摘要:

ABSTRACT:In 14 elderly male residents of a veterans' care complex who were receiving diuretic therapy for cardiac failure, oral potassium (K) supplements were withdrawn. Plasma and erythrocyte K levels were measured immediately before and six weeks after withdrawal of the supplements (38 mEq K daily). The controls comprised 19 elderly residents without disease and not taking drugs likely to influence K status. Study subjects and controls were receiving the same diet (average daily K content 100 mEq). After withdrawal of K supplements, the mean plasma K level fell significantly but the mean erythrocyte K level remained unchanged and did not differ from the control values. For a further six weeks after the withdrawal period, 7 subjects were treated with Aldactazide (diuretic hydrochlorothiazide plus K‐sparing spironolactone). The plasma K level increased significantly but the erythrocyte K level remained unchanged. It was concluded that, in this setting, diuretic‐induced hypokalemia is not necessarily accompanied by intracellular K depletion and that routine prophylaxis with K supplements or K‐sparing agents is unnecessary and not without risk. Such therapy should be reserved for patients considered at special risk of K depletion because of known poor dietary intake, advanced liver disease, secondary hyperaldosteronism with renovascular hypertension, gastrointestinal losses, or nondiuretic medication known to affect K status adve

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1981.tb01756.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACT:In this study an attempt was made to determine the relationship between cerebral amyloid angiopathy (AA) and other cerebrovascular lesions in the aged. The brains of 128 autopsy patients over 60 years of age were examined by both light and electron microscopy. The frequency of cerebral AA increased with age and was 58 percent in patients over the age of 90. The change was observed more often in women than in men. In 7 cases of severe AA, the temporal or occipital cortex was the most common site. Most cases of AA were complicated by the formation of senile plaques in the cortex. Electron microscopic examination revealed amyloid fibrils deposited in clusters in the media and adventitia of the vessels, destroying their structure. Some blood vessels on the surface of the cortex showed hyalinosis, angionecrosis, duplication of the wall, or fibrotic occlusion. AA is sometimes a cause of cerebral bleeding. Five cases of massive cerebral bleeding were found among patients aged 90 or older, including a temporal hematoma in a 92‐year‐old woman which was believed to be due to the marked AA noted in the temporal lobes. Small cortical infarctions were common in the temporal lo

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1981.tb01757.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACT:In a randomized blind study of 69 mental hospital patients over 50 years of age, a highly significant correlation was observed between the clinical symptoms of organic brain disease and the quantity of senile plaques found in the brains at autopsy. A stepwise multiple regression analysis indicated that independent significant predictors of the quantity of plaques were the level of disorientation and the age of the patient. Additional clinical tests for intellectual deterioration, affect lability, and impairment of memory and judgment did not improve the predictive ability. The correlation between incidental pathologic changes unrelated to the senile form of cerebral degeneration and the clinical symptoms was highly significant, though not obvious. Only after removal of the effect of the quantity of plaques on the clinical symptoms (multiple regression analysis) did the effect of other pathologic processes become evident. A significant one‐way fixed‐effect relationship was noted between increasing quantity of symptoms and increasing quantity of plaques in 48 cases of senile dementia correctly diagnosed by the psychiatry staff. In the control group of 21 patients without senile dementia, the quantity of plaques was correlated with the age of the patients but not with their clinical sympt

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1981.tb01758.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACT:Either supportive counseling (SC) or cognitive training (CT) was used in an attempt to enhance the efficiency of a standard pharmacologic treatment for dementia, viz, dihydroergotoxine mesylate (DEM, Hydergine). DEM was administered orally to 21 moderately demented subjects, in a dosage of 1 mg three times daily; and SC or CT was conducted for one hour every two weeks for a total of 12 weeks. The CT was designed to enhance memory and other intellectual functions by the teaching of organizational schemes and mnemonic devices. Outcome measurements included the Sandoz Clinical Assessment‐Geriatric (SCAG), a behavioral rating scale measuring selected symptoms and signs of dementia; the Hamilton Rating Scale for Depression (HRSD); and the Buschke Selective Reminding Scale (BSRT), a psychometric test of memory and learning. The DEM + CT group of patients improved more than did the DEM + SC group for the measures of memory and learning (BSRT). However, no differences between groups were noted for the HRSD or SCAG behavioral measure

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1981.tb01759.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACT:Parenteral nutrition can be a useful therapeutic and prophylactic tool in managing some geriatric patients who present with nutritional deficiences that accompany acute and chronic diseases. An outline is given of recommended procedures, e.g., solutions, dosages, indications, and contraindications. The techniques described permit a standardized approach to parenteral nutrition for most patients.

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1981.tb01760.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACT:The records of 23 elderly patients admitted to a county hospital with dehydration and hypernatremia were reviewed. One of these patients had the highest serum sodium level (202 mEq/L) reported in an adult. The overall mortality of 48 percent was not related to the degree of hypernatremia. However, two‐thirds of the 17 patients with acute bacterial infections died, whereas all 5 noninfected patients survived. Infection was not always apparent at the time of admission to the hospital. It is proposed that early and appropriate antibiotic therapy may reduce the high mortality associated with hypernatremia in the elderl

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1981.tb01761.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACT:Analysis of cause‐specific death rates among 750 elderly psychiatric inpatients revealed a markedly increased risk of death from pneumonia and a lesser but still substantial risk of death from cardiovascular disorders during the first year of hospitalization. Although the risks of cardiovascular death are considerably less among longer‐stay patients, the pneumonia risks remain high. This suggests differing preventive strategies. To help prevent cardiovascular deaths, more attention should be paid to avoiding transfer trauma and its attendant stress. To help prevent pneumonia deaths, high priority should be given to an aggressive program of immunization, adequate nutrition, reduction of hospital overcrowding, and recognition of early pneumonia sympt

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1981.tb01762.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACT:A 65‐year‐old woman with spontaneous osteonecrosis of the medial femoral condyle of the left knee was treated by a fresh cadaveric osteochondral bone graft. The latest follow‐up examination at 2.5 years demonstrated good functional results, as well as radiographic evidence of satisfactory consolidation with no aseptic necrosis or osteoarth

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1981.tb01763.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

ABSTRACT:The prevalence of chondrocalcinosis was studied in 574 hospital and clinic patients aged 50 or older who had undergone x‐ray examination of the knee. Chondrocalcinosis was found in 9.6 percent of all these patients, in 5 percent of the 50–64 age group, and in 14.6 percent of the 65–94 age group. The prevalence of knee chondrocalcinosis increased in stepwise fashion between the ages of 65 and 80. A review of the literature and of the data on our few patients over the age of 80 suggests the existence of an even higher prevalence among persons of this advanced age

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1981.tb01764.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY