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Biomedical subjects

T Kinzel

Publications and source records attributed to T Kinzel.

7 recordsLinked to original sources
PubMed1991

Managing lung disease in late life: a new approach.

Advanced pulmonary disease (APD), a progressive, incurable condition, ultimately leading to death, is associated with significant, distressing symptoms. This paper reviews how the hospice approach to care, with its emphasis on treating those symptoms causing the patient the most distress, might be used by physicians in the outpatient setting to improve the patient's quality of life. Important aspects of care include management of hypoxia, malnutrition, osteoporosis, adverse drug reactions, and, especially, the symptomatic relief of dyspnea. Relief of emotional symptoms (depression, anxiety, panic) is also discussed.

Aged↗
PubMedDate not supplied

Hyperglycemia as a predictor for mortality in veterans with pneumonia.

The elderly may have multiple problems including diabetes mellitus and pneumonia. This study was undertaken to evaluate the effect of hyperglycemia on the length of stay (LOS) and mortality of elderly veterans admitted for pneumonia. Forty-seven and forty-eight patients over the age of 60 admitted for the diagnosis of pneumonia at the Lexington, Kentucky and Iron Mountain, Michigan VAMC's respectively were evaluated. The mean age at Lexington was 72 and at Iron Mountain was 73.9. At Lexington the mean LOS was 39.5 days with a standard deviation of 9.2 for those with hyperglycemia (n = 18) and 16.5 days with a standard deviation of 2.5 for those without hyperglycemia (n = 29). At Iron Mountain the mean LOS was 21.5 days with a standard deviation of 3.3 for those with hyperglycemia (n = 10) and 13.6 days with a standard deviation of 1.2 for those without (n = 38). These differences were significant at p less than .01 using the 2-sample independent t-test. At Iron Mountain 5 of 38 (13%) of the patients with normoglycemia died during the hospital stay compared to 3 of 10 (30%) those with hyperglycemia. For Lexington the figures were 4 of 29 (13%) and 6 of 18 (33%) respectively. These differences were significant at p less than .05. Age did not have any significant effect on either mortality or length of stay. Hyperglycemia appears to be a significant predictor of a longer hospital course and increased mortality in elderly veterans hospitalized for pneumonia.

Aged↗
PubMedDate not supplied

Essential hypernatremia.

Described is a patient who presented with hypernatremia in the absence of dehydration. Further investigation revealed a tumor in the hypothalamic area, and evidence of anterior pituitary hypofunction. Water loading did not correct hypernatremia, and the results of the water-loading test suggested that hypernatremia had resulted from an elevated "osmotic set point" for the release of antidiuretic hormone, ie, "essential hypernatremia."

Adolescent↗
PubMedDate not supplied

Minimising the side effects of cancer chemotherapy in senior patients.

Over 50% of cancer deaths occur in persons aged over 65 years, but because of presumed increased toxicity of chemotherapeutic agents in the elderly, they are frequently treated with reduced doses. However, a review of the literature suggests that chronological age alone does not account for increased toxicity in the elderly. If changes in physiological function, the presence of other illness, and the use of concomitant drugs are taken into consideration, chemotherapy can be used safely and effectively in the elderly. However, this knowledge must be used with the understanding that while response rates are not lower in the elderly, the cancers most commonly encountered are notoriously unresponsive to chemotherapy. Thus, a strategy to use chemotherapy safely and effectively in the elderly involves careful selection of those cancers to be treated, full assessment of the patient's physiological functions, and a knowledge of the adverse effects of the individual agents used. Finally, the use of a limited treatment plan and an understanding of the principles of symptom relief can help optimise treatment throughout the course of the cancer.

Adult↗