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Biomedical subjects

E Lang

Publications and source records attributed to E Lang.

288 records · Page 16Linked to original sources
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[The rehabilitation potential of geriatric patients from the cardiologic viewpoint].

The potential of rehabilitation for geriatric patients depends on physiological considerations about the aging organism, as well as diseases, accompanied by the natural aging process. A common feature of the aging process of human organs is a general loss of adaptability that contributes to hypocirculation. The potential for rehabilitation may be considerably limited by diseases which burden the circulatory system (atherosclerosis, coronary heart disease, hypertension, and hypotension). Cardiac arrhythmias occurring during rehabilitation procedures call for special care. Mode and intensity of the rehabilitation program will be determined by cardiac and circulatory reactions following active rehabilitation procedures. Isometric exercise stress in conjunction with pressure breathing leads to an excessive rise of blood pressure in systemic and pulmonary circulation. Therefore dynamic muscle actions should be preferred as the most reasonable active training, but there is the possibility of heart-circulation problems arising, depending on the intensity of training.

Activities of Daily Living↗
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[Maintaining competence by physical activity and sports--circulatory physiologic and sports medicine prerequisites].

With increasing age, there is a change in the mitochondrial pattern of muscle tissue which leads to a loss of compliance of the arterial vessel wall and therefore to a slight change in contraction mode of the heart and also to a decrease of stroke and circulation volume. In the same way, lung function parameters such as vital capacity and forced ventilatory capacity are changes in the elderly. In addition to these, a higher incidence of general disease will change the organism, particularly heart circulation and the pulmonary system. In order to judge physical performance and sporting activity, certain physiological and pathophysiological features of aging have to be taken into consideration in the elderly. Avoiding any risks should be always above to intention of gaining a better physical condition, although this is desirable in principle.

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Research in geriatric medicine in the Federal Republic of Germany.

The research in the field of geriatrics in the Federal Republic of Germany is based on the teachings of Max Bürger in Leipzig. Under the impulse of René Schubert, general geriatrics medicine could be investigated. A series of reasons are responsible for the relatively late development of rehabilitative geriatrics in the Federal Republic. The clinical gerontopharmacology has nevertheless achieved resounding results through the cooperation between pharmacologists and clinicans. Preclinical geriatric medicine developed only with little reference to gerontology, the concept originates from policlinical medicine, as inaugurated by Korth, 1967. The emphasis lies on prevention, with reference to the work of general physicians "outside of the clinical gates" of geriatrics. Within the special geriatrics age related angiocardiology, rheumatology, immunology and longevity are viewed as the most essential part of the research projects. Research activities in clinical geriatrics remained for a long time a domain of clinics and institutes outside the universities. There is a promising tendency yet, to establish the clinical geriatrics in the universities.

Adult↗
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[Malnutrition in old age - diagnosis and therapy].

The nutritional state of 309 geriatric patients in a medical clinic was determined with the following parameters: Weight/height index, triceps skin fold, arm muscle circumference, creatinine/height index, albumins, prealbumin, transferrin and cholinesterase. Using these parameters we found that 54,4% of these patients were suffering from malnutrition (27,8% marasmus, 9,4% kwashiorkor-like syndrome, 17,2% marasmic kwashiorkor). Triceps skin fold, arm muscle circumference and creatinine/height index were the most precise parameters to confirm marasmus. Prealbumin and cholinesterase are especially recommended to determine acute protein deficiency, albumin to confirm chronic protein deficiency. It was also possible to demonstrate the deleterious effect of malnutrition on the immunological system of the patient through determination of the absolute lymphocyte count in peripheral blood and intracutaneous testing with streptokinase-dornase, mumps skin test antigen and candida vaccine.

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[Audiological results in hearing loss in old age].

A significant loss of performance of the ear was found to be a function of age in all audiological tests. Clear cases of presbycusis were only determined in persons above 70 years of age. According to finds, a severely handicapping loss in the ability to understand speech only occurred in the 90-year-old group suffering from primary presbycusis. A disturbing impairment of hearing in younger persons is most likely due to a secondary presbycusis. Contrary to previous opinions suprathreshold tests indicate a high percentage of sensoneural hearing losses are due to cochlear lesions. The dichotic discrimination test showed the highest correlation to age. This especially seems to be caused by age-inherent changes in central pathways. Altogether, although it has been this study were considerably handicapped, they were, however, thoroughly able to understand speech under favorable conditions.

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[Exercise as prevention of illness in the elderly].

The physiologic changes of the different organs in the elderly result in a diminishing efficiency of the organism and its capability of adapting to new and unusual conditions. Accordingly, physical exercise has to be seen and assessed as prevention of illness in old age. In terms of prevention exercise training is taking the first place within the five different types of physical activities. The other types (coordination, flexibility, strength, rapidity) have to be handled with special conditions, whose importance must be assessed individually. The importance of exercise, physical activities, and sports is increasing especially in preventing coronary artery disease. Metabolic diseases, hypertension, impairment of cerebral functions and also diseases of the musculoskeletal system are improving under suitable physical training. General training exercise training slows down the loss of cardiopulmonal efficiency due to progredient aging. Risks and benefits of physical training have to be deliberated very carefully in considering the state of health of the elderly.

