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Biomedical subjects

P J Henschke

Publications and source records attributed to P J Henschke.

13 recordsLinked to original sources
PubMed1993

Infections in the elderly.

Weakness, falls, incontinence or altered mental states may signal infection in the elderly, while fever may be absent. Bacteria are the most likely cause, and the most common sites are the respiratory system, the urinary tract and the soft tissues. Joint infections and meningitis must be remembered, as must bacterial endocarditis. Herpes zoster may be ameliorated by early treatment with acyclovir. Annual influenza vaccination is recommended, and amantadine may protect against influenza A (not B) during outbreaks. A single pneumococcal vaccination is recommended for those with chronic cardiopulmonary disease or alcoholism or for those who are immunosuppressed. All major hospitals and large nursing homes have committees which can give advice on infection control.

Aged↗
PubMed1991

A randomised study of outcomes in a defined group of acutely ill elderly patients managed in a geriatric assessment unit or a general medical unit.

The aim of this study was to identify differences in the medical management and clinical outcome in a group of elderly patients admitted to a designated geriatric assessment unit (GAU) or to two general medical units (GMUs). A prospective randomised controlled trial was undertaken in 267 patients aged 70 years and over (mean age = 78.3 years). Following discharge from hospital, patients were followed up at three monthly intervals for a total of 12 months. At the time of discharge, no significant differences were found in inpatient management, length of stay, mortality rates, discharge rates to institutional care or utilisation of community services in patients admitted to the GAU and the GMUs. Similarly, no significant differences were found at three, six, nine, and 12 month follow up in case fatality, activities of daily living indices, mental health status, rates of institutional referral and the level of community service support in patients admitted to the GAU and the GMUs studied. These findings do not show any advantage for the unselected 70+ acutely ill elderly patient who is admitted to a designated geriatric assessment unit rather than to a general medical unit. Therefore, an admission policy to GAU, based solely on age 70+ is medically inappropriate and cost-inefficient. Evidence from other sources suggests that an age cohort of acutely admitted patients beyond 80 years may well have returned more optimistic findings for the GAU. In future, GAUs will require a more selective admission policy to maximise the benefits of their rehabilitative and interdisciplinary approach.

Acute Disease↗
PubMed1983

What is the value of a Geriatric Assessment Unit in a teaching hospital? A comparative study of the management of elderly inpatients.

This study at the Flinders Medical Centre, compared the management of 50 elderly patients, admitted acutely ill to the Geriatric Assessment Unit, with the management of 50 elderly patients admitted, under similar circumstances, to other medical units in the Centre. Patients under the care of the Geriatric Unit had a comparable mean length of stay, were on less medication at discharge, and were more likely to return home to their pre-admission accommodation, compared with patients admitted to other medical units. The multidisciplinary approach adopted in such units, coupled with increased utilization of community based services, appears to significantly limit rates of referral to institutional care.

Aged↗
PubMed1981

Diuretics and the institutional elderly: a case against routine potassium prescribing.

In 14 elderly male residents of a veterans' care complex who were receiving diuretic therapy for cardiac failure, oral potassium (K) supplements were withdrawn. Plasma and erythrocyte K levels were measured immediately before and six weeks after withdrawal of the supplements (38 mEq K daily). The controls comprised 19 elderly residents without disease and not taking drugs likely to influence K status. Study subjects and controls were receiving the same diet (average daily K content 100 mEq). After withdrawal of K supplements, the mean plasma K level fell significantly but the mean erythrocyte K level remained unchanged and did not differ from the control values. For a further six weeks after the withdrawal period, 7 subjects were treated with Aldactazide (diuretic hydrochlorothiazide plus K-sparing spironolactone). The plasma K level increased significantly but the erythrocyte K level remained unchanged. It was concluded that, in this setting, diuretic-induced hypokalemia is not necessarily accompanied by intracellular K depletion and that routine prophylaxis with K supplements or K-sparing agents is unnecessary and not without risk. Such therapy should be reserved for patients considered at special risk of K depletion because of known poor dietary intake, advanced liver disease, secondary hyperaldosteronism with renovascular hypertension, gastrointestinal losses, or nondiuretic medication known to affect K status adversely.

Aged↗
PubMed1980

Acute confusional states and dementia in the elderly: the role of dehydration/volume depletion, physical illness and age.

A prospective study was undertaken to investigate the incidence and aetiology of acute confusional states in physically ill old people. The subjects were 71 patients aged 70 years or over who were admitted as emergencies to a general medical unit. Mental testing revealed that: (a) one in six patients had an acute confusional state on admission; and (b) one in four patients had evidence of dementia. The presence of dehydration/volume depletion at the time of admission was estimated by various parameters which were brought together to form a new index called the 'dehydration score'. There was a definite statistical association between high degrees of dehydration/volume depletion and poor mental function. Advanced age, on the other hand, appeared to increase the risk of dehydration/volume depletion only slightly. It was also found that a patient's mental score was a much better guide to prognosis than age. The implications of these findings are discussed.

Acute Disease↗
PubMed1980

Perspective of health in old age.

The elderly are often depicted as a deprived, disabled group of depressed people. A group of 385 elderly subjects drawn at random from those who lived in their own homes in the City of London, Ontario, or in Grey and Bruce Counties in Southwestern Ontario, were studied to assess their degree of disability, consumption of drugs, and need for health care. The method of sampling is described in detail. The proportion of cooperative subjects in the available chosen samples ranged from 80 to 92 percent. The results showed that disability, as assessed by lack of competence in five activities of daily living, ranged from about 6 percent at age 65 to over 35 percent at age 85. Within the previous year, only 15 percent of the subjects had not seen their family physician, and 36 percent had visited the doctor's office three or more times. Those living at home consumed an average of 1.6 drugs per person. In an institutional sample of 100 subjects, 12 percent were fully independent and had no obvious need to be in an institution; their consumption of drugs was more than twice that in the community sample. Old age is not necessarily a disabling period of life. On balance, it can offer more hope and fulfillment than despair.

Activities of Daily Living↗
PubMed1978

Alzheimer's disease and HLA.

Thrity-four unrelated patients with Alzheimer's disease were typed for HLA-A, -B and -C serological determinants. HLA-Cw3 was increased over control antigen frequencies. This difference lost significance when corrected for the number of antigens tested.

Alzheimer Disease↗
PubMed1977

Thyroid disease in a psychogeriatric population.

Over a six-year period, routine biochemical screening for thyroid disease was carried out on 662 patients aged 65 years and older, admitted to the psychogeriatric unit of a major psychiatric hospital. Hypothyroid values were found in 1.2% of the population (8 patients). Hyperthyroid values occurred in 0.76% (5 patients). The thyroid abnormality was considered a significant factor in the psychiatric presentation of only two patients and in both the thyroid disease was clinically apparent. Practical benefits obtained were so disappointing that they did not justify the practice of routine screening in this type of patient.

Age Factors↗