This is a study of 100 hemiplegic patients of whom 17 had downward subluxation of the shoulder joint. The mechanism of this complication is described and appropriate preventative treatment suggested.
There is considerable interest in the problems of the elderly taking drugs correctly and appropriately. A recent survey (Parkin et al. 1976) showed that these problems that have long been known in geriatric practice have now been noted by general physicians. This review was undertaken when an occupational therapist in a geriatric unit team noted that, although patients and their relatives were taught methods of dressing, toileting, shaving, bathing, eating, walking, transferring to a chair, wheelchair mobility and communication by the occupational therapist, physiotherapist and speech therapist, no advice or teaching was given concerning the accurate taking of the drugs prescribed. The results of a detailed investigation are reported elsewhere (Atkinson, Gibson & Andrews 1978). Repeatedly, patients ready for discharge were handed a batch of drugs by a nurse at the last possible moment, even while sitting by their luggage awaiting the ambulance. Following this, special attention was paid to problems such as intellectual impairment, loss of memory and confusion, poor sight, inability to handle containers, failure to take drugs and lack of patient-education. During ward rounds, particularly when a geriatric health visitor was present, attention was drawn to special topics such as the number of patients who inadvertently kill themselves and the numbers needing readmission due to failure to take drugs, overdosage or underdosage or mixing of drugs (Wade 1972). Ferguson Anderson's comment (1974) that 7.15% of hospital admissions are due to drug reactions was also noted.
This is a study of serum iron levels following myocardial infarction in a series of 18 male and 10 female patients. All showed hypoferraemia, which was variable in time of onset, intensity and duration, but was commonly sustained and severe. This was not of prognostic significance, and the Victoria Infirmary coronary prognostic index remains the most reliable prognostic guide.
This paper attempts to determine if an abnormal erythrocyte sedimentation rate (ESR) is as significant in age as in youth, by studying values for 118 men and women who had been treated for pernicious anaemia and observed for a prolonged period, and 442 in-patients. Particular attention was paid to 67 post mortem examinations in the second group, and to the fact that 34 of 51 patients who were thought to have a known cause for high sedimentation rate had a further possible cause found only at post mortem, and that this was frequently a malignant tumour. It was concluded that a normal old person should have a normal erythrocyte sedimentation rate. If the sedimentation rate is above normal, examination and culture of the urine and x-ray of chest should be the first investigations.
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