bluuebunny/crossref_metadata_2025_split huggingface dataset:
PANCREATIC EXOCRINE INSUFFICIENCY: DIAGNOSIS AND MEDICAL MANAGEMENT*
Authors: Brown James W. 
Published: April 2015

AbstractPancreatic exocrine insufficiency is discussed from the viewpoints of physiology, etiology, signs and symptoms, laboratory findings, and treatment. Characteristic manifestations are those of malabsorption, with steatorrhea. The pancreatic secretin test is still the most valuable laboratory tool, though quantitative determination of fecal chymotrypsin may ultimately prove to be more advantageous. Pancrelipase or various other combinations of digestive enzymes often provide effective therapy.
DIPHENYLHYDANTOIN (DILANTIN) NEUROTOXICITY—A DECEPTIVE SYNDROME
Authors: Ang Manuel K. , Guiang Rudolfo , Berger A. R. 
Published: April 2015

AbstractTwo patients are reported in whom diphenylhydantoin (Dilantin) neurotoxicity developed as a result of inadvertent overdosage. The clinical features indicative of such toxicity are emphasized. Prompt recognition of the condition can forestall permanent sequelae and spare the patient unnecessary or hazardous diagnostic procedures.
DREAM RECALL IN THE NORMAL AGED*
Authors: Kahn Edwin , Fisher Charles , Lieberman Lois 
Published: April 2015

AbstractRecall from REM‐period awakenings was studied in the elderly. Twenty‐seven subjects (age range, 66 to 87 years) each slept one or two nights at the laboratory. From 166 REM awakenings there were 92 (55.4 per cent) instances of recall of dream content. This 55.4 per cent recall was significantly lower than the 87 per cent we previously found for the young adult. There was a tendency for women to have more frequent recall than men. REM dreams in the elderly were not manifestly concerned with loss or frustration. A small, nonsignificant positive correlation was found between the amount of recall and verbal intelligence.
MASKED RHEUMATIC MYOCARDITIS IN AN ELDERLY MALE
Authors: Margolis Jack , Weiss Morris 
Published: April 2015

AbstractA case is described in which active rheumatic myocarditis was found at autopsy in a 77‐year‐old man. Although he had been admitted many times to the V.A. Hospital during a period of about fourteen years, at no time did the history, physical examination, roentgenograms, electrocardiograms and laboratory determinations arouse any suspicion of the presence of rheumatic heart disease.
CHANGES IN SKELETAL MASS AND FRAGILITY WITH CASTRATION IN THE RAT: A MODEL OF OSTEOPOROSIS*
Authors: SAVILLE PAUL D. 
Published: April 2015

Abstract: Skeletal calcium content was measured in 99 normal and 65 castrated male and female rats. The breaking load in compression of the femur and humerus was measured and the femur‐breaking stress calculated. Weight of muscle on the hindlimbs, and the volume and density of the femur were determined.Normal female rats have a greater skeletal calcium content than males, and stronger long bones relative to body weight. This is because bone volume is greater in females compared to males at the same body weight. Castrated males and females have a similar skeletal calcium content; this is less than normal for females but more than normal for males and is due to differences in bone volume between the sexes. When bone calcium is considered as a function of bone volume, it is similar in the two sexes among smaller animals, although among larger animals the males have more mineral. Castration reduces the calcium content—when considered as a function of bone volume—about equally in the two sexes.
FRACTURES OF THE NECK OF THE FEMUR IN THE AGED: REVIEW OF 224 CONSECUTIVE CASES
Authors: NADEN D. , DENBESTEN L. 
Published: April 2015

Abstract: A review is presented of the end‐results in the treatment of 224 patients with fracture of the neck of the femur, at the University of Iowa Hospital. Of the 224 patients, 115 were aged 80 or older.The incidence of fracture non‐union was no higher among the older patients.One fourth of the patients died in the first year after fracture; of those surviving, one fourth never walked again.There was a high correlation of adequate reduction and fixation of the fracture with final healing and a return to the pre‐fracture ambulatory state.
THE DELAYED EFFECT OF ACTH ADMINISTRATION ON THE PLASMA CORTICOID LEVEL OF NORMAL ELDERLY PERSONS AND PATIENTS WITH CHRONIC BRAIN SYNDROME*
Authors: GRAD B. , KRAL V. A. , BERENSON J. , KAPPOS W. J. 
Published: April 2015

Abstract: ACTH (40 I.U.) was injected intramuscularly into 30 normal elderly subjects (N), 30 patients with senile psychosis (S), and 30 patients with psychosis due to arteriosclerosis (CAS). The ages of the subjects ranged between 64 and 97 years, the mean ages of the N, S and CAS groups being 74, 79 and 77 years respectively. Blood samples were drawn immediately before the injection and at eight and ten hours afterwards. The plasma cortisol and corticosterone (PC) concentrations were determined by the method of Murphy et al.The time curves for the three groups differed significantly. The PC values were highest in the S patients and lowest in the N subjects at eight and ten hours. Differences between the S and CAS patients were statistically significant, as were the differences between the CAS patients and the N subjects. There was no reliable difference in PC levels between men and women. The PC values in eight and ten hours were significantly higher than those at the zero hour; in addition, the eight‐hour value was significantly higher than the ten‐hour one. However, the sex × time and the disease × sex × time interactions were not significant.The results of these studies provide at least one explanation of why patients with senile or arteriosclerotic brain syndrome are more reactive to stress than are normal aged subjects—their adrenal cortices are more reactive.
EFFECT OF PENTYLENETETRAZOL (METRAZOL) ON BLOOD CHOLESTEROL CONCENTRATION IN MAN*
Authors: BESSMAN ALICE N. , CHANDRASEKAR SUBRAMANIAM 
Published: April 2015

Abstract: The effect of pentylenetetrazol (Metrazol) on serum cholesterol concentration was studied in 29 patients with initial cholesterol levels of 200 mg per 100 ml or higher. In addition, placebo was administered to 10 suitably matched controls. The dosage of pentylenetetrazol was 200 mg four times daily.In the patients to whom the drug was continuously administered for four weeks, there was a statistically significant fall in the concentration of serum cholesterol at the end of two weeks, but a return to the initial high level at the end of four weeks. In the patients to whom the drug was intermittently administered (for two two‐week periods with a one‐week interval), there was a significant decrease in the concentration of serum cholesterol at the end of each two‐week period. In all cases there were no deleterious effects. The maximal hypocholesterolemic effect of pentylenetetrazol was at the end of two weeks, but this lowering effect disappeared when drug administration was continued.The study shows marked individual variations in the cholesterol‐lowering response of patients to pentylenetetrazol. Thus, with respect to the continuing search for such drugs, it would seem that no one drug will be effective in lowering blood cholesterol concentration in all patients. The type of hypercholesterolemia and the type of response to drug administration will each play its role.
MENTAL PATIENTS IN NURSING HOMES. I. SOCIAL DEPRIVATION AND REGRESSION*
Authors: STOTSKY BERNARD A. , DOMINICK JOAN R. 
Published: April 2015

Abstract: A one‐year controlled study was made of 16 nursing homes containing 1,400 patients, 141 of whom were former patients of the Boston State Hospital. The purpose was to determine the effect of therapeutic activities in these settings. The design of the study is described.Institutional deprivation may be physical, intellectual or spiritual. Deprivation in nursing homes was found to be particularly related to: 1) lack of stimulation, 2) lack of adequate walking space inside and outside the homes, 3) lack of recreational and occupational therapy, 4) lack of space for group socialization and activities, 5) lack of a common dining room, so that patients have to eat off trays in their rooms, 6) absence of volunteer workers from the community, 7) separation of patients on different floors, and 8) minimal socialization between male and female patients. Case reports exemplifying deprivation reactions and regressive behavior (a warning signal of possible organic changes) are presented.Proposed programs for overcoming these problems include: 1) in‐service training of staff, 2) better communication between the state hospital and the nursing home, 3) intervention for emergencies or recurring problems, 4) the establishment of recreational and occupational therapy, and 5) the recruitment of volunteers to visit, conduct group games, and arrange extramural activities.
ELECTROCARDIOGRAPHIC VARIANTS IN THE GERIATRIC PATIENT
Authors: HARRISON WILLIAM V. 
Published: April 2015

