bluuebunny/crossref_metadata_2025_split huggingface dataset:
Carcinoma of the Thyroid in Patients Aged 50 or Older*
Authors: HOFFMAN ELMER 
Published: April 2015

ABSTRACT:At the Sinai Hospital of Baltimore, carcinoma of the thyroid was studied in 60 patients whose ages ranged from 50 to 79 years (Series AA). Data on the author's Series A (185 patients of various ages) and data from reports in the literature (children or adults of various ages) are used for comparison. Carcinoma of the thyroid is fairly common in the 50+ age group, constituting 32 per cent of the cases in patients of all ages (Series A). In the patients aged 50 or older (Series AA), the ratio of females to males was 5.7:1.0 versus 3.9:1.0 for patients of all ages. The thyroid carcinoma was multifocal in 18 per cent of the elderly patients. It was found incidentally upon physical examination in almost two‐thirds of the cases. Radioiodine tracing was of little help diagnostically. The best criterion for diagnosis is a high index of suspicion on the part of the physician. If thyroid nodules are treated aggressively, carcinoma can be diagnosed earlier. Often a preoperatively palpable nodule is not the one identified microscopically as containing carcinoma. Frozen‐section diagnosis can be misleading; in 46 per cent of Series AA, the frozen section was reported as benign whereas the permanent sections were reported as carcinoma. The treatment of choice is total thyroidectomy followed by radioiodine therapy if any foci of carcinoma are found by postoperative scanning. Prophylactic removal of lymph nodes is of no value. Thyroid substitution therapy should be started as soon as possible after operation. With use of the author's methods, postoperative tetany and vocal cord paralysis can be avoided. The mortality rate for thyroid carcinoma in the 60 patients of the 50+ age group was 25 per cent. Of the 15 deaths secondary to metastases, 7 were from solid or anaplastic, 5 from follicular, and 3 from papillary or mixed papillary carcinoma. Thus the papillary type is not always benign, as described by some authors. Thirty of the 60 patients were traceable five or more years after surgery. Of these, 10 had died from thyroid carcinoma, 1 had died from another cause, and 3 were alive but with metastases; however, 16 were alive and free of thyroid carcinoma.
Menopausal Headaches—Psychogenic or Metabolic?*
Authors: GREENBLATT ROBERT B. , BRUNETEAU DANIEL W. 
Published: April 2015

ABSTRACT:Constant, adequate dosages of estrogen, androgen or estrogen‐androgen combinations provide relief from the migraine and migrainoid headaches often experienced by menopausal women. This form of therapy employs natural physiologic hormones in preference to synthetic nonphysiologic agents such as ergotamines, barbiturates or addictive drugs. In the author's studies of hundreds of women with menopausal headaches, such hormones administered by pellet implantation gave beneficial results superior to those obtained by oral or parenteral administration.
Pulmonary Infections in Elderly Patients: Treatment with Cefazolin†
Authors: Katz David , Eliasson Gudmundur 
Published: April 2015

ABSTRACTThe effects of cefazolin were studied in 15 hospital patients (average age, 67) with respiratory‐tract infections. The infections were chiefly bronchopneumonia caused by organisms such as D. pneumoniae, Staph. aureus, or E. coli. In 13 of the 15 patients the results were excellent to good (eradication of the primary pathogen and clinical improvement); in the other 2 patients the response was fair. Intramuscular injection was well tolerated and only one patient complained of pain at the site of injection; no other adverse clinical effects were observed. In the laboratory determinations, including liver and kidney function tests, the only abnormalities were 2 cases in which the Coombs' test gave positive results without hemolysis. Cefazolin seems to be a safe and effective antibiotic for the treatment of respiratory‐tract infections caused by cefazolin‐susceptible organisms.
Prevalence of Hypertension among the Elderly in an Urban Community
Authors: Cohen Carl I. 
Published: April 2015

ABSTRACTThe results of a hypertension screening project conducted in senior citizen agencies in Manhattan are presented. The prevalence of hypertension among elderly females tended to conform to the data of the Nation Health Survey of 1960–62, but the prevalence among elderly males was much higher than in the National Survey. The prevalence of hypertension varied inversely with the educational level. Various implications for future medical evaluations of the elderly are discussed, based on the clinical and social data obtained.
Gero‐Education†
Authors: Ross C. Howard 
Published: April 2015

ABSTRACTThe official representative of the American Geriatrics Society reports on the 27th Annual Conference on Aging held at Ann Arbor, Michigan, August 5–7, 1974. The subject matter revolved about the aged population and State‐wide systems of education. Plenary sessions, workshops, seminars and discussion groups filled three busy days. Higher education played a most important role in planning the training of professional and administrative personnel in the various fields of gerontology. Research programs were emphasized, as were educational opportunities for the elderly.
Primordial Follicles with Normal Oocytes in the Ovaries of Postmenopausal Women†
Authors: Costoff Allen , Mahesh Virendra B. 
Published: April 2015

ABSTRACTIn ultrastructural studies, the ovaries of postmenopausal women were compared with those of pre‐ and perimenopausal women. Primordial follicles containing apparently normal oocytes were found in all postmenopausal ovary samples. Differentiating follicles were often found in these samples, but they were in various states of atresia. The findings suggest that the menopause does not result exclusively from exhaustion of the primordial follicles.
Bilateral Lymphosarcoma of the Breast
Authors: Case Thomas C. 
Published: April 2015

ABSTRACTA case is presented of bilateral lymphosarcoma of the breast in a 77‐year‐old woman. The pre‐admission surgical history recorded a mastectomy in July 1972, for lymphosarcoma of the right breast. She had been well until shortly before admission in March 1974 because of a tumor in her left breast. This proved to be lymphosarcoma. Treatment consisted of a left mastectomy. At that time there were no signs of axillary or systemic involvement. Later, evidence of systemic lymphosarcomatosis necessitated starting chemotherapy.
Improvement of Physical Function after Stroke: Surgical and Orthotic Management†
Authors: Waters Robert , Rhoades Marques , Montgomery Jacqueline 
Published: April 2015

ABSTRACTInitial and subsequent programs for the orthotic and surgical management of the post‐stroke patient are outlined, particularly with regard to impairment of the lower extremities in hemiplegic patients. New developments in functional electrical stimulation are described.
Management of Gallstones in the Aged†
Authors: Ratner Jack T. , Rosenberg Gilbert M. 
Published: April 2015

ABSTRACTCalculous gallbladder disease is the most common indication for intra‐abdominal surgery in the elderly. Feeding bile salts may possibly increase the solubility of cholesterol in bile and may cause diminution in the size of radiolucent gallstones, the principal ingredient of which is cholesterol. However, indications for such treatment are still not clear, and long‐term effectiveness and safety still have to be evaluated. If the aged patient with gallstones has severe symptoms, is a good medical risk and is not demented, surgical treatment should not be denied because of advanced age. If the patient has “silent” or “dyspeptic” gallstones and is a poor risk or demented, surgical therapy should be postponed at least temporarily, in the hope that medical methods for dissolving gallstones soon will be perfected.
Day Care Services: An Alternative to Institutional Care†
Authors: Mehta Nitin H. , Mack Christopher M. 
Published: April 2015

ABSTRACTThe day care program at St. Camillus Nursing Home in Syracuse, New York is described. The growth rate of the program, the observed benefits to the participants, and acceptance by their family members indicate its value to the community. The admission criteria are well defined and non‐restrictive, and there is a wide scope of services. However, a greater number of participants and expansion of the services would be feasible if Medicare patients could be included in the program besides the present Medicaid and private physician referrals. Such reimbursement should be provided for the sake of participants and their families, as well as for the economics of the total health structure. This would open the doors for day care programs in many other communities across the nation.
Auditory and Visual Memory Losses in Aging Populations
Authors: Boyle Edwin , Aparicio Adolfo M. , Kaye Jonas , Acker Marjorie 
Published: April 2015

ABSTRACTSeventy‐four men and women (age range, 44–77 years) were tested for short‐term auditory and visual memory as part of a larger series of memory and cognitive function tests. All test scores for visual memory, including facial photograph recognition when a sequence requirement was adhered to, showed a significant decline (p < .05) in a comparison of subjects aged 44–54 and subjects aged 55–64. This decline was not observed with the two tests of auditory memory. Thus the data indicate that short‐term visual memory may be more susceptible to aging than is auditory memory.
Ibuprofen versus Buffered Phenylbutazone in the Treatment of Osteoarthritis: Double‐Blind Trial
Authors: Moxley Thomas E. , Royer George L. , Hearron Martha S. , Donovan James F. , Levi Leon 
Published: April 2015

ABSTRACTIn a double‐blind multiclinic trial, a new nonsteroidal anti‐inflammatory agent (ibuprofen) was compared with an established therapeutic agent (phenylbutazone‐alka) for the treatment of osteoarthritis. Of the 159 patients from the 17 contributing clinics, 144 completed the four weeks of therapy. More than 60 per cent of them reported improvement in exercise‐related pain by week 4, and there was no significant difference between treatment groups. The patients' and the physicians' evaluations of the total state of disease, as well as range‐of‐motion and functional tests, demonstrated similar degrees of improvement in both treatment groups. The incidence of side effects was within acceptable limits, and the frequency distribution was similar in both groups. Of the 70 reported side effects, 29 were considered by the investigator (blind trial) to be drug‐related—11 in association with ibuprofen and 18 with phenylbutazone‐alka. Hematologic and blood chemical studies, as well as urine and stool examinations, yielded normal results with the exception of a reduced mean value for serum uric acid and a slightly elevated mean value for SGPT in the phenylbutazone‐alka group.
Iatrogenic and Nurisgenic Effects of Prolonged Immobilization of the Ill Aged†
Authors: Miller Michael B. 
Published: April 2015

ABSTRACTThe kinesio, psychopathologic and psychosocial effects of prolonged immobilization of the ill aged are outlined. The iatrogenic (physician‐induced) and nurisgenic (nurse‐induced) factors related to such functional disabilities are described. Illustrative case histories are given. The syndrome is reversible. Thus physicians and nurses have a continued responsibility to support a sustained rehabilitation program for these patients. The biochemical effects of prolonged inactivity indicate that immobilization of the elderly patient results in adverse physical and psychologic phenomena.
Failure by a Group of Elderly Men to Use a Preventive Health Service
Authors: Elwood Thomas W. , Oakes Thomas W. 
Published: April 2015

ABSTRACTThe perceptions of 25 white males (age range, 53–62) were studied in relation to use of multiphasic screening. Each of these men had been urged repeatedly to take advantage of this service but had failed to do so. The multiphasic examination itself was free, so cost was not an inhibiting feature. This report deals with the proffered reasons why these men did not take the screening examination. The factors could be classified as: 1) social influences, 2) health care setting, 3) beliefs about health, 4) use of alternative forms of care, 5) the time involved for testing, and 6) disinterest. A discussion of some individual responses is included. Recommendations are made for structuring more effective delivery of health care services for the elderly.
Left Ventricular End‐Diastolic Pressure in Anginal Patients: Lack of Correlation with New York Heart Association's Functional Classification
Authors: Prakash Ravi , Aronow Wilbert S. , Khemka Mahaveer 
Published: April 2015

ABSTRACTThe New York Heart Association (NYHA) recently designated functional classifications I, II, and III for angina. In the authors' series of 80 male anginal patients, observations were made on the mean left ventricular end‐diastolic pressure (LVEDP) at rest and after left ventriculography, and on the percentage of anginal patients with an abnormal LVEDP under these respective circumstances. The findings indicated no significant differences on the basis of NYHA classifications I, II, and III. In the authors' opinion, the NYHA functional classification cannot be used to distinguish the presence or absence of abnormal left ventricular function in Class I, II, and III anginal patients.
Operative and Nonoperative Risks in the Cardiac Patient†
Authors: Sapala James A. , Ponka Joseph L. , Duvernoy Wolf F. C. 
Published: April 2015

ABSTRACTFour hundred and sixteen patients with documented arteriosclerotic heart disease (ASHD) underwent 424 diagnostic and therapeutic surgical procedures during the year 1970 at the Henry Ford Hospital. They were classified according to the specific clinical manifestation of their cardiac abnormality. Patients with a history of old, well‐compensated myocardial infarction, and those with cardiac arrhythmia, bundle‐branch block, congestive heart failure and A‐V block (pacemaker‐protected) but no evidence of previous myocardial infarction fared almost as well as subjects of the same age without cardiac disease, and were considered to run the lowest operative risk. Patients with angina, especially if there was a history of infarction, were an intermediate risk in terms of complications and mortality. Patients with a history of previous infarction complicated at the time of the surgical procedure by arrhythmia, A‐V block, bundle‐branch block, or congestive heart failure were in the “highest risk” category. A severe A‐V block indicated the need for insertion of a “prophylactic” pacemaker before any attempt at a diagnostic or therapeutic procedure. No patient with clinical or electrocardiographic evidence of a recent infarction (less than three months' duration) should undergo any elective surgical procedure under any form of anesthesia unless the surgeon is prepared for a high mortality rate that may approach 90 percent. In contrast, the patient with old, well‐compensated myocardial infarction and no evidence of dysrhythmia, block or congestive failure can tolerate even a major surgical operation under any form of anesthesia extremely well.
A Treatment Typology for the Elderly Alcohol Abuser†
Authors: Rathbone‐McCuan Eloise , Bland John 
Published: April 2015

ABSTRACTAlcohol abuse is a serious, though often unrecognized and untreated, problem among the elderly. Treatment is handicapped by the clinician's frequent failure to understand all aspects of alcoholism, and by the lack of adequate treatment resources. Physical, mental and social problems complicate the situation. The Levindale Geriatric Research Center has developed a diagnostic and treatment typology which involves problems with alcohol, health, and the social support system in determining the appropriate environment and treatment resources for these patients. This method has immediate value for clinical practice, and has long‐range value as a framework for planning integrated and comprehensive treatment services.
A Short Portable Mental Status Questionnaire for the Assessment of Organic Brain Deficit in Elderly Patients†
Authors: Pfeiffer Eric 
Published: April 2015

ABSTRACTClinicians whose practice includes elderly patients need a short, reliable instrument to detect the presence of intellectual impairment and to determine the degree. A 10‐item Short Portable Mental Status Questionnaire (SPMSQ), easily administered by any clinician in the office or in a hospital, has been designed, tested, standardized and validated. The standardization and validation procedure included administering the test to 997 elderly persons residing in the community, to 141 elderly persons referred for psychiatric and other health and social problems to a multipurpose clinic, and to 102 elderly persons living in institutions such as nursing homes, homes for the aged, or state mental hospitals. It was found that educational level and race had to be taken into account in scoring individual performance. On the basis of the large community population, standards of performance were established for: 1) intact mental functioning, 2) borderline or mild organic impairment, 3) definite but moderate organic impairment, and 4) severe organic impairment. In the 141 clinic patients, the SPMSQ scores were correlated with the clinical diagnoses. There was a high level of agreement between the clinical diagnosis of organic brain syndrome and the SPMSQ scores that indicated moderate or severe organic impairment.
Differential Diagnosis of Rheumatic Disease in the Elderly†
Authors: O'Duffy J. Desmond 
Published: April 2015

ABSTRACTTo illustrate the diagnostic problems of rheumatic disease in patients over 60 years of age, 4 cases are presented: 1) osteoarthritis, 2) late‐onset rheumatoid arthritis, 3) polymyalgia rheumatica, and 4) pseudogout with crystalline synovitis. In each case the correct diagnosis should have been suspected from the history and physical examination alone, with the laboratory and x‐ray findings providing supportive evidence.
Medication Procedures in a Nursing Home: Abuse of PRN Orders
Authors: Howard John B. , Strong Kenneth E. , Strong Kenneth E. 
Published: April 2015

ABSTRACTNursing home patients often receive more drugs than needed. Drug incompatibilities frequently are found, and PRN orders are apt to be overused. Regulatory agencies require periodic physician review in the hope of eliminating these loose prescribing habits. A study was made of the drugs prescribed for 98 patients in a proprietary nursing home. The principal findings were that PRN orders can indeed be inappropriate and indiscriminately followed, and that the multiplicity of drugs often prescribed can lead to drug incompatibilities and to additional illness of the patient. Concern is expressed about the medication review process currently in vogue in nursing homes.
The Use of Mechanical and Chemical Restraints in Nursing Homes
Authors: Covert Anthony B. , Rodrigues Theresa , Solomon Kenneth 
Published: April 2015

