bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevention of Falls in the Elderly
Authors: Overstall P. W. 
Published: April 2015

ABSTRACTTo prevent falls effectively, one must first understand the underlying reasons. Although environmental factors are sometimes to blame, the fundamental cause is a decline in postural control which is partly age‐related and partly due to pathologic changes in the central nervous system. Dizziness is a common complaint among those who fall, and it is often caused by a central or peripheral vestibular disorder. Many patients who complain of dizziness do not have true vertigo but are expressing a fear of falling. Balance exercises can improve postural control and confidence in these patients. Falls are not inevitable in old age and may be prevented by maintenance of health, mobility and confidence, the avoidance of certain drugs, identification of specific problems such as cardiac arrhythmias or postural hypotension, and attention to environmental hazards.
Measured versus Estimated Creatinine Clearance in the Elderly as an Index of Renal Function
Authors: Gral Thomas , Young Marilyn 
Published: April 2015

ABSTRACTMeasured endogenous creatinine clearance (requiring 24‐hour urine collection) was compared to estimated (calculated) creatinine clearance obtained by 2 formulas and a nomogram (without urine collection), in 26 elderly nursing home residents. All were clinically stable and had adequate intakes of food and fluid. Of the 26 subjects, 23 had a “normal” value for serum creatinine concentration (0.7–1.5 mg/dl) with a mean of 1.1 mg/dl. Measured creatinine clearance (Ccr) was reduced in all patients despite a “normal” serum creatinine level. The mean Ccr was 47.2 ml/min, with values as low as 21.6 ml/min. Measured Ccr findings compared well with estimated (calculated) findings, the correlation coefficients being highly significant in all instances. If it is difficult or impossible to collect a 24‐hour urine specimen, a fairly accurate assessment of renal function may be obtained by using a simple formula (or nomogram) for estimating creatinine clearance on the basis of the patient's age, weight (height) and serum creatinine level.
Evaluating Loss of Consciousness in the Elderly
Authors: Scherokman Barbara , Massey E. Wayne 
Published: April 2015

ABSTRACTIn the case of an elderly patient with transient loss of consciousness, the chief differential diagnosis is syncope versus seizure. The most helpful diagnostic aid is a thorough history obtained from both the patient and an observer. The tentative diagnosis based on the history can be confirmed by the findings on physical examination and by such secondary studies as an electroencephalogram and a series of cardiac tests.
Relationship of Depression to Physical and Psychologic Complaints in the Widowed Elderly
Authors: Elkowitz Edward B. , Virginia Arcilio T. 
Published: April 2015

ABSTRACTCoping with depression has always been a central theme in the life of the elderly, and many efforts have been made to develop a valid form of assessment. This article shows that an analysis of compliance may usefully supplement the usual instruments for measuring depression. The study group consisted of 10 widows and 8 widowers (age range, 69–74 years). They were tested by the Zung Depression Scale, particularly for physical and psychologic complaints. The pattern and correlates of these complaints are discussed in relation to depression and sex. The data indicate a relationship between compliance and the severity of depression, and also between sex and the expression of distress feelings.
Idiopathic Hypertrophic Subaortic Stenosis and Aortic Regurgitation in an 84‐Year‐Old Man
Authors: Habibzadeh M. A. 
Published: April 2015

ABSTRACTDuring the ninth decade of life, idiopathic hypertrophic subaortic stenosis (IHSS), particularly when associated with other cardiac disorders, presents a confusing clinical problem. Unless the physician has a high index of suspicion, the diagnosis is easily overlooked, and consequently inappropriate management of the patient may lead to serious complications. One such case in an 84‐year‐old man is described. Administration of certain drugs may only intensify symptoms. Echocardiography is invaluable for diagnosis. Pertinent clinical features of IHSS in the eighth and ninth age decades are outlined.
Deep Posterior Tibial Compartmental Syndrome after Accidental Hypothermia in an Elderly Hypothyroid Patient
Authors: Coni N. K. 
Published: April 2015

ABSTRACTCompartmental syndromes are uncommon, but particularly the deep posterior tibial compartmental syndrome, which is usually associated with trauma. It has not previously been recorded as a complication of hypothermic or hypothyroid coma. This case of successful surgical therapy in a 75‐year‐old woman is reported in the hope that similar occurrences in the future may be recognized in time for curative surgery or at least for palliative surgery which can offer recovery of useful function.
Conjoint Therapy of Psychiatric Problems in the Elderly
Authors: LaWall John 
Published: April 2015

ABSTRACTIn treating elderly psychiatric patients, interviewing spouses together may be the most useful setting. Data gathering, reality testing and reality orientation can all be enhanced by the “well” spouse. The physician also can assess the value of the “well” spouse as a co‐therapist. Two case reports illustrate this method of aiding treatment.
Young‐Old versus Old‐Old and the Use of Health Services. Does the Difference Make a Difference?*
Authors: Snider Earle L. 
Published: April 2015

