摘要:

ABSTRACT:Endocrine activity in patients with essential hypertension was studied by measuring the urinary excretion of catecholamines, prostaglandin E (PGE) and cyclic adenosine monophosphate (cAMP). Simultaneously, plasma renin activity, concentrations of serum sodium, potassium, blood urea nitrogen (BUN) and creatinine were determined. Systolic blood pressure and BUN increased progressively with age until the sixth decade. Urinary excretion of norepinephrine was correlated with the systolic blood pressure. In contrast, plasma renin activity and urinary excretion of PGE decreased progressively with the increase in systolic blood pressure. Although the cause of essential hypertension is not known, it is suggested that hypertension accelerates the aging process in the kidney and thus decreases renal PGE synthesis. This decrease of PGE in turn causes a reduction of plasma renin activity, possibly either by accelerating the retention of sodium and water or by failing to stimulate renin synthesis. A decrease of PGE may also potentiate the vasopressor action of norepinephrine.

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1979.tb06030.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

ABSTRACT:The results of a 3‐month trial with an ergot alkaloid preparation (Hydergine) in 16 geriatric patients showed that, in accordance with a previously proposed working hypothesis, the improvement induced by the drug in electroencephalographic age‐related changes was accompanied by clinical improvement in patients with similarly age‐related mental deterior

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1979.tb06031.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

ABSTRACT:In 1976, 130 patients aged 70 or older were admitted to the Coronary Care Unit (CCU) at Toronto Western Hospital. Arrhythmias were noted in all but 24 percent. Digoxin was given to 53 patients, lidocaine to 24, propranolol to 28, and quinidine to 11. In 2 patients, cardioversion by direct current was required for supraventricular arrhythmias. In 26 patients, temporary pacemakers were used. Of 13 patients who experienced at least one cardiac arrest in the CCU, 10 survived to be discharged to the ward. In total, only 12 of the 130 elderly patients died in the hospital, and in only 3 of these was arrhythmia the primary cause of death. The treatment of arrhythmias in the elderly is as successful and rewarding as in younger patients. Indications for the various antiarrhythmic drugs are similar. Except for digoxin, the dosages of such drugs for the elderly are the same as those for younger patients. Adverse effects apparently are not more common in the elderly.

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1979.tb06032.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

ABSTRACT:Emergency transvenous cardiac pacing can be performed in elderly patients rapidly, effectively, and with few complications. An experienced physician using the subclavian route usually can achieve effective pacing with equipment priced well within the budget of most community hospitals. Data on 36 patients (age range, 75–94 years) are presente

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1979.tb06033.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

ABSTRACT:Plasma lipids, lipoproteins and the enzyme, lecithin:cholesterol acyltransferase (LCAT), were studied in three age groups of Sprague‐Dawley rats and non‐human primates (Macaca nemestrina). In the rats, serum cholesterol levels did not change significantly from 2 months (82 ± 6 mg/dl) to 12 months of age (88 ± 9 mg/dl) but increased sharply by 24 months (173 ± 85 mg/ dl). LCAT activity (cholesterol esterified per ml per hr) decreased slightly, but a more significant decrease with age was noted in the fractional rate of cholesterol esterification (percent cholesterol esterified per hr). Fasting resulted in a progressive decrease in the serum cholesterol level, usually accompanied by an increase in the fractional rate of cholesterol esterification. In the primate study, three age groups were used. On each serum sample, the following determinations were made: free and total cholesterol, triglycerides, high‐density lipoprotein (HDL) cholesterol, and LCAT. In the serum from 4‐year, 10‐year and 20‐year‐old animals, only a few significant changes were observed. There was a slight tendency for the levels of serum cholesterol and triglycerides to increase with age, but larger changes were noted in high‐density and low‐density lipoprotein (LDL) compartments. HDL cholesterol increased while LDL cholesterol decreased with age. The significance of these findings in relation to human cholesterol metabolism, atherosclerosis, an

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1979.tb06034.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

