bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of remifentanil on esophageal motility: a double‐blind, randomized, cross‐over study in healthy volunteers
Authors: Savilampi J. , Magnuson A. , Ahlstrand R.
Published: April 2015

Background

Recent studies have shown that remifentanil increases the risk of aspiration and induces subjective swallowing difficulties. The mechanisms are not completely understood. Here, we investigated whether remifentanil impairs esophageal motility and hypothesized that this is one possible underlying mechanism. Naloxone was used to evaluate whether the effects of remifentanil are mediated through opioid receptors. We also examined subjective swallowing difficulties and the influence of metoclopramide on remifentanil‐induced effects.

Methods

Fourteen healthy volunteers participated in a double‐blind, randomized, cross‐over trial at the University Hospital in Örebro, Sweden. They were studied on two different occasions, during which they were randomly assigned to receive either naloxone given as a bolus of 6 μg/kg followed by an infusion of 0.1 μg/kg/min, or saline 5 min before target‐controlled infusions of remifentanil at three target‐site concentrations: 1, 2, and 3 ng/ml. On both occasions, 0.2 mg/kg metoclopramide was given before the final measurement. Five swallows were performed during each measuring condition, and the metrics defining esophageal motility were measured by high‐resolution manometry. Outcomes were differences in the metrics at baseline vs. during remifentanil infusion, with naloxone vs. placebo, and with remifentanil before and after metoclopramide administration. Differences in swallowing difficulties were also recorded.

Results

Remifentanil decreased swallow‐evoked esophagogastric junction relaxation and the latency time of esophageal peristalsis. There were no significant effects of naloxone or metoclopramide on remifentanil‐induced effects, and we detected no differences in swallowing difficulties.

Conclusions

Remifentanil induces dysfunction of esophageal motility; this may contribute to the elevated risk of regurgitation and aspiration.
Effect of exogenous xylanase on rumen in vitro gas production and degradability of wheat straw
Authors: Togtokhbayar Norovsambuu , Cerrillo María A. , Rodríguez Germán Buendía , Elghandour Mona M. M. Y. , Salem Abdelfattah Z. M. , Urankhaich Chuluunbaatar , Jigjidpurev Sukhbaatar , Odongo Nicholas E. , Kholif Ahmed E.
Published: April 2015

The objective of this study was to determine effects of xylanase on in vitro gas production (GP) and in sacco degradability of wheat straw. Rumen fluid was obtained from three Mongolian native goats fitted with permanent rumen cannulas. The trial consisted of five doses (0, 0.5, 1.0, 1.5, 2.0 μL/g of substrate) of a commercial xylanase (Dyadic® xylanase PLUS, Dyadic International, Inc., Jupiter, FL, USA). For the in sacco degradability, different levels of xylanase enzyme were added directly onto 2 g of wheat straw in nylon bags and incubated in the rumen for 3, 6, 12, 24 and 48 h to estimate degradability of wheat straw. Total GP increased (P < 0.001) at all times of incubation at intermediate levels of xylanase. Methane production had a similar pattern at 3 and 12 h of incubation; increased linearly at 24 h of incubation, and was unaffected at 6 and 48 h of incubation. Rumen NH3‐N concentration increased linearly at 3 h and the highest values were observed with intermediate enzyme levels. All ruminal volatile fatty acids increased linearly with intermediate levels of the fibrolytic enzyme. The in sacco rate of dry matter degradation decreased linearly (P = 0.020) with increasing enzymes. Intermediate levels of xylanase improved rumen kinetic fermentation and degradability. The outcome of this research indicated that the application of xylanase enzyme could improve in vitro GP fermentation of wheat straw.
Current status and future prospects for platelet function testing in the diagnosis of inherited bleeding disorders
Authors: Dovlatova Natalia
Published: April 2015

Platelets play a crucial role in haemostasis by preventing bleeding at the site of vascular injury. Several defects in platelet morphology and function have been identified and described over the years. Although a range of methodologies is available to assess platelet function, a significant proportion of subjects with bleeding symptoms and normal coagulation parameters still appear to have normal results on platelet function testing. This might suggest that the reason for bleeding is multifactorial and is due to a combination of several minor defects in platelet function and/or other parts of the haemostatic system or might indicate that the currently available platelet function tests do not provide optimal diagnostic power. This review will summarize the established platelet function tests used for diagnosing inherited platelet abnormalities in adults and children, and discuss the newly developed methodologies as well as unmet challenges and potential areas for further improvement in this field.
From the bush to the bench: the annual Nothobranchius fishes as a new model system in biology
Authors: Cellerino Alessandro , Valenzano Dario R. , Reichard Martin
Published: April 2015

African annual fishes from the genus Nothobranchius are small teleosts that inhabit temporary water bodies subject to annual desiccation due to the alternation of the monsoon seasons. Given their unique biology, these fish have emerged as a model taxon in several biological disciplines. Their increasing popularity stems from the extremely short lifespan that is the result of their specific life‐history adaptations and is retained under laboratory conditions. Nothobranchius furzeri, the most popular laboratory species, is the vertebrate species with the shortest lifespan recorded in captivity. In the laboratory, adults of different Nothobranchius species and populations live between 3 and 18 months and, notably, there is a negative correlation between the captive lifespan of a species and the aridity of their habitat. Their short lifespan is coupled to rapid age‐dependent functional decline and expression of cellular and molecular changes comparable to those observed in other vertebrates, including humans. The recent development of transgenesis in this species makes it possible to insert specific constructs into their genome, and the establishment of transgenic lines is facilitated by their very rapid generation time, which can be as short as 1 month. This makes Nothobranchius species particularly suited for investigating biological and molecular aspects of ageing and ageing‐associated dysfunctions. At the same time, they also represent a unique model taxon to investigate the evolution of life‐history adaptations and their genetic architecture. We review their natural history, including phylogenetic relationships, distribution in relation to habitat conditions and natural selection for differential longevity, population structure and demography, and life cycle with emphasis on diapause that may occur at three stages during embryonic development. We further critically evaluate their use as a laboratory model for understanding the evolution of a rapid ageing rate and its consequences for other life‐history traits, for cellular, molecular and integrative traits associated with the ageing process, high incidence of neoplasias, their utility for genome‐wide gene‐expression studies, and as a model for quantitative genetics. We summarize recent achievements in fostering Nothobranchius species as a widely applicable model system, including an annotated transcriptome, successful transgenesis, and existence of viable inbred lines. We compare the conditions they experience in the wild and in captivity and suggest that they are an ideal taxon to investigate natural genetic variation in a laboratory setting. We conclude that Nothobranchius species – and N. furzeri in particular – could become a unique model taxon that bridges interests in ecological and biomedical research. We hope that a conceptual and methodological integration of these two branches of biology will provide important new insights.
Measurement Issues: Depression measures in children and adolescents
Authors: Simmons Meinou , Wilkinson Paul , Dubicka Bernadka
Published: April 2015

Background

Since the recognition of youth depression, numerous instruments have been developed, but there is little consensus regarding their use. In recent years, a national programme for outcome measurement has been introduced in the United Kingdom.

Method

A pragmatic literature search was conducted to select instruments commonly used to measure depression either in research or as recommended by UK national bodies.

Results

15 depression rating scales were identified. Diagnostic instruments and rating scales are described.

Conclusions

Recent large depression trials have produced additional new data, and UK national organisations have made recommendations regarding the implementation of certain instruments.
Influence of Age on Clinical Performance of Mandibular Two‐Implant Overdentures: A 10‐Year Prospective Comparative Study
Authors: Hoeksema Arie R. , Visser Anita , Raghoebar Gerry M. , Vissink Arjan , Meijer Henny J.A.
Published: April 2015

Purpose

The aim of this prospective comparative study was to assess whether age has influence on peri‐implant health in patients treated with mandibular two‐implant overdentures during a 10‐year evaluation period.

Materials and Methods

A prospective study was carried out with two groups of edentulous patients, viz a younger (n = 52; mean age 45 years, 35–50 years) and an older (n = 53; mean age 68 years, 60–80 years) group. In all patients, two dental implants were placed in the interforaminal region of the mandible and after a 3‐month healing period overdentures were fabricated. Clinical and radiographic parameters were evaluated immediately after completion of the prosthetic treatment, and after 1, 5 and 10 years. Implant loss, plaque index, gingival index, bleeding index, and probing depth were assessed as clinical parameters. Peri‐implant bone loss was assessed on dental radiographs made with a standardized long‐cone technique with a direction device.

Results

Implant survival after 10 years was 97.1% and 93.4% in the younger and older group, respectively. Ten‐year scores of plaque, gingiva, and bleeding were between 0 and 1 for both groups (possible scores 0–3), and mean probing depth was 3 mm in both groups. Mean peri‐implant bone loss after 10 years was 1.2 and 1.4 mm in the younger and older patients, respectively. No significant differences were observed between the groups.

Conclusion

Clinical performance of mandibular two‐implant overdentures is equally successful in younger and older patients.
Framing the ecosystem concept through a longitudinal study of developments in science and policy
Authors: Aggestam Filip
Published: April 2015

This paper examines how scientific literature and policy documents frame the ecosystem concept and how these frames have shaped scientific dialogue and policy making over time. This was achieved by developing a frame typology, as a basis for organizing relevant value expressions, to assess how different frames have altered perspectives of the ecosystem concept. The frame typology and analysis is based on a semi‐grounded and longitudinal document analysis of scientific literature and policy documents using the ecosystem concept. Despite changing discourses and public priorities (e.g., cultural constructs of biodiversity) both science and policy documents are characterized by stable value systems that have not changed substantially since the 1930s. These value systems were defined based on ethical principles that delineate 6 core frames: humans first, dual systems, eco‐science, eco‐holism, animals first, and multicentrism. Specific crises (e.g., climate change) and cross‐disciplinary uptake and re‐uptake of, for example, the ecosystem services concept, have brought new perspectives to the forefront of public discourse. These developments triggered changes in the core frames that, rather than being value based, are based on how the ecosystem is conceptualized under fixed value systems and over time. Fourteen subframes were developed to reflect these longitudinal changes. There are as such clear framing effects in both scientific literature and in policy. Ecosystem research is for instance often characterized by unstated value judgments even though the scientific community does not make these explicit. In contrast, policy documents are characterized by clear value expressions but are principally management driven and human centered.
Integrating geospatial and multi‐depth laboratory spectral data for mapping soil classes in a geologically complex area in southeastern Brazil
Authors: Vasques G. M. , Demattê J. A. M. , Viscarra Rossel R. A. , Ramírez López L. , Terra F. S. , Rizzo R. , De Souza Filho C. R.
Published: April 2015

Soil mapping across large areas can be enhanced by integrating different methods and data sources. This study merges laboratory, field and remote sensing data to create digital maps of soil suborders based on the Brazilian Soil Classification System, with and without additional textural classification, in an area of 13 000 ha in the state of São Paulo, southeastern Brazil. Data from 289 visited soil profiles were used in multinomial logistic regression to predict soil suborders from geospatial data (geology, topography, emissivity and vegetation index) and visible–near infrared (400–2500 nm) reflectance of soil samples collected at three depths (0–20, 40–60 and 80–100 cm). The derived maps were validated with 47 external observations, and compared with two conventional soil maps at scales of 1:100 000 and 1:20 000. Soil suborders with and without textural classification were predicted correctly for 44 and 52% of the soil profiles, respectively. The derived suborder maps agreed with the 1:100 000 and 1:20 000 conventional maps in 20 and 23% (with textural classification) and 41 and 46% (without textural classification) of the area, respectively. Soils that were well defined along relief gradients (Latosols and Argisols) were predicted with up to 91% agreement, whereas soils in complex areas (Cambisols and Neosols) were poorly predicted. Adding textural classification to suborders considerably degraded classification accuracy; thus modelling at the suborder level alone is recommended. Stream density and laboratory soil reflectance improved all classification models, showing their potential to aid digital soil mapping in complex tropical environments.
Structural views of quinone oxidoreductase from Mycobacterium tuberculosis reveal large conformational changes induced by the co‐factor
Authors: Zheng Qianqian , Song Yunlong , Zhang Wei , Shaw Neil , Zhou Weihong , Rao Zihe
Published: April 2015

Energy generation, synthesis of biomass and detoxification of synthetic compounds are driven by electron transfer in all living organisms. Soluble quinone oxidoreductases (QORs) catalyze transfer of electrons from NADPH to substrates. The open reading frame Rv1454c of Mycobacterium tuberculosis (Mtb) encodes a NADPH‐dependent QOR that is known to catalyze one‐electron reduction of quinones to produce semiquinones. Here, we report the crystal structures of the apo‐enzyme of MtbQOR and its binary complex with NADPH determined at 1.80 and 1.85 Å resolutions, respectively. The enzyme is bi‐modular. Domain I binds the substrate, while domain II folds into a typical Rossmann fold for tethering NADPH. Binding of NADPH induces conformational changes. Among the known structures of QORs, MtbQOR exhibits the largest conformational change. Movement of Phe41 to stack against Ala244 results in partial closure of the active site. Comparison of the structure with homologs suggests a conserved topology. However, differences are observed in the region around the site of hydride transfer, highlighting differences in substrate specificities amongst the homologs. Unliganded as well as NADPH‐bound MtbQOR crystallized as a dimer. Dimerization is mediated by homotypic intermolecular interactions involving main chain Cα as well as side‐chain atoms of residues. The results of analytical ultracentrifugation analysis revealed that MtbQOR exists as a dimer in solution. Enzymatic assays indicate that MtbQOR prefers 9,10‐phenanthrenequinone over 1,4‐benzoquinone as a substrate. The ability to reduce quinones probably assists Mtb in detoxification of a range of harmful chemicals encountered in the host during invasion.

Database

The coordinates and structure factors for apo‐ and NADPH‐bound MtbQOR have been deposited in the Protein Data Bank under accession codes 4RVS and 4RVU, respectively.
Interface damage behaviour during interference‐fit bolt installation process for CFRP/Ti alloy joining structure
Authors: Li J. , Li Y. , Zhang K. , Liu P. , Zou P.
Published: April 2015

A numerical and experimental investigation was conducted to determine the effect of interference‐fit size on damage behaviour of bolted single‐lap carbon fibre‐reinforced plastic/Ti alloy composite structure. Three‐dimensional finite element analysis (FEA) was conducted for interference‐fit bolt installation process considering the friction coefficient and nonlinear shear stress–strain relationship, and damage sub‐routine was used to predict composite progressive failure region and failure type in single‐lap bolted‐joints. Experiments involving three interference‐fit sizes of 0.4%, 2.1% and 3.0% were designed to verify the FEA. In addition, micro‐analysis results show that damage type during interference‐fit bolt inserting process predicted by FEA was consistent with experimental results. Various types of micro‐scale damage around the hole after interference bolt installation were analysed and characterised, and the effects of interference‐fit size on structure strength were analysed in view of micro‐scale damage. An appropriate interference‐fit size can prompt the carbon fibre‐reinforced plastic hole to become ‘brush‐like’ and exhibit ‘soften’ and ‘buffering’ effect that improves the bearing capacity. In this paper, interference fit of 2.1% exhibits the maximum bearing damage strength.
Modeling the carbon cycle in Lake Matano
Authors: Kuntz L. B. , Laakso T. A. , Schrag D. P. , Crowe S. A.
Published: April 2015

Lake Matano, Indonesia, is a stratified anoxic lake with iron‐rich waters that has been used as an analogue for the Archean and early Proterozoic oceans. Past studies of Lake Matano report large amounts of methane production, with as much as 80% of primary production degraded via methanogenesis. Low δ13C values of DIC in the lake are difficult to reconcile with this notion, as fractionation during methanogenesis produces isotopically heavy CO2. To help reconcile these observations, we develop a box model of the carbon cycle in ferruginous Lake Matano, Indonesia, that satisfies the constraints of CH4 and DIC isotopic profiles, sediment composition, and alkalinity. We estimate methane fluxes smaller than originally proposed, with about 9% of organic carbon export to the deep waters degraded via methanogenesis. In addition, despite the abundance of Fe within the waters, anoxic ferric iron respiration of organic matter degrades <3% of organic carbon export, leaving methanogenesis as the largest contributor to anaerobic organic matter remineralization, while indicating a relatively minor role for iron as an electron acceptor. As the majority of carbon exported is buried in the sediments, we suggest that the role of methane in the Archean and early Proterozoic oceans is less significant than presumed in other studies.
Histological reassessment of the role of bridging fibrosis in the angioarchitectural features associated with lobular distortion of the liver in chronic viral hepatitis
Authors: Hano Hiroshi , Takasaki Satoshi , Endo Yasuhiko , Harada Tohru , Komine Kazumasa , Koike Yujin
Published: April 2015

Aim

To reassess the role of bridging fibrosis in the lobular distortion of the liver from an angioarchitectural aspect.

Methods

Two tissue samples obtained from surgically resected livers with chronic hepatitis and one obtained from an autopsy case with chronic hepatitis were used for the three‐dimensional observation of angioarchitecture by histological reconstruction.

Results

Samples showed bridging fibrosis with various degrees of severity, without cirrhotic changes. Two different types of portal–portal bridging fibrosis were found. In our samples, the type that developed in the bifurcation region of the portal tracts was more common than the type observed between the distal portions originating from different parent portal tracts. The angioarchitecture tended to be generally maintained in these lesions. Concerning portal–central bridging fibrosis, two types were observed. One type developed in the lesion with partial paucity of the third‐step portal branches in the portal tract at a relatively early stage of chronic hepatitis. The other type developed in an advanced lesion with a complete loss of the normal angioarchitecture of the parenchymal portion of the portal veins. The former was likely developed after large‐scale necrosis, such as bridging necrosis, while the latter was presumed to be attributable to portal vein damage associated with long standing chronic inflammation.

Conclusion

As has been previously noted regarding lobular angioarchitecture, portal–central bridging fibrosis clearly affects the lobular structure of the liver more than portal–portal bridging fibrosis. Therefore, portal vein damage may be a critical event in the eventual distortion of the lobular structure.
Evaluation of schistocyte analysis by a novel automated digital cell morphology application
Authors: Hervent A.‐S. , Godefroid M. , Cauwelier B. , Billiet J. , Emmerechts J.
Published: April 2015

Introduction

The CellaVision Advanced Red Blood Cell (RBC) Software Application is a new software for advanced morphological analysis of RBC, which automatically performs a preliminary characterization and grouping of RBC into 21 morphological categories, including schistocytes. Upon automated classification, the software offers the possibility of reclassification of RBC by the operator. The aim of this study was to evaluate the schistocyte analysis by the CellaVision Advanced RBC Application.

Methods

Schistocyte counts were evaluated comparing the automated count on a CellaVision DM96, both before and after reclassification, with the reference manual microscopic method according to the ICSH criteria. Thirty‐six samples of hospitalized patients and 40 samples of controls were analyzed.

Results

Within‐run, between‐run and between‐observer coefficients of variation were lower when counted with the CellaVision compared to the manual microscopic count. The very high sensitivity but rather poor specificity implicates the need for reclassification by the operator, following automated analysis. After reclassification, method comparison studies revealed good agreement with the manual microscopic method, with however slightly higher values of schistocytes for the automated analysis.

Conclusion

The CellaVision Advanced RBC Software Application provides a sensitive and reproducible measurement of schistocytes in peripheral blood, but still requires manual revision. Furthermore, it is an easy‐to‐use software and an excellent teaching tool that might contribute to standardization in the investigation of schistocyte‐related conditions.
MENISCUS INJURIES OF THE KNEE IN THE ELDERLY
Authors: EICHENHOLTZ SIDNEY N. , JACOBS BERNARD , PATTERSON ROBERT L.
Published: April 2015

A survey was made of the records of 119 patients aged 50 or over who had undergone arthrotomy for meniscal lesions during the period 1951–1965. The predominant complaint at the time of admission to the hospital was pain, and half the patients had had knee symptoms for at least six months. In about half the cases there was no history of injury or of injury severe enough to cause meniscal tear, yet at operation about 80 per cent of the cases showed a torn meniscus.

Meniscus tears in the knee joints of elderly patients occur with sufficient frequency to merit detailed study. Delay in necessary surgery may produce or aggravate degenerative joint disease. The symptoms and signs of meniscus lesions in the elderly are virtually the same as in younger patients. When the diagnosis is in doubt, double contrast arthrograms may be helpful. Elderly patients tolerate arthrotomy well, without an undue increase in the incidence of complications as compared to the incidence in younger persons.
THE EMOTIONAL PROBLEMS OF RETIREMENT*
Authors: CHEN RONALD
Published: April 2015

The problems of retirement are discussed from the viewpoints of aging, pre‐retirement reactions, psychological factors, clinical findings, and therapeutic approach.

Successful adjustment to the later years may be contingent upon the elderly person's ability to recognize his limitations, to give up work gradually, and to devote an increasing proportion of his time to leisure activities.
ACUTE BACTERIAL INFECTIONS IN THE ELDERLY MALE: CULTURES AND ANTIBIOTIC SENSITIVITY TESTS
Authors: LANE WILLIAM K.
Published: April 2015

In a Veterans Administration hospital, repeated cultures were made of body fluids from 92 elderly male patients who had acute illnesses during the observation period of twenty‐eight months. The urinary and respiratory tracts were the most common sites of bacterial infection.

The pneumococcus was the most common cause of respiratory‐tract infection, but in a surprisingly large number of cases the offenders were the Klebsiella‐aerobacter group, Staphylococcus aureus, Proteus mirabilis and Escherichia coli. Tracheostomy favored the growth of Pseudomonas. Escherichia coli was the most common cause of urinary‐tract infection. Next in order were Pseudomonas aeruginosa, Proteus mirabilis and the Klebsiella‐Aerobacter group. The presence of an indwelling catheter favored the growth of Pseudomonas, Staph. aureus, Paracolobactrum aerogenes and Proteus species. Staphylococcus aureus was the most common cause of skin infections. Escherichia coli was the organism most frequently found in septicemia.

Tables are presented showing the sensitivity of various bacteria to 14 selected antibiotics. The findings indicate that the term “broad spectrum” should be used with great circumspection and possibly be restricted at present to such agents as kanamycin and chloramphenicol.
FOSTER CARE AS A THERAPEUTIC PROGRAM FOR GERIATRIC PSYCHIATRIC PATIENTS
Authors: HANDY IMENA A.
Published: April 2015

This study deals with the question of what has held back the widespread use of foster homes for geriatric psychiatric patients. In the sixteen years since foster homes were first used by the Veterans Administration, the program has grown twenty‐fold. However, since all VA neuropsychiatric and twenty of the general medical service hospitals participate, this is a relatively small increase; in 1965, there was even a decrease.

Some reasons for the slow growth of the foster‐home program are: 1) the difficulties of finding, evaluating and supervising foster homes in such a way that the people who run them (sponsors) receive the satisfaction and joy that rewards them for their heavy personal investment; 2) interfering relatives who, either because of guilt for not taking the patient into their own homes or because of resentment about having to pay for him, block his placement in a foster home; 3) the problem of matching the patient's needs with the resources of the foster home; and 4) the relatively small number of spectacular successes. The results are meager in relation to the emotional investment the sponsor makes in these patients, who are bound to become progressively disabled as they grow older. The sponsor has to be satisfied with the patient's minimal improvement and his “happiness” in being out of the hospital.
RETURNING THE GERIATRIC VETERAN TO THE COMMUNITY FROM A NEUROPSYCHIATRY HOSPITAL
Authors: JUSTICE VERNELL O. , BENDER DARYL
Published: April 2015

The results of this pilot study indicate that the characteristics of 107 elderly (mostly psychiatric) patients released from the Geriatric Unit of a Veterans Administration Hospital did not differ significantly from those of most other older patients found in nursing homes. Age, diagnosis, and length of stay in the hospital proved not to be important factors in selecting the patients who should be released or in determining their adjustment potential. Of the 107 patients, 69 (64 per cent) had incomes of $200 or less per month.

Re‐education of the families and the public in general may permit more veterans to return to their own homes or to live with relatives. An increase and/or extension in the veteran's benefits may be far less costly than maintaining him in the hospital when he requires only custodial or nursing care. There is a need for more intermediate‐care facilities, such as sheltered‐care homes and homes for the aged, to accommodate these veterans.
PRESSURE WAVE VELOCITY IN THE HUMAN AORTA*
Authors: Nielsen B. Lyager , Nielsen J. Straede , Fabricius J.
Published: April 2015

Abstract

After introduction of a catheter into the aorta, the pressure wave velocity was measured in 26 subjects whose ages ranged from 9 to 68 years. The first site of registration was approximately 10 cm from the aortic valve, and the second was 50 cm distal to the first. At both sites the time difference was measured between the R‐wave of the electrocardiogram and the foot of the pressure wave (TProx. and TDist.). The time difference T50 (TDist. – TProx.) and the distance between the sites of registration (50 cm) were used for the calculation of the pressure wave velocity (PWV).

Four of the 26 subjects were normal; the others had some form of heart disease, including disease of the valves, hypertension and aortic atherosclerosis. Nevertheless, the values found for pressure wave velocity were in agreement with those stated in literature.

A significant correlation was found between T50 and age (r = —0.788), between T50 and the proximal systolic blood pressure (r = −0.537), and between T50 and the proximal pulse pressure (r = −0.491), but not between T50 and the cardiac output and peripheral arterial resistance. There was no correlation between the proximal diastolic blood pressure and T50, possibly owing to the fact that all the patients had a diastolic blood pressure below 100 mm Hg. There was no significant difference between the coefficient of correlation for T50 and age (−0.788) and the multiple coefficient of correlation for T50 and age and systolic blood pressure proximal in the aorta (−0.811). Four patients had arteriographic aortic atherosclerosis. Two of these had lower T50 values than would be expected according to the proximal systolic blood pressure and the pulse pressure, but after exercise the values were within the normal range (±2 s.d.)

Owing to the dominating influence of age on T50 and the considerable spreading of these values, it is not likely that the determination of pulse wave velocity will be of clinical value, for example, in the diagnosis of atherosclerosis.
NONSTEROID ANTI‐INFLAMMATORY AGENTS IN THE THERAPY OF RHEUMATIC DISEASES
Authors: WARD L. EMMERSON
Published: April 2015

Abstract: The management of rheumatoid arthritis is outlined in detail since certain basic principles are applicable to the management of other rheumatic disorders discussed much more briefly. Emphasis is laid on the physician‐patient relationship. It is important for the physician to inform the patient of some of the basic facts about the disease and the general objectives of treatment. Also important is the patient's choice of objectives. Therapy with the following nonsteroid drugs is discussed: salicylates, indomethacin, phenylbutazone, aminoquinoline compounds and gold salts.

The treatment of rheumatic diseases is largely empiric and is directed toward symptomatic relief and palliation. Knowledge of causes and cure is grossly deficient, and our therapeutic capabilities are limited. Nevertheless, significant advances are being made in the investigative laboratories and in the application to patients of the knowledge and therapy which are available.
INTERRELATIONSHIPS OF OPHTHALMOLOGY AND RHEUMATIC DISEASES
Authors: NOWICKI NORBERT J.
Published: April 2015

Abstract:Some of the ocular lesions associated with rheumatic diseases are described—uveitis, scleritis and scleromalacia, retinitis, and keratoconjunctivitis sicca. Also discussed are the ocular complications associated with treatment of rheumatic disease. These complications include steroid cataracts, steroid glaucoma, and chloroquine changes.

A plea is made for clinicians to be aware of the possible cata‐ractogenic influence of corticosteroid therapy, and also the possibility of steroid‐induced glaucoma, particularly in a patient with incipient glaucoma or with a family history of the disease. The possible retinotoxic effects of long‐term chloroquine or hydroxychloroquine therapy should be kept in mind. To avoid these dangers, patients receiving steroids or chloroquine for prolonged periods should undergo regular eye examinations.
ALPHA‐RAY ACTIVITY IN CORONARY ARTERY DISEASE
Authors: ELKELES ARTHUR
Published: April 2015

Abstract: The ash concentrations and the alpha‐ray activities of the coronary and of the common carotid arteries were examined in 16 subjects who died of ischaemic heart disease (average age, 64.8 years), and in 17 subjects who died of other causes (average age, 62 years).

The ash concentrations in the coronary arteries of the subjects with fatal ischaemic heart disease were twice as high as in those of the controls. They were very low in the common carotid arteries of both groups. Ulcerative and calcified atheromatous lesions in the common carotid arteries were rare at all ages.

Postmortem radiography of these vessels revealed distinctly more calcium deposits in the coronary arteries of the subjects with fatal ischaemic heart disease than in those of the controls. No calcium deposits were visible in the common carotid arteries of both groups.

The wet‐tissue alpha‐ray activities in the coronary arteries of the subjects with fatal ischaemic heart disease were four times higher than in the coronary arteries of the controls, five times higher than in their own common carotid arteries, and ten times higher than in the common carotid arteries of the controls.

The mean value of the alpha‐ray activities in the coronary arteries of subjects with fatal ischaemic heart disease equals that found for human bones. It is higher than in any other soft tissue in the human body.

X‐irradiation of the larger arteries can produce severe atheromatous lesions in animals and in human beings within a relatively short time.

The concept is advanced that the small amounts of alpha‐radiation in the arterial wall, which increase with age, may cause subtle injuries to the arterial structures, thus contributing to the development of atherosclerosis.
TRENDS IN PSYCHIATRIC HOSPITAL CARE OF GERIATRIC PATIENTS IN THE UNITED STATES
Authors: HEFFERIN ELIZABETH A.
Published: April 2015

Abstract: State (or public) mental hospitals in the United States, like many other social institutions, came into being in response to a recognized social need for providing facilities which would offer security for the mentally ill in the population.

This review of the history of these hospitals reveals several recurring themes: the tendency for public shifting of the responsibility for the care of the poor and the mentally ill upon the government, and the shifting of this same responsibility between the levels of government (from community to local to state to local community); the periodic rousing of the public interest and compassion by reform movements, too soon followed by public return to apathy or diversion to more rewarding issues; and the recurring conflict between socio‐cultural and scientific values with regard to costs of application of psychotherapeutic methods for care of the patients.

Further analysis of the data also reveals that there has been an improvement over time with regard to the physical care of patients, but not in the reduction of their numbers through this care. In fact, until just recently, better care seemed to result only in a greater average duration of hospital stay for many patients, if only because they now lived longer. After rather belatedly becoming concerned about the rising incidence of mental illness in an ever‐increasing population and therefore higher admission rates to already over‐crowded state mental hospitals, the Federal Government authorized a series of studies of the problem, and has passed legislation to begin an alleviation of the situation. Possible outcomes of these legislative measures have been discussed, along with some possibly negative effects if too‐hasty action should be taken in lieu of careful planning.
EXPERIMENTAL APPROACH TO SERVICES FOR THE READY‐TOADMIT APPLICANT TO A GERIATRIC HOME AND HOSPITAL*
Authors: BRUDNO JOSEPH J.
Published: April 2015

Abstract: Twenty‐one ready‐to‐admit applicants to a geriatric home participated in three preparatory group programs (7 members each), designed to alleviate their anxieties about entering this large, sometimes frightening setting. Friendships were made and morale was fairly high in each of the groups. After admission, member sought out member. These applicants seemed to have more personal responsibility to adjust to the home, to stay well and to assist each other than did unprepared applicants.
DIPHENIDOL IN VERTIGO: A CONTROLLED CLINICAL EVALUATION
Authors: ROWAN NOEL M.
Published: April 2015

Abstract: In a double‐blind study, diphenidol was compared to placebo in 39 patients with vertigo from various causes. Fifteen of 19 patients taking diphenidol (dosage, 25 mg four times daily) obtained good or excellent relief of vertigo, whereas only 5 of 20 patients taking placebo obtained this degree of relief (P < .01).

No side effects occurred in this series, but there are reports of such effects in the literature. Therefore, diphenidol should be used only under conditions of strict supervision.
PSYCHO‐SOCIAL CHANGES IN PERSONALITY DURING FOSTER GRANDPARENTS PROGRAM*
Authors: Rybak W. S. , Sadnavitch J. M. , Mason B. J.
Published: April 2015

Abstract

Older persons in our society are forced into retirement arbitrarily and thus experience great difficulty in psychosocial adjustment. The social benefits provided by society fail to foster the original aims of the program; as a result the older person must seek additional aid or part‐time employment.

The purpose of this report is to describe a foster grandparent program designed to promote better psycho‐social adjustment for older persons. An informal scale for assessing psycho‐social needs is presented. The results obtained with use of this scale indicated that the foster grandparents felt more positively about specified psycho‐social items after taking part in this program than before participation. Hence it is concluded that a foster grandparent program can counteract some of the negative aspects of aging and society's attitude toward the process.
MEDICAL STUDENT ATTITUDES TOWARD THE GERIATRIC PATIENT*
Authors: Spence Donald L. , Feigenbaum Elliott M. , Fitzgerald Faith , Roth Janet
Published: April 2015

Abstract

Questionnaires designed to test attitudes toward old people were given to both the freshman class and the senior class of students in the University of California School of Medicine. Results of the study showed that these two groups shared most of the general societal conceptions and misconceptions about the aged. In addition, these students adhered to a set of medical stereotypes about aging to a degree surprisingly unmodified by the much‐vaunted medical socialization process; freshmen and seniors agreed on many aspects of the subject. The results of this attitudinal status were manifested in a medical prejudice against old patients, as expressed in the replies given to the questionnaire.

How much of the difference observed between the attitudes of the freshmen and the seniors was due to non‐medical acculturative influences (such as the demographic characteristics unique to each group) and how much to the medical socialization procedure, was difficult to ascertain. More significant, however, was the lack of difference between the two student classes and the failure of three years of medical education to mitigate factors injurious to a major and growing segment of the population—aged patients.
MEDICAL CARE FOR THE ELDERLY IN THE FUTURE*
Authors: Hall Durward G.
Published: April 2015

Abstract

This article concerns: 1) some of the problems encountered under Medicare and Medicaid (especially in relation to the costs and standards of extended care facilities); 2) the problems of the doctors regarding allocation of the proper share of medical costs to the hospitals, and the campaign for pre‐paid group practice; 3) the prospects for success of the proposed amendments to the Public Health Service Act based on good results with the heart disease‐cancer‐stroke programs despite certain pitfalls; and 4) the future of the Hill‐Burton Act. Is the outcome to be more Federal authority and the disappearance of State responsibilities?

Many people who never get to Washington assume there is a magical elixir there that turns out the right solution to every problem. It should be pointed out, however, that after three years of observing riots across the country, Washington still didn't know what to do when the city exploded; after two decades of planning and supervising the Interstate Highway Program they still have some of the worst imaginable traffic jams of every artery leading out of Washington at sunrise and sunset; and the political pundits who thought they knew exactly who the two presidential candidates would be next November have had to change their predictions at least twice in the last month. Anything Washington can do, you can do better if you'll set your minds, your wills and your skills to the task.
MEDICARE: CHALLENGE OR CHORE*
Authors: Read Hilton S.
Published: April 2015

Abstract

A practicing physician in New Jersey describes how medical care for his elderly private patients is carried out under Medicare. If the office set‐up is modern and appropriate, good‐quality care can be rendered to old people under Medicare, on a “fee for service” basis, without third‐party invasion and with no additional paper work.
PREVENTION OF EXECUTIVE OBSOLESCENCE*
Authors: Ochsner Alton
Published: April 2015

Abstract

Executive obsolescence and premature senility can be controlled to a great extent by avoiding certain factors which accelerate the aging process, i.e., lack of exercise, obesity, and the use of tobacco. Prophylactic measures include exercise such as walking, with or without jogging, to the point of tolerance; the avoidance of sedentary occupations; walking up and down stairs instead of using an elevator; the prevention of obesity or the reduction of overweight when present; and abstinence from tobacco smoking.
SKIN PROBLEMS IN THE GERIATRIC AND GENERAL HOSPITAL: INCIDENCE, SCOPE, CAUSE
Authors: Young Alex W. , Miller Leon
Published: April 2015

Abstract

Five hundred and forty‐three patients (random sampling) were examined for skin disorders according to the following groups: A) 388 geriatric patients in a chronic disease hospital, B) 74 geriatric patients in a general hospital, and C) 81 younger patients in a general hospital. A cutaneous disorder was found in 440 of the 543 patients, and 56 per cent of these disorders were of the type requiring specialized attention. Factors which influenced the incidence of skin disease, especially in the geriatric patients, included the degree of ambulation, length of hospital stay, previous skin care, environment, emotional adjustment, medication, associated medical disorders, and past dermatological disease. The most important disorders in the geriatric patients included essential senile pruritis, epithelioma, cutaneous ulceration, pemphigoid, psoriasis, precancerous lesions, neurodermatoses, intertrigo, contact dermatitis, pyoderma and mycotic infections. The high incidence of these cutaneous diseases, especially in geriatric patients, justifies routine dermatological rounds in hospital wards as a factor in the total care of the patient.
REMOTIVATION OF LONG‐TERM MALE SCHIZOPHRENIC PATIENTS*
Authors: Lerner Joseph , Paik George , Sanborn Kenneth O. , Murata David M. , Moravec George G.
Published: April 2015

Abstract

A vocational rehabilitation project for chronically ill schizophrenic male patients at Hawaii State Hospital involved the comparison of two groups of patients: (a) 32 who underwent a program of work conditioning plus vocational rehabilitation services, and (b) 19 who received only the regular hospital vocational therapy. By means of work‐tolerance and adequate‐vocational‐personality tests, it was possible to assess the patient's ability to adjust to community placement. Placement in a job in the community involved follow‐up assessments at twelve and eighteen months.

The results of this study support the concept that vocational rehabilitation programs for patients with chronic schizophrenia can increase their chances for discharge from the hospital and can enable them to maintain themselves in the community if provided with vocational rehabilitation services and follow‐up. Work‐conditioning did not seem to be the prime factor in this success. The study also illustrates the cooperation of both private and governmental agencies in the use of manpower, facilities and funds to reduce the schizophrenic patient's difficult transition from the hospital to the community.
ORGANIZATION OF A COMPREHENSIVE MEDICAL CARE PROGRAM IN A CHRONIC DISEASE HOSPITAL
Authors: Mark Herbert
Published: April 2015

Abstract

A program is described for the comprehensive care of patients on the medical service in an 1800‐bed municipal chronic disease hospital. Patients with neoplastic disease or those who need merely custodial care are not considered candidates for admission. Every new patient first stays in the admitting section for about three weeks to undergo thorough evaluation of his needs and rehabilitation potential. He is then transferred to one of the four comprehensive care units on the medical service. This unit system facilitates the assignment of a personal physician to each patient. The staff is organized into teams to provide the non‐medical as well as the medical services required during the patient's entire stay in the hospital. Interdisciplinary teaching conferences encourage efficiency on the part of all staff members.

Because the chief goal of the program is the provision of comprehensive care for patients with multiple problems, the staff physicians can no longer be concerned with only a single disease or organ system. They must cope with a wide range of medical problems and also with the patient's reactions to his disease and the interrelationships between the patient, the family and the community. Such a program provides a new, flexible approach to services, teaching and research in the care of the chronically ill.
USE OF FUROSEMIDE FOR EVALUATION OF THE URINARY CONCENTRATING MECHANISM IN CHRONIC PYELONEPHRITIS
Authors: Radó János P. , Borbély Lajos , Takó József , Bános Csaba
Published: April 2015

Abstract

A report is presented of a polyuric condition associated with chronic bilateral pyelonephritis in an old diabetic patient during an aglucosuric period. On the basis of the limited response to lysin‐vasopressin and the extremely low values obtained for solute‐free water abstraction per 100 ml glomerular filtration, a defective operation of the countercurrent concentrating mechanism was demonstrated.

The normal response induced by furosemide during both maximal sustained water diuresis and hydropenia indicated that the sodium pump in the ascending limb of the loop of Henle was operating satisfactorily. Therefore, the disordered function of the countercurrent system was not due to insufficiency of sodium transport but probably to the lack of “solute‐trapping” ability of the disintegrated renal medulla.