Geriatric Medicine: Problems And Practice - Brossura

Brossura

ISBN 10: 1447116488 ISBN 13: 9781447116486

Casa editrice: Springer, 2014

Riassunto

Medical care of the elderly today challenges the practitioner to break away from narrow diagnostic labelling and view the whole picture of disease in old age. In an excellent problem-oriented approach, Geriatric Medicine offers a complete overview for practitioners. The main portion of the text deals with the common diseases of old age; important aspects such as physiology, demography, and health care delivery are discussed in separate chapters. Social and legal aspects in the major English-speaking countries receive adequate attention. All of the contributors have at some time been connected with the University Department of Geriatric Medicine in Cardiff and attest to a positive and dynamic approach in geriatric medicine, an approach that has international validity and relevance.

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Contenuti:

Section I. Ageing: An Overview.- 1 The Physiology of Ageing.- Cardiovascular Function.- Cardiac output; Blood pressure.- Respiratory Function.- Routine tests of lung function; Closing volumes; Defence mechanisms and the lung; Central control of respiration.- Renal Function.- Gastrointestinal Function.- Motility; Absorption; Liver; Exocrine pancreatic function; Glucose tolerance.- The Nervous System and Ageing.- The special senses; Cerebral function; Sleep; Peripheral nervous system.- Bone Mass.- Body Temperature Control.- Combating Physiological Decline.- 2 Demography and Epidemiology of Old Age.- Demography.- The Current Population Structure and Its Determinants.- Future trends.- The Distribution of Old People.- Future trends.- The Elderly Within the Community.- Epidemiology.- Population data; Mortality data; Morbidity data; Mortality; Future trends.- Section II. Clinical Problems in the Elderly.- 3 Headache and Facial Pain.- Headache.- Tension headache; “Vascular headaches”; Meningeal irritation; Raised intracranial pressure; Metabolic vasodilation; Drugs and toxins; Other causes.- Facial Pain.- Herpes zoster;Post-herpetic neuralgia; Trigeminal neuralgia; Glossopharyngeal neuralgia; Atypical facial neuralgia; Cluster headache; Tumours; Referred pain.- Clinical Evaluation.- Investigation.- 4 Chest Pain.- Central Chest Pain.- Myocardial ischaemia; Myocardial infarction; Pericarditis; Mitral valve prolapse; Acute aortic dissection; Aneurysm of the thoracic aorta; Pulmonary embolus; Oesophageal disorders; Mediastinal tumours; Acute mediastinitus Musculoskeletal disorders; Manubriosternal and xiphoid process syndromes; Psychogenic causes; Abdominal disorders.- Lateral Chest Pain.- Herpes zoster; Cervical spondylosis; Costochondritis; Trauma; Disorders of lungs and pleura; Spontaneous pneumothora.- Clinical Evaluation.- Management.- 5 Abdominal Pain.- Perception of Abdominal Pain.- Visceral pain; Parietal pain.- Acute Abdominal Pain.- Distension of a viscus; Intra-abdominal sepsis; Vascular disease; Miscellaneous causes.- Chronic Abdominal Pain.- Upper gastrointestinal tract disorders; Mesenteric ischaemia; Lower gastrointestinal disorders; Neuromuscular disorders; Miscellaneous causes.- Clinical Evaluation.- Further Investigation.- Blood count and blood viscosity; Blood biochemistry; Radiology; Ultrasonography and endoscopy.- Management.- 6 Musculoskeletal Pain.- Joint Disorders.- Osteoarthritis; Rheumatoid disease; Gout; Pseudogout; Seronegative spondyloarthritides; Infective arthritis; Haemarthrosis; Hypertrophic pulmonary osteoarthropathy.- Soft Tissue Pain.- Polymyalgia rheumatica; Frozen shoulder.- Bone Pain.- Paget’s disease; Osteopenia; Osteomalacia; Bone tumours.- Clinical Evaluation.- Management.- Pain relief; Surgery; Rest and exercise; Aids; Counselling.- 7 Dyspnoea.- Lung Disease.- Pneumonia; Lung collapse; Pulmonary fibrosis; Pulmonary oedema; Pulmonary embolism.- Airways Disease.- Chronic obstructive airways disease; Bronchial asthma.- Disease of the Pleura.- Pleural effusions; Spontaneous pneumothora.- Chest Wall Disease.- Bone and joint disorders; Neuromuscular disorders.- Psychogenic Factors.- Anxiety.- Metabolic Acidosis.- Clinical Evaluation.- Further Investigation.- Chest radiology; Arterial blood gases; Respiratory function tests.- Management.- Oxygen therapy.- 8 Hypertension.- Complication of Hypertension.- Stroke; Myocardial infarction; Heart failure; Aortic aneurysm; Malignant phase hypertension; Renal disease.