摘要:

ABSTRACT:The relation between lipid and carbohydrate metabolism was studied in 97 patients (average age, 82) by means of the glucose tolerance curve, blood insulin curve, and blood lipid pattern. A significant percentage of abnormal lipid values (including cholesterol and triglycerides) was found, whether or not the glucose tolerance curve was normal or abnormal. The blood insulin response to a 75–gm glucose load showed a correlation with lipid levels whereas the glucose tolerance curve alone did not. In patients with a high insulin response curve there was a greater incidence of abnormal lipid values than in patients with normal or low insulin response curves. The glucose‐insulin (G/I) ratio was an even better predictor of the lipid pattern. Low G/I ratios were more frequently associated with elevated lipid levels, regardless of the absolute glucose and insulin val

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1972.tb00752.x

出版商:Blackwell Publishing Ltd    

年代:1972

数据来源: WILEY

摘要:

ABSTRACT:The importance of estrogen in the lives of women is stressed. The Maturation Index is a valuable aid in the detection and therapeutic monitoring of estrogen deficiency. The best method of treatment is with naturally occurring estrogens, human or equine. The process is simply the transfer of natural estrogens from one mammal to another, and there are no side effects when given in proper dosage. Such estrogen maintenance can be successfully extended beyond the age of the menopause.

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1972.tb00753.x

出版商:Blackwell Publishing Ltd    

年代:1972

数据来源: WILEY

摘要:

ABSTRACT:An image of an old person is presented that emphasizes his limitations and capabilities. Isolation and depression are the main characteristics of the physiologic aging process. Hypochondriasis may be a defense against isolation. The impact of malignant tumors, cardiovascular catastrophes and chronic brain syndrome on old people is discussed.As a basic therapeutic guideline in dealing with old people, cognizance should be taken of the realistic isolation of old people and the need for integration within their own society with their own spiritual and physical standards. All attempts should be made to preserve their dignity and self‐respect. This can not be done through condescension or solicitude but through open and free discussion of their infirmities and the necessary therapeutic measure

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1972.tb00754.x

出版商:Blackwell Publishing Ltd    

年代:1972

数据来源: WILEY

摘要:

ABSTRACT:The surgical complications of biliary‐tract disease are discussed in relation to a study comprising 18 cases of cholecystoduodenal fistula, 6 cases of gallstone ileus, and representative cases of gallstones, pancreatitis and suppurative cholangitis. The average age of the patients was 67 years. The findings led to the following conclusions: 1) age is an important factor in the increased risk in these complicated cases, but with careful management, surgery can be successful; 2) acute cholecystitis usually can be treated conservatively in aged patients, but all too often the patients ignore the recommendation for an elective operation and are later admitted to the hospital with complications that demand emergency surgery; 3) this sequence of events applies particularly to patients with biliary calculi, who should undergo an elective operation before more serious complications develop. Had our patients been operated on earlier, the surgical risk would have been minimal and the complications would have been prevente

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1972.tb00755.x

出版商:Blackwell Publishing Ltd    

年代:1972

数据来源: WILEY

摘要:

ABSTRACT:Since disorders of gait may eventually deprive the aged person of his independence, they should be detected early and treated before the disability becomes irreversible. In the healthy aged, changes in gait may be caused by loss of joint mobility and a decline in the precision of neuromuscular control. More serious gait disorders are caused by neurological or musculoskeletal disorders. Difficulty in walking may be the first manifestation of a stroke, parkinsonism, or a combined system disease. Other disorders such as the small‐step senile gait or apraxia of gait are directly related to the aging process. Lesions of the low back or the lower extremities are common causes of gait disturbances. Often overlooked is a deficiency in the low‐back and hip extensor mechanism. In the early phases, this condition is at least partially correctable by suitable physical ther

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1972.tb00756.x

出版商:Blackwell Publishing Ltd    

年代:1972

数据来源: WILEY

摘要:

ABSTRACT:A Utilization Review Program in operation since January 1, 1971, has used a uniform method for studying over 5,000 patients in 35 nursing homes in the City of New York. New criteria for evaluating the need for long‐term care of these patients were accepted by the various sponsoring agencies. These criteria permit practical interpretation of the codes established for this purpose, and can serve as a blueprint for more such community programs as differentiated from programs associated with only a single institution. The new criteria should lead to tightening of the admission of patients who do not belong in nursing homes, and expedite the transfer of patients who no longer need long‐term care in these homes. The program was established for two main purposes: 1) to lower the costs for the sponsoring agencies, and 2) to improve the quality of medical care. To date there has been some progress in quality control, but no significant lowering of costs, apparently because of lack of health‐related facilities.The findings may help to stimulate the establishment of proper health‐related facilities geared to the problems of the custodial care of patients who need restorative health measures. Such a program within such health‐related facilities would take care of physical, psychological and social rehabilitation. The institutional patients would be taught how to participate in this program, and elderly persons in the community could also take part. Thus the facility could become a true geriatr

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1972.tb00757.x

出版商:Blackwell Publishing Ltd    

年代:1972

数据来源: WILEY

摘要:

ABSTRACT:A double‐blind, one‐year study was made of the effectiveness of anticoagulant therapy in senile and/or arteriosclerotic dementia. Seven such hospital patients (average age, 83.4 years) were treated with warfarin (sample oral dosage, 2.5 mg daily, monitored according to the prothrombin time). Seven other such patients (average age, 86.4 years) served as controls, and were given placebo tablets. All 14 subjects were assessed with respect to 25 variables reflecting cognitive functions and mental changes, before treatment, and at six and twelve months after starting treatment. The results were evaluated statistically. In the anticoagulant group the t‐tests showed no significant differences for the means in 24 of 25 variables during the one‐year treatment period. The control patients showed no significant changes in the psychological variables after six months; however, after one year, they showed significant deterioration in 4 variables and a trend toward deterioration in most of the others.Thus the anticoagulant group appeared to deteriorate less than the control group. Only further studies will elucidate the possible influence of undertaking therapy in patients who already may have been too deteriorated to benefit from it signif

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1972.tb00758.x

出版商:Blackwell Publishing Ltd    

年代:1972

数据来源: WILEY

摘要:

ABSTRACT:A plea is made for a conservative approach to the surgical treatment of adenocarcinoma of the head of the pancreas in geriatric patients. A radical extensive extirpative operation carries a prohibitively high rate of morbidity and mortality. A conservative by‐pass procedure often enables the patient to live a few more years in relative physical comfort and social enjoyment. Experience with 12 geriatric patients is cite

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1972.tb00759.x

出版商:Blackwell Publishing Ltd    

年代:1972

数据来源: WILEY

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1972.tb00760.x

出版商:Blackwell Publishing Ltd    

年代:1972

数据来源: WILEY