Abstract：
:The majority of patients with acute diverticulitis can be managed medically. Some will have a complication of diverticulitis such as free perforation with peritonitis, abscess formation, obstruction, or fistula formation. Perhaps even a larger number will develop recurrent diverticulitis, which is associated with an increased rate of complications. Although the preoperative diagnosis of these problems may be obvious in many patients, elderly or steroid-treated patients may have few manifestations of significant intra-abdominal disease. Of extreme importance in the management of these complications of diverticulitis is the preoperative resuscitation. Intravascular volume depletion is replaced with intravenous fluids, and intravenous antibiotics are given. At this time, with any of these complications, it is unusual to perform the classic three-stage operation, which includes an initial diverting colostomy and drainage followed by resection of the involved colon and, finally, a colostomy closure as the third stage. The usual treatment now is a two-stage operation with the initial operation being resection of the diseased segment and formation of a colostomy proximally and either a mucous fistula or a Hartmann's pouch distally. The second stage is the colostomy closure. This two-stage approach is indicated in patients with acute diverticulitis complicated by perforation, whether free or confined with abscess formation, and in patients with obstruction or fistula formation in whom a preoperative bowel preparation is not possible. Resection and primary anastomosis should not be performed in the elderly in the emergency setting for complicated diverticulitis. However, this is the procedure of choice in the elective treatment of diverticulitis and its complications in the elderly.
journal_name
Clin Geriatr Medjournal_title
Clinics in geriatric medicineauthors
Symmonds RE Jrsubject
Has Abstractpub_date
1985-05-01 00:00:00pages
471-83issue
2eissn
0749-0690issn
1879-8853journal_volume
1pub_type
杂志文章abstract：:Colorectal cancer is one of the leading causes of death in older men and women. Therefore, this age-related cancer is of particular importance to geriatricians. The high incidence of this cancer may be decreased by dietary modifications recommended by the American Cancer Society. Early cancer detection is important to...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：
更新日期：1987-11-01 00:00:00
abstract：:Palliative care is a public health concern, because the problems faced by patients and their families represent a substantial burden of illness and cost to the society that is likely to increase markedly in the future as the world's population continues to age. There are also inequities in access to palliative care an...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：10.1016/j.cger.2015.01.002
更新日期：2015-05-01 00:00:00
abstract：:Approximately 35% to 37% of older emergency department (ED) patients will have delirium or dementia, which can negatively affect safe and appropriate clinical care. This article describes the epidemiology of delirium and dementia in the ED and how it affects clinical care and patient outcomes. Screening for delirium a...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：10.1016/j.cger.2018.05.001
更新日期：2018-08-01 00:00:00
abstract：:The number of people in nursing homes is growing at a rapid rate as the population includes greater numbers of elderly Americans. Psychiatric disorders, including depression, anxiety, and paranoia, are commonly seen among this group. Recognition and treatment of these disorders by health care professionals can improve...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：
更新日期：1988-08-01 00:00:00
abstract：:The high prevalence, morbidity, and mortality of infectious diseases in the geriatric population mandates that clinicians caring for older patients become better acquainted and familiar with the special and unique characteristics and features of this common clinical problem. Only through such awareness and understandi...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：
更新日期：1992-11-01 00:00:00
abstract：:The utility of cardiac rehabilitation for elderly cardiac patients is controversial, and cost, logistic barriers, and encumbering comorbidities often seem disproportionate. Many clinicians view the emphasis of cardiac rehabilitation on behavior modification and risk-factor reduction as irrelevant for very old adults a...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：10.1016/s0749-0690(05)70031-8
更新日期：2000-08-01 00:00:00
abstract：:This article highlights new developments in assessment and management of pain and delirium. ...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：10.1016/j.cger.2004.09.002
更新日期：2005-02-01 00:00:00
abstract：:Elderly individuals, worldwide, are on the rise, posing new challenges to care providers. Hypertension is highly prevalent in elderly individuals, and multiple challenges face care providers while managing it. In addition to treating hypertension, the physician must treat other modifiable cardiovascular risk factors i...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：10.1016/j.cger.2013.05.002
更新日期：2013-08-01 00:00:00
abstract：:Malignant neoplasms of the geriatric skeleton are either primary or metastatic in nature. The vast majority are metastatic to the skeleton from carcinomas. Rarely, a primary skeletal malignancy, usually a chondrosarcoma or a malignant fibrous histiocytoma, develops in the geriatric patient. This article discusses the ...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章
doi：
更新日期：1994-11-01 00:00:00
abstract：:Lower intestinal bleeding in the elderly is a common problem with numerous and varied causes. Its diagnosis and treatment require a careful, systematic approach by physicians with special expertise. Under the proper circumstances, elderly patients with lower intestinal bleeding do well, even when surgery is required. ...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：
更新日期：1991-05-01 00:00:00
abstract：:Suicide in the elderly is a growing problem. The elderly population is increasing, and elderly patients have multiple issues that place them at higher risk of suicidality. These issues include physical illnesses, mental illness, loss of functional status, isolation, and family, financial, and social factors. Access to...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：10.1016/j.cger.2018.08.012
更新日期：2019-02-01 00:00:00
abstract：:Falls are a major health concern for elderly people and cause substantial health care costs. The authors used meta-analytic findings on the effectiveness of fall prevention interventions to determine cost-effectiveness of a proposed Medicare fall prevention program for people who experience a recent fall. Using publis...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,meta分析
doi：10.1016/j.cger.2010.07.005
更新日期：2010-11-01 00:00:00
abstract：:A comprehensive practical approach to the diagnosis, staging, and treatment of carcinoma of the prostate is presented. Prostatic cancer in the elderly patient is not a benign clinical condition. The approach is designed to minimize the morbidity of the disease process and to allow the patient to live as normal a life ...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章
doi：
更新日期：1985-05-01 00:00:00
abstract：:Because of its wide prevalence and its grave consequences on the health of older persons, malnutrition requires immediate attention. Physicians in general have been described as being nutritionally blind in their slowness to recognize undernutrition. A high degree of suspicion, a thorough history and physical examinat...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：10.1016/s0749-0690(02)00042-3
更新日期：2002-11-01 00:00:00
abstract：:In developing and validating the concept of frailty as a geriatric syndrome, it has been necessary to distinguish the clinical expression of frailty from normal age-related changes and other age-related disease pathologies. A framework for excluding potentially confounding disease and a working clinical tool to diagno...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章
doi：10.1016/j.cger.2010.08.006
更新日期：2011-02-01 00:00:00
abstract：:The definition of sarcopenia continues to evolve, from an observational phenomenon to a differential diagnostic approach. Clinical relevance for sarcopenia is defined by a loss in lean muscle mass and impairment of functional status. A therapeutic approach to the loss of skeletal muscle mass and strength in older pers...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章
doi：10.1016/j.cger.2010.02.012
更新日期：2010-05-01 00:00:00
abstract：:Depression is one of the most serious and prevalent neuropsychiatric disorders of old age. Despite its prevalence, depression in the aged is frequently unrecognized or is misdiagnosed. This article reviews the existing knowledge of several sleep-related areas and discusses possible future studies into sleep as a progn...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：
更新日期：1989-05-01 00:00:00
abstract：:Cancer screening of the elderly is warranted for those cancers for which early detection and treatment improve life expectancy. There is excellent evidence to include screening for breast cancer with clinical examination and mammography for elderly women. There is also reasonable evidence to screen for cervical cancer...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：
更新日期：1992-02-01 00:00:00
abstract：:Cardiovascular disorders are a common cause of falls and syncope in older adults. The most common cardiac disorders linked to falls and syncope are carotid sinus syndrome, postprandial hypotension, orthostatic hypotension, vasovagal syncope, and bradyarrhythmias. It is important to recognize these conditions, because ...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章
doi：10.1016/j.cger.2010.07.006
更新日期：2010-11-01 00:00:00
abstract：:In conclusion, the majority, or at least a large proportion, of accidental injuries in the elderly are preventable with careful medical and environmental evaluation and intervention. A vigorous diagnostic, therapeutic, and preventive approach is appropriate in all older patients who fall in addition to those at a high...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：
更新日期：1991-11-01 00:00:00
abstract：:Research has conclusively established that normal diploid cells in culture have a limited replicative life span, and that cells from adult organisms have a shorter life span than cells from young organisms or embryos. Although it is unlikely that death of the organism is caused by failure in cellular proliferative cap...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：
更新日期：1989-02-01 00:00:00
abstract：:Pain is a common problem encountered among elderly people in subacute and long-term care facilities. Pain often is underestimated and undertreated in these settings. Most pain problems can be improved by careful assessment and careful use of analgesic drugs and nondrug strategies. Subacute care and other long-term car...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：10.1016/s0749-0690(05)70048-3
更新日期：2000-11-01 00:00:00
abstract：:Current arrangements for health care in the United States do not adequately address the needs of a growing population that has serious, eventually fatal chronic illness. New programs and policies are necessary to encourage coordination of care; better match services to the needs of patients; better provide education a...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章
doi：10.1016/j.cger.2004.08.008
更新日期：2005-02-01 00:00:00
abstract：:New data have shown that sebum secretion is highest in young adults and then declines steadily throughout life in both men and women. This parallels the decline in androgen levels, but this cannot be the sole factor because there is so much overlap in sebaceous gland activity between men and women. The increased occur...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：
更新日期：1989-02-01 00:00:00
abstract：:Transitions in care are a vulnerable time period for patients during which unintended errors may occur. This article discusses potential risks that could occur during care transitions, suggested improvements, and the transition from hospital to skilled nursing facilities for patients needing rehabilitation after their...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：10.1016/j.cger.2014.01.017
更新日期：2014-05-01 00:00:00
abstract：:Skin ulcers of the lower extremities have a chronic, relapsing course and often are difficult to manage. Leg ulcers remain a significant management challenge to health care professionals. This article focuses on the various causes of leg ulcers, with an emphasis on venous disease. Characteristic clinical findings and ...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：10.1016/s0749-0690(03)00035-1
更新日期：2002-02-01 00:00:00
abstract：:Older adults receive care from various settings, including acute care hospitals, skilled nursing facilities, nursing homes, group homes, outpatient primary care, specialty clinics, and home. In these various settings, older adults are exposed to pathogens, which makes them "vectors" that transport pathogens from one s...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：10.1016/j.cger.2007.02.001
更新日期：2007-08-01 00:00:00
abstract：:The routine prescription of hormone replacement therapy for elderly women to prevent heart disease is not indicated. Until better data are available, the use of estrogens primarily to prevent heart disease probably should be reserved for women at high risk by virtue of their LDL/HDL ratio or the presence of manifest c...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：
更新日期：1993-02-01 00:00:00
abstract：:Norovirus infection usually results in acute gastroenteritis, often with incapacitating nausea, vomiting, and diarrhea. It is highly contagious and resistant to eradication with alcohol-based hand sanitizer. Appropriate preventative and infection control measures can mitigate the morbidity and mortality associated wit...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：10.1016/j.cger.2016.02.008
更新日期：2016-08-01 00:00:00
abstract：:Schizophrenia in late life includes both chronic early-onset schizophrenia and late-onset schizophrenia. Treatment with neuroleptics in relatively low doses is often useful in controlling psychotic symptoms in these patients. The value of neuroleptics is limited, however, by the risks of side effects such as tardive d...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：
更新日期：1992-05-01 00:00:00
