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Biomedical subjects

J B Walsh

Publications and source records attributed to J B Walsh.

At least 73 records · Page 4Linked to original sources
PubMed1992

Mortality and morbidity in patients with central retinal vein occlusion.

We investigated the risk of mortality and morbidity in 78 patients with central retinal vein occlusion (CRVO) followed for more than 2 years (mean follow-up 7.2 years). Thirteen subjects died at an average of 7.0 years after CRVO. Five subjects developed myocardial infarction at an average of 2.8 years after CRVO, and 1 developed a cerebrovascular accident 3 years after CRVO. Patients with CRVO do not carry a higher risk of mortality and morbidity than matched controls derived from national surveys.

Adult↗
PubMed1992

Idiopathic preretinal macular gliosis: a retrospective study of 200 patients.

The charts of the last 200 patients with idiopathic preretinal macular gliosis (IPRMG) seen in the Retina Service of Montefiore Medical Center, Albert Einstein College of Medicine, were reviewed. We found that IPRMG is a disease of older people, tends to have a nonprogressive course, and rarely causes severe visual loss. In our series, 91.5% of the patients were older than 50 years of age, 80% of eyes lost less than two lines of vision, and only 4% of eyes had a visual acuity 20/200.

Adult↗
PubMed1991

Prospective hospital study of community acquired lower respiratory tract infection in the elderly.

A prospective study of community acquired lower respiratory tract infection in the elderly was carried out over a 15-month period. During this time 127 consecutive admissions to two acute geriatric medical wards were studied. An aetiology was established in 77 (61%) of cases. Streptococcus pneumoniae was identified in 37% of patients. Haemophilus influenzae in 18% and Branhamella catarrhalis in 10%. Infection with Mycoplasma pneumoniae was found in only one episode and no cases of Legionella pneumophilia were diagnosed. A significant number of patients had multiple bacterial pathogens isolated: 18% of all bacterial pathogens isolated were ampicillin resistant. Fourteen patients died (11%). Lower respiratory tract infection is a frequent cause of hospital admission for those aged over 65 and is often regarded as a preterminal event. Adequately treated however, mortality is no higher than in the general population. Knowledge of the likely pathogens allows early and appropriate antibiotic therapy for these patients whether at home or on admission to hospital.

Aged↗
PubMed1991

Caring for dementia sufferers in the community: the caregivers problems.

Twenty-four carers of dementia sufferers were screened for psychological well being and compared with 19 carers of non-demented elderly. Carers of demented relatives showed significantly raised levels of stress on the Relatives' Stress Scale (RSS), and also increased psychiatric morbidity on the 30 item General Health Questionnaire (GHQ-30), when compared with the carers on non-demented relatives. Scores in the behaviour and mood disturbance scale (BMD) were significantly raised in the dementia group of patients, when compared with the non-demented group. However, high scores on the behaviour and mood disturbance Scale for the dementia sufferer were not correlated with increased stress and psychiatric morbidity scores found in the relatives of the patients with dementia. The implications of these findings are discussed.

Aged↗
PubMed1990

Inconsistencies in standard approximations for selection coefficients at loci affecting a polygenic character.

Inconsistencies exist in the standard expansions used to approximate selection coefficients for alleles at a locus underlying a quantitative character. Allelic (marginal) fitnesses obtained from expansions based on average excesses differ from allelic fitnesses obtained from expansions based on genotypic values. Similarly, W, the mean population fitness based on summing over either allelic or genotypic fitnesses usually differs mean population fitness obtained by averaging over the unrestricted phenotypic distribution. A consistent value of W requires no variation in genotypic values. If, as suggested by Nagylaki (1984), expansions are corrected for the decrease in phenotypic variance resulting from conditioning on the presence of a particular allele or genotype, inconsistencies still exist. Unless integral of W(z)[Vzp"(z) + zp'(z) + p(z)] dz = 0, where p(z) is the phenotypic probability density function, Vz the phenotypic variance, W(z) the fitness of phenotypic value z, the primes denote differentiation with respect to z, allelic fitnesses based on average effects differ from allelic fitnesses based on genotypic values. This condition must also be satisfied in order for either expansion to give a consistent W, as first shown by Nagylaki. For arbitrary W(z), this is satisfied if and only if phenotypes are normally distributed.

Alleles↗
PubMed1990

Elder abuse.

Elder abuse is an under-recognised cause of morbidity in the elderly. The frail elderly with multiple physical and psychiatric problems living with a relative who may also have a physical or psychiatric problem are particularly at risk. Although increased awareness of the problem and a high index of suspicion are necessary factors to diagnose the condition, clinical pointers towards diagnosis are available. Treatment for both victim and "carer" should be on the basis of multi-disciplinary assessment, and may result in admission of the elderly patient to an extended-care facility.

Aged↗
PubMed1990

Optic disc size in central retinal vein occlusion.

Predisposing factors in central retinal vein occlusion (CRVO) have included various systemic disorders and glaucoma. Recent reports have suggested a possible relation between specific anatomic configurations of the optic nerve head and the development of anterior ischemic optic neuropathy. The authors analyzed several optic disc parameters in 57 ocular normotensive patients with unilateral CRVO and in 27 control subjects. There was no significant difference in the horizontal disc diameter and cup-to-disc ratio between eyes with unilateral CRVO, fellow eyes with CRVO, and control eyes. The current data suggest that there is no relation between optic disc size and CRVO.

Fundus Oculi↗
PubMed1990

The effect of mild to moderate dementia on the Geriatric Depression Scale and on the General Health Questionnaire.

The Geriatric Depression Scale (GDS) and two versions of the General Health Questionnaire (GHQ 28 and corrected GHQ 28) were administered to 111 patients admitted to an acute geriatric medical unit. Depression and dementia were diagnosed by semi-structured interview using DSM III criteria. There was no statistically significant difference in the three scales between cognitively normal depressed patients and demented depressed patients. The three scales were sensitive indicators of depressive illness (greater than 90%), but the GHQ 28 and CGHQ 28 needed adjustment of their community-based threshold values.

Aged↗
PubMed1989

Do subjects with stiff arteries have high blood pressure?

It has been argued that age-related increases in arterial stiffness could lead to spuriously high indirect blood pressure measurements, with consequent overdiagnosis of hypertension in older patients. To study the relationship between arterial stiffness and blood pressure, we identified patients with 'arterial stiffness', using Osler's manoeuvre, and compared their blood pressure levels with patients of a similar age. A total of 250 hospital inpatients were assessed independently by two doctors. In the 198 patients (79%) where both observers agreed on Osler's manoeuvre status, positive Osler's manoeuvre was uncommon under the age of 50 years but became more common thereafter, rising to 58% of patients aged over 75 years. However, blood pressure levels were similar in each age group, irrespective of Osler's manoeuvre status. We conclude that increased arterial stiffness as measured by Osler's manoeuvre is not necessarily associated with raised blood pressure levels in the elderly.

Adolescent↗
PubMed1989

Effect of age on adherence of Branhamella catarrhalis to buccal epithelial cells.

The role of adherence in the pathogenicity of Branhamella catarrhalis in lower respiratory tract infection in the elderly was investigated. Differential adherence of this organism to buccal epithelial cells of elderly inpatients, outpatients, and young controls was measured. The mean number of bacteria adherent per cell was 36.9 +/- 11.2, 40.2 +/- 6.1 and 16.5 +/- 12.8 for inpatient and outpatient elderly and young controls respectively (significantly different p less than 0.01, Student's t test). This significantly higher level of adherence in the elderly subjects suggests that increased adherence may contribute to the incidence of respiratory tract infection due to B. catarrhalis seen in this group.

Adult↗
PubMed1989

Serum hypomagnesaemia in an elderly day-hospital population.

Serum magnesium concentration was measured in 223 elderly patients attending a day-hospital. Patients with medical conditions or receiving medication (other than digoxin/diuretics) which could affect magnesium levels were strictly excluded from the study. All patients were living in the community and were medically stable. Ninety-five patients were on no therapy whilst 107 were on diuretic therapy. In spite of strict exclusion criteria, 10.3% of patients on no therapy had serum magnesium levels below normal. There were 61 patients receiving a combination of frusemide and amiloride and 11.9% of these patients had below normal levels of serum magnesium. We conclude that there is a significant prevalence of unexpected hypomagnesaemia among Dublin inner city day hospital elderly patients. Significant serum hypomagnesaemia may still occur in patients on potassium/magnesium sparing diuretics.

Aged↗
PubMed1989

A double-blind evaluation of captopril in elderly hypertensives.

To establish the role of angiotensin converting enzyme inhibitors in the management of hypertension in the elderly, 16 patients were treated with captopril in a randomized double-blind placebo-controlled cross-over study. Clinic blood pressure, ambulatory blood pressure, renal function and mental performance, with emphasis on mood and psychological well-being, were assessed. Twelve patients, aged 73 (+/- 4.4) years, completed the study. The doses of captopril used were 50 mg (11 patients) and 25 mg (one patient) twice daily for 4 weeks. Mean (+/- s.e.m.) clinic sitting blood pressure during captopril therapy was significantly lower than during administration of placebo (172 +/- 4.5/83 +/- 25 versus 188 +/- 4.4/89 +/- 3.4 mmHg; P less than 0.001/P less than 0.05). Mean ambulatory blood pressure was also significantly lower on captopril treatment than during administration of placebo (166 +/- 5.3/87 +/- 1.6 versus 179 +/- 5.1/94 +/- 2.4 mmHg; P less than 0.02/P less than 0.02) and this effect was sustained over the dosing interval. Renal blood flow and mental performance were unaltered by treatment. Gastrointestinal discomfort occurred in two patients, one of whom was withdrawn and cough developed in one patient. We conclude that captopril is effective as monotherapy in lowering blood pressure in the elderly.

Aged↗