ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1983.tb02194.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

In 1982, The Mount Sinai School of Medicine inaugurated the Gerald and May Ellen Ritter Department of Geriatrics and Adult Development. On December 7th, Robert N. Butler, M.D., was invested as the first Brookdale Professor of Geriatrics and Adult Development and Chairman of this new department. Seymour S. Kety, M.D., Professor of Neuroscience in Psychiatry at the Harvard School of Medicine and Director, Laboratories for Psychiatric Research, Mailman Research Center, The McLean Hospital, delivered the guest address. The following remarks were delivered by Dr. Butler and Dr. Kety at the investiture ceremony.

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1983.tb02195.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

To assess whether care in a geriatric assessment unit using a multidisciplinary team approach with rehabilitative emphasis impacted on patient placement outcomes, a historical prospective study was initiated using records of geriatric assessment unit patients admitted during a one‐year period (n = 62). A second, diagnostically similar general medicine unit cohort was also sampled (n = 62). Placement outcomes of the two groups were compared. All study patients were 75 years of age or older, stratified by source of admission, and controlled for comparability using diagnostic grouping. The geriatric assessment unit admitted 92 per cent of its patients from home; the general medicine unit, 82 per cent. As a result of expanded rehabilitative, respite, and terminal care promoted by the geriatric assessment unit staff, mean length of stay was 36 days, whereas it was 13 days in the general medicine unit (P<0.001). There was no significant difference between the two units with respect to hospital deaths, post‐hospitalization discharges to home or nursing homes, or patient locations (home versus nursing home) six months after admission. Although improvements in patient independence may have been achieved through the efforts of a multidisciplinary team approach utilizing the geriatric assessment unit, they were not sufficient to significantly increase the proportion of patients placed at home. Superiority in placement outcome may be demonstrated only by geriatric assessment unit use of selective admission crite

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1983.tb02196.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

Eighty‐three authors who had published papers within the last five years on pharmacologic therapy in aged humans were surveyed by written questionnaire and their responses analyzed. The survey sought opinions on the scientific, clinical, and social context of legislation on drug product selection (generic legislation) and its relationship to geriatric pharmaco‐therapeutics. The majority of respondents: 1) were generally unaware of the content of the clinical or scientific opinion offered on the subject of drug product selection as part of the legislative process; 2) felt that potential cost savings for elderly people was a factor in advancing this legislation; 3) wrote prescriptions so that product substitution could occur despite their ambivalence about such substitutions and about the knowledge of pharmacist and physician concerning product substitution and drug equivalence for the elderly. Clinical pharmacologists and geriatricians, however, were less likely than other respondents to permit substitution. The implications of current opinions and practices regarding drug product selection for geriatric patients are discus

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1983.tb02197.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

Neurotoxic effects of habitual alcohol consumption were investigated by correlating the subjects' estimates of abstinence or frequency and amount of alcohol consumed with measurements of gray matter blood flow utilizing the133Xe inhalation method. Two hundred and twenty‐two subjects were studied, including 136 healthy subjects, 82 subjects with well‐established risk factors for stroke (hypertension, hyperlipidemia, heart disease, and diabetes mellitus), and four subjects with chronic alcoholic dementia of the Wernicke‐Korsakoff type. Subjects were classified according to average quantitative amounts of alcohol consumed per day, week, or month for the past five years. Comparisons of mean values for hemispheric gray matter blood flow indicated significant inverse relationships with the average amounts of alcohol consumed. This linear relationship occurred regardless of whether or not other risk factors were present and indicated that alcohol itself was a risk factor reducing gray matter blood flow and had additive effects of reducing cerebral blood flow further when combined with other risk factors. Patients who had chronic Wernicke‐Korsakoff syndrome had the most severely reduced blood flow levels, as might be predicted from extrapolation of the regression line comparing cerebral blood flow values with the degree of chronic alcohol cons

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1983.tb02198.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

Surgery has sometimes been studied as a stressful event. The aim here was to determine the relationship between degrees of anxiety before surgery and postoperative outcomes in healthy old and young men. Old and young men were selected if they had no illnesses or prior surgery and were scheduled for elective hernia repair. Levels of anxiety were measured preoperatively along with other physiologic, psychologic, and immunologic modalities. Operative data and follow‐up data for 30 days were obtained. Old and young men did not differ significantly before surgery. When age groups were divided by preoperative anxiety and their postoperative outcomes compared, more anxiety was associated with more pain‐relieving medications and more disability days in each age group. Furthermore, the old anxious had even more disability days and complications than did other groups. The study points to the need to prepare the old, even those essentially in very good health, for even a minor surgical stress in order to improve their overall health outco

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1983.tb02199.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

A long‐term clinical comparison of the effects of ergoloid mesylates and placebo on 148 healthy elderly volunteers of both sexes was analyzed after three years of study. At that point, 99 subjects (53 receiving ergoloid mesylates and 46, placebo) were still being treated under double‐blind conditions, while the remainder either had dropped out or continued to participate under open conditions. Many subjects in both groups were healthier after the three years than they had been at the onset of the study: subjective symptoms such as tiredness and dizziness were reduced, performances on tests of intelligence were improved, and some abnormal laboratory values had normalized. Blood pressures increased on the average during the investigational period and pulse rates became slower. The ergoloid mesylate regimen was well tolerated objectively and subjectively. Additional medical and psychologic improvements were noted in the group treated with ergoloid mesylates concerning cardiovascular parameters, cholesterol levels, subjective symptoms, and performances on tests of intelligence. These intermediate findings are interpreted as showing a preventive effect of ergoloid mesylates against some of the debilitating physical and psychologic concomitants of ag

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1983.tb02200.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

Antihypertensives are among the most commonly prescribed drugs for the elderly. Several studies have discussed the benefits of stepped‐care drug therapy for hypertension in the elderly, and propranolol, methyldopa, and more recently, clonidine and prazosin have been recommended as step‐two antihypertensive drugs. Recent articles omit reserpine as an alternative. A case is made for the use of reserpine by comparing factors of special importance to most elderly: cost, side‐effects, frequency of dosage, number of tablets, and the effect of omitted

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1983.tb02201.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

There is good evidence that malnutrition may alter the pharmacokinetic parameters and, thus, actions of several drugs. The elderly are probably most at risk, as malnutrition tends to affect factors already altered by primary and secondary aging.

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1983.tb02202.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

The relative merits of the hospice, palliative care units, and geriatrics departments as settings for management of the dying patient are considered.

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1983.tb02203.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY