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Biomedical subjects

S J Ogle

Publications and source records attributed to S J Ogle.

16 recordsLinked to original sources
PubMed1999

The epidemiology of serious adverse drug reactions among the elderly.

Although the incidence and prevalence of serious adverse drug reactions (ADRs) in the elderly cannot be accurately stated, published estimates appear to be unchanged since the earliest reports in the 1960s. Whereas heightened awareness of the problem may weigh in favour of a reduction in ADR frequency, the dramatic increase in the number and availability of therapeutic agents has undoubtedly contributed to the observed high proportion of drug-induced morbidity among acute geriatric hospital admissions. No single drug or drug class is of particular concern since none appears to cause serious morbidity out of proportion with its use. Although numerous studies have sought to identify risk factors for ADRs, the only truly independent predictor is the absolute number of concurrently used medications. However, other studies indicate that there is poor doctor-patient agreement regarding a patient's drug regimen, and interventions that aim to reduce the incidence of ADRs have failed to demonstrate a positive effect. Thus at present the most rational approach would appear to be to establish an accurate knowledge of the patients drug regimens: once this is known one can attempt to rationally minimise the number of medications without compromising therapeutic goals.

Age Factors↗
PubMed1995

Are medication record cards useful?

OBJECTIVE: To assess the use of patient-held medication record cards and their acceptability to patients and doctors. DESIGN: Prospective 12-month study with data collection at baseline and on three subsequent occasions at four-monthly intervals. PATIENTS AND SETTING: 187 patients with a mean age of 78.4 years (range, 60-101) were taking a mean of 5.8 medications each (range, 1-18). They lived on Sydney's lower north shore and were able to care for themselves. MAIN OUTCOME MEASURES: Availability of card on request, frequency of use, status of recorders and accuracy of records (checked by inspection of medications at home). RESULTS: Most patients retained their cards, but the proportion who presented it to their doctor fell from 61% to 23% over the 12 months (P < 0.0001), and the proportion with accurately recorded drug regimens ranged from 20% down to 16%. Of the 75 regimens written exclusively by general practitioners in the 12 months, only 19 (25%) were consistent with what the patients were actually taking. CONCLUSION: Medication record cards introduced into the doctor-patient relationship by a "third-party" are unlikely to result in better quality use of medicines.

Aged↗
PubMed1994

Functional ability of patients to manage medication packaging: a survey of geriatric inpatients.

This study measured the prevalence of difficulty experienced by elderly inpatients in opening and removing tablets from a range of common commercial medication packagings and in breaking a bar-scored tablet in half. One hundred and twenty elderly patients admitted to a teaching hospital acute geriatric service were tested for their ability to open the container and remove a tablet from it. They were rated as 'able' or 'unable' to do so. In all, 94 patients (78.3%) were unable to break a tablet or open one or more of the containers. Of the 111 patients taking medication at the time of their admission, 46 (41.4%) were unable to perform one or more tasks necessary to gain access to medications in their own treatment regimen. The factors that were significantly and independently associated with inability to open containers were poor vision, impaired general cognitive function, and female sex. Many of the drug packagings in common use significantly impede access by elderly patients to their medications.

Activities of Daily Living↗
PubMed1989

Age-associated change in pain threshold measured by transcutaneous neuronal electrical stimulation.

The measurement of cutaneous pain threshold using the Neuromod Selectra Model 7750 Transcutaneous Neuronal Electrical Stimulator is described. Pain threshold, measured in 520 healthy volunteers aged 5-105 years, increased with age. Consistent values were obtained in 22 healthy volunteers on three successive days. Pain threshold may be rapidly measured by this method which is potentially of value in the assessment of patients with neurological deficits.

Adolescent↗
PubMed1987

Validation of a brief screening test for depression in the elderly.

