Abstract:
:Elderly patients pose unique challenges perioperatively. They are more likely than younger surgical patients to be mentally and physically compromised at baseline, which increases the risk of delirium and postoperative cognitive dysfunction. Postoperative cognitive risk can be predicted, however, and effective strategies exist to reduce this risk. Elderly patients are also at increased risk of a precipitous postoperative decline in physiologic reserve, which can lead to organ failure. General recommendations for the perioperative care of elderly patients include avoiding drugs that raise the risk of delirium, ensuring adequate caloric and fluid intake, getting the patient out of bed and into physical therapy as soon as possible, and early planning for discharge. An elderly patient's postoperative cognitive risk and its impact on quality of life should be factored into the decision whether to undergo surgery. Family conferences are recommended to address the many questions and challenges that surgery in an elderly person can pose.
journal_name
Cleve Clin J Medjournal_title
Cleveland Clinic journal of medicineauthors
Palmer RMdoi
10.3949/ccjm.76.s4.03subject
Has Abstractpub_date
2009-11-01 00:00:00pages
S16-21eissn
0891-1150issn
1939-2869pii
76/Suppl_4/S16journal_volume
76 Suppl 4pub_type
杂志文章abstract::Epidemiologic and experimental data suggest that isoflavones have benefits for preventing and treating some prostate disease. Isoflavone supplements may therefore be an important tool for men concerned about prostate disease, such as those with benign prostatic hypertrophy undergoing watchful waiting or those concerne...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
doi:10.3949/ccjm.70.3.203
更新日期:2003-03-01 00:00:00
abstract::Obesity is a potent risk factor for the development and progression of type 2 diabetes, and weight loss is a key component of diabetes management. Bariatric surgery results in significant weight loss and remission of diabetes in most patients. After surgery, glycemic control is restored by a combination of enforced ca...
journal_title:Cleveland Clinic journal of medicine
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abstract::After menopause, women become more susceptible to periodontal disease. We believe the problem is due in large part to estrogen deficiency with resulting bone loss and inflammatory processes. Osteoporosis and periodontal disease are best diagnosed early so that treatment can be started sooner and fractures and tooth lo...
journal_title:Cleveland Clinic journal of medicine
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journal_title:Cleveland Clinic journal of medicine
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abstract::The Internet can be useful for physicians, but beginning users are apt to encounter two problems: too much irrelevant information, and difficulty finding the desired information. This paper offers some practical tips that can prevent frustration and wasted time when searching for medical information on the Internet. ...
journal_title:Cleveland Clinic journal of medicine
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abstract::Congestive heart failure is the most common cause of death in patients with thalassemia, as chronic accumulation of iron due to regular blood transfusions leads to biventricular systolic dysfunction and death at a very young age. The quantity of iron deposited in the heart is a key determinant of outcome. Early diagno...
journal_title:Cleveland Clinic journal of medicine
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abstract::Glomerulonephritis (GN) is a common manifestation of the antineutrophil cytoplasmic antibody-associated systemic vasculitides (AASV), which include granulomatosis with polyangiitis and microscopic polyangiitis. The level of renal involvement at presentation is highly predictive of survival and should be assessed early...
journal_title:Cleveland Clinic journal of medicine
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journal_title:Cleveland Clinic journal of medicine
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journal_title:Cleveland Clinic journal of medicine
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abstract::The ongoing outbreak of Zika virus infection that began in South America and Central America in 2014 is worrisome because of associations with fetal microcephaly and with Guillain-Barré syndrome. Here we summarize what has happened and what is known so far. As the outbreak continues to evolve, we urge clinicians to wa...
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abstract::Obesity is epidemic and dangerous. Weight loss is difficult but worth the effort. Although new weight-loss drugs are available, there are no magic bullets: to lose weight and keep it off, people must eat less and exercise more. This article presents a practical approach on how physicians can help their patients lose w...
journal_title:Cleveland Clinic journal of medicine
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abstract::Patients typically lose more than 50% of their excess weight after bariatric surgery. Obesity-related diseases markedly improve, reducing cardiovascular risk and improving life expectancy. Obese patients lose more weight with bariatric surgery than with medical weight-loss treatment. ...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
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journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
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abstract:BACKGROUND:Coronary artery disease is a major cause of death in transplant recipients. PURPOSE:To review current approaches for the detection, evaluation, and treatment of coronary artery disease in transplant recipients. SUMMARY:Renal transplantation promotes the development of coronary artery disease primarily beca...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
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更新日期:1994-09-01 00:00:00
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journal_title:Cleveland Clinic journal of medicine
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doi:10.3949/ccjm.73.suppl_2.s24
更新日期:2006-06-01 00:00:00
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journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章
doi:10.3949/ccjm.67.11.807
更新日期:2000-11-01 00:00:00
abstract::Annular pancreas is a congenital anomaly which, though present at birth, may cause few symptoms until adulthood. A case of annular pancreas with intermittent duodenal obstruction is described in a 49-year-old alcoholic man. Few other entities cause such obstruction. In similar cases, clinical suspicion of annular panc...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章
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abstract::Recommendations exist for preparticipation physical examinations, but there is no national standard, and the recommendations are not widely followed. The most common reasons for denying clearance to play are musculoskeletal conditions, hypertension, and visual acuity problems. Although detecting potentially life-threa...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
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更新日期:2004-07-01 00:00:00
abstract::Reproductive maturation, the menstrual cycle, and the transition to postreproductive life are complex processes. Detailed understanding of reproduction underlies logical patient management. Greater understanding of physiology has brought about better control of ovulatory problems and the beginnings of a logical approa...
journal_title:Cleveland Clinic journal of medicine
pub_type: 杂志文章,评审
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abstract::Subclinical hypothyroidism is defined by an elevated serum thyroid-stimulating hormone (TSH) level along with a normal free thyroxine (T4) level. Whether it should be treated remains controversial. Currently, the best practical approach is to base treatment decisions on the degree of TSH elevation, thyroid autoimmunit...
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abstract::An over-the-counter at-home test for human immunodeficiency virus (HIV) infection has been approved and will likely be available soon. It is intended to decrease the percentage of HIV-infected people unaware of their infection (estimated at 18% of the 1.2 million people infected in the United States). Since early and ...
journal_title:Cleveland Clinic journal of medicine
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更新日期:2012-10-01 00:00:00
abstract::Although most patients with emphysema are managed medically, a small subset of severely disabled patients may become candidates for surgery. This paper discusses for the internist who works with emphysema patients the risks, benefits, patient selection criteria, and outcome data for three procedures in current use: bu...
journal_title:Cleveland Clinic journal of medicine
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更新日期:1999-07-01 00:00:00
abstract:BACKGROUND:Ovarian cancer can be cured if detected early enough, but usually has already metastasized when diagnosed. A family history of ovarian cancer is still the strongest known risk factor. OBJECTIVE:To identify women at risk for ovarian cancer and design a program of surveillance. METHODS:Prospective registry o...
journal_title:Cleveland Clinic journal of medicine
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abstract::The elderly are at increased risk for dehydration and associated fluid and electrolyte imbalances. Changes in functional and mental status, medication effects, and changes in the aging renal system all may be factors. Furthermore, hypodipsia, or insensibility to thirst, may be a physiologic process of aging. These and...
journal_title:Cleveland Clinic journal of medicine
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abstract::Platelet activation is one of the essential steps in the genesis and propagation of atherothrombosis. Accumulating clinical evidence suggests that an elevated platelet count, platelet activation, and platelet hyperreactivity (defined as residual platelet activity despite antiplatelet drug therapy) may be associated wi...
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pub_type: 杂志文章,评审
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更新日期:2009-04-01 00:00:00