bluuebunny/crossref_metadata_2025 huggingface dataset:
Working-Day Effects on the Spectral Characteristics of Teaching Voice
Authors: Rantala Leena , Paavola Leila , Körkkö Pentti , Vilkman Erkki
Published: April 2003

Ten teachers made recordings during one normal working day using a portable DAT recorder and a head-mounted microphone. In addition, the subjects filled in a questionnaire of signs of vocal fatigue. The speech samples were selected from the first and last lesson from three points representing the beginning, middle and end part of the lesson, respectively. To standardize the samples, 30 [a] vowels from stressed syllables were chosen for spectral analysis. The level of the fundamental and second formant regions (L1), the level of frequency ranges 2–5 kHz (L2) and 5–10 kHz (L5) were measured. From these measurements the parameters L1–L0, L1–L2 and L1–L5 were formed and used in the analyses as well as the energy levels below and above 1 kHz (α). Statistically significant changes were observed in the following parameters: the L1–L2 and L1–L5 differences, and the α ratio. In general, there was an increase in the energy content of the high frequency components due to vocal loading. The subjective reports revealed a statistically significant relationship with the spectral characteristics.
A Comparison of Babbling and Speech at Pre-Speech Level, 3, and 5 Years of Age in Children with Cleft Lip and Palate Treated with Delayed Hard Palate Closure
Authors: Lohmander-Agerskov Anette , Söderpalm Ewa , Friede Hans , Lilja Jan
Published: April 2003

Babbling and speech in 21 children with cleft palate were compared at pre-speech level, 3, and 5 years of age. The aims were to study if misarticulations in pre-school speech appear to be articulatorily related to the sound productions in pre-speech, whether the feeding technique influenced the prevalence of anterior articulation, and if there was a relationship between speech and the size of the residual cleft at 3 and 5 years of age. All the children had the soft palate closed, whereas the cleft in the hard palate was left open to be closed later on. Perceptual judgement of speech revealed a high prevalence of hypernasality, nasal escape and retracted oral articulation of dental or alveolar plosives. The latter was correlated with the size of the residual cleft area. There was a tendency towards a relationship between absence of anterior sound productions in babbling and retracted oral articulation in speech. The feeding technique, however, appeared not to have had any influence on articulatory place.
Effect of a Logopedic Instruction Program after Adenoidectomy on Open Mouth Posture: A Single-Blind Study
Authors: Lembrechts D. , Verschueren D. , Heulens H. , Valkenburg H.A. , Feenstra L.
Published: April 2003

The effect of adenoidectomy (controls) on habitual open mouth posture was compared with adenoidectomy in combination with a logopedic instruction program (cases). One hundred and fifty-nine children were included (aged 2–10 years, mean age 4.6 years). The instruction program consisted of three individual logopedic sessions at 1 week, 2 weeks and 4 weeks postoperatively. One week preoperatively, 2 months and 1 year postoperatively an estimation of open mouth posture was carried out. Two months postoperatively there was a significant difference between the two groups (p = 0.001), but 1 year postoperatively this difference had disappeared (p = 0.526). The logopedic instruction program was not effective for the youngest age-group (<3.6 years).
Stotterreduktion bei frequenzverschobener und verzögerter auditiver Rückmeldung
Authors: Natke Ulrich
Published: April 2003

Bei 12 stotternden Probanden wurde die stotterreduzierende Wirkung von verzögerter auditiver Rückmeldung (DAF) und frequenzverschobener auditiver Rückmeldung (FAF) miteinander verglichen. Hierzu wurden drei Texte mit jeweils 300 Silben unter simultaner auditiver Rückmeldung, DAF (Verzögerungszeit: 53 ms) und FAF (Frequenzverschiebung: –½ Oktave) gelesen sowie anschliessend die Stotterrate bzw. der Prozentsatz unflüssiger Sprechzeit bestimmt. Nur unter DAF zeigte sich in den Gruppenwerten ein stotterreduzierender Effekt, nicht jedoch unter FAF. Bei 4 Probanden trat unter FAF dennoch eine Stotterreduktion von über 50% auf. Es wird gefolgert, dass der Einsatz von FAF als prothetische Massnahme beschränkt ist. Der Zusammenhang zwischen prolongiertem Sprechen und Stotterreduktion wird diskutiert.
The Insectivorous-Frugivorous Diet of the Golden-Handed Tamarin (Saguinus midas midas) in French Guiana
Authors: Pack Karen S. , Henry Olivier , Sabatier Daniel
Published: April 2003

The diet of Saguinus midas is characterised by analysis of stomach contents samples on an annual and seasonal basis. The diet comprises significant proportions of both fruit and insects all year round, although fruit use shows important seasonal variations. The tamarins reduce their use of fruit resources during the peak fruiting season and instead exploit increased opportunities for insectivory. This is suggested to be a response to differences in gross fruit availability as a function of both fruiting patterns and the presence of competitors for the available fruit resources.
Effects of Estrogen Status and Aging on Salivary Flow Rates in Healthy Caucasian Women
Authors: Streckfus Charles F. , Baur Ursula , Brown L. Jackson , Bacal Carolyn , Metter Jeffrey , Nick Todd
Published: April 2003

A comparison of salivary flow rates was made between three groups of female individuals according to their menopausal status. The three groups consisted of healthy, dentate, nonmedicated women (with the exception of the use of estrogen) from the Baltimore Longitudinal Study of Aging. One group consisted of premenopausal women (n = 51), their mean age was 39 years. Another group (n = 26) was perimenopausal with a mean age of 48 years. A third group (n = 76) was postmenopausal with a mean age of 69 years. The groups were evaluated for unstimulated (UPAR) and stimulated parotid gland flow rates (SPAR), unstimulated (USUB) and stimulated submandibular/sublingual gland flow rates (SSUB), and stimulated whole-saliva flow rates (SWHOLE). The parotid flow rates were determined using a Carlson-Crittenden cup, while the submandibular/sublingual flow rates were determined using the National Institute of Dental Research collector. A 2% citrate solution was used for stimulation in glandular collections. Chewing a 1-cm3 cube of paraffin was used to stimulate whole saliva. The results showed no significant differences in UPAR, SPAR, and SWHOLE between the three groups. However, the premenopausal women had higher USUB than the postmenopausal group. The premenopausal women also had higher SSUB than perimenopausal and postmenopausal groups. There were no differences in salivary flow rates between those taking estrogen and those that were not medicated.
Hemorheological Changes during Human Aging
Authors: Ajmani Ranjeet S. , Rifkind Joseph M.
Published: April 2003

Various researchers have reported an association of hemorheological, hematological and metabolic changes with human aging. In this article an attempt has been made to review the present understanding of hemorheological changes and their probable role in the development of certain disorders/diseases during aging. The rise in fibrinogen, blood viscosity, plasma viscosity, red cell rigidity, fibrin degradation products and early activation of the coagulation system are some of the most prominent findings. It is generally agreed that a rise in blood viscosity factors leads to a state of hypoperfusion which results in impaired microcirculation. The cumulative effect of these changes appears in the form of a disturbed blood flow profile in older subjects leading to the development or aggravation of various circulatory disorders. Many studies indicate that hemorheological parameters that change in a number of diseases prevalent during aging include hypertension, stroke, diabetes. In addition correlations found between hemorheological parameters in the aged and decrements in certain cognitive functions and behavioral patterns suggest that hemorheological changes contribute to nonclinical aging changes.
Effects of Age on Gastric Alkaline and Nonparietal Fluid Secretion in Humans
Authors: Feldman Mark , Cryer Byron
Published: April 2003

Little is known about the effect of age on gastric alkaline and nonparietal secretion. Using a previously validated technique, we prospectively measured gastric HCO–3 and nonparietal volume secretion, as well as secretion of H+, Na+, K+, and Cl–, in 114 healthy human beings over a wide age range (18–82 years). Each subject had normal oxyntic mucosal histology, was on no medication known to affect gastric secretion, and was studied under both basal (fasting) conditions and following stimulation of gastric H+ secretion by pentagastrin. There was a significant (p < 0.05) decline in gastric HCO–3, Na+, and nonparietal fluid secretion with advancing age, but not in H+, K+, Cl– or parietal fluid secretion. As a consequence of reduced gastric HCO–3 and nonparietal fluid secretion, mean H+ concentrations in gastric juice increased significantly with advancing age. Thus, in healthy subjects with normal gastric histology, advancing age was associated with a significant decline in gastric HCO–3, Na+, and nonparietal fluid secretion, resulting in an increase in gastric acidity (H+ concentration).
Effect of Short-Term Recombinant Growth Hormone Administration on Plasma Lipoproteins in Elderly Adults
Authors: Angelopoulos Theodore J. , Seip Richard L. , Cole Thomas G.
Published: April 2003

To characterize the effects of recombinant human growth hormone (rhGH) on plasma lipids and lipoproteins, rhGH was administered daily at a dose of 40 µg·kg–1 (Genentech) for 14 days in 7 healthy elderly male (67.4 ± 1.9 years, 75.8 ± 2.6 kg) adults. Six other healthy males (63.9 ± 0.7 years, 77.8 ± 3.8 kg) served as concurrent controls. Total plasma cholesterol (TC), triglycerides (TG), very-low-density lipoprotein-cholesterol, low-density lipoprotein-cholesterol, high-density lipoprotein-cholesterol, very-low-density lipoprotein-TG (VLDL-TG) and apolipoprotein AI and apolipoprotein B were determined after an overnight fast before and after the 14-day period of rhGH administration. Subcutaneous rhGH administration was physiologically effective, as shown by a threefold increase in insulin-like growth factor-I (from 110.8 ± 8.2 to 355.5 ± 41.6 ng·ml–1; p < 0.05). Plasma fasting insulin also increased from 38.0 ± 6.5 to 129.9 ± 43.8 µmol·l–1 (p < 0.05) at the end of the 14 days of rhGH treatment. With respect to plasma lipid/lipoprotein changes, rhGH administration increased plasma TG levels (from 1.5 ± 0.3 to 2.2 ± 0.4 mmol·l–1; p < 0.05) and VLDL-TG (from 1.1 ± 0.3 to 1.8 ± 0.4 mmol·l–1; p < 0.05), but did not change TC (from 5.0 ± 0.4 to 5.2 ± 0.3 mmol·l–1) or any other lipid/lipoprotein variables measured. No significant lipid changes were noted in the control group over the 14-day period. These data suggest that short-term rhGH treatment significantly alters plasma variables of TG profile, perhaps by altering metabolic parameters (i.e. synthesis and/or clearance rates) of VLDL metabolism.
Risk Factors for Major Injurious Falls among the Home-Dwelling Elderly by Functional Abilities
Authors: Koski Keijo , Luukinen Heikki , Laippala Pekka , Kivelä Sirkka-Liisa
Published: April 2003

Background: In order to identify the risk factors essential for preventing major injurious falls, the associations between injurious falls and certain factors were assessed among disabled and independent elderly, respectively, who had fallen during a 2-year period. Methods: A prospective population-based study was conducted in five rural northern Finnish municipalities. The series consisted of all inhabitants aged 70 years or over, initially 979 persons. During a 2-year follow-up period, all injurious falls were recorded on the basis of telephone contacts, diary reporting and a review of the medical records of the participants. Results: Thirty percent of the subjects having fallen sustained a major injury. The multivariate model applied to the disabled elderly showed the following variables to be related to a high risk for major injurious falls: divorced, widowed or unmarried marital status (odds ratio = 2.2), a low body mass index (odds ratio = 3.1), incomplete step continuity (odds ratio = 2.2), poor distant visual acuity (odds ratio = 2.3) and the use of long-acting benzodiazepines (odds ratio = 2.4). Among the independent elderly, the risk of a fall resulting in major injury was high among the subjects who had peripheral neuropathy (odds ratio = 2.5) or were suffering from insomnia (odds ratio = 4.1). Conclusions: The risk factors for major injuries in fall occurrences differ between the disabled and independent elderly. Preventive measures should be targeted according to the disabilities of the population.
Effect of Butylated Hydroxyanisole on Catalase Activity and Malondialdehyde Content in Aging Zaprionus paravittiger (Diptera)
Authors: Bains J.S. , Garg S.K. , Sharma S.P.
Published: April 2003

Catalase activity and malondialdehyde (MDA) content were measured in whole body and mitochondrial homogenates of the banana fruit fly, Zaprionus paravittiger, fed on control and butylated hydroxyanisole (BHA, 10 mM) mixed diets. Catalase activity increased during the reproductive period and decreased thereafter with age. However, the MDA content increased with advancing age in both sexes. In general, females exhibited higher catalase activity and lower MDA content as compared to their male counterparts. BHA feeding increased catalase activity significantly during all age intervals in both sexes. Mitochondrial fractions had lower catalase activity and lower MDA content than whole body homogenates. However, the pattern of changes was similar in both homogenates with age as well as on antioxidant feeding. These results suggest that BHA strengthens the defense mechanism of the insects by increasing catalase activity and reducing MDA content which may be responsible for increased longevity of insects.
Brisk Walking and Postural Stability: A Cross-Sectional Study in Postmenopausal Women
Authors: Brooke-Wavell K. , Athersmith L.E. , Jones P.R.M. , Masud T.
Published: April 2003

This study compared body sway, a measure of postural stability, between regular brisk walkers and control subjects. Furthermore, the relationship between body sway and physical activity duration in postmenopausal women was examined. Subjects were 31 healthy postmenopausal women, aged 61–71 years. They were recruited from a randomized controlled study of the influence of brisk walking on bone: 16 women had been completing 20 min d–1 brisk walking, whilst 15 controls had been completing habitual activities only. Body sway was measured using a swaymeter that measured displacement at the waist whilst subjects stood on a compliant surface, with eyes closed, for 1 min. The activity was measured using activity monitors which were worn at the waist for 3 consecutive days. Body sway (eyes closed, standing on a compliant surface) was lower in walkers than in controls: 2,958 ± (SE) 270 versus 5,225±371 mm2 min–1, respectively (p < 0.05). A negative correlation was found between body sway and minutes of physical activity (r = –0.47, p < 0.01). Analysis of variance revealed that body sway differed significantly (p < 0.05) between groups of differing physical activity participation, being 4,839 ± 499, 4,167 ± 516, and 2,877 ± 362 mm2 min–1, respectively, in women completing <20, 20–40, and >40 min d–1 of physical activity. Body sway was significantly lower in the most active group than in the least active (p < 0.01). These data suggest that postural stability is better in regular walkers than in control subjects. Furthermore, a dose-response relationship was observed between physical activity and postural stability in postmenopausal women. These findings provide a preliminary indication that brisk walking, a low-cost and acceptable form of physical activity for the elderly, could be incorporated into strategies for improving balance in the elderly.
Changing Causes of Death of Elderly People in the United States, 1950–1990
Authors: Smith David W.E.
Published: April 2003

Background: Causes of death have changed greatly in the United States during the 20th century. Objective: To detail these changes in elderly people during 1950–1990. Methods: The source of data was ‘Vital Statistics of the United States’ for the years discussed. Mortality rates for several causes were calculated for the 85–89 age group, and the percentage of deaths attributed to several causes was calculated. Results:There are large peaks about 1970 in both the mortality rate of ischemic heart disease and the percentage of total deaths attributed to this cause. The peaks have been followed by declines. Death rates from cancer and the percent of deaths attributed to cancer have increased during 1950–1990. Conclusions: The above changes coincide with major changes in medical science and care, the identification of the risk factors predisposing to ischemic heart disease and cerebrovascular diseases, and the implementation of Medicare, a program of health care benefits to all people 65 and over that is supported by the United States government.
How Age Changes the Content of Neuroendocrine Peptides in the Murine Gastrointestinal Tract
Authors: El-Salhy Magdy , Sandström Olof
Published: April 2003

Background: Motility disorders in the gastrointestinal tract increase with ageing, and colorectal carcinoma is a tumor of the middle-aged and elderly. Gastrointestinal secretion, absorption, motility, cell proliferation, local immune defense and blood flow are all regulated by the neuroendocrine peptides. It is conceivable that gastrointestinal disorders at an advanced age may be accompanied by changes in this regulatory system. Objective: To ascertain possible age-related changes in neuroendocrine peptides in a rodent animal model. Methods: The concentrations of various neuroendocrine peptides were determined by radioimmunoassays in tissue extracts from the antrum, duodenum and colon of mice in four different age groups: 1, 3, 12 and 24 months. The neuroendocrine peptides investigated were: secretin, gastric inhibitory polypeptide (GIP), gastrin, motilin, peptide YY (PYY), somatostatin, vasoactive intestinal polypeptide (VIP), substance P, neuropeptide Y (NPY), galanin and neurotensin. Results: Antrum: Concentrations of somatostatin, VIP and substance P decreased significantly in 1-month-old mice (but that of neurotensin increased) compared with 3-month-old mice. In 12-month-old and 24-month-old mice, concentrations of gastrin, somatostatin, VIP, substance P, NPY, galanin and neurotensin all decreased vis-à-vis 3-month-old mice. Duodenum: Whereas the levels of secretin, GIP and neurotensin increased, those of gastrin, motilin, somatostatin, VIP, substance P, NPY and galanin decreased in 1-month-old mice vis-à-vis 3-month-old mice. In both 12-month-old and 24-month-old mice, the concentrations of secretin and GIP increased, compared with those of 3-month-old mice. The levels of gastrin, motilin, somatostatin, VIP, NPY and galanin decreased in both 12-month-old and 24-month-old mice vis-à-vis 3-month-old mice. Substance P and neurotensin concentrations decreased in 12-month-old mice, but not in 24-month-old mice. Colon: In 1-month-old mice the levels of PYY, somatostatin, VIP, substance P and galanin decreased vis-à-vis 3-month-old mice. In 12-month-old mice, the concentrations of PYY, somatostatin, VIP, NPY, galanin and neurotensin decreased compared with those in 3-month-old mice. In 24-month-old mice, the VIP level decreased, whereas the substance P level increased. Conclusion: The changes in neuroendocrine peptides observed in the gastrointestinal tract of this murine animal model could be of some relevance for the increased gastrointestinal dysfunction in the elderly human. They may also be involved in the development of colorectal cancer.
Antibody Response to 1995–1996 Influenza Vaccine in Institutionalized and Non-Institutionalized Elderly Women
Authors: Iorio A.M. , Alatri A. , Camilloni B. , Neri M. , Baglio G. , Donatelli I.
Published: April 2003

Background: Concern about poor responsiveness to influenza vaccination by institutionalized elderly people. Objective: To determine whether institutionalized elderly volunteers develop a significant antibody response following influenza vaccine and to compare this response with that of non-institutionalized subjects. Methods: The haemagglutination-inhibiting antibody response after 1995–1996 influenza vaccination [A/Shangdong/9/93 (H3N2), A/Taiwan/1/86 (H1N1), B/Panama/45/90] was estimated in 80 elderly women living in a nursing home and compared with that of 51 non-institutionalized women. Results: No differences were found in the prevaccination status, and, after vaccination, a significant humoral response was elicited both in institutionalized and non-institutionalized elderly subjects against all three influenza strains tested. The immune response of institutionalized patients was satisfactory and significantly higher than that observed in non-institutionalized women. These results were confirmed both by a separate analysis of homogeneous subgroups stratified according to the presence in the two cohorts of potential causes of differential antibody response (prevaccination antibody titre, age, long-term drug treatment, risk factors for influenza infection, and physical disability) and by logistic regression analysis in order to adjust immune responses for the different variables. Conclusion: Influenza vaccination is effective in elderly people living in nursing homes. However, the postvaccination antibody response to influenza vaccine is influenced by different factors directly or indirectly related to residence.
Oral Flora of Elderly Patients following Acute Medical Admission
Authors: Preston A.J. , Gosney M.A. , Noon S. , Martin M.V.
Published: April 2003

The human oral microflora is diverse and is usually predominately composed of Gram-positive bacteria. It is uncommon to find Gram-negative bacilli (GNB) in healthy mouths. The incidence of infection with GNB rises in institutionalised, frail elderly subjects. There is also evidence of an association between intra-oral GNB presence and denture wearing. There have been few studies which have investigated intra-oral GNB carriage in acutely ill elderly patients. The aim of this study was to evaluate the oral flora of a group of elderly patients during an acute medical admission and to investigate any associations between the oral microflora and existing medical or oral factors. A total of 28 patients (17 females and 11 males; age: 74–93 years) on a care for the elderly ward were studied. Epidemiological data, detailed medical histories and oral examinations were undertaken. In addition, oral swabs of the palate area were taken to determine their oral flora. Twelve (43%) of the patients had GNB in their oral cavities. These patients were suffering from a variety of medical conditions and were on various drug regimes. There was a correlation between oral GNB presence and denture use. There was no association between GNB presence and denture hygiene. As oropharyngeal GNB colonisation can be associated with infections such as aspiration pneumonia, it is important in patients at risk that intra-oral organisms are identified and managed.
Murmurs Associated with Mitral Annular Calcification and Aortic Sclerosis
Authors: Miller Albert J. , Grais I. Martin , Abrams David L. , Kaplan Benjamin M. , Shelton-Zoiopoulos Lynn Y.
Published: April 2003

Background: Auscultation of patients with mitral annular calcification on echocardiography revealed a particular constellation of findings. Objective: To test the hypothesis that a particular auscultatory constellation provides a high degree of certainty in diagnosing the combination of mitral annular calcification and aortic sclerosis so often found in the elderly. Methods: Two groups of patients were studied to evaluate the particular auscultatory constellation under consideration which consisted of: (1) a harsh ejection systolic murmur heard from the 2nd right interspace to the cardiac apex and usually loudest between the 3rd left interspace and the apex; (2) the murmur radiates from the apex towards the left axilla and radiates poorly or not at all from the 2nd right interspace to the neck, and (3) the 2nd heart sound at the cardiac base is normal in intensity, and no ejection clicks are present. Group 1 consisted of patients with mitral annular calcification on echocardiographic examination, and group 2 consisted of patients in whom the particular constellation of auscultatory findings was present and who were then referred for echocardiographic assessment. Results: The particular auscultatory constellation under investigation allowed the diagnosis of the presence of the combination of mitral annular calcification and aortic sclerosis with substantial accuracy. Conclusion: The findings in this exploratory study suggest that the pathologic combination of mitral annular calcification and aortic sclerosis can be diagnosed with a reasonably high degree of certainty in elderly patients, if the particular auscultatory configuration is identified.
Homeostasis, Thymic Hormones and Aging
Authors: Goya RodolfoG. , Bolognani Federico
Published: April 2003

The thymic-pituitary axis constitutes a bidirectional circuit where the ascending feedback loop is effected by thymic factors of epithelial origin. The aim of the present article is, first, to introduce the idea of an immune-neuroendocrine homeostatic network in higher animals. Next, the relevance of the thymus in this network and the possible role of this gland in the neuroendocrine imbalances associated with aging are discussed. A number of studies are next reviewed which show that the endocrine thymus produces several bioactive molecules, generally called thymic hormones, which in addition to possessing immunoregulatory properties are also active on nervous and endocrine circuits. In particular, the reported activities of thymosin fraction five, thymosin alpha 1 and thymosin beta 4 on β-endorphin, adrenocorticotropic hormone, glucocorticoids, luteinizing hormone-releasing hormone and luteinizing hormone secretion in different animal and cell models are reviewed. The known hypophysiotropic actions of other thymic hormones like thymulin, homeostatic thymus hormone and thymus factor are also summarized, and the impact of aging on pituitary responsiveness to thymic hormones is discussed. As a conclusion, it is proposed that in addition to its central role in the regulation of the immune function, the thymus gland may extend its influence to nonimmunologic components of the body, including the neuroendocrine system. The early onset of thymus involution might, therefore, act as a triggering event which would initiate the gradual decline in homeostatic potential that characterizes the aging process.
Gastric Mucosal Defences in the Elderly
Authors: Guslandi M. , Pellegrini A. , Sorghi M.
Published: April 2003

Background: Elderly subjects are more prone to develop gastric injury, but human data on the state of mucosal protective mechanisms are scarce. The aim of the study was to assess gastric mucus and bicarbonate secretion as well as local microcirculation in elderly patients. Methods: Fasting gastric juice was collected in 45 elderly patients and in 45 control subjects devoid of endoscopic gastric abnormalities. Total mucoproteins, ‘mucoprotective index’ (as qualitative expression of mucus secretion) and gastric bicarbonate (Feldman’s method) were measured. In addition in 24 elderly patients, and in a matching group of younger subjects, gastric mucosal blood flow was measured by laser Doppler flowmetry. Results: Mucus and bicarbonate production was significantly reduced (p < 0.01) in elderly patients, the quality of mucus secretion being unaltered. Gastric mucosal perfusion was also significantly decreased (p < 0.01) in aged subjects. Conclusion: In the elderly gastric mucosal defences are impaired. This is in keeping with a reduced gastric prostaglandin biosynthesis and may account for the higher susceptibility of the mucosa to damaging agents. The possible role of atrophic gastritis and Helicobacter pylori infection as independent confounding factors remains to be determined.
Trimethoprim-Induced Hyperkalemia: An Analysis of Reported Cases
Authors: Marinella Mark A.
Published: April 2003

Background: Trimethoprim has been recently implicated in the development of hyperkalemia when administered at standard doses to immunocompetent patients. However, many clinicians are unaware of this potentially dangerous adverse effect. Objective: To review reported cases of trimethoprim-induced hyperkalemia in immunocompetent patients and identify predisposing factors, treatment, and outcome. Methods: A MEDLINE literature search was performed using the key words ‘trimethoprim’ and ‘hyperkalemia’. All English-language case reports and bibliographies of immunocompetent patients with trimethoprim-induced hyperkalemia were reviewed. Results: Nine cases were identified. The mean patient age was 77.6 years, and the mean duration of therapy was 10.2 days. Seven patients received standard oral dosages of trimethoprim-sulfamethoxazole for common infections, and 2 patients were concurrently receiving angiotensin-converting enzyme inhibitors. The mean pretreatment levels of creatinine and potassium were 1.01 mg/dl and 4.55 mmol/l, respectively. The mean peak serum potassium level was 7.0 mmol/l. No deaths attributable to hyperkalemia occurred. Conclusions: Hyperkalemia due to trimethoprim typically affects elderly patients administered standard oral dosages, even in the presence of a normal serum creatinine level. Concurrent angiotensin-converting enzyme inhibitor therapy may increase the risk of hyperkalemia. The prognosis is favorable with standard therapy for hyperkalemia and withdrawal of trimethoprim.
Regular Non-Vigorous Physical Activity and Cholesterol Levels in the Elderly
Authors: Knight Stephen , Bermingham Margaret A. , Mahajan Deepika
Published: April 2003

Background: High-density lipoprotein cholesterol (HDL-C) is a powerful independent risk factor for coronary heart disease (CHD) among the elderly. Regular vigorous physical activity has been found to raise the concentration of HDL-C and thus reduce the risk of CHD. There is little data on the effect of non-vigorous activity on HDL-C in the elderly. Objective: The aim of this study was to compare CHD risk factors, especially HDL-C, in a group of elderly persons who engage in regular non-vigorous physical activity with a group of frail elderly examined in a previous study. Methods: Each subject (51 women and 19 men) had anthropometric measures taken and completed a questionnaire on lifestyle and medical history. Total cholesterol (TC), HDL-C and lipoprotein (a) were analysed. Results were compared with those of a frail group examined previously using similar methodology. Results: HDL-C, adjusted for age, body mass index (BMI) and waist-to-hip ratio (WHR), was greater among women (p < 0.01) and men (p < 0.05) who were engaged in a regular physical activity at least once a week. TC was higher among active women (p < 0.001), but there was also a trend towards a lower TC/HDL ratio. Therefore, although TC is higher in active women, this could be due to a higher proportion of the cholesterol fraction consisting of HDL-C. WHR was negatively associated with HDL-C in frail men (p < 0.05), active men (p < 0.01) and active women (p < 0.05). BMI was negatively associated with HDL-C in frail women (p < 0.05). Conclusions: This sample of elderly people who participate in regular weekly non-vigorous physical activity have a higher HDL-C than frail individuals who do little or no exercise. Since HDL-C is consistently reported to be inversely associated with CHD in the elderly, an elevation in HDL-C concentration may provide some protection to elderly persons who participate in regular nonvigorous physical activity compared to frail elderly individuals who are largely sedentary. Caution should be exercised in the interpretation of a TC only reading in active elderly women without an accompanying measure of HDL.
Urinary Calcium Loss in Elderly Menon a Vegetable:Animal (1:1)High-Protein Diet
Authors: Moriguti J.C. , Ferriolli E. , Marchini J. Sérgio
Published: April 2003

Background: A high purified protein intake has been shown to induce urinary calcium loss. However, these findings could not be reproduced with a high-protein meat diet. Also, most studies have been carried out in young subjects and the applicability of their results to the elderly population on a mixed vegetable:animal diet remains unclear. Objectives: To study whether a mixed vegetable:animal high-protein intake increases urinary calcium loss in elderly volunteers, as has been shown for younger subjects on a purified high-protein intake. Methods: Eight male volunteers, with ages ranging from 66 to 88 years, recruited from the University Hospital Geriatric Medicine Outpatients Clinic, were studied. 24-hour urinary calcium, phosphorus, and creatinine were measured during a period of usual protein intake (approximately 0.6 g/kg/day) and during 7 days of vegetable:animal (1:1) high-protein intake (2 g/kg/day). Calcium and phosphorus intake were adjusted to be kept constant (1 g/day of each) during the whole study. Results: Mean calcium urinary levels did not change significantly during the study (1.89 and 1.83 mmol/24 h during the usual and high-protein diet, respectively). Urinary phosphorus and creatinine levels also remained stable throughout the entire study. Conclusions: This study has not detected any increased calcium urinary excretion in male elderly volunteers submitted to the mixed vegetable:animal high-protein diet. Therefore, it does not support the suggestion that a high-protein intake is a risk factor for urinary calcium loss in elderly men.
Morphometry of Axon Cytoskeleton at Internodal Regions of Rat Sciatic Nerve during Aging
Authors: Caselli Ugo , Bertoni-Freddari Carlo , Paoloni Roberta , Fattoretti Patrizia , Casoli Tiziana , Meier-Ruge William
Published: April 2003

Background: Nerve endings undergo a lifespan morphofunctional modulation which is reported to be markedly impaired with aging. Neurone structural remodelling is in charge of processes occurring in the nerve cell soma, however the axonal transportation of organelles and molecules by cytoskeletal elements plays a very important role in the morphological rearrangements taking place at peripheral compartments. Objective: To assess the involvement of axonal ultrastructure in the reported age-related decline of slow axoplasm flow mechanisms, we carried out a morphometric study of axon cytoskeleton in aging. Methods: Female Wistar rats (3, 12 and 30 months of age) were anesthetized and perfused with saline followed by a fixation solution (glutaraldehyde 5% + formalin 2% in 0.1 cacodylate buffer pH 7.4). The excised sciatic nerves were processed according to conventional electron microsopic procedures. Axons sectioned perpendicularly to their longitudinal axis at the internodal region (mean axoplasm area: 18.25–26.5 μm2) were sampled by a systematic random procedure. The overall number of neurofilaments (No.Nfs) and microtubules (No.Mts) per total axoplasm area analysed, the numeric density (number/μm2 of axoplasm area) of neurofilaments (NaNfs) and microtubules (NaMts), the myelin thickness, the number of myelin lamellae and the R proportion [No.Nfs/(No.Nfs + No.Mts)] were the parameters measured by computer-assisted semiautomatic methods. Results: No.Nfs, NaNfs, myelin thickness and the number of myelin lamellae did not change between 12 and 30 months of age, while a significant increase of these parameters was found in a comparison with younger rats. No.Mts and NaMts were significantly increased at 12 vs. 3 as well as at 30 vs. 12 months of age, respectively. R proportion did not show any difference due to age. Conclusions: The present findings support that the dynamic condition of the axonal cytoskeleton appears to be preserved at a high extent in aging. Thus, the intra-axonal defective spacing of cytoskeletal elements (e.g. neurofilaments), rather than their number, is proposed to contribute to the decline of the slow axonal transport of organelles and molecules reported in aging.
Does the Plasma Endothelin-1 Concentration Reflect Atherosclerosis in the Elderly?
Authors: Sayama Harumi , Nakamura Yasuyuki , Saito Noboru , Konoshita Masahiko
Published: April 2003

Background and Objective: Recently, attention has been focused on endothelin-1 (ET-1) as an indicator of atherosclerosis. However, normal levels of ET-1 are frequently found in elderly patients. We investigated the relationships between echocardiographic findings and ET-1 in 117 inpatients for rehabilitation. Methods: The patients were 34 men and 83 women, 83.4 ± 0.8 years old (mean ± SE), with the following diseases: cerebrovascular diseases (n = 83), cardiovascular diseases of New York Heart Association Class I or II (n = 57), diabetes mellitus (n = 11) and hyperlipidemia (n = 12). Ejection fraction (EF) and left ventricular mass index (LVMI) were calculated by echocardiographic studies. Results: The average ET-1 was within the normal range, but a significant positive correlation was observed between age and ET-1 (ET-1 = 1.8 ± 0.1 pg/ml, r = 0.248, p < 0.01). Moreover, plasma ET-1 was positively correlated to total cholesterol and to low density lipoprotein cholesterol in patients with a history of hypertension (n = 41, r = 0.318 and r = 0.314, both p < 0.05). Gender was not a significant factor. There was no significant difference in ET-1 between patients with mild renal dysfunction (n = 54) and patients with normal renal function (n = 63) (blood urea nitrogen = 30.9 ± 2.4 vs. 15.1 ± 0.5 mg/dl, serum creatinine = 1.03 ± 0.06 vs. 0.59 ±0.02 mg/dl, ET-1 = 1.7 ± 0.1 vs. 1.8 ± 0.1 pg/ml), or between patients with (n = 50) and without (n = 67) left ventricular hypertrophy (LVMI = 146 ± 6 vs. 83 ± 2 g/m2, ET-1 = 1.8 ± 0.1 vs. 1.8 ± 0.1 pg/ml). There was no difference in ET-1 between patients with EF <50% (n = 27) and EF ≥50% (n = 90) (ET-1 = 1.8 ± 0.2 vs. 1.7 ± 0.1 pg/ml). Conclusion: There were no significant relationships between echocardiographic findings and ET-1 in elderly subjects without overt heart failure. However, in patients with a history of hypertension, measuring ET-1 may be useful for estimating the extent of atherosclerosis.
Construct Overlap in Resource Theories of Memory Aging
Authors: Anstey Kaarin
Published: April 2003

This article evaluates the conceptual status of working memory, processing speed, executive function and sensory function as mediational constructs to explain memory aging. The main difficulty for these mediational constructs is that they may not be independent. Mediational constructs may overlap with each other or with the dependent variable due to theoretical, substantive or methodological reasons. It is argued that sensory function has an advantage over processing speed, working memory and executive function as a mediational construct because it is non-cognitive. The problem of construct overlap is relevant to both cross-sectional and longitudinal studies. Further research is required to evaluate the relative importance of mediational constructs in theories of memory aging, general intellectual aging and dementia.
How Strong Is the Evidence for Mediational Hypotheses of Age-Related Memory Loss?
Authors: Sliwinski Martin , Hofer Scott
Published: April 2003

Background: Luszcz and Bryan review research supporting three theories of age-related memory loss: the speed hypothesis, the executive function hypothesis, and the common cause hypothesis. Objective: The aim of this commentary is to extend that review by encouraging consideration of the strength (or lack thereof) of the empirical evidence supporting theories of age-related memory loss. Methods: Arguments are presented that call into the question the strength of the evidence that derives from cross-sectional analysis of individual difference sources of variance. Results: Supporting evidence for mediational hypotheses of cognitive aging (1) derives from potentially ambiguous statistical techniques; (2) is based on untested assumptions about the between and within person sources of variance; (3) is not supported by longitudinal studies, and (4) relies heavily on arguments of parsimony. Conclusions: Existing evidence is not strong enough to grant any particular theory presumptive status. We concur with Luszcz and Bryan that supplementing the now popular individual differences research designs with alternative approaches would advance theory development and testing.
Glutathione-S-Transferase in the Ageing Rat Brain Cerebrum and the Effect of Chlorpromazine
Authors: Gopal P. Venu , Sriram A.V. , Sharma Deepak , Singh Rameshwar
Published: April 2003

Lipid peroxidation increases during ageing and has been implicated in the pathogenesis of degenerative processes associated with ageing. Despite the importance of the enzyme glutathione-S-transferase (GST) in the biotransformation and detoxification of lipid peroxidation products, there have been extremely limited studies of GST in the ageing brain. The drug chlorpromazine is known to have an activating influence on the activities of certain antioxidant enzymes (glutathione peroxidase, superoxide dismutase, etc.) and it also has anti-lipid peroxidative and anti-lipofuscin influences. Therefore, information about the age-related changes in brain GST and the effect of chlorpromazine on it in the ageing brain will be of further interest. We have, therefore, studied the effect of age on the activity of GST in the whole homogenate and cytosol fractions from the cerebral hemispheres of rats aged 1, 2, 3, 6, 12, 18 and 24 months. The effect of chlorpromazine treatment (10 mg/kg i.p. on alternate days for 6 months) was examined in the whole homogenate and cytosol fraction from the cerebral hemispheres of 6-, 12-, 18- and 24-month-old rats. The results showed that the values for GST specific activities in the cytosol fraction from all the age groups were higher then those in the whole homogenate; and the pattern of age changes in the whole homogenate differed from that in the cytosol. In the cytosol fraction the enzyme activity showed several phases of alterations: a progressive increase at 3 months of age, followed by a steady level up to 12 months of age; this phase was folllowed by a fall in the activity (at 18 months of age) then turned to a gradual increase. In the whole homogenate there were two phases of alterations: a progressive increase up to 12 months of age, which then turned to a somewhat gradual decrease with ageing. Thus, the decline in GST activity during ageing was evident in both the whole homogenate and cytosol. The results from chlorpromazine experiments showed that the drug elevated the GST activity in 12-, 18-, and 24-month-old animals but not in the 6-month-old animals. The drug’s effects were most profound in 12-month-old animals. In conclusion, this study demonstrated an impairment of brain GST activity during ageing and the results further showed that the drug chlorpromazine attenuated the age-related impairment in the enzyme activity. The enhancement of the GST status of the ageing brain following chlorpromazine treatment is indicative of an additional antioxidative property of this drug.
Endometrial Cancer in Elderly Women: A Histologic and Steroid Receptor Study
Authors: Deligdisch Liane , Kase Nathan G. , Bleiweiss Ira J.
Published: April 2003

Background: Information on steroid receptor content in endometrial tissue of aging women is limited and somewhat controversial. The high incidence of endometrial cancer (EC) and the implication of hormone replacement therapy (HRT) in this group prompted the investigation of steroid receptors and endometrial cancer histology in the elderly. Objective: Review of histologic characteristics correlated with estrogen and progesterone receptors (ER and PR) status in EC in women over 75 years of age in order to determine the prevalence of a more aggressive endometrial neoplasm arising in late postmenopausal atrophic endometrium of elderly patients. Methods: Histologic slides and deeper sections stained immunohistologically for ER/PR from 54 cases of EC in women aged 75–95 years were reviewed. The histologic characteristics and degree of differentiation were correlated with the steroid receptor status, evaluated on a scale of 0–3. Benign endometrial tissue from women of the same group was used as controls. Results: The 57.4% endometrioid adenocarcinomas were mostly moderately and poorly differentiated. The nonendometrioid carcinomas were anaplastic, papillary, clear cell, squamous cell, mixed müllerian and nongestational choriocarcinoma. The staining intensity for ER/PR decreased with the degree of dedifferentiation being weak or absent in nonendometrioid tumors. Conclusion: Elderly patients have less differentiated EC displaying histologically nonendometrioid patterns (‘alienation’) with no differential loss of receptors in cancer. ER/PR are partly preserved in endometrioid tumors and controls. We conclude that differential loss of receptor capacity is not a factor in pathogenesis of this age-related cancer.
Increased Soluble Tumor Necrosis Factor Receptor Levels in the Serum of Elderly People
Authors: Hasegawa Yoshiya , Sawada Makoto , Ozaki Norio , Inagaki Toshiaki , Suzumura Akio
Published: April 2003

Background: Soluble (s) forms of tumor necrosis factor (TNF) receptors are the only natural molecules known to interfere with TNF activity by competing for TNF binding with receptors on target cells. In a variety of pathologic situations, the concentrations of sTNF receptors (R) increase. Objective: To discuss possible causes of increased risks for infectious disease and cancer seen in the elderly. Methods: The participants were healthy subjects (n = 48) of three age groups (young, middle-aged, and elderly). Patients with senile dementia of Alzheimer type (n = 25) were also studied. For detection of cytokines, interleukin (IL) 1α, IL-1β, IL-6, macrophage colony-stimulating factor (M-CSF), granulocyte colony-stimulating factor, and TNF-α were measured in serum by enzyme-linked immunosorbent assays, as were soluble (s) IL-1 receptor antagonist (IL-1ra), sIL-6R, p55sTNF-R, and p75sTNF-R. Results: IL-1α, IL-1β, IL-6, and TNF-α were not detected, and sIL-6R and IL-1ra concentrations were not significantly different between the three age groups. However, sTNF-R and M-CSF were increased in sera from the elderly, both healthy and demented. A significant correlation was seen between sTNF-R and M-CSF concentrations. Conclusions: Increased sTNF-R levels may oppose the physiologic and protective effects of TNF by interference with its receptor binding. This interaction may contribute to the susceptibility of the elderly to infectious and neoplastic diseases.