Challenges in Acute Geriatric Care by Jochanan E. Naschitz

By Jochanan E. Naschitz

This paintings fills a spot within the literature in offering a set of issues on acute geriatric care. such a lot chapters are established as grand rounds, enthusiastic about scientific difficulties that experience restricted disclosure in textbooks, provided as a conversation among conception and perform, written through clinicians for clinicians. This assortment relies on encounters among geriatricians and specialists, intended to solve medical difficulties; a collaboration the place medical adventure and interdisciplinary alternate may well supplant scanty instructions. A multidisciplinary procedure can be proposed to lessen sensible decline of aged sufferers, lessen size of medical institution remains, and forestall nursing domestic admissions.

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Postprandial hypotension: Epidemiology, pathophysiology, and clinical management. Ann. Intern. Med. 1995;122:286-295. [28] Ooi WL, Hossain M, Lipsitz LA. The association between orthostatic hypotension and recurrent falls in nursing home residents. Am. J. Med. 2000;108:106-111. [29] Eigenbrodt ML, Rose KM, Couper DJ, Arnett DK, Smith R, Jones D. Orthostatic hypotension as a risk factor for stroke: the atherosclerosis risk in communities (ARIC) study, 1987-1996. Stroke. 2000;31:2307-2313. [30] Masaki KH, Schatz IJ, Burchfiel CM, Sharp DS, Chiu D, Foley D, Curb JD.

Rev. 1990;2:161-192. [84] Roman RR. Autoregulation of cerebral blood flow. In: Joceph L Izzo, Henry R Black: Hypertension Primer, 3d edition, Amer. Heart Ass. 2003: 114-117. [85] Michael R. Edwards, Deanna L. Devitt, and Richard L. Hughson. Two-breath CO2 test detects altered dynamic cerebrovascular autoregulation and CO2 responsiveness with changes in arterial PCO2. Am. J. Physiol. Regul. Integr. Comp. Physiol. 2004;287:R627-32. [86] Robertson D. Orthostatic Tachycardia and Orthostatic Intolerance.

The association of micturition syncope with OH in Kapoor's study and our patient's clinical problem may only apparently be similar. In fact, 'early OH' (classical OH) was documented in the former, but not detectable in our patient though tested under various circumstances and repeatedly, taking in account the possible variability of OH [52,55]. 'Initial OH', that occurs within 15 s after standing up is a possible diagnosis to be considered in our patient [34]. However, 'initial OH' is very short lived and therefore probably not accountable for micturition syncope, which occurred after the patient went along the floor to the bathroom, terminated voiding and only than fainted.

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