摘要:

ABSTRACT:In a Coronary Care Unit (CCU) with no age barrier for admission, 21 percent of the patients admitted in 1976 were aged 70 or older. Myocardial infarction was documented in 55 of 130 elderly patients. The overall incidence of arrhythmias was similar to that for younger patients. The mean duration of stay in the unit and the CCU mortality (9.1 percent) were similar in both elderly and younger patients, as was the in‐hospital mortality rate. Of the patients who survived hospitalization, 75.6 percent were still living 18.1 months after the myocardial infarction. The elderly patient is as likely as the younger one to benefit from admission to a CC

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1979.tb06437.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

ABSTRACT:In 65 elderly hyperthyroid patients (age range 50–78 years), sex differences, signs and symptoms and thyroid function were studied and the data were compared with those on 48 young hyperthyroid patients (age range 20–29 years). The incidence of hyperthyroidism was 3.5 times higher in females than in males among the young patients, whereas it was approximately equal in males and females among the elderly patients. Signs and symptoms conformed with the textbook description in the young subjects but not in the elderly ones. Measurements of serum triiodothyronine (T3) and thyroxine (T4) proved useful in preventing false diagnoses in elderly patients with atypical symptoms. In some elderly subjects with marginal increases of serum T3and T4concentrations, measurement of serum thyroid‐stimulating hormone (TSH) after administration of thyrotropin‐releasing hormone (TRH) was required to achieve an accurate diagnosis. Serum T3and T4levels and the thyroidal uptake of radioiodine were slightly but not significantly lower in the elderly than in the young patients. A high titer of circulating thyroid auto‐antibody in the elderly may be related to this slight decrease in thyroid function. Serum T3levels were significantly lower in the elderly than in the young subjects; this suggests impairment of peripheral monodeidination of T4. Any abnormal serum of T4, T3and TSH before and after administration of TRH could easily be restored to normal by treatment with antithyroid drugs in the elderly

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1979.tb06438.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

ABSTRACT:A random sampling of 160 patients in a chronic disease facility showed that 36 patients (22.5 percent) had chronic hyponatremia. Their mean age was 72 years (range, 42–94 years); 75 percent of the patients were more than 65 years old. Women comprised 57 percent of the group. The mean serum sodium level was 120 mEq/L (range, 109–135 mEq/L). The mean serum osmolarity was 270 mOsm/L (range, 251–294 mOsm/L). Of the 36 patients, 9 were asymptomatic. Symptoms were associated with underlying disorders rather than with hyponatremia, although in 9 patients the hyponatremia appeared to have intensified existing symptoms. The most common cause of hyponatremia (in 41.6 percent of 20 overhydrated patients) was inappropriate secretion of antidiuretic hormone (IADHsyndrome). Factors accounting for the high incidence ofIADHwere the age of the patient and the nature of the underlying disorders, particularly diseases associated with aging. Simple measures were used to manage the hyponatremia, e.g., water restriction for patients who were overhydrated; replacement of sodium chloride for patients who were losing salt excessively and had a low sodium intake; and control of hyperglycemia in the pseudohyponatremic patients with hyperglycemia. No treatment was required for pseudohyponatremia associated with hyperlipidemia. When hyponatremia was due to drug‐inducedADHexcess, the involved drug was discontinued. Emphasis on management of the patients' primary disorders also ameliorated the hyponatremi

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1979.tb06439.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

ABSTRACT:In 1974, a 10‐month diagnostic evaluation of 80 newly admitted psychogeriatric patients was undertaken. The diagnostic categories were functional versus organic brain disease. The present report deals with results of a follow‐up evaluation three years later. to assess the prognostic validity of our measures, the initial 1974 data on survivor and nonsurvivor groups were studied, and some of the tests were repeated in 35 of the 40 survivors. Statistically significant differences between survivors and nonsurvivors were found in both “organic” and “functional” groups, with respect to performance on psychologic and psychophysiologic tests, and the level of social functioning before admission. The death rate was significantly higher in the group with orga

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1979.tb06440.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

