APTA Geriatrics' Guiding Principles for Best Practices in Geriatric Physical Therapy: An Executive Summary.

Geriatric physical therapy requires a unique skill set and knowledge to provide best practice care. The skill set requires clinicians to recognize the significance of the continuum of aging from optimal to pathology-influenced aging and how psychosocial, environmental, behavioral, accessibility, and economic factors affect this aging continuum, optimal health, and wellness. Employing this distinctive skill set while also utilizing evidence-based practice, acknowledging the variability observed in older adults, and utilizing interwoven care systems that impact outcomes are key characteristics of best practice.

Tau-tubulin kinase 1 enhances prefibrillar tau aggregation and motor neuron degeneration in P301L FTDP-17 tau-mutant mice.

Tau-tubulin kinase-1 (TTBK1) phosphorylates microtubule-associated protein tau at specific serine/threonine residues found in paired helical filaments (PHFs), and its expression is up-regulated in the brain in Alzheimer disease, suggesting its role in tauopathy pathogenesis. To understand the effects of TTBK1 on tauopathy in vivo, we have developed bigenic mice overexpressing full-length TTBK1 and the P301L tau mutant. The bigenic mice show enhanced tau phosphorylation at multiple sites (AT8, 12E8, PHF-1, and pS422), tauC3-immunoreactive tau fragmentation, and accumulation of tau aggregates in cortical and hippocampal neurons at 12-13 mo of age.

[Meckel's diverticulum (author's transl)].

Complications (inflammation, bleeding, perforation) occurred in 20 of 38 patients with Meckel's diverticulum. Complications were disproportionately common in children up to ten years of age. Because of the high mortality rate in the presence of complications (20%) it is recommended to search actively for Meckel's diverticulum during every upper-abdomen laparotomy, as long as the underlying disease and the operative procedure allow it.

[Kaposi's sarcoma (author's transl)].

Pathological epidemiological and clinical aspects of Kaposi's Sarcoma are demonstrated. The prevalence of this disease in African countries and the appearance similar to the Burkitt-Lymphoma indicate a probability of viral origin. The histo-pathologic differential diagnosis also includes other vascular tumours.

[Surgical or endoscopic papillotomy? (author's transl)].

Endoscopic papillotomy has become a competitive method to the surgical technique. Endoscopy took over many cases formerly treated surgically. The indications to either procedure are defined.

[Echinococcus cysticus (author's transl)].

Echinococcus cysticus is a parasite; the human organism is invaded by cysticercus of the dog tape worm. In liver 60% of all viable embryos are retained, 30% in the lung, the last 10% spread via the arterial system into all other organs. Diagnosis can be established by serology, sonography, scintigraphy as well as invasive and non-invasive radiological examinations.

[Surgery in patients with obstructive jaundice caused by carcinoma (author's transl)].

Malignant disease obstructing the bile ducts is diagnosed in most cases at a time, when radical surgery is not possibly any more. Diagnostic procedures applied up to now are not suited for early diagnosis. 5 years survival rates of patients with carcinoma of the bile ducts are maximally 6%, in patients with carcinoma of the papilla 36%.

[Relaparotomy or endoscopic surgery in complications after bile duct surgery].

The number of cases in bile duct surgery has continuously increased since second world war. Correcting operation is necessary in 5 to 7% after cholecystectomy. Since 1973 more and more the endoscopic treatment takes place of surgery.

[Kaposi sarcoma of the breast with osseous and pulmonary involvement (author's transl)].

The authors report on a rare case of a Kaposi-Sarcoma of the mamma with osseous and pulmonary participation. The angiographic findings of a Kaposi-Sarcoma of the right mamma is demonstrated.

[Treatment of complications after endoscopic papillotomy (author's transl)].

In 717 endoscopic papillotomies there were 52 complications in 48 patients, requiring 15 emergency operations with 11 deaths. Surgical intervention was undertaken in six patients for cholangitis after obstruction by stone, in four for retroperitoneal perforation, in two each for bleeding or jamming of the dormia basket, and in one for pancreatitis. Cause of death was very poor general condition or age over 80 years in four; retroduodenal abscess in four; haemorrhagic pancreatitis in two, and cholangiogenic sepsis in one.

[Clinic and therapy of extragenital endometriosis (author's transl)].

Patients with endometriosis are rare in surgical departments, they are however routine in gynecology. Pathogenesis, diagnosis and treatment of this disease are outlined. Treatment with estrogens, androgens or gestagens does not have the desired effect in many cases; in recent time however good results have been reported when Danazol, a new synthetic steroid was used.

[Bileduct reoperations (author's transl)].

After cholecystectomy reoperations are required in 7%. A reoperation in indicated by pathologic alterations overlooked at the first operation, not working biliodigestive anastomoses and injuries to the common bile duct. 138 reoperations of the bile duct wer performed within 4 years which were aimed at reconstructing the normal bile duct anatomy.

[Gastrointestinal sarcomas].

In 45 primary sarcomas of the gastrointestinal tract the authors attempt to derive criteria for prognosis from histology and localization of the tumors and from clinical parameters. Their observations lead to the conclusion that 1) proximal sarcomas of the gastrointestinal tract have a better prognosis than distal sarcomas, 2) lymphocytic malignant lymphomas has a better prognosis than other histologic types, and 3) there is a correlation between blood sedimentation rate and prognosis.