PubMed Health⌕ Search

Biomedical subjects

M G Baker

Publications and source records attributed to M G Baker.

25 records · Page 2Linked to original sources

The effect of emergency department policy change on Hutt district general practices.

AIM: To determine the impact of the new Hutt Hospital emergency care policy as perceived by general practitioners and measure the level of general practitioner emergency services provided. METHOD: Postal survey one year after policy instituted of Hutt district general practitioners. RESULTS: Sixty-three general practitioners replied (93% response). Eighty-one percent of general practitioners were in favour of the new policy or wanted it extended further, although 79% had noticed a slight increase in patient numbers. Most surgeries were less than 10 km from the hospital, 44% had one general practitioner, 38% had no practice nurse, 84% were staffed between 40-59 hours a week. No practice had staff on the premises between the night time hours of 8 pm and 8 am but all had after hours cover by telephone. Most practices were equipped to manage at least some emergency conditions: all had peak flow meters, 94% had nebulisers, 69% oxygen cylinders, and 47% had an ECG machine. Only two practices had slit lamps and plaster of paris facilities, and one a defibrillation machine. Almost all general practitioners suture wounds, strap ankles, and most treat fractures and pack noses. Seventy-five percent of general practitioners expressed a need for better communication with the Hutt Hospital emergency department. CONCLUSION: A general acceptance of the policy change by Hutt general practitioners although more research is needed to determine the impact of this change on patients.

Adult↗

Does patient education cause side effects? A controlled trial.

Ninety-eight adults treated with erythromycin for a variety of illnesses were randomized to two groups: the informed group received patient education about drug side effects, and the uninformed group were given no such information. Overall, 10% of the uniformed and 8% of the informed group felt the erythromycin bothered them in some way. There were no significant differences in the occurrence of various individual side effects. Compliance with therapy and the results of treatment were the same for both groups. In this study, informing patients about side effects of therapy did not have any detectable adverse effects.

Adult↗

Comparison of the use of reserpine versus alpha-methyldopa for second step treatment of hypertension in the elderly.

A retrospective chart analysis was conducted on all new elderly hypertensive patients referred to a community hypertension clinic who were being treated with either reserpine or alpha-methyldopa plus a diuretic. There were no significant differences between the two groups on entry in age, gender, co-morbid diagnoses, or systolic or diastolic blood pressure. There were no significant differences between the two groups in terms of side effects over three years, but the proportion of persons having compliance problems was significantly lower in the reserpine group. Mean diastolic pressures were significantly lower after one, two, and three years, and systolic pressures were lower after one and two years in the reserpine group. Reserpine is at least as effective as alpha-methyldopa in treating hypertension in the elderly and is associated with fewer problems in compliance.

Aged↗

A geriatric rehabilitation and assessment unit in a community hospital.

This report describes functional status at admission, discharge, and six months later for 100 elderly persons treated at a community hospital assessment and rehabilitation unit. The goal of the unit is to prevent institutionalization of frail elderly persons considered at risk for nursing home placement. Characteristics of the first 100 admissions include the following: average age, 79 years; female, 77 per cent; length of stay, 23 days; average number of admitting diagnoses, 3.4. Ninety-one new diagnoses of treatable conditions were made. On admission, 81 per cent of patients were confined to bed or chair or needed assistance with ambulation, compared with 27 per cent at discharge and 22 per cent at six months. Activities showing significant improvement include dressing, housekeeping, use of toilet, and ambulation. At six months, 15 per cent had died, 67 per cent were living in the community, and 19 per cent were institutionalized. It is concluded that care at the geriatric unit probably resulted in improved function and decreased nursing home placement.

Activities of Daily Living↗

Reduced temporal lobe blood flow in Alzheimer's disease.

We used single photon emission computed tomography with the blood flow tracer [123I]N-isopropyl-p-iodoamphetamine (IMP) to study regional cerebral blood flow (rCBF) in 50 mildly and moderately demented Alzheimer's disease (AD) patients to evaluate rCBF as a function of disease severity. Relative rCBF (normalized to occipital cortex) was significantly lower than controls in temporal cortex for both mildly and moderately demented patients. Similar numbers of patients in both groups demonstrated perfusion abnormalities in temporal neocortex. Parietal cortex was more variably involved with greater numbers of moderately than mildly demented patients showing perfusion abnormalities. Relative rCBF in dirsolateral frontal cortex was reduced only in the moderately demented patients. Disease severity, as measured by the Mini Mental Status Examination, was associated with relative rCBF only in dorsolateral frontal and parietal cortex. These results suggest that the temporal lobes are the first neocortical regions affected by AD and that other cortical areas become involved as the disease progresses.

Aged↗

Emerging infectious diseases in an island ecosystem: the New Zealand perspective.

Several unique features characterize infectious disease epidemiology in New Zealand. Historically, well-organized, government-run control programs have eliminated several zoonoses. More recently, however, communicable disease control has been mixed. Rates of rheumatic fever, tuberculosis, and enteric infectious are high, and rates of meningococcal disease are increasing. These diseases are over-represented in New Zealanders of Polynesian descent, who generally live in more deprived and overcrowded conditions than do those of European descent. Measles and pertussis epidemics are recurring because of inadequate vaccine coverage, despite a well-developed childhood immunization program. A progressive response to the HIV epidemic has resulted in relatively low rates of infection, particularly among injecting drug users; however, the response to other sexually transmitted infections has been poor. A key challenge for the future is to build on successful strategies and apply them to persisting and emerging infectious disease threats in a small, geographically isolated country with limited economic resources.

Animals↗