摘要:

ABSTRACTFour hundred and sixteen patients with documented arteriosclerotic heart disease (ASHD) underwent 424 diagnostic and therapeutic surgical procedures during the year 1970 at the Henry Ford Hospital. They were classified according to the specific clinical manifestation of their cardiac abnormality. Patients with a history of old, well‐compensated myocardial infarction, and those with cardiac arrhythmia, bundle‐branch block, congestive heart failure and A‐V block (pacemaker‐protected) but no evidence of previous myocardial infarction fared almost as well as subjects of the same age without cardiac disease, and were considered to run the lowest operative risk. Patients with angina, especially if there was a history of infarction, were an intermediate risk in terms of complications and mortality. Patients with a history of previous infarction complicated at the time of the surgical procedure by arrhythmia, A‐V block, bundle‐branch block, or congestive heart failure were in the “highest risk” category. A severe A‐V block indicated the need for insertion of a “prophylactic” pacemaker before any attempt at a diagnostic or therapeutic procedure. No patient with clinical or electrocardiographic evidence of a recent infarction (less than three months' duration) should undergo any elective surgical procedure under any form of anesthesia unless the surgeon is prepared for a high mortality rate that may approach 90 percent. In contrast, the patient with old, well‐compensated myocardial infarction and no evidence of dysrhythmia, block or congestive failure can tolerate even a major surgical operation under any form of an

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1975.tb00627.x

年代:1975

数据来源: WILEY

摘要:

ABSTRACTMembranous nephropathy (MN) accounts for about 20 percent of cases of the nephrotic syndrome. The importance of renal biopsy in establishing the diagnosis is emphasized. In the great majority of MN patients, no etiologic factor can be discerned. In a significant minority, MN appears to be a manifestation of sarcoidosis, diabetes, lupus, syphilis, malaria, or toxicity from heavy metals or drugs. In some cases the “cause” is neoplasia (including lymphoma) or a viral infection. Massive proteinuria, hypoproteinemia and edema are the principal manifestations of MN, finally resulting in renal failure. Treatment consists chiefly of diet and diuretic drugs. In the more pronounced cases, corticosteroids may have a favorable effect and in very resistant cases, cyclophosphamide is indicated. Judicious use of these modalities if often associated with the diminution or disappearance of the clinical signs of

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1975.tb00628.x

年代:1975

数据来源: WILEY

摘要:

ABSTRACTThis presentation attempts a new approach to the understanding of both normal and abnormal behavior in older persons who are ready for retirement. The suggested orientation is based upon the concept of an organic cerebral basis for the neurophysiologic disturbances which result in emotional problems. A unified concept of human behavior allows for early establishment of mature brain patterns and the disruption of these patterns by disuse atrophy in later life. This provides a clue to the development of better measures for the prevention and treatment of emotional problems in the aged — problems which now come under the classification of chronic brain syndrome or senile brain diseas

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1975.tb00629.x

年代:1975

数据来源: WILEY

摘要:

ABSTRACTA case is presented of craniopharyngioma in a 78‐year‐old woman. The symptoms and signs, except for those in the visual fields, were nonspecific. A review of the literature shows that this case history is representative of craniopharyngioma in the older adult. The findings in this elderly patient are contrasted with the signs and symptoms of craniopharyngioma in child

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1975.tb00630.x

年代:1975

数据来源: WILEY

摘要:

ABSTRACTAlthough the anti‐inflammatory action of cortisone or its derivatives is efficacious in arthritis or certain allergic and skin diseases, the standard use of such compounds is limited to short‐term administration because of induced disturbances in mineral and glucose metabolism. Another side effect of cortisone is suppression of thyroid hormone secretion. The author has found that when thyroid therapy is prescribed for patients with arthritis (300 to date), certain skin diseases or selected allergic disorders, the addition of prednisone in a small dosage of 5–10 mg daily will produce further improvement for at least a five‐year period, without side effects. The thyroid and adrenocortical hormones apparently are synergistic in the treatment of arthritis and

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1975.tb00631.x

年代:1975

数据来源: WILEY

摘要:

ABSTRACTFor many younger people, what is currently referred to as “sex,” is regarded as literally a monopoly within their group. According to their way of thinking, sexual activity diminishes after age 50 and ceases after age 60. Older people become the butt of many cruel jokes about the status of their sexual prowess; if some of them report sexual interest they are liable to be labeled “dirty old men” (or women). A 12‐year experience in working with geriatric residents of a nursing home has revealed interesting information which may be of some value in reassessing our concepts of the sexual needs of older people and understanding the appropriate modifications they may use to fulfill th

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1975.tb00632.x

年代:1975

数据来源: WILEY

摘要:

ABSTRACTAlcohol abuse is a serious, though often unrecognized and untreated, problem among the elderly. Treatment is handicapped by the clinician's frequent failure to understand all aspects of alcoholism, and by the lack of adequate treatment resources. Physical, mental and social problems complicate the situation. The Levindale Geriatric Research Center has developed a diagnostic and treatment typology which involves problems with alcohol, health, and the social support system in determining the appropriate environment and treatment resources for these patients. This method has immediate value for clinical practice, and has long‐range value as a framework for planning integrated and comprehensive treatment service

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1975.tb00633.x

年代:1975

数据来源: WILEY

摘要:

ABSTRACTGiovanni Battista Morgagni published his life work at the age of 80, consisting of 70 letters on medical cases and their autopsies. He is considered the founder of pathologic anatomy. Many of the entities which he described were found in aged subjects. Modern geriatric medicine owes much to this great medical observer.

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1975.tb00634.x

年代:1975

数据来源: WILEY

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1975.tb00638.x

年代:1975

数据来源: WILEY

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1975.tb00639.x

年代:1975

数据来源: WILEY