摘要:

ABSTRACT:The gonadal steroids—estrogens and androgens—appear to have a mood‐elevating, psychotonic effect. The improved sense of well‐being and increased vigor probably is engendered by restoration of somatic efficiency and psychic equilibrium. 1. The male climacteric, as observed in a limited number of men, is associated with a low level of serum testosterone. The levels of follicle‐stimulating hormone and luteinizing hormone are not elevated because estrogen concentration continues unaltered well into old age. Androgen replacement therapy often lessens fatigue, depression and headaches, and improves libidinous drives. 2. In the aging female, many climacteric symptoms other than those due to vasomotor instability were heretofore considered merely coincidental. Recent studies suggest that the metabolism of cerebral hormones is markedly influenced by endogenous and exogenous gonadal steroids. Thus, postmenopausal depression, headaches, and nervousness may be hormone‐dependent symptoms. 3. The incidence of endometrial cancer is no greater and is probably less in estrogen‐treated women than in women not treated with estrogen, if regular cyclic courses of an oral progestogen are added t

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1979.tb01734.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

ABSTRACT:Nutritional deficits and their correction were studied in 45 cancer patients (age range, 60–86 years) who were undergoing various modalities of cancer therapy. Their nutritional status was maintained with a variety of commercially available special diets, and serum albumin concentrations were sequentially determined in order to gauge the efficacy of the nutritional support. Serum albumin levels were preserved when nutritional support was employed in surgical therapy. However, patients undergoing palliative chemotherapy or radiotherapy responded only to adequate levels of the standard hospital diet with or without supplements of special enteral diets. In the survivors, albumin levels were maintained; in the nonsurvivors, albumin levels decreased. This group of older patients tolerated nutritional support therapy, especially when it was carefully monitored. Satisfactory nutritional therapy can be achieved by use of appropriate enteral formulas. The method lends itself to adequate management in the outpatient or nursing‐home situation during certain phases of can

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1979.tb01735.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

ABSTRACT:Ancient Greek and Roman physicians recognized the high prevalence of depressive illness in old age and began to differentiate the major mental syndromes of the elderly. Greek humoral theory connected black bile, melancholia and old age, and this formulation dominated medical thinking until the seventeenth century. Beginning with the Enlightenment and continuing throughout most of the nineteenth century, physicians spurned the idea that old age and depression were linked, or tended to view depression as evidence of brain decay. Although twentieth century studies have confirmed that depression in the elderly is a common illness, usually self‐limiting and rarely coexisting with dementia, these views have been incompletely incorporated into modern medical practic

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1979.tb01736.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

ABSTRACT:In an attempt to determine which type of antihypertensive drug is more effective in reducing left ventricular hypertrophy (LVH), thiazide, α‐methyldopa, hydralazine and propranolol were administered singly or in combination to patients with essential hypertension, and to spontaneously hypertensive rats (SHR). QRS voltage [S1+ R5(or R6)] in the electrocardiogram (ECG), the cardio‐thorax (C/T) ratio in chest x‐ray films, and the heart weight were used to assess regression of LVH and cardiomegaly. The S1+ R5(or R6) and the C/T ratio were well correlated with the pretreatment systolic blood pressure. Adequate blood pressure control produced regression of S1+ R5(or R6) and the C/T ratio, but the change in QRS voltage remained the earlier and more reliable sign of LVH for evaluating the effectiveness of therapy. The regression of QRS voltage and heart weight occurred regardless of which type of therapeutic drug was used in patients with essential hypertension and in SHR. It is suggested that LVH is directly related to the height of arterial pressure and that lowering of arterial pressure can be followed by regression of ECG‐LVH regardless of the type of depressive d

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1979.tb01737.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

ABSTRACT:A retrospective analysis revealed that 125 geriatric patients had been treated for mild to moderate essential hypertension with a combination drug, each tablet of which contained 50 mg of hydroflumethiazide and 0.125 mg of reserpine. The dosage schedule was one tablet once daily for most patients. The duration of treatment ranged from 1 to 93 months (mean, 22.1 months). After one month of therapy, the decreases in mean systolic (—18.3 mm Hg) and mean diastolic (—6.6 mm Hg) blood pressure were statistically significant and these initial reductions were well maintained over a 6‐year period, without signs of tachyphylaxis. Side effects were reported by 53 patients, but these usually were mild and typical of those associated with antihypertensive therapy; discontinuation of treatment was required in only 3 patients. Use of the hydroflumethiazide‐reserpine combination was associated with several significant advantages, including convenient once‐daily dosing, improved compliance, and decre

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1979.tb01738.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

ABSTRACT:A rapid slide technique to provide quantitative bacteriologic assessment of wounds in elderly and debilitated patients is described. It involves the use of material from dextranomer‐bead (Debrisan) wound dressings to replace tissue biopsy for deciding when a wound is ready for closure or when a specific therapy is no longer efficacious. In 27 patients an 81 percent correlation was demonstrated between the bacterial count as determined by the new method and that determined by the more complicated tissue biops

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1979.tb01739.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

ABSTRACT:During an initial 9‐week period of involvement in the operation of a health clinic for ambulatory geriatric patients in three high‐rise apartment complexes, the activities and opportunities for a pharmacist and pharmacy students were documented. For 120 of the 550 geriatric residents of the center, medication histories were completed during the study period. These 120 patients reported a total of 270 medical problems. They were taking 366 prescription drugs (average, 3.9 per patient). During the 9‐week study, 43 drug interactions were documented, and about 25 percent of the patients interviewed complained of some untoward drug effect. The opportunities for pharmacist involvement and the educational opportunities for pharmacy students were demonstrated. The period since the initial 9‐week study has shown even greater acceptance and utilization of the pharmacy services, with an increased number of visits by p

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1979.tb01740.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

ABSTRACT:Familial achalasia most often has been recorded in siblings, and only rarely (twice previously) in a parent and offspring. This report concerns a third case of achalasia in a parent and offspring (mother and son). Clinical and radiographic features of the esophageal achalasia are presented. The possibility that genetic factors may play a role in the etiology of this disorder is discussed.

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1979.tb01741.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

ABSTRACT:The effectiveness of a geriatric treatment program is determined largely by the extent to which it contributes to enhanced independent functioning. To examine the effectiveness of Reality Orientation (RO) classroom instruction, the verbal orientation and the everyday behavior of 22 residents in a Veterans Administration Nursing Home Care Unit were assessed before and after their participation in RO classes. The classes met five days a week for three months. Participants showed a significant increase in verbal orientation (as measured by the Reality Orientation Questionnaire) and a significant improvement in independent functioning (as measured by the Geriatic Resident Goals Scale). The results provide evidence of the effectiveness of RO as a treatment procedure for disoriented geriatric residents.

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1979.tb01742.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1979.tb01743.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY