bluuebunny/crossref_metadata_2025_split huggingface dataset:
PERIPHERAL VASCULAR DISEASE EN THE AGED: MODERN CONCEPTS AND DIAGNOSTIC TECHNIQUES
Authors: RICCITELLI M. L. 
Published: April 2015

Abstract: One of the most important problems in the management of elderly patients is the maintenance of adequate peripheral blood flow. The most common among the degenerative, vasospastic and inflammatory disorders interfering with the peripheral circulation is arteriosclerosis, a disease of obscure etiology and unsatisfactory therapy.Accurate assessment of the peripheral circulatory reserve is mandatory for making earlier and more accurate diagnoses, and before drawing final conclusions about specific therapy. A complete detailed history, with information from all sources, is essential. Intermittent claudication is one of the earliest symptoms of chronic occlusive peripheral arterial disease.Current techniques are discussed for the estimation of blood flow, for testing the dilatation capacity of blood vessels, and for detecting the site of arterial block. Included are oscillometry, plethysmography and claudication tests, in addition to clinical assessment. More sophisticated techniques used by research workers are thermography, conjunctival and nailbed biomicroscopy, disulfine blue clearance, and xenon133 scintiscanning.
TRIFLUPROMAZINE VERSUS PENTYLENETETRAZOL‐NICOTINIC ACID FOR TREATMENT OF CHRONIC BRAIN DISEASE ON A GENERAL‐HOSPITAL PSYCHIATRIC SERVICE
Authors: DANTO BRUCE L. 
Published: April 2015

Abstract: A comparison was made of the effects of triflupromazine (Vesprin) and pentylenetetrazol‐nicotinic acid (Nico‐Metrazol) in 118 patients with cerebral arteriosclerosis or senile brain disease. For two weeks, 63 of the patients received Nico‐Metrazol and 55 received Vesprin in relatively low dosages. The study was conducted on the psychiatric wards of a general hospital, where patients await discharge placement after fifteen days' stay.Evaluations were made according to rating scales for behavioral factors and side effects. For the 118 patients, over 90 per cent of the ratings for both drugs indicated no change, and less than 5 per cent indicated improvement. Side effects, when noted, were insignificant. Most patients still had to be discharged to state mental hospitals. These findings confirm the observations of others that a change is not observed earlier than four to six weeks.Behavioral ratings under the necessarily short‐term periods of treatment and fashions in drugs do not provide effectual information. It would seem that better therapeutic agents are needed for the immediate treatment of aged persons with chronic brain disease who are admitted to the psychiatric wards of general hospitals because of the acute onset of unmanageable behavior.
OCCULT HYDROCEPHALUS IN THE ELDERLY
Authors: Chandrasekaran Subramaniam , Reynolds Robert E. 
Published: April 2015

AbstractFour cases of low‐pressure hydrocephalus were identified in the Chronic Disease Hospital of the Baltimore City Hospitals. The patients were men whose ages ranged from 50 to 62. Much optimisn is expressed in the literature about the treatment of low‐pressure hydrocephalus. The results of treatment in our 4 cases were not satisfactory; only 1 case benefitted from the shunting operations. Moreover, there is considerable risk inherent in the various diagnostic procedures.
MANAGEMENT OF CHRONIC BRAIN SYNDROME SECONDARY TO CEREBRAL ARTERIOSCLEROSIS, WITH SPECIAL REFERENCE TO PAPAVERINE HYDROCHLORIDE
Authors: Stern Francis H. 
Published: April 2015

AbstractThe vasodilator drug, papaverine hydrochloride (sustained‐release form) was used in a double‐blind crossover study of 30 geriatric patients with symptoms of chronic brain syndrome secondary to cerebral arteriosclerosis. At a dosage level of 300 mg twice daily in sustained‐release form, papaverine hydrochloride was more effective than placebo in relieving 13 of the 15 target symptoms characterizing the syndrome. Side effects were numerous but mild, and did not interrupt the study. Drowsiness, constipation and vertigo accounted for 80 per cent of the side effects noted with the active drug, whereas 81.5 per cent of the side effects noted with placebo were nausea, vertigo, headache and flatulence. The drug had no significant effect on the weight of the patient.Papaverine hydrochloride proved to be a valuable adjunct in the subjective relief of symptoms of chronic brain syndrome secondary to cerebral arteriosclerosis.
OBSTACLES IN COORDINATING SERVICES FOR THE CARE OF THE PSYCHIATRICALLY ILL AGED*
Authors: GAITZ CHARLES M. , HACKER SALLY 
Published: April 2015

Abstract:A coordinated program for comprehensive care is a good approach to the management of the psychiatrically ill aged. Nevertheless, the patients, their families, community professionals, and the organizational patterns of many facilities and agencies offer a variety of obstacles to comprehensive care. These obstacles are discussed under the headings: 1) attributes of the patients, 2) patient‐family interactions, 3) attributes of professional caregivers, 4) adequacy of community resources and organization, 5) multidisciplinary interactions, and 6) attributes of the case coordinator. These categories are not mutually exclusive, nor do they exhaust the full range of the problems. Such a classification, however, helps to determine some of the major difficulties encountered by coordinators in implementing programs for comprehensive care.
TREATMENT OF ANGINA PECTORIS WITH DIPYRIDAMOLE: A DOUBLE‐BLIND STUDY
Authors: IGLOE MAX C. 
Published: April 2015

Abstract:In a double‐blind study, 48 patients (age range, 47 to 75) with angina pectoris received either dipyridamole (Persantine) (200 mg daily) or placebo for an average of five months. Nitroglycerin was taken sublingually as required for relief of acute attacks. Previous use of long‐acting nitrates had produced no significant improvement.Of the 26 patients receiving dipyridamole, 21 (81 per cent) showed an overall satisfactory clinical response (marked or moderate improvement) compared to 2 (9 per cent) of the 22 receiving placebo. The difference between the two treatments was statistically significant. Evaluation of objective criteria also showed the superiority of dipyridamole. The mean improvement for drug group vs. placebo group was as follows: decrease in anginal attacks, 48/24 per cent; decrease in need for nitroglycerin, 50/18 per cent; and increase in walking distance, 84/36 per cent. In terms of subjective evaluation of anginal pain, 69 per cent of the drug group improved compared to 18 per cent of the placebo group.Two patients had reactions while taking the drug. Transient blurred vision was noted by one patient, but it did not interfere with continuation of dipyridamole. Nausea and insomnia in another patient (not in the final study group) caused cessation of therapy. No reactions were reported among the placebo patients.From the results of this controlled study it is concluded that dipyridamole, a non‐nitrate coronary vasodilator, is a relatively safe and effective agent for the long‐term treatment of patients with angina pectoris.
POLYMYOSITIS ASSOCIATED WITH CARCINOMA OF THE PROSTATE
Authors: MACHTEY I. 
Published: April 2015

Abstract:The case is presented of a man who, at the age of 63, began to complain of joint pain. The clinical picture of polymyositis gradually developed, and three years after the onset of the joint pain a carcinoma of the prostate was diagnosed. The rheumatic complaints improved during treatment with indomethacin and estrogen. Early in the disease a repeatedly abnormal x‐ray finding in the duodenum raised the possibility of a carcinoma of the pancreas. At the height of this symptomatology, the patient twice exhibited neurological signs, diagnosed as a small stroke; an abnormal EEG was found immediately following the second attack and one year later.This report adds a new case to the few in which polymyositis is associated with carcinoma of the prostate.
CRANIOPHARYNGIOMA IN AGED PATIENTS
Authors: HERISHANU Y. 
Published: April 2015

Abstract:At Hadassah University Hospital, Jerusalem, in the last fifteen years there have been 4 cases of craniopharyngioma in patients more than 50 years of age. The clinical picture was characterised by organic mental signs and the absence of suprasellar calcification on regular x‐ray examination. Ocular impairment was present in 3 of the 4 cases. In all 4 patients the tumor was located behind the optic chiasm, indicating that perhaps craniopharyngioma in aged patients is a different tumor from craniopharyngioma in young patients in whom it shows several specific characteristics. Air‐contrast studies of the brain ventricles were the preoperative diagnostic method of choice. Confirmation of the diagnosis was made at operation in 3 patients, and at necropsy in the fourth.
THE PANCREATIC BETA‐CELL RESPONSE TO INTRAVENOUS ADMINISTRATION OF GLUCOSE IN ELDERLY SUBJECTS*
Authors: Barbagallo‐Sangiorgi G. , Laudicina E. , Bompiani G. D. , Durante F. 
Published: April 2015

