bluuebunny/crossref_metadata_2025 huggingface dataset:
Epileptogenic zone localization using magnetoencephalography predicts seizure freedom in epilepsy surgery
Authors: Englot Dario J. , Nagarajan Srikantan S. , Imber Brandon S. , Raygor Kunal P. , Honma Susanne M. , Mizuiri Danielle , Mantle Mary , Knowlton Robert C. , Kirsch Heidi E. , Chang Edward F.
Published: April 2015

Objective

The efficacy of epilepsy surgery depends critically upon successful localization of the epileptogenic zone. Magnetoencephalography (MEG) enables noninvasive detection of interictal spike activity in epilepsy, which can then be localized in three dimensions using magnetic source imaging (MSI) techniques. However, the clinical value of MEG in the presurgical epilepsy evaluation is not fully understood, as studies to date are limited by either a lack of long‐term seizure outcomes or small sample size.

Methods

We performed a retrospective cohort study of patients with focal epilepsy who received MEG for interictal spike mapping followed by surgical resection at our institution.

Results

We studied 132 surgical patients, with mean postoperative follow‐up of 3.6 years (minimum 1 year). Dipole source modeling was successful in 103 patients (78%), whereas no interictal spikes were seen in others. Among patients with successful dipole modeling, MEG findings were concordant with and specific to the following: (1) the region of resection in 66% of patients, (2) invasive electrocorticography (ECoG) findings in 67% of individuals, and (3) the magnetic resonance imaging (MRI) abnormality in 74% of cases. MEG showed discordant lateralization in ~5% of cases. After surgery, 70% of all patients achieved seizure freedom (Engel class I outcome). Whereas 85% of patients with concordant and specific MEG findings became seizure‐free, this outcome was achieved by only 37% of individuals with MEG findings that were nonspecific to or discordant with the region of resection (χ2 = 26.4, p < 0.001). MEG reliability was comparable in patients with or without localized scalp electroencephalography (EEG), and overall, localizing MEG findings predicted seizure freedom with an odds ratio of 5.11 (95% confidence interval [CI] 2.23–11.8).

Significance

MEG is a valuable tool for noninvasive interictal spike mapping in epilepsy surgery, including patients with nonlocalized findings receiving long‐term EEG monitoring, and localization of the epileptogenic zone using MEG is associated with improved seizure outcomes.
Lipid remodeling in Rhodopseudomonas palustris TIE‐1 upon loss of hopanoids and hopanoid methylation
Authors: Neubauer C. , Dalleska N. F. , Cowley E. S. , Shikuma N. J. , Wu C.‐H. , Sessions A. L. , Newman D. K.
Published: April 2015

The sedimentary record of molecular fossils (biomarkers) can potentially provide important insights into the composition of ancient organisms; however, it only captures a small portion of their original lipid content. To interpret what remains, it is important to consider the potential for functional overlap between different lipids in living cells, and how the presence of one type might impact the abundance of another. Hopanoids are a diverse class of steroid analogs made by bacteria and found in soils, sediments, and sedimentary rocks. Here, we examine the trade‐off between hopanoid production and that of other membrane lipids. We compare lipidomes of the metabolically versatile α‐proteobacterium Rhodopseudomonas palustris TIE‐1 and two hopanoid mutants, detecting native hopanoids simultaneously with other types of polar lipids by electrospray ionization mass spectrometry. In all strains, the phospholipids contain high levels of unsaturated fatty acids (often >80 %). The degree to which unsaturated fatty acids are modified to cyclopropyl fatty acids varies by phospholipid class. Deletion of the capacity for hopanoid production is accompanied by substantive changes to the lipidome, including a several‐fold rise of cardiolipins. Deletion of the ability to make methylated hopanoids has a more subtle effect; however, under photoautotrophic growth conditions, tetrahymanols are upregulated twofold. Together, these results illustrate that the ‘lipid fingerprint’ produced by a micro‐organism can vary depending on the growth condition or loss of single genes, reminding us that the absence of a biomarker does not necessarily imply the absence of a particular source organism.
Translation and validation of a Spanish version of the xerostomia inventory
Authors: Serrano Carlos , Fariña María P. , Pérez Cristhian , Fernández Marcos , Forman Katherine , Carrasco Mauricio
Published: April 2015

Objective

The aim of this study was to validate a Spanish cross‐cultural adaptation of the xerostomia inventory (XI).

Materials and methods

The original English version of XI was translated into Spanish, cross‐culturally adapted and field tested. The Spanish version of XI (XI‐Sp) was tested with a sample of 41 patients with xerostomia. The reliability of the XI‐Sp was determined through internal consistency and test–retest methods. The construct validity of XI‐Sp was determined by means of correlation between XI‐Sp scores and salivary flow measurements.

Results

Overall XI‐Sp scores were 40.8 (SD = 10) for the first application and 40.2 (SD = 9.5) for the second. Cronbach's alpha value for the XI‐Sp was 0.89 and 0.87, respectively, while interitem correlation averages were r = 0.44 and r = 0.39 for each application. Interitem correlation and corrected total was rc≥0.30. The test–retest intraclass correlation coefficient value for the XI‐Sp score was 0.59 and 0.91. Convergent validity for construct validity correlation with salivary flow showed a medium effect size (r2 = 0.10) for the first application but did not make a statistically significant prediction for the second (r2 = 0.7).

Conclusions

This study provides evidence concerning the reliability of the XI‐Sp, showing that it may be a useful tool for Spanish‐speaking xerostomia patients for both clinical and epidemiologic research.
Loss of RNA‐binding motif protein 3 expression is associated with right‐sided localization and poor prognosis in colorectal cancer
Authors: Melling Nathaniel , Simon Ronald , Mirlacher Martina , Izbicki Jakob R , Stahl Philip , Terracciano Luigi M , Bokemeyer Carsten , Sauter Guido , Marx Andreas H
Published: April 2015

Aims

RNA‐binding motif protein 3 (RBM3) has recently been suggested as a prognostic biomarker in an array of human cancers. This study aimed to examine its effects in colorectal cancers.

Methods and results

RBM3 expression was analysed by immunohistochemistry on a tissue microarray containing 1800 colorectal cancers (CRCs). Nuclear RBM3 immunohistochemical staining was found in 95.9% of all interpretable CRCs. Loss of RBM3 expression was linked to advanced tumour stage (P < 0.0001), right‐sided tumour localization (P < 0.0001), and poor prognosis (P = 0.0003). In a multivariable analysis including RBM3 staining, tumour grade, tumour stage, and nodal status, only tumour stage and nodal status proved to be independent prognostic markers (P < 0.0001 each), whereas the prognostic impact of RBM3 staining was not significant (P = 0.2655).

Conclusions

Our observations indicate that loss of RBM3 expression is an unfavourable prognostic marker in CRC, and is linked to right‐sided tumour localization.
Application of microencapsulated essential oils in cosmetic and personal healthcare products – a review
Authors: Carvalho I. T. , Estevinho B. N. , Santos L.
Published: April 2015

Synopsis

Nowadays, the consumers around the world are increasingly focused on health and beauty. The renewed consumer interest in natural cosmetic products creates the demand for new products and reformulated others with botanical and functional ingredients. In cosmetic products, essential oils (EOs) play a major role as fragrance ingredients. They can optimize its proprieties and preservation, as well as the marketing image of the final product. Microencapsulation of EOs can protect and prevent the loss of volatile aromatic ingredients and improve the controlled release and stability of this core materials. The importance of EOs for cosmetic industry and its microencapsulation was reviewed in this study. Also a briefly introduction about the preparation of microparticles was presented. Some of the most important and usual microencapsulation techniques of EOs, as well as the conventional encapsulating agents, were discussed. Despite the fact that microencapsulation of EOs is a very promising and extremely attractive application area for cosmetic industry, further basic research needs to be carried out, for a better understanding of the biofunctional activities of microencapsulated EOs and its release modulation, as well as the effects of others cosmetic ingredients and the storage time in the microparticles properties.
A study of delayed purchases of enabling products in the United States: the case of hearings aids
Authors: Moschis George P. , Lee Euehun , Mathur Anil , E. Rigdon Edward , Kwai Fatt Choong
Published: April 2015

Although hearing loss afflicts millions of adults globally, most of them elderly, a relatively small percentage of them purchase hearing aids, and buyers regularly delay purchase for years. This study provides explanations for the likelihood and timing of the purchase of hearing aids. Data from a large‐scale national mail survey of 507 hearing‐impaired persons in the United States reveal that consumers do not make decisions in a time vacuum or in isolation from previous life experiences. Rather, their hearing aid purchase decision is time dependent, and time exerts different effects on consumers depending on their stage in life. Because hearing impairment is a condition experienced by consumers globally, the study findings have implications for theory and practice worldwide.
Age differences in consumer financial capability
Authors: Xiao Jing Jian , Chen Cheng , Sun Lei
Published: April 2015

The purpose of this study is to examine age differences in financial capability. Financial capability is measured by five variables: objective financial literacy, subjective financial literacy, desirable financial behavior, perceived financial capability, and a financial capability index. Financial capability is expected to increase with age. Specifically, we expect older consumers to demonstrate higher levels of both objective and subjective financial literacy, more desirable financial behaviors, a higher level of perceived financial capability, and a higher score on the financial capability index. Data from the 2012 National Financial Capability Study in the U.S. was used to examine the associations between age groups and financial capability variables. One‐way ANOVAs were used to examine age differences in financial capability variables. Then multiple regressions were used to examine age differences after controlling for socio‐demographic and financial variables. The results indicated that age differences in four financial capability variables showed similar patterns. Young adults aged 18–24 had the lowest scores on objective financial literacy, subjective financial literacy, perceived financial capability, and the financial capability index. The results have implications for consumer educators to provide effective financial education for all age groups.
Interference of blast cell fragments with automated platelet counting
Authors: Frotscher B. , Salignac S. , Muller M. , Latger‐Cannard V. , Feugier P. , Lesesve J. F.
Published: April 2015

Introduction

Automated haematology analysers may inaccurately determine platelet counts in several circumstances. Spuriously elevated automated platelet counts have been reported in some acute leukaemia (AL) cases because of fragmentation of circulating blast cells (pseudoplatelets). Haemorrhagic diathesis is a common manifestation of AL, which is often caused by severe thrombocytopenia. Therefore, overestimation of the actual platelet count in patients with AL can affect its clinical management. We aimed to detect the frequency of pseudoplatelets in patients with AL.

Methods

Complete blood cell counts were performed on 86 AL patients with three automated analysers (ADVIA 2120, Coulter LH 750 and Sysmex XE‐2100D). Platelet counts were also performed by quantitative flow cytometry (QFC). The platelet counts of the automatic analysers were compared to the platelet counts by QFC. Blood smears were checked for the presence of pseudoplatelets.

Results

The automated analysers overestimated the platelet count due to the presence of pseudoplatelets in patients with AL. Pseudoplatelets were observed in the blood smears of 11 patients (13%). Three of these patients were near the prophylactic platelet transfusion threshold.

Conclusion

Spurious increases in automated platelet counts by blast cell fragments are little known but frequent artefacts that should be ruled out by careful examination of peripheral blood smears.
Reference values for reticulocyte parameters and hypochromic RBC in healthy children
Authors: Teixeira C. , Barbot J. , Freitas M. I.
Published: April 2015

Introduction

New erythrocyte and reticulocyte parameters available on modern hematology analyzers have shown to be useful markers in children. However, pediatric method‐specific reference ranges for these indices are sparse. We aim to establish pediatric reference values for reticulocyte parameters and hypochromic red blood cells in healthy children with the ADVIA 2120 hematology analyzer.

Methods

Prospective study of 311 healthy children aged from 6 months to 18 years old with normal hematological parameters. ADVIA 2120 hematology analyzer (Siemens Healthcare Diagnostics, Amadora, Portugal) was used for whole‐blood hematological measures. The sample population was grouped according to age into three cohorts, and gender distribution was used for participants aged ≥12 years.

Results

Age‐ and gender‐specific reference limits of reticulocyte hemoglobin content (CHr or Ret‐He), difference between the reticulocyte and erythrocyte hemoglobin content (Delta‐He), immature reticulocyte fraction (IRF) and percentage of hypochromic red blood cells (%Hypo) are provided. Delta‐He, IRF and %Hypo showed statistically significant gender differences in the 12–17 years group. CHr presented no significant gender variation within all age groups (median 30.8 ± 1.7 pg).

Conclusion

Establishing reliable pediatric reference intervals for these novel hematological parameters may offer valuable prospects for clinical practice and research in the pediatrics field.
A Foreigner who Does Not Steal My Job: The Role of Unemployment Risk and Values in Attitudes toward Equal Opportunities
Authors: Pecoraro Marco , Ruedin Didier
Published: April 2015

Immigration has become systematically politicized and opposed by many individuals. We examine individual attitudes toward equal opportunities for foreigners and Swiss citizens, using cross-sectional data from the Swiss Household Panel. Individuals with low levels of education tend to oppose foreigners, while the opposition by individuals with high levels of education increases with the risk of unemployment. Values and beliefs explain the negative attitudes of individuals with low levels of education, but not the association with the risk of unemployment for individuals with high levels of education. Clearly, both values and economic factors are important for explaining attitudes toward foreigners.
Risk of initial and moderate caries lesions in primary teeth to progress to dentine cavitation: a 2‐year cohort study
Authors: Guedes Renata S. , Piovesan Chaiana , Floriano Isabela , Emmanuelli Bruno , Braga Mariana M. , Ekstrand Kim R. , Ardenghi Thiago M. , Mendes Fausto M.
Published: April 2015

Aim

To investigate the risk of sound surfaces, and initial and moderate caries lesions to progress to dentine cavitation in preschool children.

Design

A cohort study was designed with 639 children (12–59 months old) who had been examined by visual inspection during a survey in 2010. After 2 years, 469 children were re‐examined regarding the presence of dentine cavitations. The probability of progression was calculated for sound and carious (initial and moderate lesions) surfaces. Relative risk of progression and 95% confidence intervals for each condition compared with sound surfaces were calculated using multilevel Poisson regression analysis. Association with explanatory variables, including caries experience of the children, was also investigated.

Results

The higher the initial score attributed to the dental surface, the more likely was the progression. Moreover, children with severe lesions at baseline had higher risk of having a sound surface or a non‐cavitated caries lesion progressing to cavitation when compared with caries‐free children; however, this increased risk was not observed in children with only initial caries lesions.

Conclusions

Initial caries lesions present a low frequency of progression. Moreover, sound surfaces and initial caries lesions in children already presenting cavitations are more likely to progress to more severe conditions.
Dissipative Competition: Evidence from a Quasi‐Natural Experiment
Authors: Chang Yuk Ying , Young Martin
Published: April 2015

We document that contrary to the conventional view, the costs of domestic firms in terms of selling, general and administrative expenses and cost of goods sold increase significantly following exogenous shocks that increase competition, namely material import tariff cuts affecting US manufacturing industries over the period 1974–2005. Incompatible with an agency explanation, the cost increase is more pronounced among firms with higher CEO/insider/board ownership. We further find that the cost increase is more evident among firms with smaller market share and among focused firms. Generally, our results are consistent with the notion of ‘dissipative competition’ discussed in the seminal papers by Tullock.
DISTINGUISHING CHARACTERISTICS OF THE AGING FROM A SOCIOLOGICAL VIEWPOINT*
Authors: BENNETT RUTH GRANICK
Published: April 2015

DR. LORENZE: The first paper at this session will be given by Dr. Ruth Granick Bennett, who received her Bachelor's Degree at Brooklyn College and her Ph.D. in Sociology at Columbia. She has been a teaching fellow in Sociology at Brooklyn College, a university fellow of Columbia University and, at the present time, is a senior research scientist at Biometrics Research, New York State Department of Mental Hygiene.
REHABILITATION IN NURSING‐HOME SITUATIONS: A SURVEY OF THE LITERATURE
Authors: HEFFERIN ELIZABETH A.
Published: April 2015

The question of whether rehabilitation programs should be included in nursing‐home care has been answered affirmatively, both in the professional literature of the past decade and by recent legislative action which focuses on the healthcare problems of the elderly. The major issue at present is the breadth and intensity of such programs.

As this brief review of the literature has indicated, the success of rehabilitation goals is conditioned by the following factors: the mental and physical status and the social situation of the patient; the experience, professional training and rehabilitation‐oriented outlook of the attending personnel; the rehabilitation resources available in the nearby community; and the ability of the nursing home to afford the costs of the rehabilitation program in terms of dollars, personnel, time, professional services, and equipment.

However, even when the breadth of a nursing‐home rehabilitation program has to be restricted because of any of the foregoing factors, the program can at least focus on aiding patients to regain some personal, though minimal, independence. This accomplishment has benefits for both the patient and the nursing home: the patient benefits from the improvement in his psychological if not physical state, and the nursing home benefits because more of the personnel's time is available for other patient‐care services.
THE AGED: SATISFIED OR DISSATISFIED?
Authors: SHEETS ALFRED W. , DACHAWICH S. JOHN , ULLMAN PAUL S.
Published: April 2015

On the basis of interviews with 129 elderly people in the Long Beach Jewish Community Center, the most impressive finding was that, with the exception of some widows and persons with serious health problems, these men and women were content with life and did not have many unmet needs or difficulties with adjustment to old age. They did not consider their life idyllic, however. Transportation was a real problem for some, and medical expenses for others. Incomes were usually too low to allow for much of the travel so many of them wished to experience. Some had difficulties in interpersonal relationships. Failing health was the greatest single problem; more than half of the group had had a major health impairment and one‐fourth had been in a hospital during the previous year. Nevertheless, in general this population of aged people was emotionally healthy, optimistic and interested in life and the opportunities it afforded them. It should be emphasized that this group was not typical of all the aged in the country. The study demonstrated, however, that in this society, old age can be a highly rewarding period of life.

It would be most desirable to find some explanation for the diversity of attitudes observed in various reports in the literature and in the present report. Over‐all conclusions can be rendered meaningless if the aged in some of the groups and areas studied are unhappy and dissatisfied whereas those in other groups and areas are radically different in their reactions. Another factor in the diverse findings may be the ecological or social concentrations of different personality types.
FOLIC ACID FOR THE TREATMENT OF CHRONIC LEG ULCERS IN ELDERLY PATIENTS
Authors: KOPJAS TIBOR L.
Published: April 2015

During a three‐month study period, folic‐acid therapy was prescribed for 10 selected office patients (3 males and 7 females) with chronic leg ulcers. The average age was 61. Six of the 10 patients had venous stasis ulcers of various sizes. Four patients had ischemic ulcers. Folic acid was administered orally (as tablets) to all the patients in a dosage of 15 mg three times daily for twelve weeks. Four patients (2 with large varicose ulcers and 2 with ischemic ulcers) received an additional 20‐mg dose of folic acid twice weekly, intravenously.

In the first weeks of therapy most of the patients showed marked improvement. In 9 of the 10 cases, complete healing was achieved in six to twelve weeks. In the tenth case there was definite improvement but not complete healing of a toe ulcer.

Folic acid plays a dual role in the healing of leg ulcers. It is an effective vasodilator for the microcirculation, and a contributor to adequate protein metabolism.
CHRONIC CEREBROVASCULAR INSUFFICIENCY TREATED WITH PAPAVERINE
Authors: DUNLOP EDWIN
Published: April 2015

A sustained‐release papaverine preparation (Pavavid Plateau Cape) was evaluated for is efficacy in relieving symptoms related to cerebrovascular insufficiency. The overall improvement rate in 37 patients whose ages ranged from 45 to 80 years, was 70 per cent. The most consistent benefit was obtained in patients whose symptoms were caused by cerebral ischemia but who did not show evidence of advanced arteriosclerosis or other cerebral damage. The symptom most frequently relieved was the most disturbing one—loss of memory or amnesia. Other symptoms relieved in over 50 per cent of the involved patients were vertigo, dizziness, incoordination and confusion. The younger patients and those whose symptoms were of shorter duration responded better than those with advanced cerebral circulatory disease.

Since the aging process is progressive, therapy which is effective in delaying the cerebrovascular insufficiency associated with aging should be started immediately upon the appearance of signs of cerebral ischemia. The results obtained in this series indicate that papaverine has a place in the management of such patients because of its pronounced cerebral vasodilator action. Even in patients in whom the cause of the symptoms is in doubt, papaverine merits consideration for a therapeutic trial.
CANCER MORBIDITY IN MARRIED COUPLES*
Authors: Manfredi Orlando L. , Gross Ludwig
Published: April 2015

Abstract

For the purpose of collecting information about cancer morbidity in the spouses of cancer patients treated during a ten‐year period, special questionnaires were sent to the physicians involved. Of 1,691 questionnaires, 898 were answered. Only tissue diagnoses by the physicians were accepted. According to th 898 returns, 40 spouses had cancer. Compared to the rate for new cases of cancer during the same period in New York State outside New York City (2,846 per 100,000), this was a rate of 4,454 per 100,000. The difference was statistically significant beyond .005.

It is postulated that an additional endogenous factor in cancer patients, possibly an infectious one, may account for the increased incidence of cancer in the spouses of cancer patients in the present study. Further investigation is required, however.
RECENT DEVELOPMENTS IN THE THERAPY OF GOUT
Authors: GUTMAN ALEXANDER B.
Published: April 2015

Abstract: The management of acute gouty arthritis is outlined, with special attention to the use of colchicine, phenylbutazone, oxyphenbutazone, ACTH, indomethacin, the uricosuric drugs (probenecid and sulfinpyrazone) and the xanthine oxidase inhibitor, allopurinol. The prevention as well as the treatment of acute attacks, tophaceous deposits and renal calculi is discussed. Also discussed is the knotty problem of what to do about the incidental finding of hyperuricemia in apparently healthy persons. Since hyperuricemia does not of itself predetermine the occurrence of renal lesions, it would seem best to wait for the first objective evidence of tophaceous deposit (usually a period of ten or fifteen years, if ever) before starting treatment to lower the concentration of uric acid.
CUMULATIVE ILLNESS RATING SCALE
Authors: LINN BERNARD S. , LINN MARGARET W. , GUREL LEE
Published: April 2015

Abstract: A Cumulative Illness Rating Scale, designed to meet the need for a brief, comprehensive and reliable instrument for assessing physical impairment, has been developed and tested. The scale format provides for 13 relatively independent areas grouped under body systems. Ratings are made on a 5‐point “degree of severity” scale, ranging from “none” to “extremely severe.” Findings, in terms of reliability and validity, reflect statistical significance at the P < .01 level. As a rapid assessment technique which is objective and easily quantified, the scale is well suited to a variety of research uses.
GERIATRICS AS SEEN BY THE PHYSIATRIST*
Authors: Lorenze Edward J.
Published: April 2015

Abstract

An important part of geriatric medicine is rehabilitation, ranging from the prevention and early detection of disease or injury to restoration of the patient to his highest possible functional level. The basic step toward this objective is a thorough evaluation of all the factors involved, so that realistic goals may be set.

Evaluation is discussed under the headings of psychological status and physical status (including the cardiac, peripheral vascular, nervous and musculoskeletal systems). Special attention is given to certain disorders affecting ambulation—hemiplegia, hip fracture, and arthritis of the lower extremities. The syndrome of musculoskeletal failure consists of joint deformities and disabilities that have developed because of several mild pathological states acting in combination. Since it is one of the most common forms of disability, it should always be considered in any program of rehabilitative therapy.
AMELIORATION OF HIGH BLOOD PRESSURE IN THE ELDERLY
Authors: Priddle W. W. , Liu S. F. , Breithaupt D. J. , Grant P. G.
Published: April 2015

Abstract

A study was made of the residents of Metropolitan Toronto Homes for the Aged attending the Cardiovascular Clinic of the Geriatric Center for the period 1963–1967, who had a systolic blood pressure as high as 180 mm Hg or a diastolic pressure as high as 100 mm on at least two occasions. These 183 patients were classified into two groups: (a) 100 who were treated for hypertension chiefly by thiazide drugs, and (b) 83 who were not treated for hypertension. These two groups were comparable in regard to age, blood pressure, associated diseases and causes of death.

For those treated with small doses of thiazide, the mortality rate was about half the rate for the untreated group. Although the findings are based on a small sample (183 persons, 560 life‐years, and 78 deaths), they suggest that even a slight reduction of high blood pressure by thiazide therapy in the elderly population studied was associated with a lower rate of mortality than in a similar group of persons who did not receive thiazides.
THIORIDAZINE IN THE MANAGEMENT OF GERIATRIC PATIENTS
Authors: Ahmed Aftab
Published: April 2015

Abstract

A five‐week study of thioridazine therapy was made in 14 geriatric patients with arteriosclerotic or “senile” disorders. The initial dosage was 75 mg daily, increased by 25 mg daily at weekly intervals. Mental alertness was preserved and no side‐effects were noted, in contrast results with some of the tranquilizers previously used by the patients.

Tranquilizers have an important role in the management of geriatric patients. Thioridazine seems particularly suited for use in senile agitated states, for the control of symptoms while carrying out a positive programme of rehabilitation.
THE PERSONAL PHYSICIAN, THE PSYCHIATRIST, THE FAMILY, AND THE OLDER PATIENT*
Authors: Thompson Prescott W.
Published: April 2015

Abstract

The provision of mental health services for the elderly is an urgent problem. There are too few psychiatrists for the task and there is great difficulty regarding their availability for such services. There should be better working relationships between psychiatrists and other physicians. In addition, close members of the patient's family should be effectively involved in the treatment situation. Some illustrative cases are present.

Older people with serious problems can be helped substantially. The fundamental attitudes involve respect for the individual and for the difficulties inevitably encountered in trying to help him. Understanding, concern, and respect—these three. And the greatest of these—and the hardest to come by—is understanding.
FACTORS INFLUENCING IN VITRO TESTS OF THYROID FUNCTION IN THE ELDERLY
Authors: Rosin Arnold J. , Farran Helen E. A.
Published: April 2015

Abstract

Determinations of erythrocyte or resin I131‐triiodothyronine (T3) uptake and the serum protein‐bound iodine (PBI) concentration were made in 39 elderly patients on a geriatric ward and (for controls) on 20 relatively healthy residents of an old people's home.

Difficulties in interpretation of these two tests of thyroid function may arise from a quantitative or qualitative alteration in thyroxine binding to protein. Some circumstances in which these test findings were altered in old people in the absence of clinical evidence of thyroid abnormality included accidental hypothermia, infections and the ingestion of certain drugs commonly used in geriatric practice, e.g., anabolic steroids. Results of the resin T3 uptake test were also more variable in elderly hospital patients than in normal old or young people. The changes in thyroxine binding by protein during administration of anabolic steroids were not due to competitive binding but to a reversible reduction in the amount of thyroxine‐binding protein.

When determinations of thyroid function by in vitro tests are questionable, the free‐thyroxine index (the product of the T3 uptake and the PBI level) gives a true assessment of thyroid status.
THE TEAM APPROACH IN THE REHABILITATON OF PSYCHIATRIC PATIENTS
Authors: Handy Imena A.
Published: April 2015

Abstract

The organization and problems of a therapeutic team on a geriatric psychiatric ward are discussed. The growing recognition of mental hospitals as social systems has impressed upon the staffs the effect of the hospital itself on patients and families, quite apart from psychotherapy, drugs, occupational therapy and other specialized experiences. The mental hospital needs a profound social re‐orientation. The sociotherapeutic model requires that all disciplines rally to the task and decide what social factors can really help the patients. At the medical and nursing levels, sociotherapeutic principles should be clearly formulated. This is the best way to dispense with status problems, to utilize all available resources, to provide for staff growth, and to offer the patients the best opportunity for improvement.
ADVANTAGES AND LIMITATIONS OF MEDICAL ASSISTANTS*
Authors: Estes E. Harvey
Published: April 2015

Abstract

An outline is given of the experience at Duke University with training young men for the manpower category of Physician Assistant. The selection of candidates, the two‐year training course and the post‐certification duties are described. Despite the stated problems and dangers, the results to date have been most encouraging.
THE GASTROCAMERA AS A DIAGNOSTIC INSTRUMENT FOR GERIATRIC PATIENTS*
Authors: Schuman Bernard M. , Carandang Napoleon , Priest Robert J.
Published: April 2015

Abstract

One hundred and ten patients aged 65 or older were examined with the gastrocamera (color photographs) because of radiologically diagnosed or suspected disease of the upper gastrointestinal tract. The gastrocamera pictures confirmed the 31 radiologically identified ulcers in 52 per cent of the cases. Radiologically suspected gastric cancers were confirmed in all 5 cases. In the 24 patients with uncertain radiologic findings, the gastrocamera revealed 4 ulcers, 3 polyps and 2 cases of gastritis; the rest had normal stomachs. The color photographs were especially useful in the diagnosis of gastritis. The procedure, when properly performed, is well tolerated and safe for geriatric patients.
THE EXTENDED CARE FACILITY AT MOUNT SINAI CITY HOSPITAL CENTER, ELMHURST, NEW YORK: THREE‐YEAR EXPERIENCE*
Authors: Libow L. S. , Viola R. M. , Stein M. F.
Published: April 2015

Abstract

Extended care facilities are much discussed but too little supported. The ECF should be quite different from a nursing home or a home for the elderly. It is best located in or near a general hospital where it may serve as an excellent center for teaching and research in the problems (medical, social or psychiatric) of the older ill patient. More importantly, it provides a final opportunity for many borderline patients to recover enough mental and physical strength to return to comunity life and thus avoid unnecessary lifelong confinement in an institution. The ECF should be a lifeline for the older patient, and a control center for the medical‐care system in helping to determine how the patient is to spend his remaining years.
A MULTIDISCIPLINARY INVESTIGATION OF NEUROSURGICAL REHABILITATION IN BILATERAL PARKINSONISM*
Authors: Cooper Irving S. , Riklan Manuel , Stellar Stanley , Waltz Joseph M. , Levita Eric , Ribera Victor A. , Zimmerman Jane
Published: April 2015

Abstract

This report concerns the authors' findings on the effect of thalamic surgery (particularly cryothalamectomy) in bilateral parkinsonism, not only from the viewpoint of neurosurgery but from that of several other disciplines, e.g., physical therapy, speech therapy, psychology, and vocational rehabilitation—in both the immediate postoperative and long‐range situations. The purpose of the investigation was to gain more knowledge concerning the treatment of parkinsonism and the pathophysiological mechanisms of the disease, and also the relationship between behavioral disturbances and alterations in the subcortical regions of the brain.

Details are given in five chapters entitled respectively: Background, Patients and Procedures, Results, Discussion and Implications, and Significant Findings for the Rehabilitation Worker. The conclusions, outlined in the fifth chapter, are:

Bilateral tremor and rigidity can be relieved by bilateral cryothalamectomy in most parkinsonian patients who are properly selected for surgery.

Symptomatic relief is significantly related to improvement in self‐care ability, functional status and return to gainful employment.

The work‐lives of preoperatively employed parkinsonian patients may be extended by surgical treatment combined with postoperative rehabilitation services. Preoperatively unemployed or disabled patients require more intensive postoperative treatment and vocational rehabilitation.

Long‐range postoperative therapy can be of great assistance for patients with postoperative sequelae such as difficulties with balance and speech, and decreased activation.

The preoperative psychological, neurological and vocational status of the parkinsonian patient is the single most important factor in predicting the overall outcome of thalamic surgery, particularly with reference to functional and vocational status. Therefore there should be greater emphasis on improvements in surgical techniques and in the criteria for selection of patients. Patients who undergo surgery early in the course of the disease have a greater chance for functional and vocational adequacy.

The importance of follow‐up programs involving physical therapy and vocational counseling cannot be overestimated. Additional programs of education and communication should be started in cooperation with community agencies and with medical and rehabilitation centers so that they may become more aware that bilateral thalamic surgery is an effective approach to the rehabilitation of patients with parkinsonism.
GERIATRIC AXIOMS, APHORISMS AND PROVERBS
Authors: Savitz Harry A.
Published: April 2015

Abstract

The axiom, the aphorism and the proverb are defined. A collection is presented of 134 pithy sayings dealing with old age in its various aspects. They are fine examples of message augmentation by the use of brief often witty statements composed with artistic precision.
MULTIPLE PATHOLOGY IN A SEPTUAGENARIAN
Authors: Howell Trevor H.
Published: April 2015

Abstract

An autopsy on a woman aged 71 revealed 25 separate pathological lesions. The cause of death was coronary thrombosis.

The case is reviewed in relation to multiple pathology found in other elderly subjects. The number of lesions increased with advancing age in these series.
TREATMENT OF CORONARY ARTERIOSCLEROTIC HEART DISEASE WITH CHONDROITIN SULFATE‐A: PRELIMINARY REPORT*
Authors: Morrison Lester M.
Published: April 2015

Abstract

The acid mucopolysaccharide, chondroitin sulfate‐A (CSA), which is active in preventing experimentally‐induced atherosclerosis in monkeys, rats and rabbits, also has anticoagulant properties in rabbits and in patients with angina pectoris from coronary arteriosclerotic heart disease.

For an average period of one and a half years (range, one to two years), CSA was administered orally (tablet or powder) to 60 patients with clinically manifest coronary arteriosclerotic heart disease, in dosages ranging from 1.5 to 10.0 gm daily. No toxic effects were noted and the medication was well tolerated. These patients were matched with a comparable group of 60 control patients for age, sex, and clinical and laboratory findings.

In the 60 control patients, 13 acute coronary incidents occurred; 7 were myocardial infarctions, of which 2 were fatal and 6 required hospital treatment in coronary‐care units for “acute coronary insufficiency” or “acute myocardial ischemia” or impending myocardial infarction.

In the 60 CSA‐treated patients there was only 1 coronary incident—a fatal case of myocardial infarction.

This preliminary report suggests that “feasibility” studies are warranted to determine the therapeutic effects of CSA for the prevention of coronary arteriosclerotic heart disease in statistically designed, triple‐blind investigations on a larger series of patients over longer periods of time.
COMPARISON OF THE EFFICACY AND SIDE EFFECTS OF TWO SYMPATHOMIMETIC AMINE BRONCHODILATOR AEROSOLS: A STUDY OF REPETITIVE DOSING*
Authors: Cohen Burton Marcus
Published: April 2015

Abstract

A comparison of two sympathomimetic amine bronchodilator aerosols was made in 10 adult patients with chronic obstructive respiratory disease. Isoproterenol, an isoproterenol‐phenylephrine combination and placebo were administered in a sequence of pairs (double‐blind pattern) at the rate of 6 inhalations at five‐minute intervals; this procedure was repeated on three successive days.

Isoproterenol‐phenylephrine was more effective than isoproterenol alone, as shown by pulmonary function tests. It seemed to prevent augmentation of the cardiovascular effects of isoproterenol. Isoproterenol‐phenylephrine had about the same effect as proterenol with regard to acceleration of the heart rate, rise in systolic blood pressure, and the production of tremulousness.

Repetitive dosing with these aerosols (strictly limited to the rates and amounts described) results in step‐like improvement in expiratory airflow defects, and side reactions are minimal.
EFFECT OF AGE ON INTESTINAL ABSORPTION: IMPLICATIONS FOR DRUG ABSORPTION IN THE ELDERLY
Authors: Bender A. Douglas
Published: April 2015

Abstract

Studies dealing with the influence of increasing age on intestinal absorption are reviewed. Interest in these studies has resulted from statements that increasing age is accompanied by a delay and a reduction in drug absorption. There are, however, no data to support this conclusion. Nevertheless, data from studies of the absorption of sugars, fats and vitamins in subjects of different ages may be relevant to the problem of drug absorption, as are the other changes in gastrointestinal function that occur with advancing age. In the elderly there is a reduction in gastric pH which, in the case of some drugs, affects the solubility and thus will influence the rate of absorption. Furthermore, there is a reduction in intestinal blood flow, which would tend to delay or reduce drug absorption. Possibly there is a reduction in the number of absorbing cells in the intestine, with a consequent loss of absorbing surface in the aged; this may explain the reported reduction in passive diffusion in the aged. A modification of special transport mechanisms is suggested by the fact that the absorption of galactose, 3‐methyl glucose, calcium, and thiamine is reduced with increasing age. All of these factors tend to imply that drug absorption in the elderly is reduced. Fortunately perhaps, the reduction in absorption is accompanied by decreased metabolism and decreased excretion. Thus, limited absorption from the intestine is balanced by delayed elimination of drugs.
INCAPACITATING DISEASES IN THE ELDERLY: A SURVEY IN GENERAL PRACTICE
Authors: Bendkowski B.
Published: April 2015

Abstract

A twelve‐month survey was made in general practice in an English town, to determine the incidence of incapacitating diseases in patients over 65 years old. Among the 885 patients in this age group, there were three times as many women as men, and 56 of the group (6.3 per cent) had diseases which rendered them totally incapacitated. They were cared for in their homes by interested relatives, friends or landladies. Cerebral arteriosclerosis, ischaemic heart disease and rheumatic diseases were the three leading crippling diseases. The diseases, and the care of elderly patients in their home are discussed.

Old patients are treated best in their homes. They know the familiar corners of their rooms, furniture, views from the windows, and their neighbours. It is important that they have willing relatives or friends to look after them. A family doctor can give them adequate medical care provided he has the full co‐operation of ancillary services.
GERIATRIC STAFF ATTITUDES TOWARD DEATH*
Authors: Kazzaz David S. , Vickers Raymond
Published: April 2015

Abstract

Multiple educational approaches to the subject of hospital staff attitudes toward death were tested. It was not known which approaches, if any, would work, and it is still not known if one is better than another. The staff's resistance to discussing the topic of death seemed connected with a culturally‐induced denial. Attempts to promote academic discussion failed. Not until situations occurred which provoked emotional involvement—an actual death, the staging of psychodrama involving death, seminars on religion and psychiatry, and attendance at an autopsy—could the staff members begin to understand their own feelings and open the way for true communication with their patients.
AGE AND THE REHABILITATIVE CARE OF STROKE
Authors: WYLIE CHARLES MURRAY
Published: April 2015

Abstract: Over a nine‐year period, 1,223 patients with cerebrovascular accidents were admitted to Montebello State Hospital, a chronic disease institution.

The findings of this study consistently reflect an adverse influence of rising age on the response of CVA patients to rehabilitation. The older patients (over 65) were more disabled on admission, improved less often while in the hospital and died more often than the younger patients. However, the better response of the younger patients did not reduce their length of stay in the hospital (21–23 weeks).

It would be unfair for clinicians to reject for rehabilitation all older patients because of these disadvantages, since our adjustment analysis has shown one way (number of hospital‐weeks of care required to obtain a living and improved patient) in which priorities can be balanced for different age groups. It would be premature, however, to apply these figures widely until larger groups of patients are studied in different rehabilitation centers. This can be done quickly if it is agreed that scientific rather than intuitive guidelines for selecting patients deserve urgent attention.
CLINICAL ASPECTS OF DEPRESSION IN A HOME FOR THE AGED
Authors: BOWERS MALCOLM B.
Published: April 2015

Abstract: This study concerns the patterns and treatment of depressive syndromes occurring in 26 of the residents of a home for the aged, during a three‐year period.

Depression is an omnipresent threat in such a setting. Admission to a geriatric facility, often the stimulus for a depressive reaction, may be experienced as a massive psychosocial insult calling for major coping activity on the part of the patient. Persons with a prior history of depressive episodes are most likely to become depressed at this time. Depressive behavior also can occur after a period of residence and usually is a reaction to an experienced loss (which may be judged minor by the staff) or a clue to somatic decline.

Treatment of depression in a geriatric facility requires first of all an active, optimistic program which is individually oriented. Psychiatric treatment is required for those who are more severely depressed. The biological and social fragility of this group of patients is stressed.
PREVENTION OF SENILE AND PRESENILE DEMENTIA BY BISHYDROXYCOUMARIN (DICUMAROL) THERAPY*
Authors: WALSH ARTHUR C.
Published: April 2015

Abstract: Research data from many sources appear to confirm the theory that circulatory insufficiency of the brain plays a major role in the development of senile and presenile dementia. This insufficiency is probably caused most frequently by sclerotic narrowing of the arteries supplying the brain combined with blood sludging or thrombosis in the arteries, capillaries or veins. Experience gained thus far from therapeutic trials in a small number of patients indicates that progression of the dementia can usually be arrested at once by the use of bishydroxycoumarin (Dicumarol). In some patients there has been worthwhile improvement in mental status. These findings suggest that for many patients, early treatment wih Dicumarol may prevent progressive mental deterioration, and thus put senile dementia in the category of a preventable disease.