Abstract: Electrocardiographic patterns change with aging, and with several other factors (some transient) that do not indicate disease. It is mandatory that an interpreter of electrocardiograms be aware of these factors. Otherwise, he may be responsible for creating a “cardiac cripple” with all the attendant emotional and familial disturbances which sometimes can be catastrophic. Such a case is presented, as are others from the literature.In conclusion, the author states: “Let us not take from the relatively healthy old person his sense of cardiac security. Let us not label him as a cardiac patient. Let us leave him to live out his years in confidence that his heart, though as old as his years, may carry him to the end of his allotted span.”
GENERALIZED SHARP ACTIVITY IN THE ELECTROENCEPHALOGRAM OF MIDDLE‐AGED AND ELDERLY PSYCHIATRIC PATIENTS*
Authors: MÜLLER H. F. 
Published: April 2015

Abstract: A survey of the electroencephalograms (EEGs) of 510 psychiatric subjects aged 50 or older revealed 41 cases of unusual spontaneous or photically evoked sharp and spiky activity.The EEGs of elderly patients often show generalized sharp activity, usually more intense than in younger subjects. This activity may be an aspect of various types of background rhythm, or it may be partly independent of them. Clinically, these patients tend to manifest psychomotor agitation and other symptoms indicating physical and mental overactivity. At least in patients whose EEGs show intense sharp activity, there can be little doubt about this EEG‐clinical relationship. It appears, therefore, that we are dealing with electrical phenomena which indicate forebrain hyperexcitability and which are associated with a hyperactive state in other parts of the organism.
COLOUR SENSITIVITY IN OLD AGE
Authors: DALDERUP L. M. , FRIEDRICHS M. L. C. 
Published: April 2015

Abstract: In two homes for the aged, 136 elderly residents underwent the Stilling test for colour sensitivity. A comparison group was composed of 33 much younger persons.Colour sensitivity decreases with age, without definite preponderance of red‐green over blue‐yellow disturbances, or vice versa. The loss of colour sensitivity occurs at slightly incongruent rates in the right and left eye.
FLURAZEPAM VERSUS AMOBARBITAL AS A SEDATIVE‐HYPNOTIC FOR GERIATRIC PATIENTS: DOUBLE‐BLIND STUDY
Authors: FISHER SEYMOUR , GAL PAUL 
Published: April 2015

Abstract: Twenty‐seven patients were given, orally, 15 mg of flurazepam (Dalmane) daily for fourteen days and then 50 mg of sodium amobarbital (Amytal sodium) daily for another fourteen days—or else these drugs in reverse order—according to a double‐blind cross‐over design. The patients were men who resided in a Veterans Administration domiliciary. Their average age was 66.5 years.Favorable subjective and objective reports were given concerning the effect of these drugs on sleep, and no adverse reactions or side effects were observed. Physical and psychological tests for assessment of both immediate and cumulative effects did not show any significant differences between the effects of the two drugs. Further studies of flurazepam are indicated.
EFFECTS OF ROUTINE VITAMIN SUPPLEMENTATION IN THE AGED
Authors: HECHT ALAN 
Published: April 2015

Abstract: A study was made in a nursing home of the effects of multivitamin therapy on appetite and weight (during periods varying from sixty to one hundred and ten days) in 59 patients (18 males and 41 females), of whom 55 were over 65 years of age. None of them manifested symptoms of vitamin deficiency.Approximately half of the patients responded with an increase in weight, and approximately half with an increase in appetite. An increase in appetite was more common in cases of appetite deficiency. When there was an improvement in appetite (and help for feeding was available), a gain in weight usually occurred. When there was no increase in appetite, there was little gain in weight unless the appetite was good before vitamin administration. Attention to feeding procedures apparently was a factor in producing some of the weight gain.There is no reliable method for predicting the outcome of multivitamin therapy when the indications for such treatment are not specific deficiency states.
Clinically Unrecognized, Silent Renal‐Cell Carcinoma in Elderly Cancer Patients
Authors: Hajdu Steven I. , Berg John W. , Foote Frank W. 
Published: April 2015

AbstractForty clinically unrecognized, silent renal‐cell carcinomas, found at autopsy in 8,921 cancer patients, are reported. A clinicopathologic study led to the following conclusions: Clinically unrecognized, silent renal‐cell carcinoma is predominantly a disease of elderly men. Renal‐cell carcinomas may range from small and clinically asymptomatic to large and clinically symptomatic, but the size of the carcinoma is not a reliable criterion of potential aggressiveness. In elderly cancer patients with unusual symptoms, every attempt should be made to rule out a possible additional primary renal neoplasm before attributing the new symptoms to the known cancer.
A SURVEY OF 100 APHASIC MEDICARE PATIENTS IN A SPEECH PATHOLOGY PROGRAM*
Authors: Sarno Martha Taylor 
Published: April 2015

Abstract100 aphasic Medicare (over age 65) patients were studied with respect to age and sex, duration and severity of symptoms, and length of speech therapy. These patients were referred to a speech pathology service in a rehabilitation center. In general, Medicare aphasic patients are older, more severely impaired, and seek services earlier in comparison to previously reported populations of aphasic patients. There is need for studying alternative methods of management for the severely aphasic group.
SUICIDE AND AGING*
Authors: RESNIK H. L. P. , CANTOR JOEL M. 
Published: April 2015

Abstract:Suicide is among the ten leading causes of death, but in addition many suicides may be concealed among accidental and natural deaths. The aged comprise 9 per cent of the population, yet they commit 25 per cent of the reported suicides.Suicide occurs in white males over age 65 at a rate nearly four times the national average, and in white females over 65 at a rate twice the national average.New techniques of intervention, case finding, and follow‐up are necessary with the aged, since they communicate their suicidal intention less frequently and are more often successful.All professionals should be alert to the possibility that older persons with a serious physical illness which could lead to death may avoid the fear and anxiety about prolonged dying, by committing suicide. Older persons also may want to die because they have accepted both real and imagined communications from a rejecting society.
WHAT WIVES SAY ABOUT NURSING HOMES
Authors: GREENWALD SHAYNA , LINN MARGARET W. 
Published: April 2015

Abstract:99 wives of patients transferred from a general medical VA Hospital to 25 nursing homes in an urban area submitted usable answers to a questionnaire asking them to comment on their experiences with the program for nursing home care. Data were first analysed by content analysis, and wives were grouped according to whether they praised (16.2%), criticized (47.4%), or did not comment (36.4%) on the homes. Comments reflecting praise were usually short and nonspecific. Criticisms were lengthy and could be grouped by categories concerning service, food, visits of a physician, medication and supplies. A series of statistical procedures were employed to determine if the wife's response was related to the husband's characteristics at the time he left the hospital or to the quality of the homes. Results indicated that wives' comments were not related to husbands' characteristics; whereas, statistical significance was found for wives' comments and the quality of nursing homes.
SOME FUNCTIONAL RELATIONSHIPS IN GERIATRIC PSYCHIATRY*
Authors: MÜLLER H. F. 
Published: April 2015

Abstract:Based upon electroencephalographic, clinical and experimental findings in the field of geriatric psychiatry, this article presents a group of working hypotheses which may lead to: 1) a better understanding of some EEG phenomena in terms of the overall clinical picture (and vice versa); and 2) more specific questions for further study. A diagram is presented which summarizes the more important points. This approach is prompted by the marked difference between the types of geriatric EEG, and also certain EEG‐clinical correlations—phenomena which make this field particularly interesting for the investigation of psychophysiological relationships.
PARKINSONISM, L‐DOPA AND MENTAL DEPRESSION
Authors: Cherington Michael 
Published: April 2015

AbstractTwelve patients with classical idiopathic Parkinson's disease were treated with L‐dopa. All 12 experienced improvement in motor status. In 6, however, marked depressive symptoms developed after several months of treatment. Although the study involved only 12 patients, it reveals a disturbing aspect of the treatment of parkinsonism with l‐dopa. The occurrence of mental depression deprives the patient of the happier existence that increased mobility should offer. There is also the increased danger of suicide; the 2 patients who attempted it were the only ones with a previous history of depression. More studies must be made to determine to what degree mental depression may limit the use of L‐dopa.
READINESS FOR PSYCHIATRIC HOSPITAL RELEASE IN RELATION TO LEVELS OF SOCIAL EFFICIENCY AND PSYCHOPATHOLOGY
Authors: Handy Imena A. 
Published: April 2015

