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Biomedical subjects

C Patterson

Publications and source records attributed to C Patterson.

At least 37 records · Page 2Linked to original sources

Disseminated Mycobacterium bovis infection in an elderly patient.

We report a fatal case of disseminated infection due to Mycobacterium bovis occurring in an elderly patient. The greatest incidence of tuberculosis is in the aged, who were likely to have been infected in childhood when the disease was more prevalent. However, the clinical or radiographic presentation of tuberculosis in the older patient may be atypical or nonspecific, contributing to delay in diagnosis, and greater morbidity and mortality.

Aged

Iatrogenic disease in late life.

Iatrogenic diseases are common in the elderly, particularly in the hospitalized patient. Adverse outcomes may be induced by poor communication with patients, inadequate history and examination, and inappropriate use of diagnostic resources. However, even when resources are used appropriately, adverse outcomes do occur, hence the price paid for sophisticated medical and surgical techniques. Medications offer a great potential for adverse reactions, and careful prescribing and knowledge of the pharmacokinetic changes that occur with aging, particularly impaired renal excretion of drugs, together with the use of the minimum number of drugs and maneuvers to improve compliance, can reduce this risk. Complications of surgery should be anticipated and promptly recognized and managed.

Aged

Left ventricular diastolic function in a population of healthy elderly subjects. An echocardiographic study.

Diastolic left ventricular function was comparatively assessed in 19 healthy elderly individuals (mean age 71 years) and in 20 young normal subjects (mean age 26 years), using digitized echocardiograms. Peak and average filling rates were slower in the group of elderly subjects than in the younger population (128 +/- 26 and 75 +/- 11 v 182 +/- 37 and 92 +/- 17 mm per second, respectively, P less than .001). The duration of the rapid filling phase and the time to peak filling rate were significantly longer in the older than in the younger population (207 +/- 39 and 125 +/- 21 v 174 +/- 38 and 90 +/- 26 ms, respectively, P less than .01). The atrial contribution to total ventricular filling was 18 +/- 6% in the elderly and 10 +/- 3% in the young (P less than .001). The group differences of most of these measurements of diastolic function retained statistical significance after correction for heart rate. Measurements of left ventricular systolic function were similar in both age groups. The authors conclude that aging is associated with a decline of left ventricular compliance, unrelated to heart rate or systolic performance. The contribution of atrial contraction to ventricular filling is quantitatively larger in elderly individuals.

Adult

Assessment of iron stores in anemic geriatric patients.

Of patients referred to a geriatric service, 66 were identified who were clearly anemic (hemoglobin less than 12 g in men, less than 11 g in women) but whose cause of anemia was not readily identifiable by noninvasive measures. The difficulty in distinguishing iron deficiency from chronic disease as a cause of anemia by noninvasive means (serum iron, total iron binding capacity, transferrin saturation ratio, and serum ferritin), is highlighted by the poor power of these investigations when compared with bone marrow iron stores. A transferrin saturation ratio of less than 11% and a serum ferritin of less than 45 pg/L serve better than currently accepted values to identify iron deficiency in this population.

Aged

A new dwarfing syndrome with extreme shortening of humeri and severe coxa vara.

A previously undescribed form of short-limbed dwarfism is reported in an 86-year-old man. All the long bones were shorter than normal, with extreme shortening of the humeri. Other features included dysplastic humeral heads, coxa vara with dysplasia of the femoral heads and acetabula, platybasia, and small vertebral bodies. In all other respects, including intelligence, the patient was normal for his age.

Aged

Calceus mellitus.

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Diabetes Mellitus