bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictors for Functional Decline Among Nondisabled Older Japanese Living in a Community During a 3‐Year Follow‐Up
Authors: Ishizaki Tatsuro , Watanabe Shuichiro , Suzuki Takao , Shibata Hiroshi , Haga Hiroshi 
Published: April 2015

OBJECTIVES: To examine predictors for functional decline in basic activities of daily living (BADL) as well as predictors for decline in instrumental activities of daily living (IADL) among nondisabled older Japanese people living in a community during a 3‐year interval from 1992 to 1995.DESIGN: A prospective cohort study.SETTING: A community‐based environment.PARTICIPANTS: A total of 583 men and women aged 65 to 89 at baseline who were independent in both BADL and IADL.MEASUREMENTS: Independent variables regarding various factors potentially associated with functional decline were obtained from an interview survey and medical examinations at baseline. Dependent variables were functional status in BADL and IADL obtained at the time of the 3‐year follow‐up.RESULTS: During the 3‐year follow‐up, significant predictors for functional decline in BADL and only IADL decline included (1) age of ≥75, (2) less hand‐grip strength, and (3) a history of hospitalization during the past 1 year. In addition, having poor intellectual activities and having poor social roles were identified as significant predictors for functional decline in only IADL during the 3‐year follow‐up. Furthermore, not having the habit of taking a walk was identified as a significant predictor of functional decline in BADL during the 3‐year interval.CONCLUSION: Having a high level hand‐grip strength, good intellectual activities, and good social roles are strongly associated with remaining independence in IADL for the nondisabled Japanese persons aged ≥65.
Subjective Memory Complaint in Relation to Cognitive Performance and Depression: A Longitudinal Study of a Rural Chinese Population
Authors: Wang Pei‐Ning , Wang Shuu‐Jiun , Fuh Jong‐Ling , Teng Evelyn Lee , Liu Chia‐Yih , Lin Cheng‐Huai , Shyu Hann‐Yeh , Lu Sbiang‐Ru , Chen Chao‐Ching , Liu Hsiu‐Chih 
Published: April 2015

OBJECTIVES: To examine the associations of subjective memory complaint (SMC) in old age with (a) objective test performance, (b) past and subsequent cognitive decline, and (c) depression.DESIGN: A group of community residents were examined twice during a 3‐year period.SETTING: Two townships on a rural Chinese islet.PARTICIPANTS: A total of 543 men and women aged 65 years and older.MEASUREMENTS: During each examination, neurologists interviewed and examined all participants for dementia and asked the question, “Do you have trouble with your memory?” In addition, research assistants administered (a) the Cognitive Abilities Screening Instrument (CASI) to assess cognitive abilities, including long‐term memory (LTM) and short‐term memory (STM), and (b) the Geriatric Depression Scale‐Short Version (GDS‐S) to assess symptoms of depression.RESULTS: At each examination, almost half of the subjects acknowledged having trouble with their memory (the SMC+ group). At both examinations, the SMC+ group scored significantly lower on the CASI and significantly higher on the GDS‐S than the SMC− group. However, the presence of SMC was not associated with faster cognitive decline over the past or subsequent 3 years. There were no consistent associations between SMC and the demographic variables of age, gender, and education at the two examinations. Logistic regression analysis showed that SMC was associated with poorer memory test scores after controlling for gender, age, education, and depression.CONCLUSIONS: SMC was associated with poorer objective memory performance even after controlling the effect of depression and demographic data, but SMC did not predict faster cognitive decline or dementia over 3 years. J Am Geriatr Soc 48: 295–299, 2000.
Dying with Acute Respiratory Failure or Multiple Organ System Failure with Sepsis
Authors: Somogyi‐Zalud Emese , Zhong Zhenshao , Lynn Joanne , Dawson Neal V. , Hamel Mary Beth , Desbiens Norman A. 
Published: April 2015

BACKGROUND: The dying experience of patients with acute respiratory failure (ARF) or multiple organ system failure with sepsis (MOSF) has not been described.OBJECTIVES: To describe patients dying from ARF or MOSF, including demographic characteristics, baseline function and quality of life, symptoms, preferences, use of life‐sustaining treatments, satisfaction with care, and family burden.DESIGN: A multicenter prospective study.SETTING: Five US teaching hospitals, in the Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments (SUPPORT).PARTICIPANTS: A total of 1295 adults who died during hospitalization for ARF or MOSF.MEASUREMENTS: Chart reviews and interviews with patients and surrogates.RESULTS: SUPPORT enrolled 2956 patients with ARF or MOSF, and 44% died during enrollment hospitalization. Quality of life before hospitalization was reported as fair by 87% of patients. The mean number of impairments in their baseline activities of daily living was 1.6. At the time of death, 79% had a DNR order and 31% had an order to withhold ventilator support. The average time from the DNR order to death was 2 days. Dying patients spent an average of 9 days on a ventilator. Surrogates indicated that one out of four patients died with severe pain and one out of three with severe confusion. Families of 42% of the patients who died reported one or more substantial burden.CONCLUSIONS: Patients in this study reported substantial functional impairments and reduced quality of life. Limitations to aggressive treatments were usually implemented only when death was imminent. Family impact and physical and emotional suffering were substantial.
Pain and Suffering in Seriously Ill Hospitalized Patients
Authors: Desbiens Norman A. , Wu Albert W. 
Published: April 2015

BACKGROUND: Previous studies had suggested a high prevalence of pain in hospitalized patients but had not specifically evaluated pain and other symptoms in seriously ill and older hospitalized patients.OBJECTIVE: The SUPPORT and HELP studies were designed to (1) assess the frequency and severity of pain and other symptoms during hospitalization 2 and 6 months later, and before death; (2) identify factors associated with pain and other symptoms; and (3) test an intervention to improve pain.DESIGN: An observational cohort and randomized controlled trial.SETTING: Five major teaching hospitals in the US.PATIENTS: Hospitalized patients aged 80 years and older or with one of nine serious illnesses.INTERVENTION: Education of patients and family members about pain control, monitoring of patients' pain, and feedback about pain with treatment suggestions to nurses and physicians.MEASUREMENTS: Data from the medical record and interview‐based information about pain and other symptoms and preferences for care and symptom control from patients and family members.RESULTS: Pain and other symptoms were frequent and often severe in seriously ill and older patients during hospitalization, at follow‐up, and before death, even in those with diseases not traditionally associated with pain. There was wide variation in symptom experience across hospitals. Patients' preference for pain control was not associated with symptom experience. The intervention did not improve pain control.CONCLUSIONS: Control of pain and other symptoms remains an important medical and ethical issue. Routine monitoring of pain and other symptoms should be linked to treatment strategies aimed at combinations of symptoms and tested to assuage concerns about side effects.
Predicting Adverse Postoperative Outcomes in Patients Aged 80 Years or Older
Authors: Liu Linda L. , Leung Jacqueline M. 
Published: April 2015

OBJECTIVE: The identification of reversible factors that are associated with postoperative morbidity in geriatric surgical patients is critical to improving perioperative outcomes in such patients. Our study aimed to compare the relative importance of intraoperative versus preoperative factors in predicting adverse postoperative outcomes in geriatric patients.DESIGN: Retrospective cohort study of consecutive patients undergoing noncardiac surgery in 1995.SETTING: Two University of California, San Francisco, teaching hospitals—Moffitt/Long and Mount Zion medical centers.PARTICIPANTS: All men and women 80 years of age or older undergoing noncardiac surgery.MEASUREMENTS: Medical records of all patients were reviewed to measure predefined pre‐ and intraoperative risk factors and postoperative outcomes. Predictors of postoperative outcomes were identified by multivariate logistic regression analyses.RESULTS: Three hundred sixty‐seven patients were studied. The most prevalent preoperative risk factors were a history of hypertension and coronary artery, pulmonary, and neurologic diseases. Postoperative in‐hospital mortality rate was 4.6%, and 25% of patients developed adverse postoperative outcomes, of which neurological and cardiovascular complications were the leading causes of morbidity (15% and 12%, respectively). By multivariate logistic regression, a history of neurological disease (odds ratio [OR] 4.0, 95% confidence interval [CI] 2.3 – 6.9, P = .0001), congestive heart failure (OR 2.7, 95% CI 1.4 – 5.3, P = .004), and a history of arrhythmia (OR 2.3, 95% CI 1.2 – 4.3, P = .01) increased the odds of adverse postoperative events. The only intraoperative event shown to be predictive of postoperative complications was the use of vasoactive agents (OR 8.0,95% CI 1.6 – 40.5, P = .009).CONCLUSIONS: In this group of geriatric surgical patients, the overall postoperative in‐hospital mortality rate was 4.6%, and 25% of the patients developed adverse postoperative outcomes involving either the neurological, cardiovascular, or pulmonary systems. Intraoperative events appeared to be less important than preoperative comorbidities in predicting adverse postoperative outcomes. J Am Geriatr Soc 48: 405–412, 2000.
The Association Between Parkinsonism, Alzheimer's Disease, and Mortality: A Comprehensive Approach
Authors: Mitchell Susan L. , Rockwood Kenneth 
Published: April 2015

BACKGROUND: The impact of parkinsonism on survival in older persons independent of dementia is not well understood.METHODS: Participants in the clinical examination of the Canadian Study of Health and Aging who had parkinsonism and were older than age 65 were identified. The impact of parkinsonism on 5‐year survival was determined for a combined cohort with and without dementia, and a stratified analysis was then conducted for the subgroups with Alzheimer's disease (AD) and those without dementia. Subjects with a previous diagnosis of Parkinson's disease and those prescribed drugs causing extrapyramidal side effects were excluded.FINDINGS: A total of 721 subjects with AD and 1705 subjects without dementia were examined. After adjusting for age and residential status (community vs institution), parkinsonism was associated with poorer survival in the combined cohort (risk ratio 1.51; 95% CI, 1.22–1.85), in those with AD (risk ratio 1.34; 95% CI, 1.02–1.76), and those without dementia (risk ratio 1.54; 95% CI, 1.11–2.15). In the combined cohort, parkinsonism remained independently associated with higher mortality after adjusting for AD status (risk ratio 1.39; 95% CI, 1.13–1.72). In the subgroup with AD, parkinsonism remained associated with poorer survival after adjusting for severity of cognitive impairment (risk ratio 1.33; 95% CI. 1.04–1.74).INTERPRETATION: Parkinsonism is significantly associated with poorer survival in older persons, regardless of whether they have dementia.J Am Geriatr Soc 48: 422–425, 2000.
Hormone Replacement Therapy Use in Urban Older Women Attending Meal Sites: Associations with Sociodemographic and Health Characteristics and Use of Preventive Services
Authors: Ganesan Kalpana , Teklehaimanot Senait , Swartz Joel B. , Reuben David B. 
Published: April 2015

OBJECTIVE: To examine sociodemographic, health and preventive health practices associated with hormone replacement therapy (HRT) use in urban community‐dwelling older women.DESIGN: Survey.SETTING: Community‐based meal sites throughout the city of Los Angeles.PARTICIPANTS: A convenience sample of 705 community‐dwelling women older than age 60 who completed questionnaires for the Prevention for Elderly Persons Program.MEASUREMENTS: Demographic and life style characteristics, functional status, preventive practices, and current and past use of HRT.RESULTS: Among the 705 women surveyed, 13% reported current use and 17% reported past use of HRT. Current users were more likely to be younger and more likely to report a history of osteoporosis, hysterectomy, and calcium use than never users. White women were more likely to be current users than black women.CONCLUSIONS: Only a small proportion of the older urban women studied are currently using HRT. In particular, efforts to increase the use of these preventive services need to focus on black women and women who do not have a prior history of osteoporosis. J Am Geriatr Soc 48:669–672, 2000.
The Involvement of Physicians in VA Home Care: Results From a National Survey
Authors: Weaver Frances M. , Hughes Susan L. , Giobbie‐Hurder Anita , Ulasevich Alec , Kubal Joseph D. , Fuller Jon , Kinosian Bruce , Lichtenstein Michael J. , Rowe Joseph 
Published: April 2015

OBJECTIVES: To examine the role of physicians in the Veteran Affairs (VA) home‐based primary care (HBPC) program and to identify variables that predict whether physicians make home visits and volume of home visits made.DESIGN: Descriptive and regression analyses of responses from a mail survey.PARTICIPANTS: Forty‐five physicians affiliated with VA HBPC programs.MAIN SURVEY TOPICS: Self‐reported work load, attitudes toward home care, reasons for home visits, administrative policies regarding physicians' role in patient care management, and time commitment to home care.RESULTS: A majority of physicians believed strongly in the importance of home care and made home visits for reasons consistent with their training. Physician attitude toward home care and preoccupation with office or hospital practice were related to whether or not physicians made home visits. Degree of preoccupation with office practice and amount of salary support from VA HBPC were significant predictors of the number of visits made (Rs2 = 0.44).CONCLUSIONS: These findings indicate that most physicians will make home visits if they believe that home care is valuable and if their time commitment is supported financially. Managed care plans that own and operate home care programs and have the capacity to transfer primary care management to physicians who derive financial support from the programs should find this information particularly relevant. J Am Geriatr Soc 48:677–681, 2000.
A Population‐Based Study on Motor Performance and White Matter Lesions in Older Women
Authors: Guo Xinxin , Skoog Ingmar , Matousek Michael , Larsson Lena , Palsson Sigurdur , Sundh Walter , Steen Bertil 
Published: April 2015

OBJECTIVE: To investigate the relationship between motor performance and white matter lesions (WMLs) on computed tomography (CT) of the brain in older women.DESIGN: Cross‐sectional study.SETTING: Population‐based study in Göteborg, Sweden.PARTICIPANTS: A total of 248 women aged 70, 74, and 78 years.MEASUREMENTS: Motor performance was measured by a Postural‐Locomotion‐Manual (PLM) test using an optoelectronic technique. WMLs on CT scans were rated as no, mild, moderate, or severe.RESULTS: White matter lesions were associated with impaired mobility of the lower extremities, that is, prolonged locomotion phase in the PLM test. This association was also present after controlling for age, hypertension, coronary heart disease, stroke, diabetes mellitus, chronic bronchitis, intermittent claudication, and smoking.CONCLUSIONS: Cerebral white matter lesions may contribute to motor impairments in older adults. J Am Geriatr Soc 48:967–970, 2000.
Periodontal status and pathogenic bacteria after gastric bypass: a cohort study
Authors: Sales‐Peres Sílvia Helena de Carvalho , de Moura‐Grec Patrícia Garcia , Yamashita Joselene Martinelli , Torres Elza Araujo , Dionísio Thiago José , Leite Celso Vieira de Souza , Sales‐Peres Arsenio , Ceneviva Reginaldo 
Published: April 2015

AbstractAimThe aim this study was to evaluate the influence of gastric bypass surgery (GBS) on periodontal disease and quantify the periodontopathogenic bacteria in patients undergoing this surgery.Material and MethodsThis prospective study was composed of 50 patients who underwent bariatric surgery and the data collection was performed in three periods pre‐operative, 6 (6M) and 12 months (12M) postoperative. The oral clinical examination to assess periodontal disease; gingival fluid sample collection for quantification of the periodontopathogenic bacteria Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, and Prevotella intermedia using q‐PCR; body mass index (BMI) and for collection of the individual's health‐related data from medical files.ResultsThere was a significant reduction in serum C‐reactive protein (CRP) and glucose levels after surgery. The mean probing pocket depth (PPD) and clinical attachment level (CAL) increased significantly in the postoperative period of 6 months (p = 0.001). In the same period, the amount of P. gingivalis increased (p = 0.028) and the other bacteria decreased slightly (p > 0.050). In the presence of P. gingivalis, T. forsythia, T. denticola and P. intermedia, a poor periodontal condition was observed.ConclusionThe periodontal disease increased in severity and P. gingivalis increased after GBS. A systemic inflammation resolution due to bariatric surgery in obese subjects does not seem to affect the course of periodontal disease.
In vitro toxicity of propolis in comparison with other primary teeth pulpotomy agents on human fibroblasts
Authors: Al‐Haj Ali Sanaa Najeh 
Published: April 2015

AbstractAimThe aim of this study was to assess and compare the in vitro toxicity of propolis with other primary teeth pulpotomy medicaments.MethodsHuman periodontal ligament (PDL) cells were subjected to different concentrations of propolis, formocresol, ferric sulfate, and gray mineral trioxide aggregate (MTA) (0.05, 0.5, 5, 50, and 100 μg/mL) for 24 h at 37°C. Cells that were not exposed to the tested materials served as the negative control. In vitro toxicity was assessed using 3‐(4,5‐dimethylthiazol‐2‐yl)‐2,5‐diphenyltetrazolium bromide assay. Statistical analysis of the data was accomplished using anova and Tukey statistical tests (P < 0.05).ResultsOnly propolis and gray MTA had comparable cell viability to the negative control group. Almost all remaining concentrations of tested materials were significantly inferior to the negative control after 24 h of exposure (P < 0.05).ConclusionPropolis and MTA are more biocompatible than formocresol and ferric sulfate since they were both able to preserve PDL fibroblasts for up to 24 h.
The use of Botulinum toxin‐A injection for facial wrinkles: a histological and immunohistochemical evaluation
Authors: El‐Domyati Moetaz , Attia Sameh K. , El‐Sawy Ashraf E. , Moftah Noha H. , Nasif Ghada A. , Medhat Walid , Marwan Belkais 
Published: April 2015

SummaryBotulinum toxin (BTX)‐A has been used for years in the reduction of facial wrinkles; however, histological and immunohistochemical changes after its use were not previously investigated. To evaluate histological and immunohistochemical changes after BTX‐A injection for facial wrinkles, sixteen volunteers, with wrinkles on the upper third of the face, were subjected to single injection of BTX‐A. Skin biopsy specimens were obtained from peri‐orbital wrinkle site (crow's feet area) before and after 3 months of BTX‐A injection. Using histological and immunohistochemical evaluation coupled with computerized morphometric analysis, measurement of epidermal thickness, wrinkle depth and width as well as quantitative evaluation of collagen types I and III and elastin was performed for skin biopsies. After BTX‐A injections, there were significant increase in wrinkle width and granular layer thickness (P < 0.001), while the other histometrical measures as well as the immunohistochemical expression of collagen types I and III and elastin showed no significant difference (P > 0.05). However, collagen fibers showed better organization and orientation after BTX‐A injection. The histological changes observed after BTX‐A injection for facial wrinkles may help in better understanding of its mechanism of action.
CEO Preferences and Acquisitions
Authors: JENTER DIRK , LEWELLEN KATHARINA 
Published: May 2015

ABSTRACTThis paper explores the impact of target CEOs’ retirement preferences on takeovers. Using retirement age as a proxy for CEOs’ private merger costs, we find strong evidence that target CEOs’ preferences affect merger activity. The likelihood of receiving a successful takeover bid is sharply higher when target CEOs are close to age 65. Takeover premiums and target announcement returns are similar for retirement‐age and younger CEOs, implying that retirement‐age CEOs increase firm sales without sacrificing premiums. Better corporate governance is associated with more acquisitions of firms led by young CEOs, and with a smaller increase in deals at retirement age.
Use of Antiepileptic Drugs in Patients with Chronic Kidney Disease and End Stage Renal Disease
Authors: Bansal Amar D. , Hill Chloe E. , Berns Jeffrey S. 
Published: May 2015

AbstractEpilepsy is a disorder with an approximate worldwide prevalence of 1%. Due to complexities of metabolism, protein‐binding, renal elimination, and other pharmacokinetic parameters, the dosing of antiepileptic drugs (AEDs) in patients with chronic kidney disease (CKD) or end stage renal disease (ESRD) deserves special attention. This is a review of the most commonly prescribed AEDs with special focus on their indication, pharmacokinetics, and unique considerations for use in patients with CKD and ESRD. A review of their renal toxicities is also included.
Thromboelastographic assessment of the contribution of platelets and clotting proteases to the hypercoagulable state of dogs with immune‐mediated hemolytic anemia
Authors: Hamzianpour Negar , Chan Daniel L. 
Published: April 2015

AbstractBackgroundHypercoagulability is a well‐known feature of canine immune‐mediated hemolytic anemia (IMHA) and is believed to increase the risk of thrombosis. This study was undertaken to differentiate the relative contribution of platelets and clotting proteases to this hypercoagulability using thromboelastography (TEG).Study DesignRetrospective observational study.MethodsThromboelastograms from 27 dogs with IMHA were retrospectively evaluated. Standard TEG parameters (R, K, α, MA), the G value, and the novel parameter delta (Δ) were determined. Hypercoagulability was attributed to the platelet component of hemostasis when there was an increased G value with a normal Δ value.Key FindingsNineteen of 27 dogs (70.4%) had ≥ 2 TEG variables suggestive of hypercoagulability, 18 (66.7%) had a hypercoagulable G value, and 11 (40.7%) had a hypercoagulable Δ value. Ten of 27 (37%) samples met the criteria for platelet hypercoagulability.SignificanceOur report documents the derivation and application of the Δ value to differentiate enzymatic from platelet hypercoagulability. Further studies are required to validate the use of these TEG variables in this manner. The hypercoagulable tendency in dogs with IMHA is complex and multifactorial, and in some dogs this hypercoagulability may be attributed primarily to platelet hyper reactivity. Our findings may support the use of anti‐platelet drugs in some dogs with IMHA.