- Clinical Evaluation.- Further Investigation.- Management.- Non-drug treatment; Drug treatment.- 9 Lower Limb Oedema.- Anatomy and Physiology.- Local Disorders.- Dependent oedema; Vascular disorders; Popliteal (Baker’s) cyst; Gastrocnemius rupture; Lymphoedema; Lipoedema; Infection.- Systemic Disorders.- Congestive cardiac failure; Hypoproteinaemic states; Thyroid dysfunction; Drugs; Exposure to extremes of temperature.- Clinical Evaluation.- Management.- 10 Weight Loss.- Decreased Ingestion of Food.- Decreased appetite; Mouth disease; Neuromuscular disorders of the pharynx and oesophagus; Structural lesions of thepharnyx and oesophagus; Nausea and vomiting; General debility; Poverty, ignorance and isolation.- Decreased Digestion and Absorption of Ingested Food.- Pancreatic disease; Coeliac disease; Bacterial overgrowth; Inflammatory bowel disease; Chronic mesenteric ischaemia; Short bowel syndrome; Cardiac failure; Drugs.- Increased Energy Requirements.- Malignant disease; Infective illnesses; Hyperthyroidism; Diabetes mellitus.- Clinical Evaluation.- Management of Weight Loss.- Oral supplementation; Enteral nutrition; Parenteral nutrition; Other measures.- 11 Constipation and Diarrhoea.- Constipation.- Motility disorders; Intestinal obstruction; Colorectal carcinoma; Endocrine disorders; Neurological disorders; Depression; Drugs.- Diarrhoea.- Infective diarrhoea; Irritable bowel syndrome; Malabsorption; Diverticular disease; Inflammatory bowel disease; Faecal impaction with overflow; Villous adenoma; Drugs; Endocrine disorders.- Clinical Evaluation.- Management.- Constipation; Diarrhoea.- 12 Incontinence.- Urinary Incontinence.- Bladder function.- Non-neurological Disorders.- Faecal impaction; Drug therapy; Impaired mobility; Urinary tract infection; Atrophic urethritis; Urethral obstruction; Pelvic floor incompetence; Psychological disorders; Endocrine disorders.- Neurological Disorders.- Uninhibited neurogenic bladder; Reflex neurogenic bladder; Atonic bladder; Autonomous neurogenic bladder.- Clinical Assessment.- Further Evaluation.- Charting; Cystometry.- Management.- Drugs; Incontinence aids.- Faecal Incontinence.- Faecal impaction; Neurogenic incontinence; Evaluation and management.- 13 Visual Impairment.- Clinical Evaluation.- Sudden Loss of Vision in the White Eye.- Retinal detachment; Retinal vein occlusion; Retinal artery occlusion; Ischaemic optic neuropathy; Vitreous haemorrhage.- Gradual Loss of Vision in the White Eye.- Cataract; Maculopathy; Chronic simple glaucoma.- Visual Impairment in the Red Eye.- Angle closure glaucoma; Acute iritis.- Diabetic Eye Disease.- Management of Visual Impairment.- Legal Aspects of Blindness in the Elderly.- Social Aspects of Blindness in the Elderly.- 14 Hearing Problems.- Conductive Hearing Loss.- Chronic otitis media; Otosclerosis; Bone disorders.- Sensorineural Hearing Loss.- Genetic disorders; Traumatic hearing loss; Ototoxic damage; Vascular disorders; Metabolic disorders; Neoplasia; Ménière’s disorder.- Clinical Evaluation.- Further Investigation.- Management.- Evaluation; Remediation.- 15 Impaired Mobility.- Locomotor Disorders.- Foot problems; Bone disorders; Joint disorders; Muscular disorders.- Neurological Disorders.- Cerebrovascular disease; Parkinson’s disease; Cervical myelopathy; Motor neurone disease; Peripheral neuropathy; Multiple sclerosis; Other neurological disorders.- Non-locomotor and Non-neurological Disorders.- Cardio-respiratory diseases; Impaired vision and hearing; Psychiatric disorders; Falls; Iatrogenic disease; Generalised weakness; Pain; Bedrest; Over protection.- Complications of Immobility.- Clinical Evaluation.- Management.- Rehabilitation; Community services; Financial support.- 16 Foot Problems.- Major Acquired Disorders.- Arthritis; Diabetes mellitus; Vascular disease; Callus and corns; Ulcers; Nails; Bursitis; Scarring; Fissures.- Clinical Evaluation.- Management.- Foot care; Footwear; Supports and appliances.- 17 Falls and Syncope.- Neurological Disorders.- Physiological age-related changes; Cerebrovascular disease; Space-occupying lesions; Parkinson’s disease; Dementia; Epilepsy; Transient ischaemic attacks; Drop attacks; Visual problems; Vestibular problems; Peripheral neuropathy; Cervical spondylosis.- Cardiovascular Problems.- Cardiac syncope; Carotid sinus hypersensitivity; Postural hypotension; Drugs.- Musculo-skeletal Problems.- Clinical Evaluation.- Further Investigation.- Complications of Falls.