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Biomedical subjects

J C Darnell

Publications and source records attributed to J C Darnell.

25 records · Page 2Linked to original sources
PubMed1986

Medication use by ambulatory elderly. An in-home survey.

The elderly residents of an urban subsidized apartment building were interviewed in their apartments to determine a comprehensive medication profile. The interviews were conducted by doctor of pharmacy candidates, and 155 residents (81.2%) participated. Compliance was similar to rates previously reported (49.3%), and adverse drug reactions were common (29.1%). Other findings included: compliance did not decrease with advancing age; most elderly individuals could open child-resistant containers (83.4%), read standard container labels (79.7%), and identify teaspoon (97.3%) and tablespoon (88.5%) quantities; inability to open easy-open (flip-off) containers decreased compliance (P = .03); men were more compliant than women (68.4 v 42.4%, P = .006) but were taking fewer medications (3.3 per male v 5.0 per female); only 12.6% of respondents thought they were taking too much medication but when they did compliance diminished (P = .003); medications were infrequently shared (5.6% of respondents reported sharing); and only 6.4% of respondents reported medication expense as a concern.

Adult↗
PubMed1986

Self-rated health as a predictor of hospital admission and nursing home placement in elderly public housing tenants.

We assessed the validity of self-rated health in a one-year prospective study of 155 elderly public housing tenants. Compared to studies of elderly community residents, tenants had poorer self-rated health, and higher hospital admission and nursing home placement rates. Poor self-rated health was a risk factor for both outcomes. We conclude that self-rated health may be useful in identifying persons at increased risk for hospital admission and nursing home placement.

Aged↗
PubMed1985

After-hours telephone access to physicians with access to computerized medical records. Experience in an inner-city general medicine clinic.

The authors examined the effect of after-hours telephone access to physicians and physician access to computerized medical records on hospitalizations and emergency room (ER) visits in an inner-city, adult, general medicine clinic. Patients were randomly assigned to a control (C) and two study groups (S1 and S2). Patients in study groups S1 and S2 had after-hours telephone access to physicians. Computerized medical records were accessible to physicians only for callers in study group S2. During the initial 18 months of study, only 7.6% of eligible patients called the after-hours service, a rate of 6 calls/1,000 patients/month (200 calls/1,849 patients/18 months). Repeated promotion of the service was subsequently undertaken, and 19.4% of the patients used the service during the final 12 months of study, a rate of 24.1 calls/1,000 patients/month (467 calls/1,616 patients/12 months). There were no significant differences in hospitalizations or ER visits among the control and two study groups.

Computers↗
PubMed1982

Recurrent postictal pulmonary edema: a case report and review of the literature.

A 37-year-old woman with a post-traumatic seizure disorder had four well-documented episodes of postictal acute pulmonary edema and respiratory failure. Subtherapeutic blood concentrations of phenytoin were documented on each admission. Each episode followed one or more grand mal seizures and was characterized by the development of diffuse nodular-appearing alveolar infiltrates, tachypnea, and severe hypoxemia that rapidly resolved with supportive therapy. There was no evidence of gastric acid aspiration, acute lung infection, or underlying heart or lung disease. To determine the frequency of postictal pulmonary edema in our institution, we reviewed the clinical records and chest roentgenograms of 45 consecutive patients who were admitted to our emergency room following a well-documented grand mal seizure. Only one patient (described in this report) had chest roentgenographic evidence of pulmonary edema. A review of the English literature revealed only 11 reported cases of postictal pulmonary edema since 1965 and a total of 42 episodes in 27 patients since 1908. There were no clearly documented cases of postical pulmonary edema following electroconvulsive therapy in 18 published reports totaling more than 38,000 subjects. Our findings suggest that while postictal pulmonary edema may occur repeatedly in the same patient, the overall frequency of this complication is low.

Adult↗