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Biomedical subjects

H S Markus

Publications and source records attributed to H S Markus.

99 records · Page 6Linked to original sources
PubMed1989

Haematogenous osteomyelitis in the adult: a clinical and epidemiological study.

Isolated reports suggest that haematogenous osteomyelitis in the adult may be presenting to the physician with increasing frequency. The disease continues to cause diagnostic difficulties. Results of a retrospective study of 26 cases over an eight-year period support previous suggestions that a second peak in incidence occurs in the elderly; they are consistent with an increasing incidence although the small numbers make firm conclusions on incidence impossible. The time from onset of symptoms to presentation is often prolonged and diagnostic delay may occur. Those clinical and laboratory features most useful in diagnosis are discussed.

Adult↗
PubMed1989

Diagnostic investigations in the elderly: the clinical usefulness of serum iron and transferrin measurements in the diagnosis of iron deficiency anaemia. An audit.

Many biochemical tests evaluated in young adults are widely used in the elderly without further evaluation. This study, designed to assess the clinical use of transferrin and transferrin saturation in the diagnosis of iron deficiency anaemia in the elderly, illustrates how these tests have a lower specificity in this age group, limiting their clinical use. Reasons for the altered results are discussed. If resources are to be used effectively, the usefulness of many investigations in the elderly needs to be examined and suitable age-adjusted reference ranges produced.

Aged↗
PubMedDate not supplied

Symptomatic haemodynamically significant carotid occlusion treated by posterior circulation revascularization.

Haemodynamic cerebral ischaemic symptoms secondary to occlusive atheromatous disease of the internal carotid artery may resolve with revascularization. We describe a case of symptomatic internal carotid artery occlusion and ipsilateral subclavian stenosis with duplex and angiographically demonstrated vertebrobasilar steal and a patent ipsilateral posterior communicating artery with flow towards the steal. The patient suffered frequent ipsilateral middle cerebral artery territory transient ischaemic attacks and one minor stroke. Transcranial Doppler demonstrated markedly impaired ipsilateral carbon dioxide reactivity (13.8%, lower-limit normal range >32.6%). Percutaneous angioplasty to the subclavian artery stenosis resulted in resolution of symptoms and an improvement in reactivity to near the lower limit of the normal range (33.5%). This case demonstrates that normalization of vertebral artery steal by subclavian artery revascularization may benefit anterior circulation haemodynamic symptoms in the presence of a functioning posterior communicating artery. The measurement of middle cerebral artery reactivity using transcranial Doppler can identify such cases of haemodynamic impairment and monitor the effect of therapy.

Angiography↗
PubMedDate not supplied

Positional vertebrobasilar transient ischaemic attacks treated with vertebral angioplasty.

We report the case of a man presenting with a brain-stem stroke from which he recovered fully, who developed right-sided weakness and numbness on walking despite no demonstrable postural fall in arterial blood pressure. Angiography revealed an occluded left vertebral artery, a tight stenosis at the origin of the right vertebral artery and non-patent left posterior communicating artery. Percutaneous transluminal angioplasty to the right vertebral stenosis results in a good angiographic result, and remission of symptoms which has persisted for 1 year. Identification of such patients with vertebrobasilar positional haemodynamic symptoms due to a focal stenosis is important as angioplasty offers an effective therapeutic option.

Angiography, Digital Subtraction↗