bluuebunny/crossref_metadata_2025_split huggingface dataset:
Split‐Course Radiation Therapy: Effects on Pulmonary Function in Patients with Bronchogenic Carcinoma
Authors: Shankar Patil S. 
Published: April 2015

ABSTRACTPulmonary function studies were made in 15 patients with unresectable bronchogenic carcinoma treated by split‐course megavoltage radiation. Forced vital capacity and forced respiratory volume per second were measured before starting each of the first and second phases of the split‐course therapy, and at 2 weeks and 12 weeks after completion of treatment. Improvement in ventilatory functions was noted in more than half of the patients. Adverse effects on lung function appeared to be minimal.
Serum Digoxin Concentration and Age*
Authors: Guggenheim Ralph , Reidenberg Marcus M. 
Published: April 2015

ABSTRACTA review was conducted of the charts of 79 consecutive inpatients (age range, 17–93 years) who were in a steady state with respect to digoxin dosage, and had serum creatinine levels below 1.6 mg/dl or urea nitrogen levels below 26 mg/ dl. In these patients whose renal function was not impaired, there was no correlation between age and the serum digoxin level normalized for dosage. Concurrent administration of quinidine significantly elevated digoxin concentration. Patients with congestive heart failure showed a higher serum digoxin level than did those without heart failure. Thus, age appeared to have little, if any effect on the relationship between the dose of digoxin and the steady‐state serum level when the factor of impaired renal function (often associated with aging) was eliminated.
Temporal Arteritis: Cerebrospinal Fluid and Brain Scan Abnormalities (Case Report)
Authors: Gordon Michael , Gordon Elaine P. 
Published: April 2015

ABSTRACTA 61‐year‐old man presented with a syndrome suggesting temporal arteritis. Abnormal radioisotope brain scan and cerebrospinal fluid (CSF) findings were consistent with a diagnosis of intracranial vasculitis. Although the clinical response to steroids was dramatic, improvement in the CSF abnormalities lagged. Nevertheless, persistent use of steroids in high dosage resulted in normalization of both CSF and brain scan abnormalities.
New Ideas for Old Eyes†
Authors: Kornzweig Abraham L. 
Published: April 2015

ABSTRACTThe most significant recent advance in ophthalmology has been implantation of an intraocular plastic lens to replace the cataractous lens. The success rate is 75–85 percent. Complications are discussed, and the importance of this operation for the aged is stressed. Vitrectomy is now being used for stopping vitreous hemorrhages and for other therapy not previously attempted. New diagnostic methods involving ultrasound have been of special help when the eye tissue is opaque. Brain tumors compressing the optic nerve have been diagnosed by computerized axial tomography. The laser beam is now being applied for treatment of diabetic retinopathy, for obliteration of retinal holes, and for the creation of holes in the iris in the treatment of narrow‐angle glaucoma. Electronic instruments can estimate the refractive error. The new devices for measuring intraocular pressure do not require the use of local anesthetics. Soft contact lenses for continuous wear have been perfected. The binocular operating microscope has been an outstanding innovation in intraocular and corneal surgery. Timolol, a new drug for the treatment of glaucoma, reduces intraocular pressure without contracting the pupil.
Psychiatric Findings in the Population of a Geriatric Evaluation Unit: Implications†
Authors: Cheah Keong Chye , Beard Owen W. 
Published: April 2015

ABSTRACTPsychiatric evaluation was performed routinely in 262 patients newly admitted to a Medical Geriatric Evaluation Unit (GEU). The study was conducted in a medical facility that provides excellent medical and surgical care for acute illnesses. The psychiatric disorders found far exceeded those one might expect in a comparable general population, and most were not recognized prior to the patient's transfer. For example, in the GEU, the incidence of organic brain syndrome was 65.3 percent, and of dysphoria‐depression 31.3 percent. The data indicate a need to recognize psychiatric problems in order to ensure appropriate care, and suggest that medical care of the elderly with acute illness will be inadequate if it is based upon the approach used for younger populations. This situation apparently exists in most hospitals, including leading medical centers. The needs of the elderly with acute illnesses are quite different from those of younger patients. Recognition of factors that potentially influence outcomes and overall future health will meet public health's primary and secondary prevention goals.
Sleep Disturbances in a Series of Elderly Patients: Polysomnographic Findings
Authors: Reynolds Charles F. , Coble Patricia A. , Black Ronald S. , Holzer Barry , Carroll Richard , Kupfer David J. 
Published: April 2015

ABSTRACTA group of 27 elderly patients with complaints of either chronic insomnia or excessive daytime sleepiness were studied in the Sleep Evaluation Center of Western Psychiatric Institute and Clinic during the period January 1977–June 1979. On the basis of anamnestic data from patients and bedroom partners, together with polysomnographic findings, sleep disturbances were classified according to the nosology of the Association of Sleep Disorders Centers. Of the 27 patients, 19 had disorders of initiating or maintaining sleep (DIMS), 7 had disorders of excessive somnolence (DOES), and 1 had parasomnia (episodic nocturnal wandering). Of the 19 DIMS patients, two‐thirds had either a primary affective disorder (depression) or a persistent psychophysiologic disturbance. Of the 7 DOES patients, 6 had a primary sleep disorder such as a sleep apnea syndrome or narcolepsy‐cataplexy. Additional electroencephalographic sleep data are presented on elderly patients with primary nonpsychotic depression. The latency of rapid eye movements (REM) in the depressed patients was shorter (p < 0.05) than in patients with a persistent psychophysiologic disturbance. The percentage of REM sleep was significantly elevated (p < 0.05) in the depressed group, and intermittent wakefulness was decreased (p < 0.01). The causes of sleep disturbance in the elderly are both heterogeneous and complex. The need for accurate differential diagnosis and a multiaxial approach is stressed.</b>
Noninvasive Detection and Prevention of Deep‐Vein Thrombosis in the Geriatric Patient
Authors: Lee Bok Y. , Thoden William R. , Trainor Frieda S. , Kavner David 
Published: April 2015

ABSTRACTNoninvasive methods for the early detection of, and prevention of deep‐vein thrombosis can significantly reduce postoperative morbidity and mortality in the elderly due to venous thromboembolism. The technique of venous impedance plethysmography provides a rapid means of assessing the patency of the venous system by detecting changes in venous volume and maximum venous outflow, thus providing for early detection of deep‐vein thrombosis. Prevention of deep‐vein thrombosis can be accomplished through use of external intermittent pneumatic compression. This technique prevents venous stasis and stimulates the natural fibrinolytic activity of the vein‐wall endothelium.
Physician Acceptance of Clinical Pharmacy Service in a Skilled Nursing Home
Authors: Taylor A. Thomas , Martell Pamela H. 
Published: April 2015

ABSTRACTA study was made of physician acceptance of pharmacist‐recommended changes in the drug therapy of elderly institutionalized patients. The records of 92 such patients were reviewed by the pharmacist. In 33 instances the pharmacist recommended changes in drug therapy. In 75.8 percent (25 of these 33 patients) the recommendations were judged appropriate and were accepted by the physician concerned.
Lack of Effect of Ascorbic Acid, Hippuric Acid, and Methenamine (Urinary Formaldehyde) on the Copper‐Reduction Glucose Test in Geriatric Patients
Authors: Nahata Milap C. , McLeod Don C. 
Published: April 2015

ABSTRACTAscorbic acid and hippuric acid (from cranberry juice) are commonly used to acidify the urine for the purpose of enhancing the degradation of therapeutic methenamine mandelate to urinary formaldehyde. A study was made of 27 nondiabetic geriatric patients with indwelling Foley catheters and chronic bacteriuria who were treated with methenamine mandelate (4 gm), ascorbic acid (4 gm), and cranberry cocktail (1 liter) daily. All of 972 urine samples showed formaldehyde in mean concentrations between 14 and 25 μg/ml. No glucose was found when the urine was tested by the copper‐reduction method. In vitro false positive reactions reported in the literature do not appear to be duplicated as an in vivo problem.
Presenile Dementia—A Form of Lafora Disease
Authors: Stam F. C. , Wigboldus J. M. , Bots G. Th. A. M. 
Published: April 2015

ABSTRACTThe autopsy findings on a 60‐year‐old man with progressive disturbances of gait, presenile dementia and incontinence, showed Lafora bodies in numerous ganglion cells of the cerebral cortex and in many nuclei of the brain stem. Histochemical analysis of the Lafora bodies revealed the presence of a polysaccharide‐protein complex containing phosphate groups. The case closely resembled the one described by Suzuki et al. It is suggested that this type of presenile dementia may be a presenile form of Lafora disease.
Early Failures of Permanently Implanted Transvenous Pacemaker Systems: Spontaneous Recovery of Sensing Function in Three of Twelve Cases
Authors: Goldberg E. , Edery T. , Delfin L. , Berger M. , Jelveh M. 
Published: April 2015

ABSTRACTAn analysis of 12 early pacemaker failures in a series of 128 transvenous implants is reported. Spontaneous recovery, maintained during long‐term follow‐up of 3 patients with isolated transient sensing failure, suggested the possibility of a transient loss of sensing voltage amplitude, or slew rate (dv/dt), or both. Conservative management is frequently indicated in these cases. In 62 patients in whom a “tined” lead was used, there were no early pacemaker failures.
Vitamin B12 Status of Elderly Persons from Urban Low‐Income Households
Authors: Bailey L. B. , Wagner P. A. , Christakis G. J. , Araujo P. E. , Appledorf H. , Davis C. G. , Dorsey E. , Dinning J. S. 
Published: April 2015

ABSTRACTVitamin B12 status was evaluated in 111 noninstitutional elderly persons (age range, 60–87 years) living in an urban poverty area. The sample was predominantly black (90 subjects); the rest were Spanish Americans. Serum vitamin B12 levels were all normal (>200 pg/ml) and ranged from 226 to 1200 pg/ml (mean ± SD = 700 ± 191 pg/ml). The findings indicate that vitamin B12 deficiency was not a problem in this elderly population.
Persistent Dislocation of the Shoulder in Elderly Patients
Authors: Ganel A. , Horoszowski H. , Heim M. , Engel J. , Farine I. 
Published: April 2015

ABSTRACTFour elderly patients with longstanding unrecognized dislocation of the shoulder were treated by physiotherapy only. Good functional results, associated with a greatly increased range of pain‐free motion, demonstrate the usefulness of conservative treatment in cases of persistent dislocation of the shoulder in the elderly.
Serum Glucagon after Arginine Infusion in Aged and Young Subjects
Authors: Ferrero Enrico , Casale Giorgio , De Nicola Pietro 
Published: April 2015

ABSTRACTIn 12 aged nondiabetic subjects, 10 aged diabetic subjects, and 6 young nondiabetic subjects the glucose, insulin, glucagon and growth hormone responses to the intravenous administration of arginine were studied. A prompt increase in the levels of blood glucose, serum insulin and serum glucagon was observed, but the glucose and glucagon peaks were significantly higher in the aged nondiabetic and diabetic subjects. Growth hormone secretion did not differ between the nondiabetic aged and young subjects. These findings suggest the hypothesis that glucose intolerance in old age is due to increased release of glucagon.
Perspective of Health in Old Age†
Authors: Cape Ronald D. T. , Henschke Philip J. 
Published: April 2015

ABSTRACTThe elderly are often depicted as a deprived, disabled group of depressed people. A group of 385 elderly subjects drawn at random from those who lived in their own homes in the City of London, Ontario, or in Grey and Bruce Counties in Southwestern Ontario, were studied to assess their degree of disability, consumption of drugs, and need for health care. The method of sampling is described in detail. The proportion of cooperative subjects in the available chosen samples ranged from 80 to 92 percent. The results showed that disability, as assessed by lack of competence in five activities of daily living, ranged from about 6 percent at age 65 to over 35 percent at age 85. Within the previous year, only 15 percent of the subjects had not seen their family physician, and 36 percent had visited the doctor's office three or more times. Those living at home consumed an average of 1.6 drugs per person. In an institutional sample of 100 subjects, 12 percent were fully independent and had no obvious need to be in an institution; their consumption of drugs was more than twice that in the community sample. Old age is not necessarily a disabling period of life. On balance, it can offer more hope and fulfillment than despair.
Modalities of Psychotherapy with the Elderly
Authors: Karpf Ronald J. 
Published: April 2015

ABSTRACTEmphasized is the view that geriatric psychotherapy can be effectively administered only with knowledge of the biology, psychology, and sociology of old age. The concepts of transference, countertransference, interpretation, conflict and defense mechanisms are crucial for understanding the various treatment modalities. Five intervention patterns are offered for the therapeutic approaches, i.e., interpretation, suggestion, reinforcement, confrontation, and clarification. The different modalities of geriatric psychotherapy may be viewed as variations of different clusters of these interventions, e.g., psychoanalysis makes most use of interpretation whereas group therapy makes most use of confrontation and clarification. For the psychologic treatment of disorders in late life, there are five basic modalities and one adjunct. The basic psychotherapies are classified as psychoanalytic, supportive, group, family, and behavioral; the adjunct is psychopharmacologic treatment, which is not a substitute for effective psychotherapy. Much semantic confusion has centered around this adjunctive treatment. Conceptual confusions about the meaning of the word “cure” are discussed.
Ischemic and Hypertensive Heart Disease in the Aged: Prognostic and Therapeutic Factors†
Authors: Rodstein Manuel 
Published: April 2015

ABSTRACTThe prognostic significance of risk factors for ischemic and hypertensive heart disease in the aged differs in many respects from that in younger persons. In old age, most risk factors for ischemic heart disease such as an elevated level of total serum cholesterol, cigarette smoking, obesity, Type A personality and abnormal glucose tolerance have a less adverse effect on morbidity and mortality from ischemic heart disease, while an elevated level of high‐density lipoprotein, and moderation in the use of alcohol each have a favorable effect. A high level of low‐density lipoprotein cholesterol exerts an adverse effect. Both systolic and diastolic hypertension have an adverse influence on morbidity and mortality from ischemic and hypertensive heart disease, as does the electrocardiographic pattern of left ventricular strain. Long‐term controlled studies are needed to determine the effects on mortality and morbidity of the modification of risk factors by means of drugs, diet, and change of lifestyle. Such studies are necessary if we are to determine whether hoped‐for favorable changes are offset by potential side effects on physical and mental health.
Effects of Aging on Hydroxyproline in Human Heart Muscle
Authors: Ito Akihiko , Yamagiwa Hirotsugu , Sasaki Rikuro 
Published: April 2015

ABSTRACTHydroxyproline concentration in the NaCl‐soluble, TCA‐soluble, and residual fractions of heart muscle was chemically determined in 40 autopsy subjects (25 men and 15 women), to study the effects of aging. In the left ventricle, the total hydroxyproline content of the endocardium and papillary muscle increased significantly in relation to age; the increase was greatest in the TCA‐soluble fraction, followed by the residual fraction. Statistical analysis revealed that hydroxyproline in the residual fraction increased from the epicardium to the endocardium and then to the papillary muscle. Significant negative correlations were found between heart weight and total hydroxyproline in the epicardium and endocardium. In the right ventricle, a significant negative correlation was noted between heart weight and total hydroxyproline content. Though no correlations were evident between age and hydroxyproline content in females, significant correlations were observed between age and the total hydroxyproline content of the endocardium and papillary muscle in males. Furthermore, soluble collagen increased in most parts of the heart in females, but insoluble collagen increased in all parts of the heart in males. It is concluded that the hydroxyproline content of heart muscle increases in proportion to age and is in inverse proportion to heart weight. The increase occurs in the TCA‐soluble and residual fractions, and extends from the endocardium to the papillary muscle. More profound changes in collagen metabolism are observed in males.
Thyroid Status and the Depressed Elderly
Authors: Gambert Steven R. , Pontzer Carol P. , Dagon Eugene M. 
Published: April 2015

ABSTRACTAlthough many studies have been devoted to linking thyroid status and depression, the results have been conflicting. This review concerns types of depression and suggests a paradigm that could encompass the role of the thyroid in aging and depression. Also discussed are thyroid function and its modification in the treatment of depression. Special precautions should be taken with the use of tricyclic antidepressants and with the enhanced cardiotoxic effects when combined with certain thyroid factors in the treatment of depression alone in the elderly.
Goals in Hemiplegia Care†
Authors: Rogers Eugene J. 
Published: April 2015

