RESUMEN
BACKGROUND: Inability to get up from the floor after an accidental fall is a frightening and potentially dangerous experience. Especially elderly individuals living alone are exposed to this. MATERIAL AND METHODS: In a geriatric five-day ward 206 patients living alone were tested for their ability to rise from the floor. This was carried out under safe conditions in a training room. Those who failed were offered instruction and training given by a physiotherapist, up to five sessions. The training programme is described. RESULTS: 154 patients (75%) were able to get up unaided within two minutes. The time needed varied considerably. Of the 52 who failed 39 accepted training, and 22 finally managed to get up independently. INTERPRETATION: Teaching elderly patients living alone how to get up from the floor is often successful and will probably reduce the risk of being unable to get up for an extended period of time.
Asunto(s)
Accidentes por Caídas , Accidentes por Caídas/prevención & control , Accidentes por Caídas/estadística & datos numéricos , Anciano , Humanos , Modalidades de Fisioterapia , Factores de Riesgo , Factores de TiempoRESUMEN
101 elderly female patients participated in a multidisciplinary programme for the diagnosis and management of urinary incontinence. Their median age was 81 years. 83 patients had been incontinent for more than 12 months. In only 23 patients was incontinence recognised as a problem prior to admission, and 69 patients claimed that they had never received any treatment for their disability. Urge and mixed incontinence were found to be the most prevalent forms, based on symptoms and simple measurements. After assessment, one to six measures were implemented for each patient in order to counteract internal and external causes of incontinence. The patients were reviewed after 6-8 weeks. 60 patients claimed there was an improvement, including 20 who described themselves as "much improved", and seven who had become continent. It is suggested that a hospital stay may provide a suitable opportunity to undertake primary assessment and treatment of incontinence in elderly women.
Asunto(s)
Incontinencia Urinaria , Anciano , Anciano de 80 o más Años , Femenino , Enfermería Geriátrica , Guías como Asunto , Unidades Hospitalarias , Humanos , Noruega , Incontinencia Urinaria/diagnóstico , Incontinencia Urinaria/etiología , Incontinencia Urinaria/terapiaRESUMEN
A geriatric five-day unit of 15 beds was studied continuously for 12 months. There were 330 admissions, mainly referrals from general practitioners via the outpatient clinic. Multiple pathology and loss of function were common. The opinion of colleagues within other specialties was sought on 133 occasions. 39% of the patients received physiotherapy, 27% received occupational therapy and 13% the services of a social worker. Compared with the cost of running a conventional ward of the same size, the financial savings are estimated to be fully NOK 750,000.
Asunto(s)
Servicios de Salud para Ancianos , Unidades Hospitalarias , Tiempo de Internación , Anciano , Ahorro de Costo , Femenino , Servicios de Salud para Ancianos/economía , Servicios de Salud para Ancianos/organización & administración , Servicios de Salud para Ancianos/estadística & datos numéricos , Unidades Hospitalarias/economía , Unidades Hospitalarias/organización & administración , Unidades Hospitalarias/estadística & datos numéricos , Humanos , Masculino , NoruegaRESUMEN
Data were recorded on mental function, urinary continence, ability to dress, falls, mobility, and vision in 340 patients aged 75 and over on admission to a medical department. Three months later, 213 patients had been discharged, 41 were still in hospital, 64 had died, and 22 had been transferred to another hospital or returned to a nursing home. Impairment of any of the functions tested, except vision, was associated with prolonged length of stay. Only two of 135 patients with no disability were still in hospital after three months, while for patients with three or more disabilities the number was 15 out of 56. Increasing age was associated with a tendency to prolonged length of stay. No such tendency was found among those who lived alone.
Asunto(s)
Anciano , Estado de Salud , Salud , Departamentos de Hospitales , Tiempo de Internación , Humanos , Salud Mental , Noruega , Pronóstico , AutocuidadoAsunto(s)
Accidentes , Enfermería Geriátrica , Heridas y Lesiones/etiología , Anciano , Femenino , Hospitalización , Humanos , MasculinoRESUMEN
Serum copper and erythrocyte sedimentation rate were recorded in 54 patients with active Hodgkin's disease and at 186 occasions in 78 patients during stable complete remission. Relatively high and age-dependent normal limits for erythrocyte sedimentation rate were used. Each of the tests was elevated in 70% of patients with active disease. During remission serum copper was elevated in 14% and erythrocyte sedimentation rate in 16.5% of the determinations. Thus the two tests are considered not far from equal in their ability to discriminate between presence and absence of specific disease activity in Hodgkin's disease. Simultaneous elevation during remission occurred in less than 5% of the recordings as compared to 61% during active disease. It is therefore concluded that serum copper level may be of some value as a supplement to erythrocyte sedimentation rate.
Asunto(s)
Sedimentación Sanguínea , Cobre/sangre , Enfermedad de Hodgkin/sangre , Adolescente , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Remisión EspontáneaRESUMEN
Forty-three patients with disseminated germ cell cancer were treated with a combination of vincristine, Adriamycin, cyclophosphamide, actinomycin-D, and medroxyprogesterone acetate. All the 43 patients were considered evaluable for response. Thirty-one patients (72%) achieved a complete or partial remission and 14 (32.5%) achieved a complete remission. The patients who attained an objective response obtained a significant prolongation of life compared with the nonresponders (median survival 55 vs. 23 weeks). Responses were seen in all histologic categories and most frequently in patients with metastases confined to the lungs. The major side effects were leukopenia and stomatitis. There were no deaths related to toxicity of the chemotherapy.
Asunto(s)
Antineoplásicos/uso terapéutico , Neoplasias de Células Germinales y Embrionarias/tratamiento farmacológico , Neoplasias Testiculares/tratamiento farmacológico , Adolescente , Adulto , Antineoplásicos/efectos adversos , Bleomicina/uso terapéutico , Niño , Preescolar , Ciclofosfamida/uso terapéutico , Dactinomicina/uso terapéutico , Doxorrubicina/uso terapéutico , Quimioterapia Combinada , Humanos , Leucopenia/inducido químicamente , Masculino , Medroxiprogesterona/uso terapéutico , Persona de Mediana Edad , Metástasis de la Neoplasia , Remisión Espontánea , Estomatitis/inducido químicamente , Factores de Tiempo , Vincristina/uso terapéuticoRESUMEN
Testicular function was estimated by sperm counts, hormone assays and recording of reported conceptions in 9 patients irradiated for malignant lymphoma. The treatment had been an inverted 'Y' field including the inguinal regions with, in addition, a mantle field in 8 patients. Azoospermia or severe oligozoospermia was found in all but 1 patient, and the FSH levels were uniformly elevated. Testosterone and LH were within normal limits except in 2 patients with slightly subnormal testosterone levels. 7 of the patients were married to women of fertile age, and in 3 cases the wife became pregnant and give birth to a healthy child. The time lapses from irradiation to conception were 18, 40 and 57 months. 2 of these patients had severe oligozoospermia on examination 2 and 4 months respectively from conception. Thus fertility may possibly be underestimated by sperm counting and hormone assays after this type of radiotherapy.
Asunto(s)
Linfoma/radioterapia , Traumatismos por Radiación , Radioterapia/efectos adversos , Espermatogénesis/efectos de la radiación , Testículo/efectos de la radiación , Adulto , Recuento de Células , Hormona Folículo Estimulante/sangre , Estudios de Seguimiento , Humanos , Infertilidad Masculina/etiología , Hormona Luteinizante/sangre , Masculino , Oligospermia/etiología , Motilidad Espermática/efectos de la radiación , Testosterona/sangreRESUMEN
Fertility was estimated by sperm counts and hormone assays in 8 patients treated for Hodgkin's disease with at least 6 courses of combination chemotherapy. This consisted of an alkylator (mechloretamine or cyclophosphamide), a vinca alkaloid (vinblastine or vincristine), procarbazine and prednisone. Azoospermia was found in 7 of the 8 patients on examination 12-29 months after termination of chemotherapy. In 1 patient semen quality improved gradually, and a sperm count of 5 mill/ml was found at 21 months. Serum FSH levels were increased in all but 1 patient who was, nevertheless, azoospermic. The levels of testosterone and LH were generally within normal limits. Thus, the germinal tissue is seriously damaged by this type of chemotherapy. The resulting infertility seems to be complete and of long duration. Partial recovery of spermatogenesis may, however, sometimes take place after prolonged unsustained remission.