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Biomedical subjects

A N Exton-Smith

Publications and source records attributed to A N Exton-Smith.

At least 19 recordsLinked to original sources
PubMed1979

Glucose tolerance, plasma insulin levels and insulin sensitivity in elderly patients.

The oral glucose tolerance test (OGTT) and the intravenous glucose tolerance test (ivGTT) were carried out in 23 elderly patients (mean age 79 years) and in 14 healthy young adults (mean age 28 years). The ivGTT was followed immediately by a second injection of glucose, this time with insulin added. The percentage rate constants for the disappearance of glucose alone (KG, % min-1) or with added insulin (KG+I, % min-1) were calculated. Seventeen of the elderly patients had a blood glucose value at 120 min in the OGTT greater than or equal to 7.7 mmol/1 (140 mg/100 ml) or had KG less than or equal to 1% min-1 and 13 were 'diabetic' by both criteria. This was associated with a sluggish pattern of insulin release and with diminished insulin sensitivity (KG+I). Since these changes could reflect impaired inhibition of hepatic glucose output, a preliminary attempt was made to assess gluconeogenic capacity. After the injection of substrate levels of L-alanine, plasma levels of glucose and alanine both rose but fell more slowly in the elderly than in young adults, suggesting impaired transmembrane transport of both substances in old people. After injection of alanine, plasma insulin rose to a lesser extent and glucagon to a greater extent in the elderly than in young adults.

Adult↗
PubMed1979

Osteomalacia.

Explore the source record for details and available documents.

Aged↗
PubMed1978

Fracture of the femur in old age: A two-centre study of associated clinical factors and the cause of the fall.

All patients with fractured neck of the femur admitted to hospitals in two areas (North London and Manchester) in a period of one year have been examined--a total of 384 patients. Compared to control groups of similar age, the older fracture patients showed a higher prevalence of chronic brain syndrome, they were in poorer physical state and their skinfold thickness was less. They also had more unrecognized visual disorders. Those who were younger had a higher prevalence of stroke than comparable controls. The type of fall leading to the fracture varied with age--tripping was the commonest cause in the younger patients the 'drop attacks' in the older. Both stroke and partial sightedness were associated with falls due to loss of balance. The older patients had a very high prevalence of pyramidal tract abnormality associated with chronic brain syndrome--and it appears that these demented patients fall not because of mental confusion but because of associated motor abnormalities. Extra-capsular fractures occur in older patients. They are more likely to have a history of falls but previous fracture is equally common at this age in the fracture and control series.

Accidents↗
PubMed1977

Accidental hypothermia and impaired temperature homoeostasis in the elderly.

A longitudinal study of the age-related decline in thermoregulatory capacity was made in 47 elderly people to try to identify those at risk from spontaneous hypothermia. During the winters of 1971-2 and 1975-6 environmental and body temperature profiles were obtained in the home, and thermoregulatory function was investigated by cooling and warming tests. Environmental temperature and socioeconomic conditions had not changed but the body core-shell temperature gradients were smaller in 1976, indicating progressive thermoregulatory impairment. People at risk of developing hypothermia also seem to have low resting peripheral blood flows, a nonconstrictor pattern of vasomotor response to cold, and a higher incidence of orthostatic hypotension.

Aged↗
PubMed1977

Falls in the elderly related to postural imbalance.

Two hundred and forty-three elderly people aged 60 to 96 years were questioned about their falls, and their sway was measured. For comparison sway was also measured in 63 younger subjects. Sway increased with age and was higher in women at all ages. There was no difference in sway between those with no history of falls and those who fell only because of tripping. In both sexes sway was significantly increases in people who fell because of loss of balance and in women whose falls were due to giddiness, drop attacks, turning the head, and rising from bed or a chair. This suggests that there is a physiological decline in postural control with advancing age and also a decline due to disease of the central nervous system.

Accidents, Home↗