摘要:

Abstract:This study involved a sub‐group of a panel of community volunteers—37 long‐lived persons (20 men, 17 women) and 37 short‐lived persons (20 men, 17 women). The findings suggest that group characteristics of long‐term survivors differ sharply from those of short‐term survivors in old age. Moreover, it seems that there is no single factor which contributes to longevity; rather, there is a constellation of biological, psychological, and social factors amounting to what may be best described aselite ***status.Persons with high intelligence, sound financial status, well‐maintained health, and intact marriages may be expected to live significantly longer than their less intelligent and poorer brothers and sisters whose health is also declining and whose marriages are no longer intact. Many of the factors identified here as contributing to longevity are not readily subject to individual, social, or political manipulation, with the possible exception of financial factors.It is hoped that investigations in other parts of the country and with differing populations of elderly people can determine if the hypotheses put forward here apply to elderly persons generally. It would also be interesting to know if these factors are similarly important in influencing survival at other stages of the life cycle. Infant mortality in this country certainly seems to be related to some of the factors examined

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1970.tb03180.x

出版商:Blackwell Publishing Ltd    

年代:1970

数据来源: WILEY

摘要:

Abstract:In a hospital population of geriatric patients with chronic disease, 1,584 patients were tested and the pathogens most commonly involved in their infections were identified. The antibiograms of these bacteria (in vitro) were established. The leading pathogens wereProteus mirabilis, Pseudomonas aeruginosa, Providence group(Proteus inconstans), Escherichia coli, Staphylococcus aureus, andStreptococcus fecalis, in descending order of frequency. Of significance was the emergence of the Providence group(Proteus inconstans), and its high degree of resistance to most antibiotics tested. It is conceivable that the Providence group might become a major pathogen in the future, because its resistance to antibiotics favors its survival. A new, more effective drug is desired for this group.

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1970.tb03181.x

出版商:Blackwell Publishing Ltd    

年代:1970

数据来源: WILEY

摘要:

Abstract:To evaluate amino acid metabolism in osteoporosis, the effects of oral loading with an amino acid mixture were studied in 11 aged patients with advanced osteoporosis, 5 aged patients with mild osteoporosis, and 7 healthy aged subjects (controls). The osteoporotic patients were free of other major diseases. In all three groups the physical examination, blood chemical determinations, urinalysis and fluoroscopy of the upper gastrointestinal tract gave normal findings; in particular, no liver or kidney disease was indicated by the results of function tests. A diagnosis of vertebral osteoporosis was made when the ratio of vertebral to disc density in the lateral tomogram of the lumbar spine was 1.0 or higher; in the normal subjects, the ratio was always less than 1.0. The presence of compression fracture(s) was considered to indicate severe osteoporosis, whereas the absence of such fractures graded the disease as mild.Gaschromatographic analysis of the serum for certain free amino acids was made on the blood specimens drawn immediately before, and at one, two, three and four hours after oral ingestion of the test amino acid mixture. The serum valine level for the severely osteoporotic group was significantly higher at one hour (215 + 21 μg/ml versus 151 + 9 for the controls) and at four hours (178 + 16 μg/ml versus 139 + 8.7 for the controls) after ingestion of the mixture. The peak height of the serum valine level was also significantly higher in the severely osteoporotic patients (263 + 25 μg/ml) than in the controls (192 + 5.5 μg/ml). In the mildly osteoporotic patients the values were intermediate. For leucine and phenylalanine, the tolerance curves for the osteoporotic patients were similar to those for the controls. The findings are consistent with the hypothesis that possibly there is a deficiency or defect of valine transaminase in osteoporo

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1970.tb03182.x

出版商:Blackwell Publishing Ltd    

年代:1970

数据来源: WILEY

摘要:

Abstract:Three vital factors should be taken into account in all attempts at geriatric rehabilitation: 1) psychological status, particularly as related to pseudosenility and peculiar character traits versus the old concept of senile dementia; 2) socioeconomic welfare in an era in which the over‐all trend is toward separation of the aged from their children, a preoccupation with prolonging survival, and a sudden drive to solve the problem by jerry‐built placeboes; and 3) vocational opportunities for the healthy and only partially handicapped a

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1970.tb03183.x

出版商:Blackwell Publishing Ltd    

年代:1970

数据来源: WILEY

摘要:

Abstract:A follow‐up study of 12 geriatric chronically ill mental patients placed in foster homes as the result of an intensive ward rehabilitation program revealed that 8 (67 per cent) of these men remained out of the hospital at the end of five years. Six had been discharged from the hospital and 2 remained on trial visit status in foster homes. All but 1 of the 8 men were still in foster homes at the time of follow‐up. Neither age, the severity of psychiatric disability nor the length of previous hospitalization was a deterrent to success in home care, as long as the patient was not extremely irritable or aggressive. Indeed, the older men in this study remained out of the hospital significantly longer than did the younger ones. Eight of the 12 patients required transfer to a new foster home, re‐admission to the hospital, or new placement after rehospitalization—which shows the importance in such a program of having continuous supervision by a persistent social work staff.The number and proportion of geriatric chronically ill patients who reside in our mental hospitals have risen dramatically during the last few decades and will almost certainly continue to increase. By the usual channels of release from the hospital, this group of patients has the poorest prospects of all to remain out of the hospital. Foster home care is a humane and economical alternative for many of these patients. Our findings indicate that if patients are carefully selected, prepared and supervised after placement, the chances of long‐term success in foster home care can be impressi

