bluuebunny/crossref_metadata_2025_split huggingface dataset:
True Aneurysm of the Radial Artery: Report of a Case with Long‐Term Follow‐Up
Authors: Lee Bok Y. , Kim Kang Kiel , Madden John L. 
Published: April 2015

ABSTRACTReports on aneurysm of the arteries of the wrist and hand are relatively rare. Presented here is a case of true aneurysm of the radial artery in a 41‐year‐old man. The patient had an enlarging painful swelling on the volar aspect of the left wrist, of six months’ duration. Under local anesthesia, a transverse incision over the wrist crease revealed an arterial aneurysm. The aneurysm was excised, followed by end‐to‐end anastomosis. The patient recovered uneventfully and was discharged nine days after the operation. A follow‐up arteriogram, five years later, showed a patent radial artery with good blood flow. This is an excellent example of a successful reconstructive surgical procedure involving a small artery.
Stable Chronic Disease: A Behavioral Model
Authors: Byl Nancy Nies , Clever Linda Hawes 
Published: April 2015

ABSTRACTA three‐year study was undertaken in the general medical clinic of a private community hospital, to assess the health behavior, health status, and profile of function of a group of 84 older patients with stable chronic disease. A working definition of stable chronic disease was developed and tested. It was shown that these patients used a disproportionate amount of health care services. Half of the group was treated by a nurse practitioner/physician team and half by a house officer/preceptor team. Patients in both groups behaved similarly. These patients: 1) made frequent demands for outpatient services but did not need more than average hospital care; 2) tended to have problems of socio‐economic indigency; 3) were likely to have hypertension, obesity, arthritis, and functional disease; 4) were chiefly women; 5) required special visits 9 percent of the time, usually for exacerbations of illness or intercurrent health problems; 6) made greater demands if they had functional complaints as a primary or secondary health problem; and 7) viewed their health more positively and functioned at a higher level if they were over 65 years of age. It was also found that the nurse practitioner, working in consultation with a physician, was able to provide high‐quality health care.
Evaluating the Quality of Nursing Home Care
Authors: Howard John B. , Strong Kenneth E. 
Published: April 2015

ABSTRACTEvaluation of the quality of care that a nursing home patient receives is difficult and requires physician participation as well as the participation of specially trained nursing personnel. A form of limited medical audit is suggested to aid in such evaluation. In the proprietary nursing home studied by the authors, the quality of care was not being effectively assessed by the survey process then employed. In addition to other factors, emphasis is now placed on the avoidance of additional costs or extra paper work in the process of determining the quality of care.
Relation of Long‐Term Electronic Cardiac Pacing to Mental Status and Adaptation in the Institutional Aged
Authors: Rodstein Manuel , Zarit Steven , Savitsky Elias , Goldfeder Madelon 
Published: April 2015

ABSTRACTThe long‐term effects of cardiac pacemakers on the mental status and adjustment of an aged population were investigated. In an institution for the aged, 25 residents (average age, 85) in whom pacemakers had been implanted for an average of 53 months were compared to 18 residents of the same age and sex who had a slow heart rate. A semistructured interview was given to determine mental status, affective condition, perceived health, and other concerns. Cardiac status was rated for all subjects according to the criteria of the New York Heart Association. By the measures of adjustment and mental status, no differences were found between pacemaker patients and those with a slow heart rate. Cardiac status was somewhat poorer in the pacemaker group. When comparison was made between the pacemaker patients with uncompromised or only slightly compromised cardiac status and subjects with a slow heart rate and similar cardiac status, no significant differences were found in the foregoing measures. These findings suggest that although there may be changes in functioning in the acute phase following implantation of a pacemaker, there are no long‐term effects on adjustment in subjects of advanced age. Adaptation in an institution for the aged may be more related to personality factors than to specific health problems.
Testing As a Component of Continuing Education Programs: Evaluation of Conference Presentations by This Method
Authors: Mitchell Merlin M. , Mayne John G. , Wellman William E. 
Published: April 2015

ABSTRACTAs a means of evaluating the effect of each presentation at a national medical conference and of the meeting as a whole, the scheduled lecturers were asked to supply the testers with several questions that summarized the most important points of their talks. Audience participants at the meeting were given tests drawn from these questions — one test before the beginning of the meeting, and another at the end. The results were compared for the answers to each lecturer's 3‐question group, and for the complete tests. All scores were better at the end than at the beginning of each lecture. A follow‐up survey of the attitudes of participants showed a positive reaction to the use of such testing at future meetings.
Tardive Dyskinesia in Psychogeriatric Patients: A Five‐Year Follow‐Up
Authors: Mehta D. , Mehta S. , Mathew P. 
Published: April 2015

ABSTRACTThe neurologic side effects of antipsychotic drugs in the treatment of major psychiatric disorders are causing great concern. The status of tardive dyskinesia in 13 elderly psychiatric patients at the 5‐year follow‐up point, is reported. In 11 of the 13, tardive dyskinesia persisted. Among these 11 patients, the severity was reduced in 2, increased in 2, and unchanged in 7. Only in 2 of the total 13 subjects had the tardive dyskinesia disappeared. However, both of these patients were receiving neuroleptic drugs and had parkinsonism, a syndrome that might have masked the dyskinesia. Recommendations are made for prophylaxis and for good clinical judgment in the use of antipsychotic drugs.
Malignancy in Rheumatic Disease: Interrelationships
Authors: Sheon Robert P. , Kirsner Allan B. , Tangsintanapas Penput , Samad Fasin , Garg Mohan L. , Finkel Robert I. 
Published: April 2015

ABSTRACTPatients with inflammatory arthritis and malignancy comprise two distinct populations. One group represents the chance occurrence of malignancy and rheumatic disease. These patients have symmetric polyarthritis, chiefly classic rheumatoid arthritis, and react positively to the rheumatoid factor test. There is no temporal relationship between tumor onset and rheumatic disease onset. In the second group, there may be a causal relationship between the malignancy and the rheumatic disease. These patients have asymmetric rather than symmetric arthritis and test results are negative for rheumatoid factor. There is a close temporal relationship between the onset of the tumor and the onset of the rheumatic disease. The mortality rate is significantly higher than in patients with symmetric polyarthritis. In 80 percent of women with asymmetric arthritis and malignancy, the tumor is mammary carcinoma. This indicates the advisability of a careful breast examination in this group of women.
Intraocular Lens Implantation: Faster, More Complete Rehabilitation of the Cataract Patient†
Authors: Hirschman Henry 
Published: April 2015

ABSTRACTCataract, the leading cause of blindness in the United States, chiefly affects the elderly. Surgical therapy in the 1920's is contrasted with that in the 1970's. Visual corrections with spectacles, contact lenses, and intraocular lenses are discussed. Intraocular lens implantation, when performed by specially trained surgeons, offers cataract patients prompt and complete visual rehabilitation.
Pathology of Centenarians. I. The Cardiovascular System and Lungs
Authors: Ishii Toshiharu , Sternby Nils H. 
Published: April 2015

ABSTRACTThe cardiovascular and lung lesions in 23 centenarians (7 males and 16 females) were examined pathologically. The heart showed varied degrees of hypertrophy, and myocardial fibrosis was present in 15 of the 23 patients. Coronary arteriosclerosis was noted coincidentally. In addition to these findings, amyloid deposition was seen in the hearts of 8 patients. Generalized atherosclerosis of the arterial tree was severe to moderate in all cases. Bronchopneumonia was present in 15 of the 23 patients, and fresh or old thromboembolism in 8. There was a tendency toward emphysema and chronic bronchitis in the structure of the lung. The frequent occurrence of myocardial fibrosis and bronchopneumonia was characteristic in the series. It was significant that cardiac amyloid deposition was noted in these cases.
Huntington's Disease: Improvement with an Anticoagulant‐Psychotherapy Regimen
Authors: Walsh Arthur C. , Melaney Catherine 
Published: April 2015

ABSTRACTA 45‐year old woman with Huntington's disease (HD) was followed for three years while under an anticoagulant‐psychotherapy regimen. The chorea disappeared and the patient improved rather than deteriorating as predicted. All psychotropic drugs were discontinued. This case of reversal of the disease may help to confirm the hypothesis that HD is probably due to circulatory insufficiency in the substantia nigra.
Sinus Bradycardia in the Aged
Authors: FRIEDMAN GEORGE 
Published: April 2015