AbstractA study was made of the serum insulin level after the intravenous administration of glucose (0.33 gm/ kg) in two groups of normal subjects—18 in the 60–85 age bracket, and 16 in the 23–45 age bracket. All had a normal coefficient of glucose utilization and a normal blood glucose curve after intravenous administration of glucose. Serum insulin was assayed by the radio‐immunological method, with use of an ion exchange resin. Blood samples were drawn at 2, 5, 10, 30, 45 and 60 minutes after the end of the glucose infusion.In the elderly subjects the maximal value was reached only after 5 minutes and the mean value was 39± 9 µU/ml (range, 27–50), whereas in the younger subjects the serum insulin level rose immediately, reaching a maximal value 2 minutes after glucose infusion, the mean value being 54 ± 10 µU/ml (range, 42–66). Thus the response of the pancreatic beta‐cells to functional stimulation in the elderly subjects was slower and weaker than in the younger ones, although there was no decrease in glucose tolerance. There were no differences with respect to the peripheral utilization of insulin.
SULFAMETER IN CLINICAL MEDICINE
Authors: Seneca Harry 
Published: April 2015

AbstractSulfameter (sulfamethoxydiazine, Sulla) is a safe long‐acting sulfonamide of low toxicity. It can maintain blood and urinary sulfonamide levels, with 5 per cent acetylation in the blood and 20–30 per cent acetylation in the urine. The dosage is 500 mg three times daily for the first day, followed by a maintenance dosage of 500 mg daily for two weeks.Good clinical and bacteriological results have been reported from both Europe and the United States in the treatment of respiratory infections, urinary‐tract infections, ear, nose and throat infections, and skin infections including pustular acne vulgaris. Sulfamethoxydiazine also can be used as a suppressive drug for as long as nine months in the management of chronic urinary‐tract infections, with no adverse side effects.
MOFETTE THERAPY AND CO2 WATERBATHS FOR ARTERIOSCLEROSIS OBLITERANS
Authors: Hadnagy CS. , Balogh L. , Krepsz I. , Benedek G. , Brassai Z. , Csorba L. , Andras E. 
Published: April 2015

AbstractAlthough for centuries balneotherapy has been popular in Europe, it has not attained wide acceptance in the United States. This article is an interesting sidelight on a specific means of inducing therapeutic vasodilatation. In Covasna, Rumania, post‐volcanic CO2 gas emanations are used in the form of mofette therapy (twice daily) and CO2 waterbaths (about once daily) for the treatment of rheumatic diseases.This study concerns 40 male geriatric patients with arteriosclerosis obliterans, whose symptoms improved markedly during treatment. In each, the state of the circulation in the big toe of an affected foot was evaluated by means of radioactivity measurements after injection of I131—both before and after therapy. The results indicated that the arterial blood supply to the feet was definitely enhanced after CO2 therapy, thus promoting the formation of collateral circulation.
ENVIRONMENT, ITS LANGUAGE AND THE AGING
Authors: Weinberg Jack 
Published: April 2015

AbstractAging should be viewed as a slowly emerging developmental phase in the life span of the individual. It involves a dual process: 1) primary aging, which may be considered the normal progression of biological matter towards eventual death, and 2) secondary aging, which is pathological and is a result of environmental deficiencies and stresses imposed upon the organism.People, regardless of age, relate to their environment only to the degree in which it contains information relevant to them. Environment has a language containing messages that constantly convey information to us. We perceive and decode these messages through our sensory apparatus. Our sensory, organs envelop each of us with personal spatial boundaries within which messages may be perceived, and which may differ in dimension and scope for each organ. With aging, our sensory organs undergo changes which limit their capacity to perceive and decode the messages received. In addition there is the psychological dynamism of the exclusion of stimuli, which is a defensive maneuver of our problem‐solving self, our ego, when our reservoir of psychic energy is at a low ebb. Yet, culturally we do everything possible to minimize the amount of information carried by these modalities.Both the aging process and the environment have their particular languages. Improving the communication between them can prevent or reduce the state of reciprocal withdrawal, which is all too common among the aged and enhances the feeling of alienation and despair. A great deal can be done to enrich the environmental information and thus augment the messages carried to the aging organism.
OXYGEN INHALATION IN OBLITERATIVE ARTERIAL DISEASE, INCLUDING ITS USE IN SENILITY
Authors: Barach Alvan L. 
Published: April 2015

