摘要:

ABSTRACT:Can the aging process be altered to prevent the pathologic changes that impair function? The matter should be put in proper perspective. This involves biologic and other forms of research as well as the therapeutic application of current knowledge.About 40 per cent of elderly patients under general hospital care are admitted for surgical treatment. In 1973, the total is expected to reach 2.5 million. Morbidity and mortality associated with surgery are highest among the elderly. However, with the use of new procedures and stress on the factors involved in proper pre‐ and postoperative care, the risk has been greatly reduced. Age‐over‐65 is no longer a contraindication to surgery. The matter of careful evaluation and treatment is discussed under the following categories: status of the patient, status of the various organs and systems (including the effect of trauma), elective versus emergency operations, and the prognosis, especially in relation to such disorders as biliary‐tract disease, cardiovascular disease, cancer, and degenerative hip disease. Preoperative assessment must be thorough and complete. If the situation is not an emergency, there should be a period of corrective nutrition, activity, supportive medication, and instruction of the patient regarding what he may expect. For selective surgical procedures, the response to those measures determines the type of anesthetic and the extent and nature of the operation. The stress of the surgical procedure should never exceed the patient's tolerance. The immediate postoperative care (recovery room) is extremely important. The objective is to prevent complications. The experience of the surgeon, the cooperation of all involved, and meticulous attention to detail are required in the surgical care of the

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1973.tb01696.x

出版商:Blackwell Publishing Ltd    

年代:1973

数据来源: WILEY

摘要:

ABSTRACT:There will be no lessening of the demand for long‐term care facilities, despite the increase in home care and community services. The subject is discussed with regard to the statistics on admission to these facilities, government attitudes toward alternative modes of care, family relationships, and social attitudes. The quality of care in nursing homes will be enhanced by the continuing education of the staff and the public concerning the potentialities for enriching the lives of the aged resident

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1973.tb01697.x

出版商:Blackwell Publishing Ltd    

年代:1973

数据来源: WILEY

摘要:

ABSTRACT:Many patients with the complications of peptic ulcer disease are in the geriatric age group. This is partly the result of the overall increase in this segment of the population in recent years, and partly the result of delay in the referral of younger patients with intractable forms of the disease. Hemorrhage is the most common life‐threatening manifestation of peptic ulcer in the geriatric patient. Prompt evaluation by esophagogastroscopy and barium x‐ray examination is of paramount importance in proper management. Perforation of peptic ulcer is less common in the elderly. When diagnosed, it requires immediate surgical treatment. Pyloric obstruction should be suspected in a patient with chronic nutritional depletion, superimposed acute dehydration, electrolyte imbalance and even shock. Nasogastric decompression of the dilated stomach and re‐establishment of fluid and electrolyte balances should be attended to before carrying out definitive surgical treatment.Geriatric patients tolerate major surgery relatively well, but only if special attention is given to associated medical and metabolic abnormalities. Chronic obstructive lung disease with diminished pulmonary reserve is among the most common of these associated disorders. The prevention of serious pulmonary complications demands aggressive management both before and after operation for peptic ulcer. Diminished cardiovascular reserve must be taken into account if postoperative congestive heart failure or pulmonary edema is to be prevented. The presence of renal disease also should be evaluated as a factor in postoperative complica

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1973.tb01698.x

出版商:Blackwell Publishing Ltd    

年代:1973

数据来源: WILEY

摘要:

ABSTRACT:This report deals with sudden unexpected deaths among 900 geriatric patients seen in a general practice of 3,050 patients in a residential area not far from London. During the year 1972, 18 of the 41 deaths among the 900 elderly patients were sudden and unexpected. Records also were obtained from the Coroner's Office dealing with 385 sudden deaths among elderly patients in this area. Cardiovascular diseases accounted for the largest number of sudden deaths, bronchopulmonary diseases second, and cerebrovascular accidents third. Multiple injuries and suicides are serious and preventable causes of death. The clinical, social and medico‐legal aspects of sudden unexpected deaths are discusse

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1973.tb01699.x

出版商:Blackwell Publishing Ltd    

年代:1973

数据来源: WILEY

摘要:

ABSTRACT:The author presents a brief survey of sexual mores through the ages from the points of view of biology and society, and more specifically, sex and love.

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1973.tb01700.x

出版商:Blackwell Publishing Ltd    

年代:1973

数据来源: WILEY

摘要:

ABSTRACT:Gerovital H3, a specially formulated preparation of procaine hydrochloride, has been employed for several years in the treatment of various manifestations of aging. Heretofore, there has been no pharmacologic basis for its use in geriatric patients, although procaine hydrochloride and inhibitors of the enzyme, monoamine oxidase (MAO), are known to have many of the same pharmacologic actions. The relative effectiveness of Gerovital H3, commercial procaine hydrochloride (Novocain), and iproniazid as MAO inhibitors was studied by means of tests involving serotonin and kynuramine metabolism by rat‐brain MAO. Gerovital H3 was a more effective MAO inhibitor than commercial procaine hydrochloride but was a less effective inhibitor than iproniazid. Moreover, Gerovital H3 seemed to have a selective affinity for certain of the multiple forms of MAO. These results, in view of the recent observations on MAO levels and aging, may offer a rationale for Gerovital H3 therapy in the elderl

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1973.tb01701.x

出版商:Blackwell Publishing Ltd    

年代:1973

数据来源: WILEY

摘要:

ABSTRACT:Persistent postsplenectomy thrombocythemia should be differentiated from transient postsplenectomy thrombocytosis, as the former leads to hemorrhagic and thrombotic complications. The authors reviewed 29 cases of “postsplenectomy thrombocythemia” collected from the literature (1933–1970) and added 2 of their own. The data on these 31 cases indicate that the disease should be diagnosed and treated as primary thrombocythemia, present in masked form before splene

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1973.tb01702.x

出版商:Blackwell Publishing Ltd    

年代:1973

数据来源: WILEY

摘要:

ABSTRACT:The residents of an inner city nursing home were studied to ascertain the status of psychiatric consultation and rehabilitative programs. Most of the patients had psychoses associated with organic brain syndromes or senile dementia. The Home was as well run as most such institutions but the record‐keeping was so poor that formal evaluation of the patients was almost impossible. It was clear, however, that there was a great need for continuing psychiatric consultation and the development of appropriate remedial programs that reach beyond custodial car

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1973.tb01703.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.tb01704.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.tb01707.x

出版商:Blackwell Publishing Ltd    

年代:1973

数据来源: WILEY