bluuebunny/crossref_metadata_2025_split huggingface dataset:
MENISCUS INJURIES OF THE KNEE IN THE ELDERLY
Authors: EICHENHOLTZ SIDNEY N. , JACOBS BERNARD , PATTERSON ROBERT L. 
Published: April 2015

Abstract:A survey was made of the records of 119 patients aged 50 or over who had undergone arthrotomy for meniscal lesions during the period 1951–1965. The predominant complaint at the time of admission to the hospital was pain, and half the patients had had knee symptoms for at least six months. In about half the cases there was no history of injury or of injury severe enough to cause meniscal tear, yet at operation about 80 per cent of the cases showed a torn meniscus.Meniscus tears in the knee joints of elderly patients occur with sufficient frequency to merit detailed study. Delay in necessary surgery may produce or aggravate degenerative joint disease. The symptoms and signs of meniscus lesions in the elderly are virtually the same as in younger patients. When the diagnosis is in doubt, double contrast arthrograms may be helpful. Elderly patients tolerate arthrotomy well, without an undue increase in the incidence of complications as compared to the incidence in younger persons.
ACUTE BACTERIAL INFECTIONS IN THE ELDERLY MALE: CULTURES AND ANTIBIOTIC SENSITIVITY TESTS
Authors: LANE WILLIAM K. 
Published: April 2015

Abstract:In a Veterans Administration hospital, repeated cultures were made of body fluids from 92 elderly male patients who had acute illnesses during the observation period of twenty‐eight months. The urinary and respiratory tracts were the most common sites of bacterial infection.The pneumococcus was the most common cause of respiratory‐tract infection, but in a surprisingly large number of cases the offenders were the Klebsiella‐aerobacter group, Staphylococcus aureus, Proteus mirabilis and Escherichia coli. Tracheostomy favored the growth of Pseudomonas. Escherichia coli was the most common cause of urinary‐tract infection. Next in order were Pseudomonas aeruginosa, Proteus mirabilis and the Klebsiella‐Aerobacter group. The presence of an indwelling catheter favored the growth of Pseudomonas, Staph. aureus, Paracolobactrum aerogenes and Proteus species. Staphylococcus aureus was the most common cause of skin infections. Escherichia coli was the organism most frequently found in septicemia.Tables are presented showing the sensitivity of various bacteria to 14 selected antibiotics. The findings indicate that the term “broad spectrum” should be used with great circumspection and possibly be restricted at present to such agents as kanamycin and chloramphenicol.
FOSTER CARE AS A THERAPEUTIC PROGRAM FOR GERIATRIC PSYCHIATRIC PATIENTS
Authors: HANDY IMENA A. 
Published: April 2015

Abstract:This study deals with the question of what has held back the widespread use of foster homes for geriatric psychiatric patients. In the sixteen years since foster homes were first used by the Veterans Administration, the program has grown twenty‐fold. However, since all VA neuropsychiatric and twenty of the general medical service hospitals participate, this is a relatively small increase; in 1965, there was even a decrease.Some reasons for the slow growth of the foster‐home program are: 1) the difficulties of finding, evaluating and supervising foster homes in such a way that the people who run them (sponsors) receive the satisfaction and joy that rewards them for their heavy personal investment; 2) interfering relatives who, either because of guilt for not taking the patient into their own homes or because of resentment about having to pay for him, block his placement in a foster home; 3) the problem of matching the patient's needs with the resources of the foster home; and 4) the relatively small number of spectacular successes. The results are meager in relation to the emotional investment the sponsor makes in these patients, who are bound to become progressively disabled as they grow older. The sponsor has to be satisfied with the patient's minimal improvement and his “happiness” in being out of the hospital.
RETURNING THE GERIATRIC VETERAN TO THE COMMUNITY FROM A NEUROPSYCHIATRY HOSPITAL
Authors: JUSTICE VERNELL O. , BENDER DARYL 
Published: April 2015

Abstract:The results of this pilot study indicate that the characteristics of 107 elderly (mostly psychiatric) patients released from the Geriatric Unit of a Veterans Administration Hospital did not differ significantly from those of most other older patients found in nursing homes. Age, diagnosis, and length of stay in the hospital proved not to be important factors in selecting the patients who should be released or in determining their adjustment potential. Of the 107 patients, 69 (64 per cent) had incomes of $200 or less per month.Re‐education of the families and the public in general may permit more veterans to return to their own homes or to live with relatives. An increase and/or extension in the veteran's benefits may be far less costly than maintaining him in the hospital when he requires only custodial or nursing care. There is a need for more intermediate‐care facilities, such as sheltered‐care homes and homes for the aged, to accommodate these veterans.
PRESSURE WAVE VELOCITY IN THE HUMAN AORTA*
Authors: Nielsen B. Lyager , Nielsen J. Straede , Fabricius J. 
Published: April 2015

AbstractAfter introduction of a catheter into the aorta, the pressure wave velocity was measured in 26 subjects whose ages ranged from 9 to 68 years. The first site of registration was approximately 10 cm from the aortic valve, and the second was 50 cm distal to the first. At both sites the time difference was measured between the R‐wave of the electrocardiogram and the foot of the pressure wave (TProx. and TDist.). The time difference T50 (TDist. – TProx.) and the distance between the sites of registration (50 cm) were used for the calculation of the pressure wave velocity (PWV).Four of the 26 subjects were normal; the others had some form of heart disease, including disease of the valves, hypertension and aortic atherosclerosis. Nevertheless, the values found for pressure wave velocity were in agreement with those stated in literature.A significant correlation was found between T50 and age (r = —0.788), between T50 and the proximal systolic blood pressure (r = −0.537), and between T50 and the proximal pulse pressure (r = −0.491), but not between T50 and the cardiac output and peripheral arterial resistance. There was no correlation between the proximal diastolic blood pressure and T50, possibly owing to the fact that all the patients had a diastolic blood pressure below 100 mm Hg. There was no significant difference between the coefficient of correlation for T50 and age (−0.788) and the multiple coefficient of correlation for T50 and age and systolic blood pressure proximal in the aorta (−0.811). Four patients had arteriographic aortic atherosclerosis. Two of these had lower T50 values than would be expected according to the proximal systolic blood pressure and the pulse pressure, but after exercise the values were within the normal range (±2 s.d.)Owing to the dominating influence of age on T50 and the considerable spreading of these values, it is not likely that the determination of pulse wave velocity will be of clinical value, for example, in the diagnosis of atherosclerosis.
NONSTEROID ANTI‐INFLAMMATORY AGENTS IN THE THERAPY OF RHEUMATIC DISEASES
Authors: WARD L. EMMERSON 
Published: April 2015

Abstract: The management of rheumatoid arthritis is outlined in detail since certain basic principles are applicable to the management of other rheumatic disorders discussed much more briefly. Emphasis is laid on the physician‐patient relationship. It is important for the physician to inform the patient of some of the basic facts about the disease and the general objectives of treatment. Also important is the patient's choice of objectives. Therapy with the following nonsteroid drugs is discussed: salicylates, indomethacin, phenylbutazone, aminoquinoline compounds and gold salts.The treatment of rheumatic diseases is largely empiric and is directed toward symptomatic relief and palliation. Knowledge of causes and cure is grossly deficient, and our therapeutic capabilities are limited. Nevertheless, significant advances are being made in the investigative laboratories and in the application to patients of the knowledge and therapy which are available.
INTERRELATIONSHIPS OF OPHTHALMOLOGY AND RHEUMATIC DISEASES
Authors: NOWICKI NORBERT J. 
Published: April 2015

Abstract:Some of the ocular lesions associated with rheumatic diseases are described—uveitis, scleritis and scleromalacia, retinitis, and keratoconjunctivitis sicca. Also discussed are the ocular complications associated with treatment of rheumatic disease. These complications include steroid cataracts, steroid glaucoma, and chloroquine changes.A plea is made for clinicians to be aware of the possible cata‐ractogenic influence of corticosteroid therapy, and also the possibility of steroid‐induced glaucoma, particularly in a patient with incipient glaucoma or with a family history of the disease. The possible retinotoxic effects of long‐term chloroquine or hydroxychloroquine therapy should be kept in mind. To avoid these dangers, patients receiving steroids or chloroquine for prolonged periods should undergo regular eye examinations.
ALPHA‐RAY ACTIVITY IN CORONARY ARTERY DISEASE
Authors: ELKELES ARTHUR 
Published: April 2015

Abstract: The ash concentrations and the alpha‐ray activities of the coronary and of the common carotid arteries were examined in 16 subjects who died of ischaemic heart disease (average age, 64.8 years), and in 17 subjects who died of other causes (average age, 62 years).The ash concentrations in the coronary arteries of the subjects with fatal ischaemic heart disease were twice as high as in those of the controls. They were very low in the common carotid arteries of both groups. Ulcerative and calcified atheromatous lesions in the common carotid arteries were rare at all ages.Postmortem radiography of these vessels revealed distinctly more calcium deposits in the coronary arteries of the subjects with fatal ischaemic heart disease than in those of the controls. No calcium deposits were visible in the common carotid arteries of both groups.The wet‐tissue alpha‐ray activities in the coronary arteries of the subjects with fatal ischaemic heart disease were four times higher than in the coronary arteries of the controls, five times higher than in their own common carotid arteries, and ten times higher than in the common carotid arteries of the controls.The mean value of the alpha‐ray activities in the coronary arteries of subjects with fatal ischaemic heart disease equals that found for human bones. It is higher than in any other soft tissue in the human body.X‐irradiation of the larger arteries can produce severe atheromatous lesions in animals and in human beings within a relatively short time.The concept is advanced that the small amounts of alpha‐radiation in the arterial wall, which increase with age, may cause subtle injuries to the arterial structures, thus contributing to the development of atherosclerosis.
TRENDS IN PSYCHIATRIC HOSPITAL CARE OF GERIATRIC PATIENTS IN THE UNITED STATES
Authors: HEFFERIN ELIZABETH A. 
Published: April 2015

Abstract: State (or public) mental hospitals in the United States, like many other social institutions, came into being in response to a recognized social need for providing facilities which would offer security for the mentally ill in the population.This review of the history of these hospitals reveals several recurring themes: the tendency for public shifting of the responsibility for the care of the poor and the mentally ill upon the government, and the shifting of this same responsibility between the levels of government (from community to local to state to local community); the periodic rousing of the public interest and compassion by reform movements, too soon followed by public return to apathy or diversion to more rewarding issues; and the recurring conflict between socio‐cultural and scientific values with regard to costs of application of psychotherapeutic methods for care of the patients.Further analysis of the data also reveals that there has been an improvement over time with regard to the physical care of patients, but not in the reduction of their numbers through this care. In fact, until just recently, better care seemed to result only in a greater average duration of hospital stay for many patients, if only because they now lived longer. After rather belatedly becoming concerned about the rising incidence of mental illness in an ever‐increasing population and therefore higher admission rates to already over‐crowded state mental hospitals, the Federal Government authorized a series of studies of the problem, and has passed legislation to begin an alleviation of the situation. Possible outcomes of these legislative measures have been discussed, along with some possibly negative effects if too‐hasty action should be taken in lieu of careful planning.
DIPHENIDOL IN VERTIGO: A CONTROLLED CLINICAL EVALUATION
Authors: ROWAN NOEL M. 
Published: April 2015

Abstract: In a double‐blind study, diphenidol was compared to placebo in 39 patients with vertigo from various causes. Fifteen of 19 patients taking diphenidol (dosage, 25 mg four times daily) obtained good or excellent relief of vertigo, whereas only 5 of 20 patients taking placebo obtained this degree of relief (P < .01).No side effects occurred in this series, but there are reports of such effects in the literature. Therefore, diphenidol should be used only under conditions of strict supervision.
PSYCHO‐SOCIAL CHANGES IN PERSONALITY DURING FOSTER GRANDPARENTS PROGRAM*
Authors: Rybak W. S. , Sadnavitch J. M. , Mason B. J. 
Published: April 2015

AbstractOlder persons in our society are forced into retirement arbitrarily and thus experience great difficulty in psychosocial adjustment. The social benefits provided by society fail to foster the original aims of the program; as a result the older person must seek additional aid or part‐time employment.The purpose of this report is to describe a foster grandparent program designed to promote better psycho‐social adjustment for older persons. An informal scale for assessing psycho‐social needs is presented. The results obtained with use of this scale indicated that the foster grandparents felt more positively about specified psycho‐social items after taking part in this program than before participation. Hence it is concluded that a foster grandparent program can counteract some of the negative aspects of aging and society's attitude toward the process.
MEDICAL STUDENT ATTITUDES TOWARD THE GERIATRIC PATIENT*
Authors: Spence Donald L. , Feigenbaum Elliott M. , Fitzgerald Faith , Roth Janet 
Published: April 2015

AbstractQuestionnaires designed to test attitudes toward old people were given to both the freshman class and the senior class of students in the University of California School of Medicine. Results of the study showed that these two groups shared most of the general societal conceptions and misconceptions about the aged. In addition, these students adhered to a set of medical stereotypes about aging to a degree surprisingly unmodified by the much‐vaunted medical socialization process; freshmen and seniors agreed on many aspects of the subject. The results of this attitudinal status were manifested in a medical prejudice against old patients, as expressed in the replies given to the questionnaire.How much of the difference observed between the attitudes of the freshmen and the seniors was due to non‐medical acculturative influences (such as the demographic characteristics unique to each group) and how much to the medical socialization procedure, was difficult to ascertain. More significant, however, was the lack of difference between the two student classes and the failure of three years of medical education to mitigate factors injurious to a major and growing segment of the population—aged patients.
MEDICAL CARE FOR THE ELDERLY IN THE FUTURE*
Authors: Hall Durward G. 
Published: April 2015

AbstractThis article concerns: 1) some of the problems encountered under Medicare and Medicaid (especially in relation to the costs and standards of extended care facilities); 2) the problems of the doctors regarding allocation of the proper share of medical costs to the hospitals, and the campaign for pre‐paid group practice; 3) the prospects for success of the proposed amendments to the Public Health Service Act based on good results with the heart disease‐cancer‐stroke programs despite certain pitfalls; and 4) the future of the Hill‐Burton Act. Is the outcome to be more Federal authority and the disappearance of State responsibilities?Many people who never get to Washington assume there is a magical elixir there that turns out the right solution to every problem. It should be pointed out, however, that after three years of observing riots across the country, Washington still didn't know what to do when the city exploded; after two decades of planning and supervising the Interstate Highway Program they still have some of the worst imaginable traffic jams of every artery leading out of Washington at sunrise and sunset; and the political pundits who thought they knew exactly who the two presidential candidates would be next November have had to change their predictions at least twice in the last month. Anything Washington can do, you can do better if you'll set your minds, your wills and your skills to the task.
PREVENTION OF EXECUTIVE OBSOLESCENCE*
Authors: Ochsner Alton 
Published: April 2015

AbstractExecutive obsolescence and premature senility can be controlled to a great extent by avoiding certain factors which accelerate the aging process, i.e., lack of exercise, obesity, and the use of tobacco. Prophylactic measures include exercise such as walking, with or without jogging, to the point of tolerance; the avoidance of sedentary occupations; walking up and down stairs instead of using an elevator; the prevention of obesity or the reduction of overweight when present; and abstinence from tobacco smoking.
SKIN PROBLEMS IN THE GERIATRIC AND GENERAL HOSPITAL: INCIDENCE, SCOPE, CAUSE
Authors: Young Alex W. , Miller Leon 
Published: April 2015

AbstractFive hundred and forty‐three patients (random sampling) were examined for skin disorders according to the following groups: A) 388 geriatric patients in a chronic disease hospital, B) 74 geriatric patients in a general hospital, and C) 81 younger patients in a general hospital. A cutaneous disorder was found in 440 of the 543 patients, and 56 per cent of these disorders were of the type requiring specialized attention. Factors which influenced the incidence of skin disease, especially in the geriatric patients, included the degree of ambulation, length of hospital stay, previous skin care, environment, emotional adjustment, medication, associated medical disorders, and past dermatological disease. The most important disorders in the geriatric patients included essential senile pruritis, epithelioma, cutaneous ulceration, pemphigoid, psoriasis, precancerous lesions, neurodermatoses, intertrigo, contact dermatitis, pyoderma and mycotic infections. The high incidence of these cutaneous diseases, especially in geriatric patients, justifies routine dermatological rounds in hospital wards as a factor in the total care of the patient.
REMOTIVATION OF LONG‐TERM MALE SCHIZOPHRENIC PATIENTS*
Authors: Lerner Joseph , Paik George , Sanborn Kenneth O. , Murata David M. , Moravec George G. 
Published: April 2015

