Biomedical subjects
M G Wallace
Publications and source records attributed to M G Wallace.
A professional approach to record completion.
The steady decrease in incomplete and delinquent records has been accomplished without suspending any of the attending physicians. On occasion, hospital administration has, at our request, sent the attending physicians a warning letter alerting them that they will be reported to the Hospital Medical Board if they fail to complete their records. Typical of a teaching facility, the housestaff is primarily responsible for dictation of discharge summaries. They are suspended without pay if they fail to complete their records after being warned. Another significant effect of this program has been the timely entry of ICD-9-CM codes into the billing system within five days of discharge. Accounts outstanding due to lack of final diagnoses and/or attestation statement signatures, ranging from 5-22 days post-discharge, have been reduced to an average of only 40-50 daily. (Vanderbilt University Medical Center averages 22,000 discharges annually). This new program has placed the Medical Record Department in total control of the incomplete/delinquent records. By having less than 300 records to handle, we can provide much better service to the physicians, locate needed records quickly, and maintain an excellent working relationship with the Patient Accounting Department. Medical and hospital administration staff members now regard medical record personnel as organized and effective record managers.
[Identification, evaluation and treatment of dementia patients in society].
Patients with "mild to moderate" dementia might improve with appropriate drug therapy whereas patients with "severe" dementia are generally considered to have an irreversible condition, providing acute metabolic disorders have been excluded and appropriate investigations have been performed to exclude neurological conditions that might be amenable to neurosurgery. Since it is unlikely that this type of patient will be referred to the hospital outpatient clinics, it is necessary to identify these patients in the community. For this purpose, authors have used the Abbreviated Mental Test. A comparison between two observers (nurse and doctor) has been made. Subsequently, a 6 symptoms check-list, as abbreviated form of the Crichton Royal Rating Scale for geriatric patients, was used in an open pilot study on 260 patients completing a 12 weeks treatment by dihydroergotoxine mesylate (codergocrine mesylate, Hydergine) 4.5 mg once a day. Although this was an open pilot study, it does show that it is possible to identify and treat patients with "mild to moderate" dementia in the community. A single dose formulation in the elderly has obvious advantages. In this study, compliance was excellent and 88% of the patients showed significant improvement using the suggested rating scales.
A new approach to the treatment of seasonal allergic rhinitis.
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A comparison of pindolol and methyldopa in the treatment of hypertension: a hospital monitored trial in general practice.
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Treatment of the premenstrual syndrome.
A placebo-controlled, randomized, double-blind, parallel group study in hospital and general practice has shown that a combination of belladonna alkaloids, ergotamine tartrate, and phenobarbitone (Bellergal) was effective in treating troublesome symptoms of the premenstrual syndrome of which fatigue, tender breasts, nervousness, irritability, lethargy and listlessness were improved to a statistically significant degree. The drug was given three times daily and caused no side effects.
A multi-centre general practice trial of mazindol in the treatment of obesity.
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A comparative study of clemastine ('Tavegil') and chlorpheniramine maleate in the treatment of hay fever.
A double-blind randomised parallel group study was carried out in 46 patinets to compare the effectiveness of clemastine with that of chlorpheniramine maleate in the treatment of hay fever. The results showed that both drugs were equally effective in controlling the symptoms of hay fever without side-efects or other untoward reactions. It is suggested that clemastine is a logical first choice antihistamine as well as being an effective alternative where tolerance to other antihistamines develops.
The use of clemastine ("Tavegil') administered parenterally in acute allergic episodes.
An open study was carried out in 41 patients, requireing an emergency doctor visit because of an acute allergic episode, to assess the effectiveness of an antihistamine, clemastine, given parenterally. The results showed that a single intramuscular injection of 2 mg clemastine was 'fully effective' in relieving the sumptoms of 19 (46.3%) patients, and gave 'some relief' in 20 (48.8%). Two (4.9%) patients failed to respond. No side-effects of treatment were reported.
A multi-centre trial of mazindol ('Teronac') in general practice in Ireland.
In a multi-centre trial of mazindol ('Teronac'), a new anorectic agent unrelated to amphetamine, 274 male and female patients were treated by 53 investigators in Eire. All patients were overweight according to the Metropolitan Life Assurance Company Tables, and 166 patients completed the treatment regime of one 2 mg. tablet daily and a 100 calorie diet for 12 weeks. The average weight loss was 18.8 lbs. (8.5 kg.); 85% of patients reported good appetite supression and good ability to adhere to their diet, and the attending physicians rated mazindol as being of considerable help in 92% of the patients. Mazindol was well tolerated, only 29 patients dropped out of the trial because of side-effects.
Prescribing by six Australian dermatologists: a pilot study.
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