ABSTRACT:A study was made of the effects of a psychosocial rehabilitative program on the behavioral functioning of elderly chronically ill patients. High school students served as remotivation and socialization therapists in a supervised structured process designed to improve the quality of life for the participating nursing‐home residents. The participants were 12 long‐term patients whose ages ranged from 62 to 99 years (mean, 73.2 years). The effectiveness of the program was evaluated by means of the Sickness Impact Profile (SIP), a questionnaire designed to assess the effect of a physical illness on daily activities, psychosocial skills and mental status. The results demonstrated that the rehabilitative program had a significant impact on several dimensions of the lives of the participants. As a consequence of the interaction with the students, there was an increase in social interaction, a reduction in daytime sleeping and an increase in mobility. The results reported here extend the successful use of remotivation techniques to areas of overt behavioral functioning not previously asses

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1979.tb06035.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

ABSTRACT:In a 10–day study, carbenicillin indanyl sodium cured urinary‐tract infections in 22 of 30 patients (ages, 24–91). In 3 of the remaining patients the treatment was a failure; in 3 others the drug had to be discontinued because of diarrhea and vomiting; and in 2 instances it induced overgrowth of Candida albicans in the urine. Carbenicillin was lethal to Pseudomonas aeruginosa in all 9 cases, to Proteus mirabilis in all 6 cases, and to enterococcus in all 3 cases. A trimethoprim/sulfamethoxazole combination cured urinary‐tract infections in 18 of 30 other patients (ages, 28–91), but failed in 3. In 3 patients it gave rise to a skin rash; in 2 to elevation of blood urea nitrogen and creatinine levels; in 1 to neutropenia; and in 1 to overgrowth of Candida albicans in the urine. Reinfection occurred in 2 patients. Carbenicillin indanyl sodium was more effective than the sulfonamide/trimethoprim co

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1979.tb06036.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

ABSTRACT:A previously described test for prosopo‐affective agnosia (impairment of facial affect recognition) had been applied in 14 disoriented elderly patients with chronic organic brain syndrome, 14 fully oriented elderly patients with non‐organic psychiatric disorders, and 14 normal volunteers. In this re‐test study of 37 of the 42 subjects, after a six‐month interval, the test was found to be reliable (r = .75, p<.001). The test was also more sensitive in detecting organic disorders than were other frequently applied neuropsychiatric tests. Prosopo‐affective agnosia (PAA) appeared unrelated to prosopo‐agnosia (PA) (r = .082, ns). Some patients who had the ability to recognize famous faces and faces of ward personnel were severely impaired in the ability to recognize facial affect. The deterioration was more pronounced for the recognition of sadness and anger than for happiness, indicating that patients with this impairment had reverted to an infantile mode of facial‐affect recognition. This reversal is another example of the neurologic regression that character

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1979.tb06037.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

ABSTRACT:In a study to determine the nature and frequent cy of cardiac side effects during long‐term administration of tricyclic antidepressant drugs in usual dosages in the aged, 32 geriatric patients were followed for an average of 36.6 weeks. Ten of them received amitriptyline in a daily dosage of 20–75 mg for 53 weeks (average); in 2, electrocardiographic side effects developed, viz, inversion of the T waves or evidence of acute coronary insufficiency. Imipramine was administered to 21 patients in a daily dosage of 20–100 mg (average, 66 mg) over a period of 40 weeks; in 3 instances major side effects developed‐intermittent left bundle‐branch block, acute coronary insufficiency with node dysfunction, or T‐wave inversion with sinus tachycardia; in 1 instance there was a minor side effect, viz, tachycardia only. In 1 patient, acute myocardial infarction developed after two 10‐mg doses of nortriptyline. Five of the 7 patients with cardiac side effects had prior organic heart disease. It was concluded that the incidence of cardiac side effects in aged persons given tricyclic antidepressant drugs in the usual therapeutic dosages for a prolonged period is great enough to warrant frequent careful monitoring of cardiac status d

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1979.tb06038.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

ABSTRACT:A double‐blind study was conducted on the effects of nylidrin hydrochloride versus placebo in 60 patients with mild to moderate symptoms of chronic brain syndrome. Their ages ranged from 65 to 99 years. Preliminary results indicated that nylidrin HCI (a vasodilator) is a relatively safe therapeutic agent and more effective than placebo in ameliorating the symptoms of cognitive impairment associated with aging, on both a short term (3‐month) and a long‐term (9‐month) basis. In a dosage of 24 mg daily, it reached its peak effectiveness after 3 months

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1979.tb06039.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY