bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Dantrolene Sodium on Spasticity Associated with Hemiplegia†
Authors: Steinberg Franz U. , Ferguson Karen L. 
Published: April 2015

ABSTRACTThe effects of dantrolene sodium (Dantrium) were studied in 23 patients with hemiplegic spasticity, 13 of whom were younger than 50, and 10 older than 50. The dosage of dantrolene ranged from 100 mg per day initially to 600 mg per day maximally. The drug was most effective in reducing or abolishing clonus and somewhat less efficacious in decreasing the resistance to stretch and the tendon reflexes. Functionally, gait was improved and the patients found it easier to take care of their personal needs. In general, motor performance was improved. The observation that patients in the 50+ age group responded less well remains unexplained. Dantrolene sodium is a valuable tool in the management of spasticity due to hemiplegia.
Management of Primary Hyperparathyroidism in the Elderly†
Authors: Block Melvin A. , Xavier Alfredo , Brush Brock E. 
Published: April 2015

ABSTRACTOf 166 surgical patients for whom the diagnosis of primary hyperparathyroidism was established over a 20‐year period, about one‐third were over 60 years of age. For an additional 9 patients, no operation was advised, usually because of other life‐endangering disease and the presence of only a mild degree of hypercalcemia without complications. In recent years, nearly 50 per cent of the patients did not have renal calculi or osteitis fibrosa cystica; this was unrelated to age. Most of the patients with management problems were seen since 1965. Age alone was not a dominant factor in relation to serious complications from hypercalcemia, the presence of other critical disease increasing the risk of operation, or the development of major postoperative complications. The only death from primary hyperparathyroidism occurred in a 74‐year‐old patient who refused re‐operation and died from an acute hypercalcemic crisis. A liberal, but selective, policy of surgical treatment is justified for primary hyperparathyroidism in the elderly. Patients for whom the diagnosis of primary hyperparathyroidism is established may be separated into three groups: those for whom early operation is indicated, those for whom operation should be delayed to permit recovery from other life‐endangering acute disease, and those for whom operation is unjustified because of minimal uncomplicated hypercalcemia and other serious disease greatly limiting life expectancy. These categories encompass all age groups and are not restricted to the elderly. All patients require periodic re‐evaluation.
The Use of Urokinase in Acute Myocardial Infarction: Report of Two Cases†
Authors: Mazel M. S. , Parsa F. , Riera R. 
Published: April 2015

ABSTRACTIn the course of a study (now including 53 patients) on the effectiveness of urokinase in the treatment of acute coronary occlusion, coronary angiography was performed in 2 patients before and after the use of this drug. In both instances the angiograms demonstrated obstruction in the coronary‐artery branches, with additional narrowing and some collateral circulation. After urokinase therapy, blood flow was restored in the areas previously obstructed. These 2 case reports are presented because they demonstrate this favorable change in coronary blood flow in association with this particular form of therapy. It is hoped that the completed urokinase study may add some information concerning the effect of thrombolysis in the management of myocardial infarction.
Possible Organic Factors in the Prevention of Emotional Problems of the Aged
Authors: Kent Edward A. 
Published: April 2015

ABSTRACTThis presentation attempts a new approach to the understanding of both normal and abnormal behavior in older persons who are ready for retirement. The suggested orientation is based upon the concept of an organic cerebral basis for the neurophysiologic disturbances which result in emotional problems. A unified concept of human behavior allows for early establishment of mature brain patterns and the disruption of these patterns by disuse atrophy in later life. This provides a clue to the development of better measures for the prevention and treatment of emotional problems in the aged — problems which now come under the classification of chronic brain syndrome or senile brain disease.
Thyroid‐Adrenocortical Relationships in the Safe Treatment of Arthritis, Allergy, and Skin Disorders with Prednisone
Authors: Barnes Broda O. 
Published: April 2015

ABSTRACTAlthough the anti‐inflammatory action of cortisone or its derivatives is efficacious in arthritis or certain allergic and skin diseases, the standard use of such compounds is limited to short‐term administration because of induced disturbances in mineral and glucose metabolism. Another side effect of cortisone is suppression of thyroid hormone secretion. The author has found that when thyroid therapy is prescribed for patients with arthritis (300 to date), certain skin diseases or selected allergic disorders, the addition of prednisone in a small dosage of 5–10 mg daily will produce further improvement for at least a five‐year period, without side effects. The thyroid and adrenocortical hormones apparently are synergistic in the treatment of arthritis and allergy.
Urinary Steroids in the Measurement of Aging and of Atherosclerosis†
Authors: Marmorston Jessie , Griffith George C. , Geller Paul J. , Fishman Eugene L. , Welsch Federico , Weiner John M. 
Published: April 2015

ABSTRACTSeveral studies conducted by the authors' group have shown that urinary steroid measurements are a valuable aid in differentiating the normal aging process, the pronounced aging associated with increased risk to coronary heart disease, and the deviations associated with myocardial infarction. Data are presented on 428 men in the age range of 30–70 years. The study design most effective in elucidating aging and disease patterns involves selection of subjects from a wide age range. Data on persons identified as clinically normal can be used to describe physiologic aging. Once this is determined, data on persons with disease can be used to identify abnormalities of aging associated with the clinical conditions studied. This approach offers a potential method for differentiating between aging effects and disease effects. The foregoing findings led to the development of an Index of Aging in males, based on combined serum lipid and urinary steroid values. This Index may be a means of differentiating between normal aging and the deviations seen in atherosclerosis and myocardial infarction. Current studies are directed toward extending these observations.
Pelvic Distress in the Aged Patient
Authors: Paulson George W. 
Published: April 2015

ABSTRACTUnexplained pelvic distress or pain was observed in the 4 patients of this report (3 women and 1 man), and also in 6 other patients during a 10‐year period of neurologic practice. In each of the 4 reported cases, the discomfort was interpreted as sexual. It is suggested that this may be a valid entity and that, as with trigeminal neuralgia and postherpetic neuralgia, it is truly limited to aged patients. The mechanism, incidence and significance are unknown.
A Follow‐Up Longitudinal Study of Selected Physiologic Functions in Former Physical Education Students–After Forty Years
Authors: Asmussen Erling , Fruensgaard Karen , Nørgaard Steen 
Published: April 2015

ABSTRACTReported is the continuation of follow‐up investigations of certain physiologic functions in former physical education students. The first follow‐up study was conducted about 30 years after the initial measurements. The present follow‐up study concerned a re‐investigation of the same group (23 men and 11 women), 10 years later, i.e., about 40 years after the first examination. Resting values for heart rate, blood pressure and metabolism were determined, as well as values for lung volume, hand‐grip strength, and reaction time. During moderately hard exercise, measurements were made of oxygen uptake, ventilatory equivalents, and heart rate. By extrapolation of these heart‐rate determinations to “maximal heart rate,” the maximal oxygen uptake was estimated and expressed as L × min−1 and as ml × kg−1 × min−1. The data show a general deterioration in practically all the physiologic functions studied, most pronounced during the last 10 years of the 40‐year period.
Psychopharmacologic Investigations in Elderly Volunteers: Effect of Diazepam in Males†
Authors: Salzman Carl , Shader Richard I. , Harmatz Jerold , Robertson Linda 
Published: April 2015

ABSTRACTForty male volunteers over the age of 60 took either a daily dose of diazepam (12 mg) or placebo for a two‐week period. Differential responses to these compounds partially depended upon age and the initial symptom level. Diazepam produced sedative side effects, a modest antidepressant effect, and a reduction in memory. Placebo had an antianxiety effect in the relatively older subjects, and was associated with decreased fatigue, improved memory and improved motor function. Considerable variability was observed in both drug and placebo responses among the elderly. A self‐rating depression scale (D30R) was useful for assessing changes in affective states and in discriminating between the effects of active drug and placebo.
What Is A Geriatrician?
Authors: Poe William D. 
Published: April 2015

ABSTRACTA geriatrician is something more than a physician who simply cares for old people. The geriatrician should, above all, be well grounded in internal medicine, have a genuine fondness for the elderly and their problems, and be experienced in neurology, psychiatry and rehabilitation medicine. A possible additional role is that of organizer and coordinator of health services for old people.
Comparison of Two Systems for Stroke Rehabilitation in a General Hospital
Authors: McCANN B. CAIRBRE , CULBERTSON RICHARD A. 
Published: April 2015

ABSTRACT: This study was designed to compare the effectiveness of stroke rehabilitation therapy in a specialized Stroke Unit with that provided on the medical service of a general hospital (Rhode Island Hospital). The 8‐bed Stroke Unit is staffed by a multidisciplinary team, and a weekly conference is held for evaluation and planning. On the basis of data obtained from the hospital records, two groups of patients were studied: 224 who were treated in the Stroke Unit, and 110 who were evaluated and approved for admission to the Unit but were not accommodated. A rigid “first come, first served” policy for admission to the Unit was observed. Hypothesis testing was performed with reference to the patient's medical condition, socioeconomic status, demographic characteristics, and difficulties during hospital stay to determine whether the groups were comparable. A patient was considered to have improved if his condition decreased in severity between the time of admission to therapy and the time of discharge. Severity was rated as: mild (level one), moderate (level two), severe (level three), and profound (level four).No significant difference in rehabilitation results was found between the two treatment systems at severity levels two (moderate) and four (profound). However, the Stroke Unit attained significantly better results with level‐three patients (severe stroke). This group received more sessions of physical therapy and remained in the hospital longer than did the level‐three patients treated on the general medical service. Physicians referred patients selectively to the Stroke Unit, although the Unit had no policy of screening patients for admission, and this may have had some influence on the achievement of better results with level‐three patients. Level‐four patients did not do well in either setting.
Section I. The Interpretation and Use of Newer Diagnostic Studies
Authors: Mayne John G. 
Published: April 2015

ABSTRACTThe diagnosis and the treatment of rheumatic diseases in older people pose special problems. Degenerative joint disease, almost universally present in the elderly, may not be the basis for the newly developing rheumatic symptoms. Systemic inflammatory disease may be confused with malignancy or it may be an initial manifestation of malignancy. Some drugs used to control central‐nervous‐system or cardiovascular disease may produce painful rheumatic syndromes. Results of laboratory tests used in the diagnosis of rheumatic diseases may be altered by other nonrheumatic disorders in older people. Papers in this symposium will explore these concepts in greater detail.
Back Pain: Osteoarthritis†
Authors: Bandilla Klaus K. 
Published: April 2015

ABSTRACTBack pain is one of the chief complaints of the elderly. It may be either a chronic deep skeletal muscular pain or an acute circumscribed pain arising from nerve‐root irritation. The main causes of back pain in older people are: 1) degenerative changes (spondylosis, osteoarthritis, ankylosing hyperostosis); 2) malignancy (multiple myeloma, metastases from carcinoma or lymphoma); and 3) metabolic disorders (osteoporosis, osteomalacia, chondrocalcinosis, Paget's disease). Mechanisms and variations are discussed in detail.
Total Joint Replacement: Lower Extremities†
Authors: Fitzgerald Robert H. 
Published: April 2015

ABSTRACTIn experience with total joint replacement in the lower extremity, to date, total hip arthroplasty has been the most successful. Total arthroplasty operations as applied to the knee and ankle are giving promising results. These methods offer new avenues for relief of pain and deformity and stabilization of arthritic joints in the lower extremity.
Mission of the National Institute on Aging†
Authors: Butler Robert N. 
Published: April 2015

ABSTRACTThe National Institute on Aging (NIA), the newest of the eleven National Institutes of Health, is dedicated to improving the quality of life of the old in America through biomedical, social, and behavioral research. Aging is viewed as more than just decline and deterioration; it is also a process of continued development and accumulated knowledge. The NIA will encourage innovative research, but will not support the delivery of health services, as that is the domain of other agencies. In areas of overlap, such as diseases common to the old, the NIA will collaborate with other Institutes. A good target area for collaboration is senile dementia. Other areas of interest to the NIA are: encouraging the incorporation of geriatric medicine as a subspecialty, developing retirement test patterns, and investigating drug‐drug and drug‐age interactions, personality and social processes, and immunocompetence.
The Biology of Aging: 1976, An Overview†
Authors: Wallace Daniel J. 
Published: April 2015

ABSTRACTThis article is a comprehensive overview of the biology of aging. The largely unproductive history of research on aging is presented, to lay the groundwork for a discussion of why such research is performed and what aging levels and human models are employed. The anatomic, biochemical, physiologic and behavioral measures used in such studies are delineated. Some of the most promising theories of aging (genetic, autoimmune, viral, free radical) are discussed, as are factors that could prolong the lifespan if optimally employed. Philosophic considerations are emphasized.
Histochemical and Ultrastructural Changes in Senile Human Skeletal Muscle
Authors: Tomonaga Masanori 
Published: April 2015

ABSTRACTEighty biopsy specimens of muscles from 79 elderly patients (chiefly in the 60–90 age group) were examined by histochemical and electron microscopic methods. Neuropathic change and type‐II fiber atrophy of various grades were prominent findings in the muscles from patients of advanced age. Nemaline rod formation, “ragged red” change and an increase of sarcolemmal nuclei were also common. Several electron microscopic features of the muscle fiber corresponded to those reported for various neuromuscular diseases. Various factors associated with the aging process apparently act on the motor neurons and cause the neuropathic and myopathic changes seen in the muscles of the aged.
A Device for Expressing the Serum Insulin‐Glucose Relationship in Diabetes, Hyper‐ or Hypothyroidism, and Chronic Hepatitis
Authors: Yamada Takashi , Ohtake Masao , Kotani Masanobu 
Published: April 2015

ABSTRACTWhen the serum insulin values during a 50‐gm oral glucose tolerance test were expressed as the function of glucose concentrations, a good linear relationship was found in normal subjects and in patients with diabetes, hyperthyroidism, hypothyroidism or chronic hepatitis. The insulin index calculated from the line representing this relationship was less than 100 in all 19 diabetic patients and most of the 13 hyperthyroid patients with oxyhyperglycemia, whereas it was more than 100 in the 14 normal subjects, the 4 hypothyroid patients, and the 8 patients with oxyhyperglycemia due to chronic hepatitis. The insulin index decreased with increasing maximal blood glucose concentration during the glucose tolerance test in diabetic patients. Furthermore, improvement in the insulin index was correlated with the effectiveness of sulfonylurea drugs in the diabetic group.
The Renal Lesion Associated with Total Lipodystrophy
Authors: Saito Ikuo , Saruta Takao , Iyori Shigeru , Sakaguchi Hiroshi 
Published: April 2015

ABSTRACTThis report concerns a 41‐year‐old man with total lipodystrophy associated with a specific renal disorder. He had massive proteinuria, mild azotemia and a normal level of serum complement in addition to the generalized loss of subcutaneous fatty tissue. Results of a 50‐gm glucose tolerance test indicated a high fasting insulin level with an exaggerated response to glucose. Hypoglycemic responses to exogenous insulin were reduced. Renal biopsy revealed changes consistent with glomerular lipidosis. This case is unique in that the renal lesion was not the Kimmelstiel‐Wilson pathologic change attributable to abnormal glucose metabolism.
Serum Enzyme Alterations in Hypothyroidism before and After Treatment
Authors: Gaede Jane T. 
Published: April 2015

ABSTRACTRecognition of a pattern of elevations in commonly measured serum enzymes [creatine phosphokinase (CPK), lactic dehydrogenase (LDH), and glutamate oxalacetate transaminase (SGOT)] can facilitate the diagnosis of hypothyroidism, especially when muscle weakness is a symptom. Elevated levels of serum cholesterol, total protein, and albumin further contribute to a chemical profile of hypothyroidism, which can be observed in a routine chemistry screening test such as that obtained with the SMA 12/60 AutoAnalyzer. An illustrative case concerns a 50‐year‐old man who presented with angina pectoris and leg weakness. Subsequently he was found to have severe hypothyroidism. Special attention is given to the serum enzyme values which initially were elevated and fell to normal levels during thyroid replacement therapy. Isoenzyme fractionation of LDH and CPK indicated skeletal muscle as the source of the elevated enzyme activity. The literature on enzyme abnormalities in hypothyroidism is reviewed, with special reference to hypothyroid myopathy.
On‐Site Geropsychiatric Services to Guests of Residential Homes
Authors: Sherr Virginia T. , Goffi Maria Teresa 
Published: April 2015

ABSTRACTDuring a 7.5‐year liaison between a 152‐bed residential (multi‐level care) home for the aged and a psychiatrist‐social worker team, 58 of the 339 residents were referred to the team. With increasing expertise of the staff of the home and with early psychosocial intervention, the need for psychiatric hospitalization dropped virtually to zero. Of the 23 persons currently referred, 65 percent are recovering well with psychiatric‐social‐nursing support and psychotropic drugs; another 26 percent are achieving significant behavioral improvement without change in their chronic mental confusion. The average time required of the psychiatrist proved to be four hours monthly; telephone consultations averaged two hours monthly. About half an hour per week was spent in conference between the psychiatrist and social worker, to allow achievement of mutual goals. Appropriate one‐site psychiatric‐social therapy permitted continuity of care and usually prevented threatened disruption of the residents' lives. Thus the modest investment of time by the psychiatrist and social worker improved the level of life satisfaction, not only for the patients but for the Home.
Intra‐Hospital Transfer: Effects on Chronically Ill Psychogeriatric Patients
Authors: Raasoch John , Willmuth Ragon , Thomson Laurence , Hyde Robert 
Published: April 2015

ABSTRACTSince the Vermont State Hospital was approaching a major transition period, it was decided to study systematically the effects of intra‐unit and inter‐unit transfer on its psychogeriatric patients. Ten patients were assessed by means of four standardized measures in the intra‐unit study, specifically investigating the effects of integrating wards previously devoted either to chronic or to acute psychiatric illness. Twenty‐five patients from a specialized geriatric unit were evaluated, by separate investigators, with respect to changes occurring as a result of their transfer to regional mixed units. The critical incident log, the problem classification form, and the clinical global impression showed some changes, for which there were several possible explanations. None of the changes was as dramatic as predicted by staff members holding divergent views prior to the study. The optimists predicted a “blossoming” of the psychogeriatric patients in the mixed, regional units, whereas the pessimists prophesied dire consequences. The group of patients studied was not completely homogeneous with respect to the effect of transfer. Clinical assessment after transfer could be relied on to detect improvement in some of these psychogeriatric patients and deterioration in others. Some understanding of the complexity of the multifactor determinants of change developed along with increased cooperation among the investigators and the nursing staff. A middle ground of mutual respect for fresh ideas and an appreciation for years of experience was reached.
Treatment Approaches with the Psychiatric Elderly†
Authors: Goga John A. , Hambacher William O. 
Published: April 2015

ABSTRACTIn reviewing the literature on treatment approaches with the psychiatric elderly, a large number of studies were found which espouse comprehensive rehabilitation programs that usually require supplementation of existing personnel and expansion of facilities. Although some agencies and institutions are fortunate in securing the needed funds for such program implementation, most others face the reality of limited personnel and funding cutbacks. This paper briefly reviews modalities which do not demand additional expenditures for specialized facilities in the treatment of chronically ill geropsychiatric patients.
Central Neurotransmitter Substances and Aging: A Review
Authors: Samorajski T. 
Published: April 2015

ABSTRACTAvailable evidence suggests that age is an important determinant of the levels of neurotransmitters and their associated enzymes and metabolites in some regions of the brain. Alterations at the synaptic level, or selective cell death in the brain, or both, may be implicated in progressive loss of function, behavioral changes and the onset of age‐related diseases. Stimulation of hypothalamic neuroendocrine transducer cells by agents that alter neurotransmitter metabolism might provide some measure of control of the process of aging.