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Biomedical subjects

L Atkinson

Publications and source records attributed to L Atkinson.

At least 55 records · Page 3Linked to original sources
PubMed1978

Diagnosis of coronary artery disease by estimation of coronary sinus lactate.

In an attempt to assess the value of coronary sinus lactate estimation before and during atrial pacing for the diagnosis of obstructive coronary artery disease, 70 patients with angina were investigated in this way and by selective coronary arteriography. Thirty-five had radiologically normal coronary arteries and 35 had coronary artery disease. When the change in coronary arteriovenous lactate difference was less than 0.09 mmol/l (0.8 mg/100 ml) between the control and the peak atrial pacing sample, the coronary arteries were normal except in one patient who had distal disease of a single vessel. When the change was greater than 0.22 mmol/l (2.0 mg/100 ml) coronary artery disease was always found, and when the change was greater than 0.39 mmol/l (3.5 mg/100 ml) there was always disease of two or three vessels. Unfortunately, the presence or absence of coronary artery disease could not be predicted when the change fell between 0.09 and 0.22 mmol/l (0.8 and 2.0 mg/100 ml). Estimation of coronary sinus lactate before and during atrial pacing can thus frequently distinguish patients with normal coronary arteries from those with coronary artery disease.

Adult↗
PubMed1978

An investigation into the ability of elderly patients continuing to take prescribed drugs after discharge from hospital and recommendations concerning improving the situation.

An investigation was made by an Occupational Therapist into the problems encountered by 50 elderly patients in the self-administration of drugs prior to discharge home. The questions asked the patients are enumerated and recommendations are made concerning how improvements can take place so that many more of the elderly will take the prescribed drugs in the right doses at the right time on discharge home.

Aged↗
PubMed1977

The difficulties of old people taking drugs.

There is considerable interest in the problems of the elderly taking drugs correctly and appropriately. A recent survey (Parkin et al. 1976) showed that these problems that have long been known in geriatric practice have now been noted by general physicians. This review was undertaken when an occupational therapist in a geriatric unit team noted that, although patients and their relatives were taught methods of dressing, toileting, shaving, bathing, eating, walking, transferring to a chair, wheelchair mobility and communication by the occupational therapist, physiotherapist and speech therapist, no advice or teaching was given concerning the accurate taking of the drugs prescribed. The results of a detailed investigation are reported elsewhere (Atkinson, Gibson & Andrews 1978). Repeatedly, patients ready for discharge were handed a batch of drugs by a nurse at the last possible moment, even while sitting by their luggage awaiting the ambulance. Following this, special attention was paid to problems such as intellectual impairment, loss of memory and confusion, poor sight, inability to handle containers, failure to take drugs and lack of patient-education. During ward rounds, particularly when a geriatric health visitor was present, attention was drawn to special topics such as the number of patients who inadvertently kill themselves and the numbers needing readmission due to failure to take drugs, overdosage or underdosage or mixing of drugs (Wade 1972). Ferguson Anderson's comment (1974) that 7.15% of hospital admissions are due to drug reactions was also noted.

Age Factors↗
PubMed1976

Pleuroperitoneal endometriosis.

A nearly unique case is presented of pleural and peritoneal endometriosis with bloody pleural effusion and 4700 cc of bloody ascites. Theories of pathogenesis, differential diagnosis, and treatment are discussed. This represents another of the protean manifestations of endometriosis to complement the many others described in the literature.

Adult↗
PubMed1975

Reassessment of failed beta-blocker treatment in angina pectoris by peak-exercise heart rate measurements.

Twenty-one patients with angina pectoris were treated with adrenergic beta-receptor antagonists. Previously the resting heart rate had been used as a guide to treatment, a reduction in the rate to 55-60 beats/min without symptomatic improvement indicating failure of medical treatment. These patients were re-evaluated before coronary arteriography using the peak-exercise heart rate as an index of adrenergic beta-receptor antagonism. The dose of beta-blocking drugs was increased to produce a peak-exercise heart rate of less than 100 beats/min or a consistent rate of 100-125 beats/min which would not lessen in spite of progressive dose increments. The resting heart rate was ignored. On these criteria 15 patients previously considered to have responded inadequately to beta-blockade responded satisfactorily and were therefore removed from the waiting list for coronary arteriography. They all remained well up to two years later. Six patients failed to respond and had coronary arteriography with a view to surgical treatment. Reliance on the resting heart rate as the index of optimum adrenergic beta-receptor antagonism is likely to lead to premature or unnecessary referral for surgery; the failure of beta-blockade in the treatment of angina pectoris can be determined simply and accurately by using peak-exercise heart rate.

Adrenergic beta-Antagonists↗
PubMed1975

Double-blind comparison of tolamolol, propranolol, practolol, and placebo in the treatment of angina pectoris.

Forty-two patients with angina pectoris have completed a randomized, double-blind trial comparing tolamolol 100 mg and 200 mg with propranolol 80 mg, practolol 100 mg, and placebo, all given three times a day. Tolamolol 200 mg thrice daily was found to be equivalent to propranolol 80 mg thrice daily in anti-anginal efficacy. Anginal attack rates and trinitrin consumption were significantly reduced by all active treatments as compared with the placebo but tolamolol and propranolol were the most effective. Tolamolol 200 mg thrice daily was most effective in reducing blood pressure, while propranolol was most effective in reducing the resting heart rate. All treatments except the placebo significantly increased the amount of exercise which could be performed before angina appeared (exercise work), while tolamolol 200 mg thrice daily significantly reduced Robinson's index when compared with all other active agents. The degree of S-T segment depression induced by exercise was significantly lessened by both tolamolol and propranolol but not by practolol or placebo. There was no difference in patient preference between tolamolol and propranolol but tolamolol at both dose levels was preferred to practolol. Both tolamolol and propranolol are potent adrenergic beta-receptor antagonists and equal in anti-anginal efficacy but tolamolol has the advantage of being cardioselective. It is superior to practolol.

Adult↗
PubMed1974

Birth control, sterilization and abortion. Attitudes of catholic and protestant clergymen in San Diego toward use in families with genetic illness.

A questionnaire comprising case histories was administered to 27 Protestant and 27 Catholic clergymen in the San Diego area to test their attitudes toward the use of birth control, sterilization and abortion in families with specific genetic problems. The responses indicated:* Catholic and Protestant clergymen do not always follow the official positions of their churches in these matters, although the majority of them do.* Protestant clergymen were more likely to approve of birth control, sterilization, and abortion than Catholic clergymen.* The approval responses of Protestant and Catholic clergymen were not greatly influenced by whether the illness variables involved high Mendelian risk, high psychological cost, high social cost, or poor prognosis.* The approval responses of Protestant and Catholic clergymen were not significantly influenced by the socio-ethnic background of the families.

Abortion, Induced↗