Driving and dementia: a cause for concern.
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Accidents, Traffic↗
Biomedical subjects
P S Lipski
Publications and source records attributed to P S Lipski.
Duodenal brush-border mucosal glucose transport and enzyme activities in aging man and effect of bacterial contamination of the small intestine.
Duodenal biopsies were collected from 38 subjects (24 female and 14 male) ranging in age from 55 to 91 years. Evidence of bacterial contamination of the small bowel (BCSB) was sought at the same time by bacterial culture of duodenal aspirates and by hydrogen and [14C]glycocholic acid breath tests; subjects were considered to be positive for BCSB if any one of the three tests was abnormal. Biopsies were analyzed for six brush-border membrane enzyme activities: maltase, sucrase, lactase, alkaline phosphatase, leucine aminopeptidase, and alpha-glucosidase. Analysis of covariance with age as the covariate indicated no significant effect of age on the specific activities of these enzymes. Mucosal Na(+)-dependent glucose transport was quantified in brush-border membrane vesicles prepared from the biopsies. In all groups, glucose transport at 20-30 sec was greater (ranging from mean values of 2.45 to 3.66 times) than at 45 min, consistent with Na(+)-coupled glucose transport, and no significant effect of age was observed. BCSB had no significant effect on specific activities of any of the duodenal mucosal hydrolases but was associated with reduced (P = 0.05) brush-border glucose transport. None of the variables studied was significantly affected by the gender of subjects. In conclusion, these biochemical data do not support the contention that reduced capacity for carbohydrate absorption in the elderly is explained by reductions in duodenal brush-border mucosal disaccharidase activities or glucose transport.
Aged↗
A study of nutritional deficits of long-stay geriatric patients.
Current information suggests that dietary intake of nutrients declines with age and that undernutrition in elderly long-stay hospital patients may be under-recognized. We undertook to describe the daily dietary intakes of a group of elderly long-stay hospital patients (n = 92) (group A), using 7-day weighed dietary records. The aim of the study was to determine the adequacy of the diet and investigate whether any differences existed in the intakes of the hospital patients. An assessment of nutritional status was carried out by anthropometry, haematology and biochemistry and was validated by comparison with two further groups: fit young subjects (n = 41) (group B) and fit community elderly subjects (n = 92) (group C). Men in group B had the highest mean values for mid-arm circumference, arm-muscle circumference, corrected arm-muscle area and arm-fat area while women in group A had the lowest mean values for all measured anthropometric indices. There were significant correlations between daily energy intake and anthropometry for men in groups B and C. In group A 68% had intakes < 2/3 recommended daily allowance for energy, 100% for vitamin D, E, B6, folic acid; 98% for magnesium and zinc; and 90% for retinol. Serum calcium and serum alkaline phosphatase were correlated with vitamin D intake in men in group A. There was no biochemical or haematological evidence of undernutrition in the three groups. Elderly long-stay hospital patients were grossly undernourished and their dietary intake did not satisfy basal metabolic demands, based on recommended daily allowances.
Adult↗
Bacterial contamination of the small bowel in elderly people: is it necessarily pathological?
Bacterial contamination of the small bowel is probably the commonest cause of occult malabsorption in the elderly. It may occur in patients without a 'blind loop' or suggestive symptoms of diarrhoea and weight loss. We have prospectively studied the apparent prevalence of presumed bacterial contamination of the small bowel and its effect on nutritional state. Subjects were divided into three groups: (A) 54 young fit subjects; (B) 103 fit community elderly subjects; (C) 73 elderly long-stay hospital patients. All subjects had simultaneous lactulose hydrogen breath test and 14C-glycocholic acid breath test. Nutritional state was assessed by anthropometry, haematology and biochemistry. There were significantly fewer positive 14C-glycocholic acid breath tests in the young than in the elderly subjects (3% vs. 20% and 17%, p less than 0.0001) but no difference in the number of positive hydrogen breath tests between groups. There was no association between positive breath tests and anthropometry, haematology and biochemistry except for a lower albumin in group B and a lower red blood cell folate in group C with positive breath tests. These abnormal breath tests indicate that bacterial contamination of the small bowel may be common in normal fit elderly people and in elderly long-stay hospital patients and may be a concomitant of 'normal' ageing, not necessarily leading to ill-health.
Adult↗
Blood ammonia and Helicobacter pylori.
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Ammonia↗
Ageing and duodenal morphometry.
Small bowel morphometry was studied in 25 subjects under the age of 70 years and 22 over the age of 70. There was no evidence of malabsorption or malnutrition in either group. Two distal duodenal endoscopic biopsy specimens were examined morphometrically. There were no significant correlations between age and areas of duodenal surface epithelium, crypts and lamina propria, heights of villi and surface epithelium, depth of crypts, crypt to villus ratio, number of intraepithelial lymphocytes, duodenal architecture, enterocytes, brush border and Brunner glands. Contrary to previous reports there was no evidence for a significant effect of age on proximal small bowel morphometry.
Aged↗
Intravenous cannulas. Survey of their use in patients undergoing elective surgery.
A study of the complications associated with use of intravenous cannulas was conducted in 254 patients undergoing elective surgery at Westmead Centre. Four brands of cannula were studied. Surflo, Jelco, Dwellcath and Abbocath. It was found that the Surflo cannula was the most frequently used at Westmead Centre, that the dorsum of the hand was the site with the least number of complications, and that gauge of cannula had no influence on the rate of complications. Complications were more likely with blood transfusion or addition of potassium or antibiotic agents to the infusion, and the increasing duration of infusion. Abbocath cannulas had fewer complications associated with their use than the other cannulas studied.
Adult↗