bluuebunny/crossref_metadata_2025_split huggingface dataset:
Chlorpromazine in Geriatric Psychiatry
Authors: BIRKETT DAVID PETER , BOLTUCH BRUCE 
Published: April 2015

ABSTRACT: Fifty patients in the psycho‐geriatric unit of a county hospital were divided randomly into two groups; 30 were treated with chlorpromazine for six weeks, and 20 constituted the controls. The morning blood pressure (with the patient in the standing position) was used to monitor chlorpromazine dosage; the highest dosage reached was 200 mg daily (5 cases), but in 11 cases the dosage could be only 50 mg daily. Improvement was assessed by means of Rating Scales (NOSIE and BPRS) and Global Assessment. Chloral hydrate and phenobarbital were prescribed as needed during the trial.No significant differences were found between the groups on the basis of the rating scales or global assessment. Nonsignificant trends favored the chlorpromazine group. (Two patients in the original control group had to be dropped from the study because chlorpromazine therapy was necessary to control violent agitated behavior.) Side effects observed more commonly in the chlorpromazine group were tremor, weight gain, and nasal congestion. Drowsiness, fatigue, unsteadiness, falling, constipation, and abnormal facial movements were no more common in the chlorpromazine group than in the control group.
Etiology and Treatment of Pancreatic Disease: Modern Concepts
Authors: RICCITELLI M. L. 
Published: April 2015

ABSTRACT:Although pancreatic disease may occur at any age, it is more prevalent in the elderly. Pancreopathy usually can be diagnosed by properly performed enzyme and function studies. However, because of its protean manifestations, the presence of pancreatic disease is often missed even after exploratory laparotomy and histologic examination. Prompt diagnosis can be life‐saving, especially in patients with acute abdominal symptoms. This requires diagnostic skill and a basic knowledge of the physiologic and pathologic mechanisms. Chronic pancreatitis follows a precise pattern of events, depending upon many complex underlying mechanisms. Early recognition can interrupt or delay its evolution. This article concerns various etiologic concepts, modern diagnostic methods (including enzyme and function studies, radiography, angiography, pancreatography), and medical and surgical treatment, with emphasis on the use of digestive enzymes.
Disseminated Leiomyosarcomatosis: Case Report
Authors: CASE THOMAS C. , GIANNELLI STANLEY , CONKLIN EDWARD F. , CAMER STEPHEN 
Published: April 2015

ABSTRACTA case of generalized leiomyosarcoma in a 60‐year‐old woman is presented. Apparently the lesion originated in the right lung prior to 1967, since the gastrointestinal and genitourinary tracts and the pelvic organs remain normal. The disease recurred five years after the first operation, necessitating further surgical therapy for removal of the variously situated tumors. The pathology report stated: metastatic leiomyosarcoma. Because of the slow growth of the lesions, the prognosis is favorable.
Three Primary Malignancies Occurring within Fourteen Months in the Same Patient
Authors: KORBITZ BERNARD C. 
Published: April 2015

ABSTRACTA 72‐year‐old woman was treated 1) for papillary cystadenocarcinoma of the ovary, by surgery and radiotherapy, 2) for carcinoma of the right breast, by surgery and radiotherapy, and 3) for terminal acute granulocytic leukemia by blood transfusions. All three of these malignancies occurred within a fourteen‐month period and the patient died about sixteen months after the diagnosis of ovarian carcinoma. The co‐existence of carcinoma of the ovary and breast in the same patient, and the possible etiologic relationship of the radiotherapy to the development of acute leukemia are discussed.
Planning for the Later Years*
Authors: FISHBEIN MORRIS 
Published: April 2015

ABSTRACTPlanning for old age is a procedure contingent upon unforeseen changes. However, the risks can be minimized if planning is started earlier in life when the person is in full possession of his senses, rather than later when his wisdom may be impaired by cerebral deterioration. The government has launched vast programs of medical and social care, but much remains to be done. Employment after age 65 is a difficult problem. Yet employment, or at least productive mental activity, is essential for mental health. Maintenance of mental health is all‐important in decreasing the need for institutional care of the elderly and preserving a satisfying independent environment.
Mental Disturbances in Old Age
Authors: RUDD T. N. 
Published: April 2015

ABSTRACTThe best approach to the care of mentally disturbed geriatric patients involves complete investigation of each case upon hospital admission so that physical factors will not be overlooked when making the diagnosis. The potential for cure should not be underestimated. Proper physical and psychologic conditions of environment and the post‐discharge strengthening of direct home support through day‐center services to relieve family strain, have a pronounced beneficial influence.
On the Genesis of Atherosclerosis*
Authors: BARNES BRODA O. 
Published: April 2015

ABSTRACTAlthough atherosclerosis has been known for over 3000 years, it came into prominence in the 20th century apparently because a reduction in deaths from infections permitted a population susceptible to atherosclerosis to reach adult life. Atherosclerosis is accompanied by an early deposit of abnormal quantities of mucopolysaccharides in the tissues. In hypothyroid children, the tissue content of mucopolysaccharides is increased, but is restored to normal by thyroid therapy. A factor in the increased death rate from atherosclerosis seems to be the survival of hypothyroid children from infectious diseases; they thus become potential candidates for premature death from atherosclerotic disease. Thyroid therapy can be a prophylactic agent against premature deaths from heart attacks, hypertension, and diabetes.
A Surgeon Reviews a Half Century of Progress in the Treatment of Coronary Heart Disease
Authors: MAZEL M. S. 
Published: April 2015

ABSTRACTGreat progress has been made during the past fifty years in the treatment of coronary heart disease. No longer are the untimely deaths attributed to stomach disorders or acute indigestion. Electrocardiography has contributed greatly to our knowledge. The coronary angiogram is rapidly becoming one of the most important diagnostic procedures. Underlying causes of coronary heart disease include heredity, the rich American diet, smoking, and such associated disorders as diabetes and hypertension. Patients with hyperlipemia, hypercholesterolemia or hypertriglyceridemia are particularly prone to coronary disease. Early fibrinolytic therapy before the occluding thrombus can become organized in gradually replacing anticoagulant therapy. For surgical treatment, the saphenous‐vein bypass graft is the procedure of choice in selected cases. In this operation the occlusion is bypassed and the heart receives the blood supply needed for survival. The morbidity and mortality from coronary heart disease will be greatly reduced if fibrinolytic agents are used early enough in an acute heart attack before the occlusion damages the heart muscle beyond repair. Afterward, when it can be performed safely, the saphenous‐vein bypass operation should be used in conjunction with one of the simple revascularization procedures to give the patient maximal protection from future attacks.
Problems of Nutrition in the Aged*
Authors: RAO DODDA B. 
Published: April 2015

ABSTRACTThe importance of nutrition for life and health is paramount, especially in the aged, who are so vulnerable to malnutrition. Important factors leading to improper nutrition in the aged, the relation of these factors to health, the problems of assessment of malnutrition in the aged, and the prevailing public and professional attitudes toward the whole question are discussed. Malnutrition and disease are a great strain on health services, so it is better to practice prevention by adhering to the principles of sound nutrition. Recommendations are made regarding the qualifications of an “ideal” food for the aged, and the planning of successful diets. Eating should not be a chore or a dietary experiment; rather, it should be a genuine pleasure, particularly in old age when so many other pleasures can be enjoyed no longer.
Identification of Mild Hypertension and Some Risk Factors That Influence Prognosis
Authors: ROBINSON S. K. 
Published: April 2015

ABSTRACTMild hypertension is identified as a state in which the blood pressure (BP) is elevated, but there are no cardiac symptoms, no heart, brain, kidney or metabolic diseases, and no abnormalities in the optic fundi. Two grades of BP are suggested for the identification of mild hypertension, since the level of blood pressure influences the prognosis: in Grade 1 the BP ranges from 140/90 to 180/110 mm Hg, and in Grade 2 from 180/110 to 220/120 mm Hg. The yearly mortality rates over a ten‐year period were 0.3 and 1.3 per cent for patients with Grades 1 and 2 hypertension, i.e., of the same order as the mortality rate for the general population. Over a twenty‐year period the mortality rate was higher for patients with Grade 2 hypertension. In the Grade 1 group, the clinical status underwent only minimal changes during the first ten years; in the Grade 2 group, adverse changes in clinical status began to appear after five years. Breathlessness or anginal pain indicated a bad prognosis in both sexes. Presistent headache increased the risk of stroke, especially in females. Proper classification of mild hypertension can lessen the load in clinics, reduce expenses for drugs, and lessen the risk for the patient.
The Goethean Culture of Experience—Aging without Abdication
Authors: Barach Alvan L. 
Published: April 2015

ABSTRACTThe exuberance of the younger generation, based on new personal freedoms and a fresh idealism in human relations, ignited a potentially rewarding path for the adult community to follow. However, the youthful revolt could not be sustained by the substitution of emotional activism for thought, and acute self‐interest for former declarations of concern for fellow human beings.Aging is an unprovoked attack on one organ after the other. Yet, our defects may constitute perpetual victories as we declare a new fidelity to whatever powers and passions remain. The creative reader will be fortified in his grasp of the Goethean culture of experience as he communes with the Prometheans who wrote in defense of personal liberty. The aim of this essay is to reveal an unpredictable turn of events in which the brief spark contributed by the younger generation illuminated a vista of a better way of life for older people, a vista of personal freedom which requires only a fresh documentation from an already available humanistic background. Our western tradition of literature and the other liberal arts may be used to define a culture of enhanced experience, without being curbed by the ultra‐cautious counseling and antiquated restraints which society had imposed upon older people.
Serum Cholesterol Concentration and Atherosclerotic Cardiovascular Disease in the Aged
Authors: VAVRIK M. , PRIDDLE W. W. , LIU S. F. 
Published: April 2015

ABSTRACT: The subjects of this investigation were 509 residents of a Home for the Aged — 195 men and 314 women whose ages ranged from 60 to 90 years. The cross‐sectional study included the distribution and prevalence of various serum cholesterol levels in the different old‐age groups and the association between serum cholesterol concentration, blood pressure, diabetes, and the prevalence of atherosclerotic cardiovascular and cerebrovascular diseases (such as ischemic heart disease and stroke). No association was found between serum cholesterol concentration and the level of systolic or diastolic blood pressure. Serum cholesterol concentrations above 250 mg/100 ml were more common in diabetic than in non‐diabetic females (p < 0.01) but no such relationship was found in the males. A positive correlation was demonstrated between serum cholesterol concentration and the prevalence of atherosclerotic cardiovascular diseases (p < 0.01). In patients with clinically evident coronary and/or cerebral atherosclerosis, the greater prevalence of high serum cholesterol concentrations (above 250 mg/100 ml) was statistically significant in both sexes (p < 0.01).The results of this study support the view that there is a relationship between serum cholesterol concentration and the prevalence of atherosclerotic cardiovascular diseases even in the older age groups. In the individual patient, however, the serum cholesterol concentration has only limited diagnostic and prognostic value.
Urinary Calcium Excretion in Relation to Kidney Function in the Adult
Authors: Goldschmied A. , Modan B. , Greenberg R. A. , Zurkowski S. , Modan M. 
Published: April 2015

ABSTRACTA study based on 55 hospital patients (age groups 40–59, 60–69, 70–79) demonstrated a significant correlation between the glomerular filtration rate (as expressed by endogenous creatinine clearance) and the mean urinary calcium concentration. Excluded were patients with thyroidal or hypophyseal disorders, osteoporosis, renal stones, immobilizing conditions, or those treated with corticosteroids. The study patients had a normal fluid intake and did not receive any diuretics. The urinary calcium concentration test is less laborious and less liable to laboratory errors than the creatinine clearance test, which requires a 24‐hour urine collection. Because of the gradual decrease in the glomerular filtration rate in the elderly, this test should be of value in geriatric practice.
The Longevity of Gerontologists†
Authors: Freeman Joseph T. 
Published: April 2015

