Biomedical subjects

Brian Pentland

Publications and source records attributed to Brian Pentland.

6 recordsLinked to original sources

PubMed2006

Parkinson's disease and driving ability.

OBJECTIVES: To explore the driving problems associated with Parkinson's disease (PD) and to ascertain whether any clinical features or tests predict driver safety. METHODS: The driving ability of 154 individuals with PD referred to a driving assessment centre was determined by a combination of clinical tests, reaction times on a test rig and an in-car driving test. RESULTS: The majority of cases (104, 66%) were able to continue driving although 46 individuals required an automatic transmission and 10 others needed car modifications. Ability to drive was predicted by the severity of physical disease, age, presence of other associated medical conditions, particularly dementia, duration of disease, brake reaction, time on a test rig and score on a driving test (all p<0.001). The level of drug treatment and the length of driving history were not correlated. Discriminant analysis revealed that the most important features in distinguishing safety to drive were severe physical disease (Hoehn and Yahr stage 3), reaction time, moderate disease associated with another medical condition and high score on car testing. CONCLUSIONS: Most individuals with PD are safe to drive, although many benefit from car modifications or from using an automatic transmission. A combination of clinical tests and in-car driving assessment will establish safety to drive, and a number of clinical correlates can be shown to predict the likely outcome and may assist in the decision process. This is the largest series of consecutive patients seen at a driving assessment centre reported to date, and the first to devise a scoring system for on-road driving assessment.

Age Factors↗

PubMed2006

Alphabetical prejudice in team discussions (or would Zebedee ever get seen on a ward round).

PURPOSE: To ascertain whether the order in which patients are discussed in a team meeting determines the time spent on discussion. DESIGN: Prospective study over 18 consecutive multidisciplinary team meetings. SETTING/SUBJECTS: Multidisciplinary team meetings on a Brain Injury Rehabilitation Unit, Edinburgh. MAIN OUTCOME MEASURE: Time spent discussing each case. RESULTS: Patients discussed early on received 3-4 minutes more discussion time than those later on. This was highly significant on a one-way analysis of variance (P < 0.001). CONCLUSIONS: Preferential treatment of patients who come at the start of the team meeting is a real phenomenon. Such alphabetical prejudice, where it exists, should be addressed.

Bias↗

PubMed2006

Myasthenia gravis masquerading as post-poliomyelitis syndrome.

A 79-year-old man with previous bulbar poliomyelitis developed dysphagia and was diagnosed as having post-polio syndrome. Over 2 years, his swallowing deteriorated and he suffered an aspiration pneumonia. Only after the subsequent development of fatigue and facial weakness was myasthenia gravis diagnosed. Diagnostic criteria for post-polio syndrome include the exclusion of all other neurological conditions such as myasthenia gravis. Moreover, in any instance where a patient develops new symptoms, it is advisable to reconsider the original diagnosis.

Aged↗

PubMed2005

Access inequalities addressed by audit.

The Disability Discrimination Act (1995) protects disabled people from discrimination in access to services, facilities and goods as well as in education and employment. All hospitals have an inherent duty to enable access to services but this will now be enshrined in law. As the health sector has most contact with disability, it may be expected that most hospitals would already be in a good position to comply with the Act, especially one treating many patients with disability. However we identified many problems in a rehabilitation hospital setting by means of a simple access audit in March 2004. Recommendations were set out and by March 2005 considerable improvements had been made costing Pound 100,000. Although many necessary changes will be expensive, not all problems identified require costly correction. Many simply involve a change in staff attitudes and practices. We recommend that all hospitals start to identify the changes needed under the Act by means of a simple access audit that can be carried out by hospital staff with no specialist equipment.

Architectural Accessibility↗

PubMed2003

Training in brain injury rehabilitation.

PURPOSE: To evaluate our current training programme for professionals involved in brain injury rehabilitation, which involves disability simulation, and to consider the ethics and consequences of such programmes. METHOD: Seventy-two professionals took part in a brain injury disability simulation exercise and completed questionnaires pre and post the workshop. RESULTS: Results suggest that participants have increased insight into the challenges faced by people with brain injuries. CONCLUSIONS: We believe that brain injury simulation exercises help professionals increase their understanding of the impairments and disabilities that may follow brain injury and can therefore form an important part of a training programme for rehabilitation staff.

Brain Injuries↗

PubMed1994

Pain in the Guillain-Barré syndrome: a clinical review.

The Guillain-Barré syndrome, or acute inflammatory polyneuropathy, is often regarded as a predominantly motor neuropathy with few sensory features, which has a good prognosis in most cases. However, pain is a common symptom occurring in up to 72% of cases. The types of pain are protean including paraesthesiae, dysaesthesia, axial and radicular pain, meningism, myalgia, joint pain and visceral discomfort, etc., and patients may present in a variety of clinical settings such as intensive care units, acute medical wards or rehabilitation departments. These factors, combined with the fact that the condition is relatively uncommon, means that no controlled trial of pain management has been done and a range of treatments has been proposed. We review the various pains which may be associated with Guillain-Barré syndrome and discuss suggestions for their management.

Humans↗