摘要:

ABSTRACT:Chemical diabetes is an incompletely defined form of glucose intolerance which is more common in the later decades of life. Long‐term observations indicate that in half of the patients with persistent chemical diabetes, overt diabetes mellitus develops in the course of one decade of aging. Other studies have established that chemical diabetes is characterized by hyperinsulinemia which may be preceded by an initial lag in the insulin responses to oral administration of glucose. As a group, persons with chemical diabetes manifest higher serum triglyceride levels, a greater frequency of electrocardiographic abnormalities, and increased proteinuria.The data presented describe growth hormone patterns in chemical diabetes. The findings indicate that the lower serum growth hormone levels of obese adults of all age decades are also evident during glucose tolerance tests indicative of mild or moderate chemical diabetes. However, more severe degrees of glucose intolerance and chemical diabetes in obese persons are characterized by further decreases in growth hormone indices beyond those characteristic of obesity alon

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1973.tb01648.x

出版商:Blackwell Publishing Ltd    

年代:1973

数据来源: WILEY

摘要:

ABSTRACT:Gastrointestinal hemorrhage in the elderly is described under the headings: 1) a single episode of hematemesis, melena or rectal bleeding, 2) active persistent bleeding, 3) slow persistent bleeding, and 4) periodic bleeding. Illustrative cases are presented. Although the signs and symptoms are sometimes misleading, a careful history and examination will suggest the diagnosis in 70 per cent of cases. However, sometimes it is very difficult to locate the bleeding point preoperatively. Endoscopy, radiography and angiography are valuable aids. Initially, it is important to learn whether the hemorrhage comes from the upper or the lower gastrointestinal tract, as the selective diagnostic and surgical procedures differ. In all cases the effective management of major gastrointestinal hemorrhage requires rapid identification of the source of bleeding.

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1973.tb01649.x

出版商:Blackwell Publishing Ltd    

年代:1973

数据来源: WILEY

摘要:

ABSTRACT:An objective test for circulation time was performed in rabbits with the use of various dyes, of which the best was 10% fluorescein. The average circulation time in rabbits was 5–6 seconds. Serum from hypertensive patients injected intravenously into rabbits usually prolonged the circulation time. Differences in the results based on the age of the patients indicated a more benign type of hypertension in the elderly.An outline is given of the treatment of hypertension in the aged. Many cases respond fairly well to reassurance, a low‐salt diet, and weight reduction when the patient is obese. If additional measures are needed, diuretics are effective, especially furosemide (40 mg once or twice daily). In moderate or severe hypertension with renal parenchymal disease and a high level of blood urea nitrogen, methyldopa (250 mg two to four times daily) is of value. Potassium supplements should be given along with diuretics. In the Philadelphia Geriatric Center there are 325 residents, nearly all between the ages of 70 and 100; and more than 140 of them have hypertension. There are about 100 cases of depression (present or past), 75 cases of hiatal hernia (some with ulcer), and 53 cases of peptic ulcer. Since reserpine can aggravate peptic ulcer and can precipitate or aggravate depression, it should not be used to treat hypertension in the aged; nor should guanethidine be used for this purpose, since it can cause weakness and cerebrovascular insufficiency. High blood pressure should be reduced slowly in the aged, to avoid untoward effe

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1973.tb01650.x

出版商:Blackwell Publishing Ltd    

年代:1973

数据来源: WILEY

摘要:

ABSTRACT:The study series consisted of 100 women and 100 men over the age of 45 who remembered their heights at the age of 20. Ninety women and 36 men also recalled their weights at age 20. The combined cortical thickness and the cortical index of both clavicles were measured, as well as the height and weight. The reduction of height for the 45–59 age group in women was 1.8 cm, and in men 1.1 cm; for the 60–69 age group in women it was 2.7 cm, and in men 1.7 cm; and for the 70+ age group in women it was 2.8 cm, and in men 2.0 cm. The difference between women and men was significant in the two younger age groups. There was a significant increase in the weight of women in the age groups 45–59 and 60–69 compared with their weight at the age of 20. No significant difference was found for the men. The reduction of stature was considered to be the result of loss of intervertebral tissue and pronounced curvatures of the spine (characteristic of old women gaining weight) rather than osteo

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1973.tb01651.x

出版商:Blackwell Publishing Ltd    

年代:1973

数据来源: WILEY

摘要:

ABSTRACT:The safety of lorazepam was compared with that of a standard drug, glutethimide, in 50 chronically ill geriatric patients. Repeated physical examinations, laboratory determinations and other tests indicated that any organic disease in these patients had become stabilized before the study and was not affected by the test drugs. Early morning drowsiness, dizziness and lethargy were noted with each drug during the first and second weeks. More patients in the glutethimide series discontinued therapy because of side effects than in the lorazepam series. Dosage reduction to 1 mg nightly was necessary in many of those treated with lorazepam. Lorazepam is useful for aiding elderly patients to sleep. The initial dosage should be 1 mg nightly. If necessary, this dosage usually can be increased with safety to 2 mg nightly.

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1973.tb01652.x

出版商:Blackwell Publishing Ltd    

年代:1973

数据来源: WILEY

摘要:

ABSTRACT:Several common eye diseases in the aged can be diagnosed and treated by the practicing physician. Techniques for eye examination are outlined. Both distant and near vision should be tested in any patient complaining of visual disturbances. Cataract formation is the most common cause of visual loss in the aged. When necessary, cataract surgery should be performed regardless of the patient's age or many physical ailments. Practicing physicians should make a determined effort to detect cases of glaucoma and start the treatment that may prevent blindness. Macular disease, although difficult to treat, often can be helped by low‐vision aids. Occlusions of the central retinal artery or vein are emergencies and should be referred to the ophthalmologist as soon as possibl

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1973.tb01653.x

出版商:Blackwell Publishing Ltd    

年代:1973

数据来源: WILEY

摘要:

ABSTRACT:Three hundred and twenty psychiatric outpatients whose ages ranged from 8 to 80 years, were evaluated by five psychiatrists according to a standard checklist describing symptoms and social strengths. The analyses compared the patients over age 50 with those under age 50, on the basis of 22 symptoms and 11 strengths. A finer analysis also was made by dividing all patients into four age groups: under 20, 21–35, 36–50, and 51 or over. A study of male‐female differences showed very few systematic changes in symptoms or strengths that were related to age. The observed systematic changes indicated that “family conflicts” decreased with age, and that “relates easily” and “good adjustment” increased with age. The findings indicate that the younger males tended to manifest more schizophrenic symptoms, whereas the older males appeared more depressed than schizophrenic. Apparently age was unrelated to symptomatology in the female groups. In all age groups, the females possessed a greater number of strengths than did the males. Thus aging per se does not necessarily lead to an increase of symptoms or a decrease of social strengths in psychiatric outpatients. This conclusion, however, must be qualified in terms of the possibility of a selective dropout rate for certain types of patients conne

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1973.tb01654.x

出版商:Blackwell Publishing Ltd    

年代:1973

数据来源: WILEY

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1973.tb01655.x

出版商:Blackwell Publishing Ltd    

年代:1973

数据来源: WILEY

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1973.tb01656.x

出版商:Blackwell Publishing Ltd    

年代:1973

数据来源: WILEY

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1973.tb01657.x

出版商:Blackwell Publishing Ltd    

年代:1973

数据来源: WILEY