ABSTRACTThe use of mechanical and chemical restraints in nursing homes is a common practice, fraught with potential abuse. The patient's freedom of movement and right to an adequate medical and psychiatric evaluation are of the utmost importance. Restraints should be used only as a last resort and should not be a substitute for inadequate staffing or incomplete medical appraisal. Guidelines are offered that maximize the patients’ freedom, maintain medical responsibility, and assure safety. Alternatives to the use of restraints are discussed.
Geriatric Profile of Thomas Jefferson (1743–1826)†
Authors: Sherman E. David 
Published: April 2015

ABSTRACTThis geriatric profile specifically reflects the impressive achievements of Thomas Jefferson during the years of his retirement (ages 66–83) following a distinguished political career culminating in the Presidency. President Monroe sought his advice even after the age of 80, and Jefferson's reasoning was instrumental in the formulation of the Monroe Doctrine. Education was a foremost priority in retirement. He was responsible for the establishment of the University of Virginia, in which his versatility was manifested as architect, builder, and fund raiser. Jefferson was a man of breadth and extraordinary vision for his time, and has come to be known as the “Father of American Democracy.” The basic concepts of his philosophy, including the realm of aging, remain valid today—150 years after his passing.
Mental Status Questionnaire for Organic Brain Syndrome, with a New Visual Counting Test
Authors: Fishback David B. 
Published: April 2015

ABSTRACTNinety aged patients at the Philadelphia Geriatric Center were asked to give answers to a 35‐item mental status questionnaire which included a new visual counting test. By this means it was found that 20 of the 90 subjects were not mentally impaired, but 34 had mild dementia, 17 moderate dementia, and 19 severe dementia. These results proved to be well correlated with the clinical findings. The test records showed that as dementia develops, the first thing to be forgotten is the awareness of time, place and recognition (in that order). Then the ability to count disappears. As mental oblivion intervenes, the last thing the patient forgets is his/her own name. It was also noted that patients with mild senile dementia fared better when kept with a similar group than with patients who have moderate or severe dementia.
Ear‐Lobe Creases and Heart Disease
Authors: Doering Carmen , Ruhsenberger Chris , Phillips David S. 
Published: April 2015

ABSTRACTIn 50 patients with coronary heart disease (CHD) and 38 controls, comparative data on age, sex, serum cholesterol level, hypertension, obesity, diabetes, smoking habits, and ear‐lobe creases were analyzed statistically. After adjustment for age differences, the factors which chiefly distinguished the two groups were the incidences of smoking, obesity, diabetes, and ear‐lobe creases. Of these, the ear‐lobe crease seemed to be correlated best with CHD, and may prove to be a useful diagnostic sign.
Palindromic Rheumatism: An Allergic Manifestation?
Authors: Margolis Jack , Margolis Lawrence S. 
Published: April 2015

ABSTRACTA case of palindromic rheumatism is presented in which the arthritic attacks usually were accompanied by an allergic vasculitis and dermatitis. Although this is not proof of the etiology, the constant association is suggestive of an allergic cause. A brief review of palindromic rheumatism is included.
Brief Psychotherapy: A Case Report Illustrating Its Potential Effectiveness
Authors: Brink T. L. 
Published: April 2015

ABSTRACTThe advance of industrialization in Mexico and elsewhere has brought about psychosocial problems of aging similar to those encountered in the United States. A case study is presented of a 64‐year‐old Mexican widow who had suicidal thoughts and feelings of uselessness. External constraints on the therapist dictated that psychotherapy be completed within 15 days. A strategy of brief psychotherapy was adopted. The focus was not on establishing transference, probing the unconscious or reconstructing the patient's personality, but on identifying problems and formulating practical solutions promptly. Four hour‐long sessions were sufficient to gather information and to counsel the patient and her family. The diagnosis was depression. Treatment centered around increasing the quality of the patient's activity. The initial success of these measures made for a good prognosis. Both patient and family were advised of the availability of antidepressant drugs, and advised against relocating the patient.