ABSTRACT:The numbers and percentages of active rosette‐forming T cells were measured in two age groups, to assess the effects of aging. The study included 21 healthy persons in the 20–40 age group and 25 persons without major disease in the 60–85 age group. In the younger subjects the number of rosette‐forming cells (RFC) averaged 1430 ± 463/cu mm (mean and S.D.), a count not significantly different from that in the older subjects (1443 ± 398/cu mm). Likewise, the active RFC count in the 20–40 age group (526 ± 185/cu mm) and that in the IJO‐85 age group (558 ± 197/cu mm) were not significantly different. There was no difference for the percentage total RFC (young 78 ± 4%, elderly 78 ± 6%) or the percentage active RFC (young 29 ± 7%, elderly 30 ± 6%). For the total lymphocyte count or the B lymphocyte count, there was no difference between the two groups of subjects. It is concluded that T lymphocytes, measured as total and active rosette‐forming cells, are not decreased in

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1979.tb06441.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

ABSTRACT:This report concerns the use of d‐amphetamine in 88 elderly in‐patients who initially failed to respond to rehabilitation procedures. These patients exhibited characteristics of the Poor Motivation Syndrome (PMS), not associated with depression or dementia. The syndrome was seen five times more frequently in women. d‐Amphetamine was given for three weeks in increasing dosage (2.5–10.0 mg twice daily). The responses were scored according to mobility, self‐care and motivation. Of the&8 patients, 48 improved and another 28 were discharged who would otherwise have remained dependent nursing cases. An unexpected finding was that 17 patients showed an age‐related resistance to the effects of the drug (P<0.05). The likelihood of a beneficial response also diminished with increasing age (P<0.01). Side effects were in the psychiatric sphere; they occurred in 23 patients early in treatment and were not age‐related; the drug was withdrawn. Thus treatment with d‐amphetamine should be restricted to selected patients who satisfy the diagnostic criteria of PMS, and administration should be carefully supervised. With these safeguards, a substantial proportion of patients previously refractory to rehabilitation will show improvement, become more independent and may be discharged from the hospital in a much more active, less dependent state o

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1979.tb06442.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

ABSTRACT:Idiopathic hypertrophic subaortic stenosis (IHSS) occurs more commonly in the elderly than is generally believed, and is often unsuspected. In 26 patients above the age of 60, the diagnosis was recognized in only 7 (27 percent) prior to echocardiography. Symptoms included dyspnea in 17, chest pain in 16, and dizziness or syncope in 8 patients. In 10 patients, establishing the correct diagnosis led to therapy with propranolol, with or without discontinuation of digitalis; in 7 of these, the chest pain was significantly reduced. An accurate diagnosis is particularly important because drugs that are useful in other forms of heart disease may have adverse effects inIHSS. Echocardiography is the diagnostic procedure of choice and is indicated in the presence of an unexplained systolic murmur, especially when it is associated with chest pain, syncope or left ventricular hypertrophy.

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1979.tb06443.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

ABSTRACT:Two elderly patients presented with generalized aches and pains (particularly in the shoulders and the pelvic girdle), stiffness, fatigue, anemia, and an elevated erythrocyte sedimentation rate, but there were no signs or symptoms directly referable to the joints. Two and five months later respectively, pain, swelling, and signs of synovitis appeared in several joints in a symmetrical pattern, and a diagnosis of rheumatoid arthritis was made. Rheumatoid arthritis in the elderly may resemble polymyalgia rheumatica. On the other hand, synovitis in many patients with polymyalgia rheumatica may resemble rheumatoid arthritis. In the elderly, the differentiation of these two entities may be difficult. Moreover, patients initially presenting with the signs and symptoms of polymyalgia may eventually manifest typical rheumatoid arthritis.

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1979.tb06444.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

ABSTRACT:The Tuckman‐Lorge Questionnaire was used to study the attitudes of three groups of health workers toward old people and to test their acceptance of geriatric stereotypes. The health workers tested were medical students, house staff members, and members of a mobile psychogeriatric screening team. Many significant differences were found between and within the groups tested, as well as between male and female subjects. The female house‐ staff had extremely high and significantly different scores from all other groups. The geriatric staff adhered least to the stereotypes. The results are discussed in the framework that the attitudes of care givers are directly related to the quality of the care provided. It is hypothesized that female house staff members have special difficulties with role conflicts that cause them to adhere to stereotypes of the aged. The milieu of geriatric treatment, rather than knowledge of statistics about old people, is the most effective background for positive changes in attitudes toward the elde

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1979.tb06445.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1979.tb06446.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY