摘要:

ABSTRACTFifty‐nine elderly patients with clinical and neurophysiologic evidence of peripheral neuropathy were reviewed. Diabetes, alcoholism and malignancy were the important etiologic factors, but other causes of acquired neuropathy such as drugs, autoimmune disease, and acute or chronic demyelinating neuropathy continue to warrant attention. Postural hypotension associated with neuropathy occurred in three patients with diabetes and one patient with lymphoma. Prognosis for the neuropathies did not seem to be adversely affected by ag

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1981.tb01226.x

年代:1981

数据来源: WILEY

摘要:

ABSTRACTIn a study specifically addressing the age‐stage relationship, the authors examined the distribution of 30,991 cancers by disease‐stage versus patient‐age at the time of diagnosis. For cancer of the bladder, breast, cervix, ovary and uterus (endometrium), a highly significant positive relationship was found between advancing stage and advancing age (P<0.001). For cancer of the kidney and stomach, the relationship held but was less significant (P<0.05). For colorectal cancer, no relationship was evident. For bronchial cancer there was a highly significant inverse relationship (P<0.001). After the site of origin of the cancer, the stage at the time of diagnosis was the next most important determinant for treatment and survival. These data emphasize the importance of periodic pelvic examination as a means of screening for asymptomatic cervical, ovarian, or other uterine (endometrial) cancer in elderly women. Also, the data support the importance of breast self‐examination and mammography in screening for breast cancer in older women. The inverse relationship of age to stage in bronchial cancer suggests that screening by periodic chest roentgenograms and cytologic sputum examinations may be more appropriate for elderly than for younger populations in whom these screening methods have proved disapp

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1981.tb01227.x

年代:1981

数据来源: WILEY

摘要:

ABSTRACTIf the shoulder‐hand syndrome is left without special care, it may lead to severe painful disabilities of the upper extremity. Early recognition of the clinical signs and symptoms and aggressive total care are essential for successful treatment and for the prevention of severe flexion contractures of the hand and shoulder, especially in patients whose symptoms have developed after a cerebrovascular accident. An outline is given of the treatment modalities (corticosteroids, physiotherapy and mechanical devices) used at the Institute for Rehabilitation Medicine (NYU) for obtaining maximum function of the involved upper extremit

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1981.tb01228.x

年代:1981

数据来源: WILEY

摘要:

ABSTRACTA rapid screening method is described for detecting amyloid angiopathy (AA) in the meningeal vessels with the use of thioflavin‐S and fluorescence microscopy. AA was found most frequently in the brains of patients in whom senile degeneration of the Alzheimer type was complicated by severe arteriosclerosis, vascular hyalinosis and multiple infarcts (73 percent). In 69 randomly drawn mental hospital patients over the age of 55, the degree of AA was significantly correlated with the degree of organic symptomatology (r = .417, p<.001). Multiple regression analysis, however, revealed that AA as a predictor of clinical symptoms was highly dependent upon another predictor, i.e., the quantity of senile plaques in the brain. In contrast, a highly significant and independent correlation was found between the clinical symptoms and AA in a control sample of 21 patients who had mental illnesses other than senile dementia (r = .683, p<.001). In these patients the plaque count was very low and arteriosclerosis was prevalent. Among the clinical symptoms, Affect Lability was consistently most highly correlated with AA, whereas Disorientation was most highly correlated with the quantity of plaque

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1981.tb01229.x

年代:1981

数据来源: WILEY

摘要:

ABSTRACTBiliary‐tract disease is not only more common in the geriatric population but carries an increased surgical risk. Described is a series of 10 middle‐aged and elderly patients who had stones in the common bile duct associated with significant underlying medical illness or peri‐ampullary pathologic changes. They were successfully treated by endoscopic papillotomy. The 80 percent success rate in such critically ill patients suggests that endoscopic papillotomy might be used as the initial treatment modality in aging patients with amenable biliary‐tract

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1981.tb01230.x

年代:1981

数据来源: WILEY

摘要:

ABSTRACTAn increasing percentage of the burn victims admitted to the Western Pennsylvania Hospital and Burn Care Center are aged 65 or older. Among 108 such elderly patients admitted during the past six years, 68 died and 40 survived—a mortality rate of 63 percent. Those who died of burns (average age 76.4) had burns over 44.8 percent of the mean body surface, whereas the survivors (average age 73.5) had burns over a smaller area (16.7 percent). Survival also was related to the presence of significant heart and lung disease which antedated the thermal injury. Treatment of the burns was in keeping with standard recommendations for intravenous fluid resuscitation, wound care, and skin grafting. Cimetadine and antacids proved effective in the prevention of significant gastrointestinal bleeding. Ninety percent of the survivors returned to their homes after treatment. Although the mortality for elderly burn patients remains high, the favorable results in rehabilitation of the survivors are encouraging. Increased attention should be paid to safety programs for the elderly and those who care for them, to prevent such serious accidental injurie

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1981.tb01231.x

年代:1981

数据来源: WILEY

摘要:

ABSTRACTCompartmental syndromes are uncommon, but particularly the deep posterior tibial compartmental syndrome, which is usually associated with trauma. It has not previously been recorded as a complication of hypothermic or hypothyroid coma. This case of successful surgical therapy in a 75‐year‐old woman is reported in the hope that similar occurrences in the future may be recognized in time for curative surgery or at least for palliative surgery which can offer recovery of useful funct

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1981.tb01232.x

年代:1981

数据来源: WILEY

摘要:

ABSTRACTAn eight‐week support group program was conducted for 15 members of the families of Alzheimer patients still living at home. It became clear that caring for an Alzheimer patient at home created tremendous practical, psychologic and social problems for family members. Frequently discussed problems included lack of support and information from physicians, poor understanding of the disease, depression, a trapped feeling, anger and fear about the patient's behavioral problems, isolation, and the caretaker's loss of self‐identity. Group participation was especially beneficial for spouses who functioned as primary care providers. It increased their understanding of the disease, made them feel more supported and less isolated, and helped them resolve some of the feelings created by the illness. It also helped spouses to become more aware of their own needs and to regain some self‐identity in relation to the patient. Such family support programs offer a way to strengthen the emotional well‐being and treatment skills of the care‐providing family and are an important aid to treatment in Alzheimer'

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1981.tb01233.x

年代:1981

数据来源: WILEY

摘要:

ABSTRACTA study was designed to measure the impact of intra‐hospital relocation upon elderly patients transferred to intermediate, skilled nursing, or psychiatric care facilities. The subjects were 389 elderly residents of a psychiatric hospital. Their mean age was 76.2 years, and mean length of hospitalization 22.4 years. A before‐and‐after analysis was made of behavior rating scores, and the mortality rate was compared with baseline values. The findings indicated that, for this type of reorganization, no deterioration was evident in the measured behaviors, nor did the move cause sufficient stress to have a substantial impact on mortality. It was concluded that, contrary to numerous reports in the literature, the mass relocation of elderly patients for the purpose of delivering more appropriate treatment services does not necessarily have detrimental effects. Additional research is required to account for outcomes related to the interaction between more specific personal characteristics and environmental compo

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1981.tb01234.x

年代:1981

数据来源: WILEY

摘要:

ABSTRACTIn treating elderly psychiatric patients, interviewing spouses together may be the most useful setting. Data gathering, reality testing and reality orientation can all be enhanced by the “well” spouse. The physician also can assess the value of the “well” spouse as a co‐therapist. Two case reports illustrate this method of aiding

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1981.tb01235.x

年代:1981

数据来源: WILEY