摘要:

The hospital records of 126 patients over 75 years of age with transmural myocardial infarction initially treated in the coronary care unit were compared with a concurrent similar group of 94 patients admitted directly to the general medical wards. The in‐hospital mortality rate for both groups together was 40%. The mortality rate within the coronary care unit was 24% as compared with 46% in the ward group (P<0.005). However, the mortality rate for the coronary care unit group as a whole (including those patients later transferred to the general ward) was 35 versus 46% in the ward group. Congestive heart failure and cardiogenic shock were the most frequent complications in both groups (47 and 30%, respectively), and they were the main cause of death. Patients with these complications were less likely to be successfully resuscitated, even in the coronary care unit. The overall incidence of serious ventricular arrhythmias and complete heart block was similar to that reported for younger patients. Eleven patients in the coronary care unit group were successfully resuscitated from these arrhythmias and eight survived to be discharged from hospital. In contrast, only two patients in the ward group were successfully resuscitated and eight (9%) patients died suddenly and the fatal event could not be diagnosed. We concluded that elderly patients with an acute myocardial infarction can benefit from early admission to a coronary care unit. J Am Geriatr Soc 35:915–919,

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1987.tb02291.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1987.tb02292.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

Depression among older minority groups, including Hispanics, has not been well studied. Little is known of the true rates of depression, its correlates or how well it is treated. This research is part of a series examining health status of older Hispanics using the Comprehensive Assessment and Referral Evaluation (CARE). Seven hundred older Hispanics living in Los Angeles County were studied using an area‐probability sampling method. The CARE items were regrouped to reflect Diagnostic and Statistical Manual III criteria for depression and dysphoria. More than 26% were found to have a major depression or dysphoria. These affective disorders were strongly correlated with physical health status. Without physical health complications, the rate was 5.5%. A number of socioeconomic, health behavior, and family variables were related to affective state. Treatment for affective disorder appeared to be very poor for this population. J Am Geriatr Soc 35:920–926,

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1987.tb02293.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

Patients admitted to an inpatient psychiatric service were screened to identify middle‐aged (35 to 50 years of age) and elderly (60 years of age and over) patients suffering from a major depressive episode with melancholia. Thirty‐seven subjects (18 middle‐aged and 19 elderly) were identified. Criteria symptoms for depression and symptoms specifically associated with melancholic or endogenous depression did not differ across age groups, with few exceptions. Major depression with melancholia in this hospitalized population was symptomatically similar in the middle‐aged and elderly. The syndrome is therefore relatively common on this inpatient service and should be easily recognized. J Am Geriatr Soc 35:927

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1987.tb02294.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

Two‐hundred women self‐described as having urinary incontinence, aged 55 to 90 years and living in the community completed a comprehensive history and physical examination. Initial presentation of urine loss was most commonly stress incontinence symptoms (35%). Scoring of peak response to volume lost and frequency revealed urine loss necessitating a clothing change for 78% and daily loss experienced by 73%. Over half had experienced a urine loss problem for more than five years. Most (65%) had sought treatment, but a minority reported current (11%) or previous (36%) treatment. Thirty‐six percent were found to have severe atrophic vaginitis with severe urethocele (10%), cystocele (13%), rectocele (12%) less common. Pelvic floor strength by clinical scoring was weak (mean, 1.05 on a 5‐point scale). The vaginal electromyograph first contraction peak mean was 5.94 micro‐volts sustained at 50% or better for 3.92 seconds. Clinical criteria established that 66% had stress, 27% a mixture of stress and urge, only 4% pure urge incontinence, and 4% other. J Am Geriatr Soc 35:933

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1987.tb02295.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

The objective of this study is to characterize urinary incontinence observed in elderly women and to assess the importance of various parameters used to evaluate urinary incontinence. Two hundred consecutive, ambulatory, outpatient, incontinent women 55 years of age and over who were seen at the Continence Program Clinic and completed a medical and urodynamic protocol are included in this paper. After a thorough medical history and a complete physical examination, urodynamic tests were performed. The urodynamic results showed that 77% of incontinent women had an incompetent urethra. Twenty‐five percent had a hyperactive bladder, 8% had “other” types, and 7% had a normal study. Comparison of the clinical diagnosis with the actual urodynamic diagnosis for stress incontinence revealed a 78% accuracy and only a 6% false negative. In contrast, a similar comparison for urge incontinence found only 44% accurate and 45% false negative. Analysis of the urodynamic tests revealed that the simple provocative full‐bladder stress test was as effective as the radiographic or electronic pressure measurement in detecting incompetent urethra producing stress urinary incontinence. Provocative upright cystometry was helpful in uncovering 33% of hyperactive bladders not provoked in the supine position. Complex urodynamic tests should be reserved for unexplained incontinence or when symptomatology is complex. J Am Geriatr Soc 35:940

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1987.tb02296.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1987.tb02297.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1987.tb02298.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1987.tb02300.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1987.tb02301.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY