摘要:

ABSTRACTThe experience with 83 patients aged 60 or older from the Stanford Sleep‐Wake Disorders Clinic is compared with that in 423 younger clinic patients seen during the same two‐year period. Each patient received a medical, psychologic and polysomnographic evaluation. The final diagnoses were recorded according to the Diagnostic Classification System of the Association of Sleep Disorders Centers. The most common major diagnoses in the elderly group were sleep apnea syndrome (39 percent) and periodic movements‐restless legs syndrome (18 percent). These syndromes showed a significantly greater prevalence in the older than in the younger patients (p<.001), and were found in 68 percent of the elderly group. The elderly manifested more objective signs of sleep disturbance, including more wake time after sleep onset, and more frequent and longer awakenings; moreover, fewer of them experienced stage‐4 sleep. The diagnostic findings seemed to indicate that complaints about sleep‐wake functioning in many elderly patients may be a result of specific pathologic sleep dis

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1981.tb01267.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACTThe lifespan of men is shorter than that of women. This study is an effort to identify some causal factors. Six dimensions of the masculine gender role are examined in relation to certain stress‐related disorders more prevalent among older men than among older women. These dimensions are “No Sissy Stuff”; “The Big Wheel”; “The Sturdy Oak”; “Give ‘Em Hell”; homophobia; and sexual dysfunctioning. Specific problems of retirement are also discussed. Only in recent years have the roles of men been studied more closely. The results may offer positive implications for

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1981.tb01268.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACTThe plasma aldosterone (PA) response to sodium restriction (25 mEq daily for 4 days) and to graded infusions of angiotensin II (AH, 2, 4 and 8 ng/kg/min each for 30 min) during a low‐sodium intake were studied in 15 elderly subjects with mild essential hypertension versus 10 elderly normotensive subjects. The PA reponse to sodium restriction relative to changes in plasma renin activity (PRA) was estimated by the ratio of PA increment to PRA increment after sodium restriction (ΔPA/ΔPRA). The PA response to graded AII infusions was determined by the increment of PA above the basal level after each dose of AII. In 10 of the 15 elderly hypertensive subjects whose PRAs responded normally to sodium restriction, the ΔPA/ΔPRA ratios and PA increments during the graded AII infusions were similar to those in the elderly normotensive subjects. However, in the remaining 5 elderly hypertensive subjects whose PRAs responded subnormally to sodium restriction, the ΔPA/ΔPRA ratios were high and the PA increments greater during the graded AII infusions. The increments of mean blood pressure during the graded AII infusions were similar in the foregoing 10 of 15 hypertensive subjects, and significantly greater during the AH infusion rates of 4 and 8 ng/kg/min in the remaining 5 hypertensive subjects when compared with those in the normotensive subjects. Apparently some elderly subjects with essential hypertension, whose PRAs respond subnormally to sodium restriction, have an abnormally enhanced adrenal responsiveness to AII under the condition of low‐sodi

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1981.tb01269.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACTSelected findings are reported from a follow‐up study conducted to determine what happened to persons aged 65 or older who were referred for evaluation to an urban Geriatric Evaluation Service (GES) but who were not approved by the GES for admission to a mental hospital. Reasons given for the referral included both physical and behavioral problems. The alternatives to institutionalization were based upon the nature of the available social support system, and the functional health status. The family provided most of the care for its aged ill, and the adult children provided most of the social support. In the absence of support by adult children, other relatives gave the necessary care, which included a wide range of services such as personal care, housekeeping, cooking, running errands, transporting, and the important service of just being present or available. Community services were used infrequently. The majority of the subjects were in the “poor health” category and required supervision or care for impaired mobility, one or more physical health problems, and sometimes for mental confusion or disorien

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1981.tb01270.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACTTwo cases of porphyria in octogenarians are presented. Both had atypical features. The first resembled acute intermittent porphyria without skin lesions, in association with a primary hepatic malignant lesion. The second patient had erythropoietic protoporphyria with hemolytic anemia and progressive hepatic failure. In neither instance was there a positive family history. Porphyria, though rare in the elderly, should be considered in differential diagnosis, as it is often associated with hepatic dysfunction and other disorders.

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1981.tb01271.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACTAmong 35 elderly patients with transtracheal aspirate (TTA)‐documented nosocomial pneumonia, 7 (20 percent) had Streptococcus pneumoniae infection. Clinical and epidemiologic data are reported on these 7 patients and on 2 others with nosocomial pneumococcal pneumonia documented by bacteremia. Malignancy and chronic obstructive pulmonary disease were the most common predisposing illnesses. Four of the 9 patients had previously received antibiotic therapy. Gram‐negative aerobic pneumonia was found before (2 cases), concomitant with (3 cases), and after (2 cases) the pneumococcal infection in these patie

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1981.tb01272.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACTIn a Canadian geriatric hospital, the report forms on the 2,177 untoward incidents occurring during the 1976–78 period were analyzed. The incident and fall rates were respectively 51.1 and 42.7/10,000 patient‐days. Falls were the most common incident (82.9 percent). Of the patients who fell, 40.4 percent were over the age of 80 and another 27.5 percent were in the 71–80 age group. The majority fell more than once. Most falls occurred during the waking activity hours, and many were associated with the changing of position or posture, notably in the course of using a wheelchair. Alcohol was a factor in 4.2 percent of the incidents. Nevertheless, the rates for mortality and serious morbidity were low. Patients' rooms and toilets should receive extra surveillance, and the caretaker staff should exercise special care in the use of wheelchairs and assistive devices. More attention should be given to recording cases of postural hypotension, cardiac arrhythmias or drug side ef

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1981.tb01273.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACTUterine procidentia is relatively common among white multiparous women. The incidence increases with age in association with other predisposing factors. Conservative management of uterine prolapse is rare today, perhaps due to definitive results with surgical therapy and the high incidence of earlier hysterectomy. Still, physicians should become familiar with pessary use and its complications. Three conservatively managed cases of pessary incarceration are reported. Applications of estrogen cream improved the condition of the vagina, permitting removal of the incarcerated pessary a few days later. Careful instruction of patients and relatives about follow‐up care can prevent such complication

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1981.tb01274.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACTSynchronous dual primary lung carcinomas were found in 8 of 482 patients with lung cancer, an incidence of 1.6 percent. Of the 8 cases, 7 were unilateral and one bilateral. Three showed dissimilar histologic patterns occurring in combinations of squamous‐cell carcinoma and adenocarcinoma. In 5 cases, two separate tumors were noted with identical histologic patterns in combinations of squamous‐cell, giant‐cell, large‐cell, adeno‐. and undifferentiated carcinoma. The patients were heavy smokers and this possibly may have been a factor in the development of carcinoma at more than

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1981.tb01275.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACTA survey was made of thyroid function tests on 1,153 patients screened for thyroid disease during a two‐year period in a Geriatric Department; 13 percent of the test results fell outside the normal range. Of 88 patients who showed above‐normal results, only 12 presented with clinical features of thyrotoxicosis. In 37 patients, the biochemical findings indicated euthyroid “thyroxine toxicosis”; high values were found for serum thyroxine (T4) and the free thyroxine index (FT4I) but there were no clinical signs or symptoms of thyrotoxicosis; the values reverted to normal within one to three weeks. This pattern was seen also in 7 examples of T4‐treated hypothyroidism. (Overall, the test findings indicated 61 cases of hypothyroidism.) The significance of this transient increase in T4and FT4I values is discussed. The false positive results suggest that, when laboratory findings are not compatible with the clinical signs, the thyroid function tests should be repeated after another

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1981.tb01276.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY