bluuebunny/crossref_metadata_2025_split huggingface dataset:
HYPERKALEMIC CHANGES DURING SPIRONOLACTONE THERAPY FOR CIRRHOSIS AND ASCITES, WITH SPECIAL REFERENCE TO HYPERKALEMIC INTERMITTENT PARALYSIS
Authors: Radó János P. , Marosi Judit , Szende László , Takó József 
Published: April 2015

AbstractThe frequency and clinical significance of the hyperkalemia associated with spironolactone therapy was studied by analyzing 755 serum potassium values obtained on 29 patients with cirrhosis and ascites. The patients were classified as follows: 1) control group treated intermittently with combinations of conventional diuretics; and 2) spironolactone groups—(A) patients treated with spironolactone alone, and (B and C) nonazotemic and slightly azotemic patients, respectively, treated with spironolactone plus diuretics.Hyperkalemia was indicated in 3.3 per cent of 302 control serum potassium determinations, and in 48 per cent of 325 determinations made during spironolactone treatment. The increase in serum potassium concentration was more marked in the slightly azotemic group, although the initial levels were no higher than in the other groups of patients. Hyperkalemic intermittent paralysis associated with spironolactone therapy occurred in 5 patients. Studies of the urinary excretory patterns suggested a distal as well as a proximal tubular site of action of spironolactone. The significance of the tubular levels of spironolactone action in the development of hyperkalemia is discussed.
BACTERIAL L‐FORMS FROM URINARY‐TRACT INFECTIONS IN A VETERANS HOSPITAL POPULATION*
Authors: Conner James F. , Coleman Sylvia E. , Davis John L. , McGaughey Fay S. 
Published: April 2015

AbstractIn a study of 115 patients with chronic and acute urinary‐tract infections, 26 (23 per cent) were found to have bacterial L‐forms in the urine which could be cultured in a special hypertonic medium. The most common genera of bacteria producing these forms were Proteus, Pseudomonas and Escherichia‐Aerobacter. Most of the patients had cystitis, pyelonephritis or a general diagnosis of “urinary‐tract infection.” In a case of acute exacerbation of chronic pyelonephritis, the L‐form of Proteus mirabilis appeared after eradication of the parent form with chloramphenicol. The L‐form was sensitive to erythromycin even though the parent form was not, and after therapy with this antibiotic the L‐form did not reappear for a ten‐month period of study.L‐forms occur frequently enough in the urine to warrant culturing for these forms specifically and considering the possible significance of L‐forms in relation to the type of urinary‐tract infection and the type of antibiotic therapy used.
DRIP INFUSION PYELOGRAPHY: A STUDY OF 300 CASES IN A GERIATRIC POPULATION
Authors: Arcomano Joseph P. , Kraft Ernest 
Published: April 2015

AbstractThe urinary tract was studied by means of drip infusion pyelography (large volume of contrast material and fluid administered rapidly) in 300 male geriatric patients.Results were better and reactions were fewer and less severe than with conventional pyelographic techniques. The necessity for retrograde pyelographic examination, with its attendant morbidity, was significantly reduced. Drip infusion pyelography is recommended as the procedure of choice for evaluating the urinary tract in elderly patients.
DIAGNOSTIC PROGRESS IN LUNG CANCER: HISTORICAL PERSPECTIVE
Authors: Rosenblatt Milton B. , Lisa James R. 
Published: April 2015

AbstractThis article is a comprehensive review (including 72 references) of progress in the previously difficult diagnosis of lung cancer, from the early 19th century to the present time. The observations are grouped according to physical signs, sputum examination, x‐ray examination, bronchoscopy, thoracic surgery, ancillary procedures, and accuracy in diagnosis.The “epidemic” rise in lung‐cancer mortality since 1930 may well be the result of newly acquired diagnostic facilities.
SUCCESSFUL SURGERY FOR CARCINOMA OF THE SIGMOID IN A 92‐YEAR‐OLD MAN: CASE REPORT
Authors: Case Thomas C. 
Published: April 2015

AbstractA case is presented of carcinoma of the sigmoid in a 92‐year‐old man. The tumor, which almost completely occluded the lumen of the bowel, was removed surgically and a two‐layer, end‐to‐end anastomosis performed. No metastases were evident. Recovery was good and the patient is well at present—more than a year later. This is an example of good prognosis for control of cancer in a very old patient who was able to withstand a major surgical procedure.
CARCINOMA OF THE PANCREAS IN ASSOCIATION WITH CHRONIC PANCREATITIS
Authors: Weinstein Eugene C. 
Published: April 2015

AbstractA well‐documented case of carcinoma of the pancreas in association with chronic pancreatitis is presented. It is hoped that other physicians with similar experiences will accurately report their cases so that an intelligent decision can be reached as to whether pancreatic carcinoma is one of the many sequelae to chronic pancreatitis.
SURGICAL CONSIDERATIONS IN THE TREATMENT OF CEREBROVASCULAR INSUFFICIENCY IN THE GERIATRIC PATIENT*
Authors: Diethrich Edward B. , McCutchen John J. , Liddicoat John E. , De Bakey Michael E. 
Published: April 2015

AbstractExtensive experience (more than 3,000 cases) with the operative treatment of cerebrovascular insufficiency has led to the recognition of definite patterns of extracranial arterial occlusive disease and the development of several concepts basic to the preoperative, operative and postoperative managment of these patients. Four case histories are presented, with detailed illustrations.Although in the geriatric patient there is a high incidence of associated arterial lesions (e.g., aneurysm of the abdominal aorta and peripheral arterial occlusive disease) and of disorders of other organ systems (particularly the heart, lungs and kidneys), careful management of these cases has resulted in a low operative mortality and a high rate of long‐term relief of symptoms.
TREATMENT OF GERIATRIC PEPTIC ULCER WITH CHYMOTRYPSIN AND AN ANTIBIOTIC
Authors: Coblentz Alexander 
Published: April 2015

AbstractIn man, the healing of a benign, non‐endocrine peptic ulcer of the stomach or duodenum is basically a process of regeneration dependent upon freedom from exposure to the digestive enzymes, unneutralized acid and infection. Under these conditions the peptic ulcer heals within ten days.Our method involved the use of chymotrypsin—an enzyme inhibitor of gastric hydrochloric acid, the substrate for conversion of pepsinogen to pepsin—together with an antibiotic. Healing was obtained in 92 per cent of roentgenologically proven peptic ulcers in 146 geriatric patients, within ten days after starting treatment.Evaluation of most methods of peptic ulcer therapy is open to criticism because of lack of controls. In this study each patient served as his own control, since during a nine‐year period, other methods of treatment had failed.
SEPTIC ARTHRITIS CAUSED BY HEMOPHILUS INFLUENZAE IN AN ADULT: CASE REPORT
Authors: Lefkovits Aaron M. , Noonan Jimmy R. 
Published: April 2015

AbstractIn a 63‐year‐old Negro male, septic arthritis developed in the right knee (already the site of advanced degenerative changes) after an upper respiratory infection. The causative organism was identified as Hemophilus influenzae only after the fluid aspirated from the knee was inoculated into chocolate‐agar under CO2, four days after admission to the hospital. Re‐accumulated fluid was aspirated repeatedly from the joint. Antibiotics were administered intra‐articularly, intravenously and later orally. The patient also was treated symptomatically and with physiotherapy. He recovered satisfactorily to the point of being able to walk with crutches, and left the hospital eight weeks after admission.
CHANGING CONCEPTS IN THE TREATMENT OF URINARY INFECTIONS
Authors: Lampe William T. 
Published: April 2015

AbstractThe present treatment of urinary‐tract infections is unsatisfactory because of the high rate of relapse. Attempts to prevent relapses should include careful study of the urinary tract (with as little instrumentation as possible) to determine the presence or absence of urinary obstruction—a prime cause of infection. The urine should be examined by cultural techniques for detecting significant bacteriuria. This should be repeated at the end of two weeks of therapy and at one month, three months, six months and a year thereafter.The most important clinical aspect of treatment is long‐term follow‐up, checked by means of urine cultures. There is good evidence that long‐term treatment for one or two years with sulfamethoxazole or nitrofurantoin in combination with methenamine mandelate will reduce the recurrence rate of urinary‐tract infections; drug toxicity is low. The recommended short‐term (ten to fourteen days) course of treatment for initial infections is inadequate for the recurrent type. Recurrent urinary‐tract infections require long‐term treament in association with careful urine‐culture examinations at periodic intervals for one to two years.
ARTHROPATHY OF THE WRIST IN A PATIENT WITH DIABETIC NEURITIS
Authors: Berenyi Magdalena R. , Siegel Martin W. , Schwarz Gerhart S. 
Published: April 2015

AbstractA case of upper‐extremity destructive hypertrophic arthritis in a 64‐year‐old patient with diabetic neuropathy is presented. No previous report of such a lesion involving the upper extremity could be found.As an increasing number of well controlled diabetic patients attain a longer life span, the incidence of diabetic neuropathy will rise, as will the incidence of associated arthropathies.
AN INTEGRATED THEORY OF AGING
Authors: Carpenter Donald G. , Loynd James A. 
Published: April 2015

AbstractAn integrated theory of aging is proposed which consists of an interrelated grouping of other current theories. Each of these has had some success in explaining various separate phenomena of aging, but none has provided an explanation of all the phenomena associated with aging and death. The theories considered are: 1) cross‐linkage, 2) free‐radical, 3) collagen, 4) waste‐product, 5) rate‐of‐living, 6) stress, 7) diffusion, 8) mutation, 9) immunologic, and 10) cybernetic. The cybernetic theory is used as the framework within which the other theories serve as functional blocks, the key functional block being the cross‐linkage theory. Within the cybernetic framework, the various theories are aligned in two modes—the non‐genetic, and the genetic. The non‐genetic mode governs the organism's level of molecular efficiency, whereas the genetic mode governs the minimal level of molecular efficiency required for survival of the organism.The integrated theory of aging appears to answer satisfactorily the objections to the individual theories, and to offer a basis for fairly accurate theoretical prediction of the experimentally observed mortality curve.
SOCIAL REHABILITATION OF THE AGED: SOME NEGLECTED ASPECTS*
Authors: Lawton M. Powell 
Published: April 2015

AbstractThe first section of this article on some neglected aspects of social rehabilitation of the aged concerns the philosophy of rehabilitation. A general principle is that the probability of improvement is highest when the goal for the old person is set successively at only the next step higher than the current level of functioning. The personnel of the institution should be kept aware of the success of their efforts in attaining these realistic goals.The ensuing sections of the article contain recommendations for certain fresh approaches to various problems regarding application of the old person to a home for the aged, the waiting period, and the crucial entry period. Since change of residence constitutes an acute stress for many old people, appropriate psychological and social attention is very important and may set the course for the success of rehabilitation. Private space, social space and furnishings in the institution are discussed. The importance of the staff is dealt with from the viewpoints of the social role, the helping role, and the personal distance between employee and resident. The goal of rehabilitation in the institution extends even to death in an attempt to add dignity and self‐respect in the final phase of life.
THE CROSSLINKAGE THEORY OF AGING
Authors: BJORKSTEN JOHAN 
Published: April 2015

Abstract: For many decades the theory and practice of cross‐linking (bonding that ties two or more large molecules together side to side) have been developed in industry, but only since the 1940's has the theory been considered in the field of medicine as a primary reaction underlying age‐dependent changes.Crosslinking is damaging to the tissues and involves loss of elasticity, reduced swelling capacity, increased resistance to hydrolases and probably enzymes generally, and thus an increase in molecular weight and a tendency toward embrittlement. There is a growing amount of direct evidence and much indirect evidence for postulating the relationship between crosslinking and aging.Crosslinking agents present in the living organism include aldehydes, lipid oxidation products, sulfur, alkylating agents, quinones, free radicals induced by ionizing radiation, antibodies, polybasic acids, polyhalo derivatives and polyvalent metals. The latter four types of compound are slow‐acting but can also accumulate in the body to form a frozen metabolic pool. Sufficient amounts of all these potential crosslinking materials are present in the body to make the changes of aging unavoidable.
GERIATRIC OPHTHALMOLOGY: MAINTAINING READING ABILITY IN THE ELDERLY
Authors: DAVIDSON M. 
Published: April 2015

Abstract: Attention is called to the great importance in a total rehabilitation program of promoting the maintenance of reading ability among the elderly. This is a powerful tool for opening channels of communication across space and time. It counteracts the tendency of the elderly toward isolation, withdrawal and mental deterioration. The primary goal is the achievement of life‐long learning, a value that cannot be measured in dollars and cents.Manpower at present is quite inadequate for taking care of the total needs of our growing population, one‐tenth of which (the aged) consumes half of our available medical resources. This is particularly true in the field of eye care. Our limited goals involve less than 1 million of the aged, after eliminating the poorly motivated and those with poor ophthalmological prognoses.A brief outline is given of the progress made in providing better visual aids for persons with partial sight, and in the development of promising research.There is also urgent need for research on dyslexia in the aged and the potentiality of bibliotherapy in an attack on the problem.
SOCIAL DYSFUNCTION AMONG PSYCHIATRIC AND NON‐PSYCHIATRIC OUTPATIENTS*
Authors: Goodman Spencer P. , Schulthorpe William B. , Evje Margaret , Slater Phillip , Linn Margaret W. 
Published: April 2015

AbstractThere has been a need for a quantitative measure of social functioning in older subjects, in addition to the intuitive appraisal made possible by social work orientation. Our purpose was to determine, through the use of a newly developed scale, the dimensions and degrees of social dysfunction in schizophrenic and medical outpatients in a VA hospital. Three teams of two social workers interviewed 80 male subjects. One worker used the scale and another made only a global judgment or adjustment. Multivariate computer analysis showed that the ratings for emotional withdrawal, adaptive rigidity, lack of participation in the community, goallessness, and low self‐concept discriminated the two groups at beyond the .01 level. Total scores on the 21‐item scale correlated at r = .89 with the global judgments of adjustment made by social workers not using the scale.These results indicate validity for the scale, which measures dysfunction in personal, interpersonal, and performance areas. The findings also suggest that the scale—easily administered by social work practitioners—will lend itself to continuing research such as profiling samples of aging populations, or for teaching or diagnosis.
RESPONSE OF ISCHEMIC HEART DISEASE TO CHONDROITIN SULFATE‐A*
Authors: Morrison Lester M. 
Published: April 2015

AbstractOne hundred and twenty patients with demonstrable ischemic heart disease (IHD) or coronary heart disease (CHD)—suggested designation, ischemic coronary disease (ICD)—were divided into two groups of 60 patients each and observed for a study period of two and a half years. Treatment was randomly assigned, and comparisons were made on the basis of clinical evaluation and mortality and morbidity rates. Sixty patients were treated with the acid mucopolysaccharide, chondroitin sulfate‐A (CSA), in addition to regular medicinal and dietary regimens. Sixty comparable patients serving as controls were not given CSA, but otherwise were treated under similar dietary and medicinal regimens. CSA was given orally in tablet form; the initial dosage of 10 gm daily was reduced to 1.5 gm daily, and was well tolerated by all patients. No abnormal laboratory or clinical findings and no toxicity or side effects from CSA were noted.At the end of the 2.5‐year observation period, 21 of the 60 ICD patients in the control group had experienced acute cardiac episodes or myocardial ischemia; of these, 4 were fatal. The 17 survivors were hospitalized—7 with myocardial infarction, 7 with acute myocardial ischemia or coronary insufficiency, and 3 with non‐critical or transient myocardial ischemia. In the matched CSA‐treated group of 60 ICD patients, there were 5 deaths. Autopsies were conducted in all cases. One patient with myocardial ischemia died from a myocardial infarction. A second patient who died from myocardial infarction had persistent hypertension which often was difficult to control. A third patient, who had chronic atrial fibrillation and flutter, died from coronary insufficiency and cardiac congestive failure following a massive cerebrovascular hemorrhage. Two other patients died from non‐cardiac causes—one from a malignant cerebral astrocytoma, and the other from a skull injury which induced ventricular fibrillation. The surviving 55 patients of this group have not required treatment or hospital admission for acute cardiac symptoms or recurrent cardiac illness.The ratio of 21:3 for coronary episodes in the CSA group versus the non‐CSA group warrants further studies with caid mucopolysaccharides such as CSA and CSC. This would involve statistically designed and controlled studies on large groups of patients and possibly on sections of the normal adult population. These data could be invaluable in determining the feasibility of the therapeutic use of acid mucopolysaccharides for the prevention and treatment of ischemic coronary disease.
BRONCHOPNEUMONIA IN TERMINALLY ILL PATIENTS
Authors: Mrazek Svatopluk A. 
Published: April 2015

AbstractBronchopneumonia was found in one third of all autopsies at the VA hospital in Fayetteville, N.C. In about two thirds of the bronchopneumonia cases there was evidence of aspiration. The risk of bronchopneumonia is increased with old age, white race, length of hospital stay, and the presence of debilitating disease. This is particularly true in cases of cerebral arteriosclerosis, especially when associated with dysphagia. Aspiration due to dysphagia is a predominant cause of bronchopneumonia in these patients. The beginning of bronchopneumonia is usually insidious, the symptoms few, and the course often rapid. Meticulous preventive measures are more important than reliance upon diagnostic procedures and therapy.
THE GERIATRIC PROFILE INDEX: A SYSTEM FOR IDENTIFYING, MANAGING, AND PLANNING FOR GERIATRIC PATIENTS IN STATE HOSPITALS
Authors: Albers Dale A. , Howard Glen W. , Pasewark Richard W. 
Published: April 2015

AbstractThe Geriatric Profile Index (GPI) is a procedure for identifying at any given time the number and characteristics of the inpatient geriatric population of a state hospital, as an aid in fiscal and program planning that will maintain quality standards of care.The results of nearly three years' experience in Wyoming State Hospital can be summarized as follows: 1) The quick identification of the number and functional characteristics of the geriatric patients in the hospital prevents these patients from becoming lost among the general hospital population. 2) The GPI is a valuable aid in planning for the geriatric patient and his return to the community. Moreover, it provides a fairly consistent baseline with which to allocate and redeploy the hospital staff for the purpose of strengthening existing hospital programs and establishing new ones such as direct‐care services, physical therapy, geriatric social services, social remotivation, and community placement. Since its introduction, 30 per cent of our geriatric inpatient population have been returned to the community. 3) The GPI brings professional roles into sharper focus and delineates professional responsibility more clearly. It enhances communication between staff members at all levels because it lessens the use of professional jargon by providing a clear and concise nontechnical summary of the patient's situation, thereby minimizing the communication impediments often found in large organizations. It has antedated, and thus placed the hospital in early compliance with the Utilization and Review requirements of Medicare, Title XVIII. Its predictive quality has facilitated the development of new programs addressed to the needs of the elderly patient (Title XIX). It has also tended to refine staff thinking, in that it makes practitioners defend their diagnostic positions and clarify their concepts of practice.
OPEN‐HEART SURGERY IN PATIENTS OVER SIXTY YEARS OF AGE*
Authors: Bowles L. Thompson , Hallman Grady L. , Cooley Denton A. 
Published: April 2015

AbstractDuring an eight‐year period 54 patients over 60 years of age underwent open‐heart operations. All these patients were in the New York Heart Association's classifications III or IV.The most common lesions requiring operation were ventricular aneurysm and aortic stenosis. The over‐all hospital mortality rate was 20 per cent. Five patients died after discharge from the hospital, mainly because of ischemic heart disease. Advanced coronary artery disease also was a factor in 4 of the 11 hospital deaths.The mortality rate in elderly patients compares favorably with that in younger patients having similar lesions.It is concluded that advanced age should not be a deterrent to surgical therapy for patients with heart disease if the operation otherwise is indicated.
QUANTITATIVE RADIOGRAPHIC SURVEY TECHNIQUE FOR DETECTION OF BONE LOSS*
Authors: ALBANESE ANTHONY A. , EDELSON A. HERBERT , LORENZE EDWARD J. , WEIN EVELYN H. 
Published: April 2015

Abstract: Bone loss in adults is a problem of epidemiology, geography, biochemical individuality and nutritional history. In recent times, the problem has been further complicated by the extensive use of corticosteroids for the clinical management of arthritic diseases. Prolonged exposure to these substances is definitely associated with the onset of severe disabling osteoporosis.Our preliminary radiographic data on 369 males and 666 females indicate that subnormal bone density in terms of finger phalanx 5–2 measurements is more prevalent in “healthy normal” subjects than heretofore realized. The procedure described here for the early detection of subclinical osteoporosis appears to be a useful aid in determination of the etiologic factors and assessment of the beneficial effects of various therapeutic modalities. As a logical continuation of this study, a questionnaire has been designed to relate change in phalanx 5‐2 bone density to such data as vital statistics, medical history, medication, fluoride exposure and dietary habits of each participant in the study. A survey of the present and future radiographic and associated biochemical data in this frame of reference should prove helpful in the determination of optimal measures for the prophylaxis and management of osteoporosis.