M. S. J. Pathy's research while affiliated with University of Wales and other places

Publications (41)

Article
Health screening for old people who live at home has been the subject of debate for 30 years or so. It has come to the fore again in the UK with the new emphasis on annual assessments by general practitioners (GPs) of those aged 75 or more. Screening in the elderly has implications for manpower. How can it best be done? We describe here a randomise...
Article
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An oral glucose tolerance test (OGTT, 75 g WHO criteria) was applied to healthy elderly subjects (mean age 76 years) within a week of measurement of random blood glucose and glycosylated haemoglobin (HbA1). The ‘Corning’ method was used to assay HbA1 (established normal range for our laboratory 5–8%). Sixty-five subjects (38 women) of whom 54 were...
Article
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We report a retrospective study of hypernatraemia (serum sodium concentration greater than 150 mmol/l) in an adult in-patient population of a health district during one year. The incidence was 0.3% with at least 60% of cases developing after hospital admission, mainly in elderly patients. Dehydration appeared to be the major cause, with the use of...
Article
The response of thyrotropin (TSH) to thyrotropin-releasing hormone (TRH) was measured in 70 clinically euthyroid elderly patients who were acutely ill and in 70 age- and sex-matched euthyroid controls who were free of acute disease. The incremental TSH response (ΔTSH) was often blunted (< 2 mU/1) in both groups, though more often in those with acut...
Article
Until recently, neuroleptic malignant syndrome (NMS) was considered to be most unusual in elderly patients. During a two-year period, we encountered five patients with the syndrome among some 13000 admissions to our acute geriatric assessment beds. As there have been few other reports of the syndrome in elderly patints, we believe that many cases g...
Article
The prevalence, symptoms, causes and natural history of pleural effusion in the elderly were studied in 4820 consecutive admissions (mean age 80 years) to an acute geriatric unit. Of 502 (10%) patients with evidence of pleural effusion on a chest X-ray (CXR), the medical notes were reviewed in 461. In 168 patients, pleural effusion was bilateral. T...
Article
Thyroid function was assessed by measurement of free thyroid hormones and thyrotrophin (TSH) in 78 acutely ill elderly patients and in a control group without acute illness. Abnormal results with any test were more frequently found in the acutely ill group than in controls. In particular, abnormal TSH values were found in 40% of the acutely ill gro...
Article
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Decisions concerning the use of intravenous fluids and antibiotics in terminally ill patients are regularly made by hospital doctors, but there is little record of staff attitudes and current practice in Britain. A questionnaire was therefore distributed to 833 Welsh hospital doctors, citing the case of a hypothetical terminally ill patient and ask...
Article
The clinical features, the treatment given, the factors governing treatment selection, and the result of such treatment were analyzed in all patients aged 65 years and over in whom a tissue diagnosis of acute mesenteric infarction was made at a major teaching hospital. Thirty-two such patients, of mean age 78.5 years, were identified during the 8-y...
Article
One hundred sixty-six elderly depressed patients were recruited from six hospital centers and entered in a double-blind, randomized, parallel group comparative study of conventional and controlled-release formulations of trazodone. Patients received a single nighttime dose of 100 mg for 1 week, followed by 3 weeks of 200 mg or less, depending upon...
Article
Medical care of the elderly today challenges the practitioner to break away from narrow diagnostic labelling and view the whole picture of disease in old age. In an excellent problem-oriented approach, Geriatric Medicine offers a complete overview for practitioners. The main portion of the text deals with the common diseases of old age; important a...
Article
The tolerance and efficacy of captopril was compared with placebo in a double-blind study in 25 elderly patients on diuretic therapy (maximum frusemide dose 80 mg/day) for mild to moderate heart failure. Eighteen patients (9 captopril, 9 placebo) completed the study. Outcome measures were consistently in favour of the patients treated with captopri...
Chapter
The strong association in elderly subjects between depression and physical ill health has been long recognized, though clear evidence regarding a causal relationship in either direction is generally lacking (Levenson and Hall, 1981; Eastwood and Corbin, 1986). That either condition can influence the development and course of the other, however, is...
Article
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Of 62 patients (mean age 75, range 65-92 years) referred to an out-patient anticoagulant clinic specifically for those aged 65 years or more, treatment was considered unsafe in only one patient and was discontinued. Minor bleeding which did not require a significant change in management was recorded on 25 (7%) of 381 clinic visits and one major hae...
Article
The clinical features and outcome were determined for 100 consecutive patients aged 65 years or older with a history of diabetes mellitus who presented to hospital with acute myocardial infarction. Each case was compared with an age- and sex-matched nondiabetic control also admitted to hospital with acute myocardial infarction. Chest pain was equal...
Article
The bioavailability of levodopa-benserazide in a standard capsule and a new dispersible tablet was compared in Parkinsonian patients, with (n = 8) and without (n = 8) swallowing difficulties. There was considerable variation within and between subjects, but no significant differences between formulations for any pharmacokinetic parameters, other th...
Article
A geriatric High Dependency Unit has been in operation at Cardiff Royal Infirmary for the past 7 years to provide "special-care" for acutely ill elderly people requiring careful bedside monitoring and intensive nursing and medical treatment. The background to the unit, its present functioning and the results of a prospective study of 432 consecutiv...
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In a prospective, randomized, controlled study an intravenous vitamin B complex and vitamin C preparation was administered pre- and post-operatively to 28 elderly patients with a fractured proximal femur and compared with 32 nonsupplemented postoperative controls. Vitamin supplementation significantly, though only transiently, improved postoperativ...
Article
We recorded anthropometric and laboratory data in 98 sick old people on admission to a high-dependency unit. The measurement of triceps skinfold thickness and arm muscle area was feasible even in very ill people, while measurement of the body mass index was difficult and sometimes unreliable. Anthropometric measurements indicated that our study gro...
Article
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Article
The diagnostic features and outcome of acute myocardial infarction in 100 very elderly (aged 85 years or more) hospitalized patients are reviewed and compared with those in a group of younger elderly (aged 65-84 years). The diagnostic triad of chest pain, sequential ECG changes and raised cardiac enzymes was present in only 24 very elderly patients...
Article
The effects of intravenous glycerol in elderly patients with recent onset of acute ischaemic stroke were evaluated in a double-blind randomised controlled trial. 173 patients received either 500 ml of a 10% solution of glycerol in physiological saline or 500 ml of physiological saline administered intravenously over 4 h daily for 6 consecutive days...
Article
Dementia is commonly diagnosed at a time of major domestic breakdown, when symptoms are severe and family and community patience has been eroded. In order to encourage early referral and identification of patients with treatable conditions, a Memory Clinic is held at the University Hospital in Cardiff. The clinic provides a service for general prac...
Article
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The symptoms associated with acute myocardial infarction in a series of 777 elderly hospitalized patients are reviewed. Their ages ranged from 65 to 100, with a mean of 76.0 years. The spectrum of presentation changed significantly with increasing age. Chest pain or discomfort were less frequently reported, although present in the majority of patie...
Article
Full-text available
Plasma potassium and sodium concentrations were measured in a group of elderly patients taking maintenance thiazide diuretic therapy alone, with a potassium supplement or in combination with a potassium sparing diuretic. Fixed dose combinations of a thiazide and potassium sparing diuretic did not significantly reduce the prevalence of hypokalaemia...
Article
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A double-blind, parallel group, randomized trial was carried out to compare the hypnotic efficacy, tolerance and psychometric effects of two doses of loprazolam and placebo in 89 elderly hospital in-patients. All had disturbed sleep patterns, which were not the result of serious psychiatric or physical illness and, after a 1 or 2 day single-blind p...
Article
The results of this double-blind study showed that both chlormethiazole and temazepam are effective, in the correct dose, for the short-term treatment of sleep disturbance in elderly patients. With chlormethiazole treatment there was no daytime drowsiness, whereas significant daytime drowsiness occurred with temazepam.
Article
This study compared the hypnotic efficacy and the psychometric effects of treatment with either chlormethiazole or triazolam for 9 weeks in elderly patients with sleep disturbance. Chlormethiazole and triazolam were found to be similarly effective in short-term use. However, evidence of sustained hypnotic efficacy throughout the 9 weeks of treatmen...
Article
The outcome of cardio-pulmonary resuscitation within an acute geriatric unit was studied in 95 patients (mean age 77 years, range 65–90) who were involved in 106 consecutive cardio-respiratory arrest calls. In 58 patients (61%), initial resuscitation was unsuccessful and a further 21 (22%) died later in hospital. Fourteen patients (15%) were alive...
Article
Full-text available
Requests for night sedation and the use of placebo as first line drug management were studied prospectively in 1174 consecutive elderly hospital in-patients. Of the 390 (33.2%) patients requesting sleeping pills in hospital, 37 were subsequently satisfied without the prescription of additional medication. A further 216 patients were entirely satisf...
Article
The pharmacokinetic and some pharmacodynamic characteristics of a single oral dose of 100 mg trazodone were compared in young and elderly volunteers. The maximum plasma concentration of trazodone was similar in both age groups. The time to maximum concentration was apparently prolonged in four subjects who swallowed the capsule with a minimal volum...
Article
A double-blind, parallel group, randomized trial was carried out to compare the hypnotic efficacy of 1.0 mg loprazolam and 5.0 mg nitrazepam in 40 elderly patients. All had disturbed sleep patterns, which were not the result of physical illness, and had been shown to be placebo non-responders during a 3-day placebo screening period. Patients receiv...

Citations

... Jedna od retkih, ali mogućih komplikacija OAT je predoziranje, s obzirom da su ovi bolesnici pod stalnom kontrolom kardiologa i transfuziologa. Što je OAT intenzivnija, povećava se rizik od krvarenja 10 . ...
... may be the lack of consciousness of disease from the patient, the presence of concomitant diseases, especially dementia (Bayer and Pathy, 1989) and the usually atypical onset of depression in elderly people (Blazer, 1980). The increased incidence and prevalence of depression with aging can be also explained considering some stressors which elderly people frequently have to face, such as physical disability, bereavement, cognitive abilities and social isolation (Koenig and Blazer, 1992) (Table 1). ...
... This point had not been well established in previous research. A few studies from Europe, of smaller size and shorter duration than the study reported here, are associated with a survival advantage among older adults receiving various types of home visits by nurses35363738. To date, most studies of care coordination models in the US, including those applying the chronic care model, focusing on primary care redesign, medical homes, or transitions of care, have either not reported mortality as a separate outcome or have demonstrated no impact on mortality394041424344454647484950515253. Two studies from the US that did not randomize individual participants and had other methodological limitations have reported improved survival for recipients of nurse care management provided within primary care settings [54,55]. ...
... If a large amount of toothpaste is ingested, a poison control center should be contacted immediately. In the USA, a wording is required on the tubes of toothpaste, inviting to contact a doctor or a control center, in case of ingestion of an excessive amount of toothpaste, and therefore of fluorine [59][60][61]. The effectiveness of fluorine is questioned by some chemists and scholars from all over the world, who appeal above all to an increasing number of studies that would highlight the toxicity of fluorine salts, capable of causing, with minimal overdoses, of fluorosis; ruining bones and teeth, and causing nervous system problems and cognitive deficits [62]. ...
... 49,51 A medium-quality review 51 conducted quantitative metaanalysis using data from 13 RCTs 120-132 and found overall "reduction in the risk of [NHP] was modest and nonsignificant" (RR 0.91 [95% CI 0.76, 1.09]). In stratified analyses by number of visits (over follow-up of 1-4 years for all studies), interventions with more than 9 visits 123,125,127,131 showed an "estimated reduction [of NHP]… 34% (RR, 0.66; 95% CI, 0.48-0.92) and the typical risk difference was 2.3%." ...
... Altogether, 24 studies have been carried out to explore the effects of PHVs on functioning, functional limitations, or frailty (Behm et al. 2016, Bleijenberg et al. 2016, Bouman et al. 2008a, Brettschneider et al. 2015, McEvan et al. 1990, Fabacher et al. 1994, Fairhall et al. 2015, Granbom et al. 2017, Gustafsson et al. 2012, Hebert et al. 2001, Imhof et al. 2012, Kono et al. 2012, Kono et al. 2016, Melis et al. 2008, Metzelthin et al. 2015, Pathy et al. 1992, Ploeg et al. 2010, Schraeder et al. 2001, Sorensen et al.1988, Stuck et al.1995, Stuck et al. 2000, Van Hout et al. 2010, Van Rossum et al. 1993, Vetter et al. 1984). These studies were performed between 1984 (Vetter et al. 1984) and 2017 (Granbom et al. 2017). ...
... However, whether to generalize HbA1c as a diagnostic criterion for diabetes in the entire population remains controversial because of the influence of factors such as age [10][11][12], race [13][14][15] and certain diseases [16,17]. Existing studies have shown that HbA1c demonstrates a limited sensitivity in detecting diabetes in the elderly population [10,18]. Although age has been reported to be an independent factor affecting the HbA1c levels [19][20][21][22], limited literature is available regarding the influence of age on the HbA1c as a criterion for diagnosing diabetes. ...
... The resultant morbidity can range from trivial to lifethreatening. Mortality of patients with hypernatraemia ranges from 20-60% and depends on the presence of co-morbidities, associated severe illness and whether hypernatraemia was acquired in the community or developed during hospitalisation (2)(3)(4). It is an independent mortality predictor in critical care and non-critical care environments (5)(6). ...
... In contrast to this, in a study done in Wales, junior doctors were more interventionist than their seniors, and tended to use aggressive life prolonging measures more, sometimes, regardless of their patients wishes, or an inability to express those wishes. [12] research from Finland also shows that younger doctors tend to oppose assisted death. [13] However, most research shows that older doctors are less likely than their juniors to favorably consider a request for assisted death. ...
... Trazodone prolonged-release (Roussel Laboratories Ltd.) was evaluated in elderly patients with depression [55]. After 4 weeks of treatment, both controlled-release and conventional formulations of trazodone (both given at night-time as single daily doses starting at 100 mg and increased to 200 mg/day based on tolerability) were similar in efficacy, as measured by changes from baseline in HAM-D and global assessments of the severity of depression scale scores [55]. ...