ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1985.tb02271.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

Fifteen patients with non‐insulin‐dependent diabetes mellitus, poorly controlled on insulin, were enrolled in a weight loss program. Criteria included a fasting plasma glucose concentration greater than 200 mg/dl, age in excess of 65 years, and the presence of obesity. Twelve of the 15 patients were able to complete the program, and the average weight loss of the group was 9 kg. Prior to initiation of the weight loss program the 12 patients were receiving (mean ± SEM) 52 ± 5 units of insulin per day and had a mean (±SEM) fasting plasma glucose concentration of 258 ± 10 mg/dl. Insulin treatment was discontinued in all subjects during the weight loss period, and did not need to be resumed when weight stabilization had occurred. On the other hand, reasonable diabetic control could not be maintained without medication, and all patients were started on chlorpropamide during the period of weight stabilization. With this approach, a mean (±SEM) fasting glucose concentration of 137 ± 4 mg/dl was achieved with a daily chlorpropamide dose of 354 ± 30 mg. This dramatic clinical change took place despite the fact that no patient achieved ideal body weight. These results document the ability of a moderate amount of weight loss to transform patients with non‐insulin‐dependent diabetes mellitus, who are overweight and older than 65 years of age, from treatment failures to treatment successes.J Am Geriatr

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1985.tb02272.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

Fifty psychiatric inpatients aged 50 and over, with no hard neurologic findings, and with a variety of DSM‐III diagnoses (adjustment disorder, affective illness, and dementia), were rated for behavioral and psychiatric symptoms using the Geriatric Rating Scale and the Nurse's Assessment of Global Symptomatology‐Elderly. These clinical ratings were correlated with computed tomographic (CT) scan assessments of various superficial cerebral regions as well as with linear measures of ventricular size. Behavioral deficits in activities of daily living (AOL) plus an interactional variable, inability to respond to requests, were correlated with superior temporal and inferior parietal CT abnormalities, particularly on the left side. Suspiciousness and peculiar thinking, mood lability and irritability, as well as impaired memory with confusion, perplexity, and disorientation were also associated with atrophy in these same regions. Prefrontal area defects correlated with mood lability and deficits in visual‐interactional responsiveness. Statistically controlling for effects of age and alcohol abuse did not alter the basic nature of these results. Regional cerebral specialization in relation to these results are discussed using concepts developed by Luria.J Am Geriatr Soc 33:96

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1985.tb02273.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

The use of a primary prosthetic replacement such as an Austin‐Moore hemi‐arthroplasty in patients sustaining fractures of the femoral neck has been associated with increased post‐operative medical morbidity and mortality. A retrospective review was performed using the medical records of patients greater than 59 years of age who sustained femoral neck fractures and were treated with either internal fixation or primary hemi‐arthroplastic replacement at Loyola University Medical Center between 1969 and 1979. Peri‐operative data were reviewed and evaluated using computer‐aided statistical analysis. Comparing the two forms of surgical treatment, statistically significant factors associated with primary hemi‐arthroplastic replacement included: pre‐injury nursing home residence, pre‐injury ambulation requiring assistance, age greater than 79 years, slight elevation in serum creatinine values, abnormal electrocardiograms in patients over 77 years of age, time from injury to surgery of four or more days, and the use of spinal anesthesia (P<0.05). Factors associated with internal fixation were: patient age of 79 years or less, independent ambulation, non‐nursing home residence, normal lab values, normal EKGs, less than four days from injury to surgery, and the use of general anesthesia. Within the limits imposed by a retrospective review in this specific patient population, there appears to be a tendency for older, less healthy patients to have been treated with primary hemi‐arthroplasty. Possibly the previously reported increased post‐operative medical morbidity and mortality associated with this procedure, as compared with internal fixation, may be a result of biased patient selection, and not a fault of the procedure.J Am

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1985.tb02274.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

A retrospective chart analysis was conducted on all new elderly hypertensive patients referred to a community hypertension clinic who were being treated with either reserpine or alpha‐methyldopa plus a diuretic. There were no significant differences between the two groups on entry in age, gender, co‐mobid diagnoses, or systolic or diastolic blood pressure. There were no significant differences between the two groups in terms of side effects over three years, but the proportion of persons having compliance problems was significantly lower in the reserpine group. Mean diastolic pressures were significantly lower after one, two, and three years, and systolic pressures were lower after one and two years in the reserpine group. Reserpine is at least as effective as alpha‐methyldopa in treating hypertension in the elderly and is associated with fewer problems in compliance.J Am Geriatr Soc 33:109

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1985.tb02275.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

Stature is an important variable in several indices of nutritional status that are applicable to elderly persons. However, stature is difficult or impossible to measure in the nonambulatory elderly person, or its value may be spurious if measured in those elderly persons with excessive spinal curvature. Simple equations are presented for estimating the stature of elderly men from a recumbent measure of knee height and for elderly women from a recumbent measure of knee height and age. The 90 per cent error bounds for these equations for an individual are about plus or minus 6.0 cm. Knee height Is highly correlated with stature.J Am Geriatr Soc 33:116, 1985

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1985.tb02276.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1985.tb02277.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

Section Editor's Note:This is the first article of a new permanent section of the journal, “Geriatric Bioscience.” The Editor and the Section Editor wish to use this section to present “work in progress” and/or state of the art reviews in areas of basic science of relevance to clinicians dealing with geriatric patients. We hope this can he a mechanism to help the clinician keep abreast of new information from the fields of physiology, anatomy, molecular and cell biology, neurobiology, immunology, etc. that are likely to impact upon our care of the geriatric patient now or in the future.We wish to encourage the submission of papers for this section that will summarize recently published work from individual investigators or investigative groups and place it in the perspective of the general state of work in the field. We welcome very broad participation in this series and also solicit the readership's views on topics or work of interest that might be commissioned for this series.Harvey Jay Cohen, MDSectio

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1985.tb02278.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

For a survey of geriatric education in medical schools in the United States in 1983, data were received from one hundred schools. Increasing numbers of schools are providing required geriatric curriculum, and over 80 per cent of schools offer fourth‐year electives. Ninety per cent of schools have physician faculty in geriatrics, affiliated with major departments, for an average of 2.5 full‐time equivalents per school. Training sites are expanding to include many noninstitutional settings. Issues of curriculum content and impact, as well as faculty development, require further investigation.J Am Geriatr Soc 33:133,

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1985.tb02279.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

A tamper‐resistant package has an indicator or barrier to entry that, if breached or missing, can reasonably be expected to provide visible evidence to consumers that tampering has occurred. Regulations to implement tamper‐resistant packaging on all over‐the‐counter drugs and certain cosmetics began in February 1983. Tamper‐resistant packaging, like child‐resistant packaging, may impede access by the elderly and other adults who have mental, motor, and/or sensory disabilities. This article describes: 1) the reasons for the increasing use of over‐the‐counter medications in the prevention and treatment of the major causes of morbidity and mortality in the elderly; 2) the types of difficulties encountered in opening tamper‐resistant packaging; 3) the causes of these inaccessibility problems; 4) the methods to correct them; and 5) testing procedures to determine whether the existing designs of tamper‐resistant packaging are accessible by the elderly and adults with selected disabilities. Testing of individual types of tamper‐resistant packaging, multiple types of tamper‐resistant packagings on the same container, and combinations of tamper‐resistant packagings and child‐resistant packagings on groups of normal elderly people and those with selected disabilities is necessary to guarantee accessibility to the growing number of therapeutically efficacious nonprescription medications used by these populations.J

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1985.tb02280.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY