摘要:

ABSTRACT:Pulmonary embolism is a serious and highly lethal disorder which is greatly underdiagnosed and undertreated. In elderly patients it is a common and often fatal complication of thrombotic disease. It is not described in the ancient literature, nor thereafter until the chair became universally used in our civilization. Present habits of prolonged sitting, as during travel, entertainment, study, and certain forms of work, contribute to venous stasis and secondary pulmonary embolism. Etiologic factors are reviewed and new iatrogenic factors discussed. Modern techniques increase the accuracy of diagnosis, but a strong index of suspicion on the part of the physician and a careful history still play a major role. Prophylactic and treatment measures are highly effective if used early and adequately. The prevention of venous stasis is important in prophylaxis. Anticoagulant drugs, notably heparin and the coumarin compounds, are the most effective weapons in the majority of cases.

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1974.tb04810.x

出版商:Blackwell Publishing Ltd    

年代:1974

数据来源: WILEY

摘要:

ABSTRACT:Geriatricians should be reminded that many old people are still capable of experiencing sexual pleasure. Since sexual experiences can have generally favorable effects, they should be encouraged under appropriate circumstances. Certain enhancements are discussed. At any rate, sexuality in the aged should not be rigidly suppressed in wholesale fashion as it is at present in most nursing homes and other institutions.

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1974.tb04811.x

出版商:Blackwell Publishing Ltd    

年代:1974

数据来源: WILEY

摘要:

ABSTRACT:One of the most remarkable manifestations of the normal aging process is loss of bone after age 45–50 in apparently normal women. The magnitude of this loss is such that after the age of 80 virtually all women have bone masses that are smaller than those of normal women before the age of 45, i.e., the two populations with respect to bone mass are entirely different. The relationship of such “physiologic” bone loss to structural failure (vertebral compressions, fractured femoral necks) is discussed by comparing the radiologically measured bone mineral mass in the proximal radius in normal women throughout the adult age range with that in a group of 71 women with vertebral compressions and 36 women with femoral‐neck fractures. At a time of life when the incidence of structural failure is still low, a critical range of bone mass can be defined in which the abnormality (bone loss) is clearly recognized in the radius. The prevention of further bone loss at this stage should markedly lower the incidence of both the “crushed vertebrae syndrome” and femoral‐neck fracture. This approach is particularly appropriate for those geriatric female patients who still enjoy active life, including spor

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1974.tb04812.x

出版商:Blackwell Publishing Ltd    

年代:1974

数据来源: WILEY

摘要:

ABSTRACT:An outline is given of the services available in a 44‐bed Mental Health Unit of a skilled nursing facility. Statistics on 103 patients are presented. The majority of the patients in the Unit respond to treatment by some increase in then‐activities and improved feelings of dignity and self‐esteem. Concerns presented are: 1) adaptation of the staff in shifting focus from impairments of the patient (as needed for the problem‐oriented record) to the abilities of the patient to function, 2) the requirement that patients can only receive Medicare benefits if they have been in a hospital for seventy‐two hours, 3) the lack of nursing‐home beds for the continued care of Medicaid patients, 4) the lack of adjunctive services (e.g., day‐care center, workship, transportation), and 5) the tendency toward overspecialization and “buck‐passing.” Physicians, psychiatrists, nurses, social workers, other therapists, patients, and their families must work together. Whether based in a Community Mental Health Center or elsewhere, a Geriatric Team gains expertise in providing service to the patients, consultation with other agencies, liaison with other medical facilities and in locating

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1974.tb04813.x

出版商:Blackwell Publishing Ltd    

年代:1974

数据来源: WILEY

摘要:

ABSTRACT:An outline is given of the development of a Chronic Disease unit as part of a Hospital‐Based Comprehensive Care Program in Baltimore City Hospitals. Special attention is paid to the Initial Evaluation Conference (I.E.C.) since this early thorough assessment of the patient by various disciplines provides essential information when the patient later may become a candidate for discharge from the hospital. Despite necessary modifications from the original plan, the I.E.C. remains a vital part of the program for long‐term hospital care of the elde

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1974.tb04814.x

出版商:Blackwell Publishing Ltd    

年代:1974

数据来源: WILEY

摘要:

ABSTRACT:Serious vascular complications can be readily overlooked in cases of hyperosmolar nonketotic diabetic coma. They were found by the authors in 3 of 5 autopsy cases. Such a high proportion attests to the importance of early recognition, not only of the type of coma but the presence of life‐threatening vascular complication

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1974.tb04815.x

出版商:Blackwell Publishing Ltd    

年代:1974

数据来源: WILEY

摘要:

ABSTRACT:The principles of an anticoagulant‐psychotherapy regimen for presenile dementia are discussed. Short histories are given of 10 patients (including one with Huntington's chorea as well as dementia) who responded well to this treatment. It is important to keep the blood prothrombin time at 2.0–2.5 times the control time. The earlier treatment is started, the better the result. Even in cases in which there is no significant improvement, the prevention of further deterioration is of great value. If properly controlled, this regimen is relatively safe and can maintain or improve the quality of life for dementia patie

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1974.tb04816.x

出版商:Blackwell Publishing Ltd    

年代:1974

数据来源: WILEY

摘要:

ABSTRACT:A 94‐year‐old insulin‐dependent diabetic female was successfully treated for ketoacidosis precipitated by streptococcal cellulitis, cardiac failure and bronchopneumonia. This patient appears to be the oldest to have survived an episode of ketoacidosis. In elderly patients with severe diabetic metabolic decompensation, multiple precipitating factors are common. Reversible causes, especially infection, must be actively tr

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1974.tb04817.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.tb04818.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.tb04821.x

出版商:Blackwell Publishing Ltd    

年代:1974

数据来源: WILEY