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At least 1,495 records · Page 83Linked to original sources
PubMed1989

[Practical management of Alzheimer's disease].

In patients with confirmed Alzheimer's disease--a condition for which no active treatment is available--the practitioner's first duty is to abstain from prescribing useless of harmful drugs that would make the situation worse. There is a long list of such potential nuisances. The most badly tolerated drugs unquestionably are anticholinergics, but one must also beware of tricyclic antidepressants, neuroleptics (sometimes unavoidable, however) and also, to a lesser extent, benzodiazepines, beta-blockers and so forth. Yet medical support is far from being ruled out. The benefits of placebos and drugs of undemonstrated value are not negligible, but above all it is mandatory to help the relative understand the truly pathological nature of almost unbearable behaviours. It is also very useful to advise the family on the life organization at home in order to perdure, on the legal safeguards, on whether or not the patient should be institutionalized, and similar topics. Inside institutions, keeping a sensible attitude between relentless therapy and euthanasia is the best way to ensure that the dignity of the demented patient will be preserved.

Alzheimer Disease↗
PubMed1989

Obstetric emergencies. Their practical management.

Many women in Australia, especially West Australians, receive their primary obstetric care from general practitioners. While most patients have normal pregnancies and confinements, emergencies will occur. While imminent dangers can usually be recognised and plans made to transfer the patient to suitably equipped and staffed specialist units, emergencies allow no time for review and successful treatment depends on early recognition of the problem and rapid management.

Emergencies↗
PubMed1989

Model for simulating the effects of management practices on pesticide concentrations in groundwater.

This manuscript describes the RUSTIC model and presents the results of an example application. RUSTIC links three subordinate models in order to predict pesticide fate and transport through the crop root zone, unsaturated zone, and saturated zone to drinking water wells: PRZM, VADOFT, and SAFTMOD. PRZM is a one-dimensional finite-difference model which accounts for pesticide fate and transport in the crop root zone. This release of PRZM incorporates several features in addition to those simulated in the original PRZM code: specifically, soil temperature simulation, volatilization and vapor phase transport in soils, irrigation simulation and a method of characteristics (MOC) algorithm to eliminate numerical dispersion. PRZM is now capable of simulating fate and transport of the parent compound and up to two daughter species. VADOFT is a one-dimensional finite-element code which solves the Richard's equation for flows in the unsaturated zone. The user may make use of constitutive relationships between pressure, water content, and hydraulic conductivity to solve the flow equations. VADOFT may also simulate the fate and transport of two parent and two daughter products. SAFTMOD is a two-dimensional finite-element model which simulates saturated solute flow and transport in either an X-Y or X-Z configuration. The codes are linked together with the aid of a flexible execution supervisor which allows the user to build models which are tailored to site-specific situations. In order to perform exposure assessments, the code is equipped with a Monte Carlo pre- and post-processor. The application of the model is to a potato field on Long Island, New York. The results indicate that RUSTIC is capable of realistically matching data observed in downgradient monitoring wells following 3 years of aldicarb application.

Aldicarb↗
PubMed1986

[Cardiotoxicity of 5-fluorouracil. Characteristics, mechanism, practical management].

5-fluorouracil is a drug that is widely used in cancerology. Its cardiotoxicity must be known, as it is not exceptional and potentially dangerous. Two cases are reported in which the coronary insufficiency was documented and recurred when 5-fluorouracil was reintroduced. The mechanism of cardiac toxicity seems to be coronary spasm, as shown by exercise tests and the normal results of coronary arteriography. It seems preferable to refrain from using 5-fluorouracil after a recent myocardial infarction or in patients with unstable angina. Reintroduction of the drug is usually followed by recurrence of cardiotoxicity, even under coronary vasodilators.

Coronary Disease↗
PubMed1988

Low back pain in the elderly: practical management concerns.

Low back pain occurs in 90% of the adult population. Previous episodes of low back pain in young adults predisposes to exacerbations and chronic problems in the elderly. Radiographic abnormalities demonstrating osteoarthrosis of the lumbar spine and facet joints and varying degrees of disk bulge and disk degeneration are the rule in both asymptomatic and symptomatic patients. Therefore, clinical assessments rather than purely morphological assessments are necessary to assess treatment plans and prognosis in elderly low back pain patients. Osteoarthritic changes are more often asymptomatic than symptomatic. CT and MRI demonstrations of spinal stenosis should be correlated with clinical findings to determine appropriate management decisions. Most elderly patients with low back pain with or without sciatica and with only radiographic CT or MRI rather than clinical evidence of spinal stenosis can be successfully managed conservatively.

Aged↗
PubMed1988

Practical management of catheter-associated UTIs.

In the long-term catheterized elderly, damage to the epithelial wall is primarily responsible for bladder infections, due to the presence of the catheter as a foreign body and its frequent manipulations. The presence of bacteriuria, a classic sign of infection in the non-catheterized patient, is of little diagnostic importance in the long-term catheterized patient, since it is both permanent and inevitable. Routine preventive measures--eg, frequent catheter changes, prophylactic antibiotics--are of no value. Other measures are worth considering and, if instituted, will reduce the frequency of severe complications from long-term catheterization and improve quality of life.

Aged↗
PubMed1986

[Thromboses of the right atrium: echocardiographic aspects, practical management. Apropos of 8 cases].

Right atrial (RA) thrombosis is rare. The aim of this study was to determine their clinical and echocardiographic features and therapeutic implications. In the last 7 years, 16 RA masses were detected by 2D echocardiography. The diagnosis of thrombosis was made in 8 cases based on anatomo-pathological examination (6 cases) or their disappearance with medical treatment (2 cases). The clinical presentations were: pulmonary embolism (4 cases), anterior myocardial infarction (2 cases), Ebstein's anomaly (1 case), thrombosis of a Leveen catheter (1 case). Only 1 patient had atrial fibrillation. Two echocardiographic appearances were observed: 1) a long, very mobile thrombus floating between the RA and right ventricle (4 cases), 2) a relatively immobile mass (4 cases). The 4 patients with relatively immobile thrombi survived: 2 underwent surgery and 2 were treated medically. All cases of floating thrombi had pulmonary embolism: 2 patients underwent surgery but the postoperative course was complicated; 2 patients died suddenly before surgery. These cases show that 2D echo is the diagnostic method of choice for detection of RA thrombosis. The floating RA thrombus is a therapeutic emergency and has a poor prognosis.

Adult↗