Biomedical subjects

L Hadley

Publications and source records attributed to L Hadley.

7 recordsLinked to original sources

PubMed1994

A double-blind trial of captopril or bendrofluazide in newly diagnosed senile hypertension.

Hypertension is a major risk factor for stroke and heart disease in the elderly. Eighty-one hypertensive subjects with mild cognitive impairement, aged over 70 years, were drawn from a community screening programme and randomized to either 12.5 mg captopril twice daily or 2.5 mg bendrofluazide daily in a double-blind trial. Subjects were excluded if they had previously received antihypertensive treatment. The mean blood pressure was reduced from 193/101 mmHg to 154/87 mmHg by captopril and from 188/102 mmHg to 151/89 mmHg by bendrofluazide after 24 weeks; there was no significant difference between the two drugs. Seven subjects withdrew due to adverse events. Adverse events occurred more frequently during the 2-week placebo phase than during active treatment with either drug. The only significant detrimental changes in pre-existing conditions were in 3 subjects (2 captopril, 1 bendrofluazide) who were noted to have worsening of their cataracts. One subject on captopril and 4 subjects on bendrofluazide became hypokalaemic. The trial results support the use of captopril as an alternative to bendrofluazide as a first-line antihypertensive agent in the community for elderly people, but large studies are required to measure accurately effects on significant morbidity and mortality.

Aged↗

PubMed1991

HIV roundtable. Professional perspectives.

As the HIV epidemic escalates, concern is mounting over the implications of infection among health care workers. Should all medical professionals be tested? Should supervisors and/or patients be notified if the results are positive? Should the infected PA continue to practice? What about performing surgery? Should he or she be considered impaired? And what about the long-term stress of working with HIV patients? Experts discuss the AAPA's latest recommendations, and share suggestions on prevention and patient care with the audience.

Cross Infection↗

PubMed1989

HIV antibody-positive. A new cause of impairment.

The American Academy of Physician Assistants Subcommittee on the Impaired Physician Assistant has begun to receive requests for help from PAs who fear that their ability to practice may be hindered because they are at risk of infection with human immunodeficiency virus (HIV). The American Medical Association and the Centers for Disease Control have already developed some guidelines for all health care providers. The special concerns of PAs are also being addressed by our national leadership. In response to specific concerns by some PAs directly affected, the former chairperson of the Task Force on the Impaired PA helped develop questions that the profession needs to address.

Acquired Immunodeficiency Syndrome↗

PubMed1987

PAs confront "denial disease".

At last year's Annual Conference, the AAPA House of Delegates formally convened, for the first time, a task force to study the problem of chemical dependency among PAs, and to help constituent chapters develop identification and intervention programs. The Task Force on the Impaired PA makes its first report to the HOD at this year's conference. In addition, a special symposium on impaired practitioners is being offered for CME credit. The task force's chairperson reviews efforts made during the past year to raise the profession's awareness of the problem. She focuses on the first-person accounts of six PAs who are recovering alcoholics and addicts (see "The Chemically Dependent PA: Role models for Recovery" on page 115).

Humans↗

PubMed1985

My brother's keeper: assisting the impaired PA.

Impairment is defined as the inability to practice medicine with reasonable skill and safety to patients because of physical or mental illness, including deterioration through the aging process, loss of motor skills, or excessive use or abuse of drugs, including alcohol. A practitioner is also impaired when personal problems interfere with the administration of medical care. Acknowledging the issue of impairment can be unpleasant. By doing so, practitioners often realize that their perceptions of themselves and their colleagues as invulnerable guardians of public health and healers of disease, are delusions. This growing problem reflects not only on the individual practitioner suffering from impairment, but on the profession as a whole. Thus, the problems of the impaired PA must be addressed in a reasonable and compassionate manner. The authors discuss how to deal with affected colleagues, and outline an alternative, nonpunitive, and humanitarian model for assisting impaired PAs, established by the Michigan Academy of Physician Assistants.

Humans↗

PubMed1981

Twice-daily insulin regimens in management of severe diabetes.

Diurnal glucose profiles have been compared in ten insulin dependent diabetics receiving, firstly, a twice-daily soluble insulin (SI): isophane insulin (NPHI) insulin (30% SI, 70% NPHI). For each patient the two regimens gave similar profiles though nocturnal blood glucose control was better on Mixtard. HbA1 values were similar on the two regimens. The findings show that, using highly purified formulations, small changes in insulin proportions in twice-daily SI: NPHI regimens may be irrelevant to diabetic control; they also suggest that highly purified NPHI may have a substantially shorter duration of action than its older counterpart and that the convenient regimen of twice-daily Mixtard is usually as good as any more complicated 'tailormade' regimen of highly purified insulins.

Adolescent↗

PubMed1976

Experiences with physostigmine in the reversal of adverse post-anaesthetic effects.

Physostigmine salicylate has proved to be a very useful agent for use in the recovery room. All but two of our first 110 patients receiving it were returned to full consciousness, whether they had been comatose or agitated. In our hands it has been used to reverse the adverse central effects of tranquilizers, antihistamines and belladonna alkaloids.

Adolescent↗