JAGS 3. Lieberman MA, Fisher L. The effects of family conflict resolution and decision making on the provision of help for an elder with Alzheimer's disease. Gerontologist 1999;39:159-166. 4. Zanetti O, Frisoni GB, Bianchetti A et al. Depressive symptoms of Alzheimer caregivers are mainly due to personal rather than patient factors. Int J Geriatr Psychiatry 1998;13:358-367. 5. Rabins P, Blacker D, Bland W et al. Practice guideline for the treatment of patients with Alzheimer's disease and other dementias of late life. food or sputum is a problem sometimes experienced in frail older people. In such an emergency, there is rarely an opportunity or time to perform computed tomographic (CT) imaging. We report a case in which CT imaging of the chest was useful in detecting the site and components of the obstruction. A 74-year-old man with hypertension and poststroke left hemiparesis was referred to our hospital because of reduced consciousness and dyspnea. He had weak breath sounds in the left chest region and hypoxemia with arterial oxygen saturation (SaO 2 ) of 76% without hypercapnia with 10 L/min of oxygen administration. Chest radiograph showed elevation of the left diaphragm, suggesting a reduction of left lung volume but no apparent bronchial obstruction. CT of the chest revealed that the left main bronchus and its branches were filled with foamy substances (see Figure 1). Bronchoscopy was immediately performed to remove the obstruction. Consistent with the finding on the CT scan, the left main bronchus was filled with sticky sputum containing food particles. After aspirating and removing the sputum through a bronchoscope, SaO 2 increased to 97% on room air, but consciousness did not occur until hyponatremia was corrected; serum sodium of 121 mEq/L on admission increased to 131 mEq/L 3 days later. Aspiration and sputum accumulation in this case may have been attributable to poststroke hemiparesis and disturbance of consciousness, although an episode of massive aspiration was not noted. In humans, a strong association between mortality and heart rate (HR) has been reported, especially in men. In younger and middle-aged men, several epidemiological studies have reported that high HR is a predictor of cardiovascular and noncardiovascular mortality, 1-4 but limited information is available about the role of resting HR in life expectancy and survival to a very old age.The present analysis included subjects who were examined at our center between 1972 and 1981, were aged 65 to 70 at the time of the examination, were free of severe cardiovascular disease at that time, and had a follow-up long enough to be likely to reach the age of 85 (16-20 years of follow-up depending on the age at the time of study entry; e.g., a 67-year-old individual at study entry must have had a minimum follow-up of 18 years). All individuals who met these criteria were included in the analysis: 1,407 men and 1,134 women. HR was measured using electrocardiogram after 5 to 7 minutes of rest in the supine position and was recorded in the database...
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