摘要:

AbstractAlthough the medical profession is slowly realizing that many disorders in the aged must be treated differently than in the young, there is still no proper appreciation of these age differences. Too often, when a patient reaches life‐expectancy age, the physician relaxes his medical attention. It is assumed that the patient will die soon, although the actuarial statistics may show that he has many more years of life. Accordingly, therapy should be more intensive in order to attain the maximal life span.Elderly people will tolerate many major operations (e.g., herniorrhaphy or thyroidectomy) as well as young people. However, when it comes to serious major operations (e.g., radical neck dissection or radical excision of the rectum for carcinoma), the mortality rate for the aged may be four to eight times higher than for young patients.Elderly patients tolerate emergency major operations and complications very poorly. The chronologic age is not the chief factor in the mortality rate; more important are the operative complications. Therefore, preoperatively, every effort should be made to identify and treat diseases that might cause complications postoperatively. After operation a close watch must be kept for complications so that they may be treated promptly and effectively.Operative technic must be meticulous, with no excessive trauma and with particular attention to hemostasis and wound closure. The operation should be completed in the shortest possible time consistent with safety.A summary of 6 reports in the medical literature shows an operative mortality rate for major operations of 2.6 per cent in patients under 60, compared to 7.2 per cent for patients over 60. The mortality rate for emergency operations is much higher than for elective operations—18.5 per cent versus 6.5 per cent, respectively. A summary of 4 reports shows that cardiac complications were the greatest single cause of postoperative mortality (21.6 per cent), with pneumonia and atelectasis a close second. Despite precautions such as bandaging the extremities and early ambulation, pulmonary embolism accounted for 9.4 per cent of the deaths. [Though inoperable carcinoma caused more deaths (22.2 per cent of the entire group) than any of the other diseases, it is classified as a multiple cause.]Since the mortality rate for major operations in both aged and young patients is still significant, there is great need for more accuracy in determining operabil

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1970.tb02804.x

年代:1970

数据来源: WILEY

摘要:

AbstractFor many patients with chronic obstructive pulmonary disease, a program of graded pulmonary exercises (preceded by bronchial drainage) will induce improvement. This improvement is manifested by increased ability to perform the activities of daily living and an increase in exercise tolerance associated with a decrease in the heart rate (both at rest and during exercise). The medical management of chronic obstructive pulmonary disease is outlined, and the drainage technique and exercises are described in detail.

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1970.tb02805.x

年代:1970

数据来源: WILEY

摘要:

Abstract737 patients were admitted to the intensive care unit of Coney Island Hospital during a twelve‐month period, at the rate of about 60 per month. The data are analyzed regarding sex, age, race, duration of illness, monthly admission rate, condition of the patient on admission, working diagnoses, length of hospital stay, effectiveness of treatment, final disposition, mortality rate, hour of death, and number of consultations. Of the 737 patients admitted, 269 died (130 of them being classified for the purposes of this study as D.O.A. because they were in the unit for less than twelve hours before death). For the remaining 468 patients, records of disposition were available on only 453; of these, 444 were transferred to the wards after improvement, and 9 were discharged. Contrary to the general impression, the number of deaths was no greater during the 11:00 p.m.–7:00 a.m. shift than at other times. For the patients receiving treatment in this intensive care unit, the mortality rate was 18.7 per cent—which seems quite low in view of the severity of the diseases, the poor prognosis, and the relatively advanced age of the patient (average age, 66 years).The medical intensive care unit, though handicapped by the scarcity of qualified physicians and nurses, is an important element in good hospital care. Every effort should be made to improve and enhance such facil

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1970.tb02806.x

年代:1970

数据来源: WILEY

摘要:

AbstractAn attempt is made to dispel some of the over‐generalizations about the futility of treating persons with chronic brain syndrome. The success or failure of such a treatment program is based upon several variables related to the patient, the therapist and the environment. Recognizing and controlling these variables is the first step toward making them work to the advantage of the patient and his recover

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1970.tb02807.x

年代:1970

数据来源: WILEY

摘要:

AbstractAlthough for centuries balneotherapy has been popular in Europe, it has not attained wide acceptance in the United States. This article is an interesting sidelight on a specific means of inducing therapeutic vasodilatation. In Covasna, Rumania, post‐volcanic CO2gas emanations are used in the form of mofette therapy (twice daily) and CO2waterbaths (about once daily) for the treatment of rheumatic diseases.This study concerns 40 male geriatric patients with arteriosclerosis obliterans, whose symptoms improved markedly during treatment. In each, the state of the circulation in the big toe of an affected foot was evaluated by means of radioactivity measurements after injection of I131—both before and after therapy. The results indicated that the arterial blood supply to the feet was definitely enhanced after CO2therapy, thus promoting the formation of collateral circulat

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1970.tb02808.x

年代:1970

数据来源: WILEY

摘要:

AbstractThis article concerns an isolated case of mumps in an 88‐year‐old woman in a geriatric‐centre hospital. The disease was preceded by what appeared to be acute pancreatitis, and was complicated by a secondary infection of the parotid. Viral studies confirmed the diagnosis. Also, mumps soon developed in 2 nursing aides who were attending the pa

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1970.tb02809.x

年代:1970

数据来源: WILEY

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1970.tb02810.x

年代:1970

数据来源: WILEY

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1970.tb02811.x

年代:1970

数据来源: WILEY

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1970.tb02812.x

年代:1970

数据来源: WILEY