RESUMEN
The authors relate their experiences in using questionnaires for taking the history of patients with gastroenterological enterological ailments. They have found that the older the patient, the more the results of the questionnaire diverge from those obtained by conventional methods of history-taking. Consequently the authors advise a cautious approach to the use of questionnaires when dealing with elderly patients.
Asunto(s)
Enfermedades Gastrointestinales/diagnóstico , Anamnesis , Encuestas y Cuestionarios , Adulto , Factores de Edad , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Relaciones Médico-PacienteRESUMEN
In old people the range of operation, as well as the adaptability of the electrolyte and water metabolism, is reduced by the involutive reduction of the renal, pulmonary and endocrinic functions, as well as by a reduced feeling of thirst, a reduction of the buffer mechanisms, and a dwindling amount of body water. The threat to the maintenance of the requisite amount of body-water and to a normal electrolysis, caused by gastro-intestinal illnesses, is discussed from the point of view of geriatrics. Hydro-mineral upsets occurring in gastroenterology are primarily caused either by an inadequate supply, inadequate absorption, or by an extra-ordinary loss of intestinal secretions, as well as by interference with the normal electrolyte and water metabolism due to medical treatment. Situations in which such hydro-mineral disturbances wright occur are indicated and therapeutic measures suggested. We assert and prove that in old people the danger of extreme reduction of body-water and electrolysis frequently presents a greater threat to life than the illness from which it proceeds, and we maintain that a due consideration of this problem can in many cases literally save the life of the old patient.
Asunto(s)
Enfermedades Gastrointestinales/metabolismo , Equilibrio Hidroelectrolítico , Equilibrio Ácido-Base , Anciano , Agua Corporal/metabolismo , Humanos , Absorción Intestinal , Secreciones Intestinales/metabolismo , Minerales/metabolismoAsunto(s)
Anamnesis/métodos , Accidentes , Humanos , Relaciones Interpersonales , Lenguaje , Personalidad , InconscienciaRESUMEN
The involutive restriction of the renal and pulmonary function and of the thirst and the reduction of body water also diminished the range of efficacy and possibility for adaptation of the water- and electrolyte metabolism of old people. Under geriatric aspects many causes for the endangering of the water- and electrolyte metabolism are discussed. It is founded that in old patients the quicker metabolism imbalance means a stronger threat of life that the disease itself. Often the consideration of this problem in much cases of diseases can save the life of the old patient.
Asunto(s)
Envejecimiento , Desequilibrio Hidroelectrolítico/prevención & control , Adaptación Fisiológica , Anciano , Agua Corporal , Humanos , Concentración de Iones de Hidrógeno , Riñón/fisiología , Capacidad de Concentración Renal , Desequilibrio Hidroelectrolítico/metabolismoRESUMEN
Emphasizing the significance of the case history for medical care, the authors discuss major points to be taken into account when interviewing elderly patients. They describe in detail both the emotional situation in later life and particularities regarding symptoms and the course of diseases in advanced age.