- Loss of confidence; Fractures; Subdural haematomas; Other complications.- Management.- Accidental Falls and their Prevention.- In the home; In hospital.- 18 Confusion.- Acute Confusion.- Causes; Clinical features; Diagnosis; Management.- Chronic Confusion.- Diagnosis; Alzheimer’s disease; Vascular dementia; Other causes; Management.- 19 Depression.- Suicide.- Aetiology.- Genetic factors; Life events; Chronic illness and disability; Drugs; Pre-morbid personality; Chronic stress; The ageing brain.- Clinical Evaluation.- Depressive pseudo-dementia; Hospitalised depressives.- Management.- Antidepressants; Electroconvulsive therapy; General supportive measures.- Prognosis.- 20 Anaemia.- Anaemia; Relative anaemia; Pre-anaemia; Incidence.- Common Forms of Anaemia.- Iron deficiency; Folic acid and B12 deficiency; Secondary anaemias; Refractory anaemias; Haemolytic anaemias.- Clinical Evaluation.- Further Investigation.- Management.- Transfusion; Iron supplementation; Vitamin B12 and folic acid supplementation.- 21 Vomiting and Haematemesis.- Gastrointestinal Causes of Vomiting.- Oesophagitis; Benign oesophageal stricture and oesophageal tumour; Peptic ulceration; Gastric outlet obstruction; Surgical emergencies.- Non-gastrointestinal Causes of Vomiting.- Clinical Evaluation.- Further Investigation.- Management.- Haematemesis.- Clinical evaluation; Further investigation; Management.- 22 Accidental Hypothermia.- Factors Predisposing to Hypothermia.- Physiological changes; Environmental factors; Pathological conditions.- Clinical Evaluation.- Cardiovascular system; Respiratory system; Renal system; Central nervous system; Gastrointestinal tract.- Laboratory Abnormalities.- Management.- Temperature stabilisation; Circulatory support; Transportation; Rewarming; Supportive measures; Laboratory investigation.- Prevention.- Diet; Conservation of body heat; Insulation; Money matters.- 23 Pruritus.- Dermatological Disorders.- Xerosis; Lichen simplex chronicus; Anogenitalpruritus; Dermatitis; Dermatitis herpetiformis; Urticaria; Infestation; Cutaneous neoplasms.- Systemic Disorders.- Hepatobiliary disease; Renal disease; Haematological disorders; Endocrine disorders; Malignant disease; Drugs; Psychogenic illness.- Clinical Evaluation.- Management.- Reduction of exacerbating factors and patient education; Physical methods; Symptomatic topical treatment; Systemic drug treatment.- Section III. Aspects of Medical Care in the Elderly.- 24 Drug Therapy.- Indications for Prescribing.- Practicalities of Drug Administration.- Determination of Dose and Dose Regime.- Absorption and bio-availability; Distribution; Metabolic biotransformation; Renal excretion; Drug sensitivity.- Assessing the Outcome.- Postural stability; Baroreceptor function; Thermoregulation; Maintenance of orientation; Pupillary autonomic responses; Neurological control of bladder and bowelfunction.- Conclusions.- 25 Rehabilitation.- The Rehabilitation Team.- The team leader; The doctor; Remedial therapists; Nursing staff; The patient.- The Rehabilitation Centre.- The Rehabilitation Process.- Assessment; Remediation; Discharge; After-care; Rehabilitation at home.- 26 Terminal Care.- Clinical Assessment.- Symptom Control.- Pain; Nausea and vomiting; Oral problems; Dysphagia; Squashed stomach syndrome; Gastrointestinal obstruction; Anorexia; Insomnia, anxiety and depression; Constipation; Dyspnoea.- Counselling.- Section IV. Delivery of Health Care to the Elderly.- 27 Geriatric Medicine and the Law.- The Law in the United Kingdom.- Compulsory Admission.- The National Assistance Act (1948) and National Assistance (Amendment) Act 1951; The Mental Health Act (1983); Guardianship.- Consent to Treatment.- Management of Property and Affairs.- Testamentary capacity; Agency and appointee; Power of attorney; Enduring power of attorney; The Court of Protection.- Medical Fitness to Drive.- The Law in Other Countries.- The Future.- 28 Supporting Old People in the Community.- Informal Carers.- Voluntary Bodies.- The Private Sector.- Statutory Bodies.- Health services; Social services.- Accommodation.- Financial Provision for the Elderly.- 29 Care of the Elderly in Other English-Speaking Countries.- Australia.- Canada.- New Zealand.- Republic of Ireland.- The United States.

Su questa edizione

• Editore: Springer
• Data di pubblicazione: 2014
• ISBN 10: 1447116488
• ISBN 13: 9781447116486
• Rilegatura: Copertina flessibile
• Numero di pagine: 404
• Redattore: Pathy M.S. John, Finucane Paul