bluuebunny/crossref_metadata_2025_split huggingface dataset:
Aging and Insulin Resistance in a Group of Nonobese Male Volunteers†
Authors: Kimmerling George , Javorski W. Curtis , Reaven Gerald M. 
Published: April 2015

ABSTRACTThe relationship of age to insulin resistance was determined in 100 nonobese men whose ages ranged from 22 to 69 years. Seventy of the 100 subjects had normal glucose tolerance, and 30 had chemical diabetes. Insulin resistance was estimated by measuring the steady‐state plasma glucose response to a continuous infusion of insulin, glucose, epinephrine, and propranolol. This approach permitted inhibition of endogenous insulin release, achievement of a comparable steady‐state plasma level of exogenous insulin, and use of the height of the steady‐state plasma glucose response as a direct estimate of insulin resistance. With this experimental method, no correlation was found between age and insulin resistance over the age span of the experimental population. Furthermore, there was no correlation between age and the height of the plasma glucose response to an oral glucose challenge in this population of nonobese, healthy ambulatory men.
Lymphocyte Reactivity in the Aged
Authors: Halbrecht Isac , Komlos Luise , Strauss Zoltan 
Published: April 2015

ABSTRACTLymphocyte reactivity in cultures toward the nonspecific T and B cell mitogens, phytohemagglutinin (PHA) and pokeweed (PWM), was studied in 46 subjects in three groups: a) young healthy persons, b) elderly healthy persons, and c) hospitalized elderly patients with atherosclerotic cardiovascular disease. No statistically significant differences in the lymphocyte reactivity of young and old healthy persons toward PHA could be observed with different incubation times, mitogen concentrations, or serum sources. A significantly decreased lymphocyte response was found in elderly hospitalized patients compared to young and elderly healthy subjects. In contrast, no differences in the lymphocyte reactivity toward PWM could be found among the three groups, including a comparison between elderly healthy and elderly hospitalized persons. The results suggest that the B lymphocyte‐dependent response to a B lymphocyte stimulator is more stable than is the T cell response in aged subjects.
Psychic Reactions to Long‐Term Hemodialysis: Evaluation in the Elderly by Means of the Draw‐A‐Person Test†
Authors: Lowenhaupt Elizabeth 
Published: April 2015

ABSTRACTTwelve patients who attended a daytime session in a hemodialysis unit were studied. Most were older than patients whose adaptation has been the subject of previous reports. Problems of life satisfaction for these elderly patients often are different from those for younger persons. Most of the group showed maladaptive reactions which interfered with their activities when away from the unit. The Draw‐A‐Person test was a useful tool in pinpointing these reactions, which can lead to feelings of helplessness and depression. Factors which encourage good adaptation to long‐term hemodialysis are discussed.
Pigmentation and Musculoskeletal Abnormalities in an Aged State Hospital Population
Authors: Campbell Katherine M. , Wade David , Ross Luther W. , Meyer George G. 
Published: April 2015

ABSTRACTIn a State hospital population, 686 patients (mean age, 65 years) were examined for patterned pigmentation on unexposed areas of the body. Of these patients, 285 (41.5 percent) met the criteria for pigmentation. There were no sex or age differences. Psychosis had been diagnosed in 96 percent of the pigmented group. All of the 239 patients examined orthopedically had vertebral malalignment greater than 15 degrees and often had other bony deformities. Nearly all of the pigmented group displayed dyskinetic activity. A possible mechanism for the production of the pigmentation‐psychosis‐skeletal deformity triad could be an alteration in the concentration of available melatonin. Continued research along these lines may lead to an effective means of pharmacologic treatment as well as better psychologic and physical care.
Temporal Arteritis
Authors: Murray T. J. 
Published: April 2015

ABSTRACTTemporal arteritis (granulomatous inflammation) usually involves the temporal and and ophthalmic arteries, but may be part of a more widespread inflammation of the medium and large vessels. The patient usually presents with an associated group of constitutional symptoms (fever, malaise, anorexia, weight loss, anemia) and rheumatic complaints (polymyalgia rheumatica). The diagnosis should be considered in any patient over 55 years old in whom these symptoms develop or in whom there is evidence of recent onset of headache, visual loss or localized arterial involvement. The diagnosis is also to be considered when the erythrocyte sedimentation rate is over 50 mm/hr, and the presence of arteritis is confirmed by temporal‐artery biopsy findings. Visual loss may occur in 50 percent of affected patients; other serious complications are less common. A strong clinical suspicion of temporal arteritis will permit diagnosis of the more uncommon and atypical presentations of the syndrome. Although cases of temporal arteritis may be self‐limited, treatment is imperative because of the threat of blindness. Patients respond well to steroid (prednisone) therapy, which should be maintained for a prolonged period.
Effects of Chronic Papaverine Administration on Mild Senile Organic Brain Syndrome
Authors: Branconnier Roland J. , Cole Jonathan O. 
Published: April 2015

ABSTRACTTwo groups of geriatric patients were treated with either 300 mg/day of papaverine hydrochloride (Pavabid) or placebo in a double‐blind study of two months’ duration. All patients (25 in each group initially) had mild to moderate senile organic brain syndrome but were ambulatory and treated on an outpatient basis. Neuropsychologic evaluations were made by means of the following six tests: Electroencephalographic Analysis (EEG), Profile of Mood States (POMS), Subject Paced Digit Symbol Substitution Test (SPDT), Continuous Performance Test (CPT), Peterson and Peterson Test (P & P) for Short‐Term Memory, and Clinical Global Impression (CGI). The tests were comparative with a baseline period and between treatment groups. There were positive responses from baseline to active‐drug treatment in four of the six evaluations—EEG, POMS, SPDT and CPT. Some side effects were noted in both drug and placebo groups, but these were not disabling and did not interrupt therapy. Positive responses were also observed between treatment groups. By the EEG criterion, the papaverine patients responded positively. By the P & P test for short‐term memory, the placebo group responded better than did the papaverine group. It is suggested that the pharmacodynamic action of papaverine in ameliorating the symptoms of senile organic brain syndrome may not be due to vasodilation but to dopamine receptor blockade.
The Changing Attitudes of Physicians Toward Prolonging Life
Authors: Noyes Russell , Jochimsen Peter R. , Travis Terry A. 
Published: April 2015

ABSTRACTThis follow‐up survey of physicians’ attitudes and practices reveals a changing approach toward the care of terminal patients. It shows that: 1) communication with dying patients is becoming more open, 2) support for the omission of life‐prolonging treatments is increasing, and 3) opposition to the use of death‐hastening measures remains strong. It indicates that the physician's experience with terminal patients and the setting of his practice influence his attitude towards these patients and the approach to treatment.
Agnogenic Venous Mesenteric Thrombosis†
Authors: Mitty William F. , Purisima Clementino O. 
Published: April 2015

ABSTRACTOne of the most difficult diagnoses to establish is that of agnogenic venous mesenteric thrombosis (AVMT). This disorder occurs chiefly in elderly patients and, unless diagnosed promptly, leads to death in most instances. AVMT may follow surgical operations or occur during a prolonged illness. In the past five years at St. Clare's Hospital and Health Center in New York City, this diagnosis was established in five patients. In reviewing these cases, it was noted that some of the signs and symptoms such as those due to hypotension and shock with marked leukocytosis, were out of proportion to those usually observed when the preoperative diagnosis is being considered. The pathologic and radiologic characteristics of this disorder are outlined, and the recommended operative procedure for treatment is discussed. The importance is stressed of prompt, vigorous and prolonged anticoagulation therapy in order to minimize the chance of recurrence in the early postoperative period. Anticoagulant therapy is also effective preoperatively, if the disease is diagnosed sufficiently early. As greater numbers of elderly patients are being treated in hospitals, this dire complication should be uppermost in the minds of physicians and surgeons if a fatal outcome is to be avoided following a successful operative procedure.
Ivan Basilevich: A Gerontologist in Transit
Authors: FREEMAN JOSEPH T. 
Published: April 2015

ABSTRACTChance often determines the names that are recorded in history. Among an earlier generation's gerontologists, Ivan Basilevich was distinguished by the promise of his career and recognition in the USSR by his peers. The military invasion of his nation changed the pattern of his life. From a professional level in his native land, at the age of 50, he became a resident in psychiatry in Rhode Island where he continued his work on aging. He became a citizen in 1954 and by 1962 was the senior psychiatrist of his hospital's staff. His contributions to gerontology included his participation in the Kiev Congress of Aging in 1938 and a monograph in English (unpublished) on the medical aspects of natural old age. He wrote some 70 articles. In his papers on the subject of aging he heralded the transition of gerontology to its modern stage.
The Estrogen‐Cancer Controversy*
Authors: GREENBLATT ROBERT B. , STODDARD LELAND D. 
Published: April 2015

ABSTRACT:Postmenopausal women should not be denied estrogen therapy because of the controversy about the alleged causal relationship of estrogens to endometrial cancer. A prestigious team of biostatisticians reviewed three publications that claimed this relationship and concluded that no such association could be confirmed. Although the incidence of endometrial cancer has doubled in the past 25 years, there is no valid basis for the assumption that the widespread use of estrogens is the cause. The incidence also has increased in Norway and Czechoslovakia where estrogens are rarely used. Moreover, the histologic pattern of endometrial dysplasias is such that many pathologists will make a diagnosis of endometrial cancer as a safeguard for the patient. Thus the statistics for the incidence of endometrial cancer may be inflated. As a test, the administration of 200 mg of an oral progestogen over 5–10 days will convert a histologic pattern of pseudomalignancy, but not of adenocarcinoma, into one of secretory endometrium. Unopposed endogenous or exogenous estrogens may induce hyperplasia, atypical adenomatous hyperplasia or adenocarcinoma in women who are genetically predisposed. To minimize such a possibility, it is advisable to give a 5–7 day course of an oral progestogen so that the endometrium will be shed at monthly intervals. The benefits of hormone replacement therapy for the postmenopausal woman far outweigh the putative risk of endometrial cancer
Clinical Research and the Noninstitutional Elderly: A Model for Subject Recruitment
Authors: LEADER MARCIA A. , NEUWIRTH ELIZABETH 
Published: April 2015

ABSTRACT:Two approaches (normative and symptomatic) are presented for recruiting volunteers for a study of the effects of a vasodilator on the psychophysiologic functioning of elderly patients with mild to moderate cerebroarteriosclerosis. The subjects had to be at least 60 years old, in good physical and emotional health, of at least average intelligence, manifesting cognitive impairment by at least one of several test measures, maintaining themselves in the community, and active in a senior citizens program. Results of both approaches were compared for rates of volunteer response, study eligibility, and admission to the study. The normative approach emphasized data on the normal cognitive changes associated with the aging process. The symptomatic approach focused on the early diagnosis and treatment of an existing cognitive impairment. A combined total of 1,030 potential volunteers, nearly equally divided according to the two techniques, were addressed in group meetings. With the normative approach, 33 percent volunteered; of this group, 27 percent were found eligible for the study, and of these, 10 percent entered the study. With the symptomatic approach, 36 percent volunteered; of this group, 54 percent were found eligible for the study, and of these, 51 percent entered the study. Thus the symptomatic approach was five times more effective than the normative approach.
Echocardiographic Evaluation of Cardiac Function and Drug Effects in Acute Myocardial Infarction
Authors: PRAKASH RAVI 
Published: April 2015

ABSTRACT:The hemodynamic evaluation of patients with acute myocardial infarction (AMI) usually is performed by invasive methods. A prospective echocardiographic study was conducted on 23 AMI patients to determine the feasibility of this technique in evaluating hemodynamics and in measuring the effect of drugs on left ventricular performance. The results showed that: 1) reproducible measurements of left ventricular end‐diastolic and end‐systolic dimensions can be obtained by echocardiography, and 2) echocardiography can be used in the assessment of the effect of drugs in AMI. As echocardiography is a simple noninvasive procedure, it is well suited for conducting longitudinal studies in patients outside the coronary care unit and in ambulatory AMI patients.
Severe Impairment of Dietary Folate Utilization in the Elderly
Authors: BAKER HERMAN , JASLOW SEYMOUR P. , FRANK OSCAR 
Published: April 2015

ABSTRACT:Absorption of folates, vitamin B(i, pantothenate, and riboflavin from a natural food source (yeast) and from synthetic folylmonoglutamate was studied in 24 elderly subjects (age range, 73 to 101 years) and in 12 healthy younger subjects (age range, 24 to 42 years). All subjects absorbed riboflavin, vitamin B6, and pantothenate from yeast. Ingested folylpolyglutamates (the preponderant folates in yeast) proved to be a very poor source of folates for the elderly subjects, whereas synthetic folylmonoglutamate served as a good source. In the younger subjects, yeast was a significant folate source. It is suggested that the folate deficits so common in the elderly are caused by impaired ability to obtain folate from ingested foods. The resultant folate deficit may induce changes in the epithelial structure and enzyme secretion of the small bowel, which may further exacerbate folate malabsorption.
Serum Uric Acid and the Renin‐Angiotensin System in Hypertension
Authors: Saito I. , Saruta T. , Kondo K. , Nakamura R. , Oguro T. , Yamagami K. , Ozawa Y. , Kato E. 
Published: April 2015

ABSTRACTTo study whether the renin‐angiotensin system is related to hyperuricemia in hypertension, the serum concentration of uric acid was determined in 96 patients with various types of hypertension and various degrees of plasma renin activity (PRA). In malignant hypertension, both PRA and the serum uric acid level were higher than in essential hypertension; but in primary aldosteronism or desoxycorticosterone‐excess hypertension, they were lower than in the essential type. In renovascular hypertension, PRA was higher than in essential hypertension, but the serum uric acid levels were similar. There were no differences in PRA and serum uric acid concentration between Cushing's syndrome and essential hypertension. The serum uric acid level in high‐renin essential hypertension was higher than in either the normal‐renin or the low‐renin type. There was a significant correlation between serum uric acid concentration and PRA in the basal state, and between the change in PRA and the change in serum uric acid induced by administration of furosemide. Apparently the close correlation between the renin‐angiotensin system and the concentration of serum uric acid is related to changes in extracellular fluid volume, although an intrarenal effect of angiotensin II cannot be excluded.
Loxapine Succinate as a Neuroleptic Agent: Evaluation in Two Populations of Elderly Psychiatric Patients
Authors: Branchey Marc H. , Lee J. Hillary , Simpson George M. , Elgart Beltran , Vicencio Alfin 
Published: April 2015

ABSTRACTLoxapine succinate, a newly developed neuroleptic drug, was administered to two groups of geropsychiatric patients: (a) 12 with psychosis and organic brain syndrome, and (b) 14 with chronic schizophrenia. After a two‐week baseline period, loxapine was given for 12 weeks. The moderate therapeutic effect of loxapine in the “responders” was similar to that of other neuroleptic drugs. The therapeutic dosage range was found to be from 10 to 80 mg daily—about half that used for younger patients. The chief side effects were drowsiness, mild extrapyramidal symptoms, and a slight increase in blood pressure.
Psychologic Problems of the Aged
Authors: Mooney Craig M. 
Published: April 2015

ABSTRACTSome serious psychologic problems associated with the biologic processes of growing old and the sociologic states of being old are discussed in the light of a recent (1974) inquiry into the sufficiency of gerontologic resources in Canada and the adequacy of provisions for the well‐being of elderly Canadians. Many inadequacies in old‐age provisions are attributable to insufficient understanding on the part of program planners, service directors and the general public, of the personal, social and cultural needs of old people. This indicates a requirement for substantial investment in basic and applied gerontology. At present, many of the psychologic problems of old age seem to be a consequence of the demoralizing effects of personal poverty, social alienation, and cultural deprivation. Significant improvements in the conditions of life in old age will depend upon wide public understanding of the vital importance and enduring nature of the human needs of old people.
Cardiovascular Changes in/of Old Age*
Authors: Neurath Otto 
Published: April 2015

ABSTRACTAlthough the causes of aging are still unknown, the effects of decrements in anatomic structure and physiologic function have led to wrong concepts and resulting discriminatory policies against old people. Cardiovascular changes are common among the aged but are not necessarily symptomatic; they may be the result of past illnesses or signs of diminished cardiac reserve. In many cases, a cardiac abnormality detected by our modern diagnostic hardware does not in itself constitute the necessity for treatment. Illustrative cases are cited. A rise in blood pressure with advanced age often is a sign of adaptation to the increased rigidity of the arterial system. Certain heart murmurs mimicking mitral insufficiency may indicate slight papillary muscle dysfunction or a clinically insignificant degree of mitral valve prolapse. On the other hand, the changing clinical status in old age may involve a diminution of symptoms. Therefore, in geriatric medicine, the physician should be on the alert for aberrant manifestations, e.g., painless myocardial infarction or atypical pulmonary embolism. Psychologic evaluation is important. There is no cardiac disorder which is typical for the older age group, but also there is none from which older people are exempt.
Electroencephalographic Sleep Recordings and Depression in the Elderly*
Authors: Kupfer David J. , Spiker Duane G. , Coble Patricia A. , Shaw David H. 
Published: April 2015

ABSTRACTEighteen patients over the age of 60 who were experiencing a major depressive episode were studied on a Clinical Research Unit after they had been drug‐free for at least two weeks. All‐night electroencephalographic (EEG) recordings revealed considerable fragmentation of sleep, a mean sleep efficiency of 58 percent, and very little delta sleep. The findings of reduced sleep time, shortened REM latency, and high REM density were similar to those in depressed patients under the age of 60. These preliminary findings support the application of EEG sleep recordings as a tool for the differential diagnosis of depression in the elderly.
The Social Behavior of Elderly Aphasic versus Nonaphasic Long‐Term Patients
Authors: Derie Fern , Pablo Renato Y. 
Published: April 2015

ABSTRACTA study was made of the social consequences of communicative disorders among 51 elderly hospitalized long‐term patients. Independent variables used to account for variations in social behavior were: 1) the presence or absence of aphasia, an impairment resulting in varying degrees of loss of verbal recognition, comprehension and language production; 2) sex; and 3) the level of nursing‐care needs as an indicator of overall physical independence. A rating scale for measuring “Social Involvement” was constructed. It involved four analytically‐derived factors — Interpersonal Behavior, Familial and Social Contacts, Group Participation, and Extent of Social Contacts. Since a comparison of the 15 aphasic and 36 nonaphasic subjects on the basis of these four factors revealed no substantial main effect, it would seem that social isolation was not attributable to aphasia per se. Rather, a number of significant interactions indicated that differences in the levels of social involvement were attributable to the combined influences of sex, presence or absence of aphasia, and varying levels of physical independence. The relationship between social involvement and social isolation has implications for the overall management and rehabilitation of long‐term patients.
Hospital Treatment of Elderly Neuropsychiatric Patients. II. Statistical Profile of the First 122 Patients in a New Teaching Ward
Authors: Spar James E. , Ford Charles V. , Liston Edward H. 
Published: April 2015

ABSTRACTData are presented on the first 122 patients admitted to a geropsychiatric teaching ward in a university hospital. A high incidence of medical problems as reflected by abnormal laboratory findings complicated the management of these patients, most of whom had dementia or depression. In all diagnostic categories, the patients appeared to benefit from the intensive inpatient treatment. Difficulties in the areas of diagnosis, treatment, length of hospital stay, discharge placement and program evaluation are discussed.
Demographic Characteristics of Elderly Drug Overdose Patients Admitted to a Hospital Emergency Department
Authors: Schernitski Paul , Bootman J. Lyle , Byers James , Likes Keith , Hughes John H. 
Published: April 2015

ABSTRACTThis study was undertaken to identify the demographic characteristics of patients aged 55 or older in a drug‐overdose group admitted to the Emergency Department of Arizona Health Sciences Center during the 3‐year period, August 1975‐July 1978. Of the 646 overdose patients observed, 60 (9.5 percent) were aged 55 or older; of these, 77 percent were women—a significantly higher proportion than in the rest of the overdose group. The majority of the overdose incidents were unintentional, and most patients required hospitalization. For the elderly, the drugs involved in the overdoses did not differ significantly from those ingested by others in the overdose group. Concurrent traumatic injury occurred more often in the older age group, necessitating a longer hospital stay and higher health care costs. Drug overdosage is a significant problem in the elderly population. Since many overdoses are unintentional, elderly persons in particular require the counsel of physicians and pharmacists in the medication process.