The Aging ProcessHENDERSON, EDWARD
doi: 10.1111/j.1532-5415.1972.tb00761.xpmid: 4639419
ABSTRACT: The sorry state of our knowledge of the process of aging calls for emphasis on basic research. Today our resources are chiefly expended on praiseworthy and necessary attempts to alleviate the diseases associated with old age and to provide good medical and psychological care. Meanwhile, through studies of healthy older humans and other species, we should try to discover what the process of aging is. Only thus can we make more significant contributions toward enhancing the quality of life in old age, let alone lengthening the life span.
An L‐Dopa Paradox: Bipolar Behavioral AlterationsRIKLAN, MANUEL
doi: 10.1111/j.1532-5415.1972.tb00762.xpmid: 4639420
ABSTRACT: Paradoxical behavioral alterations may occur during L‐dopa therapy in parkinsonian patients, particularly those of the geriatric age group. For example, there have been many reports of alleviation of depression with L‐dopa, but induction of depression has also been observed. With respect to cognition and perception, there have been many reports of disorientation and paranoid ideation from the toxic effects of L‐dopa, but increased alertness and improved intelligence have also been observed. The basic alteration appears to be a non‐modality specific increase in physiological and behavioral activation. This, in turn, may lead to opposite kinds of specific (e.g., directional) changes in emotional, cognitive and perceptual functions, depending in part upon the baseline status of the patient. A concept designated as directed‐activation is proposed as a partial hypothesis.
An Appraisal of Anorexiants in the Treatment of Obesity *FINEBERG, S. K.
doi: 10.1111/j.1532-5415.1972.tb00763.xpmid: 4639421
ABSTRACT: Descriptions of the serious effects of amphetamines refer to large overdosages, orally or parenterally. This is quite different from the dosages involved when anorexiants are used properly as an adjunct in the total treatment of obesity. They constitute an initial “crutch” to help strongly motivated stable patients to change their eating habits. Anorexiants should never be used on a long‐term basis. As the total program is difficult for both patient and physician, any temporary therapy of such value to the obese patient should not be prohibited if given under the supervision of an experienced physician who knows the indications for withdrawal. Under these circumstances, the hazards are minimal.
A Fellowship in Geriatric Medicine *LIBOW, LESLIE S.
doi: 10.1111/j.1532-5415.1972.tb00764.xpmid: 4639422
ABSTRACT: After several years of experience in training interns and residents in Geriatrics during their two‐ or three‐month rotational period on this service, a full‐time Fellowship program has now been established in Geriatric Medicine, with the cooperation of the Department of Medicine. It is expected that the Fellows will achieve: 1) a special knowledge of and adeptness with the illnesses and health needs of the elderly, and 2) special abilities to plan for community needs regarding its elderly. The base for the program is the 80‐bed medical and surgical convalescent unit of this 1000‐bed general teaching hospital. Two‐thirds of the patients admitted return to the community within ten weeks. The Fellowship program includes participation in: 1) daily bedside rounds, 2) weekly staff conferences emphasizing an interdisciplinary approach to patients' problems, 3) weekly journal‐club sessions on “current concepts” in geriatrics, 4) community‐based health programs, 5) daily teaching conferences of the Department of Medicine, and 6) a research project related to the medication problems of the elderly. The first Fellow has been accepted and a two‐year to three‐year program is planned which will be divided between Internal Medicine and Geriatric Medicine.
Therapeutic Decision Making and Institutional Advocacy in Caring for the Ill Aged *MILLER, MICHAEL B.
doi: 10.1111/j.1532-5415.1972.tb00765.xpmid: 4639423
ABSTRACT: The clinical management of the severely ill aged patient in an institution is a complex process. In addition to decision making by the patient, family and physician, there is another factor related to increased safety and an improved quality of living for the patient. This factor is the inclusion of the institution in decision making with respect to therapeutic goals and methods. Institutional participation may help in uniting the divergent attitudes of the patient, the family and the attending physician. Firm control of the clinical management of the patient must always rest with the attending physician, but a beneficial contribution can be expected from other professional sources within the health care facility when they possess the necessary skills to become involved in decision making.