AbstractThe social learning model in contrast to the medical model deserves more trials in preparing schizophrenic patients for release from mental hospitals. Observations by the three disciplines (physicians, psychologists and social workers) on 465 male schizophrenic patients in a Veterans Administration hospital indicated that release readiness was correlated more closely with the degree of social efficiency than with the degree of psychopathology. Thus, in addition to the various treatments used to reduce symptoms, there is great need for resocialization programs.
MEDICAL DIFFERENCES BETWEEN THE YOUNG AND THE AGED*
Authors: Cole Warren H. 
Published: April 2015

AbstractAlthough the medical profession is slowly realizing that many disorders in the aged must be treated differently than in the young, there is still no proper appreciation of these age differences. Too often, when a patient reaches life‐expectancy age, the physician relaxes his medical attention. It is assumed that the patient will die soon, although the actuarial statistics may show that he has many more years of life. Accordingly, therapy should be more intensive in order to attain the maximal life span.Elderly people will tolerate many major operations (e.g., herniorrhaphy or thyroidectomy) as well as young people. However, when it comes to serious major operations (e.g., radical neck dissection or radical excision of the rectum for carcinoma), the mortality rate for the aged may be four to eight times higher than for young patients.Elderly patients tolerate emergency major operations and complications very poorly. The chronologic age is not the chief factor in the mortality rate; more important are the operative complications. Therefore, preoperatively, every effort should be made to identify and treat diseases that might cause complications postoperatively. After operation a close watch must be kept for complications so that they may be treated promptly and effectively.Operative technic must be meticulous, with no excessive trauma and with particular attention to hemostasis and wound closure. The operation should be completed in the shortest possible time consistent with safety.A summary of 6 reports in the medical literature shows an operative mortality rate for major operations of 2.6 per cent in patients under 60, compared to 7.2 per cent for patients over 60. The mortality rate for emergency operations is much higher than for elective operations—18.5 per cent versus 6.5 per cent, respectively. A summary of 4 reports shows that cardiac complications were the greatest single cause of postoperative mortality (21.6 per cent), with pneumonia and atelectasis a close second. Despite precautions such as bandaging the extremities and early ambulation, pulmonary embolism accounted for 9.4 per cent of the deaths. [Though inoperable carcinoma caused more deaths (22.2 per cent of the entire group) than any of the other diseases, it is classified as a multiple cause.]Since the mortality rate for major operations in both aged and young patients is still significant, there is great need for more accuracy in determining operability.
THE CYBERNOSES OF THE AGED—THE FAILURE OF SELF‐REGULATING MECHANISMS
Authors: Meerloo Joost A. M. 
Published: April 2015

AbstractSymptoms observed in the aged are analyzed according to the cybernetic model. The concept of cybernosis encompasses all changes in macro‐ and microstructures, with their interactions and servomechanisms. Regression is the return to a genetic older self‐regulating model. There are psychic as well as somatic regressions, immunological as well as psychic defense mechanisms, and physical as well as social adaptations. According to the cybernetic model, neuroses and psychoses constitute failures in a hierarchy of structural systems and adaptational responses. The cybernosis concept is valuable when it leads to new insights, especially when it augments our forms of observation and research. Evidence of breakdowns in regulatory mechanisms in the aged may be observed in the areas of thermo‐regulation, diadic rhythm, psychosomatic security systems, symbiosis, and adaptive regressions, often enhanced by changing social attitudes toward the aged.Study of the cybernoses of the aged may be expected to give the therapist as much useful information as does study of the genesis of infantile defense mechanisms. Research on both aspects of‐life (breakdown as well as build‐up) will lead to a greater understanding of man.
PULMONARY EMBOLISM: MODERN CONCEPTS AND DIAGNOSTIC TECHNIQUES
Authors: Riccitelli M. L. 
Published: April 2015

AbstractThe subject of pulmonary embolism is assuming ever‐increasing importance, not only medically but legally. More than ever, the physician should have basic knowledge of the pathophysiology. This article outlines the modern concepts of the mechanisms involved and the etiologic factors. Pulmonary embolism is often difficult to diagnose. A thorough history and physical examination are fundamental, but there are several good diagnostic aids in the field of radiography, angiography, thermography, lung scanning, ultrasonic procedures, and enzyme and pulmonary function tests. Modern medical treatment is outlined—including preventive therapy, the treatment of shock, and the use of anticoagulants and thrombolytic agents. Surgical techniques include some ingenious new methods. However, the best results are obtained when surgical skill is combined with good judgment in the proper selection of cases.