bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Second Heart Sound in Old Age
Authors: Luisada Aldo A. , Knighten Vincent , Rao Dodda B. 
Published: April 2015

ABSTRACTThe second heart sound was studied by phonocardiography and carotid tracings in 103 elderly subjects without overt evidence of heart disease. Their ages ranged from 60 to 99 years. A normal type of splitting was found in 55.3 percent, and a single sound in 41.7 percent. The difference between these percentages and those found in 60 normal younger persons was not significant. Thus, a single second sound should not be considered a typical finding in old age. However, a reverse type of splitting, noted in only 3 patients, should be regarded as evidence of severe latent heart disease.
Pathways to the Decisive Extension of the Human Specific Lifespan†
Authors: Bjorksten Johan 
Published: April 2015

ABSTRACTThree approaches to reversal or removal of gerogenic aggregations of macromolecules have shown promise. Of these the enzyme approach is the most gentle, and can be made specific. Aside from this, the lower the molecular weight of an enzyme, the better chance it will have to be immunologically tolerated as well as replicated synthetically in whole or in part. The chelating approach provides a powerful means for removing a single class of unwanted, random crosslinkages, i.e., those due to extraneous polyvalent metals such as lead, cadmium and aluminum. The free hydroxyl radical approach is the most penetrant and most versatile means for removing otherwise insoluble aggregates, but its very lack of specificity will demand great foresight in control and use. Together, these three methods, when properly applied, might bring some principal objectives of gerontology within closer range.
Primary Health Care Provided to the Elderly by a Nurse Practitioner/Physician Team: Analysis of Cost Effectiveness†
Authors: Schultz Phyllis R. , McGlone Frank B. 
Published: April 2015

ABSTRACTAn experimental design was used to compare the delivery of primary care by two health manpower patterns—the Physician Only (PO) and the Adult Health Nurse Practitioner/Physician (NP/P) Team. The study group consisted of 167 patients in three subgroups (Ambulatory, Homebound, and Nursing Home). The dependent variables were effectiveness and efficiency. Effectiveness was measured by the Goal Attainment Scale. Efficiency was determined by measuring the operational use and cost of the primary and supportive systems for health care delivery. A cost‐effectiveness model was used to facilitate the comparison between the two approaches to primary care. Scientific hypotheses related the measures of the dependent variables to the levels of the independent variable. The conclusions of the study were: 1) The NP/P Team is as effective as the PO but substantially more efficient in its operational use of the systems for health care delivery; 2) Ambulatory patients can make a positive change in the achievement of their health care goals with efficient use of the health care system, if they receive their care on a PO basis; 3) Homebound patients can make a positive change in such achievement if they receive their care from a NP/P Team; and 4) Nursing Home patients can make a positive change in such achievement whether they receive their care from the PO or from the NP/P Team.
Treatment of the Aged Mentally Ill: Further Unmasking of the Effects of a Diagnosis of Chronic. Brain Syndrome
Authors: Ernst Philip , Beran Barbara , Badash Dina , Kosovsky Ruth , Kleinhauz Moris 
Published: April 2015

ABSTRACTSix elderly persons with a diagnosis of “chronic brain syndrome,” who resided in a home for the aged, received bi‐weekly sensory stimulation and group therapy for three months. This pilot project demonstrated that the symptoms used to classify “chronic brain syndrome” are flexible and can improve with such treatment. Not only does this cast doubt on the accuracy of this diagnosis as used, but it provides further evidence of the utility of such treatment for this type of patient. Since group therapy and sensory stimulation over a relatively short period can result in clinical and testable improvement, the diagnosis of “chronic brain syndrome” in the elderly should not be allowed to preclude the provision of appropriate psychiatric therapy.
Geriatrics Program for Medical Students and Family Practice Residents. I. Establishing Attitudes Toward the Aged
Authors: Holtzman Joseph M. , Beck James D. , Hodgetts Peter G. , Coggan Peter G. , Ryan Nelly 
Published: April 2015

ABSTRACTThis report concerns the initiation of required experience in geriatrics for undergraduate medical students and a program of research designed to evaluate that experience. Through the use of questionnaires, an attempt was made to differentiate between attitudes toward the elderly and their rehabilitation potential as stated by medical students, family practice residents, and professional and nonprofessional nursing‐home staff members. Important differences were found between professional and nonprofessional groups, but no significant differences among professionals. Implications for the training of professional and nonprofessional staff members are discussed, and further research plans specified.
Cyclandelate in the Treatment of Senile Mental Changes: A Double‐Blind Evaluation
Authors: Rao D. B. , Georgiev E. L. , Paul P. D. , Guzman A. B. 
Published: April 2015

ABSTRACTThe treatment of cerebrovascular insufficiency and its many symptoms in the ever‐increasing numbers of the aged, is of major concern to physicians engaged in such care. Despite past skepticism as to the degree of efficacy of cerebral vasodilators, there is renewed interest in this form of therapy. Our investigation was designed to assess the effectiveness of cyclandelate, under strict double‐blind conditions, in 58 geriatric patients. The cyclandelate and placebo groups (32 and 26 patients respectively) received either 1,600 mg/day of cyclandelate in fractional doses, or identical‐appearing placebo capsules — over a period of 12 weeks. During the initial examination and every four weeks thereafter, patients were assessed for possible changes in vital signs and for evidence of adverse reactions. In addition, the Sandoz Clinical Assessment‐Geriatric (SCAG) and the Nurses Observation Scale for Inpatient Evaluation (NOSIE) were completed, with particular attention to symptom clusters. A final global assessment was made in which the physician rated patients according to their overall clinical condition. The results of our study and analysis indicate that cyclandelate is a safe and effective agent for treating certain symptoms of senility in properly selected patients, provided the therapy is carried on for at least eight weeks and, if indicated, for a longer period. Clinical evidence suggests that the prudent use of this drug may definitely delay deterioration.
Physician House Calls: A Complement to Hospital‐Based Medical Care
Authors: Mims Robert B. , Thomas Lorraine L. , Conroy Mary V. 
Published: April 2015

ABSTRACTA physician‐oriented, hospital‐based Home Care Program (HCP) is described. The staff includes a director, resident physicians, nurses, social workers, and clerical personnel. House calls are made by resident physicians during off‐duty hours, but the patients, their families, and other health professionals may help with their care. Drugs, equipment and supplies are available through the hospital and contract vendors. The most common medical diseases are cardiac and cerebrovascular disorders, arthritis, diabetes mellitus, chronic pulmonary disorders and hypertension. Of 513 patients evaluated in one year, 337 were admitted to the HCP. Two‐thirds were women. Ages ranged from 18 to 106 (median, 68 years). Under the HCP there was significant improvement and control of the medical problems, and a decrease in hospital and emergency room admissions, and clinic visits; 207 of the 337 patients were discharged. The HCP cost less than other outpatient and inpatient services. It proved to be a rewarding, economical and effective means of improving medical care for a metropolitan population dependent upon hospital‐based physicians for medical services.
The Future of Health Care for the Elderly†
Authors: Skelton David 
Published: April 2015

ABSTRACTProblems facing the modern health care worker are examined. These include population changes, the changing pattern of disease, the psychosocial aspects of aging, and altered pathophysiologic mechanisms. The major future requirements in health care for the elderly are outlined. Greater emphasis should be placed upon education in the disciplines of Gerontology and Geriatric Medicine. Society needs to be made more aware of the realities of aging. Health care professionals need to develop their communication skills and to practice more effective teamwork. Greater coordination of the components of health care delivery systems will be needed in order to provide comprehensive and continuing health services. Research into the true and changing needs of the elderly recipients of health care should be emphasized. Prevention and early detection of disease is an important focus in Geriatric Medicine for the future.
Colestipol Hydrochloride for Treatment of Hypercholesterolemia in a Family Practice: Five‐Year Study
Authors: Ruoff Gary 
Published: April 2015

ABSTRACTColestipol hydrochloride (Colestid) lowered the serum cholesterol level significantly more than did placebo in hypercholesterolemic patients (21 colestipol, 19 placebo) treated for up to 5 years. In the 21 colestipol‐treated patients, the average decrease in serum cholesterol levels was 19 percent during the first year and 23 percent during the second through fifth years. Seven patients (age range, 44 to 59 years) took colestipol for the full 5 years. The data showed a consistent lowering of the serum cholesterol level. The only side effect was constipation.
Our Elderly. Who Are They?
Authors: GELPERIN ABRAHAM 
Published: April 2015

ABSTRACTWhy are today's elderly remarkable? They are the small minority who represent the survivors of Americans and immigrants born during the period 1870–1913. The mortality experience during that period shows the dramatic changes that have occurred. The future populations of the elderly are developing with an ever‐increasing number of people kept alive by the mass use of vaccines, the application of new medical, surgical and psychologic diagnoses and therapies, effective antibiotics, rapid communication, proper nutrition, safe water, a high level of health insurance coverage, and available education at all levels for those who want to participate.
Young Adult, Geriatric and Aphasic Group Responses to Simple Analogies
Authors: FARMER ALVIRDA , McLEAN SUZANNE , SPARKS ROBERT , O'CONNELL PAMELIA F. 
Published: April 2015

ABSTRACTThe efficiency of interactive language processing was compared in three groups: 25 young adults, 25 geriatric subjects, and 25 adult aphasic subjects. The task involved simple analogy completion. Data analysis included six categories of responses which represented levels of convergence toward the expected relationships. Results of chi‐square comparisons between groups were all significant, and indicated substantial reductions in interactive processing for geriatric subjects. The findings suggest that a general aging factor may contribute to the poor prognosis in elderly aphasic patients
Tocopherol in Osteoarthritis: A Controlled Pilot Study
Authors: MACHTEY I. , OUAKNINE L. 
Published: April 2015

ABSTRACTThirty‐two patients entered a simple‐blind, cross‐over study on the action of tocopherol in osteoarthritis; only 3 did not complete the course. Each patient was randomly assigned either to the tocopherol group (600 mg/day for 10 days) or to the placebo group. After 10 days the groups were transposed. The analgesic and other possible effects of tocopherol vs. placebo were assessed by the patients' daily records, by the physician's personal examination and interview, and by observations on the use of an additionally permitted analgesic (pro re nata). In 52 percent of the 29 patients who completed the study a good tocopherol analgesic effect was noted, but only 4 percent of those receiving placebo reported a similar effect. The difference was statistically significant. Further large‐scale assessment of the influence of tocopherol in osteoarthritis would seem to be justified.
Comparative Psychologic Effects of Estrogen Administration on Institutional and Noninstitutional Elderly Women*
Authors: KANTOR HERMAN I. , MILTON LINDA J. , ERNST MARVIN L. 
Published: April 2015

ABSTRACT:Previous research on elderly women living in institutions has shown a positive relationship between the administration of estrogen and improved psychologic status. In the current 12‐month study, the effects of estrogen therapy were compared in 18 institutional women versus 21 noninstitutional women who volunteered to participate. Both groups received conjugated estrogens (Premarin, 0.3 mg daily) in interrupted courses. Throughout the year, the women were evaluated by means of the Eysenck Personality Inventory, the Profile of Mood States, the Lawson Morale Scale, and various self‐perception items. Statistically significant changes occurred in the areas of neuroticism, tension, morale, and subjective mood states, but the improvement was greater in the institutional subjects. The main conclusion was that estrogen therapy has a positive effect upon psychologic status, particularly for women who reside in an institution.
Death and the Elderly Patient
Authors: ELKOWITZ EDWARD B. 
Published: April 2015

ABSTRACT:More attention should be paid to the profound needs of dying patients. The family physician can guide the family members and others in forming a team to help dying elderly patients in this life crisis, so that they may have a “good death.” The importance of honesty and cooperation by all those involved is emphasized, as is the need to support the patient emotionally and spiritually.
Depression in the Elderly. I. Relationship between Depression, Psychologic Defense Mechanisms and Physical Illness*
Authors: Salzman Carl , Shader Richard I. 
Published: April 2015

ABSTRACTDiagnosis of depression in the elderly is sometimes difficult owing to the presence of ego defensive mechanisms or somatic symptoms that can disguise the affect. Depression also may precede, or be associated with a variety of medical illnesses which are common among older persons. Specific ego defenses and representative medical illnesses are discussed. The concepts of a depressive equivalent and pseudodementia, which particularly act to disguise the depression, are reviewed in detail.
Primary Oat‐Cell Carcinoma of the Larynx Following Supraglottic Laryngectomy for Squamous‐Cell Carcinoma
Authors: Ferlito Alfio 
Published: April 2015

ABSTRACTAn extremely rare case is reported of a primary oat‐cell carcinoma of the larynx in a 70‐year‐old man who had been treated eight years previously for squamous‐cell carcinoma of the larynx by means of supraglottic laryngectomy. A review of the literature revealed only 5 unequivocal previous reports of this primary oat‐cell tumor; the present report makes a total of 6 cases. The morphologic pattern, histogenesis and biologic behavior are discussed. The patient of this report was treated by surgical intervention and radiotherapy. He was well, six months later. Only one of the 5 patients previously reported survived for more than a few months. This type of lesion has a poor prognosis because of its tendency to metastasize early to various organs.
The Evening Meal and Atherosclerosis*†
Authors: Roen Paul B. 
Published: April 2015

ABSTRACTA trial by any means that can possibly prevent or retard the development of arteriosclerosis is to be recommended. Arteriosclerosis is the chief cause of strokes and heart attacks. The heavy evening meal now in vogue is characteristically rich in animal fats. Normal digestion is at its peak at about the seventh hour, usually during sleep, when the body economy is at its lowest ebb. A large amount of digested material with a high content of lipids is dumped into the slow‐moving circulation. As this material, full of saturated fats, moves slowly through the arteries, the situation is ideal for clot formation, possibly resulting in a stroke, a heart attack, or sudden death. Such a catastrophe can occur in almost anyone, but is more apt to strike the high‐powered executive or the apparently healthy man past 45 who has a voracious appetite. It seems logical to postulate that a light, rather than a heavy evening meal would result in less arteriosclerosis with complications such as heart attacks and strokes.
Bromocriptine: Effect on Serum Prolactin and Growth Hormone in Psychogeriatric Hospital Patients
Authors: Hontela S. , Nair N. P. V. , Rosenberg G. , Schwartz G. , Guyda H. 
Published: April 2015

ABSTRACTSerum prolactin (PRL) and human growth hormone (HGH) were assessed before, and three hours after oral administration of 2.5 mg of bromocriptine in 39 hospitalized geriatric patients with organic brain syndrome. Serum PRL concentrations decreased significantly irrespective of initial values (also in the 7 geriatric control subjects), but HGH levels were low in all patients and did not change during the three hours after administration of bromocriptine. Closer scrutiny of the HGH responses to bromocriptine in 5 patients and 5 controls showed that the serum HGH response was more variable among the patients than among the controls. The findings are discussed in relation to neuroendocrine changes associated with aging, institutional living, and mental disease.
Sliding Inguinal Hernia in Patients Over 70 Years of Age*
Authors: Ponka Joseph L. , Brush Brock E. 
Published: April 2015

ABSTRACTIn a 1973 study of 200 aged patients with groin hernias, a comparatively high incidence of the type known as sliding hernia was noted. The present study of 60 patients over age 70 seen at the Henry Ford Hospital between the years 1940 and 1972 was devoted specifically to the problem of sliding hernias. The threat of bowel strangulation is often advanced as a reason for the operative repair of such hernias, but this complication is rare. Bowel dysfunction, constipation and local discomfort are far more common, and gave rise to annoying symptoms in 75 percent of the patients studied. Barium enema x‐ray examinations often revealed some degree of bowel obstruction. Most often the sigmoid colon on the left side and the ileocecal segment on the right side constituted the sliding components of the hernia; the bladder was involved less often. Repair of 62 sliding hernias in 60 patients was performed successfully. There were no deaths, and only one recurrence of the hernia.
Centrophenoxine: Effects on Aging Mammalian Brain
Authors: Nandy K. 
Published: April 2015

ABSTRACTA study was made of the effects of centrophenoxine on the learning and memory of old mice. The results were correlated with changes in neuronal lipofuscin in the cerebral cortex and hippocampus. Old female mice (11–12 months) were treated with centrophenoxine for three months and their learning and memory were tested in a T‐maze. The number of trials required to attain the criterion in the 20 treated old mice were compared with those for 20 untreated mice of the same age and for 20 younger untreated mice. The treated animals learned the task with significantly fewer trials, and also exhibited a reduction of neuronal lipofuscin pigment in both the cerebral cortex and the hippocampus. The changes in lipofuscin were demonstrated by study of the characteristic autofluorescence, and by histochemical and ultrastructural (electron microscope) observations.
Avoiding Diagnostic Errors in Admitting Patients to a Nursing Home
Authors: LOESER WILLIAM D. , DICKSTEIN EMIL S. 
Published: April 2015

ABSTRACTSometimes the members of the medical profession have been castigated for unpreparedness and shortcomings in the management of nursing home populations because their pre‐admission diagnoses often have not agreed with the post‐admission evaluations. In contrast, the authors' survey of a local situation revealed a high degree of diagnostic accuracy in admissions to a nursing home. Discussed are appropriate steps that nursing‐home admission evaluators can take to ensure the avoidance of errors in the entrance diagnosis.
Improving the Quality of Life for the Elderly*
Authors: Mathias Charles McC. 
Published: April 2015

ABSTRACTThe United States Senator from Maryland, as speaker at the Awards luncheon of the American Geriatrics Society (Washington meeting), presented his views on priorities in various health programs for the elderly, and asked for the Society's cooperation in making some of the difficult decisions that lie ahead. An important item is cost‐effectiveness. These decisions will affect every discipline involved in geriatrics, and have an important bearing upon the quality of life for the elderly. A better understanding is needed of the interaction between aging and disease, and the use of preventive measures.
Reduced Incidence of Endometrial Cancer among Postmenopausal Women Treated with Progestogens*
Authors: Gambrell R. Don , Massey Fred M. , Castaneda Tristan A. , Ugenas Aldonna J. , Ricci Corrine A. 
Published: April 2015

ABSTRACTA prospective study begun in 1976 to determine the incidence of endometrial cancer in postmenopausal women was undertaken because of the adverse publicity alleging an increased risk of endometrial cancer in women receiving estrogen therapy. A retrospective study for the year 1975 was added. During 8,170 patient‐years in the 3‐year 1975–1977 period, 14 endometrial malignancies were diagnosed, for an annual incidence of 1.7 per 1,000 women. During the 3,792 patient‐years of observation of estrogen‐progestogen users, the incidence of endometrial cancer was 0.5:1,000. The incidence of this carcinoma among estrogen users (8 cases during 2,088 patient‐years) was 3.8:1,000. The difference between these two groups was statistically significant (p < 0.01). One adenocarcinoma was detected in a patient who used estrogen vaginal cream for 7 months, for an incidence of 1.7:1,000 during 573 patient‐years of observation. In the untreated women, during 1,515 patient‐years, there were 3 endometrial cancers, for an incidence of 2.0:1,000. There was no significant difference between the untreated group and the estrogen users, and only a trend (p < 0.21) between the estrogen‐progestogen users and the untreated women. Synthetic progestogens were used to treat 199 women with endometrial hyperplasia (a precancerous lesion) for 3–6 months. The hyperplastic endometrium reverted to normal endometrium in 96.5 percent. The authors believe that all postmenopausal women with an intact uterus should be given the Progestogen Challenge Test, and the progestogen continued each month as long as bleeding follows. Such methods should be highly effective in preventing most endometrial cancer in these women.