PubMed Health⌕ Search

Biomedical subjects

P C Gautam

Publications and source records attributed to P C Gautam.

8 recordsLinked to original sources
PubMed1993

Guillain-Barré syndrome in the elderly. A retrospective comparative study.

There have been no reported studies specifically devoted to the Guillain-Barré syndrome in elderly patients. The survey reported in this paper investigated the manifestations of the disease in older patients and compared them with those seen in younger patients. All adult patients with an established diagnosis of Guillain-Barré syndrome admitted over 9 years to a Regional Referral Centre providing services for a population of 543,213 were identified and studied. Fifteen patients were over the age of 60 years and 21 between 19 and 60 years of age. Antecedent illnesses and, in particular, gastro-intestinal symptoms were reported less frequently in older patients. Where there was an antecedent illness, this was of shorter duration in elderly subjects. Neurological symptoms related to peripheral nerve damage, such as paraesthesiae, myalgia, backache and an inability to stand, occurred with a similar frequency in both age groups. Double vision and facial weakness, however, occurred less often in older patients, and cerebellar features were not encountered in the older age group. The cerebrospinal fluid immunoglobulin abnormality was more marked in the elderly. The interval between onset and peak severity was shorter in elderly patients. The duration of hospital stay was significantly greater in the elderly, though the overall prognosis was similar in both age groups. There was only one death in each group. The incidence of the Guillain-Barré syndrome in the elderly was higher than in subjects aged 19-60 years, but this difference was not significant.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

Hypothermia in the elderly: management in a purpose-built chamber.

Results of treatment of 86 hypothermic elderly patients in a purpose-built chamber are presented. They were barrier-nursed, continuously monitored and treated by slow active rewarming by warm air. The early 24-hour mortality did not significantly differ from other published reports. The complications of 'rewarming shock' and 'after drop' were prevented. It is concluded that a specially built hypothermia room facilitates management of hypothermic elderly patients and is recommended in all geriatric departments.

Aged↗
PubMed1987

Upper gastrointestinal haemorrhage in the elderly: a record of 92 patients in a joint geriatric/surgical unit.

Ninety-two consecutive elderly patients suffering from acute gastrointestinal bleeding were studied over a 3-year period. All were admitted to a specially designated Geriatric/Surgical Ward under the care of consultant physicians in geriatric medicine. The nurses were trained to look after acute surgical and geriatric patients. Patients were aged between 65 and 93 years. All were managed jointly by the surgeons and physicians. Only 13 needed emergency surgery which was preceded by urgent endoscopy. The rest were managed conservatively with intravenous cimetidine and blood transfusions as required. The overall mortality was low at 5.4%. It is concluded that in a series of elderly patients with acute gastrointestinal bleeding the mortality was not high in a unit where the management was conservative and there was joint care between geriatricians and surgeons.

Aged↗
PubMed1987

Pharmacokinetics of lisinopril (MK521) in healthy young and elderly subjects and in elderly patients with cardiac failure.

The pharmacokinetics of lisinopril were determined in 6 healthy young, 6 healthy elderly and 6 elderly patients with cardiac failure. Lisinopril (5 mg day-1) was administered for 7 days. Plasma lisinopril concentration was measured at 1, 2, 4, 6, 8 and 24 h on days 1 and 7 of the study. The two elderly groups had higher serum lisinopril concentrations than the healthy young subjects (P less than 0.05). There were no significant differences in any of the areas under the curve (AUC) for lisinopril plasma concentration (over time) between the healthy young and healthy elderly groups. The healthy young patients had AUC values on day 7 lower than elderly patients with cardiac failure (P less than 0.01). Creatinine clearance was correlated with lisinopril clearance (r = 0.63; P = 0.006) and with AUC on day 7 (r = -0.67; P = 0.004). Lisinopril clearance was different in the three groups (P less than 0.05): healthy young patients had the highest and elderly patients with cardiac failure the lowest values. Thus, in the elderly a reduced renal clearance of lisinopril leads to higher and more sustained blood levels. In elderly patients with cardiac failure, renal function should be estimated before lisinopril is prescribed as a reduction in dose may be appropriate.

Adult↗
PubMed1986

The electrophysiological effects of intravenous xamoterol in man.

The electrophysiological effects of xamoterol were studied in ten patients with suspected coronary artery disease by intracardiac electrography. Sino-atrial and atrioventricular conduction times were both slightly shortened by 0.1 mg/kg of xamoterol. The atrioventricular nodal refractory periods were shortened without consistent change in atrial refractoriness. This dose raised mean blood pressure by only 3 mmHg and resting heart rate by only 4 beats/min. The effects suggest a beta 1 agonist activity closer to that of prenalterol than that of pindolol under conditions of rest.

Adrenergic beta-Agonists↗
PubMed1986

Preoperative clinical predictors of long term survival in mitral stenosis: analysis of 200 cases followed for up to 27 years after closed mitral valvotomy.

Two hundred patients aged 17-40 years undergoing closed mitral valvotomy during 1955-60 were studied by actuarial survival analysis. The period of follow up was 22-27 years. The following preoperative features were found to be independent predictors of long term survival: sinus rhythm (p less than 0.05); pulmonary arterial pressure below systemic pressure (p less than 0.01); absence of congestive cardiac failure (p less than 0.01) and pure mitral stenosis (p less than 0.01). A better long term survival was found for mitral valvotomy with a Tubb's dilator than finger splitting or Brock's method. The presence of calcification at the time of valvotomy adversely affected survival (p less than 0.01). Anticoagulation improved survival (p less than 0.01). It is concluded that closed mitral valvotomy gives good results if performed before the onset of established atrial fibrillation and congestive cardiac failure and that all patients should have anticoagulation. These results have important implications for selection of patients in countries with limited facilities for open heart surgery.

Adolescent↗
PubMed1984

Antibiotic prophylaxis for pacemaker implantation: a prospective randomized trial.

Prophylactic antibiotics are frequently prescribed for patients undergoing permanent pacemaker implantation even though data confirming their effectiveness are limited. Five hundred patients requiring elective permanent pacemaker implantation or generator replacement were prospectively randomized either to receive or not receive prophylactic antibiotic treatment at the time of implantation. The implantation site was treated with 10% povidone-iodine solution and 0.5% alcoholic chlorhexidine preoperatively. The wound were inspected for evidence of infection at 3 days and 1, 3, 6 and 12 months postimplantation. Three patients (two receiving prophylactic antibiotics and one no antibiotics) developed pacemaker pocket infection; Staphylococcus aureus was the pathogenic organism in each case (P = 0.56). Eighteen patients developed clinical evidence of superficial wound inflammation requiring antibiotic treatment but not pacemaker removal. Six had received prophylactic antibiotics and 12 had not (P = 0.27). We conclude that pacemaker pocket infection is unusual with careful preoperative skin preparation and close postoperative follow-up. Under these circumstances prophylactic antibiotic treatment is of no practical value.

Adult↗