ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1983.tb04866.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

Mantoux‐type skin tests were applied to 29 elderly residents of an intermediate care floor of a nursing home. Eight antigens were used with each resident, and the size of the reactions was measured at 6, 24, 48, and 72 hours. All but one resident had at least one response ≥ 3 mm at 48 or 72 hours, and most had more than one response of that size. At 48 compared with 72 hours, there was one more responder and the mean size of the reactions to each antigen was greatest. However, there were two responders at 72 hours who did not react at 48 hours, and the total number of reactions in the group was greater at the later reading. Only one resident did not produce any response at either 48 or 72 hours. The minimum number of antigens needed to identify all responsive subjects was five (PPD‐Avian, coccidioidin, histoplasmin, streptokinase‐streptodornase, and trychophytin). The purified protein derivative of tuberculin skin test was repeated on subjects who had an initial response<10 mm, and one increase of more than 6 mm was observed in a resident who was initially unresponsive to that

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1983.tb04867.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

A 30‐item screening examination for cognitive deficits was administered to 65 hospitalized elderly patients and to 60 elderly controls. A high proportion (73 per cent) of the hospitalized patients were found to have low cognitive scores indicative of probable organic mental syndrome (OMS). Especially high deficits were found among the patients with orthopedic and cerebrovascular conditions. The test correctly identified the 15 cases of established OMS. The percentage of false positive results in the normal controls was reasonably low. The importance of routine cognitive measurements in medical wards is stresse

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1983.tb04868.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

The dexamethasone suppression test (DST) was performed on 26 elderly male outpatients in a geriatric medical clinic. Patients with depression were excluded. All patients had two or more medical diagnoses. Fourteen patients also met DSM‐IM criteria for dementia. No patient had an abnormal DST result. The authors suggest that neither chronic medical illness nor dementia causes false‐positive DST results in this patient population in an outpatient setting, and discuss the findings in relation to previous repo

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1983.tb04869.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

The elderly patient with malignancy is often considered a poor risk for treatment. To assess the effect of age on the treatment of one such disease, multiple myeloma (a disease with increased incidence in the elderly), a study was made of 280 patients treated with 1,3‐bis (2‐chloroethyl)‐1‐nitrosourea (BCNU), cyclophosphamide and prednisone on a Southeastern Cancer Study Group protocol. Initial response rates after six months of treatment were equivalent for the older compared with the younger age groups, with a slightly longer remission duration for those over 70. Likewise, survival was equivalent for the older patients. This was not the result of selection of older patients with less advanced disease, since the proportion with both good and poor risk factors are not significantly different in the various age groups. Moreover, for patients with each of the prognostic factors, older patients responded at least as well as younger patients. There were no significant differences among the age groups in gastrointestinal, skin, hair, or hematologic toxicity, although there was a slightly higher incidence of mild granulocyte and platelet toxicity in patients over 60. These findings are in contrast to the widely held belief that older patients cannot tolerate chemotherapy. On the contrary, they suggest that the elderly patient with myeloma may be expected to respond and survive, without excessive toxicity, at least as well as a younger counterpart with similar prognostic

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1983.tb04870.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

A survey of all patients in a 527‐bed skilled nursing facility was carried out to determine the prevalence of bladder catheterization. The institution surveyed is a teaching nursing home and rehabilitation center comprising three intermediate‐stay and rehabilitation units of 126 beds and nine long‐term care units.The institutional prevalence of recurrent urinary incontinence was 46 per cent, or 243 patients. The prevalence of chronic indwelling urethral catheters was 2.5 per cent, or 13 patients. The prevalence of urethral catheterization was further reduced to 1.5 per cent on the long‐term care units, where the rate of recurrent urinary incontinence exceeded 60 per cent.The results of our survey were then compared with similar surveys at the institution during the years 1975 through 1980. Despite a fluctuating but increasing prevalence of incontinence over the years studied, a favorable trend was shown toward a reduction in the number of patients with indwelling urethral catheters.This study indicates that unless specific complicating factors are present, urinary incontinence in all but a very few of the elderly can be successfully managed without chronic indwelling catheterization. The authors believe that the introduction and growth of an education and research program in the nursing home environment has led to improvement in the standards of medical and nursi

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1983.tb04871.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

The use of acute‐care hospitals by the elderly is rising rapidly, particularly in the age group 75 and older. Any changes that will reduce the length of stay could result in considerable savings in health care costs. It is imperative to look at present policies and explore possible changes that could reduce costs by reducing the total hospital days. A study was conducted in a 290‐bed county‐funded community hospital in California that serves the majority of disadvantaged and poor elderly residing in an area with a population of approximately 300,000 persons. The objective was to determine what demographic, medical, and sociologic characteristics of elderly patients recorded at admission would be of value in predicting those most likely to change their functional status.It was found that the most important predictors of deterioration of function are (1) older age, especially 85 +, and (2) abnormal mental status. Patients admitted from nursing homes had a longer than average length of stay, and those who survived (80 per cent) returned to a nursing home.It was concluded that routine assessment of elderly patients admitted for acute illness or injury could facilitate discharge planning by an early prediction of the level of care that will be required after discharge. This assessment should include preadmission mental and functional status; identification of causes for, and correction of, acute confusional states; and an assessment of the impact of the present illness or injury on future level of function following rehabilitation. This could result in a reduced length of average hospital

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1983.tb04872.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

Constipation in institutionalized elderly is a common and difficult problem. Thirty‐three institutionalized demented patients with severe constipation were given a high‐bran bread instead of their accustomed laxatives. Changes in defecation habits, food and liquid intake, and metabolic status were registered. During the high‐bran bread treatment period, the number of bowel evacuations and the estimated volume of feces increased. The total laxative consumption (doses given per day) decreased by 93 per cent. Nutritional data and metabolic status were unchanged during the high‐bran bread period except for a reduction of the postprandial blood glucose response after the glucose toleran

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1983.tb04873.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.tb04874.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.tb04875.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY