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Biomedical subjects

J A de Fockert

Publications and source records attributed to J A de Fockert.

At least 19 recordsLinked to original sources
PubMed1989

[Urinary incontinence and senile dementia. The relationship between the severity of dementia and the potential for treatment of the urinary incontinence].

The occurrence of urinary incontinence was traced of 1077 patients, admitted to the geriatric department from 1978 through 1986 and was observed in 444 patients (41.3%), in women a little more frequent than in men (respectively 43.5% and 35.2%). In cases of people being psychiatrically ill incontinence was more frequent than in somatic cases. The percentages are respectively 45.1% and 38.0%. Among patients with dementia those SDAT did not show a higher prevalence of urinary incontinence than those with other types of dementia. Treatment (bladder-training, in 50% of the patients combined with medication) proved to be successful in 54.4% of all patients, for the group of somatically ill patients not significantly better than for the psychiatric patients (respectively 58% and 50.1%). Patients with SDAT showed better results (50% versus 32.1%) than cases of other types of dementia. The results of treatment in patients in the amnestic stage were 2.5 times better (65.9%) than in patients with more advanced stages of senile dementia (25.9%).

Activities of Daily Living↗
PubMed1987

[Clinical presentation of acute myocardial infarct in the elderly].

From the district Haarlem-Noord, 558 patients suffering from an acute myocardial infarction (AMI) were admitted in the years 1982 through 1985. Of these patients 62.9% was 65 years or older, 63.6% was male. The chance of getting an AMI was 8 times greater for the elderly than for younger people, which is in agreement with figures in the whole country. The most important feature--precordial pain--was less frequent in the elderly, i.e. 63.8% compared to 87% for younger people. However, the elderly suffered more from less specific symptoms as breathlessness, heartfailure, dizziness, syncope, neurological and psychiatric symptoms. The frequency of these symptoms varied from 4.5 to 30%. This is 2 to 5 times higher than for people younger than 65 years old. The mortality rate was 31% for people older than 65 years. This was significantly higher than the rate for younger patients (7.7%).

Acute Disease↗
PubMed1986

[Thyrotoxicosis in the very old, a changed disease picture].

The diversity of symptoms arising from thyreotoxicosis was investigated by means of the Wayne and New Castle diagnostic indices in 13 psychiatric and 14 mentally healthy old people as well as in 14 young people, all of whom clearly suffered from hyperthyroidism, according to the appropriate radiochemical indicators. Due to the absence of the usual ophthalmological and adrenergic symptomatology, the Wayne index (normal over 20) was found to be insufficient among all the old people (the mean scores for the two groups were 9.0 and 17.9 respectively). The New Castle index (normal over 40) showed a low normal value in the case of 12 of the 14 mentally healthy old people, and was too low in the mentally disturbed old people (averages 41.5 and 29). Certain typical characteristics were nonetheless observable within the limits of the psychiatric picture. For the present the mechanism of this shift in symptoms remains unexplained. The shift may theoretically have connections with the sharply reduced TRH concentration, or, more reasonably, with the decreased reactivity of adrenergic receptors in the elderly. Whether this explanation also suits for the findings in the psychiatric ill is far from certain. In cases of psychiatric or somatic problems of an undefined nature among very old people it would seem to be advisable to check the functioning of the thyroid in order to avoid the risk of missing the correct diagnosis, especially that of a reversible organic psychosyndrome.

Adolescent↗
PubMed1985

[Clinical geriatrics in the United Kingdom].

Great Britain is generally regarded as the cradle of clinical geriatrics and still deserves this reputation, even though under present conditions the integration of acute geriatric assessment, rehabilitation and long-term care in the hospital setting is far from satisfactory by Dutch standards, the more so as this means that modern nursing-home care does not get the chance to fully develop. A very positive aspect is the well-functioning of the geriatric chain of care, especially the links within and to the top level. The level of geriatric teaching in the universities and research in the clinical geriatric departments is certainly high in comparison to the Netherlands. An attempt is made to present a profile on the basis of impressions obtained during several working visits.

Day Care, Medical↗
PubMed1984

[Clinical geriatrics, quo vadis? Careful considerations of the future of a new specialty].

It is something of a rope-dancer's trick to try to indicate what future is to expect for a young and controversial specialism like clinical geriatrics. Even so, it is a challenge to those who are directly involved. In the expectations we have of geriatrics we deal not only with the geriatric department of a general hospital (GAAZ), the clinical geriatrician's workshop, as such, but also with its place and functioning in the total chain of geriatric care. The most desirable distribution of clinical geriatricians and their departments is discussed; this is followed by a cautious quantitative prognosis. A different effort has been made to indicate how the policy of recognition of geriatricians and the existence of clinical geriatrics are closely interconnected. Within their curriculum the Universities are expected to see it as an educative and stimulating task for them to promote geriatrics in general and clinical geriatrics particularly.

Education, Medical, Graduate↗