摘要:

Abstract:A survey of the electroencephalograms (EEGs) of 510 psychiatric subjects aged 50 or older revealed 41 cases of unusual spontaneous or photically evoked sharp and spiky activity.The EEGs of elderly patients often show generalized sharp activity, usually more intense than in younger subjects. This activity may be an aspect of various types of background rhythm, or it may be partly independent of them. Clinically, these patients tend to manifest psychomotor agitation and other symptoms indicating physical and mental overactivity. At least in patients whose EEGs show intense sharp activity, there can be little doubt about this EEG‐clinical relationship. It appears, therefore, that we are dealing with electrical phenomena which indicate forebrain hyperexcitability and which are associated with a hyperactive state in other parts of the organis

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1969.tb05350.x

出版商:Blackwell Publishing Ltd    

年代:1969

数据来源: WILEY

摘要:

Abstract:As part of an attempt by a teaching hospital to improve care of the patients in a selected group of 12 nursing homes in a metropolitan area, mental health consultation and education was offered to 4 of the 12 facilities for periods varying from a year to three years. The method involved fortnightly discussions with groups consisting of administrative and supervising nursing personnel. The shortcomings of this necessarily cautious and exploratory approach, and the need to include elementary instruction in any program for nursing‐home personnel are discussed. A model program which calls for a serious commitment of time and effort by the participating nursing‐home facilities is outlined.There is no short‐cut to good care of the patient. Mental health principles cannot be taught by brief superficial contact with nursing‐home facilities, and nothing short of commitment and effort on the part of all concerned will make any lasting impact in this growing area that is crucially inadequate. Legislation to ensure minimal standards (already on the books in the form of Medicare and Medicaid) will require for implementation the efforts of the public health and welfare authorities, the medical profession, and the public. Realistic reimbursement of the facilities for their services, and training grants to enable them to meet the costs of in‐service training are an essential part of

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1969.tb05351.x

出版商:Blackwell Publishing Ltd    

年代:1969

数据来源: WILEY

摘要:

Abstract:Colonic diverticulosis, a common disorder in the elderly, may have life‐threatening complications, e.g., diverticulitis, hemorrhage or obstruction. Important causative factors in diverticulosis are high intraluminal pressure and weakness of the colonic muscular wall. A high‐residue rather than a low‐residue diet may be preferable in treatment and prevention. Psyllium‐seed hydrophilic mucilloid bulking agents are useful in therapy. Anticholinergic medication may be used if the patient has symptoms or fluoroscopy shows colonic spasm. Morphine, which induces high intracolonic pressure, should never be used. Surgery is rarely indicated if there are no compli

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1969.tb05352.x

出版商:Blackwell Publishing Ltd    

年代:1969

数据来源: WILEY

摘要:

Abstract:The findings of this study of 41 aged (over 65) non‐acidotic diabetic patients demonstrated not only a correlation between glycosuria and tubular reabsorption of phosphates but also an increase of renal phosphate excretion with an increase in clearance (35 per cent of the cases) despite a virtually normal level of blood phosphorus. By contrast, this pattern was demonstrated in only 16 per cent of 31 aged nondiabetic controls. There was no statistical difference between the blood phosphorus and calcium values in the two series of subjects.In 12 of 14 aged diabetic subjects who underwent the induced hypercalcemia test, phosphate clearance values indicated depression of parathyroid function.Among the possible hypotheses regarding the pathogenesis of the renal phospho‐calcium metabolic disturbance in aged diabetic patients, that of secondary adaptive hyperparathyroidism is discussed, although not accep

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1969.tb05353.x

出版商:Blackwell Publishing Ltd    

年代:1969

数据来源: WILEY

摘要:

Abstract:Fifteen elderly patients with chronic subdural haematoma were studied by various clinical and laboratory methods, including lumbar puncture, roentgenography, electroencephalography, echo‐encephalography, air studies and exploratory craniotomy. A history of head injury was obtained in only 6 of the 15 cases.Two mechanisms seem to account for the neurological picture: 1) disturbed cerebral arterial circulation owing to direct pressure of the haematoma on the main artery of the hemisphere, and 2) progressive cerebral edema owing to impaired venous return. Since the condition of the patient may vary, the signs and symptoms may be confused with those of transient cerebral ischemic attacks. With early diagnosis and treatment of chronic subdural haematoma in the elderly, the prognosis is excellen

