By Edmund H. Duthie Jr., Michael H. Keelan Jr. (auth.), Steven R. Gambert M.D. (eds.)
This quantity marks the 1st of a brand new sequence, modern Geriatric medication, becoming a member of the ever starting to be "Contemporary" kin. As with the opposite "Contem porary" volumes, our aim is to help the reader in retaining forex in a quickly altering box. possibly no box has proven such significant advances in the sort of short while as geriatrics. during the last a number of years, the "demographic impera tive" has develop into a resource of shock for lots of, together with clinicians, scientists, econ omists, and wellbeing and fitness planners. Our geriatric wisdom base keeps to develop, frequently making it tricky to maintain abreast of advances and present healing modalities. modern Ger iatric medication provides the state of the art considering concerning a number of themes all of significant main issue to the health professional taking care of the aged individual. The authors, for the main half serving as participants of a reliable editorial board, have selected themes that are supposed to have quick curiosity to the readership. by way of having a good editorial board, continuity is ensured in successive volumes. each years, a next factor will both deal with new strategies on already offered issues or concentrate on new themes of present curiosity. As with the opposite "Contempo rary" sequence volumes, the any other yr period is meant to permit new locate ings to strengthen and be confirmed. It additionally offers the authors with time to supply the very best quality of work.
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Additional info for Contemporary Geriatric Medicine: Volume 1
1. Presentation and Diagnosis Manifestations of coronary artery disease in the elderly may be quite atypical. Neurologic symptoms including confusion, weakness, and transient cerebral vascular events frequently replace the classic symptoms of anginal chest pain. Pathy reviewed the clinical presentation of MI in 387 patients over age 65 years. 23 Only 19'70 had the typical presentation. Dyspnea without pain was found in 20'70 and over 25'70 had neurologic presentations including confusion, stroke, or syncope.
Subsequently reported similar data in elderly patients with essential hyperten- 30 EDMUND H. , AND MICHAEL H. KEELAN, JR. sion. 94 They found a subpopulation who had subnormal plasma renin increase after sodium restriction and this same group had an abnormally enhanced adrenal response to angiotensin II infusion. Ogihara et al. confirmed that elderly hypertensives have suppressed plasma renin and aldosterone compared to age-matched controls and young hypertensives. 9s When an angiotensin II antagonist (saralasin) was administered, the elderly hypertensives and normotensives had greater blood pressure elevation and renin-aldosterone suppression than middle-aged hypertensives.
Aortic 14 EDMUND H. , AND MICHAEL H. KEELAN, JR. Figure 1. Thoracic CT scan with contrast. (AAo) ascending aorta; (DAo) descending aorta; (IF) intimal flap; (FL) false lumen; (TL) true lumen; (RPA) right pulmonary artery; (PA) pulmonary artery. angiography had been the diagnostic procedure of choice, but computerized thoracic tomography has proven to be a useful screening technique (Fig. 1). Therapy should be instituted once the tentative diagnosis has been made since direct contrast angiography may precipitate rupture or extension of the dissection.
Contemporary Geriatric Medicine: Volume 1 by Edmund H. Duthie Jr., Michael H. Keelan Jr. (auth.), Steven R. Gambert M.D. (eds.)