Adherence therapy improves medication adherence and quality of life in people with Parkinson's disease: a randomised controlled trial.

Background: Many factors are associated with medication non-adherence in Parkinson's disease (PD), including complex treatment regimens, mood disorders and impaired cognition. However, interventions to improve adherence which acknowledge such factors are lacking. A phase II randomised controlled trial was conducted investigating whether Adherence Therapy (AT) improves medication adherence and quality of life (QoL) compared with routine care (RC) in PD.

The use of carer assisted adherence therapy for people with Parkinson's disease and their carers (CAAT-PARK): study protocol for a randomised controlled trial.

Background: Pharmacological intervention is essential for managing the symptoms of Parkinson's disease. Adherence to medication regimens however is a major problem. Poor adherence leads to significant motor deterioration and inadequate symptom control.

High mortality of older patients admitted to hospital from care homes and insight into potential interventions to reduce hospital admissions from care homes: the Norfolk experience.

There is a high mortality rate in patients admitted to hospitals acutely from care homes. In a retrospective case analysis study of 3772 older people admitted to the Department of Medicine for the Elderly between January and June 2005, 340 (9.0%) were from care homes, and 93 (27.

Lung carcinosarcoma as a rare biphasic sarcomatoid carcinoma: a case report.

Introduction: A fit, 57-year-old man admitted with chest pain and haemoptysis turned out to have a primary tumour in the left lung.

Case Presentation: In this 57-year-old Caucasian man, the diagnosis followed a computed tomography scan and histopathological evidence gained post-resection. The biopsy showed a uniform, spindle shape with focal pleomorphism which was suggestive of lung carcinosarcoma.

Nocardia - Opportunistic chest infection in elderly: A case report.

In this rare case a non-immunocompromised patient with old Tuberculosis on low dose of steroids presents with opportunistic infection of a weakly aerobic gram positive acid fast, filamentous bacteria called Nocardia.An 80 year old non-smoking white female presented with cough, shortness of breath and purulent sputum.Initial antibiotics given were not helpful.

Post-stroke seizure and post-stroke epilepsy.

Post-stroke seizure and post-stroke epilepsy are common causes of hospital admissions, either as a presenting feature or as a complication after a stroke. They require appropriate management and support in long term. With an increasingly ageing population, and age itself being an independent risk factor for stroke, the incidence and prevalence of post-stroke seizure and post-stroke epilepsy is likely to increase.

Role of grand rounds in the education of hospital doctors.

The educational role of grand rounds in continuing medical education of junior hospital doctors is unclear. In this article, the authors examine the benefit for junior doctors of attending grand rounds by assessing a groups' knowledge a week before, and 4 days after a grand round. The scores obtained were compared between pre- and post-grand round periods and between grand round attenders (fully or partly) and non-attenders.

Giant cell arteritis presenting as renal vasculitis.

Giant cell arteritis commonly presents with headache, polymyalgia, and visual signs and symptoms. Other neurological, respiratory or vascular symptoms occur in 10-30% of patients. It is extremely rare for giant cell arteritis to present initially with haematuria.

Intimal sarcoma of the right brachiocephalic vein presenting as the superior vena caval syndrome.

A case of an 84 year old man presenting with obstruction of the superior vena cava caused by an intimal sarcoma of the right brachiocephalic vein is reported. The tumour morphology was similar to intimal sarcomas arising in major arteries, a more common primary site, and showed malignant fibrous histiocytoma-like features. Immunohistochemistry was suggestive of myofibroblastic differentiation.

A comparative study of the pharmacokinetics and pharmacodynamics of atenolol, hydrochlorothiazide and amiloride in normal young and elderly subjects and elderly hypertensive patients.

Six normal young and six normal elderly volunteers and six elderly hypertensive patients took part in an acute and chronic dose study of a combination capsule containing atenolol (50 mg), hydrochlorothiazide (25 mg) and amiloride (2.5 mg) designed for the treatment of hypertension. No difference in any of the drug pharmacokinetic parameters could be detected between the hypertensives and the normal elderly subjects.

Urinary tract infection after cystometry.

Eighteen of 67 patients who underwent cystometry for assessment of incontinence had a urinary tract infection 72 hours later. Though four of the 18 had an infection prior to cystometry, the true postcystometry infection was still high at 21%. Clinical details and urodynamic studies on these patients showed no correlation with sex, mobility, mental score, random blood sugar, renal function, initial residual volume of urine, previous pelvic operations or the type of bladder abnormality diagnosed on cystometry.

The problem of bacteriuria with indwelling urethral catheterization.

Bacteriuria following long-term catheterization is more likely to occur in elderly females over the age of 50 years, in patients with some abnormality of the bladder and when traumatic catheterization has taken place. Breaks in the closed system of drainage are the most important factors leading to bladder infections which, once there, are difficult to eradicate. Antiseptics are important at the time of catheterization but have little place afterwards except to reduce cross-infection and growth in the catheter bag.

Cervico-mediastinal lymphangioma.

Two cases of cervico-mediastinal lymphangioma ppesenting in adults are reported. In one the lesion originated in the mediastinum and only when advanced showed extension into the neck. The other was associated with a cervical cystic hygroma.