ABSTRACTThe forces of mortality are the prime determinants of longevity. Longevity is a basic consideration of gerontology and includes the life expectancy of the species, the average expectancy of survival at birth, and the average lifespan. In the history of the study of old age, for which the modern period began about 1930, there are no reports of the average lifespan for the students of aging. A survey revealed that the average lifespan of 28 special groups (15,000 individuals) was 68 years; this included an average of 68.01 years for 394 gerontologists during the same eras. These figures are comparable because the attainment of a particular status in a profession or vocation is evidence of survival to maturity. Comparison could not be made with data for the general population whose vital statistics begin at birth. The average duration of life for men whose work in part or in whole prior to the 20th century was in gerontology falls midway between the high level of 77 years for classical Greek authors and the low level of 51 years for revolutionary statesmen, and exactly between the levels of life duration for eunuchs and physical and medical scientists.
Left Ventricular Filling Pressures in Cardiac Patients†
Authors: Prakash Ravi , Aronow Wilbert S. 
Published: April 2015

ABSTRACTPulmonary artery end‐diastolic pressure (PADP), pulmonary artery wedge pressure (PAWP), and pre‐“a” wave left ventricular diastolic pressure (LVDP) were correlated with post‐“a” wave left ventricular end‐diastolic pressure (LVEDP) in 51 patients with coronary disease and in 43 cardiac patients with non‐coronary disease, excluding mitral stenosis. In patients with coronary disease, the PADP was more closely correlated with PAWP (r = 0.83) and LVDP (r = 0.84) than with LVEDP (r = 0.62). In patients with non‐coronary disease, the PADP also was more closely correlated with PAWP (r = 0.82) and LVDP (r = 0.77) than with LVEDP (r = 0.70). In patients with coronary disease, the PAWP was well correlated with LVDP (r = 0.94) and with LVEDP (r = 0.84). In patients with non‐coronary disease, the PAWP was well correlated with LVDP (r = 0.81) and with LVEDP (r = 0.81). The PADP and PAWP may be helpful in evaluating left ventricular function at the bedside.
Challenging Residents to Assume Maximal Responsibilities in Homes for the Aged†
Authors: Rodstein Manuel 
Published: April 2015

ABSTRACTA program for activating residents of homes for the aged to assume maximal responsibilities is described. Promoting maximal physical and mental health through various modalities including activity programs, appropriate exercise and participation in democratic self‐government mechanisms, will result in a happier, healthier population of residents in institutions for the aged. The increased demands on staff time and patience will be compensated for by relief of the too‐frequent feelings of hopelessness and boredom endemic among the staff of long‐term care facilities. Such programs demand constant effort by all staff members, patients, volunteers and relatives because if they succumb to the usual human dislike of persistency, short‐term gains can easily be lost.
Communication for the Aphasic Stroke Patient: Assessment and Therapy†
Authors: Harrington Robert 
Published: April 2015

ABSTRACTLoss of communicative ability is one of the most devastating handicaps associated with stroke. The goals of therapy require continuous adjustment. Early ambulation facilitates breathing, chewing and swallowing, which are important factors in voice control. Hearing and vision should also receive concentrated attention. Formal speech therapy should begin when the patient shows an interest in regaining speech. Even before that, however, family members and friends can be of great help in laying the foundation for a good prognosis.
Changes in Elderly Welfare Hotel Residents During a One‐Year Period†
Authors: Plutchik Robert , McCarthy Martin , Hall Bernard H. 
Published: April 2015

ABSTRACTAfter a one‐year interval, a structured interview designed to assess the quality of life was again conducted with most of the tenants in a single‐room occupancy hotel in New York City. Comparisons were made between the two sets of findings. During the year, a program had been in effect to provide social, psychiatric, recreational, medical and other services to all the tenants at the hotel. Of the original 181 interviewees, 100 completed the second interview. Statistically significant changes occurred in 9 of the 35 variables assessed for the one‐year period. There was significant improvement in the self‐care index, but some negative mood changes were also found. The subgroup of identified alcoholics showed the most positive improvements of any of the subgroups.
Withdrawn, Apathetic Geriatric Patients Responsive to Methylphenidate
Authors: Kaplitz Sherman E. 
Published: April 2015

