clinical trials of pharmacological agents for ischaemic stroke. Details of all consecutive admissions with a diagnosis of acute stroke (n = 410, 55% female, mean age 77, range 22-99 years) admitted over a 12-month period to a district general hospital were recorded. Major exclusion criteria used in acute stroke trials were applied to data collected from the study patients. Exclusion criteria were met by 386 (94%) stroke patients, 188 (46%) had admission delay > 12 hours, 85 (21%) had pre-existing major disability, 80 (20%) minor stroke, 66 (15%) had coexisting severe illness, 51 (12%) were unconscious, and 30 (7%) had major electrolyte or ECG abnormalities. One hundred and five (26%) had two or more exclusion criteria. The majority of acute stroke patients admitted to a district general hospital would be likely to be excluded from most current pharmacological treatment studies.

Adult↗
PubMed1991

Pulmonary infiltrates and eosinophilia associated with sulphasalazine administration.

A case of blood eosinophilia with pulmonary infiltrates associated with sulphasalazine therapy in a patient with ulcerative colitis is described. These manifestations resolved when sulphasalazine was ceased and recurred with rechallenge. The failure of recurrence after treatment with mesalazine (5-aminosalicyclic acid in a sustained release preparation) suggests that sulphapyridine is the component responsible for this reaction.

Adult↗
PubMedDate not supplied

Microalbuminuria: pathogenesis, prognosis and management.

The development in recent years of sensitive assays specific for albumin has facilitated extensive investigation of the pathophysiology and clinical significance of microalbuminuria. It is now clear that the appearance of microalbuminuria represents a crucial event in the natural histories of diabetes mellitus and essential hypertension. It reflects the presence of generalized vascular damage and is strongly predictive of subsequent renal failure, cardiovascular morbidity, and death. Therapeutic interventions, including strict diabetic and blood-pressure control, can reduce microalbuminuria and improve the overall prognosis. The detection and treatment of microalbuminuria in these high-risk groups should now form an integral part of their management. Large-scale screening programmes are also recommended for insulin-dependent diabetics.

Albuminuria↗
PubMedDate not supplied

Pharmacological therapy for acute stroke: the future.

Stroke is a major cause of mortality, morbidity, and resource consumption. To reduce this burden, enormous efforts have focused on the development of drugs to limit brain damage. However, a breakthrough has not yet materialised, and data suggest that even if future drug trials do demonstrate a benefit, the overall impact of such drugs will be relatively limited. The pathophysiology of stroke is too complex to be markedly influenced by interruption of one or two components of the ischaemic cascade; intervention needs to be very soon post-stroke; and multiple pre-existing diseases and disabilities in elderly patients diminish their scope for recovery. In contrast, wider application of primary prevention, secondary prevention, and better organisation of services (eg setting up stroke units), could have a far greater effect on public health. Despite considerable enthusiasm for drug therapy in acute stroke, it is likely that the overall potential of such therapy will be disappointing.

Acute Disease↗
PubMedDate not supplied

Frusemide-induced bullous pemphigoid.

Bullous pemphigoid is a rare complication of frusemide therapy. We present two patients in whom the link between frusemide and this condition was not recognised early, and continued frusemide therapy resulted in prolonged leg blistering and ulceration. On withdrawing the drug, all lesions in both patients resolved completely. Although uncommon, this frusemide reaction needs to be borne in mind as it can add to the morbidity of elderly patients with heart failure.

Aged↗
PubMedDate not supplied

Blood pressure measurement and antihypertensive therapy in acute stroke.

Inappropriate management of high blood pressure in acute stroke can adversely affect outcome. We examined blood pressure evaluation and antihypertensive therapy during the first week post-stroke in 40 patients at a district general hospital with no stroke unit. In the first 24 hours, median frequency of blood pressure recording was 3 (range 1-12). After day 1, 11 (28%) had no blood pressure readings for one or two consecutive days. The side of measurement was not recorded in any patient. None of the 22 hypertensives (55%) had a bilateral measurement to exclude interarm inequality, and only 3 (7%) of all patients had postural readings to exclude orthostatic hypotension. Fourteen (35%) received antihypertensive therapy without meeting recommended indications; some even had low blood pressure. As most stroke patients are managed in general medical wards rather than stroke units, a greater awareness of these important aspects of blood pressure evaluation and therapy are needed among medical and nursing staff.

Aged↗