Biomedical subjects
Publications and source records attributed to J B Cook.
Mental confusion in the elderly can be manifested by impairments in the areas of memory, orientation, concentration, and judgment. The number and classification of drugs prescribed for elderly residents of nursing care facilities can contribute to the development of mental confusion. As the number of drugs prescribed for confused elderly increases, the potential for these persons to engage in group social behavior decreases.
A case of acute spinal epidural abscess is reported demonstrating many of the important features in the natural history of the disorder. The pathological changes in the cord at the level of the lesion are described. A series of 12 patients is reviewed. The average interval between the initial consultation and the onset of complete paralysis is 5 days and it is essential that the diagnosis is made during this period. Two indicators of prognosis are discussed--the duration of complete paralysis and the extent of sensory disturbance.
This study of 200 paraplegics shows that occupational status at the time of becoming paralysed exerts as great an influence upon readmission to hospital as does the level or the extent of the lesion and that the effect of the level of the lesion on readmission to hospital increases with lower occupational status.
The variety and method of use of condom urinals was reviewed and an investigation conducted to ascertain the problems which arise. Effects arising from material failure and methods of use were disclosed.
Percutaneous cystostomy using a fine calibre (9 Charriere) plastic trocar and cannula has been used in 51 male patients in the early weeks following spinal cord injury. The results are satisfactory. Of the last ten patients none has been catheterised per urethram; eight of these patients are now passing urine satisfactorily using a condom urinal.
Tetraplegia produces exceptionally severe physical impairment causing disability which demands almost total dependence on others for the activities of daily living but there is no impairment of mental function. The tetraplegic is, therefore, capable of influencing his environment and those features of it which may lead to the need for readmission to hospital. Of the factors studied relating to readmission to hospital, only age and occupational status of the patient at the time of his paralysis are of significance.
The results of treatment of urinary bladder paralysis with small calibre (9 Charriere) suprapubic drainage in 41 male patients are described. It was found that suprapubic drainage could be maintained for an average of 8 weeks and that the urine in 43% of patients remained sterile for an average of 7 weeks. This technique merits further trial, both in the paraplegic patient and in normal patients requiring catheterisation because of obstruction of the lower urinary tract.