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Biomedical subjects

L Pousada

Publications and source records attributed to L Pousada.

9 recordsLinked to original sources
PubMed1997

Fellowship training.

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Fellowships and Scholarships↗
PubMed1995

Hispanic-American elders. Implications for health-care providers.

American health-care practitioners are faced with a rapidly growing, geriatric, Hispanic-American population. This group shares certain cultural links but is largely heterogeneous and comprised of many subgroups, the largest of which are Mexican Americans, Puerto Ricans, and Cuban Americans. Health-care practitioners face significant socioeconomic, cultural, and language barriers in providing care to these patients. An understanding of Hispanic-American social dynamics, an understanding of culture-bound syndromes, and efforts to successfully overcome language barriers are essential to optimal patient care. Exploration of the ethnic complexity of Hispanic-American subgroups will help to free practitioners from medical and racial stereotypes and allow development of cultural insights that can strengthen and enrich the doctor-patient relationship.

Aged↗
PubMed1993

Emergency services use by elderly individuals.

Population predictions suggest that the proportion of elderly people will continue to rise until 1996, will remain constant until 2016, and will continue to rise again. If the current trends continue, the ED will become an increasingly important provider of primary health care for the elderly population. Practitioners, educators, and administrators in emergency medicine should prepare now to meet the growing needs of this population. The high cost and high rate of recidivism by aged ED patients suggest that attention should be paid to appropriateness, continuity, and effectiveness of care. Early social service intervention in the ED may prove beneficial to older patients. In addition, the basic principles of the care of elderly patients should be included in the training curriculum of ED physicians and primary care providers.

Aged↗
PubMed1993

Common neurologic emergencies in the elderly population.

Aged individuals often present to the ED with acute neurologic syndromes. The disorders described in this article are among the most difficult to diagnose in the older patient. Accurate diagnosis of syndromes such as delirium or syncope mandates a thorough history and physical examination, even in the most frail or combative of patients. Treatment should be guided by the cause, and the reflex prescription of psychotropics avoided. The diagnosis of spinal cord compression in an older patient requires awareness of typical signs and symptoms as well as performance of a careful neurologic examination. This neurologic emergency demands prompt and aggressive treatment, with immediate neurologic or neurosurgical consultation.

Aged↗
PubMed1992

Cecal bascule: an overlooked diagnosis in the elderly.

This elderly male with a long history of alcohol abuse presented with an acute pleural trauma and hemopneumothorax, which may have served as the precipitating medical illness for cecal volvulus. He subsequently developed bacterial peritonitis as a complication of his bowel obstruction. It is probable that his pleural cavity was seeded hematogenously via a bacteremia from his peritonitis, thus accounting for the empyema with species typical of bowel flora. Cecal bascule is a type of cecal volvulus that causes intestinal obstruction. Diagnosis is difficult, but a delay in recognition may result in intestinal ischemia, perforation, sepsis, and even death. Cecal ischemia or gangrene cannot always be determined based on physical examination or laboratory findings. Plain films of the abdomen may be helpful, and barium enema has been advocated by some authors. However, laparotomy is often necessary for definitive diagnosis and therapy. While cecal volvulus has not been reported to occur frequently in the elderly, the relatively common occurrence of anatomic predisposition in addition to the widespread use of respirators and the increasing age and number of medical illnesses of our population make it possible that cecal volvulus will be seen with increasing frequency in the future.

Aged↗
PubMed1990

Rapid bedside assessment of postoperative confusion in older patients.

As the number of elderly patients undergoing surgery increases, postoperative confusion becomes an increasingly encountered problem. Postoperative confusion has long been recognized as a specific entity, but the etiology and risk factors have not been well defined. To make the diagnosis promptly, the physician must maintain a high index of suspicion. This review provides a series of brief mental status tests that can be administered quickly at the bedside and outlines a specific approach to treatment.

Activities of Daily Living↗