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Biomedical subjects

J Pathy

Publications and source records attributed to J Pathy.

8 recordsLinked to original sources
PubMed1990

Cognitive and functional competence after anaesthesia in patients aged over 60: controlled trial of general and regional anaesthesia for elective hip or knee replacement.

OBJECTIVE: To determine the influence of general or regional anaesthesia on long term mental function in elderly patients. DESIGN: Prospective study of patients randomly allocated to receive general or regional anaesthesia. SETTING: The patients' homes and a large teaching hospital in Cardiff. SUBJECTS: 146 Patients aged 60 and over scheduled for elective hip or knee replacement. MAIN OUTCOME MEASURES: Scores achieved in tests of cognitive function and functional competence. RESULTS: 72 Patients were allocated to receive general anaesthesia and 74 regional anaesthesia. Anaesthetic technique did not influence the duration of the operation, time to mobilisation postoperatively, requirements for analgesia after the operation, or duration of stay in hospital. Three months after the operation there was an improvement in the score for the recognition component (76 ms, 95% confidence interval 9 to 144) and the response component (82 ms, 5 to 158) of the choice reaction time in the group receiving general anaesthesia compared with the group receiving regional anaesthesia. This was the only significant difference between the two groups in the assessments of cognitive and functional competence. Eleven patients receiving regional anaesthesia and 12 receiving general anaesthesia reported that their memory and concentration were worse than before the operation, but this was not confirmed by testing. CONCLUSION: Cognitive and functional competence in elderly patients was not detectably impaired after either general or regional anaesthesia when attention was paid to the known perioperative influences on mental function.

Activities of Daily Living↗
PubMed1988

Pulmonary embolism in the elderly.

A retrospective study was made of a consecutive series of patients over 65 years of age diagnosed as having a pulmonary embolus by either ventilation-perfusion lung scan or at necropsy. No clinical features were particularly helpful in making the diagnosis though signs of deep-vein thrombosis were present in 35%. Anticoagulants were well tolerated by all patients to whom they were prescribed. Postmortem findings showed a decreasing frequency of pulmonary emboli in the elderly which may indicate a reduction in predisposing factors.

Aged↗
PubMed1987

Pharmacokinetics of ciprofloxacin in the elderly.

The pharmacokinetics of ciprofloxacin, administered orally as a 250-mg tablet were compared in 10 young (age 20-30 years) and 10 elderly (age 60-73 years) healthy volunteers. The time to peak serum concentrations was about 80 min in both age groups, although the maximum concentration attained was significantly greater in the old (1.7 mg/l) than the young (1.2 mg/l). Area under the plasma concentration-time curve, corrected for body weight, was on average 48% greater in the elderly, but the mean terminal elimination half-life was not significantly different, averaging 4.3 h in the old and 3.7 h in the young. Overall 24-hour urinary recovery in both age groups was comparable. The differences may be explained by a reduced volume of distribution of ciprofloxacin in old age and do not suggest a general need for significant dose alteration in the elderly.

Administration, Oral↗
PubMed1977

Betahistine hydrochloride (Serc) in cerebrovascular disease: a placebo-controlled study.

A double-blind, placebo-controlled, clinical study was performed to assess the effects of oral betahistine hydrochloride (Serc) on mental impairment and physical disability in patients with established cerebrovascular disease. Fifty-three patients were admitted to the study during 18 months. Forty-five patients completed the study. They received either betahistine 24 mg daily or placebo for eight weeks. Clinical assessments of general functional activity were done and a battery of nine mental function tests was administered pretreatment and at two-weekly intervals during therapy. The results were analysed statistically using distribution-free tests. Significant differences were demonstrated between betahistine and placebo at week 8 of treatment for associate learning, digit retention, general knowledge, orientation, sentence learning and simple arithmetic. These differences were consistently in favour of betahistine at or close to the 5% level of significance. The results of the remaining mental function tests showed no significant differences between betahistine and placebo, but trends were in favour of the former. General functional activity assessments also demonstrated that betahistine-treated patients were significantly better than those on placebo (P less than or equal to 0.05). No untoward side-effects were noted during the study.

Activities of Daily Living↗
PubMed1975

Continuous combined assessment in rehabilitation of strokes.

Treatment of strokes by the method of continuous combined assessment and management is described. It is suggested that stroke patients can only obtain rational and comprehensive assistance when the multiple agencies available use their skills in a multi-disciplinary team situation. A simple scoring system was devised to evaluate the continuous combined assessment and management method of treating a defined group of 454 patients aged 60-85 with strokes. Data on comparative recovery rates in reported series of strokes is confounded by varying criteria for recording disability, evaluating recovery and age patterns. The importance of an internationally acceptable system of scoring disability is emphasised.

Aged↗