bluuebunny/crossref_metadata_2025 huggingface dataset:
RELATIONSHIP BETWEEN PAST AND PRESENT ACTIVITY OF FEMALE RESIDENTS IN A GERIATRIC HOME*
Authors: GORDON HELEN G. , McTAVEY HARRIET E.
Published: April 2015

Abstract: A study was made to determine the relationship between prior lifetime activity and present participation of aged female residents in the activities of a geriatric home, as measured by the Prior Lifetime Activity and Present Participation check lists.

The study sample (randomly drawn) consisted of 30 aged female residents in a selected geriatric home. Their ages ranged from 65 to 95 years. Statistical analysis of the data showed that prior lifetime activity had little influence on present participation of these aged females. This applied equally to career, housewife, and career/housewife categories. The only prior lifetime activities carried over into old age were the sedentary ones, such as reading and sewing. The relation to the disengagement and activity theories of old age is discussed. Implications for the nursing staff are emphasized.

On the basis of the study findings, the hypothesis that the aged female resident in a geriatric home participates in a significantly greater number of present activities than she did in prior lifetime activities was rejected. However, the effect of past environmental, social and cultural factors must be considered as a possible determinant in the degree of present participation.
CUES TO STROKE REHABILITATION REFERRAL AMONG FAMILY PHYSICIANS
Authors: Wylie Charles M.
Published: April 2015

Abstract

The analyses in this study—from the Rehabilitation Center at Montebello State Hospital, Maryland—indicate that physicians have been slow to accept as a legitimate activity the rehabilitation of their stroke patients. The physicians who are more likely to send patients for such care tend to be more recent graduates, to belong to hospital staffs and medical societies, and possibly to graduate from schools in which the faculty has more interest in rehabilitation. From the experience with their first patients, physicians may learn how to refer more suitable patients.

The situation is complex, however; the available data concerned only indirectly those factors which are probably most crucial to the degree of innovation. To avoid upsetting Montebello's program, this study did not include personal interviews with the 294 general practitioners involved, thus leaving some crucial questions dangling in mid‐air, and possibly overlooking some valid reasons for nonreferral for rehabilitation during this period.

The findings are tentative but they seem to indicate that the norms for physicians may not favor the use of outside sources of help nor encourage the energetic treatment of stroke patients. Cultural norms change only slowly, and this may partly explain the slow referral for rehabilitation. However, we should strive to ensure that the concepts and scientific basis of rehabilitation be as clear and as strong as possible, and that the concepts be communicated accurately, intensively and repeatedly. This will prepare a more fertile field for the seeds of change.
TREATMENT OF ISCHEMIC AND STASIS ULCERS WITH GOLD LEAF AND POLYETHYLENE FILM: PRELIMINARY REPORT
Authors: Chick N.
Published: April 2015

Abstract

Fourteen ischemic or stasis ulcers in 8 patients were treated by means of gold leaf overlaid with polyethylene film; a piece of foam rubber was inserted before application of a bandage. The average length of treatment was four weeks. Of the 14 ulcers, 9 were completely healed, 4 were greatly reduced in size, and only 1 (a large decubitus lesion in a terminal cancer patient) failed to respond. The length of hospital stay was reduced as compared to previous admissions for treatment by other methods, and the patients did not experience any undue allergic reactions nor discomfort.

Although our sample was small, the dramatic tissue response, the simplicity of application, and the effectiveness of this therapeutic technique deserve further investigation.
THE LAUNCHING EFFECT IN BIOLOGIC SENESCENCE
Authors: Calloway N. O.
Published: April 2015

Abstract

The individual begins with an event having the characteristics of a launching. An analysis of the decline in basal metabolic rate and percentage of total body water, as examples of the continuous processes of senescence, upholds this concept. The highest functional values are present at or shortly after conception, but they decline continuously throughout life.
THE INTRADERMAL CANCER TEST (ICT)*
Authors: Makari Jack George
Published: April 2015

Abstract

A reliable test for the early detection of cancer is much to be desired and has long been sought. The Intradermal Cancer Test (ICT) is based upon immunological principles, and according to the author's findings, is not influenced by certain non‐neoplastic diseases or physiological changes. The author first reported his work in 1955, and in the ensuing years has accumulated data on 995 subjects. He concludes that the test can detect early cancer, and that it is specific, reproducible and practical. The data are presented here with the hope that other research workers in this field will be encouraged to inquire further into the methods outlined in this article.
NUTRITION IN THE AGED: REVIEW OF THE LITERATURE
Authors: Esposito Salvatore J. , Vinton Paul W. , Rapuano J. Alfred
Published: April 2015

Abstract

The subject of nutrition in the aged is reviewed under the headings of requirements for calories, protein, carbohydrates, fats, minerals (calcium, phosphorus, iron and iodine), and vitamins (water‐soluble and fat‐soluble).

Our knowledge of the process of aging is distinctly limited. Although many changes in body composition and functioning occur during senescence, the exact mechanisms are still unknown. Thus the matter of possible changes in the requirements for various nutrients during aging needs much more investigation. At present many of the reported findings are conflicting and controversial.
THE BASIC LAWS OF BIOLOGIC SENESCENCE
Authors: Calloway N. O.
Published: April 2015

Abstract

Some general laws of biologic senescence are proposed. The aging process from conception to death follows definite and continuous pathways. The decrease in the percentage of body water and the decrease in heat production (basal metabolic rate) are used as measures to show that the continuous processes take place according to previously derived equations.

