摘要:

Ultraviolet (UV) light treatment of pressure sores enjoyed widespread popularity for many years, but recently its effectiveness has been increasingly questioned. Surprisingly, it appears that this form of treatment has never been tested by a randomized placebo‐controlled trial. Eighteeen patients residing in the Extended Care Unit of the Health Sciences Centre Hospital at the University of British Columbia and suffering from superficial pressure sores of recent onset were therefore randomly assigned to active and placebo treatment groups. Since treatment procedures appeared identical in both groups, both patients and hospital staff were blind as to individual allocation. Sixteen patients completed the study. Mean time to complete healing was 6.3 weeks in the UV treated group, significantly (P<.02) less than the mean of 8.4 weeks in the placebo group. This difference persisted unchanged when each patient's age and the initial size of the sore were taken into account by an analysis of covariance. Thus, in spite of growing skepticism about its effectiveness, it appears that UV light may play a useful role in the treatment of pressure sores, and a systematic evaluation of different treatment protocols seems to be justifie

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1983.tb04850.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

Two‐hundred thirty‐four residents (220 male, 14 female) of a Veterans Administration Nursing Home and a Hospital Based Home Care program, 24–99 years old (mean 66), were examined for the presence (or absence) of earlobe creases and their correlation with cardiovascular disease. Unilateral or bilateral earlobe creases were found in 119 patients (55 unilateral, 64 bilateral), or 50.85 per cent. One hundred forty‐two patients had one or more forms of cardiovascular disease: 20 had coronary artery disease, 45 had cerebrovascular disease, 12 had peripheral vascular disease, 48 had atherosclerotic heart disease and/or hypertension, and 17 had “other” cardiovascular disease, mostly congestive heart failure. Seventy‐three of them (51.4 per cent) had earlobe creases. The rest—92 patients—had no clinically apparent cardiovascular disease, and the incidence of earlobe creases in this group was 50 per cent.Cross‐tabulation (chi square) and multivariate (stepwise logistic) regression analyses relating the presence (or absence) of earlobe creases to diagnosis, age, sex, smoking, body weight, height, blood pressure, serum cholesterol, glucose, urea nitrogen, creatinine, uric acid, calcium, phosphorus, albumin, and hemoglobin revealed no significant correlation between the presence of earlobe creases and any of the above parameters. Earlobe creases were present in about half the study group regardless of diagnosis, and only about half the patients with cardiovascular and coronary artery disease had earlobe creases.It was concluded that in our patient population earlobe creases were not specifically associated with cardiovascular disease, as they were associated about equally with both cardiovascular and noncardiovascular disease. Their significance in the diagnosis of coronary artery disease may be greater in a younger age group, because in the elderly these creases may occur as part of skin aging, and they may also accompany noncard

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1983.tb04851.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

Studies in age‐related cognitive changes do not necessarily take into account the clinical and social phenomena associated with age that may have more effect on cognition than does psychologic senescence. Clinically inapparent biologic deterioration, drugs, mild dementia, and atypically presenting depression may influence cognition. Selection bias may skew the results of studies on the elderly when control groups are made up of undergraduates or of “normal” elderly whose normality is taken for granted rather than verified. The epiphenomena of aging, such as retirement, social isolation, and bereavement, which are not inherent in the aging process, influence cognition, as do labeling and learned helplessness. Laboratory‐based tests of cognition may not sufficiently resemble real‐life conditions to have validity. Future research will be shaped by how we conceptualize the relation between aging and intellectual

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1983.tb04852.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

The thermogenic response to a 100 g oral glucose load was studied by indirect calorimetry in 13 older persons (age range, 38–68 years) and compared with that of 16 young matched controls of similar body weight (age range, 19–30 years). The glucose‐induced ther‐mogenesis measured over 180 min and expressed as a per cent of the energy content of the glucose load was found to be reduced in the older subjects, i.e., 5.8 ± 0.3 per cent vs 8.6 ± 0.7 per cent,P<0.002). This was also accompanied by a significant decrease in the glucose oxidation rate when averaged over the same three‐hour period following the glucose load, i.e., 153 mg/min vs 213 mg/min in the control subjects(P<0.001) despite a similar time course of glycemia. This study suggests that the thermogenic response to an oral glucose load is blunted in older people, and this may represent an additional factor that contributes to the decreased energy requirement with age and therefore to the increased propensity to obesity if energy intake is n

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1983.tb04853.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

To assess the worth of a newly established geriatric unit, outcomes for 50 subject patients cared for on this unit were compared with outcomes for 50 control patients. Both groups of patients were hospitalized in Highland View Hospital, the chronic illness and rehabilitation section of a major teaching hospital in Cleveland, Ohio. Analysis of admission data showed the two groups to be closely comparable. All patients were managed by multidisciplinary teams, and the length of stay of both groups was comparable. The discharge data showed that the subject patients were more independent, with significantly greater numbers improving in ambulation and significantly more subject patients being discharged to a home setting. Although the patients in the control group were discharged at lower levels of function, they showed improvement at follow‐up. Follow‐up data also showed that both groups largely remained in their discharge environments. Explanations for these findings are discussed. The results of this study support the establishment of geriatric inpatient un

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1983.tb04854.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

By use of echocardiography and radiologic imaging, a prospective study was made of 98 elderly men, 65 to 102 years old, to define degenerative calcific valvular disease (DCVD)—its prevalence, morphologic features, functional significance, and relationship to systolic murmurs in the elderly. DCVD was diagnosed in 74 per cent of the group and murmurs were detected in 55 per cent, the incidences increasing with age. Fibrotic and calcific change of the aortic valve was the most common abnormality, occurring alone or together with alteration of the mitral valve. The murmurs were characteristically early systolic, of low intensity and medium pitch, and heard at more than one area. Of the group with valve degeneration, only 7 per cent was judged to be functionally significant and no more than moderate. It was concluded that DCVD is the cause of most systolic murmurs in the elderly and is usually hemodynamically unimportant. Echocardiographic criteria are important in identifying those subjects with possibly significant valvular dysfunction requiring invasive stud

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1983.tb04855.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1983.tb04856.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1983.tb04857.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1983.tb04858.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1983.tb04859.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY