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Biomedical subjects

S R Gambert

Publications and source records attributed to S R Gambert.

At least 73 records · Page 4Linked to original sources
PubMed1982

The value of the yearly medical evaluation in a nursing home.

This study evaluates the benefit of the annual medical examination in an academically affiliated Veterans Administration Nursing Home Care Unit. Ninety-six male residents with a mean age of 74.4 yr who were all receiving ongoing medical care underwent annual evaluations including a history, physical examination, chest X-ray and appropriate laboratory testing. All residents have had continual updating of their problem lists and are part of an ongoing geriatric educational program. Findings on the annual evaluation were compared to the most recently formulated problem list. Our evaluation revealed a total of only eight previously unknown abnormalities. Data suggest that ongoing health care as part of an academic geriatric program may obviate the need for annual evaluations.

Aged↗
PubMed1982

Bacterial infections in a hospital-based skilled nursing facility.

The incidence of bacterial infections occurring in 132 residents in a Veterans Administration hospital-based nursing home care unit (VA NHCU) was studied retrospectively over a 1 yr period. There were a total of 35 non-Foley-catheter-related bacterial infections documented during this time, occurring in 21 residents. Of these infections, 14 were pulmonary, 18 urinary and 3 of the integument. Of the 23 residents having indwelling urinary catheters, 47.8% became clinically symptomatic due to a urinary infection at least one time during the year. Thirty-six per cent of these infections were due to Pseudomonas aeruginosa and 48% were due to E. coli and Proteus mirabilis. Eighteen of 23 residents (78.3%) with Foley catheters had more than one predominant organism cultured from their urine during the year, making the practice of monthly cultures not very useful in considering treatment. If one grouped all urinary tract infections on the NHCU, the major pathogens were Pseudomonas (19.5%), Klebsiella (17.1%). Proteus (17.1%) and E. coli (14.6%). Documented pulmonary infections were predominantly due to Streptococcus pneumonia (50.0%) and Hemophilus influenza (35.7%). Our data suggest that the location of the institutional setting must be considered in caring for the elderly resident in a skilled nursing facility. Future plans to establish hospital based nursing home units must consider the benefits resulting from easy access to acute health care and educational programs against problems of hospital bacterial flora.

Aged↗
PubMed1982

Interpretation of laboratory results in the elderly. 1. A clinician's guide to hematologic and hepatorenal function tests.

An understanding of the normal aging process and its effects on common laboratory values is essential when evaluating the elderly patient. Although results of research to determine precise changes in values for this age-group in hemoglobin, hematocrit, white cell count, ESR, serum bilirubin and alkaline phosphatase, SGOT, and glomerular filtration have not been conclusive in most instances, some of the findings described here warrant consideration. We believe that the established normal ranges for these values do not need to be significantly modified for the elderly and that slight deviations from them are normal for the healthy patient. However, all abnormal test results should not be attributed to aging alone; the clinician might overlook the need for further diagnostic workup for possible serious disorders.

Adult↗
PubMed1982

Effect of cold exposure on thyroid hormone in Fischer 344 rats of increasing age.

Male rats aged 6 weeks, 6 months, and 18 months were kept at 4 to 5 degrees C for 12 days and compared with age-matched controls at room temperature as to survival, weight change, food consumption, core body temperature, and several parameters of thyroid hormone economy. After 12 days in the cold, 14%, 50%, and 71% of 6-week-, 6-month-, and 18-month-old rats, respectively, were living. Weight declined in both older groups, though at a faster rate in the oldest. Increasing age did not affect serum T3, rT3, TSH, or the ability to convert T4 to T3 by 20% liver homogenate. Cold exposure, however, resulted in an increase in serum T3 and a decrease in T4 to T3 conversion by liver homogenate in a similar magnitude both in mature and early senescent rats.

Adaptation, Physiological↗
PubMed1982

Emergency detention of the elderly: demographics, diagnoses, and outcome.

Involuntary medical detention is an increasing problem in many large teaching hospitals. Forty-two elderly patients involuntarily admitted for protective service to the general medical wards were compared with an age-matched group of 25 elderly persons voluntarily seeking care in the same institution. The comparison showed that most of the involuntarily admitted patients were more than 70 years of age, and more of them lived alone. On admission they had more dementia and dehydration but less urinary-tract infection than did the controls. Their hospital stays were longer. There was no difference between the groups with respect to discharge dispositions.

Age Factors↗
PubMed1981

Importance of resident placement within a skilled nursing facility.

Specific attention to the placement of nursing-home residents within a skilled nursing facility is often neglected. a study was made of the effects on mental and emotional status, sensory perception, and capability for the needs of daily living when a mentally incompetent resident was placed as a room-mate with a competent resident. By means of a rating scale designed for this study, the mentally competent subjects were assessed before and after this type of placement. A significant change occurred in mental and emotional status (p less than 0.001) but there was no change in either sensory perception or the ability to perform the tasks of daily living. The data suggest that the placement of a mentally incompetent resident with one who is mentally competent may result in an alteration of mental and emotional status for the latter. It is important that placement conditions be considered in the initial processing of all nursing-home residents.

Aged↗
PubMed1981

Evaluation of the systolic murmur in the elderly.

A common clinical entity in the elderly population is the systolic murmur detected during cardiac auscultation. Although it can occur in patients of any age group, the approach to diagnosis differs in the elderly. Two cases are presented which illustrate different pathologic processes that can result in the development of a systolic murmur. The prevalence of this entity in the elderly is highlighted, and a strategy for diagnosis is outlined.

Aged↗
PubMed1981

Interaction of age and thyroid hormone status on beta-endorphin content in rat corpus striatum and hypothalamus.

These studies investigated the effect of aging on thyroid hormone regulation of beta-endorphin in rat corpus striatum and hypothalamus. In both brain areas, basal levels of beta-endorphin declined with age. In addition, age modified the response of beta-endorphin to thyroid hormone status. Hypothyroid rats aged 6 months (mature) exhibited a 67% mean decline in the level of beta-endorphin in the corpus striatum. Hypothyroid rats aged 20-24 months (senescent) exhibited no change in the level of beta-endorphin in the corpus striatum. Hypothyroid rats aged 6 months had a 28% mean decline in the level of hypothalamic beta-endorphin. There was no change in hypothalamic beta-endorphin content in hypothyroid senescent rats. Hyperthyroidism resulted in elevations of beta-endorphin in both the corpus striatum and hypothalamus in senescent, but not mature rats. Changes in beta-endorphin seen with age are at least in part thyroid hormone dependent. In addition, age is capable of modifying the response of brain tissue to thyroid hormone.

Aging↗