AbstractIn elderly persons with excellent mental and physical health there may be only a 7 per cent decrease in cerebral blood flow with aging, whereas in patients with cerebral arteriosclerosis and organic brain disease there is demonstrable hypoxia of the brain tissue with a 20–25 per cent decrease in cerebral blood flow. As suggested by Kety et al., lack of oxygen seems to be the primary disturbance, rather than inability of the aging brain cells to absorb and metabolize oxygen. An adequate environmental oxygen supply to the brain is an important factor in the maintenance of unimpaired function of the higher faculties in man.This article outlines the historical development of our knowledge of ischemic hypoxia as a physiological background for the therapeutic use of hyperbaric oxygen in cerebral arteriosclerosis and senility. Data also are included on the intermittent inhalation of high concentrations of oxygen at atmospheric pressure, over prolonged periods. With either type of oxygen therapy there have been reports of improvements in patients with obliterative disease of the cerebral, coronary and peripheral circulation, especially with regard to the acute manifestations.Additional studies are required to confirm the value of such oxygen therapy in cerebral arteriosclerosis, particularly as it often appears to be effective in acute coronary arteriosclerosis. This admittedly speculative concept seems worthy of investigation.
SPECULATIONS ON VASCULAR CHANGES WITH AGE
Authors: Goldman Ralph 
Published: April 2015

AbstractSeveral extracardiac age changes may affect cardiovascular efficiency. Extracellular fluid and blood volume are relatively increased with age. The loss of aortic elasticity results in a rise in systolic pressure when work produces increases in cardiac output. The vascular rigidity further consumes energy by loss of the propulsive effect of elastic recoil. Finally, peripheral resistance increases due to arteriolar constriction; this appears to be under reversible physiologic control. The sum of these normal changes contributes to the functional decrement of aging; it is more universal and more important than atherosclerosis, yet has commanded inadequate attention.
IMPLANTABLE TRANSVENOUS CARDIAC PACEMAKERS: INDICATIONS, COMPLICATIONS AND MANAGEMENT*
Authors: Goldman B. S. , Black L. L. , Lipton I. H. 
Published: April 2015

AbstractPermanent transvenous pacing of the heart for control of both rate and rhythm has achieved widespread acceptance in the treatment of heart block. It is now performed in adults of any age group, and there are no special contraindications. Data are presented on the results of 122 transvenous pacemaker implantations from one to three years after operation. The average age of the patients was 68, and 38 of them were over 75 years old. Episodic sinus arrest or asystole in patients with otherwise adequate cardiac rates can be detected by continuous electrocardiographic monitoring and treated by implantation of demand‐type pacemakers. Asynchronous units now are used only in very elderly patients with stable complete heart block.Displacement of the catheter has been the major problem; if recurrent, it is managed by direct epicardial insertion of the pacemaker leads through an extrapleural approach to the heart. The longevity of the power‐pack components and the battery still falls short of the manufacturers' claims. This emphasizes the need for establishment of pacemaker clinics so that sudden failure of pacemakers can be prevented.
SERUM CHOLESTEROL AND CHOLESTEROL‐ESTERIFYING ACTIVITY IN ATHEROSCLEROSIS*
Authors: GHERONDACHE CONSTANTIN N. , BLINSTRUB CHESTER A. 
Published: April 2015

Abstract: In a group of 240 elderly subjects (149 women and 91 men, age range 65 to 95) drawn at random from a population of 650 geriatric patients, the women showed a higher incidence of coronary artery disease and a lower incidence of cerebral atherosclerosis than the men.In the atherosclerotic patients there was a higher concentration of total serum cholesterol (213.4 ± 3.5 S.E. mg/100 ml) and a lower level of cholesterol‐esterifying activity (27.7 ± 0.8 S.E.) than in the healthy elderly subjects (180.8 ± 6.9 S.E. mg/100 ml, P < .001; and 46.8 ± 1.1 S.E., P < .001 respectively). These differences were more significant in women than in men. In general, the mean serum cholesterol level was higher in the women with atherosclerotic manifestations than in the men (223.4 ± 5.7 S.E. mg/100 ml versus 200.9 ± 2.8 S.E. mg/100 ml in the coronary artery disease group; and 220.0 ± 6.2 S.E. mg/100 ml versus 196.8 ± 7.9 S.E. mg/100 ml in the cerebral atherosclerosis group). These sex differences may be related to the hormonal changes that occur in women at the age of the menopause.The cholesterol‐esterifying activity of serum was significantly higher in the healthy group (46.8 ± 1.1 S.E.) than in the group with coronary artery disease (30.3 ± 1.2 S.E., P < .001) or in the group with cerebral atherosclerosis (25.5 ± 1.0 S.E., P <.001).
SELF‐ADMINISTRATION OF MEDICATIONS BY PATIENTS IN HOSPITALS OR EXTENDED CARE FACILITIES
Authors: LIBOW L. S. , MEHL B. 
Published: April 2015

