摘要:

ABSTRACT:Urinary disorders associated with the menopause were studied in 300 postmenopausal women between the ages of 45 and 85; 210 were multiparous and 90 nulliparous. The presenting urinary symptom was dysuria in 60 patients and incontinence in 100 patients. In the latter group, 25 had urgency‐incontinence, 45 stress‐incontinence, and 30 a combined form. The distal part of the urethra, being of the same embryologic origin as the genital tract, is estrogen‐dependent. Hormone replacement in the form of implants resulted in improvement in 70 percent of the patients and thus reduced the need for surgical interve

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1976.tb03308.x

出版商:Blackwell Publishing Ltd    

年代:1976

数据来源: WILEY

摘要:

ABSTRACT:In 2 elderly patients with ascites due to hepatic cirrhosis, potassium excretion decreased during re‐administration of potassium‐sparing diuretics after recurrence of ascites following withdrawal of previous prolonged treatment. An exaggerated antikaliuretic response and a paradoxic rise in potassium excretion are “unpredictable” changes which may occur during administration of potassium‐sparing diuretics at different times in the same patient treated with the

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1976.tb03309.x

出版商:Blackwell Publishing Ltd    

年代:1976

数据来源: WILEY

摘要:

ABSTRACT:Data in the literature show that there is a constant ratio of total body fluid to lean cell mass with increasing age (1.15 for males and 1.31 for females). Since the drug receptors usually are found in the tissues, and since cell mass and total body fluid apparently decrease at a constant rate, it would seem that the volume of distribution of drugs decreases proportionally with increasing age. Kidney function, as measured by the glomerular filtration rate and transport maximum, apparently decreases with increasing age according to zero‐order kinetics. Based on these data, correction factors were established for the change in volume of distribution and renal functions with increasing age. Equations were derived for calculating the loading dose and maintenance dosage of drugs in multiple‐dose therapy in females and males. Equations are presented for drugs following the minimal inhibitory concentration (MIC) pattern and the log dose‐response pattern, respectively. The MIC pattern is recommended in the use of bacteriostatic drugs, for which it is essential to maintain during the entire course of therapy a minimum inhibitory concentration. The log dose‐response pattern is recommended for bactericidal and antiarrhythmia drugs, for which it is essential to obtain an average therapeutic steady‐state concentration. Based on this pharmacokinetic approach, it would seem that elderly patients, during multiple‐dose therapy, are exposed to dose sizes that are too large if no correct

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1976.tb03310.x

出版商:Blackwell Publishing Ltd    

年代:1976

数据来源: WILEY

摘要:

ABSTRACT:in a double‐blind cross‐over study, 50 geriatric patients with organic brain disease were divided into two groups. One group first received piperacetazine for 15 days and then thioridazine for 15 days. For the other group the sequence was reversed. Piperacetazine proved to be at least as effective as thioridazine and seemed to be more effective against certain target symptoms; side effects were less common and less sev

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1976.tb03311.x

出版商:Blackwell Publishing Ltd    

年代:1976

数据来源: WILEY

摘要:

ABSTRACT:Twenty‐eight elderly volunteers of the 65+ age group and 28 control subjects of the 20–40 age group each received a single oral dose (1 gm) of acetaminophen in powder form. The plasma level of acetaminophen was measured over 6 hours. Plasma half‐life, clearance and relative volume of distribution of the drug were calculated. Within each age group there was a wide (threefold) range of plasma half‐life and clearance rate, with a great deal of overlap between the two groups. However, for the elderly, the group mean half‐life of acetaminophen was 2.17 hours, significantly longer than for the young (1.75 hours). The clearance rate in the elderly was significantly slower than in the young (.254 and .340 L/kg/hour respectively). There was no age‐related difference in volume of distribution of the drug by any measure, and no significant influ

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1976.tb03312.x

出版商:Blackwell Publishing Ltd    

年代:1976

数据来源: WILEY

摘要:

ABSTRACT:At Norristown State Hospital a mobile Team of workers was organized to give personalized and preventive psychiatric, medical and social attention to distressed elderly people within the communities served by this large psychiatric institution. The Team's mobility permitted flexible approaches to problem‐solving at the person's own home or other place of residence. Over its 8.5 years of existence the Team evaluated 1,438 elderly persons and acted in a consultant capacity to 77 nursing or retirement homes. Most of these clients were treated successfully within the community; only 222 required admission to the parent hospital during that time. Those treated in their own homes usually were able to maintain or improve the quality of their lives. The timely psychiatric, medical and social help often uncovered physical and social factors that previously had been overlooke

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1976.tb03313.x

出版商:Blackwell Publishing Ltd    

年代:1976

数据来源: WILEY

摘要:

ABSTRACT:Aortic systolic murmurs and aortic dilatation were studied in a randomized sample of 100 hospital patients over the age of 60. Clinical, phonocardiography, radiologic and carotid‐pulse data provided the basis for graphic characterization of the murmurs. Senile aortic dilatation was common (66 patients). In a high percentage (39 patients), dilatation of the ascending aorta (and sometimes of the arch) was associated with an aortic systolic murmur. The “innocent” type wasalwaysassociated with aortic dilatation. This “innocent murmur of the aged,” even though caused by structural alterations, should be considered in the same light as the “innocent murmur of children,” as it is not associated with dynamic embarrassment of th

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1976.tb03314.x

出版商:Blackwell Publishing Ltd    

年代:1976

数据来源: WILEY

摘要:

ABSTRACT:This report covers a 2.5‐year experience with colonoscopy in the management of 208 patients (104 men and 98 women, average age 58 years). Colonic bleeding of unknown cause and abnormal barium‐enema findings were the most common indications for colonoscopic examination. During this period, 110 colonoscopic polypectomies were performed. Among the few complications was one case of perforation of the sigmoid from transcolonoscopic removal of a small carcinoma; the perforation was incidentally discovered at the time of subsequent laparotomy. Bleeding occurred in 6 patients, but only one of them required surgical intervention to arrest the hemorrhage. Colonoscopy is a safe, effective and reliable diagnostic and therapeutic procedure. Its use can reduce expense for the patient and obviate a long painful postoperative per

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1976.tb03315.x

出版商:Blackwell Publishing Ltd    

年代:1976

数据来源: WILEY

摘要:

ABSTRACT:Surgical experience at the hospital of a State Veterans Home is reviewed over a period of two and a half years (1973–1975). The average age of the patients was 74 years, and many had severe pulmonary or cardiac disease. Of the operations performed, 283 were major and 301 were minor. For the major operations (including emergencies) the mortality rate was 4.2 percent, for the minor procedures the rate was zero, and for all types of procedures the overall mortality rate was 2 percent. Emergency operations increased the expected mortality tenfold. Colonic and biliary‐tract operations bore the highest mortality. The incidence of malignant lesions was high. In the elderly, indicated surgical procedures are justified, provided they are carried out by an organized, highly trained health t

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1976.tb03316.x

出版商:Blackwell Publishing Ltd    

年代:1976

数据来源: WILEY

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1976.tb03317.x

出版商:Blackwell Publishing Ltd    

年代:1976

数据来源: WILEY