bluuebunny/crossref_metadata_2025_split huggingface dataset:
MORTALITY FROM MYOCARDIAL INFARCTION BEFORE AND AFTER ESTABLISHMENT OF A CORONARY CARE UNIT
Authors: Fagin I. Donald , Rajagopal R. 
Published: April 2015

AbstractIn a study involving 657 patients, a retrospective comparison was made of the mortality rates for myocardial infarction during respective one‐year periods, before and after the establishment of a coronary care unit in the hospital. No significant changes were observed.The mortality rates for patients with myocardial infarction admitted to the coronary care unit for the initial portion of their hospital stay were not significantly different from the mortality rates for patients admitted directly to the general medical service during the same year.Salvage of cardiac‐arrest patients in the coronary care unit was much higher than in the general medical wards. This factor alone would justify the establishment of these special units.
TRACHEOSTOMY IN ACUTE RESPIRATORY FAILURE: EFFECTS ASSESSED BY ARTERIAL BLOOD GASES
Authors: Neufeld Oscar , Anagnost Basil D. , Navarre J. Robert , Dziad P. , Osten Taylor A. , Klever Thomas G. , Bakondy Thomas T. 
Published: April 2015

AbstractThe effects of tracheostomy in 27 patients with severe respiratory difficulty are described in terms of arterial blood gas values and clinical observations. Postoperatively, mouth breathing was compared with tracheostomy breathing.Obstruction of the lower respiratory tract from accumulated secretions leads to hypoventilation, ineffective coughing, carbon dioxide retention, anoxia and coma. In such cases, tracheostomy may be life‐saving because it provides a reliable pathway: a) for suctioning the secretions (which may be unusually abundant in emphysema with bronchitis), and b) for the administration of artificial respiration.An important factor in the outcome of tracheostomy is meticulous postoperative care. Attention to such things as proper tube alignment and proper suctioning techniques goes a long way toward preventing possible mucosal damage and infection. Tracheostomy provides therapeutic relief even to patients who are gravely ill (narcosis, coma) with emphysema and bronchitis.
A RESPIRATORY CARE PROGRAM FOR THE ELDERLY
Authors: Kiss George T. 
Published: April 2015

AbstractThere is great need for respiratory care programs in medical institutions for the elderly, for both diagnostic and therapeutic purposes. Such a program in St. Joseph's Manor, Trumbull, Connecticut is described and some statistics are given for the first eleven months of operation. Detection of tuberculosis was much improved. The benefits were outstanding in the management of intercurrent respiratory difficulties.
THE EXTENDED CARE FACILITY—A COMMENTARY ON DEFINITIONS*
Authors: Miller Michael B. 
Published: April 2015

AbstractDiscussions are presented of definitions for custodial care, the nursing home, the extended care facility, the nursing care institution, and personal care and sheltered care institutions.If the hospital is to become the “locus of total health organization” in any community, as recommended by the American Hospital Association, the continued fragmentation of services in long‐term care—justified on the basis of a variety of appellations—will frustrate the development of high‐quality care for the chronically ill aged. The hospital must be involved centripetally and centrifugally in all medical problems of the community concerning health and disease. If the medical needs of the populace are to be served, the hospital must educate the community in affairs related to health, train professionals involved in health care, set criteria for the performance and delivery of high‐quality medical services, and serve as a liaison between governmental agencies and the public.The ill aged, wherever housed, need diagnostic, medical, nursing and psychiatric services. The instability and complexities of their medical, psychiatric and social problems require all the talent and resources of the nonsurgical hospital for effective long‐term management. The multiplicity of new terminologies will not obviate the obligation of the hospital to broaden its perspectives and create a progressive care program for the chronically ill, who are afflicted with all gradations of disability. To fulfill this obligation, the hospital can build, acquire, merge, form partnerships, or affiliate with existing extended care facilities, public or private. If this generation is to be proud of its accomplishments in health care, then, by definition, any institution in which ill people are housed should have the status of a hospital.
COMING OF AGE: A CHALLENGE FOR GERIATRIC NURSING*
Authors: Davis Barbara Allen 
Published: April 2015

AbstractThe author reviews the historical evolution of geriatric nursing in this country from its earliest beginnings to the present, with a focus on the work being done in this area by the Geriatric Division on Nursing Practice of the American Nurses' Association—the professional organization of registered nurses. A discussion of trends in geriatric nursing and of changes in geriatric nursing practice is included. A plea is made for more cooperation between doctors and nurses in plans to improve the care of the aged.
BREAST METASTASES TO PELVIS, RESEMBLING RECTAL CARCINOMA WITH BLUMER SHELF
Authors: Case Thomas C. 
Published: April 2015

AbstractA case of multiple malignant metastases is reported. The original carcinoma was in the left breast, with metastasis to the ovary and later to the pelvis. The pelvic metastatic process with the associated proliferative changes could have been confused with primary carcinoma of the rectum. There was a discharge from both the rectum and the vagina, and the Blumer shelf of proliferative tissue threatened colonic obstruction. Radical surgery was contraindicated because of the far advanced pelvic malignancy.
SOMATIC ILLNESS—PREVENTION AND REHABILITATION*
Authors: Geltner Luzer 
Published: April 2015

AbstractSomatic illnesses of the elderly are discussed from the standpoints of prevention and rehabilitation.The Periodic Health Examination (P.H.E.) after age 40 should play a prime role. This form of prevention merges into treatment, maintenance care and rehabilitation. Purely laboratory screening without expert medical interpretation has many pitfalls and is a dehumanizing process. P.H.E. and maintenance care should be undertaken by the general practitioners. Examples in Edinburgh and The Netherlands are cited.It is recommended that Age Guidance Clinics be established. These would be patterned somewhat after Child Welfare Clinics, but adapted to the needs of patients of advanced age. They would require much larger staffs of specially trained nurses.The first important step on the long road to successful rehabilitation is the total evaluation of the patient's physical, mental and social assets. A simple assessment of the physical deficiencies cannot serve as an adequate foundation for successful total restoration. Physico‐medical rehabilitation has added a great deal to acceptable methods of treatment for elderly people. Definite criteria and limitations must be recognized, however, and the programme should be employed with common sense and realism.
EFFECT OF EXERCISE ON OVERWEIGHT MIDDLE‐AGED MALES*
Authors: Oscai Lawrence B. , Williams Ben T. 
Published: April 2015

AbstractAn exercise program (running) significantly reduced body weight in 5 previously sedentary, overweight males whose ages ranged between 35 and 46 years. (Five control males remained sedentary.) With exercise, body weight decreased an average of 4.5 kg (from 88.1 to 83.6 kg). The weight reduction was primarily the result of loss of body fat; the fat‐free weight did not change significantly. Each subject participated in 47 training sessions during a 16‐week period. The heart rate, measured by palpation at ten‐minute intervals throughout each training session, ranged between 155 and 170 beats per minute.It appears that exercise is effective in reducing body weight and can reverse the trend towards increased adiposity in middle age and thereafter.
SENILE TIBIAL NODULES
Authors: Young Alex W. 
Published: April 2015

AbstractIn a series of 462 geriatric patients, 22 had senile tibial nodules. The incidence, clinical appearance and diagnosis are discussed. The nodules are split‐pea sized, palpable but rarely visible lesions found in the tibial fat in older geriatric women. Although the pathogenesis cannot be firmly established, they may be related to underlying progressive vascular disease.
SERUM PROTEINS, PROTEIN‐BOUND IODINE AND TRIIODOTHYRONINE UPTAKE IN THE ELDERLY
Authors: MEINDOK H. , FRANKS W. M. 
Published: April 2015

Abstract: Values (means and standard deviations) for serum total protein, albumin, electrophoretic protein fractions, protein‐bound iodine and triiodothyronine uptake were determined in 45 men and 55 women whose ages ranged between 60 and 102 years. Groups of healthy younger people were used as controls.In the elderly, the serum total protein and albumin levels were lower and the alpha‐2 globulin level was higher than in the younger persons.The elderly persons in the study group were residents of a home for the aged, and had varying degrees of minor degenerative illnesses. It is extremely difficult to find an old person for study who is completely free of disease.It is suggested that changes in the serum protein in the elderly result from degenerative and undetected pathological processes, and that chronological age by itself is probably unimportant. Our values would seem to be more useful in clinical geriatric practice than previously published values on small groups of completely disease‐free old persons or those with crippling disability.
FUNCTIONAL ASSESSMENT OF THE SUSPECTED MENTALLY ILL AGED*
Authors: Gaitz Charles M. 
Published: April 2015

AbstractA study of 100 consecutive admissions of elderly persons to a county psychiatric screening ward revealed that functional assessment of such persons is a highly complex procedure. Our experience confirmed the belief that such patients have a combination of social, medical and psychological problems; evaluation requires the services of persons qualified in several disciplines. In this instance, a multidisciplinary team examined each patient, consensually agreed on a treatment plan, and then used existing community resources to implement the program. This report describes some of the methodological and philosophical aspects of screening procedures, and some of the pitfalls encountered unless a comprehensive examination is performed.The team consisted of a psychiatrist, internist, social worker, nurse and psychologist. Each discipline obtained information in a more or less traditional manner. The “art” of assessment begins with the understanding of the interrelatedness of specific functions. Adequate assessment of a patient required an exchange of information among the team members; no single discipline could rely completely on its findings. A comprehensive treatment plan could evolve only after the data were integrated. In making judgments about patients, an examiner must not overlook the limitations of partial examinations and the intrusion of personal values and other subtleties.
PROLONGATION OF LIFE: ROLE OF FREE RADICAL REACTIONS IN AGING
Authors: Harman Denham 
Published: April 2015

AbstractThe mean life span has plateaued in the developed countries at around 70 years. Future substantial increases in the mean life span are apt to be due to inhibition of the process(es) involved in aging. One potentially practical means of inhibiting the rate of human aging is based on the hypothesis that free radical reactions play a significant role in the degradation of biological systems. Experiments based on this hypothesis have been encouraging. For example, several inhibitors of free radical reactions have been found to increase the mean life span of mice when added to the daily diet; 2‐mercaptoethylamine and butylated hydroxytoluene were the most effective. Likewise, decreasing the amount and degree of unsaturation of the dietary fat of female C3H mice resulted in a decrease in the mortality rate. The probable role of free radical reactions in the pathogenesis of four age‐associated diseases—cancer, atherosclerosis, hypertension and amyloidosis—is discussed.It is suggested that the addition of one or more inhibitors of free radical reactions to nutritionally adequate and acceptable natural diets selected to minimize the intake of substances that might participate in random endogenous free radical reactions, may increase the average life span of man by five or more years, with accompanying increases in the years of useful, healthy life.
CARCINOID TUMORS AND THE CARCINOID SYNDROME
Authors: Kazi Majid‐Uddin , Grover Victor 
Published: April 2015

AbstractData are presented on 10 cases of carcinoid tumor; 8 of the tumors were in the gastrointestinal tract and 2 in the lung. Two cases were associated with carcinoid syndrome (flushing attacks, diarrhea, bronchospasm); in one of these with marked symptoms, the 24‐hour excretion of 5 hydroxy indole acetic acid reached 107 mg.On the basis of these findings and those reported in some pertinent literature, it would seem that the carcinoid syndrome does not develop unless carcinoid products (including excessive amounts of serotonin) are discharged into the systemic circulation. These products are secreted in abnormally high proportions over normal pathways, and thus reduce the normal formation of other substances necessary for health. The question of whether all carcinoid tumors originate in the gut is still unresolved.
THE CYBERNETIC THEORY OF AGING
Authors: Still Joseph W. 
Published: April 2015

AbstractAn outline is given of the basic facts that the cybernetic theory of aging attempts to harmonize. An experiment is cited which adds substantially to support of the theory. The theory is described and its relation to Bjorksten's crosslinkage theory indicated. Ten significant questions for further study and an outline of the possible basic causes of aging are presented. The potential role of preventive endocrinology is stressed. A plea is made for more support for research on aging.
NON‐FATAL CLOSTRIDIUM PERFRINGENS BACTEREMIA*
Authors: Ellner Paul D. , O'Donnell Edward D. 
Published: April 2015

AbstractSixteen cases of bacteremia due to Clostridium perfringens are documented. None of these patients had hemolytic phenomena or shock, and all survived the bacteremic episode; 9 of them were more than 50 years old (mean age, 64). A review of these 16 cases and the 34 in the literature indicates that invasion of the blood by Clostridium perfringens may take two clinical forms: 1) a septicemia with intravascular hemolysis, shock and a high mortality rate; and 2) a benign bacteremia without hemolysis. Of the 50 reported cases of the benign bacteremic form, 68 per cent occurred in patients past the age of 50 (mean age, 64), and the recovery rate was 90 per cent.
ANESTHESIA FACTORS AFFECTING SURGICAL MORBIDITY AND MORTALITY IN THE ELDERLY MALE
Authors: Stevens Kenneth M. , Aldrete J. Antonio 
Published: April 2015

AbstractThis study concerns the relationship of anesthesia and related factors to surgical morbidity and mortality in 178 males over the age of 70 who underwent 204 operations. Of the 110 complications during anesthesia, arterial hypotension was the most common. Postoperatively there were 139 complications, and 16 deaths. The influences of age, pre‐anesthetic risk, type and duration of surgery, type of anesthesia, and the occurrence of hypotension during surgery are discussed in relation to the postoperative course.Adequate preoperative preparation of elderly patients is extremely important. This includes complete examination, replacement of any blood volume deficits, and possibly prophylactic digitalization.Epidural block anesthesia resulted in higher operative and postoperative morbidity and mortality. Hypotension during anesthesia was more common when halothane was the main anesthetic. Postoperative morbidity and mortality were higher in patients anesthetized by a combination of nitrous oxide, muscle relaxants and intravenously administered sedation.
SEGMENTAL ULCERATIVE COLITIS IN THE AGED: REPORT OF TWO CASES
Authors: Case Thomas C. 
Published: April 2015

AbstractTwo cases of segmental ulcerative colitis in the aged are presented. Barium‐enema x‐ray examinations were useful in locating the lesions but not in identifying the exact nature of the disease. Early surgery is indicated in most cases in order to prevent complications, and especially to detect malignant lesions.
AN IMMUNIZATION PROGRAM FOR DOMICILIARIES (CHRONIC DISEASE FACILITIES)*
Authors: Fisher Seymour 
Published: April 2015

AbstractA program of immunization should be mandatory at all domiciliaries. This would concern chiefly elderly people. The program should include immunization against diphtheria, influenza, poliomyelitis, smallpox and tetanus. Immunization against typhoid or typhoid‐paratyphoid fevers and rabies should be left to the discretion of the individual station. A suggested schedule is presented. Although the intradermal route for immunization is highly recommended, the method used should be that which the staff finds most satisfactory.Immunization is not without danger. The label on the vial of immunizing agent always should be read carefully and the instructions followed. Means for combating local or anaphylactic reactions should always be readily available.
THE CONCEPT OF BIOLOGIC HALF‐LIFE IN RELATION TO SENESCENCE
Authors: Calloway N. O. 
Published: April 2015

AbstractThe half‐life of the biologic processes of aging can be calculated accurately. Since the processes change more rapidly in early life, the half‐life (time required for half the process) occurs very early, even before the individual is born. Data on the change in tissue water percentage and in the basal metabolic rate are illustrative.The half‐life is of great interest to both the gerontologist and the internist since it indicates the paramount importance of the inherent initial material in the individual. The obstetrician and the pediatrician have tremendous responsibilities to see that the individual is well maintained in early life so that he may retain the great biologically competitive thrust with which he is born, because by the time of birth he has already aged half or more than he will ever age.
THE PSYCHIATRIST AND THE POLYGRAPH
Authors: Lerner Joseph 
Published: April 2015

AbstractThe polygraph technique, a professional method for detecting deception, has wide application in medical and legal circles and in the evaluation of employees and applicants for jobs. In the specific environment of the polygraph interview, some emotional problems may come to the surface. In this way, the technique also may be of psychotherapeutic value.Although no one can hold a brief for the infallibility or complete innocuousness of the procedure, its constructive aspects merit recognition in balance with all other considerations. As a part of the broad process of evaluation, the polygraph can make a significant contribution. As with other ancillary procedures, it deserves a place in the field of medical and psychological evaluation.
RESPIRATORY DEPRESSION IN THE COMA OF MYXEDEMA: TREATMENT WITH ETHAMIVAN INTRAVENOUSLY*
Authors: Schneider P. J. 
Published: April 2015

AbstractA case of myxedema coma is presented. The patient had severe hypothyroidism, marked hypercapnia, hypothermia, and fluid and electrolyte abnormalities. He was treated with l‐triiodothyronine intravenously, ethamivan intravenously, and intermittent positive‐pressure breathing (oxygen and air). Recovery from the coma apparently was attributable to the effect of ethamivan on the respiratory depression; whenever ethamivan was omitted the stuporous state returned.Supportive respiratory measures are an integral part of treatment in the coma of myxedema, and further investigation of the effect of analeptic agents such as ethamivan is justified.
THE AGEING CELL: AGEING AND DEATH AS ASPECTS OF GROWTH AND DEVELOPMENT; NATURAL PHENOMENA CONTROLLED BY GENETIC FACTORS
Authors: Fikry M. Essam 
Published: April 2015

AbstractDevelopment of an organism from a fertilised egg, entails growth and differentiation in structure and function, classic genetics and molecular biology.Ageing and death are forms of differentiation. Development and growth, differentiation and ageing, proceed according to a definite predestined programme in the nucleus. The nucleus contains DNA molecules (genes), in which information is coded governing all biochemical cellular activities which are catalysed by enzymes formed according to a messenger RNA. The nucleus contains a mechanism of repression and derepression of genes which regulates the production and suppression of enzymes, and therefore the type of growth, differentiation, ageing and death.Ageing and death, as aspects of differentiation are inherited characters controlled by DNA molecules (genes). They can be affected, as are other inherited characters, by external factors which have an impact on the DNA molecules.
REHABILITATION OF GERIATRIC AMPUTEES
Authors: Cheek Richard C. , Britt Louis G. 
Published: April 2015

AbstractThe study group comprised 60 indigent patients (average age, 70) in a public hospital who had undergone amputations of the lower extremity, chiefly because of gangrene. These patients sought aid only in the last stages of disease, and meanwhile they neglected personal hygiene. There were 10 deaths. The most common contraindications for the use of a prosthesis were chronic brain syndrome (dementia) and muscle weakness or contractures. Of the 60 patients, 22 were considered to be candidates for prostheses, and 5 of these were lost to follow‐up. Thus only 17 potential candidates underwent preprosthetic training, for maximal ability. Eight of the 17 ultimately, because of contraindications, had to be content with crutches or a wheelchair. In the other 9 cases, however, prostheses were successful.Recommendations regarding the management of such patients in a large public hospital include: 1) continuity of management by having the amputee under the supervision of the same physician(s) throughout his course; 2) a series of lectures for the house staff on the rehabilitation of amputees; and 3) a definite protocol for the immediate fitting of a prosthesis in suitable cases.
NEW GERIATRIC ADMISSION POLICY IN A STATE MENTAL HOSPITAL*
Authors: Friedman Jacob H. , Lehrman Nathaniel S. 
Published: April 2015

AbstractState hospitals are still being used as a dumping ground (the End of the Road) for geriatric patients who present serious nursing problems. The Geriatric Service at Bronx State Hospital, affiliated with the Albert Einstein College of Medicine, underwent a marked metamorphosis from the traditional custodial service to a community‐oriented unit with emphasis on treatment. This was accomplished only when the admission criteria were changed.The community can be educated to accept such a modern admission policy for geriatric patients in a state hospital by: 1) having definite criteria for admission; 2) explaining to the referring agency the reasons why patients may or may not be suitable for admission; 3) answering all complaints of public officials who intervene for their constituents; 4) advising the family what procedure should be followed to have the patient admitted to an old age home or nursing facility, or for obtaining a homemaker; 5) providing an out‐patient department (preferably to include a day hospital) for those patients who are not sufficiently ill to be admitted to the state hospital for 24‐hour maintenance; 6) providing a speaker to explain especially to hospital staffs the criteria for admission; and 7) providing a mobile psychiatric team to visit the patient in his home, hospital, nursing home or old age home, and also to consult with the family physician.