ABSTRACTIn the aged, sinus bradycardia represents the sinus‐node‐dysfunction component of diffuse conduction system disease associated with coronary and cerebral arteriosclerosis. Findings are presented on 15 patients whose ages ranged from 69 to 93 years at the time of admission to a home for the aged. They remained under observation (with electrocardiographic data) for from less than 1 year up to 18 years. The findings illustrate the evolution of conduction system abnormalities, including sinus node dysfunction, occurring either as an initial or an interval event. These abnormalities represent positive indications for pacemaker insertion in the aged.
Depression in the Elderly. II. Possible Drug Etiologies; Differential Diagnostic Criteria*
Authors: SALZMAN CARL , SHADER RICHARD I. 
Published: April 2015

ABSTRACTDrugs for the treatment of various medical or psychiatric disorders may sometimes cause or exacerbate depression in the elderly. Drug interactions due to polypharmacy (a common method of prescribing for aged patients) may also play a role in the genesis of depression. The roles of specific drugs and of drug interactions are reviewed. Criteria for the diagnosis of depression in the elderly, as well as differential diagnostic guidelines, are presented and constructive suggestions offered.
Pharmacy Services in a Federal Extended Care Facility, as Provided by a Pharmacy Student
Authors: III WILLIAM L. GLENN , PATRY ROLAND A. , KROEGER RUTH 
Published: April 2015

ABSTRACTThe objective of this study was to identify the role of the pharmacy student in providing health care to a Federal Nursing Home Care Unit. Under the supervision of a graduate pharmacy resident, the student was responsible for monitoring compliance in drug therapy, providing consultation services, and developing several research projects. A detailed study of allergy documentation in 78 patients showed that 25.6 percent of their records indicated drug allergies, but upon further investigation only 5.1 percent could be confirmed. Fourteen (41 percent) of the 34 reported allergy‐producing substances had been administered again after the initial allergic incident, without ensuing difficulties. Evaluation of the self‐medication program indicated that 71.4 percent of 14 study patients could not easily open their child‐proof medicine containers. A change to “tight” containers enhanced the patients' ability to open them. However, no significant conclusions could be drawn regarding improvement in the patients' compliance with prescription directions. Pharmacy students can be a valuable resource in improving documentation, testing drug prescription compliance, and participating in the general care of patients in long‐term facilities.
Clinical Utility of a Rapid Diagnostic Test Series for Elderly Psychiatric Outpatients
Authors: MURKOFSKY CHARLES , CONTE HOPE R. , PLUTCHIK ROBERT , KARASU TOKSOZ B. 
Published: April 2015

ABSTRACT:Psychiatric evaluation of the elderly is especially difficult for several reasons, e.g., the presence of organic impairment, the effects of multiple drug therapy, and the tendency to confuse the normal concomitants of aging with neurotic symptoms. The authors have developed and evaluated a brief series of self‐report assessment tests (GRDB) designed to assist the psychiatrist in the process of diagnosis. Coefficients of the internal consistency of the seven scales are presented. A comparison was made between 28 psychiatric patients attending a geriatric clinic and 48 well‐functioning elderly persons matched for age and sex, and living in the same community. Results showed that the geriatric outpatients functioned at a lower level of adaptation than did the control group, on all seven scales—depression, daily living skills, social interaction, cognitive skills, number of illnesses, number of life problems, and the use of drugs and alcohol. These findings provide a measure of discriminant validity. The advantages of this brief assessment instrument are discussed.
Unusual Abdominal Complications of a Suicidal Overdose of Analgesic and Psychotropic Drugs in an Elderly Patient
Authors: MEHTA D. , MEHTA S. , MATHEW P. 
Published: April 2015

ABSTRACT:A suicidal 67‐year‐old woman with manic‐depressive psychosis took an overdose of aspirin, amitriptyline and diazepam. The initial effects were pyrexia, tachycardia, hyperpnea, metabolic acidosis, electrocardiographic changes, hypo‐prothrombinemia, gastritis, and pancreatitis. Four to six weeks later, she was examined because of persistent abdominal pain with nausea, anorexia, anemia, and possibly a malabsorption syndrome. An exploratory laparotomy was performed. The surgeon found several adhesions, a small intestinal volvulus, and a nodular pancreas. This suggested previous perforation of the small bowel from enteritis, causing a “blind‐loop” syndrome. The involved section of the small bowel was resected. With appropriate treatment, the patient is well three months after operation.
Are the Aged a Minority Group?*
Authors: PALMORE ERDMAN 
Published: April 2015

ABSTRACT:The aged resemble minority groups in three ways, i.e., they suffer from prejudice, discrimination, and deprivation. On the other hand, they are not born into their age group, and they have little sense of group identity or political unity. The most descriptive term would seem to be “quasi‐minority group.” However, the aged are becoming less and less like minority groups as society seems to be moving toward an “age‐irrelevant” era.
Relationship of Age and Biomedical Risk Factors to Progression of Coronary Artery Disease*
Authors: Abrahams Joel Peter , Nash David T. , Gensini Goffredo G. , Arno Thomas 
Published: April 2015

ABSTRACTThe relationship between age, biomedical risk factors and the progression of occlusive disease of the coronary arteries was studied in 176 patients (age range, 27–66 years) who had undergone at least two cine angiograms. The biomedical risk factors of interest were serum concentrations of cholesterol and triglycerides, smoking, hypertension, diabetes mellitus, family history of coronary disease, electrocardiographic abnormalities, obesity, and age. The findings did not reveal any significant differences in mean lipid levels between patients showing progression of disease and those who did not. However, the distribution of serum cholesterol values indicated more hypercholesterolemic patients among the disease‐progression group, and more patients with ideal cholesterol levels among the no‐progression group. The other biomedical variables did not appear to be related to the progression of coronary disease. Among the older patients, hypercholesterolemia and diabetes mellitus were related to disease progression. Among the younger patients, smoking was related to progression.
Geriatric Rigidity and Its Psychotherapeutic Implications
Authors: Brink T. L. 
Published: April 2015

ABSTRACTThe elderly tend to be more rigid than younger adults in their attitudes and personalities, and such rigidity is correlated with poor adjustment. However, the rigidity is not the cause of the poor adjustment; rather, it is an attempted solution. One of the patterns of rigidity is an outgrowth of the lifestyle of pessimism, suspicion, self‐reliance, self‐discipline, determination, and endurance. Two case studies are presented illustrating how rigidity can channel thoughts and prevent the brooding which works itself into depression or anxiety, while simultaneously reinforcing self‐help behavior. Geriatric psychotherapy should be problem‐centered and should not launch a frontal assault on rigidity or attempt to reconstruct the patient's personality. Behavioral modification, authority, and motivation slogans can be used in conjunction with the rigidity to improve the patient's coping ability.
Disengagement versus Engagement — A Need for Greater Expectations
Authors: Bell Joanne Zysk 
Published: April 2015

ABSTRACTAn attempt is made to clarify some existing perspectives of successful aging. The environmental milieu of the aged is laden with potent and pervasive implications about successful adaptation. Considerable exploration is required to facilitate a realistic focus upon various theoretical contributions already presented. The influence of stresses and adaptive energy depletions preceding the senescent state is discussed in an effort to facilitate knowledgeable assimilation of the potential impact of the socioeconomic milieu upon the aged. It is the author's contention that the elderly person, upon retirement, presents an adaptive energy reserve highly personalized in its ability to accommodate to change, and especially dependent upon the nature, number and intensity of environmental stressors to adapt, successfully or unsuccessfully, to senescence. Various environmental stressors are identified (e.g., changes in social opportunities and expectations which create new needs and constrict the realm of emotional and vocational influence, thus reducing opportunities and diminishing self‐esteem). Heavy emphasis is placed upon role theory, interaction ritual, and transactional analysis. These concepts are extended to the institutional setting–an environment which serves only to magnify mechanisms occurring diffusely throughout the social system while adding its own unique dimension to the stressors confronting the elderly.
Topical Fluorouracil Therapy for Precancers and Cancers of the Skin
Authors: CULLEN STANLEY I. 
Published: April 2015

ABSTRACTTopical fluorouracil (FU) is an extremely effective agent for treating multiple actinic keratoses. It is also of value in the treatment of Bowen's disease, actinic cheilitis, arsenical keratoses, radiodermatitis, X‐ray‐induced keratoses, leukoplakia, and the erythroplasia of Queyrat. Topical FU may be successful in the treatment of superficial basal‐cell carcinomas, but should not be used for nodular carcinomas of the face or neck except under unusual circumstances and with mandatory histologic follow‐up evaluation. The usual method of treatment is twice daily application of a 1 percent FU solution in propylene glycol. Several modifications of various types of commonly employed preparations and the manner in which each is used are described, along with the respective indications. The considerable discomfort associated with the use of topical FU can be lessened by the stepwise approach outlined—a method extraordinarily valuable for older patients. Occasional complications are primary irritant dermatitis and allergic contact dermatitis; these must be recognized promptly and treated, as must other less frequent side effects. Topical FU appears to be of great value in the destruction of existing precancerous skin lesions. When used repeatedly, it may postpone indefinitely the development of significant precancerous and cancerous skin lesions.
Age‐Related Changes in Endocrine and Renal Function in Patients with Essential Hypertension
Authors: Yamada Takashi , Endo Toyoshi , Ito Kazuki , Nagata Hajime , Izumiyama Tomio 
Published: April 2015

ABSTRACTEndocrine and renal functions were studied in 149 patients with essential hypertension by measuring plasma electrolytes, renin activity, creatinine and aldosterone, as well as the urinary excretion of creatinine and sodium chloride, before and during treatment for hypertension. Half of the patients responded to trichlormethiazide (thiazide‐responsive group) but the other half did not (thiazide‐unresponsive group). Systolic and diastolic blood pressures increased progressively with age in the thiazide‐unresponsive group, but were lower and did not progress with age in the thiazide‐responsive group. There was no consistent difference in plasma renin activity between the thiazide‐responsive and the thiazide‐unresponsive groups. The fluctuation of plasma renin activity in response to an excess of sodium chloride or to thiazide treatment was reduced progressively with age. Creatinine clearance decreased and the blood urea nitrogen level increased with age. The age‐related decrease of plasma renin activity is discussed in the light of the age‐related impairment in the ability of the kidney to excrete sodium and water.
Experience with an Incontinence Clinic*
Authors: Overstall P. W. , Rounce K. , Palmer J. H. 
Published: April 2015

ABSTRACTIn an “incontinence clinic,” a study of 309 elderly patients showed the most common causes of incontinence to be: unstable bladder (57 percent), outflow obstruction (13 percent), and atonic bladder (7 percent). Pure stress incontinence was rare (2 percent). One third of the patients improved, one third had to be catheterized, and one third did not improve. An individually designed program of bladder retraining for the patient, coupled with support and instruction for the relatives and for the professional care providers, offered the best chance of success.
Psychotropic Drug Prescriptions for Elderly Patients in a General Hospital
Authors: Salzman Carl , Kolk Bessel Van Der 
Published: April 2015

ABSTRACTA survey was made of drug prescriptions written for all medical/surgical patients in a general hospital on a single weekday in 1978. Of these 348 patients, 195 were over the age of 60. In this elderly group, 62 (32 percent) were receiving psychoactive drugs. Flurazepam was the drug most commonly prescribed (in 63 percent of the patients). Diazepam was the most frequently prescribed nonhypnotic psychoactive drug (in 29 percent). Neuroleptic drugs and phenothiazine anti‐emetics (in 52 percent) were not prescribed for psychosis but for augmenting analgesia and sedation and for reducing nausea. The average daily doses were about 20 percent of those used to treat psychotic young adults. All antidepressants (in 9.7 percent) had been prescribed before admission. No monoamine oxidase inhibitors were used, and doses of tricyclic antidepressants were half to one‐third lower than those used to treat younger depressed adults. Antidepressants, which pose a risk to the elderly patient, were overprescribed and underdosed.