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Biomedical subjects

R L Hewer

Publications and source records attributed to R L Hewer.

66 records · Page 4Linked to original sources
PubMed1968

Study of fatal cases of Friedreich's ataxia.

A study of 82 fatal cases of Friedreich's ataxia showed that over half the patients died of heart failure while nearly three-quarters had evidence of cardiac dysfunction during life. A high incidence of diabetes mellitus (23%) was another finding, and four patients developed diabetic ketosis terminally.

Acidosis↗
PubMedDate not supplied

Selected cognitive losses after stroke. Frequency, recovery and prognostic importance.

Data collected in a population-based study on 976 patients suffering an acute stroke have been analysed to discover the frequency of disturbance of selected cognitive functions, particularly orientation, non-verbal reasoning, and copying. Further analysis investigated how these deficits related to other impairments, their prognostic importance, and their recovery. Considering patients assessed within the first week, only 45% were orientated, only 44% could be assessed for IQ and their average score was 94 (SD 16), and only 36% could copy a cross satisfactorily. Seventeen per cent of patients had a reduced level of consciousness preventing assessment, and the other unassessable patients had other impairments such as aphasia preventing assessment. In general failure to pass these tests was associated with evidence of a more severe stroke; the patients had other impairments such as a more severe paralysis. No independent effect of cognitive dysfunction upon recovery could be demonstrated. By 6 months most surviving patients passed all the tests used.

Activities of Daily Living↗
PubMedDate not supplied

Development of a stroke and neurological rehabilitation unit in a district general hospital.

We describe the experience of setting up a 16-bed unit for the rehabilitation of non-progressive and progressive neurological disorders. Its aim was the active involvement of patients and their families in the rehabilitation process. Various innovations were instigated by the multidisciplinary teams, including early visits home and a leisure service. Over the first two years, 318 patients were admitted to the unit, 51% attributable to stroke.

Activities of Daily Living↗
PubMedDate not supplied

Long-term outcome after discharge from a stroke rehabilitation unit.

The evidence is compelling that stroke units are effective when compared to management of patients on general medical wards. However, the evidence remains equivocal that better outcome is sustained in the longer term. This paper reports an investigation of cognitive and emotional outcome, environmental consequences, social activities, and physical outcome in 57 consecutive one-year survivors of a stroke discharged from a stroke and neurological rehabilitation unit. Satisfaction with inpatient and outpatient services was also investigated. Results were compared with previously reported studies of long-term outcome after stroke. Mean Barthel activities of daily living score at one year or more post-stroke was 16.8. Arm function was impaired in 43% of the participants in the study. Nearly half had cognitive and emotional problems, 19% communication problems, and 25% problems with access both inside and outside their house. All but four of the one-year survivors were less active after their stroke than before. More than 40% were dissatisfied with at least one aspect of inpatient and/or outpatient services. The long-term consequences of stroke in all areas investigated were considerable and in line with previous reports. Some suggestions for reducing these effects are made, including better information for patients about stroke and rehabilitation, improved access to psychology services, detailed assessment prior to hospital discharge of the patient's living environment and effective coordination with social services to improve access to their living environment.

Activities of Daily Living↗