摘要:

AbstractAn integrated theory of aging is proposed which consists of an interrelated grouping of other current theories. Each of these has had some success in explaining various separate phenomena of aging, but none has provided an explanation of all the phenomena associated with aging and death. The theories considered are: 1) cross‐linkage, 2) free‐radical, 3) collagen, 4) waste‐product, 5) rate‐of‐living, 6) stress, 7) diffusion, 8) mutation, 9) immunologic, and 10) cybernetic. The cybernetic theory is used as the framework within which the other theories serve as functional blocks, the key functional block being the cross‐linkage theory. Within the cybernetic framework, the various theories are aligned in two modes—the non‐genetic, and the genetic. The non‐genetic mode governs the organism's level of molecular efficiency, whereas the genetic mode governs the minimal level of molecular efficiency required for survival of the organism.The integrated theory of aging appears to answer satisfactorily the objections to the individual theories, and to offer a basis for fairly accurate theoretical prediction of the experimentally observe

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1968.tb02774.x

年代:1968

数据来源: WILEY

摘要:

AbstractSixteen uremic patients aged 50 or older were treated at the Ochsner Medical Center by hemodialysis, renal transplantation, or both, during a 30‐month period. Nine had acute uremia, and 7 chronic uremia. Renal function was restored in 2 of the 9 patients with acute uremia, but only 1 survived. The most common causes of unsuccessful results were respiratory failure due to aspiration pneumonitis and death due to complicating diseases, usually arteriosclerosis. Of the 7 patients with chronic uremia, 5 survived; 2 of these have reduced renal function but the other 3 have been completely rehabilitated by hemodialysis (at home) or renal transplantation.As a result of our experience, we advocate that hemodialysis be used in all patients with acute renal failure, regardless of age, and that hemodialysis and renal transplantation be considered in all patients with chronic renal failure, regardless of age, as long as complicating diseases do not preclude long‐term survi

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1968.tb02775.x

年代:1968

数据来源: WILEY

摘要:

AbstractStudies dealing with the influence of increasing age on intestinal absorption are reviewed. Interest in these studies has resulted from statements that increasing age is accompanied by a delay and a reduction in drug absorption. There are, however, no data to support this conclusion. Nevertheless, data from studies of the absorption of sugars, fats and vitamins in subjects of different ages may be relevant to the problem of drug absorption, as are the other changes in gastrointestinal function that occur with advancing age. In the elderly there is a reduction in gastric pH which, in the case of some drugs, affects the solubility and thus will influence the rate of absorption. Furthermore, there is a reduction in intestinal blood flow, which would tend to delay or reduce drug absorption. Possibly there is a reduction in the number of absorbing cells in the intestine, with a consequent loss of absorbing surface in the aged; this may explain the reported reduction in passive diffusion in the aged. A modification of special transport mechanisms is suggested by the fact that the absorption of galactose, 3‐methyl glucose, calcium, and thiamine is reduced with increasing age. All of these factors tend to imply that drug absorption in the elderly is reduced. Fortunately perhaps, the reduction in absorption is accompanied by decreased metabolism and decreased excretion. Thus, limited absorption from the intestine is balanced by delayed elimination of drug

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1968.tb02776.x

年代:1968

数据来源: WILEY

摘要:

AbstractA twelve‐month survey was made in general practice in an English town, to determine the incidence of incapacitating diseases in patients over 65 years old. Among the 885 patients in this age group, there were three times as many women as men, and 56 of the group (6.3 per cent) had diseases which rendered them totally incapacitated. They were cared for in their homes by interested relatives, friends or landladies. Cerebral arteriosclerosis, ischaemic heart disease and rheumatic diseases were the three leading crippling diseases. The diseases, and the care of elderly patients in their home are discussed.Old patients are treated best in their homes. They know the familiar corners of their rooms, furniture, views from the windows, and their neighbours. It is important that they have willing relatives or friends to look after them. A family doctor can give them adequate medical care provided he has the full co‐operation of ancillary servi

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1968.tb02777.x

年代:1968

数据来源: WILEY

摘要:

AbstractThe first section of this article on some neglected aspects of social rehabilitation of the aged concerns the philosophy of rehabilitation. A general principle is that the probability of improvement is highest when the goal for the old person is set successively at only the next step higher than the current level of functioning. The personnel of the institution should be kept aware of the success of their efforts in attaining these realistic goals.The ensuing sections of the article contain recommendations for certain fresh approaches to various problems regarding application of the old person to a home for the aged, the waiting period, and the crucial entry period. Since change of residence constitutes an acute stress for many old people, appropriate psychological and social attention is very important and may set the course for the success of rehabilitation. Private space, social space and furnishings in the institution are discussed. The importance of the staff is dealt with from the viewpoints of the social role, the helping role, and the personal distance between employee and resident. The goal of rehabilitation in the institution extends even to death in an attempt to add dignity and self‐respect in the final phase of lif

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1968.tb02778.x

年代:1968

数据来源: WILEY

摘要:

AbstractMultiple educational approaches to the subject of hospital staff attitudes toward death were tested. It was not known which approaches, if any, would work, and it is still not known if one is better than another. The staff's resistance to discussing the topic of death seemed connected with a culturally‐induced denial. Attempts to promote academic discussion failed. Not until situations occurred which provoked emotional involvement—an actual death, the staging of psychodrama involving death, seminars on religion and psychiatry, and attendance at an autopsy—could the staff members begin to understand their own feelings and open the way for true communication with their pat

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1968.tb02779.x

年代:1968

数据来源: WILEY

摘要:

AbstractA case is presented of a large rectal villous adenoma of eighteen months' duration associated with marked fluid and electrolyte imbalance, in a 65‐year‐old man. At operation, the bowel was found to be so extensively involved that an abdominoperineal resection with colostomy had to be performed.Abdominoperineal resection is the procedure of choice in dealing with extensive lesions of this character. Without complete removal of the tumor, the patient may fail to recover and secondary operations may not be success

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1968.tb02780.x

年代:1968

数据来源: WILEY

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1968.tb02781.x

年代:1968

数据来源: WILEY

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1968.tb02782.x

年代:1968

数据来源: WILEY

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1968.tb02783.x

年代:1968

数据来源: WILEY