AbstractA vocational rehabilitation project for chronically ill schizophrenic male patients at Hawaii State Hospital involved the comparison of two groups of patients: (a) 32 who underwent a program of work conditioning plus vocational rehabilitation services, and (b) 19 who received only the regular hospital vocational therapy. By means of work‐tolerance and adequate‐vocational‐personality tests, it was possible to assess the patient's ability to adjust to community placement. Placement in a job in the community involved follow‐up assessments at twelve and eighteen months.The results of this study support the concept that vocational rehabilitation programs for patients with chronic schizophrenia can increase their chances for discharge from the hospital and can enable them to maintain themselves in the community if provided with vocational rehabilitation services and follow‐up. Work‐conditioning did not seem to be the prime factor in this success. The study also illustrates the cooperation of both private and governmental agencies in the use of manpower, facilities and funds to reduce the schizophrenic patient's difficult transition from the hospital to the community.
ORGANIZATION OF A COMPREHENSIVE MEDICAL CARE PROGRAM IN A CHRONIC DISEASE HOSPITAL
Authors: Mark Herbert 
Published: April 2015

AbstractA program is described for the comprehensive care of patients on the medical service in an 1800‐bed municipal chronic disease hospital. Patients with neoplastic disease or those who need merely custodial care are not considered candidates for admission. Every new patient first stays in the admitting section for about three weeks to undergo thorough evaluation of his needs and rehabilitation potential. He is then transferred to one of the four comprehensive care units on the medical service. This unit system facilitates the assignment of a personal physician to each patient. The staff is organized into teams to provide the non‐medical as well as the medical services required during the patient's entire stay in the hospital. Interdisciplinary teaching conferences encourage efficiency on the part of all staff members.Because the chief goal of the program is the provision of comprehensive care for patients with multiple problems, the staff physicians can no longer be concerned with only a single disease or organ system. They must cope with a wide range of medical problems and also with the patient's reactions to his disease and the interrelationships between the patient, the family and the community. Such a program provides a new, flexible approach to services, teaching and research in the care of the chronically ill.
USE OF FUROSEMIDE FOR EVALUATION OF THE URINARY CONCENTRATING MECHANISM IN CHRONIC PYELONEPHRITIS
Authors: Radó János P. , Borbély Lajos , Takó József , Bános Csaba 
Published: April 2015

AbstractA report is presented of a polyuric condition associated with chronic bilateral pyelonephritis in an old diabetic patient during an aglucosuric period. On the basis of the limited response to lysin‐vasopressin and the extremely low values obtained for solute‐free water abstraction per 100 ml glomerular filtration, a defective operation of the countercurrent concentrating mechanism was demonstrated.The normal response induced by furosemide during both maximal sustained water diuresis and hydropenia indicated that the sodium pump in the ascending limb of the loop of Henle was operating satisfactorily. Therefore, the disordered function of the countercurrent system was not due to insufficiency of sodium transport but probably to the lack of “solute‐trapping” ability of the disintegrated renal medulla.
CANCER OF THE BREAST WITH METASTASIS TO THE FALLOPIAN TUBE
Authors: Case Thomas C. 
Published: April 2015

AbstractA 36‐year‐old woman had two successive primary cancers of the breast (left, right) removed surgically. At the time of the second mastectomy a bilateral salpingo‐oophorectomy also was performed. Unexpectedly, a breast cancer metastasis was found in the right Fallopian tube; infiltrating cancer was also present in the left ovary.Although reports in the literature increasingly indicate that the length of survival after breast cancer is not dependent upon the more radical forms of treatment, the history of the case described here brings up the question of whether or not contralateral mastectomy and bilateral salpingo‐oophorectomy at the time of the first breast operation would help to prevent the development of a second primary breast cancer.