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1970.tb03184.x

出版商:Blackwell Publishing Ltd    

年代:1970

数据来源: WILEY

摘要:

Abstract:The serum levels of folic acid and vitamin B12were estimated in 3 groups of subjects: Group 1 consisted of 59 elderly patients screened from 152 consecutive hospital admissions from homes for the aged and from a geriatric center; Group 2 consisted of 51 geriatric patients admitted to the hospital from their own homes; and Group 3 (controls) consisted of 100 younger healthy subjects who were not in the hospital. Medication with drugs known to interfere with the biologic assay of these vitamins was the chief reason for eliminating all but 59 of the 152 patients tested originally for Group 1.Very low levels of serum folate (less than 3 mμg/ml) were found in 24 per cent of the Group 1 geriatric patients, in 7.8 per cent of the Group 2 geriatric patients, and 5 per cent of the younger controls. Two of the geriatric patients had anemia due to folate deficiency and responded to oral administration of folic acid. The high incidence of unusually low serum folate levels was attributed to widespread folic‐acid deficiency resulting from poor nutritional intake and related to organic disease, especially neurologic disability; apparently it bore no relationship to the chronologic age of the patients. The significantly higher level of serum vitamin B12found in the geriatric group possibly was due to the increasing use of vitamin B12(orally or parenterally) in the treatment of elderly patients during the last fourteen yea

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1970.tb03185.x

出版商:Blackwell Publishing Ltd    

年代:1970

数据来源: WILEY

摘要:

Abstract:Interest in the extracerebral circulation, particularly in the elderly, has led to new methods of estimating blood pressure in the carotid arteries. The method described here involves use of the ophthalmodynamograph, which simultaneously monitors orbital blood pressure and brachial artery blood pressure.The study was made on 66 patients in a geriatric day hospital. The 53 females (average age, 76) and 13 males (average age, 70) had multiple disease. The five most common diagnoses were cerebrovascular accident with hemiplegia (18 cases), osteoarthritis (10 cases), cerebral arteriosclerosis (9 cases), ischaemic heart disease with congestive failure (9 cases), and parkinsonism (6 cases). In 120 eyes, the orbital diastolic pressure varied from 50 mm to 135 mm Hg, being between 80 and 100 mm in 50 per cent and below 80 mm in 27 per cent. The orbital diastolic pressure often was greater than the brachial; in 10 cases the difference was greater than 20 mm. When the diastolic pressures in the two eyes were compared, 9 cases showed a difference greater than 10 mm and 24 cases a difference greater than 6 mm.Problems exist regarding the interpretation of certain waveform changes in the tracings. However, the apparatus is reliable, safe, and easier to use than most available techniques for studying blood flow in this region.

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1970.tb03186.x

出版商:Blackwell Publishing Ltd    

年代:1970

数据来源: WILEY

摘要:

Abstract:A survey was made of the cases of lung carcinoma referred to the Radiology Department for cobalt60therapy during the first five years after installation of the cobalt unit at Creighton Memorial St. Joseph's Hospital in Omaha. After elimination of 27 cases in which there had been other conjunctive therapy such as surgery, chemotherapy or x‐ray irradiation, there were 85 cases for study. Two cases were lost to follow‐up, so the data pertain to 83 patients (mean age 60, range 30–78).The complete planned course of cobalt60irradiation delivered a total dose of 4,000–5,000 r during six to eight weeks, with half the dose given in the first two weeks, followed by a two‐week rest period. Only 39 of the patients were able to complete the planned course of 4,000–5,000 r. The mean length of survival for all the patients was fourteen and a half months after starting therapy. Two patients are still living at seventy‐five and seventy months, and 1 at thirty months. The overall survival rate was 4 per cent, but for the group receiving the full course of therapy it was 7.5 per cent. About three quarters of the 83 patients obtained moderate to marked relief of symptoms.These results are similar to several reported in the literature, and serve to emphasize the benefits of cobalt teletherapy in otherwise incurable cancer

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1970.tb03187.x

出版商:Blackwell Publishing Ltd    

年代:1970

数据来源: WILEY

摘要:

Abstract:Tears of the knee meniscus are contrasted in the young versus the elderly. The diagnosis may prove difficult in the elderly, as often there is no definite history of trauma. Characteristic signs and symptoms and methods for examination are outlined. Early menisectomy may prevent erosion of the cartilage and degenerative changes in the joint.

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1970.tb03188.x

出版商:Blackwell Publishing Ltd    

年代:1970

数据来源: WILEY

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1970.tb03189.x

出版商:Blackwell Publishing Ltd    

年代:1970

数据来源: WILEY