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Biomedical subjects

P W Belfield

Publications and source records attributed to P W Belfield.

17 recordsLinked to original sources
PubMed1992

Reduced erythropoietin response to anaemia in elderly patients with normocytic anaemia.

We studied the effect of age on the relationship between haemoglobin and serum erythropoietin (EPO) levels in anaemic patients. 568 patients over 70 years of age were compared with 137 patients under 70 and a reference group of 144 patients of all ages with proven iron deficiency. EPO was measured using a radioimmunoassay. We found that elderly patients with a normocytic anaemia (N = 375) had a statistically lower EPO response than younger patients with normocytic anaemia (N = 61) (p < 0.05) or patients of all ages with iron-deficiency anaemia (p < 0.05). There was no difference between the sexes. Elderly patients with microcytic or macrocytic anaemia had a normal EPO response as compared to the "gold standard" of iron deficiency. These findings suggest that a proportion of elderly patients with normocytic anaemia has an impaired EPO response.

Adolescent↗
PubMed1991

The effect of dietary supplementation with vitamins A, C and E on cell-mediated immune function in elderly long-stay patients: a randomized controlled trial.

Thirty elderly long-stay patients were randomly allocated to receive either placebo or dietary supplementation with vitamins A, C and E for 28 days. Nutritional status and cell-mediated immune function were assessed before and after the period of supplementation. Following vitamin supplementation, cell-mediated immune function improved as indicated by a significant increase in the absolute number of T cells (p less than 0.05), T4 subsets (p less than 0.05), T4 to T8 ratio (p less than 0.01) and the proliferation of lymphocytes in response to phytohaemagglutinin (p less than 0.01). In contrast, no significant changes were noted in the immune function of the placebo group. We conclude that supplementation with the dietary antioxidants vitamins A, C and E can improve aspects of cell-mediated immune function in elderly long-stay patients.

Aged↗
PubMed1991

Pulmonary embolism: a cause of acute confusion in the elderly.

Large numbers of elderly patients are admitted to hospital with an acute confusional state. In many of these, the underlying cause is easily found, but in a proportion, correct diagnosis is very difficult. Two cases of acute confusion due to hypoxia are presented, in which the diagnosis of pulmonary embolic disease was made late. The importance of considering this in all patients presenting with acute confusion and the value of blood gas analysis is discussed.

Acute Disease↗
PubMed1989

Purple urine bags.

Purple urine drainage bags were found in 7 of 71 chronically catheterized elderly women. The purple staining of the bags is due to a violet discoloration (indirubin) of the plastic of the catheter bag and fine blue crystals of indigo in the urine. The colors are formed from the substrate indoxyl sulfate (indican) and all 7 patients had bacteria in the urine that would produce blue colonies on agar enriched with the urine (filter sterilized) of the patients involved. Organisms identified were Providencia or Klebsiella species. Indican excretion was higher in patients with purple urinary catheter bags than in controls.

Aged↗
PubMed1987

Deliberate falls in the elderly.

Two cases of deliberate falls in hospitalized elderly patients are reported. The falls were multiple and were the only form of self-destruction available to two disabled people. Deliberate falls are probably uncommon but should be considered in those who fall repeatedly.

Aged↗
PubMed1987

Pituitary function tests in the elderly: are hypothalamic releasing factors the investigation of choice?

The use of the new hypothalamic releasing factors corticotrophin releasing factor (CRF) and growth hormone releasing factor (GHRH) has been proposed as a potential replacement for the insulin stress test in the investigation of pituitary function. The response to the injection of 100 micrograms of each compound was studied in nine elderly in-patient subjects. In response to GHRH, only four subjects demonstrated a rise in growth hormone; in response to CRF, only one subject showed a rise in cortisol. In the patients studied the combined GHRH and CRF test did not cause any cortisol or GH response in the majority.

Aged↗
PubMed1986

Platelet activation during exercise induced asthma: effect of prophylaxis with cromoglycate and salbutamol.

Peak expiratory flow (PEF) and plasma concentrations of platelet factor 4 and beta thromboglobulin were measured before and after exercise in nine asthmatic patients and 12 non-asthmatic volunteers. Exercise was preceded by administration in random order of either placebo, salbutamol 200 micrograms, or sodium cromoglycate 2 mg from a pressurised inhaler. In control subjects there were minimal changes in PEF and plasma concentrations of platelet factor 4 and beta thromboglobulin. In the asthmatic patients the typical changes in PEF were seen on exercise; plasma concentrations of platelet factor 4 and beta thromboglobulin rose significantly in parallel, the rise preceding the fall in PEF. The changes in peak flow and platelet activation induced by exercise were attenuated by prior administration of salbutamol or cromoglycate. These results indicate that exercise induced asthma is associated with a rise in platelet release products similar to that observed in antigen induced asthma.

Adult↗
PubMed1986

Postal survey of bronchoscopic practice by physicians in the United Kingdom.

In 1983 a postal survey of the bronchoscopic practice of chest physicians in the United Kingdom produced a 90% response rate. Two hundred and thirty one physicians were carrying out bronchoscopy; they had performed about 40 000 bronchoscopies in the preceding year, 87% of these being fibreoptic procedures with topical anaesthesia. The mortality rate of fibreoptic bronchoscopy was 0.04%, with a 0.12% incidence of major complications. Transbronchial biopsy carried both an appreciably higher mortality rate of 0.12% and a major complication rate of 2.7%. There is wide variation in the use and choice of sedative drugs for fibreoptic bronchoscopy. Many of the drug combinations could be criticised on pharmacological grounds. The mean dose of lignocaine was 342 mg, most operators exceeding the usual maximum recommended dose; but adverse reactions were rare. Routine supplemental oxygen was given by only 18% of bronchoscopists. Basic resuscitation equipment was often inadequate. Radiological screening was used for transbronchial lung biopsy by 53% of respondents and significantly reduced the incidence of pneumothorax from 2.9% to 1.8%. Both the number of bronchoscopies performed and the complication rate were higher than previous estimates. Bronchoscopists should re-examine their policy on drugs and safety precautions to minimise the risks of the procedure.

Anesthesia↗
PubMed1984

Recent experience of tuberculosis in junior hospital doctors in Leeds and Bradford.

Over a 2-year period, six cases of active tuberculosis were seen in doctors in two adjacent northern cities. Five patients were junior hospital doctors and three were in close contact with children. Pre-employment screening in four doctors did not take place. Despite screening, two subsequently developed active disease. The advisability and difficulties of screening junior hospital doctors are discussed.

Adult↗
PubMed1981

Influence of sympatholytic drugs on the cardiovascular response to isometric exercise.

1. The effects of single oral doses of various sympatholytic drugs on the heart rate and blood pressure increases during isometric handgrip contraction were studied in six healthy subjects. 2. Bethanidine reduced both the systolic and diastolic increases in pressure. Clonidine reduced the systolic but not the diastolic increase. Oxprenolol alone or in combination with phentolamine or phenyoxybenzamine failed to influence the pressor response. 3. The increase in systemic blood pressure associated with sustained contraction of voluntary muscle appears to be relatively resistant to acute sympathetic adrenoreceptor blockade in man.

Adult↗