Biomedical subjects
I Füsgen
Publications and source records attributed to I Füsgen.
[Attitude of residential patients toward the old age home and nursing home].
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[The attitude of stationary hospital patients towards the old people home and the nursing home (author's transl)].
Changes in our health and hospital policy towards shorter stays in hospital as well as changes in our social and family structures have led to a lot of problems in geriatrics. It is complicated to insure a necessary continuing home-treatment or a supply of daily necessities which are often necessary with advancing age after acute sicknesses. This has resulted in that many of the old peoples' or nursing home places are filled directly from the hospital. During investigations of 496 patients of an internal clinic we found that a rather high number of geriatric patients accepted a change into an old peoples or nursing home in contrast to investigations conducted outside the clinic. But the hospital patients complained about the same points in these institutions as the non-hospitalized. Therefore hospital personnel (doctors, sisters, nurses, therapeuts and social workers) ought to try all possibilities for rehabilitation inside and outside the usual stationary institutions (Reha-clinic, day-clinic) to insure the reintegration of old people in familiar or neighbourly surroundings. If this is not possible, the patients should be given enough time and opportunity to adjust themselves to the new life situation and to make independent decisions.
[An alternative in the therapy of primary hyperlipemias: etofibrate in depot preparations].
In a randomised blind study with 404 patients 1 capsule Etofibrate per day (500 mg) in sustained release dosage form was tested in comparison to other lipid-lowering drugs. The trial extended to eight weeks and was performed in eight clinics and in four practices for internal medicine. Serum-cholesterol and serum-triglycerides were controlled at the beginning and at the end of the observation period. The result was a significant decrease of the cholesterol-level up to 22% and a decrease of the triglyceride-level up to 43%. Also the patients pretreated with other drugs showed a furthermore improvement of the former therapy. Side effects were very rare and it was never necessary to stop the treatment.
How much sense is there in an attempt to resuscitate an aged person?
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[Behaviour of oxytetracycline and doxycycline serum levels under forced diuresis in severe bromcarbamide intoxication (author's transl)].
A dose of 500 or 1000 ml respectively was infused at hourly intervals over 12 or 24 hours respectively, using a standardised infusion schedule. It was found that this enormous increase in renal function did not cause any changes in the behaviour of the serum levels of oxytetracycline and doxycycline as compared to normal renal excretion. This result comes hardly as a surprise in the case of doxycycline due to its high degree of protein binding, it is, however, unexpected for oxytetracycline.
[Dependence of diverticulosis on age (author's transl)].
The diverticulosis of the gastrointestinal tract is a widespread senile disease. The dependence of the diverticulosis on age is investigated on the basis of 1 000 proven cases of this disease. The importance of the anatomicomorphological lesions of the organs at old age as its cause is pointed out. The males seem to be affected by the diverticulosis somewhat more than the females, whereas its percental manifestation in the different organs is about equal for both sexes. It prevails in the colon with 48.4% and in the duodenum with 35.4% of all cases of organ diverticulosis. The existence of constitutional associations with other diseases, such as diabetes mellitus, is discussed. Finally, the therapeutic problems of the diverticulitis and their dependence on age are examined.
[Age and time of hospitalization (author's transl)].
A reduction of the time of hospitalization has been repeatedly considered as a cost-saving possibility in the projects of reforming the hospital system. The time of hospitalization of older patients is longer than that of younger patients. Every plan to reduce it fails for lack of flanking institutions, such as geriatric hospitals, nursing homes, etc. However, all age groups include a small number of patients staying in hospital for long periods of time and taking therfore a disproportionately large share in the nursing day total. This fact is proved by statistic data on 11,875 internal cases admitted to the Nuremberg hospitals. The transformation of the complex acute-case hospital into a graded ward system could create a possibility of accommodating, and attending to, this small group of people in better medical conditions and on better financial terms.
Immunglobuline and drug intoxication.
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[Chronic geriatric patient in the hospital].
The cost explosion in the health system, especially in the hospital field, and the prolongation of life, i.e. the increase of the proportion of old people in the total population, oblige us to ask the question as to the part of geriatric patients in the present and future hospital treatment. By means of statistically relevant material, i.e. 25,342 female and 20,189 male in-patients in the Municipal Hospitals Nuremberg during the year 1974, compared with investigations of the year 1964, the growing significance of the geriatric patients for the total health system is demonstrated. Particular interest is paid to the old chronically ill persons, as is shown in an estimate of the internal in-patients. 50% of the internal in-patients are chronically ill persons. The present structure of hospitals is by no means complying with this situation. As an improvement, a ward system with different aims instead of the one complex acute hospital is presented. Apart from the existing acute stations there should be provided geriatric rehabilitation wards, social stations and day-hospitals. Humanitarian and financial advantages to be expected of these new wards are outlined. Particular emphasis is given to the active rehabilitation in the sense of a comprising social-medical help.
[Phospholipid metabolism and function of the mammalian brain in vivo. I. Catabolic changes of phospholipids in different parts of the rabbit brain during ischemia].
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[Lipid metabolism of the rabbit CNS during ischemia].
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[Geriatrics in the acute care hospital].
Since 1985, a graded system of medical care has served as a model at the III. Medical Clinic, Antonius hospital, Velbert-Neviges, FRG; Geriatric I (diagnostic, therapeutic, and intensive medicine), Geriatric II (therapy unit), and Geriatric III (day clinic) have not only reflected diagnostic and therapeutic improvements but they have also changed daily hospital operational requirements. Because of the structural adjustment of the hospital geriatric patients receive better care and patient-care costs are reduced.
[Combination treatment of insulin dependent elderly diabetics (type II diabetes) with the sulfonylurea compound glibenclamide].
About 20 per cent of our patients between sixty and eighty years suffer from maturity onset diabetes including many subjects with an insulin requiring form. Beside cases of secondary failure were those with increased insulin resistance. In order to improve low compliance, a clear therapy is desirable. Therefore a combination of sulfonylurea with insulin is suitable instead of a repeated insulin-delivery by day. This way of treatment is known since the late fifties and its application increases in the last years. These results suggest that a combination with glibenclamide leads to a decrease of insulin-requirement. This is true both for secondary failure and difficult insulin monotherapy. More than 80 per cent of those patients who needed a twice by day insulin injection now do with only one delivery. The course of daily blood sugar profile is clearly smoothed.
[Oral antidiabetics of the sulfonylurea group and their problems in therapy].
By the abolition of biguanids as oral antidiabetics the importance of derivatives of sulfonylcarbamids became prominent in the treatment of diabetic elderly patients. Because of the properties of that group, there are a number of problems by the therapy with these derivatives. There is the mostly existing multimorbidity in geriatric patients with the risk of incompatibilities of drugs in cause of multitherapy and there is the influence of morbid states on the pharmacokinetics. Some of the various questions will be shortly described in this article. There are then given also practical advices for the relations with the derivatives of sulfonylcarbamids in treating diabetic patients.
[Identification of functional deficits in the acute hospital by geriatric assessment].
Functional deficits of elderly patients are often not recognized during routine treatment in acute hospital care. In Germany, there are only limited experiences with the use of standardized assessment-scales in this health care setting. In this study, 112 patients were recruited for a very broad geriatric assessment focused on methodological and practical questions. There were 38.8% with deficits in the ADL and 12.6% with depressive symptoms. Many patients showed low motivational factors such as energy, efficacy and will. Geriatric syndromes such as malnutrition were also very common. In general, many patients in acute care hospitals have functional deficits which are not recognized by the physicians. For many patients, short instruments are sufficient for screening purposes. The effectiveness of a complete geriatric assessment depends mostly on the use of good selection criteria.