Mean deep body temperature fell by 0.4 +/- 0.1 (SD) degrees C in five sedentary, clothed 63-70 year old men and by 0.1 +/- 0.1 degrees C in four young adults after 2 h exposure in still air at 6 degrees C (P less than 0.001). The mean increase in systolic and diastolic pressure was significantly greater (P less than 0.002) in the older subjects (24 +/- 4 mmHg systolic, 13 +/- 4 mmHg diastolic) than in the young (14 +/- 6 mmHg systolic, 7 +/- 3 mmHg diastolic) after 2 h at 6 degrees C. A small rise in blood pressure occurred in the older men at 12 degrees C, but there was no increase in either group at 15 degrees C. The association of variables is particularly marked between systolic blood pressure and core temperature changes at 6 degrees C. There were no appreciable cold-adaptive changes in blood pressure or thermoregulatory responses after 7-10 days repeated exposure to 6 degrees C for 4 h each day. Blood pressure elevation in the cold was slower but more marked in the older men. These changes in blood pressure may provide a possible basis for delineating low domestic limiting temperature conditions.
To obtain more accurate information about respiratory function in the elderly, we carried out spirometry and constructed maximum expiratory flow-volume curves in 136 volunteers over the age of 60 years (90 women, 46 men). Significant age related differences were found. Although vital capacity appeared well preserved in all groups, mid expiratory flow rates were low, even in lifelong non-smokers. On the basis of previous work, many of the subjects in this study would have been assessed as having small airways obstruction. The number of subjects is larger than in previous studies of airflow in this age group. Old people have often smoked, and many have a history of cardiovascular disease. Such individuals were included provided that they were fit and active for their age, and had no overt respiratory disease. It is argued that our findings will be of more clinical relevance to the elderly population than values derived either from population studies or studies that have used rigorous selection criteria to exclude subjects who smoked or had a history of non-respiratory disease.Respiratory disease is common, and its prevalence increases with age. though the way in which subjects were selected (and the inclusion of smokers) may be responsible. None of these studies report flow rates. The recent report from Knudson's group,"2 including a separate analysis of the results from elderly women, is probably the best current source of reference values for this age group. This report also shows the discrepancies that arise (which appear to increase with age) when different recommendations13-15 are followed for the measurement of flow rates from the flow-volume curve. Schoenberg's study,5 which adopted a curvilinear relationship between lung function and age, is also relevant to this age group, though the numbers are small. Other studies'6 17 include too few elderly subjects and too little methodological detail for current use in this age group.Our study tries to provide more information by reporting the results of spirometry and measurement of maximal expiratory flow in a volunteer group of healthy white Londoners aged 60 years and over. People who survive into old age rarely escape physical insults, and we have therefore included those with a history of non-respiratory disease. We have also included smokers, because lifelong non-smoking men are a small, possibly unrepresentative, fraction of the elderly population.
A double blind controlled trial was carried out to measure the efficacy of Sudocrem, compared with zinc cream BP, in the treatment and prevention of incontinence-associated dermatitis in an elderly inpatient population. Three objective measures of skin condition were used to assess efficacy. Sudocrem was shown to be superior to zinc cream BP in the treatment of dermatitis, with no significant difference shown in terms of prophylaxis. The objective measures of skin health seemed to be a promising advance on earlier, subjective methods, and their further development is recommended. There was some indication that the normal skin of an incontinent patient does not deteriorate when managed with Sudocrem or zinc cream.
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