This paper describes the clinical validation of the 10-question Short Zung Interviewer-assisted Depression Rating Scale (Short Zung I.D.S.) which has been derived from the 20-question Zung Self-rating Depression Scale (Zung S.D.S) for use in the elderly. The Short Zung I.D.S. was administered to 104 elderly volunteers from the community and to 33 elderly depressed patients assessed by a psychiatrist. The mean scores (41.3 and 81.0, respectively) were significantly different (P less than 0.0001). The Short Zung I.D.S. has proved to be a useful brief screening test for depression in the elderly and should be of value in measuring changes in mood.

Aged↗
PubMed1984

Day hospital rehabilitation--effectiveness and cost in the elderly: a randomised controlled trial.

The effectiveness and cost of day hospital care in rehabilitation were studied in a randomised controlled trial in 120 elderly patients who were assessed at referral and six weeks and five months later in activities of daily living skills and mood. Day hospital patients were compared with a control group, who were managed as they would have been before the availability of day hospital care. Day hospital patients showed a significant improvement in performance of activities of daily living at six weeks but not at five months; however, they had a sustained improvement in mood. The cost of day hospital rehabilitation was one third greater than that of rehabilitation by alternative means. In its current form the geriatric day hospital is not a cheap alternative to other means of rehabilitation. Expensive components of the day hospital should be critically re-examined and renewed emphasis placed on sufficient inpatient beds, domiciliary services, and day care centres.

Activities of Daily Living↗
PubMed1981

Changing views on diverticular disease as a cause of gastro-intestinal bleeding.

Over the past 60 years there has been continuing controversy and changing views about the relative importance of diverticular disease as a cause of gastro-intestinal haemorrhage. In the 1920s neoplasms were thought to be the commonest cause of colonic bleeding, then in the 1950s diverticulitis and subsequently diverticulosis. However, at that time the diagnosis of diverticular haemorrhage was mostly one of exclusion. In the 1960s an attempt was made to identify the site of bleeding and it was found that even though diverticula are mostly in the left colon, bleeding occurred from the right colon. A partial explanation for this came with the advent of arteriography and the discovery of caecal angiodysplasias. The relative importance of the two conditions remains uncertain but it is clear that, in patients with gastro-intestinal haemorrhage, the presence of diverticula should not stop a thorough search for other causes of bleeding.

Aged↗
PubMed1981

Paraplegia and quadriplegia in the elderly due to spinal cord lesions: association with malignancy.

A retrospective study showed that paraplegia and quadriplegia due to spinal cord lesions occurred with a frequency of 1 in 500 admissions to a geriatric department. These cases predominantly were caused by malignant disease, particularly of the bronchus. However, elderly patients presenting to other hospital departments included a far higher proportion of cases with benign causes, particularly cervical spondylosis which affects patients of lower average age. Male patients predominated in both malignant and benign categories.

Age Factors↗
PubMed1978

Oesophageal function in cirrhotic patients undergoing injection sclerotherapy for oesophageal varices.

Oesophageal function has been studied in three groups of cirrhotic patients: those without varices, those with varices and those with varices treated by injection sclerotherapy. Using the Honeywell Model 31 oesophageal motility probe and the Ingold combined stomach pH electrode, measurements were made of the lower oesophageal sphincter (LES) pressure and length, swallowing responses, reflux and clearance of acid. The presence of varices was associated with an increase in LES length and reduced lower oesophageal contraction pressure during swallowing and some failure of sphincter relaxation during swallowing. Sclerotherapy was associated with a reduction in the maximum LES pressure both at rest and during swallowing, and an impairment of acid clearance, but postural reflux of acid was not observed in any patient.

Deglutition↗
PubMed1977

Liver damage from long-term methyltestosterone.

Of 60 patients (42 female transsexuals and 18 impotent males) receiving long-term therapy with methyltestosterone 50 mg three times a day, 19 had abnormal liver-function tests and 33 out of 52 had abnormal liver scans, particularly those who had been treated for more than a year. Liver biopsy specimens showed accumulation of hepatocytes in the liver cords and within the walls of centrilobular veins, and early peliosis hepatis. One patient had a hepatic adenoma. Of the androgens, only 17alpha-alkylated steroids seem to be implicated in the development of cholestatic jaundice, peliosis hepatis, and liver tumours.

Adenoma↗