Homocystiene profile in elderly

Homocysteine [Hcy] is a sulfurated amino acid an elevated homocysteine level is a marker for a pathogenic process as well as a cause of pathology. It is across sectional study conducted on 91 elderly participants 60 years and older selected from geriatric outpatient clinic and geriatric inpatient departmentthey underwent comprehensive geriatric assessment, and homocysteine [Hcy] level in blood by Enzyme Immunoassay [EIA]. homocysteine not significantly related to age, sex and functional status. Also mean Hcy level is 15.4 micromol/liter. Further studies to evaluate Hcy level in elderly with different ages are recommended

Nosocomial bacterial infections and antimicrobial resistance among the elderly in geriatric unit of Ain Shams university hospital

Increasing numbers of elderly people are being treated in hospitals and are additionally at particular risk of acquiring nosocomial infections [Nl] with antibiotic-resistant organisms. Prevalence of Nl had been evaluated in this study in all inpatients in Geriatric Medicine Unit, EL Demerdash Hospital of Ain Shams University from March 2004 till September 2006. The association of Nl with intrinsic and extrinsic risk factors was also assessed, as well as the emergence of antibiotic resistant bacterial strains. All specimens were processed by routine methods and their antibiotic sensitivity was performed using the disc diffusion method in accordance with the Clinical and Laboratory Standards Institute [CLSI] guide lines. A total of 107 NIs were found among 100 of the 1202 hospitalized patients [prevalence 8.2% prevalence varied greatly from 3.3% in the internal ward to 14.2% in the ICU]. Respiratory tract as well as urinary tract infections was the most common NIs [43% each]. The most commonly isolated pathogens from ICU and the internal ward were Klebsiella spp.[25%], Candida spp.[12%], Pseudomonas aeruginosa [12%] and methicillin-resistant Staphylococcus aureus [MRSA] [9%]. They were followed by Escherichia coli and Enterobacter spp. [7.5% each], coagulase negative Staphylococci [6%] and Proteus spp. [5%]. Depending on infection site, the most frequent isolates were Klebsiella spp. [41%], MRSA [22%] for respiratory tract infection; Candida spp. [28%], Klebsiella pneumonie [15%], E.coli and Pseudomonas auruginosa [13% each] for urinary tract infection. Our results showed that 61.9% of studied patients with lower respiratory infections were due to endotracheal intubation and 95.2% of patients had urinary catheters and developed urinary tract infections. About 82.0% of the elderly patients were taking antibiotics, for at least 1 month prior to admission, which have contributed to the emergence of highly resistant pathogens among geriatric patients, including methicillin-resistant Staphylococcus aureus, penicillin-resistant Streptococcus spp., and multiple-drug-resistant Gram-negative bacilli and coagulase-negative staphylococcal strains. Colonization and infection with antibiotic resistant bacteria [ARB] is a rising menace in geriatric medicine. Establishing a surveillance system and developing an antibiotic policy provide the basis for antibiotic therapy and controlling antimicrobial resistance

Risk factors of degenerative calcification of cardiac valves in the elderly

The underlying cause of age related degenerative valvular calcifications is largely unknown. As a result, a case control study was used to evaluate the hypothesized risk factors. One hundred seventy two elderly matched for age and gender participated in this study [86 cases and 86 matched controls]. Assessment of risk factors for atherosclerosis was done with medical history as well as measurement of body mass index [BMI], blood sugar, lipid profile, and homocysteine. Measurement of bone minerals, parathyroid hormone [PTH] and bone mass density [BMD] were also done. This study confirmed the vascular hypothesis of degenerative calcification of cardiac valves. It showed that with multiple logistic regression analysis, the magnitude of the risk conveyed by atherosclerotic risk factors was particularly high for high cholesterol level, low HDL level, high LDL level and high homocysteine level. Those factors were independent risk factors for degenerative calcification of cardiac valves [P = 0.019]

Reduced bone mineral density in polytransfused patients with beta thalassemia, poorly defined role of hypoparathyroidism in pathogenesis

Patients with beta thalassemia frequently develop bone disease of multi-factorial etiology. We studied the prevalence of hypoparathyroidism in addition to other laboratory indices of bone and calcium metabolism [serum calcium, phosphorus and alkaline phosphatase], in fifty patients with beta thalassemia major and ten patients with beta thalassemia intermedia. These biochemical indices were correlated to bone mineral density assessed by dual x-ray absorptiometry [DEXA]. Hypoparathyroidism was found in 8% of the studied thalassemic patients with significantly lower serum parathormone and calcium and significantly higher serum phosphate compared to control subjects. Results of DEXA scan revealed decreased bone mineral density in 90% of the studied thalassemic patients. Serum parathyroid hormone showed no significant correlation with any of the studied DEXA parameters. In conclusion, bone disease is present in the majority of thalassemic patients with no significant correlation with parathyroid hormone, denoting that bone disease in beta thalassemia is likely to be multi-factorial