ABSTRACTPhysicians should assume leadership and a greater role in the post‐stroke management of the hemiplegic patient, so that the recipient of care becomes an active participant in the treatment team. The patient should be fully aware of his condition, and partake in establishment of the goals together with subsequent evaluation of accomplishments and progress. Some short‐term and some longer‐term goals are outlined as a guide. A method for performance scoring is suggested. These performance ratings may assist in establishing priorities for discharge planning and continuation of care. They also may permit more accurate assessment and documentation of the patient's capacities and the efficacy of the various approaches to adequate care.
Nursing Home Candidates: Hospital Inpatient Trial to Identify Those Appropriately Assignable to Less Intensive Care
Authors: Sloane Philip D. 
Published: April 2015

ABSTRACTPrimary care physicians are often confronted with demands that elderly patients be institutionalized. Patients who appear to have no new medical problems present a therapeutic dilemma. Should they be admitted to a general hospital or should they be placed directly in a nursing home? This longitudinal prospective study involved 29 consecutive elderly patients judged to be in need of nursing home placement but who were without medical indications for admission. They were assessed and treated in a 30‐bed ward of a general hospital. The mean length of stay was 19 days. Of the 29 patients, 8 (24 percent) benefited from the hospitalization; the outcome was placement and retention at a level of care less intensive than that in a nursing home. On admission to this special ward, the presence of 2 of the following 3 characteristics identified the patients who would benefit from this preplacement hospitalization (with 75 percent sensitivity and 86 percent specificity): 1) a score of A or B (Katz Scale) for activities of daily living; 2) a score of 3 or fewer errors on the mental status scale (Pfeiffer); and 3) the presence of family members willing to care for the patient, although unable to do so at the time of admission. These 3 factors constitute a screening tool to differentiate elderly patients who will benefit most under a regimen of intensive rehabilitation from those who will be inevitable recipients of long‐term care.
Cancer Stage‐to‐Age Relationship: Implications for Cancer Screening in the Elderly*
Authors: Holmes Frederick F. , Erwin Hearne 
Published: April 2015

ABSTRACTIn a study specifically addressing the age‐stage relationship, the authors examined the distribution of 30,991 cancers by disease‐stage versus patient‐age at the time of diagnosis. For cancer of the bladder, breast, cervix, ovary and uterus (endometrium), a highly significant positive relationship was found between advancing stage and advancing age (P < 0.001). For cancer of the kidney and stomach, the relationship held but was less significant (P < 0.05). For colorectal cancer, no relationship was evident. For bronchial cancer there was a highly significant inverse relationship (P < 0.001). After the site of origin of the cancer, the stage at the time of diagnosis was the next most important determinant for treatment and survival. These data emphasize the importance of periodic pelvic examination as a means of screening for asymptomatic cervical, ovarian, or other uterine (endometrial) cancer in elderly women. Also, the data support the importance of breast self‐examination and mammography in screening for breast cancer in older women. The inverse relationship of age to stage in bronchial cancer suggests that screening by periodic chest roentgenograms and cytologic sputum examinations may be more appropriate for elderly than for younger populations in whom these screening methods have proved disappointing.
Problems of Families Caring for Alzheimer Patients: Use of a Support Group
Authors: Barnes Robert F. , Raskind Murray A. , Scott Monte , Murphy Colleen 
Published: April 2015

ABSTRACTAn eight‐week support group program was conducted for 15 members of the families of Alzheimer patients still living at home. It became clear that caring for an Alzheimer patient at home created tremendous practical, psychologic and social problems for family members. Frequently discussed problems included lack of support and information from physicians, poor understanding of the disease, depression, a trapped feeling, anger and fear about the patient's behavioral problems, isolation, and the caretaker's loss of self‐identity. Group participation was especially beneficial for spouses who functioned as primary care providers. It increased their understanding of the disease, made them feel more supported and less isolated, and helped them resolve some of the feelings created by the illness. It also helped spouses to become more aware of their own needs and to regain some self‐identity in relation to the patient. Such family support programs offer a way to strengthen the emotional well‐being and treatment skills of the care‐providing family and are an important aid to treatment in Alzheimer's disease.