bluuebunny/crossref_metadata_2025 huggingface dataset:
Creation of Myelomeningocele in the Fetal Rabbit
Authors: Housley H. Tamiko , Graf Joy L. , Lipshultz Gerald S. , Calvano Christopher J. , Harrison Michael R. , Farmer Diana L. , Jennings Russel W.
Published: April 2003

Objective: Myelomeningocele is a neural tube defect resulting in an exposed spinal cord, which leads to irreversible neurologic damage at birth. We proposed development of a fetal rabbit model of myelomeningocele to study in utero spinal cord injury and repair strategies. Methods: New Zealand white rabbits (n = 10) at 22 days of gestation (term = 31 days) underwent laparotomy to expose the gravid uterus; a hysterotomy exposed the fetal hindlimbs and back. A three to four level lumbar laminectomy was performed, and the dura over the posterior spinal cord was removed. At 30 days of gestation, the does underwent C-section for fetal harvest, and total fetal number, length, weight, and the presence or absence of a spinal defect were recorded for all viable fetuses. Results: All injured fetuses were smaller and weighed less than the nonoperated littermate controls, and histologic examination confirmed a spina bifida-like lesion of their spinal cords. Conclusions: We successfully created an exposed spinal cord defect in the fetal rabbit model similar to the lesion found in humans. Advantageous because of low animal cost, relatively large fetal size, multiple fetuses per pregnancy, and short total gestation, this model will allow us to study the mechanism of injury to the exposed spinal cord, and perhaps develop strategies to repair human myelomeningoceles.
A Fetus with Prader-Willi Syndrome Showing Normal Diurnal Rhythm and Abnormal Ultradian Rhythm on Heart Rate Monitoring
Authors: Hiroi Hisahiko , Kozuma Shiro , Hayashi Naoki , Unno Nobuya , Fujii Tomoyuki , Tsutsumi Osamu , Okai Takashi , Taketani Yuji
Published: April 2003

Clinical features of Prader-Willi syndrome in neonates are marked hypotonia with the absence of crying and feeding difficulty so that prenatal diagnosis of Prader-Willi syndrome is strongly hoped in order to provide appropriate medical and psychological care for neonates and their families. However, the clinical picture of Prader-Willi syndrome in utero has not been well described. We report a pregnancy associated with Prader-Willi syndrome manifesting polyhydramnios, large biparietal diameter of the fetus and characteristic fetal heart rate pattern: prolonged inactive periods and diurnal variation of the incidence of heart rate accelerations. These findings may offer a clue to the prenatal diagnosis of Prader-Willi syndrome, although molecular cytogenetics is mandatory for the definite diagnosis.
Adenosine Triphosphate for Cardioversion of Supraventricular Tachycardia in Two Hydropic Fetuses
Authors: Dangel J.H. , Roszkowski T. , Bieganowska K. , Kubicka K. , Ganowicz J.
Published: April 2003

Objective: We performed a retrospective study to check the effectiveness of adenosine triphosphate (Striadyne) for cardioversion of fetal supraventricular tachycardia (SVT) and to evaluate neonatal outcome after prenatal treatment of severe SVT with fetal hydrops. Methods: Two hydropic fetuses with SVT were treated with Striadyne injection into the umbilical vein, as an additional treatment to the digoxin given intravenously to the mother. Both fetuses were in severe condition, with ultrasound, Doppler and laboratory signs of fetal distress and congestive heart failure. Results: Sinus rhythm was obtained in both cases for different periods of time, without side effects of Striadyne. The children survived. There were severe cardiac and neurologic problems after delivery. Conclusions: Striadyne was an effective drug in converting SVT to the sinus rhythm in hydropic fetuses. Digoxin was useless in these fetuses in spite of the therapeutic level which was obtained in both mothers. We suppose that fetal SVT causing fetal hydrops could be the reason of brain damage, and intensive antiarrhythmic treatment seemed to be necessary.
Evaluation of Some Velar Functions before and after Surgical Treatment of Snoring
Authors: Woisard V. , Puech M. , Yardeni E. , Percodani J. , Serrano E. , Pessey J.J.
Published: April 2003

The aim of this prospective study was to evaluate velar function before and after uvulopalatopharyngoplasty for isolated snoring and for sleep apnoea. It is based on the analysis of oral and nasal airflow during phonation by an EVA workstation of 24 patients before and after the surgical intervention. The results show (1) quantitative and qualitative airflow abnormalities before the operation, (2) an increase in the percentage of nasal airflow after the operation, and (3) a change in the airflow sequence, which is improved after the surgical procedure. In conclusion, this work confirms a modification of velar function after uvulopalatopharyngoplasty and raises the problem of contra-indications to this intervention.
Hyperactivity, Inattention and Motor Control Problems: Prevalence, Comorbidity and Background Factors
Authors: Gillberg Christopher
Published: April 2003

This paper provides a brief review of syndromes associated with activity dysregulation, inattention and motor control problems, usually referred to as attention-deficit/hyperactivity disorder, developmental coordination disorder and deficits in attention, motor control and perception. Several percent of school age children are affected by such problems. Disorders tend to overlap and show significant comorbidities. Familial and brain-damaging factors are involved in the pathogenesis and appear to impinge on specific attentional brain systems. Outcome is variable but restricted if appropriate diagnosis/intervention is not accomplished. Effective interventions are available. Given the high prevalence of these disorders and their relatively poor outcome, such interventions could constitute effective prevention in a general population health perspective.
Neuroimaging and the Trimodal Brain: Applications for Developmental Communication Neuroscience
Authors: Lauter J.L.
Published: April 2003

New details generated by neuroimaging and other methods for studying the neural correlates of behavior have led to the formulation of a new model of brain organization, the Trimodal Brain. The model incorporates current biochemical, anatomical, and physiological concepts of prenatal brain growth and combines them with findings on right/left functional asymmetries. It provides a means of relating a wide range of human behaviors and clinical states according to a common base of neural organization, and stresses the utility of an organizational rather than a lesion model for understanding developmental communication disorders.
Reading and Writing Development: Report from an Ongoing Longitudinal Study of Language-Disordered and Normal Groups from Pre-School to Adolescence
Authors: Nauclér Kerstin , Magnusson Eva
Published: April 2003

This interim report provides information on an ongoing longitudinal study of 115 subjects, 78 language-disorderd children and 39 children with no known language disorders as a control group. This follow-up study reports on a subgroup of the original subjects, 90 adolescents who completed a questionnaire, and 48 of the 90 who have been administered a full test battery compiled by the authors. Ongoing analyses indicate that early language problems are slow to resolve, persisting in one linguistic form or another in these adolescents who are now age 18 and about to leave school.
Morphological Representationin Specific Language Impairment:Evidence from Greek Word Formation
Authors: Dalalakis J.E.
Published: April 2003

Specific language impairment (SLI) is characterized by difficulties in inflectional morphology. Here we investigate SLI morphological competence to build and represent complex word structure. We examine the findings of two tasks where SLI subjects’ performance is compared to that of controls: (a) plural formation and (b) compound formation. Subjects were presented with real and novel singular nouns in Greek and required to form plurals and compounds in each respective task. Both plural formation and compound formation are productive processes readily observed in non-impaired youngsters, with typical non-impaired errors being mostly constrained over-generalizations. The SLI children whose performance we consider here are below par in their morphological competence and the findings suggest that they do not build lexical representations that represent sublexical features or complex word-internal structure.
Uninflected Structure in Familial Language Impairment: Evidence from French
Authors: Rose Yvan , Royle Phaedra
Published: April 2003

We present the results of 20 French subjects with familial language impairment (FLI) on a linguistic battery task, with an emphasis on verb production. The results show strong qualitative differences between the verb production of FLI subjects and that of controls. Language-specific factors do not seem to determine the production of verbs in French FLI individuals. Rather, verb frequency and the inflectional status (uninflected vs. inflected) of the form seem to be determining factors in correct/incorrect production of a verb in a sentence context. The phonetic structure of French inflection provides additional arguments against the hypothesis of a processing deficit in FLI subjects. French tense morphemes are stressed and salient, and should therefore be produced without problems, according to the processing hypothesis. We found evidence contrary to this postulate. We therefore submit that the morphological deficit hypothesis is supported by the French data.
Issues in the Management of Dysphagia
Authors: Langmore Susan E.
Published: April 2003

Management of patients with dysphagia is a necessary part of our clinical intervention. Some areas of management include implementing dietary changes that the patient will accept and training caretakers to feed dependent patients safely and to provide oral care to dependent patients. The tube-fed patient has special needs in regard to quality of life and is at greater risk for pneumonia, requiring the effective skills of multiple disciplines to effectively manage this patient. The most successful dysphagia programs address these management concerns from a multidisciplinary perspective; the speech-language pathologist cannot function effectively as a sole provider.
Dyslexia: Oral and Written Language Disorder
Authors: de Montfort Supple Marie
Published: April 2003

It is now generally accepted that written language attainment is directly associated with oral language ability, and that deficits in oral language will be reflected in written language. This paper examines the links that exist between these two modes of communication from a historical perspective, as well as from current research. The concept and terminology of dyslexia – written language disability – are explored. The impact of deficits in phonology, vocabulary, semantics and syntax on the acquisition of written language is discussed.
Developmental Language Impairments with Complex Origins: Learning from Twins and Multiple Birth Children
Authors: Mogford-Bevan Kay
Published: April 2003

Various factors that make language development vulnerable in twins and multiple birth children are discussed. Researchers have investigated single explanations for language impairment in twins. However, this paper argues that in individual cases the language impairment is more often the outcome of a complex interaction of factors. Some factors play a greater part than others in some cases. It is suggested that clinicians can develop a dynamic model of language acquisition from understanding the effect of multiple birth and other exceptional circumstances on language acquisition. This model is needed to underpin investigations into individual cases of language impairment. An approach to assessment is described that identifies factors operating in individual cases of multiple birth, providing an essential precursor to implementing appropriate case-based intervention.
Sprechgeschwindigkeit bei kompensatorischer Artikulation von Patienten mit Lippen-Kiefer-Gaumenspalten
Authors: Bressmann Tim , Sader Robert , Merk Michael , Ziegler Wolfram , Busch Raymonde , Zeilhofer Hans-Florian , Horch Hans-Henning
Published: April 2003

Infolge eines primären Defizits der velopharyngealen Funktion liegen bei vielen Patienten mit Lippen-Kiefer-Gaumenspalten sekundäre kompensatorische Lautbildungen vor. Mit zwei neuen Computerprogrammen werden die Auswirkungen der kompensatorischen Artikulation auf die durchschnittliche Sprechgeschwindigkeit von 146 Patienten mit Lippen-Kiefer-Gaumen-spalten untersucht. Die Patienten wurden dabei nach dem Schweregrad der artikulatorischen Auffälligkeit gruppiert. Bei der schnellen Silbenwiederholung zeigte sich, dass die durchschnittliche Silbenrate pro Sekunde bei Patienten mit deutlich auffälliger Artikulation signifikant reduziert war. Beim Nachsprechen von Sätzen war die zum Nachsprechen benötigte Gesamtzeit bei dieser Patientengruppe signifikant erhöht, und das Zielwort des Satzes wurde signifikant später begonnen. Die Ergebnisse zeigen, dass die mittlere Sprechgeschwindigkeit von Patienten mit Lippen-Kiefer-Gaumenspalten mit kompensatorischer palatolalischer Artikulation niedriger ist.
Temporal Speech Characteristics of Individuals with Multiple Sclerosis and Ataxic Dysarthria: ‘Scanning Speech’ Revisited
Authors: Hartelius Lena , Runmarker Björn , Andersen Oluf , Nord Lennart
Published: April 2003

‘Scanning speech’ has been used as a description of a prominent characteristic of the dysarthria of multiple sclerosis (MS) as well as of ataxic dysarthria in general. It is thought to be measurable as equalised syllable durations. There are seemingly contradictory prosodic-temporal characteristics of ataxic dysarthria: perceptually characterised as prosodic excess as well as phonatory-prosodic insufficiency and acoustic characteristics including signs of isochrony as well as variability. This study investigates the temporal characteristics at two levels, duration and variability of syllable durations and the durations of interstress intervals. A group of 14 individuals with MS and ataxic dysarthria as well as 15 control subjects were studied. It was concluded that individuals with ataxic dysarthria and MS showed (a) for syllables: significantly increased durations and decreased intrautterance variability (more isochrony or syllable equalisation) as well as significantly increased interutterance variability; (b) for interstress intervals: significantly increased durations and increased variability (less isochrony). The results point to inflexibility as well as instability of temporal control, which could contribute to the explanation of why the perceptual characteristics are contradictory.
Treatment of Reflux-Related and Non-Reflux-Related Dysphonia with Profound Gastric Acid Inhibition
Authors: Willems-Bloemer L.H. , Vreeburg G.C.M. , Brummer R.-J.M.
Published: April 2003

Thirty-eight patients with dysphonia exceeding 3 months, not caused by trauma, infection, paralysis or allergy, were studied. In all patients a 24-hour ambulatory dual-probe pH monitoring, 5 and 20 cm above the lower oesophageal sphincter was performed. Subsequently they were treated with lansoprazole 30 mg once daily during 6 weeks. A voice range profile, perceptual evaluation of the voice and videolaryngostroboscopy were performed in all patients before and after treatment. A questionnaire about laryngeal symptoms and heartburn was completed on the same two occasions. Thirty-nine percent (15 out of 38) of the patients had an abnormal pH profile and were considered to have reflux-related dysphonia. Only these patients showed a significant improvement in their subjective score on dysphonia (p < 0.05), chronic cough (p < 0.05), dysphagia (p < 0.05) and heartburn (p < 0.01). Also posterior erythema decreased significantly in these patients (p < 0.01). Only 2 of the 15 subjects did not complain of heartburn.
Analyse morphofonctionnelle des fémurs et des tibias des «Adapis» du Quercy: mise en évidence de cinq types morphologiques
Authors: Bacon Anne-Marie , Godinot Marc
Published: April 2003

The study of 13 partial femora and 3 tibiae from late Eocene Quercy localities (France) confirms the distinction of the two adapinine genera Adapis and Palaeolemur. The femora come from both new (Rosières 2 and Escamps) and old collections (of uncertain provenance). They allow the distinction of 5 morphological groups, whose morphological characteristics are functionally explained. Adapis and Palaeolemur show strong similarities to some small living platyrrhines (Saimiri, Cebus, Aotus) and much less to lorisines. Type 1 and type 2 were probably branch walking and running forms, using climbing less frequently. Types 4 and 5 were probably less specialized for running and used climbing more frequently. These relatively close 4 types are interpreted as 4 species of Adapis. Type 3 is associated with the only species known from Escamps, Palaeolemur betillei. This last species appears to have been predominantly a climber, however, without the morphological specializations of the posterior limb associated with slow climbing in lorisines.
Diet and Feeding Ecology of Ateles belzebuth belzebuth at Maracá Ecological Station, Roraima, Brazil
Authors: Nunes Andréa
Published: April 2003

The diet and feeding behaviour of an habituated group of free-ranging spider monkeys (Ateles belzebuth belzebuth) were studied from 1987 to 1989. Their dietary patterns were analysed in relation to the temporal and spatial distribution of food resources. The results indicate that ripe fruit was regularly eaten throughout the study period and that diet composition was significantly related to the overall availability of ripe fruit sources.
Colour Cues for Leaf Food Selection by Long-Tailed Macaques (Macaca fascicularis) with a New Suggestion for the Evolution of Trichromatic Colour Vision
Authors: Lucas P.W. , Darvell B.W. , Lee P.K.D. , Yuen T.D.B. , Choong M.F.
Published: April 2003

Leaf colour, size and toughness were investigated in five plant species important in the diet of Macaca fascicularis in Singapore. Leaf colour and size were examined as potential visual cues for food selection, whereas toughness mirrored fibre content, the inverse of food quality. As leaves matured, they changed colour and toughened. Leaf lightness and yellowness were strongly negatively correlated with toughness, but variation in both the red-green axis of the CIE Lab colour space and leaf size were not. Leaves selected as food by the macaques were distinguished by being very light, yellow to slightly green. Some leaves were dappled with red. The literature suggests that these leaves are relatively rich in protein without being tough and therefore would be sought after by primates. We argue that leaf colour is an important indicator of the nutritive value of leaves. Trichromatic vision is an important advantage in finding those palatable leaves that are dappled red. These would appear dark to dichromatic primates and be deceptive by making leaves look older (lower in quality) than they actually are. This would decrease the perceived window of feeding opportunity for such primates who would be at a disadvantage in trying to find these leaves. It is possible that trichromatic vision in catarrhine primates may have originally evolved for the detection of red coloration in the leaves of shade-tolerant tropical plants, enabling the better exploitation of a food resource.
Social Rank and Sex-Biased Maternal Investment in Captive Japanese Macaques: Behavioural and Reproductive Data
Authors: Schino Gabriele , Cozzolino Roberto , Troisi Alfonso
Published: April 2003

This study investigated the relationship between social rank and sex-biased maternal investment in captive Japanese macaques (Macaca fuscata) using reproductive and behavioural data. High-ranking mothers showed a significantly male-biased secondary sex ratio, spent more time in contact with and carried male infants for longer than female infants. Low-ranking mothers showed no bias in secondary sex ratio nor in the time spent in contact with male and female infants, but carried female infants for longer. No differences were observed in the interbirth intervals following male and female infants nor in the frequency and intensity of aggression received by mothers with male and female infants, either in high-ranking or in low-ranking mothers. These results show that Japanese macaque mothers can adopt flexible and rank-dependent rearing strategies.
Basal Synthesis of Heat Shock Protein 70 Increases with Age in Rat Kidneys
Authors: Maiello Michele , Boeri Daria , Sampietro Lorenzo , Pronzato Maria A. , Odetti Patrizio , Marinari Umberto M.
Published: April 2003

The heat shock protein (HSP) system is a mechanism of cell defense induced by stress, constitutively expressed during basal conditions and essential to the maintenance of cellular integrity. Acutely induced HSP synthesis decreases with aging, but the effect of age on the basal expression of HSP70 has not been specifically addressed so far. The aim of this work is to study the age-dependent basal concentrations of HSP70 mRNA in rat kidneys. In 8 young (2–3 months), 6 adult (6–11 months) and 6 old male Wistar rats (22–27 months), steady-state concentrations of HSP70 and γ-actin mRNA and of rRNA were measured. Pentosidine was measured by HPLC. The basal, unstimulated HSP70 mRNA is increased in young and old rats compared with adult subjects [young: 182% of adult levels (100–299), old: 167% of adults (142–209); p < 0.005]. The amount of pentosidine increases with age (young: 0.6 ± 0.1; adult: 1.65 ± 0.15; old: 2.3 ± 0.3 pmol/mg of protein; p < 0.0001). It seems likely that different mechanisms are responsible for the increased HSP70 basal synthesis in both the young and old animals. The prevalence of anabolic activity can trigger the increased basal production of HSP70 in young rats. The accumulation of posttranslational modified proteins, documented by pentosidine, can chronically enhance HSP70 synthesis in aged animals. The suppression of the synthesis of other proteins accompanying HSP-selective production might contribute to the impairment of specific cell functions in aging.
Thiol-Disulfide Exchange Systems in the Liver of Aging Fischer 344 Rats
Authors: Rikans Lora E. , Hornbrook K. Roger
Published: April 2003

The purpose of this study was to determine whether the major thiol-disulfide oxidoreductase activities of the rat liver were altered as a consequence of aging, and whether the alterations had any consequences in terms of hepatic thiol concentrations. Liver fractions were prepared from male and female Fischer 344 rats at ages representing young adulthood (5 months), middle age (15 months) and old age (24–29 months), and the activities of the major thiol-disulfide exchange enzymes, together with protein and nonprotein sulfhydryl contents, were measured using spectrophotometric procedures. Thioltransferase, protein disulfide isomerase and thioredoxin reductase activities in livers of male and female rats were unchanged with aging, while glutathione disulfide (GSSG) reductase activity remained the same (in male livers) or increased (in female livers) as a consequence of aging. Both protein and nonprotein sulfhydryl concentrations were well maintained in old age. The absence of age-dependent alterations in the thiol-protein disulfide exchange enzymes and the lack of compromise in the glutathione GSSG reductase system suggest that aged livers retain their capacity to regulate their thiol-disulfide redox balance under normal physiological conditions.
The Long-Term Clinical Outcome of Elderly Patients with Helicobacter pylori-Associated Peptic Ulcer Disease
Authors: Pilotto Alberto , Franceschi Marilisa , Di Mario Francesco , Leandro Gioacchino , Bozzola Loredana , Valerio Gianni
Published: April 2003

The objective of this study was to evaluate the long-term efficacy of Helicobacter pylori (HP) eradication treatment in elderly patients with HP-associated peptic ulcer. A total of 56 subjects, 25 affected with gastric ulcer (GU, 9 males, 16 females, mean age 77.8 years, range 67–93) and 31 with duodenal ulcer (DU, 19 males, 12 females, mean age 76.5 years, range 65–87) were confirmed to be HP-positive by gastric histology and the rapid urease test. All patients were then consecutively treated with omeprazole for 4 weeks plus one or two antibiotics for 1 week as anti-HP treatment. Clinical checkups were then performed every 3 months for 1 year for the evaluation of symptoms and clinical recurrences. Endoscopy with gastric biopsies was repeated after 1, 3 and 12 months for the evaluation of ulcer healing, HP infection and chronic gastritis activity. Statistical analysis was performed by means of the Student t test for unpaired data, the Fisher exact test (two-tailed), and the McNemar χ2 test. After 4 weeks of treatment, endoscopy confirmed healing of the ulcer in all patients, regardless of the treatment used to cure HP infection. Two months after the end of therapy, a total of 44 patients were HP-negative and 12 patients were still HP-positive. During the 1-year follow-up period 1/44 (2.2%) of the HP-eradicated patients and 5/12 (41.6%) of the still HP-positive patients suffered relapses (p = 0.001): the difference between the two groups remained statistically significant when patients were divided into the subgroups, GU (p = 0.01) and DU (p = 0.04). Two months after the end of therapy, there was still a significant reduction of symptoms both in HP-eradicated (p < 0.0000) and in HP-positive (p = 0.002) patients. After 1 year, however, there was a significantly decreased symptomatology only in HP-eradicated subjects (p < 0.0000) and not in patients still HP-positive. After both 2 months and 1 year of follow-up, chronic gastritis activity demonstrated a significant improvement only in HP-eradicated patients (p = 0.0000). In conclusion, the eradication of HP infection significantly improved the long-term clinical outcome of peptic ulcer disease in the elderly, reducing the recurrences of GU and DU, the patient’s symptomatology and the histological signs of chronic gastritis activity. The cure of HP infection is, therefore, strongly recommended in elderly patients with HP-associated peptic ulcer disease.
Prevalence Study of Thyroid Dysfunction in the Elderly of Taiwan
Authors: Chuang Chia-Chang , Wang Shan-Tair , Wang Pei-Wen , Yu Mei-Lin
Published: April 2003

The present study was aimed at investigating the prevalence of thyroid dysfunction in the elderly, aged 65 years or older, in a community of southern Taiwan. By using the records of the local household registry, a sampling frame for the elderly population was constructed, and a sample of 1,400 subjects was drawn by simple random sampling. After the exclusion of nonresponse subjects, 917 subjects aged between 65 and 88 years (mean 71.9) were included in our survey. The serum thyrotropin levels of these participants were measured by monoclonal antibodies TSH immunoradiometric assays. A normal range, 0.45–4.65 µU/ml, was determined from the middle 95% of the TSH distribu- tion of 140 ‘disease-free’ subjects. By reference to the normal range, 23 (2.51%) participants had high (>4.65 µU/ml), and 41 (4.47%) had low (<0.46 µU/ml) TSH levels. The overall prevalence of thyroid dysfunction in the sample was 6.98%. Of the 23 participants with high TSH levels, 8 (34.8%) had low free T4 values (<1.21 ng/dl), so-called overt hypothyroidism, and of the 41 participants with low TSH levels, only 1 (2.4%) had high T3 values, so-called T3 thyrotoxicosis. Antithyroid antibodies were found in 56.5% of those with high TSH levels but only 12.2% of those with low TSH levels (odds ratio = 8.53, 95% confidence limits = 2.55–28.50, p < 0.001). This result indicates that autoimmune disease is still the major cause of hypothyroidism in aged people. However, the prevalence of subclinical hyperthyroidism is higher than that of subclinical hypothyroidism and it might relate to nonautoimmune factors.
How Older People Watch Television
Authors: Grajczyk Andreas , Zöllner Oliver
Published: April 2003

This study has been prompted by the relatively small body of knowledge on the media use of the elderly. The aim of this study was to show how people 50 years and older use the medium television in Germany. Therefore, the 1996 television usership data collected in a representative ‘peoplemeter’ panel of about 4,800 German television households have been surveyed, processed and analyzed using standard audience research software. In 1996, Germans 50 years and above watched on average 233 min television per day. The older a person, the longer he or she watches television. Individuals 65 years and older watch television for 253 min per day. This subgroup appears to comprise the most intensive users of the medium. Men 65 years and above may be depicted as the heaviest weekend TV watchers, older women as the medium’s closest followers from Monday to Friday. Television program broadcast late in the afternoon and early in the evening have by far the best chances to be chosen by seniors. The affinity of the elderly for the medium can be explained by its potential for offering entertainment, information, and companionship, being a substitute for primary interpersonal communication, a tool for structuring time patterns and keeping up the rhythms of long-established everyday rituals. On the one hand, television can be a ‘lifeline’ and a ‘window to the outside world’ for people with little opportunity for direct, unmediated social contact, thus possibly raising their satisfaction of life. On the other hand, prolonged TV use may be seen as an indicator for the degree of loneliness and neglect of the elderly.
Memory Awareness in Nursing Home Residents
Authors: McDougall Graham J.
Published: April 2003

Background: Health care providers often believe that individuals with cognitive disturbance are unaware of their deficits. The term unawareness was first used to describe hemiplegia following right hemisphere stroke but has since been applied to unawareness of any neurological or neuropsychological deficit. Clinicians usually rely on their subjective observations to evaluate the patient’s awareness of deficits, and few investigators have systematically evaluated this important clinical phenomenon. Objective: The aim of this study was to compare cognition, depression, health, and metamemory (capacity, change, locus, and strategy) in four groups of nursing home residents: the cognitively impaired (29%), depressed (18%), mixed with both cognitive impairment and depression (32%), and controls (21%). Methods: Subjects were 106 residents of six nursing homes between the ages of 79 and 87 with a mean age of 84.18 (SD = 10.01) years, and an average of six comorbid medical conditions. Cognitive function was measured with the Mini Mental State (MMSE); depression with the Geriatric Depression, and metamemory with the Metamemory in Adulthood scales. Anyone scoring <15 on the MMSE was excluded. Subjects included 31 with cognitive impairment, 19 depressed, 34 mixed, and 22 controls. Results: In this sample, 61% were cognitively impaired; however, only 12 had a diagnosis in their records indicating cognitive disturbance. Forty-three percent were depressed. The correlations between depression and capacity (r = –0.38), change (r = –0.50), and locus (r = –0.25) were significant. The controls were significantly younger than the cognitively impaired group. The controls also had higher perceived health status scores than either the cognitively impaired or the depressed group. However, the mixed group’s perceived health status scores were significantly higher than the depressed group’s scores. Conclusion: The metamemory components of capacity and change were able to differentiate the cognitively impaired from the mixed group. Information on the etiology of cognitive impairment was not available since residents’ charts in the six nursing homes provided inadequate documentation and incomplete diagnostic histories. Therefore, quantitative methods for examining memory awareness and the affective state of elderly patients is important for clinicians in order to make informed treatment decisions.
Clinical Relevance of Thiamine Status amongst Hospitalized Elderly Patients
Authors: Pepersack Thierry , Garbusinski Johanna , Robberecht Jean , Beyer Ingo , Willems Dominique , Fuss Michel
Published: April 2003

Background: The prevalence and the consequences of thiamine deficiency among elderly patients admitted to acute geriatric wards are not known. Objectives: (1) To assess the prevalence of thiamine deficiency in patients admitted to a geriatric ward compared to age-matched ambulatory outpatients; (2) to identify their diseases and problems associated with thiamine deficiency, and (3) to determine the relationship between the thiamine status and the cognitive and functional status of these patients. Materials and Methods: 118 aged hospitalized patients (83 ± 7 years; mean age ± SD) were prospectively enrolled on admission to the geriatric ward. Their cognitive status was assessed using the Mini-Mental State Examination (MMSE) and their ability to perform their activities of daily living (ADL) using ADL scales. The effect of exogenous thiamine pyrophosphate (TPP) addition on the blood transketolase (TK) activity (TPP TK effect) served to estimate thiamine deficiency. Socioeconomic data, diseases and treatment were identified as potential associated risk factors. This group of hospitalized patients was divided according to their thiamine status to characterize the conditions associated with thiamine deficiency. Thirty-five outpatients without any functional or cognitive impairment served as a control group. Results: Of 118 inpatients, 46 (39%) presented with a TPP TK effect of >15%, and 6 with values of >22%, indicating moderate and severe thiamine deficiency, respectively. Only 6 of 30 outpatients (20%) exhibited a TPP TK effect of >15% and none of them reached values of >18%. Although it tended to be lower in outpatients, the mean TPP TK effect did not statistically differ from the mean of inpatients. Thiamine-deficient inpatients comprised a larger proportion of institutionalized subjects than nondeficient inpatients (87 versus 47%, p < 0.001). Functional status, cognitive functions and the occurrence of delirium did not differ according to their thiamine status. By contrast, thiamine-deficient inpatients exhibited a higher proportion of Alzheimer’s disease, depression, cardiac failure and falls. Furosemide was more frequently taken by thiamine-deficient patients. Conclusions: Severe thiamine deficiency remained quite low among the hospitalized elderly. The prevalence of moderate thiamine deficiency approached 40%. Institutionalized subjects were at particular risk of developing thiamine deficiency. Its clinical relevance on functional status and on cognitive function remained not significant. By contrast, a high proportion of falls, Alzheimer’s disease, depression, cardiac failure and furosemide use could have been related to thiamine deficiency.
Aging and the Scope of Visual Attention
Authors: Kosslyn Stephen M. , Brown Halle D. , Dror Itiel E.
Published: April 2003

Objective: To discover whether some cognitive deficits associated with aging could be related to a restricted scope of visual attention. Design: Cross-sectional study, with subjects in each age group receiving the same four conditions. Subjects: 24 elderly (mean age 65.2 years, 12 men and 12 women) and 24 young (mean age 21.8 years, 12 men and 12 women) matched for handedness, gender, and education level. Methods: Subjects viewed a display that contained four light-gray squares arranged as if on the tips of a plus sign, then black X marks appeared and the subjects indicated whether one or two Xs appeared in the squares as quickly and accurately as possible. The time to respond and accuracy level were recorded. Two types of displays were used; one with squares spread out over a large area and one with squares condensed into a small area. In two thirds of the trials the size remained the same (with half being large, and half small), and in one third it changed (with half of these trials changing from large-to-small and half from small-to-large). Results: In the trials that had a consistent display size, the elderly subjects performed the task better with the smaller display, whereas the young subjects performed equally well with both sized displays. In addition, the elderly found it easier to shift from large to small scope than to maintain attention at the large scope; in contrast, the younger subjects found it easiest to maintain attention on a static display size. Conclusions: The elderly prefer to focus attention on a smaller region of space than do younger people.
Relationship between Oral Alveolar Bone Loss and Aging among African-American and Caucasian Individuals
Authors: Streckfus Charles F. , Parsell Douglas E. , Streckfus Jeffrey E. , Pennington Whitney , Johnson Roger B.
Published: April 2003

Background: The periodontal attachment apparatus consists of the periodontal ligament, alveolar bone, cementum and supra-crestal connective tissue. They are interdependent and provide protection and support to the dentition. It is theorized that the integrity of the periodontal apparatus can be maintained throughout life by exercising comprehensive oral hygiene practices and routine dental care. Additionally, it appears to be unaffected by aging. As a consequence, the investigators performed a study to determine the effects of chronological aging on alveolar bone loss. Objective: The present study was conducted to determine the relationship between oral alveolar bone loss, oral hygiene, and aging among African-American and Caucasian populations. Methods: The population consisted of 229 individuals. There were 131 men and 98 women. With respect to race there were 89 African-Americans and 140 Caucasians. Oral examinations, oral hygiene and missing teeth determinations and bitewing radiographs were performed on all the individuals. Radiographs were digitized and measurements were made from the cementum/enamel junction to the alveolar bone crest. Measurements were made for both the maxillary and mandibular jaws. Results: The results of the study showed a significant multiple linear regression model relationship between oral bone loss and aging. Oral hygiene was a factor, but contributed only slightly to the overall model. Race, gender and the number of missing teeth were not significant variables in the overall model. Conclusion: The results of this study suggest age-related alveolar bone loss.
Risk Factors and Incidence of Postoperative Delirium in Elderly Chinese Patients
Authors: Dai Yu-Tzu , Lou Meei-Fang , Yip Ping-Keung , Huang Guey-Shiun
Published: April 2003

Objectives: To investigate the incidence of postoperative delirium among elderly patients and to examine the interrelationship between basic vulnerability and precipitating factors for delirium. Design and Methods: This was a prospective cohort study. Data were collected in a tertiary medical center in Taipei, Taiwan. From the 1st to the 5th postoperative day, nurses assessed patients using a confusion-screening tool. Patients with signs of delirium were closely examined for changes in behavior and cognitive status and vital signs, and laboratory data were collected to further validate the organic etiology of delirium. Patients were finally diagnosed according to the DSM-IV criteria in consensus meetings. Subjects: Seven hundred and one elderly patients, that were admitted consecutively for elective orthopedic or urologic surgery, were enrolled in this study. All subjects met the following criteria: (1) 65 years of age or older; (2) able to communicate orally in Chinese, and (3) not unconscious, delirious, deaf, or aphasic upon admission. Results: The overall incidence of delirium among these subjects was 5.1%. Logistic regression analysis identified that older age and preexisting cognitive impairment were vulnerability factors, and that the use of psychoactive drugs was a precipitating factor for delirium. Patients with both basic vulnerability and the precipitating factor had a 56-fold increased probability of delirium (0.28 vs. 0.005 in comparison with those who did not exhibit these factors). Conclusion: Few risk factors of postoperative delirium in the older Chinese sample were identified. The only modifiable risk factor appears to be the use of psychoactive drugs.
Measuring Human Age by Estimating Lifetime Caloric Consumption
Authors: Gruber Ronald P. , Kalamas Alicia D.
Published: April 2003

Background: This study was prompted by a desire to measure human age by a means other than chronological or biological age. The purpose of the study was to use the total lifetime caloric intake in men as an index of aging. Method: The study was carried out by developing an algorithm to approximate the lifetime caloric intake. The total caloric intake is expressed such that one calorie-age year is defined as the total calories expended by an individual during his/her 20th year. Results: The results indicated that (1) the caloric intake of men progressively decreases with advancing age, that (2) the caloric-age is usually less than chronological age, and that (3) the caloric-age algorithm is a simple although crude method to assess lifetime caloric intake. Conclusion: The most important conclusion is that a person can get a better appreciation of the importance of avoiding excess caloric intake if human age is measured in terms of lifetime caloric intake.
A Randomized Controlled Trial of Fall Prevention Strategies in Old Peoples’ Homes
Authors: McMurdo Marion E.T. , Millar Angela M. , Daly Fergus
Published: April 2003

Background: Falls are a major cause of morbidity in old age. A small number of fall prevention trials in cognitively intact community-dwelling older people have been effective. This study set out to examine the preventability of falls in older people living in institutional care. Objective: To evaluate the effectiveness of falls risk factor assessment/modification and seated balance exercise training in reducing falls among elderly people living in residential care. Methods: 133 residents with a mean age of 84± (SD) 6.8 years were allocated at random by home to receive either a 6-month falls risk factor assessment/modification and seated balance exercise training programme (n = 77) or 6 months of reminiscence therapy (n = 56). The risk factors targeted were postural hypotension, polypharmacy, visual acuity, and ambient lighting levels. Falls risk factor assessments and recommendation for modifications were performed at baseline in the intervention group and assessments repeated at 6 months. Functional reach, reaction time, timed up-and- go, grip strength, spinal flexibility, and Philadelphia Geriatric Centre Morale Scale and Mini-Mental State Examination scores were determined at baseline and at 6 months by a ‘blind’ observer. Falls and fractures were then monitored in both groups during a 7- to 12-month falls-monitoring follow-up period. Results: Only 90 of 133 (67.7%) residents completed the 6-month intervention period, and 84 (63.2%) completed the 7- to 12-month falls-monitoring follow-up period. Both prevalence of postural hypotension (p = 0.0005) and poor visual acuity (p = 0.04) were reduced in the intervention group. There was no difference between the groups in the number of falls sustained, the risk of falling [odds ratio 0.45 (95% CI 0.19–1.14)], or in the risk of recurrent falling [odds ratio 1.07 (95% CI 0.40–2.97)]. No significant differences were found between the groups with regard to change in other outcome measures. Conclusions: The high drop-out rate reduced the power of this study to detect any effect of the interventions used. It is possible that either the exercises were not sufficiently vigorous or that to improve balance exercises must be performed standing. Further research is required to identify effective fall prevention strategies for elderly people in residential settings.
Lipid Peroxidation and Nitrite plus Nitrate Levels in Brain Tissue from Patients with Alzheimer’s Disease
Authors: DiCiero Miranda Maira , de Bruin Veralice M.S. , Vale Marcus R. , Viana Glauce S.B.
Published: April 2003

Background: Although oxidative stress has been implicated in the pathogenesis of neurodegenerative diseases, data found in the literature are still a matter of controversy. Objective: To study lipid peroxidation and nitrite plus nitrate levels in brain specimens (frontal, parietal, temporal, and occipital cortices) from 8 patients with Alzheimer’s disease (AD) in comparison to 6 young and 7 age-matched controls. Methods: Lipid peroxidation was estimated by the thiobarbiturate test for malonaldehyde and nitrate/nitrite using the Griess method. Results: Our results show a clear malonaldehyde increase tendency in all brain areas from AD cases in relation to older individuals and younger controls. In temporal cortex there was no difference between AD cases and age-matched controls. We suggest that this may be due to incipient temporal cortex damage in control individuals and that this area could be more susceptible to age-related changes. We showed that nitrite plus nitrate levels significantly decrease in brain areas of AD cases in relation to young controls. Except for the frontal cortex, there was a trend for a decreased concentration of nitrite/nitrate in the aged group in all brain areas studied as compared with young controls. Conclusion: Our results support a major role for lipid peroxidation alterations in cerebral cortex of AD patients and showed not only a decrease in nitrite/nitrate levels in frontal cortex of AD cases in relation to young and old individuals, but also a reduction in these nitric oxide metabolites in the other cortical areas as related to young controls.
Body Composition and Osteoporosis in Elderly Women
Authors: Gillette-Guyonnet S. , Nourhashemi F. , Lauque S. , Grandjean H. , Vellas B.
Published: April 2003

Objectives: To study body composition in elderly osteoporotic women to determine the relationship of body weight, body fat mass and lean mass to bone mineral density (BMD), and to investigate the association between one-leg balance, osteoporosis and sarcopenia. Design and Setting: A cross-sectional study of a community-based population in Toulouse, France. Methods: For each participant, whole body composition and BMD were estimated using a dual-energy x-ray absorptiometry scanner. We investigated balance using a one-leg balance test. Participants: 129 healthy women aged 75–89 years, volunteers, ambulatory and living at home. Results: Total fat mass and appendicular skeletal muscle mass (ASM) were significantly lower in osteoporotic women than in the age- and sex-matched non-osteoporotic controls [18.7 ± 4.6 vs. 22.2 ± 6.6 for total fat mass (p < 0.01); 13.1 ± 1.6 vs. 13.8 ± 2.2 for ASM (p < 0.05)]. We did not find a positive association between osteoporosis and sarcopenia (OR = 0.75, CI 0.3–1.84), osteoporosis and one-leg balance (OR = 1.27, CI 0.51–3.17), or sarcopenia and one-leg balance (OR = 1.31, CI 0.52–3.36). There were significant positive correlations between BMD in all areas and body measurements (weight, fat mass, lean tissue mass), but fat mass accounted for more of the variance in total body and femoral BMD than lean tissue mass. Total fat mass alone, in a multivariate model, was correlated with whole body BMD, whereas femoral BMD was associated with both fat mass and lean tissue mass. Conclusion: Higher values of fat mass and lean tissue mass may have a protective effect on femoral bone density. Sarcopenia and osteoporosis are not necessarily linked with balance.