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Biomedical subjects

M J Denham

Publications and source records attributed to M J Denham.

At least 37 records · Page 2Linked to original sources
PubMed1980

Perforation of the peptic ulceration in the elderly.

A retrospective survey of elderly patients admitted with perforation of a duodenal ulcer showed that some presented with typical symptoms and signs of a perforation, while others presented as a gastro-intestinal bleed or with confusion or malaise. Diagnosis tended to be delayed in the latter group and mortality was higher. Earlier diagnosis may be helped by taking a chest radiograph or lateral decubitus films of the abdomen with a repeat film in a few hours if the diagnosis is still being considered.

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PubMed1980

A clinico-pathological survey of thyroid glands in old age.

A quarter of the thyroid gland obtained at post-mortem examination from a group of elderly inpatients were nodular. There was a significant preponderance of women with goitre, but no relationship to age. The incidence of hyperthyroidism was increased in patients with nodular glands. There was no correlation between the weight of the thyroid gland, the age of the patient and the free-thyroxine index. Histological examination of macroscopically normal glands showed tiny follicles, microscopic colloid nodules and fibrosis. Nodular glands had the features of long-standing colloid nodular goitre. Focal lymphocytic thyroiditis was observed in a fifth of the glands. Microscopic evidence of altered function was common but could not always be correlated with the results of the thyroid function studies.

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PubMed1979

Beta-thromboglobulin and the diagnosis of thrombosis in elderly patients.

The plasma concentration of beta-thromboglobulin was estimated in elderly in-patients using a radio-immuno-assay technique. There were highly significance differences between the mean values of patients with arterial or venous thrombosis, as compared with controls. The ability of the test to detect thrombosis above the inguinal ligament means that it is a useful addition to the existing battery of tests for detecting thrombosis.

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PubMed1978

Capillary fragility in elderly in-patients.

Capillary fragility has been examined in 110 elderly patients, excluding those patients who might have been expected to have abnormal fragility. Nonetheless, fragility appeared to be greater in elderly patients than in younger subjects. It was much increased in the non-paralysed arm of hemiplegic patients but not in the paralysed arm--perhaps because petechiae were obscured by trophic changes. Capillary fragility was significantly correlated with systolic blood pressure but not with age. This suggests that higher values in elderly patients may be related to the high prevalence of arteriosclerosis rather than to age itself.

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PubMed1977

Thyroid function tests in the elderly in the community.

A study of the well elderly living at home has demonstrated that the ranges for serum thyroxine (T4), triiodothyronine (T3) uptake and free-thyroxine index (FTI) are much narrower than those for the sick elderly in-patient. The prevalence of thyroid disease appears similar in both types of elderly population.

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PubMed1977

The value of blood cultures in geriatric practice.

Forty-nine of 498 (10%) blood cultures taken in a 14-month period in a geriatric department were positive. These cultures were taken from 295 patients. Respiratory infections, recent onset of confusion, non-specific malaise and suspected sub-acute bacterial endocarditis were the most common clinical indications for the test. Twenty-seven of the 49 positive cultures were considered significant, the remainder being regarded as due to skin contaminants. This yield was found to be of clinical value, particularly in chest infection when the responsible organism often could not be cultured from the sputum.

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PubMed1977

Pathological validation of auscultation of the elderly heart.

Systolic murmurs present in 129 geriatric patients followed to post-mortem were assessed as mitral or aortic in origin by simple clinical assessment alone. Post-mortem examination contradicted clinical findings in only 2% of cases. Mitral valve pathology, mostly post-inflammatory scarring or mucoid degeneration, was present in 50% of the cases with murmurs. There was a significant correlation between the presence of murmurs, particularly mitral murmurs, and congestive cardiac failure, and there was also a significant correlation with age. A tendency for aortic systolic murmurs to be associated with a higher mean systolic blood pressure was not significant and there was no significant association between systolic murmurs and ischaemic heart disease.

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PubMed1975

Glomerular filtration rate in sick elderly inpatients.

The glomerular filtration rate was measured in the sick elderly patients using the single shot 51Cr EDTA method. As would be expected, such patients have worse renal function than the fit elderly. The filtration rate can be usefully predicted from either blood urea or serum creatinine, but a superior prediction is obtained when these factors are combined using a formula derived from multiple regression analysis.

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PubMed1975

Unilateral clubbing in hemiplegia.

A study of clubbing, assessed by spherometer measurements of fingernail-skinfold angle, was made in recent and long-established hemiplegic elderly patients. This showed that clubbing developed in all digits studied and that it increased with the duration of the stroke. Clubbing did not correlate with the grip strength of the weakened hand.

Adult↗
PubMed1974

Hyperthyroidism induced by potassium iodide given in the course of 125I-fibrinogen test.

Hyperthyroidism developed in three patients during the administration of potassium iodide given for the purpose of blocking the thyroid uptake of radioactive iodine liberated in the course of the 125I-fibrinogen test. In a consecutive series of 31 geriatric patients, who received potassium iodide for the same reason, biochemical hyperthyroidism developed in three instances and significant depression of thyroid function was observed in 10. The performance and the interpretation of the 125I-fibrinogen test are unaffected if iodide is not administered to the patient. The possible hazards to some patients of either induced hyperthyroidism or faulty assessment of thyroid function may be greater than the risk of thyroid irradiation. It is suggested that for the performance of the 125I-fibrinogen test potassium iodide need not be given to the elderly and should be given in a dose of 30 mg daily for two weeks to younger patients. Under certain circumstances potassium perchlorate may be a preferable drug for preventing the accumulation of radioactive iodine by the thyroid.

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