摘要:

ABSTRACT:Effective factors that have made it possible for an increasing proportion of the population to reach old age have nevertheless presented society with new problems and ethical dilemmas. Several questions that arise include: 1) What are the responsibilities of the medical profession in providing medical care or supervision for patients who manifest irreversible decremental processes associated with old age?; 2) Under what circumstances is there a moral imperative to preserve life, especially in patients who manifest an irreversible loss of awareness or are sustained by purely mechanical means?; 3) What are the limits of the resources which can be allocated to health care in general, and to the aged in particular, in a society in which resources are no longer infinite and allocations may become necessary?; 4) What is the profession's responsibility for identifying decremental aging changes and characterizing them, even if this information is personally threatening and socially disturbing to those who would prefer to consider them diseases, and thus reversible by traditional means?; and 5) Is there a moral mandate to identify mechanisms of aging and techniques for slowing the process, in order to prolong life beyond what appears to be the normal biologic limit of three generations?

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1981.tb02185.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACT:In a series of 302 autopsies, 47 elderly subjects during life had shown signs or symptoms suggesting cerebrovascular accidents. At autopsy they showed no less than 506 pathologic lesions, an average of10.7per patient. Of these lesions, 36.5 percent were cardiovascular, 15.8 percent pulmonary, 11.0 percent renal, 9.0 percent cerebral, 8.3 percent hepatic, 6.5 percent gastrointestinal or pancreatic, 5.0 percent genital, 3.5 percent splenic, and 4.4 percent in other tissues. Multiple autopsy findings are the rule and not the exception in patients of the age group in which strokes are liable to occur.

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1981.tb02186.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACT:Bromocriptine is a potent dopamine agonist which directly stimulates dopamine receptors. In the corpus striatum, this action results in alleviation of many of the signs and symptoms of parkinsonism. The effectiveness of bromocriptine may persist for at least one to two years; results of more prolonged treatment are not available. Adverse reactions are common and often severe, but safety in dosages up to 100 mg daily for one to two years has been adequately established. Bromocriptine is qualitatively and quantitatively similar to levodopa in both beneficial and adverse effects. However, because of variations in individual response, bromocriptine sometimes ameliorates the problems of prolonged levodopa therapy, i.e., declining efficacy, fluctuations in therapeutic response, and the development of disabling abnormal involuntary movements. Thus bromocriptine is a valuable adjunct in the treatment of parkinsonism.

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1981.tb02187.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACT:In a 78‐year‐old woman receiving perhexiline maleate for intractable angina pectoris, a syndrome of parkinsonism and peripheral neuropathy developed. The neuropathy was confirmed by electromyographic and nerve conduction studies. The parkinsonism and peripheral neuropathy disappeared when perhexiline maleate was discontin

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1981.tb02188.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACT:Digoxin monitoring was examined according to 13 criteria in two nursing homes: 1) an intermediate care facility (ICF) with private physicians, and 2) a skilled care (SCF) plus ICF with 3 housestaff physicians from a medical college. The digoxin review was a retrospective chart analysis to: 1) identify all patients receiving digoxin, 2) evaluate dosage patterns, 3) evaluate monitoring patterns, and 4) detect possible toxic reactions and determine whether management was appropriate. The calculated correct dosage of digoxin was administered to 82 percent of patients in the SCF and to 40 and 48 percent in both ICFs. More frequent monitoring of serum creatinine and potassium levels was associated with fewer symptoms of toxicity. Possible toxicity occurred in 46 percent of the SCF and in 68 and 71 percent of patients in the ICFs. Documented toxicity occurred in 18 percent of the SCF patients and in 16 and 10 percent of the ICF patients. Eighty percent of patients who had symptoms of digoxin toxicity were not examined or managed appropriately in the SCF, and 43 and 33 percent in the ICFs. Often standing orders had been assigned for drugs to treat nausea, vomiting or diarrhea. A number of possible drug interactions with digoxin were discovered. The participation of the pharmacist in nursing home care is discussed.

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1981.tb02189.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACT:Aortic aneurysms may become infected. This unusual complication carries a highly unfavorable prognosis. In any patient with sepsis and a known aneurysm, spread of the sepsis to the aneurysm should be suspected if no other source of infection can be found. A case report is presented, together with a brief review of the literature.

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1981.tb02190.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACT:A total of 2,923 elderly subjects were studied to determine the relationship between obesity, hypertension, thyroid disease, renal function, alcohol consumption, selected drugs, and the serum uric acid level. Comparison of the serum uric acid levels with indices of obesity demonstrated a strong correlation in normotensive (p<.0001) and hypertensive (p<.001) subjects. The serum creatinine level, when used alone, was not a reliable indicator of renal function. Of the drugs evaluated, diuretics had the most pronounced effect upon the serum uric acid level.

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1981.tb02191.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACT:This study focused on predictors of consistency and inconsistency in health and treatment expectations among 77 new patients (mean age, 73) at a geriatric outpatient clinic. Just before their first appointment, and again one week afterward, the patients were asked about their overall health status, their specific illness complaints, their reasons for visiting the clinic, and their expectations regarding treatment and the future outlook. Few predictors of consistency were found for such outcome measures as the number of health problems reported, present and future health status, and the duration, difficulty and benefits of treatment. Inconsistency and uncertainty were more evident in these geriatric outpatients' perceptions, especially among those with self‐rated poor health and mobility. This study emphasizes: 1) the importance to the treatment context of geriatric patients' inconsistencies about their health, and 2) the additional burden clinicians must bear in dealing with such discrepancie

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1981.tb02192.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACT:Described is the development of a self‐rating geriatric behavioral scale modeled after the Sandoz Clinical Assessment‐Geriatric (SCAG). This new Self‐Assessment Scale‐Geriatric (SASG) provides a valid and reliable measure of behavioral pathologic changes for the selective screening of elderly patients who manifest mild to moderate symptoms of dementia. Further use and refinement of this new measuring device are required to confer on it the maximum possible a

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1981.tb02193.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY