摘要:

ABSTRACTPulmonary artery end‐diastolic pressure (PADP), pulmonary artery wedge pressure (PAWP), and pre‐“a” wave left ventricular diastolic pressure (LVDP) were correlated with post‐“a” wave left ventricular end‐diastolic pressure (LVEDP) in 51 patients with coronary disease and in 43 cardiac patients with non‐coronary disease, excluding mitral stenosis. In patients with coronary disease, the PADP was more closely correlated with PAWP (r = 0.83) and LVDP (r = 0.84) than with LVEDP (r = 0.62). In patients with non‐coronary disease, the PADP also was more closely correlated with PAWP (r = 0.82) and LVDP (r = 0.77) than with LVEDP (r = 0.70). In patients with coronary disease, the PAWP was well correlated with LVDP (r = 0.94) and with LVEDP (r = 0.84). In patients with non‐coronary disease, the PAWP was well correlated with LVDP (r = 0.81) and with LVEDP (r = 0.81). The PADP and PAWP may be helpful in evaluating left ventricular fu

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1975.tb00215.x

年代:1975

数据来源: WILEY

摘要:

ABSTRACTA double‐blind cross‐over procedure was used to evaluate the effects of papaverine hydrochloride on the electroencephalogram (EEG), cognition, mood and psychologic test performance of 10 healthy geriatric volunteers. During the two‐week period, each subject was tested four times: before and after receiving papaverine and before and after receiving placebo. Period analysis revealed that a 300‐mg dose of papaverine (Pavabid Plateau Caps) increased EEG alpha activity (8–13 cycles per second) and decreased the beta2range (27–40 cps). Baseline values for six mood factors, short‐term memory, complex problem solving, and attention were not altered significantly by either drug or placebo. Results of the Subject Paced Digit Symbol Substitution Test indicated that papaverine may produce some improvement in simple cognitive functioning. No adverse effects were associated with the use

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1975.tb00216.x

年代:1975

数据来源: WILEY

摘要:

ABSTRACTGanglioside lipid fractions in the cerebral gray matter were studied in 13 patients with various forms of dementia. In 2 patients with Alzheimer's disease and 1 with senile dementia an abnormal ganglioside pattern was observed, i.e., a decrease of G1and G3in association with an increase of G2. In the light of the total clinical and histologic data on the patients, it would seem that this disturbance in ganglioside metabolism may be a phenomenon accompanying extensive degradation of brain tissue rather than a factor in the etiology of dementia.

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1975.tb00217.x

年代:1975

数据来源: WILEY

摘要:

ABSTRACTThe current literature on suicide by medicinal overdose among the elderly population of the United States and Britain is discussed. The older white male is a high risk in this regard. Physical and mental illnesses contribute to the problem of suicide among the aged, and some of the drugs prescribed for treatment (e.g., barbiturates and psychotherapeutic agents) are often accessible to the older person for misuse in suicide. The responsibilities of the prescribing physician and the practices of the dispensing pharmacist are considered in relation to the exposure of the elderly patient to potentially lethal drugs. Prediction of suicidal attitudes in the elderly is complicated by the fact that any attempt at suicide usually is serious and rarely preceded by gestures. Depression, based on social factors, is common among older people. Some of them face problems of declining income and prestige, as well as a loss of physical and mental powers. A change in the attitude of society towards the elderly may help to alleviate the depressive state which so often contributes to the suicidal potential.

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1975.tb00218.x

年代:1975

数据来源: WILEY

摘要:

ABSTRACTThe prescription and administration of drugs (especially of the neuroactive class) was observed in 131 patients in an extended care facility. The average number of neuroactive drugs prescribed (2.1) was distinctly different from the average number administered (1.3) because of the large number of pro re nata (prn) prescriptions. More neuroactive substances were prescribed for patients with superior mentation and minimal physical disability; the difference between low and high groups was 1.7 (mentation) and 2.8 (physical status). The most common neuroactive drugs prescribed were: 1) analgesics, 2) major tranquilizers, and 3) hypnotics. Questionable prescribing practices were demonstrated by the fact that 30 patients had prescriptions for 38 “not‐recommended” drugs; 23 of these prescriptions were for propoxyphene compound. After requiring physicians to rewrite drug orders every thirty days, a survey made ten months later showed that there was a decline (0.8) in the number of drugs prescribed per patient and a slight increase (0.45) in the number of drugs administered.Professional drug surveillance is crucial for improving the therapeutic process. At least two modifications of current prescribing practices are recommended: 1) a record should always be made of the precise condition(s) under which a drug prescribed “prn” is to be administered; and 2) a strong effort should be made to reduce the total number of drug prescriptions. The results of this survey suggest that certain procedural matters necessitating change are not in themselves the most substantive factors in improvement. Present “third party” review mechanisms likely will not ameliorate the current situation. It will be necessary to implement complex organizational changes in most extended ca

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1975.tb00219.x

年代:1975

数据来源: WILEY

摘要:

ABSTRACTA program for activating residents of homes for the aged to assume maximal responsibilities is described. Promoting maximal physical and mental health through various modalities including activity programs, appropriate exercise and participation in democratic self‐government mechanisms, will result in a happier, healthier population of residents in institutions for the aged. The increased demands on staff time and patience will be compensated for by relief of the too‐frequent feelings of hopelessness and boredom endemic among the staff of long‐term care facilities. Such programs demand constant effort by all staff members, patients, volunteers and relatives because if they succumb to the usual human dislike of persistency, short‐term gains can easily

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1975.tb00220.x

年代:1975

数据来源: WILEY

摘要:

ABSTRACTIn an investigation of some of the external causes of decubitus ulcer, a small flexible sensor has been developed as a clinical device to measure the relative humidity (RH) of the environment between the patient and the surface on which he lies. The sensor (described in detail) can indicate RH in the range of 20 to 90 per cent by a color‐matching method (chemically impregnated circles); accuracy is within 5 to 10 per cent. In a preliminary study on 28 patients, the readings showed that RH was higher in the sacral region than in the scapular region, and higher for patients who were inactive than for those who were active. The device was well accepted by both patients and nurse

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1975.tb00221.x

年代:1975

数据来源: WILEY

摘要:

ABSTRACTParticipation in human experimental research constitutes a major problem for the geriatric subject. Because there is a high incidence of noncontagious disease in the elderly, they are the group most useful for the study of new therapeutic agents or procedures. However, normal aging processes, often coupled with disease of the central nervous system, render elderly persons less able to comprehend the nature and risks of such studies. These factors permit easy exploitation of geriatric subjects in medical experimentation, with possible exposure to a significant risk of serious drug reactions and unnecessary hospitalization. Recent federal regulations have given “special protections” to children, prisoners and the mentally infirm in experimental research, to guard against abuse of their human rights. A basic requirement is that informed consent be carefully obtained and documented. Such “special protections” should now be extended to geriatric subjects so that there will be no further exploitation in the course of valid clinical r

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1975.tb00222.x

年代:1975

数据来源: WILEY

摘要:

ABSTRACTA case is presented of bilateral lymphosarcoma of the breast in a 77‐year‐old woman. The pre‐admission surgical history recorded a mastectomy in July 1972, for lymphosarcoma of the right breast. She had been well until shortly before admission in March 1974 because of a tumor in her left breast. This proved to be lymphosarcoma. Treatment consisted of a left mastectomy. At that time there were no signs of axillary or systemic involvement. Later, evidence of systemic lymphosarcomatosis necessitated starting chemoth

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1975.tb00223.x

年代:1975

数据来源: WILEY

摘要:

ABSTRACTAn unusual case of patient ductus arteriosus (PDA) in a 78‐year‐old man is presented. The patient was known to have PDA since the age of 30, but it had remained well compensated until shortly before death. He had undergone some difficult operations successfully, and had no specific pulmonary complaints. Death at age 78 was caused by arteriosclerotic heart disease following myocardial infarction. Autopsy revealed a smooth patent ductus arteriosus with no perforation. The survival of a PDA patient to such advanced age is a comparatively rare occurre

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1975.tb00224.x

年代:1975

数据来源: WILEY