RESUMO
Skin test reactivity and in vitro lymphocyte stimulation responses to varicella-zoster (VZ) were examined in a large normal population ranging in age from 6 months to 93 years. Warning of cellular immunity, as examined by skin delayed hypersensitivity, began at age 40 years. Skin test responses to phytohemagglutinin, however, remained positive into the eighth decade of life. In vitro lymphocyte stimulation responses to VZ were usually positive (stimulation index greater than or equal to 2.5) until age 60 years, after which time levels, as observed with nonimmune individuals, were often demonstrated. Antibody levels, as measured by fluorescent antibody to membrane antigen, remained positive into the ninth and tenth decades of life. This was especially so with a history of reactivation (zoster) VZ infections, while skin test and in vitro responses were rarely positive in those individuals. This cellular, as contrasted with humoral, immunity decreases with advancing age, which may account for a propensity to reactivation of VZ virus.
Assuntos
Herpesvirus Humano 3/imunologia , Adolescente , Adulto , Idoso , Envelhecimento , Anticorpos Antivirais/análise , Antígenos Virais/imunologia , Criança , Pré-Escolar , Humanos , Imunidade Celular , Lactente , Recém-Nascido , Linfócitos/imunologia , Pessoa de Meia-Idade , Fito-Hemaglutininas/imunologia , Testes CutâneosRESUMO
Psychiatric evaluation was performed routinely in 262 patients newly admitted to a Medical Geriatric Evaluation Unit (GEU). The study was conducted in a medical facility that provides excellent medical and surgical care for acute illnesses. The psychiatric disorders found far exceeded those one might expect in a comparable general population, and most were not recognized prior to the patient's transfer. For example, in the GEU, the incidence of organic brain syndrome was 65.3 percent, and of dysphoria-depression 31.3 percent. The data indicate a need to recognize psychiatric problems in order to ensure appropriate care, and suggest that medical care of the elderly with acute illness will be inadequate if it is based upon the approach used for younger populations. This situation apparently exists in most hospitals, including leading medical centers. The needs of the elderly with acute illnesses are quite different from those of younger patients. Recognition of factors that potentially influence outcomes and overall future health will meet public health's primary and secondary prevention goals.
Assuntos
Transtornos Mentais/epidemiologia , Doença Aguda , Sintomas Afetivos/diagnóstico , Fatores Etários , Idoso , Arkansas , Encefalopatias/diagnóstico , Depressão/diagnóstico , Etnicidade , Feminino , Serviços de Saúde para Idosos , Humanos , Masculino , Transtornos Mentais/diagnóstico , Pessoa de Meia-IdadeAssuntos
Doenças das Artérias Carótidas/diagnóstico , Adolescente , Adulto , Arteriopatias Oclusivas/diagnóstico , Arteriosclerose/diagnóstico , Aspirina/uso terapêutico , Auscultação , Doenças das Artérias Carótidas/terapia , Criança , Pré-Escolar , Ensaios Clínicos como Assunto , Feminino , Humanos , Ataque Isquêmico Transitório/diagnóstico , Ataque Isquêmico Transitório/terapia , Masculino , Pessoa de Meia-Idade , Sulfimpirazona/uso terapêuticoRESUMO
Psychiatric evaluation as a part of the complete geriatric workup was done on 143 consecutive patients transferred to a Medical Geriatric Evaluation Unit. The patients' age ranged from 48 to 94 years. The findings were: free of psychiatric problems--19.1%; organic brain syndrome--58.8%; dysphoria-depression--36.8%; paranoid--3.7%; alcohol abuse--8.1%; marital maladjustment 18.3% (of marrieds). The Geropsychiatrist diagnoses, participates in psychiatric management, consults, and supervises psychiatric evaluation by other team members. He is an esential member of the Geriatric team since proper recognition and treatment of psychiatric problems is necessary to complete treatment and to make optimum disposition.
