摘要:

Abstract:The problems of peripheral vascular disease in the aged have been greatly neglected. Preventive measures should be established in the younger years so that there will not be so much need for therapeutic attempts in old age.The chief cause of peripheral vascular disease in the elderly is atherothrombosis, with elements of both atherosclerosis and thrombosis. The study of these two elements should not be conducted in strictly separate categories, as at present. Robertson's theory of the pathogenesis is described, including the cellular and biochemical influences. The genetic element is emphasized in the concept of susceptible atherophils versus resistant atherophils in relation to elevated blood lipid levels.Prevention involves anti‐obesity dietary measures, appropriate exercise, and the avoidance of smoking. If hypertension, hyperlipidemia or hyperglycemia (diabetes) develop, early detection and treatment are important. Patients with peripheral vascular disease should avoid extremes of cold or heat and pay special attention to cleanliness of the feet. Even though all the etiologic factors in the disease are not known, it is essential to apply all the available preventive measures. Such a program requires improved education of the medical and associated professions, as well as of the lay publi

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1970.tb02120.x

出版商:Blackwell Publishing Ltd    

年代:1970

数据来源: WILEY

摘要:

Abstract:Based upon electroencephalographic, clinical and experimental findings in the field of geriatric psychiatry, this article presents a group of working hypotheses which may lead to: 1) a better understanding of some EEG phenomena in terms of the overall clinical picture (and vice versa); and 2) more specific questions for further study. A diagram is presented which summarizes the more important points. This approach is prompted by the marked difference between the types of geriatric EEG, and also certain EEG‐clinical correlations—phenomena which make this field particularly interesting for the investigation of psychophysiological relationsh

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1970.tb02121.x

出版商:Blackwell Publishing Ltd    

年代:1970

数据来源: WILEY

摘要:

Abstract:Advances in psychiatry and new attitudes of society toward the mentally ill have been instrumental in the transformation of the mental hospital from an asylum for deviants into an active therapeutic center for mental illnesses. Also a new approach has crystallized towards the geriatric group who until recently were placed indiscriminantly in mental hospitals.In New York State mental hospitals the new selective admission policy for elderly patients showed in nine months more than a 30 per cent reduction of geriatric admissions and a significantly decreased mortality rate in the geriatric group. The use of newer therapeutic techniques has shown good promise and has changed the outlook for geriatric patients who previously received custodial care only. The release of elderly patients who improved to the extent of being able to live outside the hospital has been rather slow because of shortages in facilities and services in the communities. The Department of Mental Hygiene gives high priority to the funding of community programs for the elderly which will serve as alternatives more desirable than placement in a mental hospital. It is expected that when these programs are fully implemented the release of elderly patients from mental hospitals will be accelerated.

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1970.tb02122.x

出版商:Blackwell Publishing Ltd    

年代:1970

数据来源: WILEY

摘要:

Abstract:A review has been made of the literature on the changes with age in the sensitivity of various organs and tissues to catecholamines. The objective of this review was to examine these changes and to interpret them in the light of related compounds that are employed commonly in the treatment of the elderly. The available evidence strongly indicates that there is an increase with age in the sensitivity to exogenously administered amines. In terms of the therapeutic application of related drugs in the elderly, this finding indicates that caution should be used when administering such agents, particularly if they have significant secondary effects which are related to the stimulation of adrenergic receptors. Additional information indicates that perhaps there is a delay in the excretion and in the distribution of catecholamines. Thus, higher blood levels might be anticipated when sympathomimetic amines are employed in the treatment of various disease states.

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1970.tb02123.x

出版商:Blackwell Publishing Ltd    

年代:1970

数据来源: WILEY

摘要:

Abstract:In a double‐blind study, 48 patients (age range, 47 to 75) with angina pectoris received either dipyridamole (Persantine) (200 mg daily) or placebo for an average of five months. Nitroglycerin was taken sublingually as required for relief of acute attacks. Previous use of long‐acting nitrates had produced no significant improvement.Of the 26 patients receiving dipyridamole, 21 (81 per cent) showed an overall satisfactory clinical response (marked or moderate improvement) compared to 2 (9 per cent) of the 22 receiving placebo. The difference between the two treatments was statistically significant. Evaluation of objective criteria also showed the superiority of dipyridamole. The mean improvement for drug group vs. placebo group was as follows: decrease in anginal attacks, 48/24 per cent; decrease in need for nitroglycerin, 50/18 per cent; and increase in walking distance, 84/36 per cent. In terms of subjective evaluation of anginal pain, 69 per cent of the drug group improved compared to 18 per cent of the placebo group.Two patients had reactions while taking the drug. Transient blurred vision was noted by one patient, but it did not interfere with continuation of dipyridamole. Nausea and insomnia in another patient (not in the final study group) caused cessation of therapy. No reactions were reported among the placebo patients.From the results of this controlled study it is concluded that dipyridamole, a non‐nitrate coronary vasodilator, is a relatively safe and effective agent for the long‐term treatment of patients with angina p