Abstract: Patients in hospitals and extended care facilities usually are given their medications by a nurse until the very moment of discharge. Then they are expected to adhere accurately to often difficult schedules which may include taking several drug preparations of confusing sizes, shapes and colors.A group of 20 elderly long‐term hospital patients were studied for their abilities regarding self‐administration of medications. They demonstrated surprising accuracy. In the two‐week study, only 5 of the 20 patients made errors; and in a total of 588 opportunities, only 14 errors occurred.Self‐administration, in properly selected cases, appears to offer a chance to “teach” patients and to tailor the medication schedules realistically to their limitations. The results of our small pilot study indicate that, through appropriate application of this policy, we may expect a freeing of nursing time for other services, a decrease in hospital costs, and a reduction of post‐hospital morbidity through increased accuracy of drug administration. Several other facets of this policy are under study, e.g., how well patients will perform during longer periods; the methods for checking reliability of the patient; the roles of nurse, pharmacist and physician; and the hospital legal aspects.
GERIATRIC HERPES ZOSTER*
Authors: Rogers R. S. , Tindall John P. 
Published: April 2015

AbstractA retrospective study was made of the 243 geriatric patients with herpes zoster and post‐zoster complications referred to Duke University Medical Center during the years 1939 through 1968. The factors of age, race, sex, distribution, laterality, duration, severity, complications, and associated disorders were evaluated. There was an absolute increase in the frequency of trigeminal nerve involvement among geriatric zoster patients compared with zoster patients of all ages. The commonly‐held belief that the duration is longer and the disease more severe in geriatric patients was confirmed. The incidence of complications also was significantly increased in the 243 geriatric zoster patients.Suggestions concerning the management of both uncomplicated and complicated cases of herpes zoster are made. The use of large systemic dosages of corticosteroids is discussed in terms of the benefits versus the risks.
PROBLEMS IN ACUTE PANCREATITIS
Authors: KalliomÄKi J. L. , Antila L. E. 
Published: April 2015

AbstractThe overall mortality in a series of 132 hospitalized patients (43 men and 89 women) with acute pancreatitis was 28 per cent; for patients younger than 60 it was 9.1 per cent, and for those older than 60 it was 41.6 per cent. The typical case with a fatal ending was represented by the aged patient with several diseases, especially heart disease, for whom pancreatitis was a catastrophic stress. Fifty‐one per cent of the deaths occurred during the first twenty‐four hours after the hospital admission. In one‐third of the cases, the pain differed from the usual pain of pancreatic disease; in 18 per cent it simulated pain from cardiac infarction; and in 9 per cent there was no pain. The gall bladder was definitely pathological in 48 per cent of the patients; 18 per cent had undergone subtotal gastrectomy for gastric ulcers; 4.5 per cent had active ulcers; and 9 per cent had diabetes. Palpation findings were negative in 13 per cent. Half of the serum transaminase (SGOT) values and nearly half of the alkaline phosphatase values were elevated. In 38 per cent of the cases, icterus was present in some phase of the disease. Nasogastric intubation was used for treatment in 13.6 per cent of the cases, and enzyme inhibition by trypsinkallikrein inactivator was attempted in about 30 per cent. For mild pancreatitis, several therapeutic methods give beneficial results. However, necrotic pancreatitis with a violent course usually leads rapidly to death, despite treatment.
CARDIAC DIAGNOSIS AND DECISION‐MAKING IN A HOSPITAL EMERGENCY ROOM
Authors: Desser Kenneth B. , Goldberg Emanuel 
Published: April 2015

AbstractThe emergency room records of 140 patients with cardiac complaints were reviewed. The average age was 60 years. Chest pain was the most common symptom and a majority of patients with this complaint expressed fear of an acute coronary episode. Of 41 cases admitted with the initial diagnosis of myocardial infarction, only 21 had that diagnosis at the end of two weeks. Of 91 patients sent home from the emergency room, 83 were alive and well at the end of six weeks. A single patient died of acute myocardial infarction ten days after leaving the emergency room. No patient was averse to admission, and in 10 instances patients came to the emergency room equipped with personal items indicating anticipation of admission. Such studies are feasible and may elucidate further the role of the emergency room in the early care of the “coronary suspect.”