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Biomedical subjects

C I Gryfe

Publications and source records attributed to C I Gryfe.

18 recordsLinked to original sources
PubMed1982

The relationship of postural sway in standing to the incidence of falls in geriatric subjects.

A double-blind study was undertaken to determine the relationship (if one exits) between the extent of postural sway in standing of individual elderly subjects and their frequency of falling. A total of 205 subjects were studied; their average age was 81.8 years. Thirty per cent of the men, and 46% of the women, had one or more falls; the proportion of all subjects with one or more falls was 42%. The average speed of sway was significantly greater (P less than 0.05) for those who fell one or more times in a year than for those who did not fall. In this group of institutionalized elderly, there was no sex-related difference in the mean speed of sway; moreover, no age-related trend was demonstrated by the regression of mean speed upon age for all subjects. The mean speed of sway even for the non-fallers was found to be greater than that measured in a sample of non-institutional elderly subjects studied in the past. Thus, mean speed of postural sway was found to be only of statistical value for determining the risk of falling among these institutionalized elderly. We found postural sway to be an indicator of a tendency to fall, but the difference was less than might have been expected. No trend of increasing postural sway correlating with the increased frequency of falls was found.

Accidents↗
PubMed1982

Unnecessary diuretic therapy in the elderly.

The possible beneficial or adverse effects of long-term diuretic use in the elderly were evaluated in 60 males (mean age 80.0 years) and 17 females (mean age 84.3 years). All subjects were found to have no obvious need for diuretics when initially assessed and were not receiving concurrent digoxin therapy. Residents were randomly allocated to placebo or active groups with stratification for prior hypertension or congestive heart failure (CHF) and they were followed for one year in a double-blind design. Mean BP, heart rate and weight at one year were similar to baseline values in both groups. Six active and two placebo subjects developed CHF and two other placebo subjects had a return of BP to hypertensive levels. Serum creatinine, cholesterol, potassium and BUN were significantly improved at one year in the placebo group. Chronic diuretic use did not alter appreciably the occurrence of CHF or hypertension in this elderly population and may not be necessary.

Aged↗
PubMed1982

An evaluation of falls, syncope, and dizziness by prolonged ambulatory cardiographic monitoring in a geriatric institutional setting.

Fifty-nine patients living in a geriatric residential setting underwent prolonged ambulatory cardiographic monitoring with the Holter monitor (AHM) as part of an investigation of falls, dizziness, and syncope. In 16 instances, cardiac arrhythmias were a contributing factor; in 12, the diagnostic AHM recordings were associated with unrevealing standard electrocardiographic (ECG) tracings. In 12 patients who had fallen, cardiac arrhythmias played a contributing role, but in only two of these cases was the ECG diagnostic. The value of the AHM for use in managing elderly patients, whose cardiac complaints may be vague, and especially in managing those who have sustained falls, is emphasized.

Aged↗
PubMed1982

Testing your older patient's thyroid function.

Thyroid disease cannot be diagnosed through any single test. Normal aging does affect the values of some test parameters in the elderly. When interpreting laboratory test results in the elderly, careful consideration should be given to gender, concurrent acute or chronic illness, nutritional and mental status, as well as possible recent administration of iodinated radiocontrast media and drug therapy. When these factors have been excluded and preliminary routine thyroid function are abnormal or marginally suspect, the usual standards for younger adults, slightly modified, should suffice for diagnosing both hypo-and hyperthyroidism. Patients with complications may require special measurements of serum FT4 and FT3 levels as well as the TSH and T3 response to TRH. These tests will provide additional supportive diagnostic assistance.

Adult↗
PubMed1979

Reasonable expectations in geriatric rehabilitation.

Rehabilitation and traditional medical treatment have different primary orientations within philosophic, operational and time frameworks. As a result, traditionally trained physicians often do not understand the possible benefits of energetic rehabilitation efforts in the elderly. Accurate assessment includes differentiating the irreversible handicaps of normal aging from the disabilities of remediable disease. Such assessment is the essential prerequisite of effective rehabilitation; together with positive attitudes and continuous reevaluation, the likelihood of a successful outcome is greatly enhanced.

Aged↗
PubMed1977

A longitudinal study of falls in an elderly population: I. Incidence and morbidity.

Falls among the elderly, although associated with substantial morbidity and mortality, have not been previously the subject of a longitudinal study. This five-year prospective study of an active ambulatory institutionalized population over 65 years of age, revealed an annual fall rate of 668 incidents per 1000, with a rising frequency in successive age groups after age 75. Forty-five per cent of all subjects suffered at least one fall during the study period. Women had a higher fall rate in all age groups and the severity of their injuries appeared to increase with age. Injuries severe enough to be brought ordinarily to the immediate attention of a physician occurred in 17.5% of falls. Among subjects who ultimately died after suffering many falls, there appeared in some to be a 'clustering' of falls prior to death.

Accidents↗
PubMed1977

A longitudinal study of falls in an elderly population II. Some circumstances of falling.

Some of the circumstances surrounding 651 falls which occurred in elderly residents of a standard care unit in a home for the aged are described. Falls occurred as frequently at night as during the day-time, and there was no significant variation by day of the week or by season. The great majority occurred inside the home, mainly in the resident's own suite. The subsequent morbidity varied according to the place of occurrence, the percentage of severe injuries being lower in falls occurring in toilets and elevators, and to a lesser extent hallways, compared with those occurring in other inside locations and outside. The commonest activity associated with falling was going to or returning from the toilet. However, one-third of day-time falls occurred when the resident was sitting in a chair. The severity of injury did not vary with associated activity. Possible explanations for these findings are discussed, particularly from the preventive viewpoint.

Accidents↗
PubMed1973

Bone loss in primary hyperparathyroidism.

X-ray images of the second metacarpals of 153 hyperparathyroid subjects were measured and an index of cortical bone was derived. Compared with normal standards, the cortical index was above the 50th percentile in only 17.8% of women and 13.6% of men. Comparing the mean index of hyperparathyroid subjects with the normal indices of each 10-year age group, it was found that the differences were highly significant and were the same for all age groups in each sex. In particular, the difference was not greater between older female hyperparathyroid and normal subjects than it was between younger female hyperparathyroid and normal subjects. It appears that bone involvement in the form of excessive cortical thinning is extremely common in hyperparathyroidism and that sex and age do not further influence its incidence or severity.

Adolescent↗
PubMed1969

A standardized test of renal concentrating capacity in adults with some results in essential hypertension.

THREE GROUPS OF PATIENTS: A with normal glomerular filtration rate, B with moderate and C with advanced renal damage, were dehydrated and fasted for 30 hours. At regular intervals measurements were taken of urine osmolality, urine specific gravity and serum osmolality. The time required to reach maximum urine osmolality varies with the degree of dehydration and inversely with the severity of kidney damage. In patients with normal glomerular filtration rate, maximum urine osmolality is not attained by 30 hours of dehydration. Thus, for shorter periods, all "normal ranges" of concentrating capacity must be related to specific durations of dehydration. Carefully measured urine specific gravities parallel urine osmolalities closely, especially when proteinuria and glucosuria are absent. The measurement of U/P osmolality ratio offers no clinical advantage in the assessment of renal concentration capacity over the measurement of urine osmolality alone. In Group A, hypertensives achieved higher urine concentrations than did the nonhypertensives under identical test conditions. A normal range for renal concentrating capacity has been presented.

Adolescent↗
PubMedDate not supplied

The noisy elderly patient: prevalence, assessment, and response to the antidepressant doxepin.

To measure the prevalence of noisy behavior as a nursing problem, a survey of head nurses was done in a chronic care hospital to identify patients whose vocalizing was frequently disturbing to other patients, staff, or visitors. We found 17 patients among the total of 154. Subsequently, the medical records of 13 surviving subjects were reviewed more exhaustively, and 11 were described as disruptive, usually when they were left alone. Of these "lonely" patients, eight had a previously documented diagnosis of depression. All were demented. Antipsychotic medication had previously been given to all 11 "lonely" patients, but had failed to control their disruptive behavior. Empirically, six patients were treated with doxepin, and in five, all with a history of previous depression, agitation and noisiness diminished. These observations suggest that the prevalence rate of disturbingly noisy behavior among long-term institutionalized elderly patients is about 11% and that the disturbingly noisy patient is often demonstrating depression in conjunction with dementia.

Aged↗