摘要:

ABSTRACT:Although, with the newer and more sophisticated radiologic methods the precision of bone mass measurement has been greatly improved, it is still impossible to predict the imminence of osteoporotic fractures, for two main reasons. First, current radiologic methods measure bone mass accurately only in appendiceal bone (largely cortical and regularly shaped) and not in axial bone (largely trabecular and irregularly shaped). However, most clinically significant fractures occur in the axial skeleton and involve trabecular bone, which is more prone than cortical bone to resorptive losses. Second, because of large differences in body habitus, the normal range of bone densities varies widely in any cohort of the same sex and race. Thus, although bone density measurements cannot be used to predict osteoporotic fractures, they have an important application in monitoring changes in skeletal mass for therapeutic and prophylactic purposes.

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1981.tb01969.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACT:Involutional osteopenia contributes to older persons' susceptibility to fractures of the hip, spine and wrist. Experimental evidence is reviewed that supports the hypothesis that involutional bone loss can be prevented by physical exercise. Weightlessness and immobilization result in accelerated bone loss. In cross‐sectional studies measuring total body potassium (TBK), both muscle mass and bone mass in normal humans have remained strikingly constant. The usual decrease in total body calcium (TBCa) and TBK with increasing age was not observed in a cross‐sectional study of marathon runners. Localized hypertrophy of bone and muscle has been reported for a variety of occupations and sports. Two prospective studies have demonstrated an increment in bone mass after a program of physical exercise. It would seem that certain involutional changes in body composition (loss of TBCa and TBK) can be prevented by increased physical activity, but the effectiveness of specific types and durations of exercise should be investiga

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1981.tb01970.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACT:This article presents a comparison of acute glomerular nephritis (AGN) with rapidly progressive glomerular nephritis (RPGN) in patients aged 60 or older. In 7 elderly patients with AGN, the renal disease was preceded by skin infection (4 cases), sore throat (2 cases), or pneumonia (1 case). The 7 patients with RPGN had no history of prior infection. Both AGN and RPGN were manifested clinically as acute renal failure, but the RPGN patients had significantly higher serum creatinine levels and lower hematocrit readings. Hypocomplementemia was a feature only of AGN. The biopsy specimens from patients with RPGN showed crescents in 50–100 percent of the glomeruli, whereas specimens from patients with AGN showed no significant extracapillary proliferation. Six AGN patients recovered and 1 died. Despite dialysis, 4 RPGN patients died and the remaining 3 require maintenance dialysis. It is concluded that AGN in the elderly is more common than previously believed, frequently follows skin infections, and has a reasonably good prognosis. In contrast, RPGN, also not rare in the elderly, has a much worse prognosi

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1981.tb01971.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACT:Nursing assistants (aides) and licensed practical nurses (LPNs) from three proprietary nursing homes participated in a continuing education program designed to enhance knowledge and attitudes about the elderly in long‐term care. The program covered six weeks for the initial 115 aides and one full‐day seminar for the 83 LPNs. The content covered knowledge about human anatomy, the physiology of normal aging, physical and psychosocial problems of the elderly and, for the nurses, problems associated with cardiovascular accidents. The final participants (29 aides and 52 LPNs) consisted of those who were tested before and after their training with respect to knowledge, life satisfaction, and attitudes toward the elderly. Results indicated overall favorable changes for both aides and LPNs, particularly in the areas of increased knowledge and more positive attitudes. The data suggest that continuing education is an effective means of influencing the knowledge and attitudes of personnel in long‐term care facilities, and it should be a first step toward improving the quality of care for elderly resi

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1981.tb01972.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACT:Hypertension detection and follow‐up programs have recently received increased attention. The authors studied the effect of screening for hypertension in a geriatric screening program for a large ambulatory elderly population in Dunedin, Florida, over a three‐year period. Of the 4,247 participants initially screened, 39 percent had some form of hypertension, and 15.6 percent of these had not received any form of treatment. At the time of the first year follow‐up, the proportion of participants with treated, controlled hypertension had increased from 14.7 to 21 percent. These data lend support to the value of hypertension screening among persons over 65 years o

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1981.tb01973.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACT:A retrospective study showed that paraplegia and quadriplegia due to spinal cord lesions occurred with a frequency of 1 in 500 admissions to a geriatric department. These cases predominantly were caused by malignant disease, particularly of the bronchus. However, elderly patients presenting to other hospital departments included a far higher proportion of cases with benign causes, particularly cervical spondylosis which affects patients of lower average age. Male patients predominated in both malignant and benign categories.

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1981.tb01974.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACT:The case is presented of a 65‐year‐old man with neurofibromatosis manifesting facial and skeletal features resembling those of the “elephant man” described by Sir Frederick Treves. Autopsy revealed not only a pheochromocytoma (a common accompaniment of neurofibromatosis), but an enlarged infarcted spleen and a subphrenic abscess. These findings have not been described previously in a patient with neurofibro

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1981.tb01975.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACT:Seven case reports of alcoholism in the elderly are presented. These patients formed a significant proportion of 108 patients seen in the first eight months of a new comprehensive psychiatric service for the elderly. None of them initially presented as alcohol abusers; three were first seen by geriatricians because of repeated falls, and four who came directly to psychiatrists were referred for atypical dementia, confusion or self‐neglect. Three patients had started to abuse alcohol only late in life; the remainder were life‐long heavy drinkers. In three instances, close relatives who abused alcohol themselves, were in collusion. The diagnosis of alcohol abuse in these elderly patients depended upon the recognition of such manifestations as repeated falls, confusion, and self‐neglect. The prognosis was influenced by age at onset, social and family factors, and the presence or absence of brain damage. In two of the patients, a poor prognosis was linked to collusion by alcohol‐abusing c

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1981.tb01976.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACT:First‐year medical students at UCLA are introduced to the special health problems of the elderly by a process in which they interview symptomatic volunteers at both extended care and ambulatory care facilities. In addition, they interview healthy elderly volunteers to gain information on gerontology and lifespan development, with supplementation from selected readings, films, lectures and panels. This curricular model seems effective in reducing prejudice about the aged and in training future physicians to render humane competent care in the field of geriatric

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1981.tb01977.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1981.tb01978.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY