bluuebunny/crossref_metadata_2025_split huggingface dataset:
Splenomegaly Secondary to Malaria In Utero?
Authors: CASE THOMAS C. 
Published: April 2015

ABSTRACT:A case of splenomegaly probably secondary to malaria in utero is presented. The patient was a 50‐year‐old male who was admitted to the hospital because of longstanding abdominal pain and swelling. Otherwise he had had no serious illnesses and no symptoms of malaria. Splenectomy was performed because of the hazard of injury to the organ in the patient's occupation as a laborer handling heavy machinery.
Kaposi's Sarcoma
Authors: GLATT O. S. 
Published: April 2015

ABSTRACTA review of Kaposi's sarcoma and 2 case abstracts are presented. There are many conflicting theories about the pathogenesis of this multiple hemorrhagic sarcomatosis of the skin and internal organs. Clinically, in the adult, it may run a relatively benign course, though subject to recurrences. The differential diagnosis is important, as several other diseases resemble it. In cases in which bleeding of an internal organ is the only presenting symptom, a history of a forgotten healed skin lesion may be an important clue. X‐ray therapy is the most effective treatment.
Recognition, Relevance and Deactivation of Gerontophobia: Theoretical Essay
Authors: BUNZEL JOSEPH H. 
Published: April 2015

ABSTRACTGerontophobia, or irrational dislike of the elderly, is a psychopathological defense mechanism on a mass basis. There are medical, legal and social varieties. Three therapeutic possibilities are: 1) mass education, 2) insight therapy, and 3) intra‐group mobilization.
Oxygen Inhalation in the Control of Psychogeriatric Symptoms in Patients with Long‐Term Illness
Authors: FRAIBERG PAUL L. 
Published: April 2015

ABSTRACTDaily hypobaric (low pressure) oxygen inhalation was given to 59 behaviorally disturbed geriatric patients at a nursing center. They were either disruptive in behavior or withdrawn, and all had a serious chronic or terminal illness, as evidenced by a mortality rate of 8 per cent during the two‐month study period. The scores for changes in psychogeriatric and behavioral manifestations showed that 28 of these oxygen‐treated patients (47.5 per cent) achieved ratings of “excellent” or “good,” i.e., they became more alert, less confused, less hostile, more cooperative, more sociable and much more interested in the world around them. There were no untoward results. Hypobaric oxygen therapy is a simple and relatively effective aid in the control of behaviorally disturbed elderly patients.
Gold Leaf in the Treatment of Leg Ulcers
Authors: RISBROOK ARTHUR T. , GOODFRIEND STANLEY S. , REITER JULIA M. 
Published: April 2015

ABSTRACTUpon admission to a nursing home, a 79‐year‐old woman with peripheral arteriosclerosis had a large (10 times 17.5 cm) raw painful ulcer of the left leg. She had had the ulcer for five years and, ten months before admission, had undergone an aorto‐femoral bypass with sympathectomy. Gold leaf therapy was started but was discontinued after two years for a trial of other methods. These were unsuccessful. After another two‐year course of gold leaf therapy, the ulcer was healed. The length of time that elapsed before healing emphasizes the need for perseverance.
Biochemical Observations during a Trial of Inosiplex in Senile Dementia*
Authors: MARCH JAMES , FIELD JACK , SHANLEY JOSETTE , TURNER WILLIAM J. 
Published: April 2015

ABSTRACTInosiplex (Isoprinosine), a complex containing hypoxanthine riboside, was administered to 7 men with senile dementia; in 6 it was given for six to nine months, and in 1 for three months. During the first six months, neither further regression nor clinical improvement was noted, although 5 patients gained weight. Originally the study had included 9 patients, but 1 was dropped at one month because of certain diagnostic features and 1 was dropped at one month because the serum uric acid level had risen to 11.3 mg/100 ml. Among the remaining 7 patients, the serum uric acid level in 1 case rose to 10.2 mg/100 ml at six months, but in the other 6 the uric acid values had returned to normal at six months after an earlier slight rise. The urinary excretion of hypoxanthine, xanthine, guanine and uric acid accounted for about 60 per cent of ingested hypoxanthine at one month and 40 per cent at three to seven months. The biochemical data are discussed in relation to some current approaches to the treatment of senile dementia. Inosiplex may prove to have a significant anabolic effect.
Pre‐ and Postoperative Management of Elderly Surgical Patients*
Authors: GLENN FRANK 
Published: April 2015

ABSTRACT: Can the aging process be altered to prevent the pathologic changes that impair function? The matter should be put in proper perspective. This involves biologic and other forms of research as well as the therapeutic application of current knowledge.About 40 per cent of elderly patients under general hospital care are admitted for surgical treatment. In 1973, the total is expected to reach 2.5 million. Morbidity and mortality associated with surgery are highest among the elderly. However, with the use of new procedures and stress on the factors involved in proper pre‐ and postoperative care, the risk has been greatly reduced. Age‐over‐65 is no longer a contraindication to surgery. The matter of careful evaluation and treatment is discussed under the following categories: status of the patient, status of the various organs and systems (including the effect of trauma), elective versus emergency operations, and the prognosis, especially in relation to such disorders as biliary‐tract disease, cardiovascular disease, cancer, and degenerative hip disease. Preoperative assessment must be thorough and complete. If the situation is not an emergency, there should be a period of corrective nutrition, activity, supportive medication, and instruction of the patient regarding what he may expect. For selective surgical procedures, the response to those measures determines the type of anesthetic and the extent and nature of the operation. The stress of the surgical procedure should never exceed the patient's tolerance. The immediate postoperative care (recovery room) is extremely important. The objective is to prevent complications. The experience of the surgeon, the cooperation of all involved, and meticulous attention to detail are required in the surgical care of the elderly.
Complications of Peptic Ulcer Disease in Geriatric Patients*
Authors: GRODSINSKY C. , NIBLER J. G. , BRUSH B. E. 
Published: April 2015

ABSTRACT: Many patients with the complications of peptic ulcer disease are in the geriatric age group. This is partly the result of the overall increase in this segment of the population in recent years, and partly the result of delay in the referral of younger patients with intractable forms of the disease. Hemorrhage is the most common life‐threatening manifestation of peptic ulcer in the geriatric patient. Prompt evaluation by esophagogastroscopy and barium x‐ray examination is of paramount importance in proper management. Perforation of peptic ulcer is less common in the elderly. When diagnosed, it requires immediate surgical treatment. Pyloric obstruction should be suspected in a patient with chronic nutritional depletion, superimposed acute dehydration, electrolyte imbalance and even shock. Nasogastric decompression of the dilated stomach and re‐establishment of fluid and electrolyte balances should be attended to before carrying out definitive surgical treatment.Geriatric patients tolerate major surgery relatively well, but only if special attention is given to associated medical and metabolic abnormalities. Chronic obstructive lung disease with diminished pulmonary reserve is among the most common of these associated disorders. The prevention of serious pulmonary complications demands aggressive management both before and after operation for peptic ulcer. Diminished cardiovascular reserve must be taken into account if postoperative congestive heart failure or pulmonary edema is to be prevented. The presence of renal disease also should be evaluated as a factor in postoperative complications.
Feeding the Elderly Heart
Authors: Kupers Edward C. 
Published: April 2015

ABSTRACTTreatment of the elderly cardiac patient should not be limited to the heart alone. Many other factors demand attention, e.g., psychic stress (depression), nutritional deficits and physiologic imbalances. Dietary guidelines are presented, including special references to carbohydrates, proteins, fats, vitamins and minerals. A nutritional program for the aged cardiac patient should be carried out on an individual basis to allow for appropriate modifications. Mass nutritional programs for the elderly may not be suitable for the specific cardiac patient with his various problems.
An Ergot Alkaloid Preparation (Hydergine) in the Treatment of Presenile Brain Atrophy (Alzheimer's Disease): Case Report
Authors: Burian Ernst 
Published: April 2015

ABSTRACTAn ergot alkaloid preparation, Hydergine, when used therapeutically for arteriosclerotic brain disease and after cerebrovascular accidents usually has a beneficial effect. Thus Hydergine was used on the Intermediate Care Service of a Veterans Administration hospital to treat 21 such patients. The dosage of Hydergine was two 0.5‐mg tablets sublingually three times daily for ninety days. A good response was obtained in 62 per cent. Because of this encouraging result, 4 patients with presenile brain atrophy (Alzheimer's disease) were treated similarly. Of these 4 patients, 2 improved and 2 did not. One of the 2 who improved was a 62‐year‐old man who had become a total nursing‐care problem. Alzheimer's disease was confirmed by brain biopsy. His response to Hydergine was so dramatic that his case is reported here. The improvement and the absence of side effects justify further trials of Hydergine in presenile brain atrophy.
Sudden Death in an Elderly Population from Aspiration of Food
Authors: Gelperin Abraham 
Published: April 2015

ABSTRACTDuring the year 1973, sudden death from food aspiration was identified in 3 patients of a geriatric hospital population. The correct diagnosis was made only at autopsy. As is usual under these circumstances, the clinical diagnosis had been myocardial infarction. This article emphasizes the importance of recognizing the possibility of food aspiration in these cases, as immediate bronchial aspiration or tracheostomy is the only life‐saving procedure.
Peritoneoscopy in Geriatric Patients*
Authors: ANSELM KLAUS , GLUCKMANN ROBERTO M. 
Published: April 2015

ABSTRACT:The results of peritoneoscopy in 119 patients of advanced age are described. The procedure permits thorough inspection of the entire abdominal cavity and, in association with guided biopsy, leads to early diagnosis in patients with suspected carcinoma, ill defined chronic liver disease or ascites of undetermined etiology. The relative lack of serious complications makes this procedure feasible in patients of all ages.
“High Risk” Factors and Atherosclerotic Cardiovascular Diseases in the Aged
Authors: VAVRIK M. 
Published: April 2015

ABSTRACT:The association between the so‐called “high risk” factors — hypercholesterolemia, hypertension, diabetes — and atherosclerotic cardiovascular diseases (ACVD) was studied in 509 subjects over 60 years of age. The correlation between these factors (especially their cumulation) and the prevalence of clinically evident ACVD was statistically significant. Nevertheless, in comparison to the high prevalence of atherosclerosis in these groups of elderly subjects, the prevalence of cumulation of two or even three of these atherogenic factors was relatively so low that their atherogenic importance appeared questionable. This fact may be of great importance in the strategy for prevention of myocardial infarction and cerebrovascular accidents in these age groups.
Functioning of the Elderly Patient in Relation to the Physician's Diagnosis of Chronic Brain Syndrome*
Authors: CARMICHAEL JOAN , LINN MARGARET W. 
Published: April 2015

ABSTRACT:Physicians may respond to the age of the patient rather than to the degree of impairment in making a diagnosis of chronic brain syndrome (CBS), A study of 800 male veterans placed in nursing homes during a seven‐year period included demographic data, ward staff rating and physicians' assessments of impairment. In 159 patients the diagnosis was CBS, and in 80 this diagnosis was the primary one. A comparison was made with 159 patients (drawn at random) who did not have CBS. The CBS group showed greater impairment of the vascular, renal and nervous systems. Analysis of intergroup differences was performed with controls for age, since the CBS group was significantly older. Confusion and uncooperativeness as rated by ward nurses still ranked highest as discriminators. The findings suggest that diagnosis was supported by the behavioral and impairment data rather than by the age of the patient. Age alone was not a basis for predicting confused behavior. Rather than label the CBS patient as an “old crock,” we should learn to understand him as an individual with a valid diagnosis of real impairment.
Continuous Cyclic Hormonal Therapy*
Authors: RHOADES FRANCIS P. 
Published: April 2015

ABSTRACT:A two‐year study of estrogen replacement therapy was conducted on 1,200 postmenopausal women. Computerized data concerning the effect on 20 common symptoms showed 95 per cent relief during an appropriate regimen of estrogen‐progesterone therapy. The improvement in the ability to enjoy life counteracted any reluctance to undergo hormone‐induced withdrawal bleeding in the women with an intact uterus. There was no laboratory or clinical evidence that the treatment caused cancer. The benefits of continuous cyclic hormone therapy for estrogen‐deficient women far outweigh the possible dangers.
Rehabilitation of the Geriatric Amputee*
Authors: STEINBERG FRANZ U. , GARCIA WILSON J. , ROETTGER RICHARD F. , SHELTON DOROTHY J. 
Published: April 2015

ABSTRACT: During a five‐year period, 90 patients who had undergone lower‐extremity amputations when aged 60 or older were treated at the Amputee Clinic of the Jewish Hospital of St. Louis. Seventeen of the 90 were not fitted with prostheses because of various medical contraindications. Thirteen of the remaining 73 patients who were fitted with prostheses had died by the time of follow‐up, and 23 others could not be located. Of the 37 known survivors, 23 wore their prosthesis for more than six hours daily and used it as their main mode of locomotion; 14 used it only occasionally or not at all.Sex and age at the time of amputation were of little value in predicting the success of prosthetic rehabilitation. Patients with below‐knee amputations fared much better than those with above‐knee amputations. Contraindications to fitting an aged amputee with a prosthesis are mental deterioration, congestive heart failure, severe angina pectoris, and advanced chronic obstructive pulmonary disease. Neurologic disorders such as parkinsonism or stroke with a significant neurologic residual are additional contraindications. Patients who have ulcerations or infections of the remaining extremity or who have severe contractures of the stump usually cannot be fitted with a prosthesis. The ability to use axillary crutches is not a realistic prerequisite for supplying an aged amputee with a prosthesis. A patient who has walked before the amputation and who afterward can walk with a walker, usually will be able to use an artificial limb. Amputees who cannot be expected to use a prosthesis can still be rehabilitated to an independent wheelchair existence.
Medical Planners and the Geriatric Imperative
Authors: Poe William D. 
Published: April 2015

ABSTRACTThe health needs of old people demand a change in the attitudes of physicians and social planners. There is a great gap between complicated models for health care and the delivery of that care to the ill elderly. Physicians should have better training in geriatrics in better and more coordinated facilities. Home health services are important. However, it is essential to avoid false starts and to adhere to sound principles. This is the job of the planners rather than the prophets; it is the geriatric imperative.
Visual Hallucinations and Delirium During Treatment with Amantadine (Symmetrel)
Authors: Postma J. U. , Van Tilburg W. 
Published: April 2015

ABSTRACTIn 13 elderly patients, 12 of whom had Parkinson's disease, visual hallucinations and delirium developed as a side effect of amantadine hydrochloride (Symmetrel) therapy. The symptoms promptly disappeared when amantadine was discontinued. Thereafter, each parkinsonian patient was treated satisfactorily with levo‐dopa. Treatment with a combination of amantadine and an anticholinergic agent increases the likelihood of delirium because of the hazard of retention of urine. Although amantadine is effective in the treatment of Parkinson's disease in the elderly, the incidence of delirium as a complication seems higher in this age group.
Some Differences Between Elderly People Who Use Community Resources and Those Who Do Not
Authors: Rosenzweig Norman 
Published: April 2015

ABSTRACTThis study initially involved 120 subjects in four groups of 30 members each. It was designed to compare institutional aged persons (Jewish Home for the Aged, or JHAs) with ambulatory persons who used community resources (Jewish Community Center, JCCs). Controls were selected from a stratified sample in a community‐wide study of the Detroit Jewish population; half of the control subjects lived alone (LAs) and half lived with their families (LWFs); none of them used community resources. All 120 subjects were at least 60 years old. The female:male ratio was 71:49. They were asked to fill in a 442‐item questionnaire which yielded data about personal and family background, current status, attitudes, interests and self‐evaluation. The 30 JHAs were significantly older than the 30 JCCs, but otherwise there were few differences. Therefore the focus of the study was shifted to a comparison of the 30 JCCs, who used community facilities, with the 30 LAs and the 30 LWFs, who did not.The JCCs were not well educated and were of low economic status. They obtained social gratification through group activities. They had many acquaintances but few close friends whose loss could be a threat. As a group, they seemed content. The LA and LWF groups were better educated, more successful financially, and more likely to derive personal satisfaction from their work. They formed closer family attachments and were more object‐oriented, so they were more vulnerable to loss of home and family. Setting high value on individual capacities, they were more likely to be threatened by illness. Any attempt to extend a helping hand to elderly citizens who do not avail themselves of community resources will have to take into account the prevalence of these distinctly different life styles.
A Survey of the Prescribing and Administration of Drugs in a Long‐Term Care Institution for the Elderly
Authors: Ingman Stanley R. , Lawson Ian R. , Pierpaoli Paul G. , Blake Paula 
Published: April 2015

ABSTRACTThe prescription and administration of drugs (especially of the neuroactive class) was observed in 131 patients in an extended care facility. The average number of neuroactive drugs prescribed (2.1) was distinctly different from the average number administered (1.3) because of the large number of pro re nata (prn) prescriptions. More neuroactive substances were prescribed for patients with superior mentation and minimal physical disability; the difference between low and high groups was 1.7 (mentation) and 2.8 (physical status). The most common neuroactive drugs prescribed were: 1) analgesics, 2) major tranquilizers, and 3) hypnotics. Questionable prescribing practices were demonstrated by the fact that 30 patients had prescriptions for 38 “not‐recommended” drugs; 23 of these prescriptions were for propoxyphene compound. After requiring physicians to rewrite drug orders every thirty days, a survey made ten months later showed that there was a decline (0.8) in the number of drugs prescribed per patient and a slight increase (0.45) in the number of drugs administered.Professional drug surveillance is crucial for improving the therapeutic process. At least two modifications of current prescribing practices are recommended: 1) a record should always be made of the precise condition(s) under which a drug prescribed “prn” is to be administered; and 2) a strong effort should be made to reduce the total number of drug prescriptions. The results of this survey suggest that certain procedural matters necessitating change are not in themselves the most substantive factors in improvement. Present “third party” review mechanisms likely will not ameliorate the current situation. It will be necessary to implement complex organizational changes in most extended care facilities.
Patent Ductus Arteriosus in Old Age
Authors: Syrkis I. , Machtey I. , Sagiv M. 
Published: April 2015

ABSTRACTAn unusual case of patient ductus arteriosus (PDA) in a 78‐year‐old man is presented. The patient was known to have PDA since the age of 30, but it had remained well compensated until shortly before death. He had undergone some difficult operations successfully, and had no specific pulmonary complaints. Death at age 78 was caused by arteriosclerotic heart disease following myocardial infarction. Autopsy revealed a smooth patent ductus arteriosus with no perforation. The survival of a PDA patient to such advanced age is a comparatively rare occurrence.
Triiodothyronine Turnover in Hospitalized Psychogeriatric Patients†
Authors: Hontela S. 
Published: April 2015

ABSTRACTIn a group of 12 hospitalized psychogeriatric patients, the fractional triiodothyronine (T3) turnover rate was significantly higher than in healthy control subjects of the same age, whereas the thyroxine (T4) turnover rate and other aspects of pituitary‐thyroid function were virtually similar in both groups. Despite the presence of manifestations of sympathetic overactivity or hypermetabolism, the patients did not have true hyperthyroidism, as verified by the laboratory findings and the results of antithyroid treatment. The increased T3 turnover in aged hospitalized patients with brain disorders may be a compensatory mechanism which develops under these particular circumstances in order to maintain neurohormonal homeostasis. An alternate possibility is that the increased T3 turnover is secondary to hyperkinesis.
Psychopharmacologic Investigations in Healthy Elderly Volunteers: Effects of Pipradrol‐Vitamin (Alertonic) Elixir and Placebo in Relation to Research Design†
Authors: Shader Richard I. , Harmatz Jerold S. , Kochansky Gerald E. , Cole Jonathan O. 
Published: April 2015

ABSTRACTNinety‐nine healthy elderly volunteers were tested to assess the effects of: 1) a pipradrol‐vitamin (Alertonic) elixir, 2) a placebo, and 3) no treatment, during a one‐week period. The assessment measures were the Minnesota Multiphasic Personality Inventory Depression Scale, the Zung Depression Scale, Profile of Mood States, and the WAIS Digit Span. Alertonic had no significant effects on mood, memory or appetite, and the placebo effect was rarely greater than 50 per cent. There were no significant side effects. The findings demonstrate a valid method for studying psychotropic agents in the elderly.
Radical Mastectomy in the Aged Female†
Authors: Cortese Armand F. , Cornell George N. 
Published: April 2015

ABSTRACTOf 142 female patients over age 75 at The New York Hospital‐Cornell Medical Center, 58 underwent radical mastectomy and 40 simple mastectomy for primary breast cancer. After five years, 49 per cent of the radical mastectomy group were cancer‐free compared with 35 per cent of the simple mastectomy group. The gross five‐year survival rates were 50 per cent and 47 per cent respectively. In the radical mastectomy group, when the axillary nodes did not show cancer at the time of operation, there have been no known recurrences and 70 per cent of the patients have survived at least five years. There was no surgical mortality. These findings support the view that until more controlled data are available, radical mastectomy is still the preferred therapy for primary breast cancer.