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Biomedical subjects

K S Lachnit

Publications and source records attributed to K S Lachnit.

8 recordsLinked to original sources

[Albert Müller-Deham--an unjustly forgotten Austrian pioneer in geriatrics].

Albert Mueller-Deham played a role of great importance in the history of American and general geriatrics. He was born in 1881 in Vienna where he studied medicine. After graduation he was an intern, and later assistant professor at the First University Department of Medicine in Vienna. Among his teachers were such famous names as von Nothnagel, von Noorden und Wenckebach. In 1925 he was appointed chief of the medical department in the large, renowned "Versorgungsheim Lainz" in Vienna and became director of the geriatric research unit established by his initiative. With many scientific papers and his most important work, the textbook on geriatrics "Internal Medicine in Old Age" (in three languages) he became one of the pioneers of modern geriatrics. His main interest laid in the importance of the pathology of old age and its connection with clinical diseases. In 1938 he emigrated to the United States for politico-racial reasons and worked as attending physician at the Goldwater Memorial Hospital in New York. There he had the chance to continue his scientific work and pass on his vast experience to colleagues and students until his retirement from clinical practice in 1951. His new interests were philosophy and art, resulting in a book entitled "Human Relations and Power". Mueller-Deham died at the age of 90 in Santa Barbara, California. Albert Mueller-Deham deserves an important place in the history of medicine for recognizing, as one of the first in Austria, the characteristic features of diseases in old age as opposed to younger age groups. His clinical observations in the light of subsequent post-mortem analyses laid the foundation of modern geriatric medicine.

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[The efficacy of cytoplasmatic therapy in elderly patients].

It has been studied whether cytoplasmatic therapy with macromolecular substances can favourably influence symptoms of the progressive aging process in old patients. For this purpose a randomized double-blind study was carried out in a geriatric clinic. A marked and statistically significant improvement was observed in the patients after four weeks real treatment as compared with the placebo group, using as criteria the ECG, the frequency of cerebral symptoms and the result of psychological tests. Concomitant chemical and haematological laboratory controls did not indicate a difference between the two treatment groups.

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Midazolam in the treatment of sleep disorders in geriatric patients.

The use of hypnotics in the elderly must be approached with special care in view of possible changes in pharmacokinetic behaviour and drug interactions in older patients. In a randomized, double-blind study in a large geriatric department, midazolam was compared with the barbiturate combination Vesparax with regard to efficacy and safety. The comparison of the efficacy of the 2 hypnotics showed them to be almost identical in this respect. Side-effects, however, were more frequent with Vesparax. Furthermore, in the Vesparax group, unlike in the midazolam group, a troublesome cumulation of effect was observed, together with relatively frequent signs of hangover. It is concluded that, in appropriately titrated dosage, midazolam is an effective and well-tolerated hypnotic for use in the elderly.

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[Possibilities of rehabilitation in the geriatric hospital (author's transl)].

Rehabilitation is with medicine and nursing care an inseparable part of the modern geriatrics. In opposition to other medical subjects there is no certain direction. Generally joy of life, self-confidence and independence should be the aim of geriatric rehabilitation. In the geriatric hospital a particular classification has been proved: Rehabilitation with the most serious sick, reduced and bedridden aged patient and actual rehabilitation-generally and at special diseases. A special care of the rehabilitated patients after discharge from hospital has to be wished.

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[Modern geriatrics and the care for the aged in vienna (author's transl)].

All over the world there is an increase of the aged in this century. In Europe Austria occupies the second place in the percentage of people over 65 years. Therefrom results also an increase of the medical and psychosocial problems of the old age. Three sections of care for old people have developed: the open care at home, the homes for the aged and the institutional care in hospitals and nursing-homes. A new form is the day-hospital. Advantages and disadvantages are discussed. Finally a survey of the situation in Vienna is given, specially of the Viennese geriatric hospital in Lainz, which is the largest geriatric centre in Austria.

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[Significance of cardiac arrhythmias in the aged and their treatment with propafenone controlled by plasma level].

Every form of cardiac arrhythmia can complicate the existing cardiovascular and cerebrovascular changes in elderly people. A controlled clinical study was performed on 37 geriatric patients, aged 45-93 years (average 77.3 years), with supraventricular and ventricular premature beats (SVPB, VPB). The effect of propafenon on premature beats was tested in a 24-hour ECG monitoring: propafenon has a significant reducing influence on SVPB and VPB in elderly patients. More than 50% of all patients had these results with a daily dosage of 2 X 150 mg. In 40% the dosage had to be increased to 2 X 300 mg. There was a negative correlation between plasma levels and number of arrhythmias, i.e. high plasma levels were connected with lower arrhythmias. No laboratory findings were changed, no side effects were observed. Contrary to much higher doses in other studies the good results of our small doses can be explained by the different pharmacokinetics of old age. Bearing this fact in mind, propafenon can be valuable in the treatment of arrhythmias even in older patients.

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