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At least 1,279 records · Page 71Linked to original sources
PubMed1992

Empirical approach to psychopharmacology for institutionalized individuals with severe or profound mental retardation.

There is at this time no conceptual model of psychopharmacology for individuals with severe or profound mental retardation who exhibit behavior disorders that unifies this area of psychopharmacology with general psychiatry practice while addressing the unique aspects of this population. The following article presents a 6-step program of diagnostic inquiry and treatment strategy that allows alternate etiological hypotheses to be tested in a clinical practice framework. This format unifies psychopharmacy practice in mental retardation with psychopharmacy practice in general psychiatry.

Behavior Therapy↗
PubMed2003

An amantadine hydrochloride dosing program adjusted for renal function during an influenza outbreak in elderly institutionalized patients.

OBJECTIVE: We tested the hypothesis that individualized dosing of amantadine hydrochloride, based upon a patient's creatinine clearance, would maintain efficacy against influenza A infection while reducing adverse reactions to the drug. DESIGN: A prospective cohort study PARTICIPANTS: Residents of two nursing homes with a total population of 301 individuals INTERVENTION: Amantadine hydrochloride was administered prophylactically subsequent to a confirmed influenza A outbreak. The dose was individualized based upon the resident's calculated creatinine clearance. RESULTS: The concentration of amantadine hydrochloride in the circulation at steady-state in patients who had doses adjusted for their estimated creatinine clearance was not different by nursing home or by sex of the resident. The mean concentration was within the 95% CI for the target concentration of 1.6 micromol/L. Side effects were modest and did not require discontinuation of amantadine hydrochloride therapy. Only the presence of concurrent influenza-like illness was significantly associated with adverse events during amantadine hydrochloride therapy. CONCLUSIONS: Adjustment of doses for estimated creatinine clearance is feasible in a long term care facility when amantadine hydrochloride is indicated for influenza A prophylaxis. These data form the basis for a definitive study of amantadine hydrochloride efficacy in patients with reduced renal function. Concurrent influenza-like illness is likely to confound attempts to associate adverse reactions to the administration of amantadine hydrochloride therapy.

Aged↗
PubMedDate not supplied

[Urinary tract infection in institutionalized elderly patients. Incidence of bacterial resistance and risk factors].

INTRODUCTION: The goal of the present work was to study urinary tract infections (UTI) in a sociosanitary center in order to characterize etiology, define sensitivity profiles, and study associations between these profiles and various clinical parameters. MATERIAL AND METHODS: A prospective study of all urinary tract infections at the caring unit of a geriatric sociosanitary center was carried out. Antibiograms were performed on all patients in which a UTI was suspected, and the association between the isolated organism or E. coli resistance with various clinical parameters (gender, bed confinement, recurrence, incontinence, neural impairment, basic daily life activities and drug use) was studied using a multivariate logistic regression analysis. RESULTS: Escherichia coli and Proteus mirabilis are the most commonly isolated organisms (51% and 15%, respectively). The former is associated with bed confinement and the female gender. The latter shows an inverse relation with recurrence in 90 days. Resistance to the antibiotics studied correlates with a number of clinical parameters, although associations vary for each antimicrobial agent. Previous use of antibiotics and recurrence of infection have no influence on resistance. DISCUSSION: Geriatric patients' characteristics may well account for some of the results encountered. However, the development of resistance in the center may be related to spreading from direct contact between patients. The relationship between resistance and drug use may be affected by the external administration, rather than in-center administration, of drugs.

Aged↗
PubMed2004

[Accidental falls among institutionalized elderly. Assessment of risks and interventions].

There is an extensive known bibliographic file which lists a multitude of risk factors in falls by the elderly in nursing homes; these include postural hypertension, walking and balance alterations, muscular weakness, cognitive and functional alterations, visual problems, etc. There is also a long list of manners to evaluate these risks and of interventions available for their treatment. This quantity of information inhibits the establishment of an effective clinical practice because it is impossible to try to identify or intervene in all of them. The objective of this article is to identify the most frequently described risk factors in the bibliographical review which the author carried out, to establish an effective form of identifying them and an efficient manner of intervention for them.

Accidental Falls↗
PubMed1992

Specialized treatment for behavior problems of institutionalized persons with mental retardation.

The extent of use and effectiveness of special treatment options (in-house behavior shaping units, specialized outside referral agencies, and mobile intensive treatment teams) in dealing with behavior problems of persons with mental retardation was determined. A survey was completed by 144 institutions throughout the United States; 86% of all facilities recognized a need for special treatment options to deal with clients who had severe behavior problems. Sixty-eight percent of the institutions had presently or in the recent past used at least one of the three treatment options. Comparisons of these options in terms of perceived effectiveness, length of intervention, and type of problem addressed were reported.

Affective Symptoms↗