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Biomedical subjects

S G Scholer

Publications and source records attributed to S G Scholer.

6 recordsLinked to original sources
PubMed1992

Altered epithelial lining fluid parameters in old normal individuals.

Pneumonia is a leading cause of morbidity and death in older patients, and immunosenescence is believed to contribute to their susceptibility. In order to investigate whether age-related changes occur on the epithelial surfaces of the lung, bronchoscopy and bronchoalveolar lavage (BAL) were performed without complication in 19 young (27.7 +/- 4.2 yrs), 6 middle-aged (49.8 +/- 3.5 yrs), and 8 old (74.1 +/- 4.3 yrs) normal, nonsmoking subjects. BAL was performed by instilling and retrieving five 20 ml aliquots of normal saline into three sites. The returns from the first aliquots (the bronchial sample) were analyzed separately from the returns from the subsequent aliquots (the distal sample). Lavage fluid cellularity was characterized and IgA, IgG, and albumin were measured by ELISA. Lavage fluid returns were lower in the elderly group and correlated with spirometric parameters. Significantly elevated numbers of neutrophils were recovered by the bronchial sample fluid from the old group. In contrast, no consistent difference in macrophage recovery by either the bronchial or distal sample was noted. In both the bronchial and distal samples, IgG, but not IgA or albumin, was elevated in the group of old subjects. Alterations occurring in BAL fluid with aging may reflect changes in local host defenses.

Adult↗
PubMed1990

The effect of age on the relative potency of midazolam and diazepam for sedation in upper gastrointestinal endoscopy.

Diazepam and midazolam are considered safe and effective sedative agents for diagnostic procedures. However, there have been recent reports of deaths in older patients receiving midazolam for sedation. We examined the relative potency of diazepam compared with midazolam as a function of age in two large groups of patients receiving intravenous benzodiazepines for upper gastrointestinal endoscopy. While midazolam and diazepam are approximately equivalent before age 60, after age 60 the relative potency of midazolam compared with diazepam increases markedly. The rapid decline in dose necessary to sedate older patients with midazolam may explain deaths occurring in older patients who have received this drug. Until this problem receives definitive study, we advise that diazepam be preferred over midazolam for intravenous sedation in patients over 60.

Adult↗
PubMed1990

Does the Williams Manual Test predict service use among subjects undergoing geriatric assessment?

This study examines the utility of the Williams Manual Test (WMT) in predicting those older patients who will eventually require formal services. One hundred seventeen older subjects underwent comprehensive geriatric assessment that included administration of the WMT and questionnaires assessing current service use. Study participants returned at 6 and 12 months for repeat measurement of study variables. The WMT was found to be a significant predictor of additional service use at 12 months (chi 2 = 6.4, P less than .01). The test had high specificity (83%) but relatively low sensitivity (40%). The lack of sensitivity in this study group was likely due to high levels of stress among caregivers whose relative was otherwise not predicted to need services. When the WMT was repeated after 6 and 12 months, the results were highly reproducible. The WMT appears to be a useful predictor of increasing formal service use. However, in certain study groups, its predictive ability may be affected by high levels of caregiver stress.

Activities of Daily Living↗
PubMed1988

Hearing impairment as a predictor of cognitive decline in dementia.

Thirty-eight patients with dementia of various etiologies were studied longitudinally to determine the change in cognition over time in subjects with and without hearing impairment. Hearing impaired subjects were older (P less than .0001), but subject groups were otherwise comparable with respect to living arrangements, medical illness, number of drugs taken, mood, years of education, and cognitive functioning at the beginning of the study period. Decline in cognitive functioning at follow-up was greater in hearing impaired subjects and this difference persisted after adjustment for the greater age of hearing impaired subjects (P less than .009). Further division of subject by diagnosis showed that only in the Alzheimer's group did hearing impairment predict more rapid cognitive decline at follow-up.

Aged↗