摘要:

AbstractAn analysis of the personality traits of 13 patients with proven angina pectoris and 7 patients with authentic rheumatic heart disease but no angina showed that, psychodynamically, there were significant differences between the two groups. The features which characterized the anginal patients included compulsiveness, repressed hostility, unfulfilled oral needs and a strong superego. In contrast, the non‐anginal patients with rheumatic heart disease were passive, non‐hostile persons whose oral needs seem to have been adequately fulfilled. Such factors should be carefully considered in designing a therapeutic program for the rehabilitation of patients with angina pecto

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1968.tb02679.x

年代:1968

数据来源: WILEY

摘要:

AbstractAn important part of geriatric medicine is rehabilitation, ranging from the prevention and early detection of disease or injury to restoration of the patient to his highest possible functional level. The basic step toward this objective is a thorough evaluation of all the factors involved, so that realistic goals may be set.Evaluation is discussed under the headings of psychological status and physical status (including the cardiac, peripheral vascular, nervous and musculoskeletal systems). Special attention is given to certain disorders affecting ambulation—hemiplegia, hip fracture, and arthritis of the lower extremities. The syndrome of musculoskeletal failure consists of joint deformities and disabilities that have developed because of several mild pathological states acting in combination. Since it is one of the most common forms of disability, it should always be considered in any program of rehabilitative therap

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1968.tb02680.x

年代:1968

数据来源: WILEY

摘要:

AbstractExperiences with art therapy in Hawaii State Hospital are illustrated by 2 case reports. Such experiences should engender more widespread use of this modality to help fulfill the needs of elderly persons. Painting, drawing and other forms of art therapy are being used by an ever‐increasing number of institutions for the care of psychiatric patients. Art therapy, by providing outlets for self‐expression, is a valuable adjunct to the spectrum of activities available to the older citizens of our coun

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1968.tb02681.x

年代:1968

数据来源: WILEY

摘要:

AbstractThe frequency and clinical significance of the hyperkalemia associated with spironolactone therapy was studied by analyzing 755 serum potassium values obtained on 29 patients with cirrhosis and ascites. The patients were classified as follows: 1) control group treated intermittently with combinations of conventional diuretics; and 2) spironolactone groups—(A) patients treated with spironolactone alone, and (B and C) nonazotemic and slightly azotemic patients, respectively, treated with spironolactone plus diuretics.Hyperkalemia was indicated in 3.3 per cent of 302 control serum potassium determinations, and in 48 per cent of 325 determinations made during spironolactone treatment. The increase in serum potassium concentration was more marked in the slightly azotemic group, although the initial levels were no higher than in the other groups of patients. Hyperkalemic intermittent paralysis associated with spironolactone therapy occurred in 5 patients. Studies of the urinary excretory patterns suggested a distal as well as a proximal tubular site of action of spironolactone. The significance of the tubular levels of spironolactone action in the development of hyperkalemia is discusse

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1968.tb02682.x

年代:1968

数据来源: WILEY

摘要:

AbstractA study was made of the residents of Metropolitan Toronto Homes for the Aged attending the Cardiovascular Clinic of the Geriatric Center for the period 1963–1967, who had a systolic blood pressure as high as 180 mm Hg or a diastolic pressure as high as 100 mm on at least two occasions. These 183 patients were classified into two groups: (a) 100 who were treated for hypertension chiefly by thiazide drugs, and (b) 83 who were not treated for hypertension. These two groups were comparable in regard to age, blood pressure, associated diseases and causes of death.For those treated with small doses of thiazide, the mortality rate was about half the rate for the untreated group. Although the findings are based on a small sample (183 persons, 560 life‐years, and 78 deaths), they suggest that even a slight reduction of high blood pressure by thiazide therapy in the elderly population studied was associated with a lower rate of mortality than in a similar group of persons who did not receive thiazi

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1968.tb02683.x

年代:1968

数据来源: WILEY

摘要:

AbstractIn a study of 115 patients with chronic and acute urinary‐tract infections, 26 (23 per cent) were found to have bacterial L‐forms in the urine which could be cultured in a special hypertonic medium. The most common genera of bacteria producing these forms were Proteus, Pseudomonas and Escherichia‐Aerobacter. Most of the patients had cystitis, pyelonephritis or a general diagnosis of “urinary‐tract infection.” In a case of acute exacerbation of chronic pyelonephritis, the L‐form of Proteus mirabilis appeared after eradication of the parent form with chloramphenicol. The L‐form was sensitive to erythromycin even though the parent form was not, and after therapy with this antibiotic the L‐form did not reappear for a ten‐month period of study.L‐forms occur frequently enough in the urine to warrant culturing for these forms specifically and considering the possible significance of L‐forms in relation to the type of urinary‐tract infection and the type o

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1968.tb02684.x

年代:1968

数据来源: WILEY

摘要:

AbstractThe urinary tract was studied by means of drip infusion pyelography (large volume of contrast material and fluid administered rapidly) in 300 male geriatric patients.Results were better and reactions were fewer and less severe than with conventional pyelographic techniques. The necessity for retrograde pyelographic examination, with its attendant morbidity, was significantly reduced. Drip infusion pyelography is recommended as the procedure of choice for evaluating the urinary tract in elderly patients.

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1968.tb02685.x

年代:1968

数据来源: WILEY

摘要:

AbstractIn a study involving 657 patients, a retrospective comparison was made of the mortality rates for myocardial infarction during respective one‐year periods, before and after the establishment of a coronary care unit in the hospital. No significant changes were observed.The mortality rates for patients with myocardial infarction admitted to the coronary care unit for the initial portion of their hospital stay were not significantly different from the mortality rates for patients admitted directly to the general medical service during the same year.Salvage of cardiac‐arrest patients in the coronary care unit was much higher than in the general medical wards. This factor alone would justify the establishment of these special un

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1968.tb02686.x

年代:1968

数据来源: WILEY

摘要:

AbstractThis article is a comprehensive review (including 72 references) of progress in the previously difficult diagnosis of lung cancer, from the early 19th century to the present time. The observations are grouped according to physical signs, sputum examination, x‐ray examination, bronchoscopy, thoracic surgery, ancillary procedures, and accuracy in diagnosis.The “epidemic” rise in lung‐cancer mortality since 1930 may well be the result of newly acquired diagnostic fac

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1968.tb02687.x

年代:1968

数据来源: WILEY

摘要:

AbstractThe effects of tracheostomy in 27 patients with severe respiratory difficulty are described in terms of arterial blood gas values and clinical observations. Postoperatively, mouth breathing was compared with tracheostomy breathing.Obstruction of the lower respiratory tract from accumulated secretions leads to hypoventilation, ineffective coughing, carbon dioxide retention, anoxia and coma. In such cases, tracheostomy may be life‐saving because it provides a reliable pathway: a) for suctioning the secretions (which may be unusually abundant in emphysema with bronchitis), and b) for the administration of artificial respiration.An important factor in the outcome of tracheostomy is meticulous postoperative care. Attention to such things as proper tube alignment and proper suctioning techniques goes a long way toward preventing possible mucosal damage and infection. Tracheostomy provides therapeutic relief even to patients who are gravely ill (narcosis, coma) with emphysema and bronchiti

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1968.tb02688.x

年代:1968

数据来源: WILEY