bluuebunny/crossref_metadata_2025_split huggingface dataset:
JOHN S.—WIDOWER
Authors: Freeman Joseph T. 
Published: April 2015

AbstractA surgeon writing in 1895 described a surgical procedure that enabled “John S., aged 66, widower” to regain his ability to sustain erections. The article was entitled “Old Age a Myth”—a conclusion that was not justified on the basis of the data presented. The indexer for Index Medicus seemed to realize this and added the explanatory phrase “[in sexual matters].” All too often, even today, re‐potentiation is equated with rejuvenation.
RETIREMENT*
Authors: Sherman E. David 
Published: April 2015

AbstractThis review outlines the problems associated with retirement and some of the vital factors in their solution. A study of the psychological aspects indicates that often psychiatric illness is diagnosed in elderly persons when the real issue is low morale. Retirement is discussed under the headings of timing, type (compulsory or voluntary), programs, mental health, self‐employment, retirement occupations, preventive medicine, and medico‐social aspects.Society must strive to attain a goal in which each older worker approaching the stage of retirement is afforded the opportunity to choose between an economically secure and purposeful role in retirement, or a similar role in employment if he is able and willing to work. This objective can be achieved only when there is a flexible program for retirement with adequate pension plans, both public and private, and a pre‐retirement program which assists older workers to prepare adequately for constructive roles in retirement.
CHOLECYSTOSTOMY: UTILITY IN GERIATRIC PATIENTS*
Authors: Ficarra Bernard J. 
Published: April 2015

AbstractAlthough cholecystectomy is the procedure of choice for cholelithiasis with stone impacted in the cystic duct, there are occasions in the management of this disease in geriatric patients when cholecystostomy with removal of the impacted stone is preferable. The surgeon must be guided in his decision by the physical status of the elderly patient, the anesthesia tolerance, and the findings at the time of starting the operation. When in doubt, perform a cholecystostomy. The gallbladder can always be removed at a later date if necessary. Though it may be more impressive to remove the gallbladder, simple drainage with removal of the stone may be life‐saving.
AMINO ACID METABOLISM IN OSTEOPOROSIS
Authors: OHATA MASAHIRO , FUJITA TAKUO , ORIMO HAJIME , YOSHIKAWA MASAKI 
Published: April 2015

Abstract:To evaluate amino acid metabolism in osteoporosis, the effects of oral loading with an amino acid mixture were studied in 11 aged patients with advanced osteoporosis, 5 aged patients with mild osteoporosis, and 7 healthy aged subjects (controls). The osteoporotic patients were free of other major diseases. In all three groups the physical examination, blood chemical determinations, urinalysis and fluoroscopy of the upper gastrointestinal tract gave normal findings; in particular, no liver or kidney disease was indicated by the results of function tests. A diagnosis of vertebral osteoporosis was made when the ratio of vertebral to disc density in the lateral tomogram of the lumbar spine was 1.0 or higher; in the normal subjects, the ratio was always less than 1.0. The presence of compression fracture(s) was considered to indicate severe osteoporosis, whereas the absence of such fractures graded the disease as mild.Gaschromatographic analysis of the serum for certain free amino acids was made on the blood specimens drawn immediately before, and at one, two, three and four hours after oral ingestion of the test amino acid mixture. The serum valine level for the severely osteoporotic group was significantly higher at one hour (215 + 21 μg/ml versus 151 + 9 for the controls) and at four hours (178 + 16 μg/ml versus 139 + 8.7 for the controls) after ingestion of the mixture. The peak height of the serum valine level was also significantly higher in the severely osteoporotic patients (263 + 25 μg/ml) than in the controls (192 + 5.5 μg/ml). In the mildly osteoporotic patients the values were intermediate. For leucine and phenylalanine, the tolerance curves for the osteoporotic patients were similar to those for the controls. The findings are consistent with the hypothesis that possibly there is a deficiency or defect of valine transaminase in osteoporosis.
OPHTHALMODYNAMOGRAPHY IN GERIATRIC PATIENTS
Authors: RAO D. B. , CORY C. C. 
Published: April 2015

Abstract:Interest in the extracerebral circulation, particularly in the elderly, has led to new methods of estimating blood pressure in the carotid arteries. The method described here involves use of the ophthalmodynamograph, which simultaneously monitors orbital blood pressure and brachial artery blood pressure.The study was made on 66 patients in a geriatric day hospital. The 53 females (average age, 76) and 13 males (average age, 70) had multiple disease. The five most common diagnoses were cerebrovascular accident with hemiplegia (18 cases), osteoarthritis (10 cases), cerebral arteriosclerosis (9 cases), ischaemic heart disease with congestive failure (9 cases), and parkinsonism (6 cases). In 120 eyes, the orbital diastolic pressure varied from 50 mm to 135 mm Hg, being between 80 and 100 mm in 50 per cent and below 80 mm in 27 per cent. The orbital diastolic pressure often was greater than the brachial; in 10 cases the difference was greater than 20 mm. When the diastolic pressures in the two eyes were compared, 9 cases showed a difference greater than 10 mm and 24 cases a difference greater than 6 mm.Problems exist regarding the interpretation of certain waveform changes in the tracings. However, the apparatus is reliable, safe, and easier to use than most available techniques for studying blood flow in this region.
SPLIT‐COURSE COBALT60 IRRADIATION FOR TREATMENT OF ADVANCED CARCINOMA OF THE LUNG
Authors: WILKIE LOUIS J. 
Published: April 2015

Abstract:A survey was made of the cases of lung carcinoma referred to the Radiology Department for cobalt60 therapy during the first five years after installation of the cobalt unit at Creighton Memorial St. Joseph's Hospital in Omaha. After elimination of 27 cases in which there had been other conjunctive therapy such as surgery, chemotherapy or x‐ray irradiation, there were 85 cases for study. Two cases were lost to follow‐up, so the data pertain to 83 patients (mean age 60, range 30–78).The complete planned course of cobalt60 irradiation delivered a total dose of 4,000–5,000 r during six to eight weeks, with half the dose given in the first two weeks, followed by a two‐week rest period. Only 39 of the patients were able to complete the planned course of 4,000–5,000 r. The mean length of survival for all the patients was fourteen and a half months after starting therapy. Two patients are still living at seventy‐five and seventy months, and 1 at thirty months. The overall survival rate was 4 per cent, but for the group receiving the full course of therapy it was 7.5 per cent. About three quarters of the 83 patients obtained moderate to marked relief of symptoms.These results are similar to several reported in the literature, and serve to emphasize the benefits of cobalt teletherapy in otherwise incurable cancers of the lung.
MENISCAL TEARS OF THE KNEE IN THE ELDERLY
Authors: GARDNER RICHARD C. 
Published: April 2015

Abstract:Tears of the knee meniscus are contrasted in the young versus the elderly. The diagnosis may prove difficult in the elderly, as often there is no definite history of trauma. Characteristic signs and symptoms and methods for examination are outlined. Early menisectomy may prevent erosion of the cartilage and degenerative changes in the joint.
AGGRESSIVE MANAGEMENT OF RHEUMATOID ARTHRITIS IN THE ELDERLY
Authors: NASTRO LAWRENCE J. 
Published: April 2015

Abstract: Usually the elderly patient with rheumatoid arthritis manifests the residual of several years of active disease. Eleven cases are cited to illustrate that effective treatment must be tailored to the current stage of the disease. Acute rheumatoid arthritis is not common in the elderly. When it develops, salicylates and complete bed rest in a hospital remain the therapeutic anchors. If symptoms do not subside in from two to three weeks, indomethacin, gold therapy and corticosteroids may be tried. In most cases, distinct improvement occurs with this regimen. Chronic deforming rheumatoid arthritis is a different story, however. It is extremely difficult to treat effectively.In both the acute and the chronic form of rheumatoid arthritis, an active rehabilitation program is the key to the prevention of functional deterioration and to the maintenance of the patient as a fairly self‐sufficient person.
VITAMIN‐C DEFICIENCY IN THE ELDERLY AND ITS MANIFESTATIONS
Authors: MITRA M. L. 
Published: April 2015

Abstract: In a 64‐bed geriatric unit, 4 cases of vitamin‐C deficiency were found. The patients manifested anaemia (chiefly normocytic), multiple bruises and intense tibial tenderness; the results of Hess's capillary fragility test were positive. The diagnosis was confirmed by the urinary ascorbic‐acid saturation test. One of the patients also had folic‐acid deficiency. The relation between the two conditions is discussed. All the signs of vitamin‐C deficiency cleared up quickly during treatment with ascorbic acid, although the urinary test indicated that it took three weeks for the saturation point to be reached.These results emphasize the importance of a full clinical examination for elderly patients. Vitamin‐C deficiency, if unrecognized, can defeat efforts at rehabilitation because the intense tibial pain (preventing ambulation) and the weakness due to anaemia usually keep the patient bedfast.
LONG‐TERM CARE FOR THE ELDERLY: OPTIMUMS, OPTIONS AND OPPORTUNITIES
Authors: Brody Elaine M. 
Published: April 2015

AbstractThe medical profession has participated in many scientific breakthroughs which have prolonged the life‐span of millions of people. The physician, in the daily practice of his art, continues to prolong individual lives. Whether he will or no, the modern doctor therefore finds that he has a continuing responsibility to deal with the social consequences of those historic and current acts. When his patient is elderly and impaired, and when institutional placement must be considered, the doctor has a view from the bridge. His professional and human judgments indicate the optimum solution. The current realities dictate the options. He can look towards the general community and press for the development of services to make possible his prescription of continued community living for the patient and he can look towards the institutional community for what is necessary in care and programs to make the lives he has prolonged worth living. That is the opportunity.
A NOVEL GAIT OF PSYCHOGENIC ORIGIN
Authors: Baltzan David M. 
Published: April 2015

AbstractA novel gait in a 78‐year‐old woman is described. Though tentative diagnoses gave priority to an organic degenerative process, careful observation led to the diagnosis of a psychomotor aberration. (The patient claimed that the disorder was drug‐induced.) After starting a program of concentration on self‐control in association with imipramine, chlordiazepoxide and a regulated diabetic regimen, the patient recovered completely. The case illustrates how psychogenic counterparts can mimic organic cerebral deficits.
NEW PATHOLOGIC ASPECTS OF PRIMARY CARCINOMA OF THE PROSTATIC URETHRA
Authors: Milstoc M. 
Published: April 2015

AbstractTwo cases of an extremely rare tumor, the primary transitional‐cell carcinoma of the male prostatic urethra, are presented. The diagnostic problems of the 2 cases are emphasized in relation to a special group of elderly long‐term patients in a hospital for chronic diseases. In addition, one of the patients had two primary carcinomas and mixed widespread metastases. It is the first such case.This report of the 2 cases and the discussion of their pathologic aspects may help in the diagnosis of other primary urethral tumors in an early stage.
LARGE LEIOMYOSARCOMA OF THE STOMACH CARDIA TREATED BY GASTRIC‐REMNANT INTERPOSITION
Authors: Case Thomas C. 
Published: April 2015

AbstractA case is presented of a large invasive leiomyosarcoma of the stomach cardia, with metastases to the spleen. Operation consisted of removal of the tumor, most of the stomach, and the adherent spleen. Continuity of the gastrointestinal tract was established by gastric‐remnant interposition, thus avoiding total gastrectomy. Instead of the usual Roux‐Y procedure, a loop of jejunum was used in order to insure a good blood supply at the esophagojejunal anastomosis.
NEW HORIZONS IN OUR KNOWLEDGE OF DIABETES MELLITUS*
Authors: Levine Rachmiel 
Published: April 2015

AbstractA summary is given of the latest advances in our knowledge of the fundamental processes in diabetes, including the nature of insulin and the regulation of its production, the role of glucagon in diabetes, and the problem of the associated vascular disorders. Intensified research is needed in the areas of more specific criteria for diagnosis, etiology and pathogenesis, and the precise mode of insulin action at the molecular level; also, the basis for the acceleration of arteriosclerosis in diabetes, and the possible relationship between microangiopathy and the abnormal nutritional metabolism. Successful implantation of functioning human islet tissue is another goal.
DEGOS' DISEASE ASSOCIATED WITH A “SPONTANEOUS CURE” OF DIABETES
Authors: Salomon Mardoqueo I. , Mandel Edward H. , Gallo Gloria 
Published: April 2015

AbstractA case is presented of a 50‐year‐old woman with Degos' disease (malignant atrophic papulosis) of 2.5 years' duration. Almost simultaneously with the onset of Degos' disease, the diabetes mellitus which had been present for 13 years began to fade and vanished entirely within a few months. This occurred although the patient was receiving corticosteroid therapy which proved indispensable for control of the severe Degos' disease. A renal biopsy revealed normal renal tissue despite the long duration of the diabetes.
UTILIZATION OF IN‐PATIENT SERVICES BY THE ELDERLY
Authors: Berkman Barbara , Rehr Helen , Siegel Doris , Pomrinse David , Paneth Janice 
Published: April 2015

AbstractThe authors present descriptive data on the 5,312 patients aged 65 or older, admitted in 1967 to the medical and surgical in‐patient services of the Mount Sinai Medical Center in New York City. These patients accounted for 24 per cent of the total number of adults admitted. The services admitting most of the elderly were General Medicine, General Surgery, Urology, Ophthalmology and Neurology. These patients had a longer average stay in the hospital than the national average for hospitalized elderly; almost 20 per cent of them stayed thirty‐one days or longer. Over four‐fifths of the elderly were admitted to Private and Semi‐Private Pavilion accommodations, and the remainder entered the teaching services of the Semi‐Private Division. The Division patients had longer lengths of stay, on the average, than patients in the Pavilions. The patients referred to Social Service were chiefly from the General Medical, Neurological, and Orthopedic services. The most significant factor determining who was referred to Social Service was extended “length of stay.” Over half of the elderly receiving social services were patients whose hospital stays were thirty‐one days or longer.It is anticipated that the elderly will become a larger proportion of the sick, requiring more medical care and hospitalization. They will continue to use more bed‐days than any other group of patients. It is recommended that health‐care institutions become more consciously aware of the elderly and their impact on hospital resources, and that the hospital stay be regarded as one phase in a continuum of care.
PREDICTIVE MEDICINE. IX. DIET
Authors: Cheraskin E. , Ringsdorf W. M. 
Published: April 2015

AbstractA unique feature in a predictive medicine program is the role of diet in the prediction of classical disease. Examples are given of the relationships between diet and the clinical state, the electrocardiographic P1 wave, and the biochemical state. Countless dietary interrelationships are based on the link‐ages between nutritional substances, metabolic reactions, and hormones.
PREDICTIVE MEDICINE. X. PHYSICAL ACTIVITY
Authors: Cheraskin E. , Ringsdorf W. M. 
Published: April 2015

AbstractPhysical activity is a factor in preventing disease. Examples are given of the relationships to age, clinical and biochemical states, electrocardiographic signs, and the consumption of coffee/tea, alcohol, tobacco, and vitamin supplements. Physical activity is a cardinal feature of any predictive medicine program.
TOPICAL 5‐FLUOROURACIL: VARIABILITY OF EFFECTIVE DOSAGE AND DURATION OF REACTION
Authors: Sykes Marguerite P. , Salem Philip , Joffe Bernard 
Published: April 2015

AbstractTopical 5‐fluorouracil (ointment) is an effective, inexpensive and safe remedy for solar and actinic keratoses. This form of therapy also seems to be indicated for patients with multiple and recurrent epitheliomas that have not responded well to surgery and/or x‐ray therapy. It is important to keep in mind the occasional variability in the effective dosage and the rare occurrence of a prolonged disfiguring reaction to treatment.
SERUM LACTIC DEHYDROGENASE ISOENZYMES IN DIABETES AND CHLORPROPAMIDE THERAPY
Authors: Haunz E. A. , Cornatzer W. E. , Luper Miltza , Baldwin Jerry J. 
Published: April 2015

AbstractSerum LDH isoenzyme fractions were evaluated in non‐diabetic control subjects, diet‐controlled diabetic patients and diabetic patients receiving chlorpropamide (Diabinese) in addition to diet. Statistically significant elevations of fraction I were observed in both the diet‐controlled and the chlorpropamide diet‐controlled diabetic groups when compared with the normal controls. Fraction III, however, showed a statistically significant decrease in activity in the two diabetic groups when compared with the normal controls. No significant changes were observed in the other fractions. The findings indicate that the diabetic state per se may elicit an increase in fraction I with a decrease in fraction III, and that chlorpropamide therapy has no effect on the relative concentrations of the various serum LDH isoenzymes. This evidence confirms a previous observation from this laboratory that liver function remains unaltered during chlorpropamide therapy and that the mild abnormalities reported here are in all likelihood peculiar to the diabetic state itself.
BRIEF MAXIMAL ISOMETRIC EXERCISE IN HYPERTENSION
Authors: Kiveloff Broino , Huber Olive 
Published: April 2015

AbstractBrief, maximal isometric exercise of six seconds' duration, repeated three times daily for five to eight weeks may be associated with lowering of the blood pressure in hypertensive patients. In 8 subjects with hypertension there was a decrease of 16–42 mm Hg in systolic pressure and 2–24 mm in diastolic pressure. In 5 subjects receiving a constant dosage of hypotensive drugs, there was a decrease of 4–28 mm in systolic pressure and 2–14 mm in diastolic pressure. In 2 subjects previously treated with hypotensive drugs in whom isometric exercise was substituted for the drugs, normal blood pressure was maintained for eleven months.
IMPROVEMENT IN CLAUDICATION AFTER INSERTION OF A CARDIAC PACEMAKER
Authors: Terplan Martin 
Published: April 2015

AbstractDespite severe arterial insufficiency (with claudication) in both lower extremities, insertion of a cardiac pacemaker improved the distal circulation in a 76‐year‐old man with atrioventricular dissociation. This result suggests that when the cardiac condition requires insertion of a pacemaker, this procedure should antedate any arterial reconstruction in cases of severe peripheral vascular disease.
THE AMBIENT AIR, THE GOOD OF IT AND THE BAD OF IT: THE DEVELOPMENT OF THERAPEUTIC GASES AND AIR POLLUTION*
Authors: Barach Alvan L. 
Published: April 2015

AbstractThe author outlines the history of the isolation of therapeutic gases from the ambient air, and also the industrial introduction of gases that pollute the air and menace the health of man. Both geriatric and middle‐aged patients with respiratory and cardiac disease have experienced exacerbation of symptoms and even death as a result of high concentrations of air pollutants.Methods have been developed (e.g., alkaline sprays and air‐filtering units) for combatting emergency periods of air pollution in the home and hospital. Every physician should keep up to date in this regard. Thus unnecessary illness and death may be prevented while communities work out good over‐all programs on the basis of valid information.
PHYSICIANS AND LONG‐TERM CARE FACILITIES
Authors: Freeman Joseph T. 
Published: April 2015

AbstractThe author discusses dilemmas confronting the physician in view of the rapidly expanding over‐65 population—particularly the matter of post‐hospital care. The older person usually has three options on leaving the general hospital: (a) return home to the family, (b) enter an extended care facility before returning home, or (c) enter a nursing home. Five important questions to be considered are: 1) the objectives of post‐hospital care of the aged; 2) where such services shall be rendered; 3) who shall render them; 4) who shall pay for them; and 5) the possibility of deterring the rate of senescence in the aging population. Seven proposals are made for improving the present post‐hospital program.
PREDICTIVE MEDICINE. VIII. FAMILIAL VERSUS GENETIC FACTORS
Authors: Cheraskin E. , Ringsdorf W. M. 
Published: April 2015

AbstractThough genetic factors influence health and disease, they are involved less often than supposed. Environmental factors possibly may be an “overlay” in genetic problems. There is reasonable evidence that the environment plays a role in diet, enzymes, the biochemical state, and the clinical picture. Supportive data are presented showing statistically significantly correlations in married couples (who seldom are genetically linked).More emphasis should be placed on environmental factors in predictive medicine programs. Although it may be difficult to alter the environment, it is not as difficult as trying to alter the genetic state.
TREATMENT OF DIABETIC NEUROPATHY WITH CLOFIBRATE
Authors: Berenyi Magdalena R. , Straus Bernard , Miglietta Osvaldo E. 
Published: April 2015

AbstractSince angiopathy is an important factor in the pathogenesis of diabetic peripheral neuropathy, any drug which modifies lipid deposition in the peripheral vessels is of value in therapy. Therefore a double‐blind study was made of the lipid‐lowering agent, clofibrate (ethyl chlorophenoxyisobutyrate). Clofibrate (2 gm daily) was given to 9 patients with diabetie neuropathy, and a placebo to 6 such patients, during a 12‐month period. The diagnosis of neuropathy was confirmed by electromyography.Seven of the 9 clofibrate patients improved clinically during the medication period, as judged by the disappearance of pain, paresthesia and numbness, by an increase in muscle strength, and by a return of deep tendon reflexes. Only 1 of the 6 placebo patients showed clinical improvement. Moreover, in 3 of the placebo group, peripheral vascular complications developed which resulted in gangrene and leg amputation. In none of the clofibrate patients did vascular complications develop during the same period. No untoward side effects were noted.The concentration of serum lipids (cholesterol, total lipids, phospholipids and triglycerides) did not change significantly in either group. Changes of conduction velocity in the motor and sensory nerves were not significant in the clofibrate group, whereas there was a tendency toward deterioration in the placebo group.The clinical improvement observed and the lack of major side effects with the dosage used warrant further study of clofibrate in the management of diabetic neuropathy.