PubMed Health⌕ Search

Biomedical subjects

R Tallis

Publications and source records attributed to R Tallis.

29 records · Page 2Linked to original sources
PubMed1978

Neurophysiological studies of autogenous sural nerve grafts.

Sixteen autogenous sural nerve grafts used for ulnar and median injuries in the forearm have been studied neurophysiologically up to two and a half years after operation. Motor and sensory nerve conduction studies revealed a slow but sustained improvement during the follow-up period. By two years, motor conduction velocity across the graft itself reached in most cases 40 to 85% of the conduction velocity in the contralateral normal limb. Some reduction of motor conduction velocity was observed in the uninjured nerve proximal to the graft but this was less marked. Sensory nerve action potentials were obtained in 44% of nerves after 18 months although in all cases the amplitude of the potentials and in most cases their velocity, was greatly reduced.

Action Potentials↗
PubMedDate not supplied

Age-specific incidence and prevalence rates of treated epilepsy in an unselected population of 2,052,922 and age-specific fertility rates of women with epilepsy.

BACKGROUND: There are no data on prevalence or incidence of treated epilepsy, and no data on fertility of women with epilepsy from an unselected UK population. METHODS: We used the General Practice Research Database to ascertain the incidence and prevalence of people with treated epilepsy in an unselected population of 2,052,922 people in England and Wales, and also age-specific fertility rates. We defined period prevalence of treated epilepsy as the number of people with epilepsy taking an antiepileptic drug per 100,000 people during 1995. The incidence of treated epilepsy was defined as the number of new cases of treated epilepsy per 100,000 people during the same period. We calculated fertility rates among women with treated epilepsy between 1991 and 1995 and compared these rates with the population rates for England and Wales in 1993. FINDINGS: The period prevalence of treated epilepsy in 1995 was 5.15 per 1000 people (95% CI 5.05-5.25). The prevalence was lower in children (age 5-9 years 3.16 [2.86-3.48]; 10-14 years 4.05 [3.70-4.42]), and higher in older people (65-69 years 6.01 [5.50-6.57]; 70-74 years 6.53 [5.97-7.14]; 75-79 years 7.39 [6.73-8.11]); 80-84 years 7.54 [6.78-8.39]; 85 years and older 7.73 [6.98-8.66]). The incidence of treated epilepsy was 80.8 per 100,000 people (76.9-84.7). The incidence was lower in children (5-9 years 63.2 [50.5-79.1]; 10-14 years 53.8 [42.4-68.3]) and higher in older people (65-69 years 85.9 [68.5-107.3]; 70-74 years 82.8 [65.0-105.2]; 75-79 years 114.5 [116.9-179.2]; 80-84 years 159 [125.2-202.6]; > or = 85 years 135.4 [100.4-178.7]). Fertility was lower among women with treated epilepsy, with an overall rate of 47.1 livebirths per 1000 women aged 15-44 per year (42.3-52.2), compared with a national rate of 62.6 in the same age-group. The standardised fertility ratios were significantly lower between the ages of 25 and 39 years in women with epilepsy (p<0.001). INTERPRETATION: Compared with previous studies, we found that the incidence of epilepsy was higher in elderly people and lower in children. The prevalence rates also increase with age. Women aged 25-39 years with treated epilepsy have significantly lower fertility rates than those in the general population. Research is needed to identify any potentially preventable causes for the low fertility rates.

Adolescent↗
PubMedDate not supplied

Impact of valproate and phenytoin on cognitive function in elderly patients: results of a single-blind randomized comparative study.

Thirty-eight patients (median age 77 years; range 62-88 years) with elderly-onset seizures were entered into a single-blind, randomized study designed to compare the impact of phenytoin (PHT) and valproate (VPA) on cognitive function. A stratified minimization program matched the two groups for age, sex, and seizure type. Attention, concentration, psychomotor speed, and memory were assessed twice before treatment (to minimize practice effects), at 6 weeks and (for patients remaining in the study) at 3 months, 6 months, and 1 year by an extensive battery of psychologic tests. Changes in cognitive function were minor, and some tended toward improvement. Contrary to expectation, there was little difference between PHT and VPA with regard to impact on cognitive function. Frequent noncognitive adverse effects were reported. Thus, we did not replicate the findings of previous literature. We conclude that antiepileptic drug (AED) monotherapy as used in our trial did not produce significant adverse cognitive effects. The choice of AED in the elderly may therefore be more influenced by consideration of other adverse effects.

Age Factors↗
PubMedDate not supplied

Rehabilitation: objective assessment of muscle function.

The lack of an appropriate and objective measuring scale or tool has ensured that rehabilitation nurses' assessments of patients' muscle function have tended to be subjective and, arguably, inconsistent. Such inexact methods are no longer acceptable to the increasingly audit-conscious health service and research-oriented nursing profession. The authors introduce a means of completing an objective assessment of patients' muscle function which, they claim, will enable nurses to evaluate the efficacy of current and potential treatment options. In follow-up articles appearing in the next two editions of Nursing Standard, they discuss electrotherapeutic rehabilitation of skeletal muscle function.

Humans↗
PubMedDate not supplied

Rehabilitation of muscle function. Part 1.

This article, which develops the concepts introduced in the authors' paper in last week's edition (1), is the first of two which review and summarise recent studies describing techniques to test the hypothesis that uniform frequency stimulation of skeletal muscle deprives the muscle of the type of signals that are necessary for rapid, appropriate and effective adaptation. Next week, clinical trials which have tested this hypothesis will be described, and the implications of the results for nurses involved in rehabilitation work discussed; Part 1 sets out the methodology of extracting the firing patterns of single motor units from a fatiguing muscle.

Electric Stimulation↗
PubMedDate not supplied

The burden of chronic illness in local authority residential homes for the elderly.

A survey of all Part III residential homes in the Central and Southern area of Liverpool Health District examined the diagnoses and medication of 331 residents. A heavy burden of chronic illness was observed with cardio-vascular, psychiatric and orthopaedic problems being the most prevalent. Of the top 10 diagnoses, accounting for over half of all conditions, all disease instances required monitoring of their response to treatment. At least two thirds of these diseases were likely to progress, and the usual treatment of three quarters of the sample was associated with possible side-effects. This heavy burden of chronic illness in Part III residential homes implies a major need for both anticipatory and event-related medical care. These needs are unlikely to be met, given that the subtle, but significant, deterioration in the health of residents has been shown to go undetected.

Aged↗
PubMedDate not supplied

Rehabilitation of muscle function. Part 2.

This article describes the utilisation of a physiologically based research technique developed to facilitate the nursing care of patients with skeletal muscle wasting. The technique, which involved electrotherapeutic stimulation to the first dorsal interosseous muscle of a group of arthritic patients, demonstrates that patterned neuromuscular stimulation of skeletal muscle can have enormously beneficial effects in preserving and regenerating skeletal muscle. The reasons for the muscle wasting, and the subsequent vicious spiral of immobility, were reviewed in Part 1 (1), and both articles build on the concepts described in a previous paper published in Nursing Standard (2).

Electric Stimulation Therapy↗