bluuebunny/crossref_metadata_2025_split huggingface dataset:
Thyroid Function Tests in Elderly Hyperthyroid Patients
Authors: Caplan Robert H. , Glasser James E. , Davis Kent , Foster Linda , Wickus Gary 
Published: April 2015

ABSTRACTSeveral tests of thyroid function were performed in 35 hyperthyroid patients over the age of 65 (elderly). The results were compared to those of similar tests in 48 hyperthyroid patients under the age of 65 (young). Total serum thyroxine (T4) was within the normal range in 14 per cent of the elderly and 11 percent of the young hyperthyroid patients. The free thyroxine index (FTI) was within the normal range in 11 percent of both groups. The triiodothyronine uptake (T3U) proved to be a poor test in both groups. Although elevation of the triiodothyronine (T3) level allowed a diagnosis of “T3‐toxicosis” in 2 elderly and 3 young hyperthyroid patients, the T3 level was normal in 34 percent of the elderly and 13 percent of the young subjects. Correction of the T3 range for age reduced the number of normal T3 values to 12.5 percent in the elderly hyperthyroid patients. The 24‐hour uptake of radioactive iodine was normal in 12 percent of the young hyperthyroid patients, 27 percent of the elderly patients with Graves' disease, and 70 percent of the elderly patients with toxic nodular goiter, despite recent readjustment of the normal range for the test. It is concluded that the diagnosis of hyperthyroidism in the elderly may be difficult and that no single test can be relied upon to exclude the diagnosis.
Hyaluronuria in a Case of Progeria (Hutchinson‐Gilford Syndrome)
Authors: TOKUNAGA M. , WAKAMATSU E. , SATO K. , SATAKE S. , AOYAMA K. , SAITO K. , SUGAWARA M. , YOSIZAWA Z. 
Published: April 2015

ABSTRACTA classic case of progeria (Hutchinson‐Gilford syndrome) in a 9‐year‐old Japanese boy is presented. The characteristic clinical features in this patient were similar to those reported in the literature. The total amount of acid glycosaminoglycans excreted in the urine was within the normal range, but there was an increase in hyaluronic acid excretion. The hyaluronuria was a novel finding in progeria, providing a common linkage with the hyaluronuria found in Werner's syndrome.
The Social Hour for Geropsychiatric Patients
Authors: CARROLL PAUL J. 
Published: April 2015

ABSTRACT:This study was an attempt to evaluate the effects of a controlled alcohol intake on the socialization of a group of geropsychiatric patients in a clinical setting. Although 47 patients of the Geriatric Unit were involved at various times, 16 remained in the study for the entire eight weeks. The Social Hour consisted of a half‐hour session every weekday. The alcohol served was whisky, gin, vodka, and wine. Soft drinks were available for those who preferred them. Each patient was rated on a 5‐point scale with regard to ward and off‐ward activities. A planned four‐week placebo period met with so much negativism that it had to be shortened to three days. According to our observations, the socialization process was increased significantly for these mentally ill geriatric patients during this type of Social Hour.
Etiology of Primary Osteoporosis: An Hypothesis
Authors: SANDLER RIVKA BLACK 
Published: April 2015

ABSTRACT:By convention, osteoporosis has been described in two categories: 1) primary (involutional or postmenopausal), and 2) secondary, in association with a wide variety of pathologic disorders. Primary osteoporosis is the ultimate consequence of progressive bone loss, which starts in the middle of the fourth decade. Given the apt name of “adult bone loss,” it is considered to be a universal phenomenon in that it afflicts all people of all races and both sexes. However, careful analysis of past studies generates evidence that not every person of advanced age loses bone. The etiology of “adult bone loss,” and thus of primary osteoporosis, is conceded to be unknown or at least controversial. Nevertheless, the complex dependencies of bone metabolism on the functional integrity of major organ systems imply a multifactorial etiology. The age‐related progressive declines in functional reserves of major organ systems may indicate that primary osteoporosis evolves secondarily to a protracted suboptimal metabolic support of bone remodeling. Further confirmation of this hypothesis may have important implications for the prophylactic management of primary osteoporosis.
Bromide Intoxication in the Elderly
Authors: RASKIND MURRAY A. , KITCHELL MARGARET , ALVAREZ CARROL 
Published: April 2015

ABSTRACT:Four patients with dysfunction of the central nervous system secondary to bromide intoxication are reported. Three of them were referred because of symptoms of “senility,” which appeared to preclude further independent living. After diagnosis and treatment of the bromism, they were able to continue living at home. The development of bromide toxicity with relatively low serum bromide levels in the elderly is discussed. The importance of a home visit to establish the diagnosis of drug‐induced cognitive dysfunction is emphasized.
Primary Empty Sella Syndrome and Bipolar Affective Illness: Case Report
Authors: MEHTA DINESH , MEHTA SHOBHANA , MATHEW POYANIL 
Published: April 2015

ABSTRACT:This report concerns an elderly woman with primary empty sella syndrome and bipolar affective illness. She had no endocrine, visual, or neurologic dysfunction and had received electroconvulsive therapy with no long‐term adverse effects. Remission of the affective illness has been maintained for five years with lithium carbonate therapy.
Nursing Home Medication Costs
Authors: HOWARD JOHN B. , STRONG KENNETH E. , STRONG KENNETH E. 
Published: April 2015

ABSTRACT:The cost of discarded drugs at a level‐IH nursing home was calculated for a four‐year period. A significant percentage of the cost seemed to be the result of poor prescribing practices. Prescriptions for antibiotics and for psycho‐tropic drugs (particularly PRN orders) are discussed in some detail. Medication policies were developed to improve physicians' prescribing habits in order to reduce these costs without jeopardizing the quality of care.
Lactulose Syrup Assessed in a Double‐Blind Study of Elderly Constipated Patients
Authors: SANDERS JACK F. 
Published: April 2015

ABSTRACT:The laxative effects of 50% lactulose syrup and 50% glucose syrup were compared in a 12‐week, double‐blind study of 47 elderly constipated patients living in a nursing home. The dosage was 30 ml daily taken at bedtime; it was reduced to 15 ml if the initial dosage produced two or more bowel movements daily. The number of bowel movements during treatment in comparison to pretreatment was significantly increased in the 42 patients (19 lactulose, 23 glucose) who completed at least 8 weeks of the study. Lactulose was superior to glucose in the mean number of bowel movements per day (p < 0.02) and in the percentage of days in which at least one bowel movement occurred (p < 0.05). Reduction in the severity of each of 5 symptoms (cramping, griping, flatulence, tenesmus, bloating) was greater with lactulose. For relief of all 5 symptoms, lactulose was significantly more effective than glucose (p < 0.04). The striking reduction in the number of fecal impactions (only 6 in the lactulose patients vs 66 in the controls) was highly significant (p < 0.015). The lactulose patients needed fewer enemas than did the controls. No abnormal values were observed in laboratory tests.
Non‐Threatening Mental Testing of the Elderly
Authors: Comfort Alex 
Published: April 2015

ABSTRACTHeavyhanded mental testing as part of a geriatric admission examination may seriously prejudice subsequent psychotherapy by the physician, and is unnecessary for the basic intended purpose. Most questions of importance in determining orientation are already part of normal casetaking. Those which are not are least threatening to the patient's morale when included as components of an examination of the central nervous system. This division agrees with the premise that only those persons unable to answer informational questions are likely to prove unable to answer orientational questions.
Erythrocyte Parameters in the Elderly: An Argument Against New Geriatric Normal Values*
Authors: HTOO MARK S. H. , KOFKOFF RICHARD L. , FREEDMAN MICHAEL L. 
Published: April 2015

ABSTRACTErythrocyte parameters in 292 unselected geriatric patients were studied retrospectively. Statistically significant mean decreases compared to the laboratories' normal mean values were found in the red blood cell count (RBC), hemoglobin level, hematocrit, and mean corpuscular hemoglobin concentration; there also was a slight increase in mean corpuscular volume and mean corpuscular hemoglobin. However, when 17 patients with a hemoglobin level less than 10 gm/dl or a hematocrit reading less than 35 percent were excluded, all of the mean values for erythrocyte parameters fell within the normal range. In 71 percent of these 17 patients the etiology of the anemia was documented. Although one cannot definitely exclude a slight change in erythrocyte parameters with aging, it is concluded that the establishment of so‐called new geriatric norms is premature, as the population studied included patients with various diseases. Good medical practice dictates continued evaluation and monitoring of patients in whom erythrocyte values are outside the established normal ranges.
Epidemiology of Hyperuricemia in an Ambulatory Elderly Population
Authors: STEWART RONALD B. , YOST RICHARD L. , HALE WILLIAM E. , MARKS RONALD G. 
Published: April 2015

ABSTRACTThe relationship of serum uric acid concentration to age and sex was assessed in 1,701 participants in a geriatric multiphasic screening clinic. Included were 1,067 women and 634 men. The mean uric acid level for men was 6.35 mg/100 ml compared to 5.44 mg/100 ml for women. No statistically significant increases in serum uric acid between age groups were apparent, except for women over 84 years of age. The mean serum urate concentrations found in this geriatric study are higher than those reported for other population groups, suggesting a higher normal value for the elderly.
Hospitalization of the Elderly Patient for Acute Illness
Authors: Munoz Rodrigo A. , Mesick Betty 
Published: April 2015

ABSTRACTThere is a paucity of studies on the characteristics of elderly patients who are admitted for treatment of acute disorders, even though their utilization of hospitals is high. This study involved 828 older persons admitted to a general hospital during a period of six months, for the treatment of acute illness. The typical patient appeared to be a woman in her 70's who entered the medical department because of a cardiovascular or a gastrointestinal disturbance, stayed no longer than 10 days, and returned home to live with her spouse. Though such a person apparently needed minimal assistance in readjusting successfully to the community, there were some exceptions, especially among those who had been living alone or with persons other than a spouse. There was minimal utilization of professional services that might help to assure an optimal post‐hospital readjustment.
Practical Considerations in the Rehabilitation of the Aged†
Authors: Hunt T. E. 
Published: April 2015

ABSTRACTEnlightened geriatric care provides assistance to the elderly for living independently as long as possible. Essential to this amenity is the high priority placed upon restoration in coordination with other forms of therapy. Medical rehabilitation too often has been associated with employment‐oriented goals and with major physical achievements. Restoration of the young spinal‐injured paraplegic patient has been a model for rehabilitation medicine. The aged, also, often can be restored to optimal levels of functional capacity commensurate with their lesser needs. Rehabilitative principles for the management of disability are the same in old age as at any other time of life. Certain age‐related factors, however, profoundly influence programs of restoration for the elderly. These factors need full consideration when physicians plan appropriate care for their aged patients. A list of guidelines is presented.
Psychosocial Problems of the Aged: A Shared Medical Responsibility
Authors: KRAL V. A. 
Published: April 2015

ABSTRACTThe respective roles of the psychiatrist and the family physician in dealing with the psychologic and some of the social problems of the aged are briefly outlined. By close cooperation of these two groups of physicians, many aged patients can be helped. More important is the fact that both groups of physicians can contribute to a change in attitude toward aging among the younger members of society. This offers hope that many of the psychosocial problems of the aged can be minimized or prevented.
Primary Hodgkin's Disease of the Stomach in a 72‐Year‐Old Man
Authors: Geboes Karel , Bossaert Herman , Dooms Marie‐Therese , Helewaut Johan 
Published: April 2015

ABSTRACTPrimary Hodgkin's disease of the stomach is rare, but it may occur at any age. In surgically treated patients, the prognosis is better than for adenocarcinoma. Therefore, a precise diagnosis of the gastric tumor is paramount. Endoscopic biopsy is a valuable aid. A case report is presented of a 72‐year‐old man in whom a diagnosis of gastric lymphoma was made preoperatively. Results were good one year after surgical therapy.
Relative Mortality of Chronically Ill Geriatric Patients with Organic Brain Damage, Before and After Relocation†
Authors: Csank J. Z. , Zweig J. P. 
Published: April 2015

ABSTRACTElderly patients in whom mental impairment is associated with organic brain damage (chronic brain syndrome) usually bear a higher mortality risk than do other sick geriatric patients, especially under the stress of relocation. When Ste. Anne's Hospital moved, the patients with chronic brain syndrome had the highest mortality rate during the following year. Apparently these brain‐damaged subjects failed to cope with the situation until it became real (after relocation). Thus, in a stress prevention program adopted when a geriatric institution plans to move, special attention should be paid to the subpopulation with chronic brain syndrome in the period immediately following the relocation.
Age Differences in the Severity and Outcome of Burns
Authors: Linn Bernard S. 
Published: April 2015

ABSTRACTThis study concerns the relationship between age and injury in 1,297 patients with recent burns who were admitted variously to 73 hospitals. Older patients showed a significantly higher proportion of severe injuries than did middle‐aged and younger groups. Even after adjusting for the severity of injury, the morbidity and mortality were higher in the over‐65 group. These poorer results did not seem to be entirely accounted for by older age and greater severity of the burn. Surgical treatment such as debridement and grafting was used no more frequently in older patients than in younger ones, even though the greater severity of the burns would normally be expected to require more operations. The fact that older patients had more complications could have influenced physicians in their surgical decisions. Also, the attitude that the elderly are less able to tolerate surgical procedures may have played a role in the use of less aggressive treatment in relation to the severity of the burn.
Role of Physical Therapists in Physical Activity Programs in Nursing Homes: A Survey
Authors: Skeist Helen Deborah 
Published: April 2015

ABSTRACTA survey was conducted to help define the role of physical therapists in physical activity programs in nursing homes. Questionnaires were completed by 64 physical therapists working in nursing homes of 130–150 bed capacity. The major factors studied were employment status, work‐time at the facility, interprofessional relationships, and available equipment and space. Of the respondents, 43.7 percent were involved in physical activity programs, the most common roles being staff instruction and consultation. Only a small percentage of the time was used for programs; most of the time was occupied with individual physical therapy treatment. The principal types of programs with physical therapist involvement were ambulation and gait training, bed exercises, and general group exercises. Equipment and space seemed adequate. Physical therapists were likely to be involved in physical activity programs if: 1) they were employed by the nursing homes, were paid on a salary basis, worked at the nursing homes full‐time or nearly full‐time, and did not work elsewhere; 2) such programs were mentioned during discussion of the work agreement; and 3) the coordinator of the physical activity programs was an occupational therapist or a nurse rather than an activities director or recreational therapist.
Hysteroscopy in the Diagnosis of Endometrial Carcinoma: Case Report
Authors: Poma Pedro A. , Diaz Alfonso 
Published: April 2015

ABSTRACTThe incidence of endometrial carcinoma is particularly high in postmenopausal women. Screening techniques are not yet satisfactory. Postmenopausal anatomic physiologic changes in the genitalia may prevent visualization and exploration of the uterine cervix. A case report is presented of an 87‐year‐old woman with a 6‐month history of genital bleeding. Severe vaginal stenosis prevented diagnostic curettage, even under adequate anesthesia. To perform the indicated hysteroscopy, a panendoscope had to be employed for direct visualization of the cervix and uterine cavity. Selective biopsy specimens revealed endometrial adenocarcinoma. The hysteroscopy technique is easy to learn. However, if the patient's physician has not acquired this experience, a urologist, who must necessarily use endoscopy extensively, can be of great help in the evaluation of gynecologic patients with uterine problems similar to those described in this report.
Gerontologic and Geriatric Training in Medical School: Curricular Preferences Shown by Medical Students, Educators, and General Practitioners
Authors: Levenson Alvin J. , Thornby John I. , Tollett Susan M. 
Published: April 2015

ABSTRACTThe need for incorporating gerontologic and geriatric training into the education of medical students is evident. Two main obstacles are the lack of educator knowledge in planning such training, and negative attitudes toward aging and the aged. Curriculum planning requires a design for the goals/objectives, the content, and the delivery vehicles. This article concerns chiefly the delivery vehicles, a subject which has received little attention in the literature. Negative attitudes on the part of students and their educators may defeat the incorporation of geriatric training into the curriculum. To assist in reducing these obstacles, a study was conducted for the purpose of providing data to educators which might facilitate the design of a delivery component for a medical student curriculum in gerontology and geriatrics. Senior medical students, their educators, and some general practitioners were surveyed in randomized groups, to determine: 1) their preferences for delivery vehicles in such a curriculum, 2) their attitudes toward aging and the aged, and 3) relevant demographic variables. The results are discussed from the viewpoint of the potential impact of these factors on their preferences and on the creation of obstacles to curriculum incorporation.
Paraphrenia: Paranoid States of Late Life. I. European Research
Authors: Bridge T. Peter , Wyatt Richard Jed 
Published: April 2015

