Browsing by Author "Van der Merwe, P. L."

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    Inappropriate involuntary admissions to psychiatric hospitals
    (Health & Medical Publishing Group, 1999) Van der Merwe, P. L.; Allan, A.; Allan, M. M.
    Background. In order to preserve scarce resources, treatment in tertiary psychiatric hospitals should be restricted to those whose treatment needs make admission to such hospitals essential. However, anecdotal evidence suggests that a number of patients involuntarily admitted to tertiary psychiatric hospitals are discharged within 7 days of admission. The aim of this study was to identify the legal and clinical reasons that contribute to this situation. Method. The first stage involved reviewing the mental health legislation and psycholegal literature. Thereafter we undertook a retrospective study of the records of the patients involuntarily admitted to Stikland Hospitar, a tertiary psychiatric hospital in the Western Cape. Treatment and security-related variables were compared for the ≤ 7 day and ≥ 8 day groups. Results. Eighteen per cent of involuntarily admitted patients were discharged within 7 days. The ≤ 7 day group differed significantly from the ≥ 8 day group in terms of gender, age, substance abuse history, diagnosis and previous admissions. There were more male patients, younger people, and individuals with a history of substance abuse in the ≤ 7 day group, while more patients in the ≥ 8 day group had a diagnosis of schizophrenia or bipolar mood disorder. Conclusions. This study of involuntarily admitted patients in a tertiary psychiatric hospital demonstrated that a small but notable group was discharged within 7 days of admission. The data do not allow us to determine exactly what caused this situation, and further research at primary and secondary level is necessary in order to clarify this.
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    The influence of contrast media on serum osmolality, haematocrit and cardiac output : a comparative study in dogs
    (Health & Medical Publishing Group, 1985) Van der Merwe, P. L.; Basset, A.; Els, D.
    Thirty-two mongrel dogs were used in a comparative study to assess the effect of normal saline solution, metrizamide and Cardioconray on serum osmolality, haematocrit and cardiac output. The study demonstrated that the higher the osmolality of the test substance, the greater the reduction in haematocrit and the higher the increase in cardiac output.
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    Progressive familial heart block: Part II. clinical and ECG confirmation of progression - report on 4 cases
    (Health & Medical Publishing Group, 1986-09) Van der Merwe, P. L.; Weymar, H. W.; Torrington, M.; Brink, A. J.
    ENGLISH ABSTRACT: Two types of progressive familial heart block controlled by a single gene have been described; 4 cases show that type I is progressive and that the pathogenesis is still unknown.
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    Supraventricular tachycardia in children
    (Clinics Cardiv Publishing, 2004-04) Van der Merwe, D. M.; Van der Merwe, P. L.
    The mechanisms causing different supraventricular tachycardias can be identified with the aid of the 12-lead ECG using Tipple’s approach. The main aims of this retrospective study were to use the 12-lead ECG to determine the underlying mechanisms of supraventricular arrhythmias and to evaluate the effectiveness of the treatment modalities used. Forty-one patients were included in the study. The main findings were: nine of the 41 patients had atrial tachycardias while junctional tachycardia occurred in 32/41 of our patients. The underlying mechanisms causing the junctional tachycardias were: AVNRT (n = 21), AVRT (n = 10) and JET (n = 1). Of the 10 patients presenting with AVRT, eight were less than one year old. AVNRT occurred more often in the older age group (>1 year of age). Fifteen of the 41 patients had spontaneous cessation of their supraventricular tachycardia. The drug most commonly used during the acute and long-term phases was digoxin. Amiodarone was used in six patients with an 80% success rate. In the early 80s verapamil was used in five patients with a 100% success rate. It is important to note that verapamil is no longer used in children due to its side effects. Lately, adenosine phosphate is the drug of choice in most supraventricular tachycardias. The management of supraventricular tachycardias in paediatric practice is mainly based on clinical studies and individual experience. Care must therefore be taken to choose medication regimens that are likely to be effective with the minimum risk of potentiating abnormal haemodynamics or conduction.