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[Women live longer--biological, medical and sociologic causes].

The results of studies concerning the mortality rates of both sexes are of great similarity in all industrial countries. For underdeveloped countries, little information is available, but analogue proportions can be supposed. In the nations of the industrialized world males have a significantly higher mortality rate, which shortens their life expectancy in comparison with that of woman. Since about 1970 a deceleration of this development has been observed. The diseases responsible for this fact are ischemic heart disease, lung cancer, accidents, and other traumatic incidences, but also infectious diseases. Concerning the origins of ischemic heart disease, the influence of sex hormones especially on the lipid profile are being discussed; nevertheless, for the enhanced coronary risk of males environmental and behavioral factors seem to be more important than biological reasons. As for carcinosis being a reason for the mortality of males, lung cancer is in the foremost position. Cigarette consumption, as well as the higher exposure to cancerogenic substances related to typically male professions, are held responsible for this. As for other types of cancer, environmental factors depending on gender are strongly considered as a reason for different rates of mortality. Furthermore, sociological explanations for these differing frequencies are being discussed. Occupational differences and the different positions held in working life by each gender are believed to be responsible for the higher rate of mortality among males. Also, risktaking behavior seems to be found more often among males, than among females. A variety of hypotheses based on genetics have been given to explain the different gender-specific rates of mortality, but none of them has yet been proven correct.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
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[Pain--from the physiological and internal medicine viewpoint].

Physiology of pain is a manifold and very complex phenomenon that is far from being understood. It cannot be explained without reference to psychosocial conditions. Pain has the function of a warning system, but the system is far from perfect, because a number of chronic diseases (e.g., arterial hypertension or malignant neoplasms) begin slowly and nearly painless. The role of pain in internal medicine will be exemplified by thoracic and abdominal pain. With regard to diagnoses both types of pain represent ambiguous symptoms. Their anatomic and physiologic substrates often cannot be ascertained completely by anamnestic means (according to localization, quality, trigger factors, time structure, and concomitant symptoms of pain). Visceral pain is regularly characterized by the phenomenon of the so-called "transferred pain": that means that the perception of pain is not restricted to the place of its origin but is also found in distant regions of the body, primarily in well defined dermatomes ("Head's areas"). This makes the differential diagnosis of internal diseases very difficult because of the parallel connection of nociceptive afferences from the skin and deeper-seated strata on identical spinal segments. Statements according to the pharmacotherapeutic aspects of pain primarily focus on the causal therapy of the prethoracic pain. In this regard differential-therapeutic aspects of angina pectoris, pericarditis, pleurisy, gastro-esophageal reflux, and vertebragenic, myogenic, and neurogenic disturbances are well to the fore.

Abdominal Pain↗
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Cardiac autonomic involvement and peripheral nerve function in patients with diabetic neuropathy.

The aim of our study was to investigate the relationship between cardiac autonomic neuropathy and dysfunction of myelinated and unmyelinated nerve fibres in the peripheral nerve. We measured nerve conduction velocities, warmth/cold perception thresholds at the foot dorsum, sympathetic skin response (SSR), and performed the quantitative sudomotor axon reflex test (QSART). Forty-three diabetic patients with distal-symmetric polyneuropathy were included. According to the results of heart rate variation, 20 patients had cardiac autonomic neuropathy (CAN+). Apart from motor nerve conduction velocities, all tests were more often abnormal in CAN+ patients. Warmth thresholds (afferent C-fibres) and reduced compound muscle action potentials (CMAPs) of the tibial and peroneal nerve, indicating axonal damage, were more often abnormal in CAN+. Cold threshold and sural nerve conduction velocity were indicators of involvement of myelinated small and large nerve fibres, but not of the cardiac autonomic system. Ninety-four percent (94%) of patients with absent SSR and 78% of patients with abnormal QSART had CAN+. SSR and QSART may be useful for assessment of autonomic neuropathy in diabetic patients with cardiac arrhythmia where direct measurement of heart rate variability is not possible. In the majority of our patients with CAN+, the vagal-cardiac and the sudomotor-sympathetic systems were involved simultaneously, although two entirely different systems were tested. This may reflect a C-fibre directed selectivity of the pathological process in autonomic diabetic neuropathy. In conclusion our results show that diabetics with and without cardiac autonomic neuropathy have a different profile of involvement of peripheral nerve fibres.

Adult↗
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[Cardiopulmonary normal values in geriatrics].

Because of age-related modifications of the heart, lung, and circulation, several cardiopulmonary parameters present altered normal and reference values with increasing age. Other parameters, for example, arterial blood pressure, change only insignificantly with age. In older age groups it is more difficult to establish reference ranges and values because of the lack of "healthy" subjects. To establish cardiopulmonary parameters, appropriate investigations for the age group, for example, treadmill-ergometer, should be preferred. In judging if a value resulting out of the reference range is to be considered really pathologic, other factors are to be taken into account, such as circadian variations, motivation, associated pathologies as well as the actual physical and psychological conditions, when we are dealing with older subjects or patients.

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