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1970.tb02124.x

出版商:Blackwell Publishing Ltd    

年代:1970

数据来源: WILEY

摘要:

Abstract:In an attempt to ascertain the incidence of post‐operative pulmonary emboli (including early small emboli) in the elderly, 50 surgical patients (age range, 21–91) were studied both preoperatively and postoperatively by means of the following: lung scintiscanning (four views), electrocardiograms, chest roentgenograms, and determinations of serum glutamic oxalacetic transaminase (SGOT), lactic dehydrogenase (LDH), and bilirubin. These tests were performed twice postoperatively at one‐week and two‐week intervals.In 4 cases the postoperative lung scan findings were compatible with recent pulmonary emboli, although the patients were asymptomatic. There was no consistent correlation with serum enzyme elevations, nor with the sex of the patient, type of operation, type of anesthesia, or diabetic status. All 4 patients with indications of postoperative emboli were over 40 years of age, and 3 of them had undergone their operations in the lithotomy position. The overall incidence of positive findings with postoperative lung scanning was 8 per cent, but in patients over 40 years of age it was 10 per cent.In view of the significant incidence of postoperative pulmonary emboli and the possible age correlation, further study is needed to ascertain the feasibility of prophylactic postoperative anticoagulation therapy in elderly p

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1970.tb02125.x

出版商:Blackwell Publishing Ltd    

年代:1970

数据来源: WILEY

摘要:

Abstract:The case is presented of a man who, at the age of 63, began to complain of joint pain. The clinical picture of polymyositis gradually developed, and three years after the onset of the joint pain a carcinoma of the prostate was diagnosed. The rheumatic complaints improved during treatment with indomethacin and estrogen. Early in the disease a repeatedly abnormal x‐ray finding in the duodenum raised the possibility of a carcinoma of the pancreas. At the height of this symptomatology, the patient twice exhibited neurological signs, diagnosed as a small stroke; an abnormal EEG was found immediately following the second attack and one year later.This report adds a new case to the few in which polymyositis is associated with carcinoma of the prostat

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1970.tb02126.x

出版商:Blackwell Publishing Ltd    

年代:1970

数据来源: WILEY

摘要:

Abstract:Pseudoneurotic schizophrenia has been used as a diagnostic classification for about twenty years. A review of thousands of reports fails to indicate that such a diagnosis has effectively differentiated it from other categories. The term has added to the confusion of both psychiatrists and nonpsychiatrists who are responsible for the use of psychiatric reports in the various processes of adjudication. The modern psychiatrist, participating with labor and industry in the management of psychiatric aspects of personal adjustment, will find no advantage in using the diagnosis “pseudoneurotic schizophrenia

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1970.tb02127.x

出版商:Blackwell Publishing Ltd    

年代:1970

数据来源: WILEY

摘要:

Abstract:At Hadassah University Hospital, Jerusalem, in the last fifteen years there have been 4 cases of craniopharyngioma in patients more than 50 years of age. The clinical picture was characterised by organic mental signs and the absence of suprasellar calcification on regular x‐ray examination. Ocular impairment was present in 3 of the 4 cases. In all 4 patients the tumor was located behind the optic chiasm, indicating that perhaps craniopharyngioma in aged patients is a different tumor from craniopharyngioma in young patients in whom it shows several specific characteristics. Air‐contrast studies of the brain ventricles were the preoperative diagnostic method of choice. Confirmation of the diagnosis was made at operation in 3 patients, and at necropsy in the fou

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1970.tb02128.x

出版商:Blackwell Publishing Ltd    

年代:1970

数据来源: WILEY

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1970.tb02129.x

出版商:Blackwell Publishing Ltd    

年代:1970

数据来源: WILEY