ABSTRACTAmerican psychiatry has traditionally viewed late‐life paranoid states either as rare or not part of the schizophrenic syndrome. European psychiatry has not subscribed to this view. The literature (chiefly European) is reviewed from the standpoints of history of the disorder, diagnostic reliability, pre‐onset sensory loss, the multiple determinants of paranoia, and the response of paraphrenic patients to treatment with phenothiazines. The evidence leads to the conclusion that late‐life paranoid states are not rare, and that the diagnosis “paraphrenia” has real clinical utility. Moreover, there seems to be a substantial relationship between schizophrenia and paraphrenia.
Mechanism of Age‐Related Changes in Renin and Adrenocortical Steroids†
Authors: Saruta Takao , Suzuki Akira , Hayashi Matsuhiko , Yasui Toshiyuki , Eguchi Toyohisa , Kato Eiichi 
Published: April 2015

ABSTRACTAge‐related changes in plasma renin activity (PRA) and in plasma levels of adrenocortical steroids were studied in 140 normotensive men and 128 normotensive women. All were free of disease, and their ages ranged from 20 to 86 years. PRA decreased gradually with age in both men and women, and was slightly lower in women than in men. In the older subjects, the responses of PRA to the administration of furosemide or to dietary sodium restriction plus the upright position for blood sampling were significantly less than in the younger subjects. Apparently the suppression of PRA with age is due either to dysfunction of the juxtaglomerular cells induced by aging, or to reduction in the number of functioning nephrons. The plasma level of aldosterone was also reduced with age, but the levels of desoxycorticosterone, corticosterone, and cortisol were not significantly affected. The suppression of aldosterone seemed to be chiefly dependent upon the suppression of renin activity. However, the possibility remains that disturbed function of the glomerular cells with aging also is related to the suppression of aldosterone, since the response of aldosterone to dietary sodium restriction (upright position for blood sampling), to angiotensin II, and to potassium were greatly reduced.
Bulk Laxative Ileus
Authors: Berman Joseph I. , Schultz Michael J. 
Published: April 2015

ABSTRACTIn an elderly nursing home resident who had taken excessive dosages of bulk laxative for many years, small‐bowel obstruction developed, requiring surgical intervention. A carcinoma of the ascending colon probably was the immediate cause of the obstruction, which resulted in the accumulation and inspissation of the bulk laxative throughout the small bowel. Great care should be exercised in the long‐term use of these laxatives.
Estrogen Therapy and Breast Cancer in Postmenopausal Women†
Authors: Gambrell R. Don , Massey Fred M. , Castaneda Tristan A. , Boddie Arthur W. 
Published: April 2015

ABSTRACTDuring the 6‐year period 1972–1977, 123 postmenopausal women with breast cancer either had the disease diagnosed at Wilford Hall USAF Medical Center or were referred there for therapy. Their ages ranged from 33 to 90 (mean, 56.6 years). Of these women, 64.2 percent had never taken hormones, 25.2 percent were estrogen users, 4.9 percent were estrogen‐progestogen users, 4.9 percent had a history of hormone usage, and 1 patient was using estrogen vaginal cream. In a subgroup of 27 clinic patients (1975–1977 period) during 14,548 patient‐years of observation, breast cancer was diagnosed for an overall incidence of 185.6:100,000 women per year. Among the 27 patients, the annual incidence of breast cancer was highest in the untreated group at 410.5: 100,000 women. In comparison, the incidence in the estrogen users was 137.7: 100,000 women—a significant difference (p < 0.01). The incidence in estrogen‐progestogen users was 155.6:100,000 compared with the incidence in the untreated patients; this difference was also statistically significant (p < 0.05). There was no significant difference in the incidence of breast cancer between the estrogen users (137.7:100,000) and the estrogen‐progestogen users (155.6:100,000). These data indicate that estrogen therapy decreases the risk of breast cancer and that, unlike the situation with adenocarcinoma of the endometrium, progestogens do not offer additional protection from breast carcinoma.
Protein‐Calorie Malnutrition in the Elderly
Authors: Gambert Steven R. , Guansing Alejandro R. 
Published: April 2015

ABSTRACTProtein‐calorie malnutrition, common among the elderly, often escapes recognition. This article reviews some of the etiologic factors and the clinical manifestations. Ways to assess and prevent protein‐calorie malnutrition are also discussed.