It is concluded that there are two basic and absolute laws of senescence: I. The rate of aging is proportional to the size of the function. As the function diminishes with age, the rate of aging decreases. II. The rate of aging is inversely proportional to some function of the age. As the individual ages, the rate of aging decreases. These two laws are predicated on the basis of general inspection of the data curves, and also on deductions made from the mathematical equations describing the shape of these curves.
THE EDENTULOUS PATIENT. I. XEROSTOMIA AND THE SERUM CHOLESTEROL LEVEL
Authors: Cheraskin E. , Ringsdorf W. M.
Published: April 2015

Abstract

Sixty‐seven edentulous patients with complete dentures were studied during 168 visits. Xerostomia was reported during only 38 of the 168 visits, and in most of these instances it was mild and intermittent; there were no severe cases, and only 5 patients reported that the condition was constant. The serum cholesterol level was definitely elevated (250 mg per 100 ml, or higher) during 42 per cent of the visits, and marginally elevated during another 45 per cent. Statistical analysis showed that the concentration of serum cholesterol was significantly higher in the patients with xerostomia.
A TREATMENT‐FOCUSED GERIATRIC PROGRAM IN A STATE MENTAL HOSPITAL*
Authors: Lehrman Nathaniel S. , Friedman Jacob H.
Published: April 2015

Abstract

At Bronx State Hospital, active treatment modalities—psychotherapeutic, social and psychopharmacological—are offered from the time of admission. Families are dealt with energetically from the start, with particular attention to preventing extrusion of the patient from the family unit. For retraining patients whose social and psychological skills have atrophied from prolonged hospitalization, there is an intensive treatment ward. A “hotel ward” without staff has been established for those who are able to live in a minimally structured environment but have no homes to go to. A work‐for‐pay program, specially tailored to the needs of geriatric patients, also has been organized. For regressed patients there are special programs, including reality orientation and sensory training. A major factor in maintaining staff morale in this difficult work is their active involvement at all staff levels in the regular teaching conferences.

After release of the patient, hospital responsibility continues. Supportive services—psychiatric, social, psychological and recreational—are supplied when necessary, but emphasis is placed on the ex‐patients becoming involved with local community organizations such as community houses and Golden Age clubs.

In the future we hope to place more emphasis on prevention by helping to establish or maintain supportive services in the community for the elderly before they become ill, and by starting therapeutic activities in the earliest stages of illness so that disability and hospital admission can be minimized if not averted. Much can be done for geriatric psychiatric patients.
HEALTH PATTERNS OF AGED MIGRANT RETIREES*
Authors: Bultena Gordon L.
Published: April 2015

Abstract

Data are reported from interviews with 349 retirees who have moved permanently from the Midwest to communities in Florida and Arizona. Analysis is made of the role of health considerations in their migration decision, as well as the implications of health problems for their differential adaptation to retirement living. Although health frequently was given as a motive for moving, the respondents were found to be in as good health as persons retiring in the Midwest. Migrants in poor health experienced greater financial difficulty and were less satisfied with their move than those in good health.
CARDIOPULMONARY RESUSCITATION IN THE ELDERLY
Authors: McGraw Walker C.
Published: April 2015

Abstract

This study of 110 patients (aged 65 and older) indicates that cardiopulmonary resuscitation is as feasible in the patient with pulmonary disease as it is in the patient with cardiac disease. This applies particularly to the elderly.

Early recognition of pulmonary insufficiency in elderly patients may be delayed because of concomitant multiple disease. Yet treatment must be started promptly and intensively if resuscitation is to be successful. Those who treat these patients must have wide experience with respiratory disease and must be intelligent, alert and constant in their attendance. This phase of medical care is truly a team effort.
THE PROCESS OF AGING: SERUM GLUCOSE AND IMMUNOREACTIVE INSULIN LEVELS DURING THE ORAL GLUCOSE TOLERANCE TEST*
Authors: ZEYTINOGLU IBRAHIM Y. , GHERONDACHE CONSTANTIN N. , PINCUS GREGORY
Published: April 2015

Abstract: A five‐hour oral glucose tolerance test and simultaneous determinations of serum immunoreactive insulin were performed on 20 male and 20 female elderly nondiabetic subjects whose ages ranged from 68 to 91 years. Results of the glucose tolerance test were abnormal in 29 of the 40 subjects (72.5 per cent) according to accepted standards for young and middle‐aged normal adults. The abnormalities were similar to those found in cases of diabetes mellitus in young adults. The response to glucose stimulation in these elderly subjects was delayed and less efficient than normal. Significant differences were observed with respect to both serum glucose and immunoreactive insulin, the females exhibiting higher levels than the males. Regression analysis showed no immunoreactive insulin in the serum when the glucose level was less than 50 mg per 100 ml.
ARTERIAL INSUFFICIENCY OF THE BRAIN: PROGRESSION PREVENTED BY LONG‐TERM ANTICOAGULANT THERAPY IN ELEVEN PATIENTS
Authors: WALSH ARTHUR C.
Published: April 2015

Abstract: Eleven elderly patients with arterial insufficiency of the brain (senile dementia, presenile dementia, transient ischemic attacks or recurrent strokes) were treated with an anticoagulant (bishydroxycoumarin) for periods varying from eight years to twenty‐four days. All 11 patients showed improvement. Interruption of treatment proved safe in 2 patients, harmful in 2 others, and fatal in 3 patients. In a case of Alzheimer's disease in which bishydroxycoumarin was stopped four times, the patient deteriorated each time the drug was discontinued and improved each time it was resumed.

Anticoagulant therapy appears to be effective in relieving the symptoms of arterial insufficiency of the brain and preventing progression of disability. In a selected group of patients, considerable improvement may be expected. Once relief is obtained, discontinuing anticoagulant therapy (especially within two years) may be very risky since deterioration is likely to occur. The risks of using anticoagulants for this purpose are not discussed but probably they are the same as in the treatment of coronary artery disease. Not using anticoagulants may be more harmful than using them; discontinuation withdraws effective treatment.
RENAL TUBULAR CLEARANCE AND REABSORPTION OF PHOSPHATES IN AGED DIABETIC PATIENTS
Authors: MAZZI CARLO , CARULLO PAOLO
Published: April 2015

Abstract: The findings of this study of 41 aged (over 65) non‐acidotic diabetic patients demonstrated not only a correlation between glycosuria and tubular reabsorption of phosphates but also an increase of renal phosphate excretion with an increase in clearance (35 per cent of the cases) despite a virtually normal level of blood phosphorus. By contrast, this pattern was demonstrated in only 16 per cent of 31 aged nondiabetic controls. There was no statistical difference between the blood phosphorus and calcium values in the two series of subjects.

In 12 of 14 aged diabetic subjects who underwent the induced hypercalcemia test, phosphate clearance values indicated depression of parathyroid function.

Among the possible hypotheses regarding the pathogenesis of the renal phospho‐calcium metabolic disturbance in aged diabetic patients, that of secondary adaptive hyperparathyroidism is discussed, although not accepted.
THE GERIATRIC CENTER OF PARDES‐HANA IN ISRAEL
Authors: GOLDSCHMIDT L.
Published: April 2015

Abstract: The author considers the Geriatric Center at Pardes‐Hana, Israel, to be a model for those working in the field of care of the aged. He was most impressed not only by the beautiful cottage settings and landscaping but predominantly by the principle of separating the living quarters of the 1,100 residents (average age, 80) according to functional categories rather than medical diagnoses. The healthy and capable elderly residents were not exposed to the depressing effect of having to live in the same rooms or cottages with those who were severely demented, incontinent and disruptive. The separation of the occupational facility from the occupational therapy facility was an additional point of interest. The residents felt that they were not just passing time but were really productive and creative. A withdrawn, depressed or passive resident was a rarity within the normal and moderately infirm groups. In addition to being well trained in medicine and in drug therapy, the staff has a sympathetic approach to the patients. This human element strikes the visitor more than anything else.
Cephaloglycin in Urinary‐Tract Infections
Authors: Seneca H. , Zinsser H. H. , Peer P.
Published: April 2015

Abstract

Cephaloglycin is an effective and safe antibiotic in the management of urinary‐tract infections. It completely cured 14 of 31 chronic cases. In bacteremias and systemic infections, parenterally‐active cephalothin or cephaloridine is recommended.
ON THE PATHOGENESIS OF GASTRIC ULCER IN THE AGED AND ON THE ANTAGONISM BETWEEN CALCIFIED ATHEROSCLEROSIS AND GASTRIC CARCINOMA: A RADIOLOGICAL STUDY
Authors: Elkeles Arthur
Published: April 2015

Abstract

Radiography of the abdominal aorta was used to study the incidence of calcified atheroma in 330 cases of primary gastric ulcer, 224 cases of gastric carcinoma, and 1,704 control cases. It is emphasized that the solitary gastric ulcer in the aged differs in its pathogenesis from gastric ulcers which are associated with lesions in the pyloric antrum or in the duodenum. Apparently classical gastric ulcer in patients over 50 years of age is a complication of atherosclerosis. “Calcified” atheroma in the abdominal aorta is relatively rare in gastric carcinoma even in the high age groups. The role of calcium in the stability of chromosomes, and the possible clinical applications are discussed.

The concept is advanced that, when ageing is associated with increased affinity of the tissues for calcium, it leads to calcified atherosclerosis and relative immunity to cancer.
PRESBYCUSIS
Authors: Lehman Roger H. , Miller Alfred L.
Published: April 2015

Abstract

Presbycusis is the insidious bilateral loss of hearing for high tones that occurs in the aged. The differential diagnosis should include deafness based on factors such as heredity, trauma, vascular disease and neoplasia. The pathologic changes involve the organ of Corti, the cochlear nerve, the central nuclei and the auditory cortex. No form of medical therapy has been beneficial. Auditory training and hearing aids play an important role in rehabilitation.
NITROGENOUS COMPOUNDS IMMOBILIZED IN AN AGED RAT
Authors: BJORKSTEN JOHAN , ASHMAN STEPHEN
Published: April 2015

Abstract:

A pregnant rat received 8 mc of tritiated tyrosine at the time of giving birth (from seven days before, to six days after). No radioisotopes were ever given directly to the litter born. A male from this litter died from pneumonia at age 809 days. After removal of water and acetone solubles and of phospholipids, hydrolysis of the residue released the following radioactive amino acids, parts of molecules fixed until death and containing tritium present at birth: lysine, arginine, aspartic acid, glutamic acid, serine, listed in order of decreasing radioactivity, with lysine carrying 29 per cent of the total tritium present.
PERIPHERAL VASCULAR DISEASE PROBLEMS IN THE AGED—CONSIDERATIONS REGARDING PREVENTION*
Authors: WRIGHT IRVING S.
Published: April 2015

Abstract:

The problems of peripheral vascular disease in the aged have been greatly neglected. Preventive measures should be established in the younger years so that there will not be so much need for therapeutic attempts in old age.

The chief cause of peripheral vascular disease in the elderly is atherothrombosis, with elements of both atherosclerosis and thrombosis. The study of these two elements should not be conducted in strictly separate categories, as at present. Robertson's theory of the pathogenesis is described, including the cellular and biochemical influences. The genetic element is emphasized in the concept of susceptible atherophils versus resistant atherophils in relation to elevated blood lipid levels.

Prevention involves anti‐obesity dietary measures, appropriate exercise, and the avoidance of smoking. If hypertension, hyperlipidemia or hyperglycemia (diabetes) develop, early detection and treatment are important. Patients with peripheral vascular disease should avoid extremes of cold or heat and pay special attention to cleanliness of the feet. Even though all the etiologic factors in the disease are not known, it is essential to apply all the available preventive measures. Such a program requires improved education of the medical and associated professions, as well as of the lay public.
THE INFLUENCE OF AGE ON THE ACTIVITY OF CATECHOLAMINES AND RELATED THERAPEUTIC AGENTS
Authors: BENDER A. DOUGLAS
Published: April 2015

Abstract:

A review has been made of the literature on the changes with age in the sensitivity of various organs and tissues to catecholamines. The objective of this review was to examine these changes and to interpret them in the light of related compounds that are employed commonly in the treatment of the elderly. The available evidence strongly indicates that there is an increase with age in the sensitivity to exogenously administered amines. In terms of the therapeutic application of related drugs in the elderly, this finding indicates that caution should be used when administering such agents, particularly if they have significant secondary effects which are related to the stimulation of adrenergic receptors. Additional information indicates that perhaps there is a delay in the excretion and in the distribution of catecholamines. Thus, higher blood levels might be anticipated when sympathomimetic amines are employed in the treatment of various disease states.
PULMONARY EXERCISES IN CHRONIC OBSTRUCTIVE PULMONARY DISEASES
Authors: Blocker William P. , Gonzalez Frank R.
Published: April 2015

Abstract

For many patients with chronic obstructive pulmonary disease, a program of graded pulmonary exercises (preceded by bronchial drainage) will induce improvement. This improvement is manifested by increased ability to perform the activities of daily living and an increase in exercise tolerance associated with a decrease in the heart rate (both at rest and during exercise). The medical management of chronic obstructive pulmonary disease is outlined, and the drainage technique and exercises are described in detail.
TREATMENT PROGRAMS FOR PATIENTS WITH CHRONIC BRAIN SYNDROME CAN BE SUCCESSFUL
Authors: Inskip Wilma
Published: April 2015

Abstract

An attempt is made to dispel some of the over‐generalizations about the futility of treating persons with chronic brain syndrome. The success or failure of such a treatment program is based upon several variables related to the patient, the therapist and the environment. Recognizing and controlling these variables is the first step toward making them work to the advantage of the patient and his recovery.
STRESS AND AGING*
Authors: Selye Hans
Published: April 2015

Abstract

The experimental “aging” exemplified in the progeria‐like syndrome (induced by dihydrotachysterol, DHT, in rats) is not the cause but the consequence of disturbed calcium metabolism. Certain anabolic steroids can prevent the loss of body weight (protein) and the abnormal tissue calcification. Moreover, steroidal substances designated “catatoxic” have been found to play a role in adaptive reactions, particularly the maintenance of resistance to stress. Thus the anti‐DHT effect of the steroids is not due to their antimineralocorticoid or anabolic action, but to their catatoxic (antitoxic) potency.

An experimental biochemical disease model—the “Electrolyte‐Steroid‐Cardiopathy with Necrosis” (ESCN)—was developed to demonstrate a typical pluricausal disease in which several factors operate conjointly to produce a lesion. Glucomineralo‐corticoids plus sodium salts were outstanding factors in the production of cardiac necrosis. This experimental necrosis could be prevented by KCl or MgCl2. However, oral administration of KCl has many drawbacks for the prophylaxis or treatment of myocardial infarction; more convenient and lasting methods of providing potassium are needed. Certain catatoxic steroids also were found to be efficacious in preventing ESCN.

These data may eventually help in finding ways to combat spontaneous aging. Aging has no specific cause. Body hormones and numerous other factors play decisive roles.
CELSUS ON GERIATRICS
Authors: Howell Trevor H.
Published: April 2015

Abstract

The author quotes many of Celsus' astute observations on the characteristics of the aged and recommendations for treatment of their diseases. If the pertinence of these observations—made in the first century A.D.—seems surprising, it may be because of the contrast with our present‐day obtuseness in the field of geriatrics.
METABOLIC EFFECTS OF ETHACRYNIC ACID IN THE AGED*
Authors: Rosenberg Gilbert , Wener Joseph
Published: April 2015

Abstract

Ethacrynic acid was given to 41 aged men and women who had previously been treated with thiazides for congestive heart failure. Twenty‐three of these patients had diabetes. After ten weeks of maintenance therapy with ethacrynic acid, there were no statistically significant changes in the levels of blood urea nitrogen, serum uric acid, chloride, sodium and potassium. Glucose tolerance was not adversely affected; rather, glucose tolerance improved (P < .05) in the 20 diabetic patients tested. Of the 41 patients, 7 had gastrointestinal symptoms of mild to moderate severity for one to three days, but when ethacrynic acid was started again these symptoms did not recur. Ethacrynic acid, as used in the present study, would appear to be an effective, relatively safe diuretic, particularly well suited for long‐term use in patients with diabetes mellitus.
RUPTURED ABDOMINAL AORTIC ANEURYSM*
Authors: Taheri Syde A.
Published: April 2015

Abstract

Rupture of an abdominal aortic aneurysm is a dire surgical emergency. The mortality rate in surgically treated cases, although declining due to better diagnosis and advances in vascular surgery, is high. However, the mortality in untreated cases is virtually 100 per cent. By contrast, the mortality rate in elective operations is very low. For this reason all authors urge early diagnosis and elective surgery. Every such aneurysm, if the patient lives long enough, will eventually rupture.

Because patients with an abdominal aneurysm have significant atherosclerosis and perhaps other degenerative cardiovascular disease, and because only rarely do they have symptoms of impending rupture, geriatricians are urged to include an x‐ray search for this lesion in the periodic examination of these patients. The author's series of 26 cases is presented.
SERUM CHOLINESTERASE ACTIVITY IN SENECTUS PRAECOX
Authors: Dénes Susanna
Published: April 2015

Abstract

Serum cholinesterase activity was reduced in 13 (32.5 per cent) of 40 cases of senectus praecox (premature aging). This is an indication of a reduction in general enzyme activity. The associated symptoms of parasympathetic excitation (profuse sweating, weakness and a state of collapse) may be the clinical indicators of the biochemical changes. This impairment of cholinesterase activity is found chiefly in prematurely old persons with disturbances of the digestive system.
SERUM PROTEINS, AMYLOID AND ALZHEIMER'S DISEASE*
Authors: Behan Peter O. , Feldman Robert G.
Published: April 2015

Abstract

Serum protein analysis in 60 patients with histologically confirmed Alzheimer's disease (Group A) and in 60 others with clinical dementia and radiographic evidence of diffuse cerebral atrophy compatible with Alzheimer's disease (Group B) revealed a decrease in albumin and an increase in alpha‐1 antitrypsin, alpha‐2 macroglobulin and haptoglobin fractions. These abnormalities occurred in 66 per cent of these two groups, but in only 13 per cent of a third group of patients with dementia of the non‐Alzheimer type. In addition, the highest values for alpha‐2 macroglobulin were found in Groups A and B. The possible relationships of these findings to amyloidosis of the central nervous system is discussed.

The significance of these data may lie in their value as an aid in making the diagnosis of Alzheimer's disease in vivo, in the absence of a brain biopsy. Further study is needed to confirm these observations.
MORTALITY, MORBIDITY AND VOLUNTARY CHANGE OF RESIDENCE BY OLDER PEOPLE*
Authors: Lawton M. Powell , Yaffe Silvia
Published: April 2015

Abstract

In this study there was no statistical difference in mortality rates that could be ascribed to the voluntary relocation of a group of relatively independent older people as compared with two non‐relocated groups of older people individually matched for age, sex, and initial functional health status—a total of 103 matched “triplets.” Two similarly matched, 77‐member groups of relocated and non‐relocated older people whose health was evaluated over a twelve‐month period showed no increased morbidity due to moving, as judged by behavioral and subjective health indices. Physicians' ratings of functional health in the two groups showed both improvements and declines among the relocatees. Although the small number of subjects makes caution imperative, the data suggest that relocation is stressful for some elderly people, but felicitous for others. The voluntary nature of the move may account for the lack of major negative relocation effects.
MANAGEMENT OF HYPERTENSION—FURTHER SODIUM AND POTASSIUM STUDIES
Authors: Priddle William W. , Liu Sim F. , Breithaupt David J.
Published: April 2015

Abstract

Since the senior author's first publication forty years ago on the relationship of sodium and potassium to hypertension, these clinical investigations have continued, and in 1958 were established at the Geriatric Study Centre in Toronto. Here, studies were started on the urinary excretion (as an index of intake) of sodium and potassium in subjects with normal blood pressure and in patients with hypertension. Some of the findings are reported in this article, including evidence for the accuracy of the laboratory values, and determination of the normal ranges for serum sodium, serum potassium, serum chloride and blood urea nitrogen in a small group of elderly persons. These studies demonstrated: 1) in persons with normal blood pressure, the urinary excretion (and presumably the intake) of sodium averaged 3.75 gm (9.375 gm NaCl) per day; 2) sodium‐restricted diets, as applied before the study, had been grossly inadequate (excretion 2 gm sodium per day); 3) the study regimen (sodium‐restricted, potassium‐rich intake plus chlorothiazide) had a beneficial effect on hypertension; 4) the potassium supplements induced a sharp rise in the urinary excretion of potassium; and 5) the lack of serious abnormalities in the levels of serum sodium, serum potassium and blood urea nitrogen indicated the safety of this regimen within the limits of this study.

The authors have continued to treat hypertension with a sodium‐restricted (400 mg daily) diet, a small dosage (250 mg daily) of chlorothiazide, and potassium (4 gm daily) supplements. The findings on groups of patients treated as long as twelve years are recorded.

Hypokalemia as a complication of thiazide therapy is discussed and its potential dangers emphasized. A case of recurrent hypokalemia during a three‐year period is presented to demonstrate certain clinical manifestations and the influence of hypokalemia on the electrocardiogram. The effect of the described therapeutic regimen is also detailed in a case of renovascular hypertension engrafted on essential hypertension, and in a case of hypertension treated by the Smithwick operation. The effect of therapy on morbidity and mortality from hypertension is discussed.
PERIARTICULAR CALCIFICATION IN A HEMIPLEGIC LIMB—A RARE COMPLICATION OF A STROKE
Authors: Rosin Arnold J.
Published: April 2015

Abstract

The occurrence of calcification around the hip joint of a hemiplegic limb within a few weeks of a stroke is reported in 2 cases. This is a rare complication in hemiplegia although it is observed more commonly in paraplegia. Both patients had considerable pain, which subsided after a course of radiotherapy. Possible aetological factors are discussed.
THREE VITAL CONSIDERATIONS IN GERIATRIC REHABILITATION
Authors: WHEELER PAUL C. , WOLCOTT LESTER E.
Published: April 2015

Abstract:

Three vital factors should be taken into account in all attempts at geriatric rehabilitation: 1) psychological status, particularly as related to pseudosenility and peculiar character traits versus the old concept of senile dementia; 2) socioeconomic welfare in an era in which the over‐all trend is toward separation of the aged from their children, a preoccupation with prolonging survival, and a sudden drive to solve the problem by jerry‐built placeboes; and 3) vocational opportunities for the healthy and only partially handicapped aged.
OBSERVATIONS ON 750 GEROPSYCHIATRIC PATIENTS*
Authors: KOPITS IMRE
Published: April 2015

Abstract: 750 aged mentally ill patients in a state hospital (450 males and 300 females) were evaluated from the medical, psychiatric and social standpoints. Medico‐surgically, there were 180 cases of cardiac disease, 120 cripples, 75 cases of diabetes, 68 of blindness, 25 of deafness, and 12 of aphasia or mutism. Also, 252 patients were incontinent, 205 needed full or partial nursing care, 33 were spoonfed, 632 were ambulatory, 98 were wheelchair‐bound and 20 were permanently bedridden. Psychiatrically, there were three major diagnostic categories: chronic brain syndrome (52.5 per cent), mental deficiency (10 per cent), and psychogenic disorders (37.5 per cent). The incidences of these disorders varied according to the patients' sex, age, and length of hospital stay. Socio‐economically, the length of hospital stay was an important factor. When compared to younger mentally ill patients, the medical and socioeconomic problems were relatively of greater significance than the mental problems among these elderly patients.

Through appropriate medical treatment (drugs, group psychotherapy, and social services) within the framework of a coordinated team approach, the ratio of released to admitted patients more than tripled in the period 1963 through 1966. In contrast to the “continued care” of the past in mental institutions, the modern policy is an intensive program of rehabilitation, comprehensive in scope.
ABDOMINAL SURVEY RADIOGRAPHY OF GERIATRIC PATIENTS IN A NEUROPSYCHIATRIC HOSPITAL*
Authors: KRAFT ERNEST , FINBY NATHANIEL
Published: April 2015

Abstract: A radiographic survey of the abdomen was performed on 672 male patients over 50 years of age who had been hospitalized for neuropsychiatric disorders only. Conventional abdominal radiographs were obtained to supplement routine physical examinations.

Significant findings included a retroperitoneal mass, a mega‐sigmoid, bladder distention and marked fecal stasis in older patients; also calculi in the gallbladder, pancreas, kidneys and bladder, and calcifications in an adrenal and in an aortic aneurysm. Massive hepatomegaly and splenomegaly were rarely observed. The liver frequently appeared to be of small size in the elderly. The combination of a small liver and a large spleen also served as a clue to hepatic cirrhosis.

The abdominal radiographic survey is valuable, particularly when an abdominal emergency develops in a long‐term hospital patient.
NEW SYSTEM FOR SUPPORTING THE PATIENT IN THE MANAGEMENT OF DECUBITUS ULCER: PRELIMINARY REPORT
Authors: ROWAN NOEL M.
Published: April 2015

Abstract: A new patient‐support system designed for the prevention and treatment of decubitus ulcers was evaluated in 6 bedridden patients in a nursing home. The system consists of three specially‐treated polyurethane foam pads; each pad is surface‐slit into a pattern that provides maximal support and comfort, and is covered with a custom‐fabric contour sheet. Five patients had ulcerations when they were placed on the pads; in all 5 cases the decubitus lesions cleared or improved greatly despite no change in the patient's care except for the addition of the pads. The sixth patient (aged 78 and considered particularly susceptible to ulceration) was placed on the pads at the time of admission to the nursing home; no ulcers developed during the month that they were used.

The effectiveness, simplicity and comparatively low cost of this support system indicate that it should find wide acceptance, not only for geriatric patients but for any patients who do not have normal freedom of movement in bed.
REVIEW OF RESULTS IN A GERIATRIC INTENSIVE TREATMENT UNIT: SOME PROSPECTS
Authors: RISDORFER EMERICH N.
Published: April 2015

Abstract: A Geriatric Intensive Treatment Unit was established in Binghamton State Hospital under the Broome County Unitized Program. The aim was: 1) to rehabilitate newly admitted patients over 65 years of age, and 2) to resocialize geriatric patients over 65 previously in other units of the hospital for long periods (one year to fifty‐three years) so that they could be discharged from the institution. In the first ten months—June 1, 1968 to March 31, 1969–59 per cent of the 96 newly admitted geriatric patients were rehabilitated and returned to society. Their average hospital stay was 38.5 days—a distinct reduction in the length of stay for newly admitted patients. Almost 50 per cent of the 278 long‐term patients left the Intensive Treatment Unit in the 1968–69 period; 27 per cent were returned to the community.

Milieu therapy, modified for the geriatric service, was used for rehabilitation and resocialization. Members of a small but well oriented and dedicated staff represented the family and society to the patients, as a therapeutic community in a “one to one” therapy program. Male and female patients of both short‐term and long‐term groups mixed together in activities. This beneficially influenced the rehabilitation and re‐socialization process.

In the interests of continuity of care, it seems desirable that the Geriatric Intensive Treatment Unit, rather than the Outpatient Clinic, supervise the management of these patients after discharge from the hospital.
CONFUSIONAL STATES IN RELATION TO VITAMIN DEFICIENCIES IN THE ELDERLY
Authors: Mitra M. L.
Published: April 2015

Abstract

The author uses case abstracts to illustrate deficiencies of thiamine/vitamin‐B complex and vitamin C associated with confusional states in the elderly. The biochemical indicators were chiefly the pyruvate metabolism test and the level of ascorbic acid in the leukocyte layer (“buffy coat”) of the blood. The confusional states usually disappeared or improved with appropriate vitamin therapy.
DYSFUNCTION OF THE TEMPOROMANDIBULAR JOINT IN THE GERIATRIC PATIENT
Authors: Grieder Arthur , Vinton Paul W. , Cinotti William R.
Published: April 2015

Abstract

Dysfunction of the temporomandibular joint and the associated musculature of the head and neck may be caused by physiologic imbalance or by psychologic stress. In the geriatric patient this dysfunction can cause severe pain and discomfort. Detailed steps in the diagnosis are presented, with emphasis on differentiation from pathologic conditions. Treatment consists of removal of the traumatic forces (chiefly dental abnormalities) causing the physiologic imbalance. The basic form of treatment (after initial adjunctive therapy) is in the field of prosthodontia. When such a treatment program is properly carried out, relief from symptoms can be expected in about 85 per cent of the patients.
ORPHENADRINE CITRATE (NORFLEX) FOR THE TREATMENT OF “RESTLESS LEGS” AND RELATED SYNDROMES
Authors: Popkin Roy J.
Published: April 2015

Abstract

The purpose of this study was to evaluate the effects of orphenadrine citrate (Norflex) in the syndrome of “restless legs” and nocturnal leg cramps. Of the original 32 patients, 12 were dropped from the study because of gastrointestinal intolerance to the first few doses of the drug or because they were unreliable observers; the symptoms subsided as soon as orphenadrine was discontinued. In the 20 remaining patients the drug was well tolerated; they received it in an oral dosage of 100 mg (occasionally 200 mg) daily for periods ranging from three months to one year. Orphenadrine citrate was found to be an effective therapeutic agent by itself in 16 of the 20 cases, and in combination with other drugs in 4 cases.
CONTINUING POSTGRADUATE MEDICAL EDUCATION IN GERIATRICS*
Authors: LAWTON ALFRED H.
Published: April 2015

Abstract:

At present the medical student's education in geriatrics is left chiefly to the postgraduate period. There are encouraging signs, however, that medical students are being made more aware of the relationship of aging and chronic disease to the understanding of medicine in general. In the postgraduate period, when physicians are supposed to keep up to date by means of continuing education, there are very few opportunities in the field of geriatrics. Moreover, such programs often are not properly coordinated and monitored. Attempts are being made to rectify this situation.

Single individuals or professional societies are weak alone, but can be strong when united in establishing training programs in geriatrics. The American Geriatrics Society and the Gerontological Society should be in the forefront. They should either develop a specific program of their own or should cooperate with the American Academy of General Practice and the American Medical Association in formulating courses that include geriatrics. These programs would undoubtedly lead to institutional postdoctoral education in the subject, and eventually would involve medical students. Meanwhile, all such efforts would improve the care of the aged and infirm.
RESULTS OF HORMONE IMPLANTS IN THE TREATMENT OF THE CLIMACTERIC
Authors: SCHLEYER‐SAUNDERS E.
Published: April 2015

Abstract:

Based on the assumption that the menopause or climacteric is due to a decline in function of the sex glands as part of the process leading to old age with all its physical and mental implications, 1,000 women and 300 men (age range, 40–75 years) were treated with hormone implants during the years 1945–1970. The advantages of the implant method are listed. This therapy resulted in a marked improvement in flushes, in general condition, in depression and fatigue, and in the local changes of the genital tract and skin; the patients looked better and younger. The arguments against hormone treatment (especially with oestrogen) are: 1) it might cause post‐menopausal bleeding, and 2) it might produce cancer. In our series, the incidences of bleeding and of cancer were lower in the hormonally treated women than in the women who did not receive hormone therapy.

This evidence combined with that in the literature indicates that menopausal patients need not be deprived of the benefits of hormone therapy, which will contribute greatly to their well‐being and may at least delay the development of degenerative diseases.
RENAL FAILURE FROM ATHEROEMBOLISM AFTER TRANSLUMBAR AORTOGRAPHY
Authors: Pollitt Jorge , Lee Bak Moo
Published: April 2015

The author reports a case of renal failure due to atheroembolism precipitated by translumbar aortography. When the abdominal aorta contains atheromatous plaques, there is great danger of producing showers of atheroemboli by this procedure.
PRESIDENTIAL STATEMENT
Authors: Wright Irving S.
Published: April 2015

Abstract

We are now confronted with an enormous problem—our aging population, involving many millions of persons. Our nation is not preparing to meet this problem adequately, either economically or medically. Several of the challenges are outlined: prevention of disease (with special reference to cardiovascular disease), retirement problems, medical school training in geriatrics, and economic priorities. Hard examination of present attitudes and inadequate systems is needed, as well as a great deal of rethinking and retooling of our national effort to meet the future needs. The American Geriatrics Society should assume a more significant position of leadership in this progressive movement.
A SURVEY OF GERIATRIC EDUCATION: CATALOGUES OF UNITED STATES MEDICAL SCHOOLS*
Authors: Freeman Joseph T.
Published: April 2015

Abstract

Among students committed to the study of aging including its clinical manifestations, there is concern that the field is not attracting younger scientists. It is a consensus that there are too few educational centers where gerontological training is available. Geriatric teaching resources in United States medical schools have not been tabulated and evaluated. Therefore, catalogues of schools approved as of 1970 were reviewed to ascertain their curriculum content and staff appointments with respect to the subject of aging. Rigid guidelines were used to determine specificity of designation. There were 124 citations in 48 of 99 catalogues, and there were 15 staff appointments under the heading of Geriatrics or Gerontology. The conclusion seems justified that the question of geriatric education has not made much impact upon scholastic policies of United States medical schools.
DAY HOSPITALS AND WELFARE HOMES IN THE CARE OF THE AGED
Authors: Rao D. B.
Published: April 2015

Abstract

This discussion of the role of day care hospitals and welfare homes in the comprehensive care of the aged includes special problems in design and management. These hospitals and homes are vital components in a program of comprehensive care of the aged. Such a program for old people enables them to remain in their homes when otherwise they would have to be admitted to an institution or receive only inadequate care at home.
THE EFFECT OF ORAL ZINC SULFATE THERAPY ON DECUBITUS ULCERS
Authors: Norris John R. , Reynolds Robert E.
Published: April 2015

Abstract

A double‐blind crossover study was conducted for twenty‐four weeks to evaluate the effect of oral zinc sulfate therapy in 14 patients with decubitus ulcers. An objective method was used to determine ulcer (crater) volume. Statistical analysis of the findings in this small study showed that the difference in effect between zinc sulfate and placebo was not significant. However, the authors' impression of clinical efficacy leads them to recommend further study with a much larger number of patients.
PREDICTIVE MEDICINE. VII. THE SPECIFICITY OF TESTS
Authors: Cheraskin E. , Ringsdorf W. M.
Published: April 2015

Abstract

In full‐blown cases of disease, the results of certain biochemical tests may be highly diagnostic. However, in the early stages of illness, these tests are not pathognomonic and not even characteristic of a particular disease. For predictive purposes, biochemical testing is simply a measure of the syndrome of sickness.
DYSURIA IN OLD AGE*
Authors: Brocklehurst J.C. , Fry John , Griffiths L.L. , Kalton G.
Published: April 2015

Abstract

The incidence of symptoms of bladder dysfunction and of urinary‐tract infection in a population aged 65 and over is reported. The population represented 85 per cent of all the men and women in this age group on the list of one general practice. Nocturnal frequency of micturition occurred in 64 per cent, including 29 per cent who got up two or more times at night to pass urine. Nocturia became more common and more severe with advancing age, and was more common in patients with intellectual deficits. It was considered to be a neurogenic symptom. Incontinence was present in 20 per cent. Neurogenic changes and also trauma at parturition seemed to be contributing causes. Diurnal frequency (occurring in 10 per cent) showed no age association in women, but in men it became more common with advancing age, probably due to prostatism. Precipitancy (in 30 per cent) and scalding (in 11 per cent) were not associated with ageing, sex or infection. The symptoms generally are regarded as the ‘urethral syndrome,’ and our findings suggest a nonspecific urethritis. Although a significant degree of bacteriuria was present in 20 per cent of the women from the age of 65 and men from the age of 70, it played little part in producing any of the foregoing symptoms. Bacteriuria was not related to previous pregnancies, nor to trauma at parturition. It was related in men to a history of prostatectomy.
PLACEMENT OF ELDERLY PSYCHIATRIC PATIENTS*
Authors: Gaitz Charles M. , Baer Paul E.
Published: April 2015

Abstract

One hundred patients (age range, 60–84 years) who had been admitted to a county psychiatric ward were diagnostically evaluated by a multidisciplinary team. Based on a consensus from the diagnostic findings, 22 patients were placed in a non‐institutional setting, 24 in a local psychiatric hospital, 23 in a state psychiatric hospital, 23 in a nursing home, and 8 in a local general hospital. The diagnostic team's evaluations led to a sharp decrease in the number of patients placed in the state hospital, compared to the rate for a group of 110 patients not so evaluated, of whom 79 had been placed in the state hospital. By means of a variety of measures drawn from the multidisciplinary assessment procedures, it was possible to characterize the groups according to placement. Several combinations of physical, cognitive and social variables were found to delineate the placements.