摘要:

Abstract:In a group of 240 elderly subjects (149 women and 91 men, age range 65 to 95) drawn at random from a population of 650 geriatric patients, the women showed a higher incidence of coronary artery disease and a lower incidence of cerebral atherosclerosis than the men.In the atherosclerotic patients there was a higher concentration of total serum cholesterol (213.4 ± 3.5 S.E. mg/100 ml) and a lower level of cholesterol‐esterifying activity (27.7 ± 0.8 S.E.) than in the healthy elderly subjects (180.8 ± 6.9 S.E. mg/100 ml, P<.001; and 46.8 ± 1.1 S.E., P<.001 respectively). These differences were more significant in women than in men. In general, the mean serum cholesterol level was higher in the women with atherosclerotic manifestations than in the men (223.4 ± 5.7 S.E. mg/100 ml versus 200.9 ± 2.8 S.E. mg/100 ml in the coronary artery disease group; and 220.0 ± 6.2 S.E. mg/100 ml versus 196.8 ± 7.9 S.E. mg/100 ml in the cerebral atherosclerosis group). These sex differences may be related to the hormonal changes that occur in women at the age of the menopause.The cholesterol‐esterifying activity of serum was significantly higher in the healthy group (46.8 ± 1.1 S.E.) than in the group with coronary artery disease (30.3 ± 1.2 S.E., P<.001) or in the group with cerebral atherosclerosis (25.5 ± 1.0

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1970.tb04113.x

出版商:Blackwell Publishing Ltd    

年代:1970

数据来源: WILEY

摘要:

Abstract:Sixty female Wistar‐Imamichi rats, each weighing 85 gm, were divided into 10‐rat groups and fed respectively (by mouth) daily for four weeks: corn oil; dihydrotachysterol (DHT), 50 μg; DHT + conjugated estrogens (Premarin), 25 μg; DHT + Premarin, 100 μg; Premarin, 25 μg; or Premarin, 100 μg. Data were collected on body and organ weights; the calcium content of serum, aorta, heart, kidney and femur; x‐ray examination of the tail bone; and histological changes in the tissues involved.Under the experimental conditions, administration of DHT caused marked hypercalcemia and a significant increase in the calcium content of the kidney and heart. On the other hand, the calcium content of the femur in the rats treated with DHT was markedly decreased as compared with that in the controls. Histological and radiological evidence indicated that the administration of DHT was associated with increased bone resorption, subsequently developing into osteoporosis.All these DHT‐induced changes were prevented by the simultaneous administration of Premarin. Thus conjugated estrogens apparently prevent the development of the “progeria‐like syndrome” in rats—a syndrome which is quite similar to premature aging. The possibility of a relationship to slowing of the aging

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1970.tb04114.x

出版商:Blackwell Publishing Ltd    

年代:1970

数据来源: WILEY

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1970.tb04115.x

出版商:Blackwell Publishing Ltd    

年代:1970

数据来源: WILEY

摘要:

Abstract:The angiokeratoma of Fordyce, “caviar” tongue, venous lake, and senile angioma are common in people over 70 years old. A study of these phlebectasias was made in 390 male subjects in a geriatric home and hospital. A statistical analysis regarding the incidence of various combinations of these lesions indicated that, in the elderly, their coexistence in the same person is only accidental. It seems that local factors predominate as the cause, and it is not possible to demonstrate the presence of a systemic disposition such as generalized ageing of the supportive tissues in order to explain the coexistence of various local types in one person. In old age, the two most important elements to be considered are: 1) local degenerative changes due to damaging factors acting locally on the connective tissue, and 2) increased venous press

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1970.tb04116.x

出版商:Blackwell Publishing Ltd    

年代:1970

数据来源: WILEY

摘要:

Abstract:Significant advances in the physiological concepts, diagnosis and therapy of respiratory failure are reviewed. The etiology of the respiratory failure in a given patient can be deduced by studying the ventilation, perfusion, diffusion and distribution of the inspired air. This assessment and a knowledge of the mechanics of ventilation are essential for the determination of specific therapy. Curves for bicarbonate and arterial carbon dioxide tension in animals, in normal persons and in patients with chronic pulmonary disease are discussed with regard to their clinical applications.Cardiovascular complications and neuromuscular and cerebrovascular changes due to acute relative hypocapnia and hyperbasemia induced by inadvertent mechanical hyperventilation are the most common hazards of artificial or assisted ventilation. Clinical and chemical recognition of these states by means of blood gas analyses enables prompt correction, accomplished by increasing deadspace ventilation, reducing the respiratory rate, and giving acetazolamide. In respiratory failure, the administration of oxygen is essential for the correction of hypoxia. When the respiratory failure is caused by an acute exacerbation of chronic pulmonary disease, the corrective oxygen concentrations should be kept strictly within the range of 21 to 35 per cent.

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1970.tb04117.x

出版商:Blackwell Publishing Ltd    

年代:1970

数据来源: WILEY

摘要:

Abstract:A Geriatric Intensive Treatment Unit was established in Binghamton State Hospital under the Broome County Unitized Program. The aim was: 1) to rehabilitate newly admitted patients over 65 years of age, and 2) to resocialize geriatric patients over 65 previously in other units of the hospital for long periods (one year to fifty‐three years) so that they could be discharged from the institution. In the first ten months—June 1, 1968 to March 31, 1969–59 per cent of the 96 newly admitted geriatric patients were rehabilitated and returned to society. Their average hospital stay was 38.5 days—a distinct reduction in the length of stay for newly admitted patients. Almost 50 per cent of the 278 long‐term patients left the Intensive Treatment Unit in the 1968–69 period; 27 per cent were returned to the community.Milieu therapy, modified for the geriatric service, was used for rehabilitation and resocialization. Members of a small but well oriented and dedicated staff represented the family and society to the patients, as a therapeutic community in a “one to one” therapy program. Male and female patients of both short‐term and long‐term groups mixed together in activities. This beneficially influenced the rehabilitation and re‐socialization process.In the interests of continuity of care, it seems desirable that the Geriatric Intensive Treatment Unit, rather than the Outpatient Clinic, supervise the management of these patients after discha

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1970.tb04118.x

出版商:Blackwell Publishing Ltd    

年代:1970

数据来源: WILEY

摘要:

Abstract:This paper concerns the indications for the surgical management of diverticulitis and its complications, including the choice between one‐stage and three‐stage procedures, and between elective and emergency operations. Primary resection of the colon should be reserved for the treatment of localized or quiescent diverticulitis. Staged resection is the preferred operation for treating the complications of divertculitis, particularly in the elde

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1970.tb04119.x

出版商:Blackwell Publishing Ltd    

年代:1970

数据来源: WILEY

摘要:

Abstract:Usually the elderly patient with rheumatoid arthritis manifests the residual of several years of active disease. Eleven cases are cited to illustrate that effective treatment must be tailored to the current stage of the disease. Acute rheumatoid arthritis is not common in the elderly. When it develops, salicylates and complete bed rest in a hospital remain the therapeutic anchors. If symptoms do not subside in from two to three weeks, indomethacin, gold therapy and corticosteroids may be tried. In most cases, distinct improvement occurs with this regimen. Chronic deforming rheumatoid arthritis is a different story, however. It is extremely difficult to treat effectively.In both the acute and the chronic form of rheumatoid arthritis, an active rehabilitation program is the key to the prevention of functional deterioration and to the maintenance of the patient as a fairly self‐sufficient perso

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1970.tb04120.x

出版商:Blackwell Publishing Ltd    

年代:1970

数据来源: WILEY

摘要:

Abstract:In a 64‐bed geriatric unit, 4 cases of vitamin‐C deficiency were found. The patients manifested anaemia (chiefly normocytic), multiple bruises and intense tibial tenderness; the results of Hess's capillary fragility test were positive. The diagnosis was confirmed by the urinary ascorbic‐acid saturation test. One of the patients also had folic‐acid deficiency. The relation between the two conditions is discussed. All the signs of vitamin‐C deficiency cleared up quickly during treatment with ascorbic acid, although the urinary test indicated that it took three weeks for the saturation point to be reached.These results emphasize the importance of a full clinical examination for elderly patients. Vitamin‐C deficiency, if unrecognized, can defeat efforts at rehabilitation because the intense tibial pain (preventing ambulation) and the weakness due to anaemia usually keep the pati

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1970.tb04121.x

出版商:Blackwell Publishing Ltd    

年代:1970

数据来源: WILEY

摘要:

Abstract:Thirty hospitalized male geriatric patients with a variety of organic disorders causing moderate to severe anxiety‐tension states were treated with a sustained‐release form of meprobamate in a three‐week, placebo‐controlled, double‐blind study. Meprobamate in this form (800 mg per day in two doses) was significantly superior (clinically and statistically) to placebo for all factors tested—chiefly anxiety, tension, and insomnia—and the overall response. There were no significant side effects. Early in the study 10 patients (at the end of the study uncoded as 7 in the placebo group and 3 in the drug group) complained of lack of symptom relief, so the medication was changed to labelled sustained‐release meprobamate (Meprospan) without breaking the code. Marked improvement then occurred in 4 of this group.The important reduction in frequency of administration and the prolonged effectiveness of the drug were also great advantages in giving the hospital staff members more time for intensive care

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1970.tb04122.x

出版商:Blackwell Publishing Ltd    

年代:1970

数据来源: WILEY