摘要:

AbstractDuring the six‐month period, February—August 1966, 400 cystoscopies and 228 urological operations were performed on ward and semiprivate patients on the Urological Service of Columbia‐Presbyterian Medical Center. Postoperative complications occurred in 63 cases:There were 12 suspected cases of endotoxic shock, in only 5 of which was bacteremia proved to be present.There were 51 cases of pyrexia with a temperature of more than 102° F.Most of these complications were caused by urea‐splitting bacteria.If a urea‐splitting bacterium is present in the urine, instrumentation and/or operation should be deferred if possible until a specific bactericidal can be given. In emergency situations, two specific antibacterials should be available for the control of possible endotoxic shock.Attempts at prevention of postoperative endotoxic shock by means of prophylactic antibacterial therapy have been disappointing.In view of the fact that anabolic, relatively nonandrogenic steroids increase the resistance of animals to experimental infection with Aerobacter aerogenes and Streptococcus hemolyticus, and neutralize the effect on A. aerogenes endotoxin (lipopolysaccharide), it is suggested that these steroids be used to supplement the present treatment of bacteremia or bacterial endot

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1968.tb02756.x

年代:1968

数据来源: WILEY

摘要:

AbstractThe voltage gain in human muscle under conditions of prolonged isometric contraction was measured in 24 subjects—12 “young normal” subjects whose ages ranged from 26 to 53 years, and 12 “normal over‐65” subjects whose ages ranged from 66 to 78 years.In terms of rate of voltage increase and initial voltage, there was little or no difference between the two age groups. The mean percentage increase in voltage for the older group was about half that for the younger group. However, this was interpreted on the basis of about a 50 per cent reduction in contraction time for the older group.Skeletal muscle fatigue when the biceps brachii muscles were subjected to prolonged isometric contraction developed in the over‐65 group in about the same manner (electrically) as in the young group. The only significant difference was the ability of the younger subjects to sustain the contraction about twice as long as did the o

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1968.tb02757.x

年代:1968

数据来源: WILEY

摘要:

AbstractThe axiom, the aphorism and the proverb are defined. A collection is presented of 134 pithy sayings dealing with old age in its various aspects. They are fine examples of message augmentation by the use of brief often witty statements composed with artistic precision.

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1968.tb02758.x

年代:1968

数据来源: WILEY

摘要:

AbstractAn autopsy on a woman aged 71 revealed 25 separate pathological lesions. The cause of death was coronary thrombosis.The case is reviewed in relation to multiple pathology found in other elderly subjects. The number of lesions increased with advancing age in these series.

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1968.tb02759.x

年代:1968

数据来源: WILEY

摘要:

AbstractSomatic illnesses of the elderly are discussed from the standpoints of prevention and rehabilitation.The Periodic Health Examination (P.H.E.) after age 40 should play a prime role. This form of prevention merges into treatment, maintenance care and rehabilitation. Purely laboratory screening without expert medical interpretation has many pitfalls and is a dehumanizing process. P.H.E. and maintenance care should be undertaken by the general practitioners. Examples in Edinburgh and The Netherlands are cited.It is recommended that Age Guidance Clinics be established. These would be patterned somewhat after Child Welfare Clinics, but adapted to the needs of patients of advanced age. They would require much larger staffs of specially trained nurses.The first important step on the long road to successful rehabilitation is the total evaluation of the patient's physical, mental and social assets. A simple assessment of the physical deficiencies cannot serve as an adequate foundation for successful total restoration. Physico‐medical rehabilitation has added a great deal to acceptable methods of treatment for elderly people. Definite criteria and limitations must be recognized, however, and the programme should be employed with common sense and realis

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1968.tb02760.x

年代:1968

数据来源: WILEY

摘要:

AbstractA program is described for the comprehensive care of patients on the medical service in an 1800‐bed municipal chronic disease hospital. Patients with neoplastic disease or those who need merely custodial care are not considered candidates for admission. Every new patient first stays in the admitting section for about three weeks to undergo thorough evaluation of his needs and rehabilitation potential. He is then transferred to one of the four comprehensive care units on the medical service. This unit system facilitates the assignment of a personal physician to each patient. The staff is organized into teams to provide the non‐medical as well as the medical services required during the patient's entire stay in the hospital. Interdisciplinary teaching conferences encourage efficiency on the part of all staff members.Because the chief goal of the program is the provision of comprehensive care for patients with multiple problems, the staff physicians can no longer be concerned with only a single disease or organ system. They must cope with a wide range of medical problems and also with the patient's reactions to his disease and the interrelationships between the patient, the family and the community. Such a program provides a new, flexible approach to services, teaching and research in the care of the chronically

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1968.tb02761.x

年代:1968

数据来源: WILEY

摘要:

AbstractThe acid mucopolysaccharide, chondroitin sulfate‐A (CSA), which is active in preventing experimentally‐induced atherosclerosis in monkeys, rats and rabbits, also has anticoagulant properties in rabbits and in patients with angina pectoris from coronary arteriosclerotic heart disease.For an average period of one and a half years (range, one to two years), CSA was administered orally (tablet or powder) to 60 patients with clinically manifest coronary arteriosclerotic heart disease, in dosages ranging from 1.5 to 10.0 gm daily. No toxic effects were noted and the medication was well tolerated. These patients were matched with a comparable group of 60 control patients for age, sex, and clinical and laboratory findings.In the 60 control patients, 13 acute coronary incidents occurred; 7 were myocardial infarctions, of which 2 were fatal and 6 required hospital treatment in coronary‐care units for “acute coronary insufficiency” or “acute myocardial ischemia” or impending myocardial infarction.In the 60 CSA‐treated patients there was only 1 coronary incident—a fatal case of myocardial infarction.This preliminary report suggests that “feasibility” studies are warranted to determine the therapeutic effects of CSA for the prevention of coronary arteriosclerotic heart disease in statistically designed, triple‐blind investigations on a larger series of patients over

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1968.tb02762.x

年代:1968

数据来源: WILEY

摘要:

AbstractA comparison of two sympathomimetic amine bronchodilator aerosols was made in 10 adult patients with chronic obstructive respiratory disease. Isoproterenol, an isoproterenol‐phenylephrine combination and placebo were administered in a sequence of pairs (double‐blind pattern) at the rate of 6 inhalations at five‐minute intervals; this procedure was repeated on three successive days.Isoproterenol‐phenylephrine was more effective than isoproterenol alone, as shown by pulmonary function tests. It seemed to prevent augmentation of the cardiovascular effects of isoproterenol. Isoproterenol‐phenylephrine had about the same effect as proterenol with regard to acceleration of the heart rate, rise in systolic blood pressure, and the production of tremulousness.Repetitive dosing with these aerosols (strictly limited to the rates and amounts described) results in step‐like improvement in expiratory airflow defects, and side reactions

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1968.tb02763.x

年代:1968

数据来源: WILEY

摘要:

AbstractAn exercise program (running) significantly reduced body weight in 5 previously sedentary, overweight males whose ages ranged between 35 and 46 years. (Five control males remained sedentary.) With exercise, body weight decreased an average of 4.5 kg (from 88.1 to 83.6 kg). The weight reduction was primarily the result of loss of body fat; the fat‐free weight did not change significantly. Each subject participated in 47 training sessions during a 16‐week period. The heart rate, measured by palpation at ten‐minute intervals throughout each training session, ranged between 155 and 170 beats per minute.It appears that exercise is effective in reducing body weight and can reverse the trend towards increased adiposity in middle age and there

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1968.tb02764.x

年代:1968

数据来源: WILEY

摘要:

AbstractThe present treatment of urinary‐tract infections is unsatisfactory because of the high rate of relapse. Attempts to prevent relapses should include careful study of the urinary tract (with as little instrumentation as possible) to determine the presence or absence of urinary obstruction—a prime cause of infection. The urine should be examined by cultural techniques for detecting significant bacteriuria. This should be repeated at the end of two weeks of therapy and at one month, three months, six months and a year thereafter.The most important clinical aspect of treatment is long‐term follow‐up, checked by means of urine cultures. There is good evidence that long‐term treatment for one or two years with sulfamethoxazole or nitrofurantoin in combination with methenamine mandelate will reduce the recurrence rate of urinary‐tract infections; drug toxicity is low. The recommended short‐term (ten to fourteen days) course of treatment for initial infections is inadequate for the recurrent type. Recurrent urinary‐tract infections require long‐term treament in association with careful urine‐culture examinations at periodic intervals f

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1968.tb02765.x

年代:1968

数据来源: WILEY