Clinics in geriatric medicine
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Hip surgery is the most common major orthopedic procedure performed in the elderly. The indications are fracture and pain secondary to degenerative arthritis. Patients undergoing hip replacement for arthritis have excellent outcomes with decreased pain, increased mobility, and a low mortality. ⋯ Pressure ulcers, delirium, deep venous thrombosis, urinary retention and urinary tract infection, and cardiac events are the most frequent complications seen. These complications can be anticipated and prevented with careful preoperative assessment and post-operative prophylactic management. A team approach including the orthopedic surgeon, primary care physician, nursing staff, and physical therapists is essential for optimal outcome.
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Clin. Geriatr. Med. · May 1988
ReviewApproach to the diagnosis and management of musculoskeletal disease.
Musculoskeletal disease is not an inevitable consequence of aging. Complaints of musculoskeletal disease indicate disease. Differential diagnosis relies on clinical skills. Management is directed toward maintaining function.
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The most common forms of brain tumor in the elderly are metastasis, glioma, meningioma, pituitary adenoma, and acoustic neuroma. They produce a variety of neurologic symptoms and usually can be readily diagnosed by CT scan. ⋯ The prognosis of a patient with a brain tumor depends on the tumor's histology, its location, and the patient's ability to tolerate therapy. Early diagnosis is important for successful treatment.
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In order to approach infections in elderly patients with cancer, one must have an understanding of infections in normal elderly populations. This article approaches infections in elderly patients by an examination of host factors, presentation of various organisms, infections of various body sites, diagnosis, treatment, and prevention.
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Some of the considerations that go into resuscitation decision making and the withdrawal of life support are discussed. These considerations include: ethical principles (benevolence, autonomy, and informed consent); surrogate decision making (the principles of substituted judgment, patients' best interests, and reason); medical decisions concerning resuscitation; and guiding principles for the individual care giver.