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[Thoracic surgical interventions]. [胸外科干预]。
Aktuelle Gerontologie Pub Date : 1983-07-01
W J Stelter, P Ziegler
{"title":"[Thoracic surgical interventions].","authors":"W J Stelter,&nbsp;P Ziegler","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Thoracic surgery necessitates more intensive care postoperatively than general surgery. For elective lung resections mortality was significantly higher in patients older than 70 years. Operative risk has to be considered very thoroughly versus natural history of the diseases involved. Vascular reconstructions in the chest, however, were performed mainly in symptomatic patients, when increased operative risk must be accepted because of an increased threat by symptomatic disease. For surgery of the trachea or esophagus techniques are preferred which avoid thoracotomy.</p>","PeriodicalId":75459,"journal":{"name":"Aktuelle Gerontologie","volume":"13 4","pages":"133-5"},"PeriodicalIF":0.0,"publicationDate":"1983-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"17202335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Falls and accidents in the nursing home--review of a 5-year period]. [疗养院里的跌倒和事故——5年回顾]。
Aktuelle Gerontologie Pub Date : 1983-07-01
H P Fisch
{"title":"[Falls and accidents in the nursing home--review of a 5-year period].","authors":"H P Fisch","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>61 falls and accidents and one suicide needed medical attention in our nursing home during a five-year period. Most frequent sequelae were scalp lacerations, followed by fractures of the femoral neck. 73% of the patients who got hurt by falls suffered of dementia. 38% were being treated with neuroleptic, antihypertensive or diuretic drugs. It was not possible however to document a relationship between drug treatment and falls. Most falls occurred while patients were walking on the floor without obstacles and without external influences. 3 patients died as immediate consequence of their falls. We observed falls more often in the first period of the patient's stay in our institution and again shortly before the patient's death. Prophylactic measures against falls include bed-rails, little tables that can be fixed to the wheel-chairs in order to hinder unassisted standing up of patients, unable to walk alone and judicious treatment with sedative drugs. The most important measure however seems to be compassionate and attentive patient care that conveys trust and confidence between patients and the nursing personnel. Possibly the incidence of falls and accidents could be used as a measure of the quality of nursing care in geriatric institutions.</p>","PeriodicalId":75459,"journal":{"name":"Aktuelle Gerontologie","volume":"13 4","pages":"146-8"},"PeriodicalIF":0.0,"publicationDate":"1983-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"17203021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Possibilities for orthopedico-surgical reconstruction in joint damage in elderly patients]. [老年患者关节损伤骨科手术重建的可能性]。
Aktuelle Gerontologie Pub Date : 1983-07-01
W Schwägerl
{"title":"[Possibilities for orthopedico-surgical reconstruction in joint damage in elderly patients].","authors":"W Schwägerl","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>If no higher risk operation for the older patient is involved, indication for an arthroplastic joint prosthesis is given on the basis of today's large and world-wide experience. The postoperative mortality is naturally higher than with the younger patients and amounts to 2% in our statistics. A smooth cooperation between the internist and the orthopaedic surgeon enables also to the older patients with higher risk operations, especially thanks to the modern anaesthetic possibilities (f.i. lumbar anaesthetics), a functional recovery of the joint. We should, however, use already with the younger patients all possible joint preserving and supporting surgical operations in order to save the old patients in many cases from the need of implanting a prosthesis.</p>","PeriodicalId":75459,"journal":{"name":"Aktuelle Gerontologie","volume":"13 4","pages":"139-41"},"PeriodicalIF":0.0,"publicationDate":"1983-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"17203019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Fractures of the proximal femur in patients over 70 years--choice of procedure and results]. [70岁以上患者股骨近端骨折——手术方法和结果的选择]。
Aktuelle Gerontologie Pub Date : 1983-07-01
H Dittmer, E Faist, W D Hamperl
{"title":"[Fractures of the proximal femur in patients over 70 years--choice of procedure and results].","authors":"H Dittmer,&nbsp;E Faist,&nbsp;W D Hamperl","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>From 1978 till oct. 1981 110 patients between 70 and 99 years old were operated upon fractures of the proximal femur. Out of those 43 presented with fractures of the femoral neck, 46 with pertrochanteric, and 17 with subtrochanteric. In fractures of the femoral neck we generally perform alloplastic replacement of the femoral head or total hip arthroplasty. By means of a 24 hour preparing period (volume and electrolyte replacement, digitalis) and intraoperative administration of dopamine the systemic reaction to bone cement could be avoided. Pertrochanteric fractures are treated by Ender- rods immediately. Subtrochanteric fractures are the greatest technical problem. We now use long-stem-prosthesis as compound-osteosynthesis. Physiotherapy is applied aggressively. The patients are trained to walk from the second day p.op. on. Perioperative lethality rated 17%. Within the group of age 70 till age 80 only four died (7,5%), over 80 years 15 (30% of this group). Following hip-replacement there were 13 deaths, after Ender-rods only 4 lethalities. 83% of all patients could be discharged after a mean of 19 days, 86% of those ambulatory.</p>","PeriodicalId":75459,"journal":{"name":"Aktuelle Gerontologie","volume":"13 4","pages":"142-5"},"PeriodicalIF":0.0,"publicationDate":"1983-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"17203020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Age as an individual social syndrome (anthropologic and pedagogic remarks)]. [作为个体社会综合症的年龄(人类学和教育学的评论)]。
Aktuelle Gerontologie Pub Date : 1983-07-01
W Braun
{"title":"[Age as an individual social syndrome (anthropologic and pedagogic remarks)].","authors":"W Braun","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The terms \"social\" and \"gesellschaftlich\" have in the German language almost an identical meaning although this was not originally the case. The modern conception of what is meant by \"society\" originated during the enlightenment. According to Rousseau this implied the subjection of the individual to the general will. This is the rule set by society. Originally \"social\" contained the meaning of the spontaneous relationship of a person to the world and his fellow-human beings. Older people, however, want to establish a direct social relationship again. Their needs are not met by the system of rules laid down by society. There is no pedagogical or therapeutic service-system based on the rules of society which can help them in this respect. What is required in the direct social relationship which transcends the \"Ego\" and leaves him a human-being. These considerations are particularly important regarding the proposals to reduce the years of employment.</p>","PeriodicalId":75459,"journal":{"name":"Aktuelle Gerontologie","volume":"13 4","pages":"152-5"},"PeriodicalIF":0.0,"publicationDate":"1983-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"17203023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Accidental hypothermia]. (偶然的体温过低)。
Aktuelle Gerontologie Pub Date : 1983-07-01
J Schneider
{"title":"[Accidental hypothermia].","authors":"J Schneider","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Accidental hypothermia in the elderly is a rather unknown clinical syndrome in Germany. Manifestations are those of a generalized disease without striking symptoms or signs. To assure the clinical diagnosis, a low graded thermometer is necessary. Treatment consists of slow and passive rewarming and of correction of the accompanying disturbances. As important as correct diagnosis and treatment are preventive efforts against exogenous and endogenous risk factors.</p>","PeriodicalId":75459,"journal":{"name":"Aktuelle Gerontologie","volume":"13 4","pages":"156-8"},"PeriodicalIF":0.0,"publicationDate":"1983-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"17203024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Vascular stress reaction in the aged]. [老年人血管应激反应]。
Aktuelle Gerontologie Pub Date : 1983-07-01
K Klein
{"title":"[Vascular stress reaction in the aged].","authors":"K Klein","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Based on atraumatic measurements by means of dynamographical, sonometrical and echographical methods reaction patterns of the blood pressure and the cerebral arteries in 50 patients aged from 65 to 83 during and after conflict stress situations were qualified and quantified. Without exception impairments of already preexisting vascular-hemodynamic lesions resp. blood pressure slips caused by hyperreactive (sympathicogenic) or hyporeactive (vagotonic) disorders of the autoregulation appeared. These alterations being typical of vascular stress reactions in the age became (partly) reversible after the end of the psychotraumatic phases. Additional risks for the (cerebro) vascular system by stress induced cardiogenic troubles have to be simultaneously calculated. The consideration for these circumstances within the geriatric diagnosis and treatment strategy is an important contribution to the prevention of vascular catastrophes and to the stability and the improvement of the quality of life.</p>","PeriodicalId":75459,"journal":{"name":"Aktuelle Gerontologie","volume":"13 4","pages":"149-51"},"PeriodicalIF":0.0,"publicationDate":"1983-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"17203022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Peripheral arterial occlusive disease of the lower extremities]. [下肢外周动脉闭塞疾病]。
Aktuelle Gerontologie Pub Date : 1983-07-01
H M Becker, P Walter
{"title":"[Peripheral arterial occlusive disease of the lower extremities].","authors":"H M Becker,&nbsp;P Walter","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Disturbance of the arterial perfusion of the lower limbs with occlusion in the aorto-iliac area presents a broad field of operative treatment in younger patients below 70 years of age. In older people caution is necessary depending on preexisting multiple morbidity. If necessary, extra-anatomic bypass operations have to be taken into consideration in order to save a jeopardized leg. Limb salvage should be accomplished whenever possible. In case of involvement of the femoro-popliteal region even in old age patients aggressive surgery for limb salvage is important because of high mortality due to primary amputation and last not least because of better life quality and for cardiovascular training. Conservative treatment of occlusions in the aorto-iliac area is not promising much success. Therefore in this area vascular surgery is the treatment of choice. In contrary arterial occlusion of the femoro-popliteocrural region--especially if both are combined--can be positively influenced by conservative angiological regimen. Hence conservative therapy should always be tried first, before difficult and long lasting vascular reconstructions are taken into consideration. One should not forget that surgery of occlusive vascular disease is only a symptomatic therapy, not a curative one. Life expectancy is not enhanced, but only ability of walking is saved. Generally spoken, the patient with occlusive vascular disease of the lower limbs nowadays can be offered a differentiated and individualized therapy including, also, non-surgical procedures. Well planned reconstructive vascular surgery has a good long time prognosis saving the physical integrity and efficiency of the older patient suffering from disabling vascular alterations.</p>","PeriodicalId":75459,"journal":{"name":"Aktuelle Gerontologie","volume":"13 4","pages":"129-32"},"PeriodicalIF":0.0,"publicationDate":"1983-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"17202334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Age-dependent adjustment to disease in patients with cardiovascular diseases]. [心血管疾病患者的年龄相关性疾病适应]。
Aktuelle Gerontologie Pub Date : 1983-05-01
J Egger
{"title":"[Age-dependent adjustment to disease in patients with cardiovascular diseases].","authors":"J Egger","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>During their rehabilitation treatment 61 inpatients with different cardiovascular diseases or disorders were investigated with structured interviews, questionnaires about anamnesis and psychological tests in order to determine the individual coping strategies. The mean results show that three of four pts with functional heart and circulatory disorders don't know anything or something wrong about the pathology of their symptoms. Pts with coronary heart disease without myocardial infarction don't have any or any right information in 45%, but coronary infarction-pts don't have any right pathogenetic knowledge in only 12% (differences: p less than .05). The pathogenetic knowledge is not statistically correlated with the age of the pts. In total 54% can't give any reasons for the incidence, 18% are accusing their own health behaviour, 15% say that it is fate and 13% are believing that primarily environmental factors are the best conception about the etiology of their disease. The subjective illness-related psycho-physical irritation show a moderate to average strength and does not depend on pts' age. The main actual cognitive and emotional reaction to illness is in 40% denial, 30% are trying to adept actively to the given situation, 22% show acute mourning and anxiety and 8% respond with rebellion, aggressiveness or anger (differences: p less than .01). There is a tendency growing with increasing life-age to accept the event of illness as a chance for an active change to a better style of life in future. Pts with cardiovascular diseases design an overall optimistic development for their own future: they expect an age of 66.2 years, male pts believe to grow older than female (p less than .01). The prospected satisfaction with life doesn't show any significant differences depending on diagnosis or age. All in all the results lead to the conclusion that the factor \"age of life\" does not play a dominant role in the process of managing with cardiovascular diseases compared with psychological factors of coping with the illness.</p>","PeriodicalId":75459,"journal":{"name":"Aktuelle Gerontologie","volume":"13 3","pages":"96-100"},"PeriodicalIF":0.0,"publicationDate":"1983-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"17201233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Age-related problems of wound healing]. [与年龄有关的伤口愈合问题]。
Aktuelle Gerontologie Pub Date : 1983-05-01
M Nagelschmidt, G H Engelhardt
{"title":"[Age-related problems of wound healing].","authors":"M Nagelschmidt,&nbsp;G H Engelhardt","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A study on wound failures after surgical operations performed at the Dep. of Surgery, Köln-Merheim, revealed an overall rate of 10,8%. 40,3% of all complications were observed in patients aged more than 60 years, which gives a rate of 19,1% for those people. To date this significant increase of wound failures in older individuals is preferently explained by the reduced resistance of the old organism to infections. Our trials with rats as well as numerous publications of other authors on the topic of age-related changes of metabolism prove that the wound healing process is delayed in older individuals. This fact does not consequently lead to complications but the prolonged healing in connection with the repeated change of wound dressing gives an enhanced risk for infections. If special precautions are observed the age of a patient is not a principal contraindication to a great surgical operation today.</p>","PeriodicalId":75459,"journal":{"name":"Aktuelle Gerontologie","volume":"13 3","pages":"108-10"},"PeriodicalIF":0.0,"publicationDate":"1983-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"17201330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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