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1969.tb05354.x

出版商:Blackwell Publishing Ltd    

年代:1969

数据来源: WILEY

摘要:

Abstract:The author considers the Geriatric Center at Pardes‐Hana, Israel, to be a model for those working in the field of care of the aged. He was most impressed not only by the beautiful cottage settings and landscaping but predominantly by the principle of separating the living quarters of the 1,100 residents (average age, 80) according to functional categories rather than medical diagnoses. The healthy and capable elderly residents were not exposed to the depressing effect of having to live in the same rooms or cottages with those who were severely demented, incontinent and disruptive. The separation of the occupational facility from the occupational therapy facility was an additional point of interest. The residents felt that they were not just passing time but were really productive and creative. A withdrawn, depressed or passive resident was a rarity within the normal and moderately infirm groups. In addition to being well trained in medicine and in drug therapy, the staff has a sympathetic approach to the patients. This human element strikes the visitor more than anything els

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1969.tb05355.x

出版商:Blackwell Publishing Ltd    

年代:1969

数据来源: WILEY

摘要:

Abstract:In two homes for the aged, 136 elderly residents underwent the Stilling test for colour sensitivity. A comparison group was composed of 33 much younger persons.Colour sensitivity decreases with age, without definite preponderance of red‐green over blue‐yellow disturbances, or vice versa. The loss of colour sensitivity occurs at slightly incongruent rates in the right and left

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1969.tb05356.x

出版商:Blackwell Publishing Ltd    

年代:1969

数据来源: WILEY

摘要:

Abstract:Under Medicare, the author has performed 112 elective cataract operations in elderly patients, which for the most part would have been financially prohibitive without such coverage. Medicare has been of distinct, unqualified benefit to these patients. It is not the sovereign remedy for all the ills of the aged, but on the other hand it has not corrupted or demeaned these people, nor shattered the American way of life. After a preliminary chaotic period in 1966, the billing and collecting machinery has become smooth and efficient, and payment is prompt. There is a high degree of satisfaction on the part of the patients.

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1969.tb05357.x

出版商:Blackwell Publishing Ltd    

年代:1969

数据来源: WILEY

摘要:

Abstract:Therapeutic success in the treatment of urinary‐tract infections in aged patients is admittedly unpredictable because of the high frequency of anatomical urinary‐tract abnormalities and degenerative vascular disease. This preliminary study involved 90 aged patients in a chronic disease hospital. Before the study began, 65 of the 90 patients had bacteriuria; during approximately four weeks of methenamine mandelate therapy, the bacteriuria cleared in 72 per cent. Initially, 25 of the 90 patients did not have bacteriuria, but in 13 of the 25, bacteriuria was present by the end of the treatment period. The medication was well accepted by the patients, and no significant adverse reactions were observed.The data indicate that the prophylactic or therapeutic use of methenamine mandelate to suppress bacteriuria does not involve any medical risk. If the causes of urinary‐tract obstruction are removed, this medication may control bacteriuria even in geriatric patients with severe and debilitating dis

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1969.tb05358.x

出版商:Blackwell Publishing Ltd    

年代:1969

数据来源: WILEY

摘要:

Abstract:Twenty‐seven patients were given, orally, 15 mg of flurazepam (Dalmane) daily for fourteen days and then 50 mg of sodium amobarbital (Amytal sodium) daily for another fourteen days—or else these drugs in reverse order—according to a double‐blind cross‐over design. The patients were men who resided in a Veterans Administration domiliciary. Their average age was 66.5 years.Favorable subjective and objective reports were given concerning the effect of these drugs on sleep, and no adverse reactions or side effects were observed. Physical and psychological tests for assessment of both immediate and cumulative effects did not show any significant differences between the effects of the two drugs. Further studies of flurazepam are

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1969.tb05359.x

出版商:Blackwell Publishing Ltd    

年代:1969

数据来源: WILEY