摘要:

ABSTRACTThe diagnosis and the treatment of rheumatic diseases in older people pose special problems. Degenerative joint disease, almost universally present in the elderly, may not be the basis for the newly developing rheumatic symptoms. Systemic inflammatory disease may be confused with malignancy or it may be an initial manifestation of malignancy. Some drugs used to control central‐nervous‐system or cardiovascular disease may produce painful rheumatic syndromes. Results of laboratory tests used in the diagnosis of rheumatic diseases may be altered by other nonrheumatic disorders in older people. Papers in this symposium will explore these concepts in greater det

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1977.tb00226.x

年代:1977

数据来源: WILEY

摘要:

ABSTRACTTo illustrate the diagnostic problems of rheumatic disease in patients over 60 years of age, 4 cases are presented: 1) osteoarthritis, 2) late‐onset rheumatoid arthritis, 3) polymyalgia rheumatica, and 4) pseudogout with crystalline synovitis. In each case the correct diagnosis should have been suspected from the history and physical examination alone, with the laboratory and x‐ray findings providing supportive evide

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1977.tb00227.x

年代:1977

数据来源: WILEY

摘要:

ABSTRACTResults of serologic tests in rheumatic disease require good judgment in interpretation, based upon familiarity with the present knowledge of immunologic mechanisms, including the action of antibodies, auto‐antibodies, T‐cells and B‐

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1977.tb00228.x

年代:1977

数据来源: WILEY

摘要:

ABSTRACTThe indications and contraindications for use of intrasynovial steroid therapy are discussed. When properly used, the intrasynovial injection of steroids is a valuable method of treatment.

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1977.tb00229.x

年代:1977

数据来源: WILEY

摘要:

ABSTRACTOlder people often complain of back pain, but it usually is not a major complaint except in the presence of serious disease such as malignancy, compression fractures from osteoporosis, or disc‐space infections. When back pain is a serious symptom in the elderly patient, the physician should look beyond the obvious evidences of degenerative joint disease for these other more serious conditions. Satisfactory examination of the back does not require an undue amount of time. It is important that it be done systematically. Simple, rapid, and adequate procedures are describe

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1977.tb00230.x

年代:1977

数据来源: WILEY

摘要:

ABSTRACTBack pain is one of the chief complaints of the elderly. It may be either a chronic deep skeletal muscular pain or an acute circumscribed pain arising from nerve‐root irritation. The main causes of back pain in older people are: 1) degenerative changes (spondylosis, osteoarthritis, ankylosing hyperostosis); 2) malignancy (multiple myeloma, metastases from carcinoma or lymphoma); and 3) metabolic disorders (osteoporosis, osteomalacia, chondrocalcinosis, Paget's disease). Mechanisms and variations are discussed in detai

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1977.tb00231.x

年代:1977

数据来源: WILEY

摘要:

ABSTRACTIn experience with total joint replacement in the lower extremity, to date, total hip arthroplasty has been the most successful. Total arthroplasty operations as applied to the knee and ankle are giving promising results. These methods offer new avenues for relief of pain and deformity and stabilization of arthritic joints in the lower extremity.

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1977.tb00232.x

年代:1977

数据来源: WILEY

摘要:

ABSTRACTThe principles of total joint arthroplasty recently have been expanded to the upper extremity, following the dramatic success with total hip and total knee replacement procedures. New problems have been encountered with the rebalancing of the soft tissues and the technical nature of joint mechanics in the upper extremities. Work on shoulder joint replacement is in the very early stages and of unknown success. Several prostheses are being used and tested. For elbow and wrist replacement, early and predictable success has been accomplished, enabling relief of pain and satisfactory motion. Total joint replacement in the fingers and thumb has provided excellent relief of pain but has been hindered by difficulties in rebalancing the soft tissues in patients with rheumatoid arthritis. It appears that total reconstruction of arthritic upper‐extremity joints will be commonplace in the not‐too‐distant future. Clinical trials are being expanded, with increasing su

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1977.tb00233.x

年代:1977

数据来源: WILEY

摘要:

ABSTRACTThe basic conservative therapy programs for elderly patients with arthritis include adequate physical rest and mental relaxation, analgesics, aspirin, and physical rehabilitation consisting of occupational and physical therapy with a good home therapy program providing appropriate balance between rest and activity. Proper protection from trauma and overuse of the involved joints, and appropriate nutrition can afford optimal improvement in health status and general resistance. Proper orientation of the patient regarding the nature of his disease and treatment program usually is required to obtain his full cooperation. A kind, encouraging, and understanding approach is most helpful in the elderly patient. Physical rehabilitation can help to relieve pain, decrease edema and deformities, improve muscle weakness and incoordination, and increase stamina. Difficulties with gait, transfers, and self‐care can be solved or improved. Physical medicine and rehabilitation measures are important components of the challenging treatment of patients of all age groups who are afflicted with severe arthritis. It is most important to tailor these components of the treatment program to the problem presented by geriatric arthritic patient

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1977.tb00234.x

年代:1977

数据来源: WILEY

摘要:

ABSTRACTNursing home patients often receive more drugs than needed. Drug incompatibilities frequently are found, and PRN orders are apt to be overused. Regulatory agencies require periodic physician review in the hope of eliminating these loose prescribing habits. A study was made of the drugs prescribed for 98 patients in a proprietary nursing home. The principal findings were that PRN orders can indeed be inappropriate and indiscriminately followed, and that the multiplicity of drugs often prescribed can lead to drug incompatibilities and to additional illness of the patient. Concern is expressed about the medication review process currently in vogue in nursing homes.

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1977.tb00235.x

年代:1977

数据来源: WILEY