摘要:

Abstract:At present the medical student's education in geriatrics is left chiefly to the postgraduate period. There are encouraging signs, however, that medical students are being made more aware of the relationship of aging and chronic disease to the understanding of medicine in general. In the postgraduate period, when physicians are supposed to keep up to date by means of continuing education, there are very few opportunities in the field of geriatrics. Moreover, such programs often are not properly coordinated and monitored. Attempts are being made to rectify this situation.Single individuals or professional societies are weak alone, but can be strong when united in establishing training programs in geriatrics. The American Geriatrics Society and the Gerontological Society should be in the forefront. They should either develop a specific program of their own or should cooperate with the American Academy of General Practice and the American Medical Association in formulating courses that include geriatrics. These programs would undoubtedly lead to institutional postdoctoral education in the subject, and eventually would involve medical students. Meanwhile, all such efforts would improve the care of the aged and infirm.

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1971.tb01923.x

出版商:Blackwell Publishing Ltd    

年代:1971

数据来源: WILEY

摘要:

Abstract:Seven case reports are used to illustrate various aspects of quality care for the ill aged in an extended care facility or a nursing home. The majority of these patients require maximal nursing care for activities of daily living. Quality medical care implies the physician's capacity to design a therapeutic program involving the coordinated efforts of a total rehabilitation approach on the part of the available multidisciplinary professional team. If the concept of custodial care were made obsolete and only skilled care provided for all patients, quality medical care would ensue.

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1971.tb01924.x

出版商:Blackwell Publishing Ltd    

年代:1971

数据来源: WILEY

摘要:

Abstract:Based on the assumption that the menopause or climacteric is due to a decline in function of the sex glands as part of the process leading to old age with all its physical and mental implications, 1,000 women and 300 men (age range, 40–75 years) were treated with hormone implants during the years 1945–1970. The advantages of the implant method are listed. This therapy resulted in a marked improvement in flushes, in general condition, in depression and fatigue, and in the local changes of the genital tract and skin; the patients looked better and younger. The arguments against hormone treatment (especially with oestrogen) are: 1) it might cause post‐menopausal bleeding, and 2) it might produce cancer. In our series, the incidences of bleeding and of cancer were lower in the hormonally treated women than in the women who did not receive hormone therapy.This evidence combined with that in the literature indicates that menopausal patients need not be deprived of the benefits of hormone therapy, which will contribute greatly to their well‐being and may at least delay the development of degenerative d

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1971.tb01925.x

出版商:Blackwell Publishing Ltd    

年代:1971

数据来源: WILEY

摘要:

Abstract:The utilization of glucose, glucose + insulin, insulin, fructose, galactose and ribose (after intravenous injection) was studied in healthy subjects—6 of each age group (approximately 20, 40 and 80 years) in each of the 6 phases of the study.We confirmed that glucose is not used as well by the elderly as by the young. When glucose and insulin were given together, however, there was little variance with age. When insulin was given alone, there was no age difference regarding the rates of fall in the blood sugar level, but in the older subjects there was a slight slowing of the rate of recovery from the hypoglycemia. Fructose metabolism showed a slight variation with age; the older persons were not able to utilize fructose as rapidly as the younger persons. The same situation applied to galactose. Ribose utilization, however, was not affected by the age of the subjec

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1971.tb01926.x

出版商:Blackwell Publishing Ltd    

年代:1971

数据来源: WILEY

摘要:

Abstract:The 23rd Annual Conference on Aging, held at the University of Michigan, Ann Arbor, August 12–14, 1970, is reviewed. A general theme was developed for the role of the elderly in the 1970 decade. Plans were presented for the White House Conference in 1971. Social Security, Medicare, and Medicaid—past, present and future—were expounded. Historical tributes were paid to social legislation and its architects. The subject of Health and Security for the Aged pervaded all sessions and workshops. Nationally recognized leaders provided the inspired fa

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1971.tb01927.x

出版商:Blackwell Publishing Ltd    

年代:1971

数据来源: WILEY

摘要:

Abstract:Forty female Wistar‐Imamichi rats, each weighing 98 gm, were divided into 5 equal groups and the effects of dihydrotachysterol (DHT) on the calcium content and weight of the kidney, heart, aorta and femur were compared in ovariectomized and in intact rats. The effect of DHT was much more pronounced in the ovariectomized than in the intact rats. These findings strongly suggest the protective effect of endogenous estrogens on the DHT‐induced progeria‐like syndrome in

