摘要:

ABSTRACT:During a two‐year period, 363 women with postmenopausal bleeding were studied. Included were women in whom the menses had been absent for one or more years and women treated with exogenous estrogens for at least one year. Endometrial tissue obtained by curettage was found to be hyperplastic (sometimes malignant) in a third of the cases, atrophic in a third, and proliferative in a third. Mechanisms of bleeding and sources of endogenous estrogens in postmenopausal women are discussed, as is the subject of steroidogenesis in patients unusually susceptible to endometrial carcinoma. In women with obesity, diabetes, or liver disease there is either an increased production rate of Δ4‐androstenedione or increased conversion of this hormone to estrone. The management of postmenopausal bleeding is discussed. The role of progesterone in preventing hyperplastic changes in the endometrium is emphasized. It is recommended that, during the climacteric, women receiving estrogen therapy and even those who are not, should be given progestogen for several cycles to see if withdrawal bleeding can be induced. If such bleeding does not occur, then progestogen therapy should be disconti

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1974.tb04838.x

出版商:Blackwell Publishing Ltd    

年代:1974

数据来源: WILEY

摘要:

ABSTRACT:This article reviews current surgical concepts regarding the management of elderly patients with peripheral vascular disease. The indications for surgical reconstruction may be either relative or absolute, but only absolute indications (e.g., incipient gangrene) apply in the elderly. A review of the natural history of the disease shows that although some cases remain stable for long periods, many progress to a state of serious deterioration with painful intermittent claudication, incipient gangrene and threatened loss of the limb. The mechanisms of deterioration include thrombosis, embolism and minor trauma. Peripheral vascular occlusive disease is only one manifestation of a generalized disease process, and vascular reconstruction is only a palliative measure. However, since high morbidity and mortality are associated with amputation, reconstruction should always be considered, even in the geriatric patient. The aorto‐iliac reconstruction technique is associated with a fairly low mortality rate and a limb‐salvage rate of 85 per cent; simpler alternatives are available in high‐risk patients. For femoro‐popliteal procedures the mortality rate is low and the limb‐salvage rate is 75 per cent. Such results emphasize that vascular reconstruction usually is preferable to amputation. Measures for conservative management, particularly in aged patients, are

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1974.tb04839.x

出版商:Blackwell Publishing Ltd    

年代:1974

数据来源: WILEY

摘要:

ABSTRACT:The author reviews the literature on benign prostatic hypertrophy and adenocarcinoma of the prostate and summarizes the current concepts on the etiology and treatment of these diseases. Special reference is made to hormonal relationships.

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1974.tb04840.x

出版商:Blackwell Publishing Ltd    

年代:1974

数据来源: WILEY

摘要:

ABSTRACT:Depression is the most important of the various psychiatric illnesses (including organic brain syndromes, schizophrenia, neuroses and personality disorders) that may develop in old age. The symptoms and the relationship to suicide are discussed. Therapeutic efforts (chemotherapy, electroshock, psychotherapy) may be directly affected by the physician's attitude. Drugs for the treatment of depression include the tricyclic antidepressants, MAO inhibitors, amphetamines, phenothiazines, minor tranquilizers (chlordiazepoxide, diazepam) and lithium. Contraindications and the dangers of misuse are emphasized. Electroshock is indicated for suicidal or medically endangered patients or for those who do not respond to chemotherapy. The psychiatric skills of the family practitioner are very important in helping the patient to adjust to the crises of old age and in preventing mental illness.

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1974.tb04841.x

出版商:Blackwell Publishing Ltd    

年代:1974

数据来源: WILEY

摘要:

ABSTRACT:A method for quantitating biologic age is described. Biologic age was calculated by this method from 7 different measurements made in subjects who were objectively and subjectively well. The 29 “well” subjects were selected by a computer program on the basis of the medical questionnaire, chest roentgenogram, urinalysis and electrocardiogram, from 705 “apparently well” females who attended a mutiple screening centre. These subjects had a lower calculated biologic age compared with the reference population. The model could be of value in assessing the aging rate and comparing the effect of social and environmental factors on aging in different population

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1974.tb04842.x

出版商:Blackwell Publishing Ltd    

年代:1974

数据来源: WILEY

摘要:

ABSTRACT:The mechanism by which Gerovital H3 (GH3), a specially stabilized form of procaine hydrochloride, produces a weak inhibition of the enzyme, monoamine oxidase (MAO), was studied by several methods. Purified rat‐brain mitochondrial MAO was used as the enzyme source and the reaction velocities were determined by quantitating the rate of appearance of 4‐hydroxyquinoline from kynuramine. Data on dilutional studies with pre‐incubated enzyme‐inhibitor complexes, as well as other data, strongly indicated that GH3 was a reversible inhibitor of MAO. Analysis of Lineweaver‐Burk and Dixon plots obtained by determining the velocity of oxidation of kynuramine with various concentrations of substrate and inhibitor, showed that GH3 was a fully competitive inhibitor of MAO. The weak, reversible, fully competitive inhibition of MAO produced by GH3 is in marked contrast to the potent, irreversible inhibition of MAO produced by currently available agents. The mechanism by which GH3 inhibits MAO may help to explain the absence of severe adverse reactions with GH3 that are traditionally associated with irreversible MAO inhibitors in the treatment of depressive illness. Because of these characteristics of GH3 as an inhibitor of MAO, assessment of its activity in vivo may not be easily accomplished, despite its pronounced pharmacologi

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1974.tb04843.x

出版商:Blackwell Publishing Ltd    

年代:1974

数据来源: WILEY

摘要:

ABSTRACT:An epidemiologic survey of the dietary habits of 369 dentists and 288 wives indicated that about 50 per cent of them consume suboptimal amounts of vitamin E, according to the conservative estimates of the Food and Nutrition Board of the National Academy of Sciences‐National Research Council. By means of simple health education measures, it seems possible to increase significantly the consumption of vitamin E and, in association, to reduce reported cardiovascular finding

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1974.tb04844.x

出版商:Blackwell Publishing Ltd    

年代:1974

数据来源: WILEY

摘要:

ABSTRACT:Twenty subjects (average age, 67.9 years) were given hyperbaric oxygen (100% at 2 atmospheres pressure) for 15 daily sessions of two hours each. Comparison of “before” and “after” intelligence‐test results revealed substantial improvement, particularly in tests concerned with short‐term memory and visual organization. The subjects who benefited most were those whose “before” Wechsler Memory Quotients were between 70 and 110. There was no indication that the improvement reached a plateau af

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1974.tb04845.x

出版商:Blackwell Publishing Ltd    

年代:1974

数据来源: WILEY

摘要:

ABSTRACT:Sexual activity and habits in the aged are analyzed on the basis of the pertinent literature and also personal observations on 85 subjects (53 males and 32 females) whose ages ranged from 62 to 81 years. The importance of diseases and of environmental, social and psychologic factors is discussed in connection with the impairment of sexual activity in old people. Sexual activity in the aged is not exceptional and may give serenity to aging. Medical, social and psychologic prophylactic counselling should be applied as early as possible by geriatricians in collaboration with sexologists.

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1974.tb04846.x

出版商:Blackwell Publishing Ltd    

年代:1974

数据来源: WILEY

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1974.tb04848.x

出版商:Blackwell Publishing Ltd    

年代:1974

数据来源: WILEY