bluuebunny/crossref_metadata_2025_split huggingface dataset:
Psychopharmacologic Investigations in Healthy Elderly Volunteers: MMPI Depression Scale†
Authors: Harmatz Jerold S. , Shader Richard I. 
Published: April 2015

ABSTRACTThe Depression Scale of the Minnesota Multiphasic Personality Inventory (MMPI) was used as a screening test for healthy volunteers in a psychopharmacologic research study. Data were collected on 43 men and 46 women under age 35 versus 33 men and 43 women over age 65 (plus a subsequent group of 40 men over age 65), and comparisons were made with more extensive data from the Mayo Clinic. The evidence indicates that elderly subjects differ strikingly from young subjects in their responses to items in the MMPI self‐ratings of depression. Revised information on normative responses is needed. At present there are too many problems of interpretation when the Depression Scale items are applied to the elderly.
Autopsy Data and Their Total Evaluation†
Authors: Cherry W. H. , Forbes W. F. 
Published: April 2015

ABSTRACTThe role of the autopsy is discussed in the study of the etiology of the current major causes of death (cardiovascular and neoplastic diseases) in developed countries. Evidence is accumulating for the importance of environmental factors in the etiology of these diseases. The study of regional differences in occurrence is described as a method of identifying specific factors. Maps are shown of mortality rates for all causes of death in Ontario counties for males aged 65–74 and 95+ during 1964–68. Some of the difficulties in obtaining data in this form, and in their analysis, are indicated. Regional mortality patterns can be interpreted by the use of associations with available regional socioeconomic measures, or by the use of regional data on trace‐metal levels in autopsy samples of human lung, rib, vertebra, kidney and liver. The methodology and the difficulties involved in the determination of trace‐metal levels in these tissues are discussed, as is the possible relevance of these levels to the study of degenerative diseases. All these considerations emphasize the valuable contributions of autopsy studies.
Collagenase in the Treatment of Dermal and Decubitus Ulcers
Authors: Rao D. B. , Sane P. G. , Georgiev E. L. 
Published: April 2015

ABSTRACTThe current management of decubitus ulcers, factors in wound healing and the role of enzymes in treatment are discussed. The therapeutic benefits of collagenase (Santyl) ointment in 21 patients are described, supplemented by serial color photographs. Statistical evidence is provided for the conclusion that collagenase ointment is an excellent adjunct to therapy.
Surgical Mortality in the Elderly
Authors: Santos Antonio L. , Gelperin Abraham 
Published: April 2015

ABSTRACTSurgical mortality rates were reviewed for the four‐year period 1970–1973, in a series of 2,186 operations. The majority of these operations were performed in patients aged 70 or older; of these, 116 were performed in patients of the 90+ age group. Predictably, the surgical mortality in the older groups was higher than in the younger groups. However, the overall mortality for patients aged 70 or older was 4.9 per cent as compared with 8 to 21 per cent for series reported in the literature. Gastrointestinal, biliary, and chest procedures carried a much higher mortality than did the other major categories. Minor surgical operations in the elderly should be approached with caution since they may be associated with a significant mortality rate. Nevertheless, elderly patients should not be denied surgical intervention, major or minor, on the basis of age alone when the operation can make their remaining years more comfortable.
Behavioral Disorders in the Elderly
Authors: Sadowski Adam , Weinsaft Paul 
Published: April 2015

ABSTRACTBased on the study of 40 patients in a unit of a large geriatric center, as well as on long overall experience, the problems of aged men and women with various emotional disorders are discussed. Case abstracts are presented to illustrate chronic organic brain syndrome, delirium, hallucinatory behavior, paranoid ideation, depression, and reactions triggered by physical illness. The geriatrician should be fully aware of all the interlocking factors in the patient's adjustment to his condition. Only in this way can the geriatrician and staff choose the best relevant therapy.
Metastatic Hemangiopericytoma Associated with Microangiopathic Hemolytic Anemia: Review and Report of a Case
Authors: Kupers Edward C. , Friedman Nathan B. , Lee Stephen , Wolfstein Ralph S. 
Published: April 2015

ABSTRACTThe hemangiopericytoma is an invasive tumor of vascular origin. No matter how benign the course and how circumscribed the mass, it must be considered a lesion with high malignant potential. In the case reported here, a hemangiopericytoma of the pancreas with metastasis to the liver was associated with microangiopathic hemolytic anemia in a 78‐year old woman. The anemia may have been present before the onset of metastasis. If so, it could have been a major factor in the breakdown of host response and could have initiated the malignant dissemination. Under these circumstances it could be an indicator of metastasis in patients with previously diagnosed tumors. However, there are many cases of metastatic malignancy associated with this anemia in which the opposite situation holds. The anemia is usually of extracorpuscular origin. Apparently intravascular coagulation caused by injury from tumor‐cell aggregates in small vessels induces erythrocyte fragmentation on fibrin strands. A vicious cycle of cell fragmentation, vascular injury and fibrin strand formation completes the course. Analysis of the findings should be based upon more than a strictly pathologic approach; it should also be related to the new discoveries in cancer research.
Membranous Nephropathy: An Overview
Authors: Salomon Mardoqueo I. , Hsu Konrad , Tchertkoff Victor 
Published: April 2015

ABSTRACTMembranous nephropathy (MN) accounts for about 20 percent of cases of the nephrotic syndrome. The importance of renal biopsy in establishing the diagnosis is emphasized. In the great majority of MN patients, no etiologic factor can be discerned. In a significant minority, MN appears to be a manifestation of sarcoidosis, diabetes, lupus, syphilis, malaria, or toxicity from heavy metals or drugs. In some cases the “cause” is neoplasia (including lymphoma) or a viral infection. Massive proteinuria, hypoproteinemia and edema are the principal manifestations of MN, finally resulting in renal failure. Treatment consists chiefly of diet and diuretic drugs. In the more pronounced cases, corticosteroids may have a favorable effect and in very resistant cases, cyclophosphamide is indicated. Judicious use of these modalities if often associated with the diminution or disappearance of the clinical signs of MN.
Craniopharyngioma in the Elderly Patient: Case Report
Authors: Schonder A. A. 
Published: April 2015

ABSTRACTA case is presented of craniopharyngioma in a 78‐year‐old woman. The symptoms and signs, except for those in the visual fields, were nonspecific. A review of the literature shows that this case history is representative of craniopharyngioma in the older adult. The findings in this elderly patient are contrasted with the signs and symptoms of craniopharyngioma in children.
A Geriatric Functional Rating Scale to Determine the Need for Institutional Care
Authors: Grauer H. , Birnbom F. 
Published: April 2015

ABSTRACTThis study was carried out to validate a rating scale which could serve as a guide in determining the need for institutional care. The scale assesses the subject's physical and mental disability, balanced against his ability to function and the support available from relatives and community resources. Cut‐off points were tested by the use of an 18‐month follow‐up interval. Initially, 130 aged men and women from three different settings were rated. At the time of follow‐up eighteen months later, 83 per cent of the subjects who had obtained an initial score indicative of their inability to function in the community were either dead or in an institution. In contrast, 90 per cent of those who obtained an initial score indicating that they were able to continue in the community, were not in an institution at the time of follow‐up. The rating scale can be used not only to help decide the need for institutional care, but also to help determine the most suitable setting for the patient if placement is necessary.
Transitional‐Cell Cloacogenic Carcinoma of the Anal Canal: Case Report
Authors: Case Thomas C. , Gillooley John F. 
Published: April 2015

ABSTRACTA case is presented of transitional‐cell cloacogenic carcinoma of the anal canal in a 66‐year‐old woman. Eight years previously she had received radiation therapy for early carcinoma of the uterine cervix, but there was no evidence of recurrence. The rectal carcinoma was therefore regarded as a second primary malignant tumor. This point in differential diagnosis was considered important because of its bearing on the plan of treatment. After abdominoperineal resection of the tumor, the prognosis seemed favorable.
Amyloid in the Aged Heart: Frequency and Clinical Significance
Authors: Wright John R. , Calkins Evan 
Published: April 2015

ABSTRACTCardiac amyloid accumulation is a common autopsy finding in elderly persons, the frequency increasing with each advancing age decade. In most cases the deposits are microscopic, confined to the atrial subendocardium, and of dubious significance. In a few cases, however, there is much more extensive cardiac involvement, with infiltration of the ventricular musculature and intracardiac conduction system. In the authors’ recent autopsy study of 100 patients over 60 years of age, 10 had diffuse cardiac amyloidosis with biventricular involvement. Microscopically, the amyloid deposits often resembled foci of interstitial fibrosis. Significant cardiac enlargement (weight > 380 gm) was present in only 2 of these patients, and in only one of them were the clinical signs and symptoms clearly attributable to the amyloid infiltration. It was difficult to assess the possible contribution of ventricular amyloid to congestive failure since most of the patients also had coronary arteriosclerosis.In the aged, clinically significant cardiac amyloidosis associated with cardiac enlargement appears to be part of a disease spectrum more commonly characterized by focal, clinically insignificant cardiac amyloid deposits. Yet several features suggest that senile cardiac amyloidosis may differ from the clinically significant cardiac amyloidosis occasionally seen in younger patients.
Drug Therapy for Cardiovascular Disease in the Aged
Authors: Kennedy Robert D. 
Published: April 2015

ABSTRACTCardiovascular diseases and their treatment in the aged are discussed under the headings of ischemic heart disease, hypertension, cardiac failure (with special reference to the use of diuretics and digoxin), infective carditis and thyroid disorders. Advanced age modifies the approach to treatment; the choice of drugs and the dosage must be adjusted accordingly. Possible drug interactions should also be considered. A rehabilitation program is of great benefit for many elderly cardiac patients. It should be planned individually and involve psychologic and environmental factors as well as medical therapy. After successful treatment of the acute episode, even the aged patient can undertake rewarding activities in his remaining lifetime.
Psychosomatic Rehabilitation of Elderly Persons
Authors: Hutterer Ilona , Dénes Zsuzsanna 
Published: April 2015

ABSTRACTThe psychosomatic rehabilitation of the elderly is an important task from both social and economic viewpoints. For psychic rehabilitation, moderate activity and the playing of games (such as chess, dominoes or cards) are recommended. Based on experiences with a group of 50 persons of the 70–90 age group, bridge playing is an especially desirable form of recreation. For somatic rehabilitation, physical exercise is a valuable aid, based on experiences with 338 partially disabled patients of the 51–81+ age group.
Measuring Dementia
Authors: Birkett David Peter , Boltuch Bruce 
Published: April 2015

ABSTRACTMaudsley Tests of the Sensorium (used by clinicians to assess verbal memory and orientation) and Kendall's Memory for Design (used by psychologists to assess visual memory) were employed to differentiate between elderly patients with organic brain damage (neurologic disease, chiefly stroke) and those with functional psychiatric disorders which had been present in youth. There were 25 patients in each group. Both tests differentiated organic from functional disorders. There was no statistically significant difference in the effectiveness of the two tests.
Age‐Associated Statural Loss and Socioeconomic Status
Authors: Himes John H. , Mueller William H. 
Published: April 2015

ABSTRACTAssociations between socioeconomic score (SES) and age‐related statural loss were investigated in a cross‐sectional sample of 718 adults from rural Colombia. Estimates of statural aging were calculated by estimating the maximum statural attainment of each subject from statural relationships with subischial length. Statural loss was correlated with SES, r = –0.06 (not significant) for men, and r = –0.14 (p < 0.01) for women. Subjects with a high SES tended to lose stature at a slower rate than those with a low SES. For women, the difference in rates of statural loss between the two SES groups was significant (p < 0.05).
Mental Impairment in the Elderly: Medical‐Legal Assessment
Authors: Gunn Albert E. 
Published: April 2015

ABSTRACTAs life expectancy has lengthened, research has been increasingly directed toward improving the quality of life in old age. Social agencies work in the field of socioeconomic factors, and medical research seeks the causes and remedies for mental deterioration. It is time to review the legal status of the mentally impaired elderly and to ensure that our lawmakers are cognizant of the changing situation. Before any characterization of mental capacity is made, a comprehensive investigation should be carried out to make sure that no potentially correctable physical disorder underlies perceived mental disabilities. In the past, the law has taken a global view of mental capacity. A person was adjudged either competent for all purposes or incompetent on a similar universal basis. A system is suggested to change this outdated approach and to assess separately the divisible components of mental capability. This would permit the courts to delineate their judgments and allow persons with partial mental incapacities to live a fuller life than if they had been declared totally incompetent.
Psychologic and Behavioral Assessment of Geriatric Patients: A Review†
Authors: Goga John A. , Hambacher William O. 
Published: April 2015

ABSTRACTA review of the literature and a study conducted at a state hospital indicated that valid psychologic test results on geriatric patients are often difficult to obtain. Reasons most frequently offered by psychometricians for inconclusive or incomplete findings were the patient's uncooperativeness, unavailability, or severity of physical/mental dysfunction. A need was apparent for alternate assessment instruments for measuring current and potential levels of functioning in the elderly. In the investigation, attention was focused on the following areas: 1) studies in which the more traditional measurements were used, 2) articles stressing the need for caution in using the traditional techniques, and 3) studies in which behavioral rating scales and checklists were used as the evaluative devices. A large number of checklists and behavioral rating scales were found to be relevant and applicable to an institutional setting. Five were selected and are reviewed in depth.
Attempted Suicide Among the Aged
Authors: Sendbuehler J. M. , Goldstein S. 
Published: April 2015

ABSTRACTAlthough the rate for suicide in old age is high, the rate for attempted (unsuccessful) suicide is low. Among the elderly, suicide‐attempt groups have more physical disorders, more psychoses, and more psychopathologic findings, and are under‐represented demographically. Fifty percent of the elderly suicide attempters have organic brain syndrome (OBS), compared to only 5–10 percent of the “normal” population over age 60. Among what might be expected to be a high‐risk suicide population, OBS apparently interferes with the success of suicide attempts by impairing coordination, planning, determination, and awareness of reality.
An Evaluative Study of Silver's Cerebral Function Test
Authors: Ross Nola , de L. Horne David J. 
Published: April 2015

ABSTRACTThe aim of this study was to evaluate the usefulness of Silver's Cerebral Function Test in predicting the management and placement of patients admitted to a psychogeriatric hospital. Overall, 205 consecutively admitted patients and 54 age‐matched controls living in the community were examined, thereby greatly extending the normative data for the test. The results indicated that this brief, easily administered test could distinguish the patients from the controls. Also, the selected cut‐off score of 28 significantly differentiated between patients able to benefit from rehabilitation and occupational therapy programs and those who required primarily maintenance care. The test‐retest reliability of the test was good (r = 0.91).
Identifying Needs and Services for the Aged†
Authors: Bayne J. R. D. , Caygill J. 
Published: April 2015

ABSTRACTThe Assessment and Placement Service (APS) of the Hamilton‐Wentworth District Health Council assists health professionals in identifying the needs of persons with chronic disabling diseases, and in finding appropriate resources or programs. More than 80 percent of the 9,300 persons referred between September 1971 and December 1975 were over the age of 64. Although most referrals were local, some came from as far away as British Columbia and Florida for persons wishing placement locally. Of the 2,005 persons referred and placed in 1975, 1,063 came from acute disease hospitals, 201 from other institutions, 628 from the community within this District, and the remainder from elsewhere. There were 1,187 women, of whom 89.5 per cent were over the age of 64, and 811 men, of whom 65.8 per cent were over that age. In the opinion of their physicians, only 20 percent of all persons referred had normal memory, and only 13 percent had normal judgment. In the 64+ age group, 71.1 percent of the women were widows, and 25.9 percent of the men were widowers. One‐third of those referred were living alone, and one‐fourth with a spouse only. For placement, 453 patients went to private residences or boarding homes, often with the support of community services, and the remainder went to various institutions according to identified needs. Follow‐up contact one month later showed conditions to be satisfactory in most instances. Deficiencies in the health care system were identified and reported to the Health Council.
Increased Appetite (Bulimia) in Parkinson's Disease
Authors: Rosenberg P. , Herishanu Y. , Beilin B. 
Published: April 2015

ABSTRACTFive patients with Parkinson's disease, when first seen, manifested an abnormal increase in appetite. This bulimia decreased concomitantly with clinical improvement in the parkinsonism during treatment with L‐dopa plus a decarboxylase inhibitor. A possible role of dopamine in the central control of appetite is discussed. Abnormally increased appetite (bulimia) is proposed as a new autonomic sign in Parkinson's disease.
Effect of Age and Weight on Plasma Glucose and Insulin Responses in the Rat†
Authors: Bracho‐Romero Enoc , Reaven Gerald M. 
Published: April 2015

ABSTRACTPlasma glucose and insulin responses to orally administered glucose were determined in rats of varying ages and weights. The results indicated that glucose tolerance tends to deteriorate as rats grow from 1 month to 9 months of age. This change in glucose tolerance was associated with an increase in the response of plasma insulin to glucose, consistent with the hypothesis that the decline in glucose tolerance is due to a loss of normal insulin sensitivity. The changes in glucose and insulin responses could not be explained entirely on the basis of the associated weight gain. They seemed to be at least partially secondary to either age or an age‐related factor other than obesity.
Acute Drug Testing with Nitrates: Angina Relief during Treadmill Exercise
Authors: Fletcher Gerald F. , Alimurung Benjamin , Watt Edward 
Published: April 2015

ABSTRACTTo evaluate the effect of sublingual nitroglycerin (N) and chewable isosorbide dinitrate (I) in patients with angina pectoris, 12 subjects underwent treadmill exercise to the point of onset of angina. At that juncture, N or I or placebo (P) was administered and walking was continued until moderately severe angina recurred. For those patients who completed the initial 10‐minute exercise period, testing was repeated until moderately severe angina recurred or until a total test time of three hours elapsed. Retesting ensured that each patient was tested separately with N, I and P within a two‐week period. Within the I group, four patients experienced the onset of angina relief (AR) at 10 minutes (′) 6 seconds (″) ± 3′ 4″ with a mean recurrence time (RT) of 154′ 3″ ± 4′ 27″ (P ≤ 0.05), for a significant difference. Within the N group, six patients had AR of 8′ 3″ ± 1′ 1″ with an RT of 49′ 39″ ± 1′ 15″ (P ≤ 0.01), for a significant effect. Within the P group, only one patient experienced AR. For all other patients in each group, testing was terminated because of moderately severe angina in the 5–8′ period of the first test. In comparing subgroups for RT during I therapy (4 patients) versus N therapy (6 patients), a significant difference was noted (154′ 3″ ± 27″ versus 49′ 39″ ± 1′ 15″) (P < 0.05). The data suggest a possible benefit of I in selected patients. The effect may last as long as three to four hours. There is also an enhanced benefit of N with the patient in the upright position. This effect may last as long as 40–50′. Treadmill testing is recommended with nitrate administration to determine which drug (I or N) is the more suitable for the specific patient.
Incidence of Polypharmacy in a Long‐Term Care Facility
Authors: Kalchthaler Thomas , Coccaro Emil , Lichtiger Simon 
Published: April 2015

ABSTRACTThe incidence of polypharmacy was investigated in a 200‐bed long‐term care facility. One hundred residents were drawn at random for the study. The average number of drugs prescribed per patient was 3.33, and the average number of pills was 6.34 daily. The most frequently prescribed drugs were the analgesics, followed in order by antihypertensive agents, cardiotonic preparations and antimicrobials. The literature is reviewed with respect to the incidence, causes and end‐results of polypharmacy. It is recommended that long‐term care facilities develop enlightened and aggressive pharmacy committees to monitor and evaluate drug use routinely in an institutional setting.
Utilization of Hospital In‐Patient Services by the Elderly
Authors: Polliack M. R. , Shavitt N. 
Published: April 2015

ABSTRACTA survey was made of the patterns of hospital admission for patients aged 65 or older in an urban practice under the management of a primary care team composed of a family physician, nurse, and medical social worker. Results showed that the elderly used a higher percentage of in‐hospital facilities than did the younger age groups. However, admission rates were significantly lower than the local national rates, and involved relatively fewer cases of long‐term illness. No patients over 65 were admitted for psychiatric care during the one‐year period of observation. This was attributed to the provision of planned domiciliary programs for supervision of patients with long‐term illness within a coordinated framework of primary medical care.