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1971.tb01928.x

出版商:Blackwell Publishing Ltd    

年代:1971

数据来源: WILEY

摘要:

Abstract:The present philosophy in the treatment of mental patients tends to bring the problem back to the community. In such a rehabilitative program, the Binghamton State Hospital is using supervised family‐care homes as a successful alternative to the long‐term hospital confinement of homeless geropsy‐chiatric patients.Within the administration of Binghamton State Hospital, there are 60 family‐care homes for 390 patients, of whom about one third are over 65 years of age. In some homes there are mixed populations with respect to both age and sex. In October 1969 there were 77 geriatric females and 36 geriatric males under family care. The average age was 69 for the females and 71 for the males. The average length of hospital stay before placement in family care was nine years and ten months. The average duration of residence in a family‐care home up to October 1969 was four years and four months. The homes are selected by the State Hospital Administration and are supervised by various teams of the unitized Broome County Unit. A team consists of a physician, a social worker, nurses, attendants, an occupational therapist and a recreational therapist. It instructs the family‐care “mother” and the patient about the various methods for resocialization, takes care of medical and psychiatric supervision, and makes arrangements for eventual working activities.Placement in a family‐care home has three practical results: 1) elderly psychiatric patients are returned to the community without being under the stress of having to manage their own daily problems; 2) in the hospital there is better utilization of the beds for patients who require residential treatment programs; and 3) family care is more economical for the hospital and, conseque

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1971.tb01929.x

出版商:Blackwell Publishing Ltd    

年代:1971

数据来源: WILEY

摘要:

Abstract:Two groups of diabetic patients of comparable age were studied. In Group I were 14 patients who had a history, physical findings and electromyographic readings consistent with diabetic peripheral neuropathy. In Group II were 17 patients with a comparable history of diabetes but without any physical or EMG signs of diabetic peripheral neuropathy. Valsalva's maneuver was used to detect abnormal circulatory reflexes, and thus to determine whether or not autonomic neuropathy regularly accompanies peripheral neuropathy in diabetes.In Group I, 2 of the 14 patients showed a normal response, and 4 a partial response (42.7 per cent). In Group II, 5 of the 17 patients showed a normal response, and 7 a partial response (70.6 per cent). The significantly lower number of responses to Valsalva's maneuver in Group I suggests a close correlation between peripheral neuropathy and autonomic neuropathy in diabetes mellitus.

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1971.tb01930.x

出版商:Blackwell Publishing Ltd    

年代:1971

数据来源: WILEY

摘要:

Abstract:Sixty‐four patients aged 65 or older were examined with the Olympus fiber esophagoscope. Fifteen had inflammatory changes, 10 had carcinoma or lymphoma, 5 had stomal ulcers after partial gastrectomy and 3 had esophageal varices. The procedure was tolerated well by all patients. Fiberoptic esophagoscopy offers a thorough and reasonably safe method of examination for the geriatric patien

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1971.tb01931.x

出版商:Blackwell Publishing Ltd    

年代:1971

数据来源: WILEY

摘要:

Abstract:New admission criteria at the Bronx State Hospital exclude patients with non‐psychotic organic brain syndrome, mild psychoses or mild psychoneuroses. Thus an intensive psychiatric geriatric program was started consisting of chemotherapy; individual and group psychotherapy; family, recreational, and occupational therapy; and necessary medical attention. The comunity gradually is being educated successfully to accept the new policy.Nevertheless, because of outside influences, 66 patients who did not meet the new criteria had to be admitted during the period October 1, 1967 through September 30, 1969. In this study, these 66 are compared with a control group of 82 patients who met our admission criteria during the same period. Included are data on sex, marital status, age, method of referral, diagnoses, and results of therapy. The findings indicate that patients in the 65–69 age group, rather than the 70+ group, are the ones whom the community tries to “dump.” The patients who were admitted but did not meet the criteria had much more insight into their condition than those who met the criteria. Those who were admitted without meeting the criteria fared much more poorly in regard to duration of hospital stay, convalescent status, discharge status, and mortality rate.The improper placement of geriatric patients in a state mental hospital with a modern therapeutic geriatric psychiatric program is detrimental to these patients, and is a grievous error for all co

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1971.tb01932.x

出版商:Blackwell Publishing Ltd    

年代:1971

数据来源: WILEY