ABSTRACTA double‐blind randomized study showed that methylphenidate, as compared to placebo, was singularly effective in 44 withdrawn, apathetic geriatric patients. Study selection and exclusion criteria were rigidly enforced. Patients receiving methylphenidate in a dosage of 20 mg daily improved significantly over a period of six weeks as measured by results of tests for mental status, ward behavior (nurses' rating), target‐symptom response, and physician's and nurses' global evaluations. For this reason and because there were no side effects, this form of antidepressant therapy should be considered in the treatment of previously unresponsive or oversedated patients.
Progressive Deterioration of Glucose Tolerance in the Aged†
Authors: Grobin Wulf 
Published: April 2015

ABSTRACTThis long‐term study of the natural history of glucose tolerance in the aged is now in its eleventh year. Of 411 nondiabetic persons screened on admission to the Jewish Home for the Aged (J.H.A.) since 1968, 15 per cent had abnormally elevated levels of postglucose blood sugar (PGBS) as compared with 25 per cent in the period 1964–1968. Fewer positive reactors were discovered with annual screenings and with the glucose tolerance test (GTT). Although the proportion of positive reactors and of diabetic‐type GTT curves was higher in subjects over age 80 than under age 80, there were 82 residents screened annually for five to nine years who retained normal glucose tolerance despite advancing age. The relatively lower rate of deterioration of glucose tolerance in the second period was attributable to: 1) the younger age of residents admitted since 1968, and 2) the diabetes‐oriented diet plus emphasis on exercise and prevention of obesity. The reactive hypoglycemia found in 6 per cent of the residents was asymptomatic, whereas iatrogenic hypoglycemia was usually symptomatic and often severe. This led to a deliberate policy of undertreatment. Dietotherapy induced a lasting remission in about 60 per cent of newly diagnosed cases of diabetes, often to the point of normal glucose tolerance. Early diagnosis of chemical diabetes, by postponing or obviating the need for antidiabetic therapy, reduced the incidence of iatrogenic hypoglycemia. Diabetes‐oriented measures are recommended for the aged in general, and for residents of homes for the aged in particular.
Uncontrolled Diabetes in Psychogeriatric Subjects†
Authors: Hontela S. , Müller H. F. 
Published: April 2015

ABSTRACTIn a group of 20 long‐term psychogeriatric patients with uncontrolled diabetes, data on body weight, blood pressure and blood sugar concentration (fasting and postprandial) were correlated with the electroencephalographic (EEG) findings. The patterns were similar for the study subjects and for healthy subjects of the same age. The psychogeriatric patients with diabetes, in contrast to psychogeriatric patients with chronic hypoglycemia, showed an increase in body weight and blood pressure and an increase in blood sugar concentration with aging; they also showed a normal EEG whereas chronically hypoglycemic patients usually had an abnormal EEG. In terms of blood glucose levels and excess glucose in the urine despite treatment, the diabetes had to be considered uncontrolled. However, these patients were clinically asymptomatic. Apparently, in these particular circumstances, the diabetes may be an adaptive biologic phenomenon.
Evaluation of Isobaric Oxygenation for the Aged with Cognitive Impairment: Pilot Study
Authors: White Leonard , Crovello James N. , Rosenberg Samuel N. , Neiditch Jon A. 
Published: April 2015

ABSTRACTThe effect of isobaric oxygenation on psychogeriatric subjects with mild cognitive impairment was assessed in a single‐blind controlled pilot study. Three of the 7 subjects were treated with a mixture of 97% oxygen plus 3% carbon dioxide, and 4 were treated with compressed air. The oxygen or air was administered during two 1.5‐hour sessions daily for fifteen consecutive days. Use of a miner's type mask ensured a closed system which permits the maximal partial pressure of oxygen. Psychologic and clinical observations did not indicate any advantage for the oxygenation therapy. Minimal side effects, which arose only in the oxygen group, may have involved some interaction between CO2 sensitivity and anxiety. Careful differential diagnosis and the control of motivational factors are of major importance in any study of the effects of oxygenation upon symptoms in psychogeriatric patients.