Journal Article Cardiac Ultrasound in the Management of Heart Failure in the Elderly Get access A. Hendry, A. Hendry Search for other works by this author on: Oxford Academic PubMed Google Scholar L. Hacking, L. Hacking *Departments of Geriatric Medicine and Radiology Gartnavel General HospitalGlasgow Search for other works by this author on: Oxford Academic PubMed Google Scholar P. Langhorne, P. Langhorne Search for other works by this author on: Oxford Academic PubMed Google Scholar R. Vallance, R. Vallance *Departments of Geriatric Medicine and Radiology Gartnavel General HospitalGlasgow Search for other works by this author on: Oxford Academic PubMed Google Scholar J.B. MacDonald J.B. MacDonald Search for other works by this author on: Oxford Academic PubMed Google Scholar Age and Ageing, Volume 22, Issue suppl_2, 1993, Pages P9-a–P9, https://doi.org/10.1093/ageing/22.suppl_2.P9-a Published: 01 June 1993
Studies have suggested that routine chest x-ray is never indicated but all new attenders at our day hospitals have a chest x-ray carried out. Our aim was to determine if this investigation altered the clinical management of patients and to try to select those patients in whom a chest x-ray is indicated.A prospective study was carried out over a 7 month period from February to September 1995. All new patients had cardiorespiratory symptoms/signs documented and a management plan made. A chest x-ray was then carried out and change in management as a result of the x-ray report noted.Knightswood and Drumchapel Geriatric Day Hospitals, West Glasgow University NHS Trust.All new Day Hospital attenders.Of 207 new Day Hospital attenders, 53 had no clinical indication for a chest x-ray and although 70% had an abnormal film in no case was patient management changed as a result of this. A chest x-ray was indicated in 154 patients and of these 114 (74%) had an abnormal film with a resultant change in management in 23 patients (this comprised either a change in drug treatment or a further investigation.) Of those whose management was changed as a result of the x-ray report 61% had respiratory symptoms.We would recommend that chest x-ray should be performed in those patients who have a clear clinical indication and that the diagnostic yield is highest in the presence of respiratory symptoms or signs.
Ninety-seven consecutive patients more than 70 years old (Group O) undergoing barium enema were studied to assess the usefulness of this investigation in their management. The patient's ability to co-operate was studied. Diagnostic yield was noted and compared to 70 consecutive patients less than 60 years old (Group Y). There was no correlation between mental test score, hearing or visual impairment and the patient's ability to co-operate. A significantly greater number of positive examinations was found in Group O (P less than 0.05). Following a positive examination, 55% of patients in Group O had a change in management. Surgical management was pursued in 14 patients, 11 of whom had a tumour.
We describe a patient with recurrent hemarthrosis of one knee. Investigation demonstrated a vascular abnormality of the synovium as the likely cause. Structural abnormalities of the synovial vasculature should be considered, in the absence of a systemic cause, as a potential source of bleeding in older patients with recurrent hemarthrosis.
Proximal faecal stasis may occur when faecal matter accumulates in the uninflamed colon above an area of active ulcerative colitis. This phenomenon is thought to be the cause of symptoms in some patients with distal disease. It is not known, however, how often patients with active distal colitis exhibit slow colonic transit. Fifty two consecutive patients with active ulcerative colitis each ingested 10 radio-opaque markers nightly for 14 days. Minimum colonic transit times were derived from counts of retained markers shown by plain abdominal radiography on the 15th day. The transit times for each patient were related to their disease extent and bowel frequency. Four patients had colonic transit times greater than one week and two others had evidence of relative stasis. The results indicate that approximately 10% of attacks of distal colitis are associated with faecal stasis.
Summary Fourteen patients with symptomatic atheromatous stenoses of common or external iliac arteries underwent percutaneous arterial dilatation. Twelve procedures were considered successful in terms of arteriographic and symptomatic improvement but the application of three haemodynamic indices (pressure index, pulsatility index and the papavarine test) indicated that only 8 patients had gained a significant improvement in blood flow. These results illustrate the need for quantitative measurements in the assessment of this new technique.
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