摘要:

ABSTRACT:A program for the practice of preventive medicine in the 70+ age group is outlined. This type of work is extremely satisfactory, as in all countries it is essential not only to treat illness but to keep the population as healthy as possible. Old age can be a time of great pleasure and enjoyment and should not be associated in the public mind with either poverty or ill health. In essence, it is postulated that the positive planning of activities with a purpose clearly understood by the elderly will improve their physical, mental and social health. Such activities will provide a place and life purpose for older citizens in the community and will ensure their continued integration as a useful and essential part of society.

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1974.tb05406.x

出版商:Blackwell Publishing Ltd    

年代:1974

数据来源: WILEY

摘要:

ABSTRACT:Defective sexual adjustment can be managed more easily when there is some understanding of the respective roles of psychogenic and endocrine factors in sexual behavior. Millions of men and women are in need of help. The problems are discussed under the headings of maleness and femaleness, sex interest in the female, sexual inadequacy, and sexual gluttony. Only after differentiation of the psychogenic and endocrine factors can proper therapy be started.

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1974.tb05407.x

出版商:Blackwell Publishing Ltd    

年代:1974

数据来源: WILEY

摘要:

ABSTRACT:A double‐blind cross‐over study was made of the effects of betahistine hydrochloride in 50 patients who had symptoms and signs of vertebrobasilar insufficiency associated with dementia, confirmed by detailed neurologic and clinical investigation. They were treated for six weeks by oral administration of either betahistine‐HCl (32 mg daily in four doses) or an identical‐appearing placebo, and then for six weeks by these preparations in reverse order. Evaluations made initially and at six‐week intervals included detailed assessment of neurologic functions rated according to a quantitative scale. A series of neuropsychologic tests was also given before and after each treatment period. Statistical analyses of neurologic and of psychologic status showed significant improvement with betahistine‐HCl therapy, particularly with respect to verbal and nonverbal cognition, memory, language use, spatial construction, perceptual‐motor coordination and perception. Measurements of regional and mean cerebral blood flow indicated a significant increase with betahi

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1974.tb05408.x

出版商:Blackwell Publishing Ltd    

年代:1974

数据来源: WILEY

摘要:

ABSTRACT:Postoperative pulmonary complications are a serious danger to any patient who undergoes surgery. The increase in geriatric surgery has brought into focus certain marginal factors that can spell the difference between success and failure. In a series of 300 elderly patients who underwent major surgery at the Henry Ford Hospital, there were 34 in whom clinical and radiologic evidence of atelectasis developed. In 19 others, x‐ray examination of the chest showed various infiltrates suggesting pneumonitis, and sputum cultures grew coliform bacteria. Despite appropriate treatment, 5 patients died from postoperative pulmonary complications. Illustrative cases of hypoventilation, atelectasis, pneumonia and pneumothorax are presented. Recommendations are made for the care of the elderly undergoing major surgery, including the preoperative identification of chronic lung disease, determination of the respiratory reserve, preoperative exercises in deep breathing and coughing for use after operation, adequate oxygenation during the surgical procedure, close supervision of postoperative respiratory ventilation for the first seventy‐two hours, selective use of mechanical respiratory assistance, and emphasis on early ambulat

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1974.tb05409.x

出版商:Blackwell Publishing Ltd    

年代:1974

数据来源: WILEY

摘要:

ABSTRACT:Twenty‐three cases of metastatic malignant disease in the elderly were investigated for possible hypercalcemia. Regular biweekly estimation revealed that 7 (about 30 per cent) of these patients had hypercalcemia with many severe symptoms. The commonest symptom was generalized weakness. Though care of the malignant disease usually is not possible, these terminal patients can be made much more comfortable by reducing the concentration of serum calcium. Low dosages of magnesium sulphate were used for this purpose, with excellent results. It is concluded that serial estimation of serum calcium concentration in cases of malignant disease, particularly when distant metastases are present, is a useful adjunct in management. Magnesium sulphate is a simple and effective agent for reducing the serum calcium leve

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1974.tb05410.x

出版商:Blackwell Publishing Ltd    

年代:1974

数据来源: WILEY

摘要:

ABSTRACT:A study was made of the possible usefulness of certain sociodemo‐graphic characteristics as early indicators of the need for referral of elderly hospital patients to Social Service. The study population covered the 5,312 elderly patients accommodated in the private, semiprivate and teaching wards of the hospital's medical and surgical services during the year 1967. Of these patients, 520 were referred to Social Service. The data on 6 items (age, sex, marital status, religion, color, and medical service location) routinely recorded on each admission sheet were collected to determine whether they would prove predictive of the need for referral to Social Service; if so, they would constitute an inexpensive automated screening device for this purpose. At present, most elderly patients who need the services of social workers are referred only late in the course of hospitalization. Incidental to the original plan of study was the collection of data on the length of hospital stay. The 6 “admission” variables were found to be of no value as early predictors, but the ancillary variable (length of stay) proved to be importantly related to the overall need for Social Service. However, since the data on this variable can be obtained only at the time of discharge, they cannot be used as a screening device for early identification of the need. Further studies may reveal a means of early prediction of the length of hospital

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1974.tb05411.x

出版商:Blackwell Publishing Ltd    

年代:1974

数据来源: WILEY

摘要:

ABSTRACT:A study was made of 20 patients (average age, 74) admitted to the Internal Medicine Service from the emergency ward because of acute infections of the lower respiratory tract, to determine the degree of correlation between the findings upon immediate Gram‐stain examination of the sputum and the subsequent findings upon examination of the sputum culture. It was found that the choice of initial antibiotic therapy could be made on the basis of the immediate Gram‐stain examination and the clinical picture. There was a high incidence of pneumonia from nosocomial Gram‐negative organisms in the hospital population of elderly debilitated patients who usually had several chronic diseases. This characteristic made careful examination of the Gram‐stain sputum preparation an essential part of the initial evaluation of all patients admitted with acute infections of the lower respiratory tract, in order to reduce the excessive mortality associated with these initial inf

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1974.tb05412.x

出版商:Blackwell Publishing Ltd    

年代:1974

数据来源: WILEY

摘要:

ABSTRACT:The second heart sound was studied in 43 old people in order to ascertain whether left anterior hemiblock (LAHB) caused any change in the sequence of and the interval between the components of this sound. The second sound in LAHB was compared with that in subjects with a normal electrocardiogram, and the second sound in right bundle‐branch block (RBBB) plus LAHB was compared with that in uncomplicated RBBB. Despite a slight trend toward a narrower degree of splitting (later A component) in LAHB, the difference did not prove statistically significant. Thus LAHB seems to cause no dynamic changes affecting the second heart soun

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1974.tb05413.x

出版商:Blackwell Publishing Ltd    

年代:1974

数据来源: WILEY

摘要:

ABSTRACT:The relationship between glucose tolerance values and electrocardiographic (ECG) deviations was studied in 50 subjects (25 men and 25 women, average age 73.4 years). The loading consisted of 24 gm of glucose in 60 ml of solution, given intravenously to the fasting patient. ECG records and blood determinations were obtained before the injection and 5 minutes afterward; then blood sugar was determined at 10‐minute intervals up to 60 minutes; at 60 minutes an ECG was also recorded. For a control, similar examinations had been carried out previously in 20 of the 50 subjects, the injection consisting of 60 ml of physiologic saline instead of glucose. The various deviations occurring in the ECG included depression of the ST segment, a U wave, premature beats and partial A‐V block. None of these changes had been observed after injection of physiologic saline. A possible mechanism may have been an insulin‐induced change of potassium metabolism. In view of the fact that a relatively small excess of sugar can affect myocardial metabolism, it is essential that the subject undergo the standard fasting procedure when observations are being made. On the basis of the ECG findings it is important that the dietary intake of sugar be low, particularly in persons approaching middl

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1974.tb05414.x

出版商:Blackwell Publishing Ltd    

年代:1974

数据来源: WILEY

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1974.tb05415.x

出版商:Blackwell Publishing Ltd    

年代:1974

数据来源: WILEY