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H Kallman

Publications and source records attributed to H Kallman.

7 recordsLinked to original sources
PubMed1989

Mental status assessment in the elderly.

Mental status testing is an essential element of evaluating elderly patients. A structured examination often helps identify the etiology of symptoms that are responsible for changes in patient behavior, that lead to family stress, but that are otherwise not indicative of cognitive dysfunction. A structured mental status examination is also helpful in distinguishing cognitive changes caused by dementia, delirium, and depression. This article examines the steps in mental status assessment and the commonly used assessment instruments. The experience of a family medicine ambulatory multidisciplinary evaluation service in mental status testing is discussed.

Aged↗
PubMed1987

The aging eye. A family physician discusses some inevitable changes and suggests methods for dealing with them.

The aging eye undergoes a variety of structural and physiologic changes that can impair vision and cause functional disability. Among the changes are backward displacement of the eye into the orbit, thickening and yellowing of the lens, decrease in pupil size, increase in laxity of the lids, and accumulation of waste products in the retina. The specific diseases of the eye that occur with aging include macular degeneration, cataracts, glaucoma, diabetic retinopathy, and sudden vision loss. Preventive care both in old age and earlier in life may help forestall ocular changes and the subsequent morbidity and mortality they cause. Environmental changes to accommodate visual change can be important in accident prevention and in improved functioning and quality of life.

Aged↗
PubMed1987

Digitalis for congestive heart disease in the elderly. A family practice view of the efficacy of long-term therapy.

The long-term efficacy of digoxin maintenance therapy must be determined individually for patients with normal sinus rhythm who have a history of congestive heart failure but no remaining signs or symptoms. Predictive factors for successful discontinuation of the agent in the elderly include normal mental status (including absence of depression), ability to adequately perform activities of daily living, general feelings of well-being, absence of multiple organic disease, absence of multiple drug use, and no evidence of existing congestive heart failure or atrial fibrillation. Our findings indicate that physicians and patients need to reexamine the concept that congestive heart failure is necessarily a chronic disease. Certainly, evidence exists that continuing digitalis therapy indefinitely is inappropriate and may be harmful. Further investigation may prove that congestive heart failure in the elderly, like pneumonia, is a common acute occurrence and in many cases not a chronic state for which patients are destined to receive medication indefinitely. We hope that the findings from our small sample will stimulate other investigators to question the indiscriminate long-term use of digitalis in the elderly.

Aged↗
PubMed1985

Protecting your elderly patient from winter's cold.

A recent study in England indicated that people prone to orthostatic hypotension are at increased risk of developing accidental hypothermia. Thus, a history of orthostatic hypotension might be prudently viewed as a risk factor. Symptoms are insidious. Since the sensation of cold seems to disappear after the core temperature falls below 95 degrees F, the recognition of cold is transient at best, and often minimal, once the patient is in the hypothermia range.

Aged↗
PubMed1983

Constipation in the elderly.

Constipation is a frequent complaint among the elderly. Misconceptions about normal function and insistence on a daily bowel movement may be factors which have led to the overuse of laxatives. Evidence of gastrointestinal blood loss, a recent change in bowel elimination pattern or complications of constipation are indications for evaluation by complete laboratory, endoscopic and radiographic procedures. Natural fiber, careful attention to diet and fluid intake, regard for toilet needs and encouragement of activity are recommended as effective means for correcting constipation.

Adult↗
PubMed1967

The primary goal.

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Optometry↗