ABSTRACTThe literature indicates the necessity for different levels of health service for various age cohorts among the elderly. The present study concerns the relationship between age cohorts and the use of community‐based ancillary health services in comparison with other enabling, predisposing, and health status factors. In a probability sample of Western Canadian older persons, three enabling variables were found to be most closely associated with the use of such health service, i.e., knowledge of health services, education, and monthly family income. Age differences among the elderly, a predisposing variable, were unrelated. Implications for the delivery of health services are discussed.
Effect of Age on Active and Inactive Plasma Renin in Normal Subjects and in Patients with Essential Hypertension*
Authors: Nakamaru Mitsuaki , Ogihara Toshio , Higaki Jitsuo , Hata Takeshi , Maruyama Anna , Mikami Hiroshi , Naka Toru , Iwanaga Keiichi , Kumahara Yuichi , Murakami Kazuo 
Published: April 2015

ABSTRACTThe effect of age on the levels of active and trypsin‐activatable inactive plasma renin was examined in 41 normal subjects and 54 patients with essential hypertension, during recumbency and after stimulation with furosemide and ambulation. Active renin levels in supine subjects and patients decreased with age. Inactive renin levels did not change with age in normal subjects, whereas in hypertensive patients they decreased with age. Following stimulation with furosemide and ambulation, the levels of active renin increased but the responsiveness to stimulus decreased with age in both groups. In contrast, inactive renin levels slightly increased after furosemide administration and ambulation, resulting in an increased proportion of active to total renin. These data show that an acute stimulation with furosemide and ambulation affects mainly the active form of plasma renin, and the effect of age on inactive plasma renin in normal subjects may be different from that in patients with essential hypertension.
Heart Weights Among Octogenarians
Authors: HOWELL TREVOR H. 
Published: April 2015

ABSTRACTThe weights of hearts among 110 octogenarians were studied. At autopsy they ranged from 174 to 785 gm, which is more than the customary norm for adults. In only 15 subjects were the hearts considered completely normal. Other hearts showed hypertrophy, friable muscle, fatty infiltration, brown atrophy, a flabby myocardium, valvular changes, and atheroma or calcification of the coronary arteries. The frequency of these changes and their relationship to heart weight are discussed. A previous study of heart weights among 39 nonagenarians had shown weights ranging from 159 to 539 gm — somewhat less than those among the octogenarians. Heavy heart weights are common in these two age groups.
The Masculine Gender Role and Its Implications for the Life Expectancy of Older Men*
Authors: SOLOMON KENNETH 
Published: April 2015

ABSTRACTThe lifespan of men is shorter than that of women. This study is an effort to identify some causal factors. Six dimensions of the masculine gender role are examined in relation to certain stress‐related disorders more prevalent among older men than among older women. These dimensions are “No Sissy Stuff”; “The Big Wheel”; “The Sturdy Oak”; “Give ‘Em Hell”; homophobia; and sexual dysfunctioning. Specific problems of retirement are also discussed. Only in recent years have the roles of men been studied more closely. The results may offer positive implications for the lifespan of men.
Social Support and Alternatives to Institutionalization for the At‐Risk Elderly
Authors: LINDSEY ADA M. , HUGHES ELIZABETH M. 
Published: April 2015

ABSTRACTSelected findings are reported from a follow‐up study conducted to determine what happened to persons aged 65 or older who were referred for evaluation to an urban Geriatric Evaluation Service (GES) but who were not approved by the GES for admission to a mental hospital. Reasons given for the referral included both physical and behavioral problems. The alternatives to institutionalization were based upon the nature of the available social support system, and the functional health status. The family provided most of the care for its aged ill, and the adult children provided most of the social support. In the absence of support by adult children, other relatives gave the necessary care, which included a wide range of services such as personal care, housekeeping, cooking, running errands, transporting, and the important service of just being present or available. Community services were used infrequently. The majority of the subjects were in the “poor health” category and required supervision or care for impaired mobility, one or more physical health problems, and sometimes for mental confusion or disorientation
Nosocomial Pneumococcal Pneumonia in the Elderly
Authors: BERK S. L. , GALLEMORE G. M. , SMITH J. K. 
Published: April 2015

ABSTRACTAmong 35 elderly patients with transtracheal aspirate (TTA)‐documented nosocomial pneumonia, 7 (20 percent) had Streptococcus pneumoniae infection. Clinical and epidemiologic data are reported on these 7 patients and on 2 others with nosocomial pneumococcal pneumonia documented by bacteremia. Malignancy and chronic obstructive pulmonary disease were the most common predisposing illnesses. Four of the 9 patients had previously received antibiotic therapy. Gram‐negative aerobic pneumonia was found before (2 cases), concomitant with (3 cases), and after (2 cases) the pneumococcal infection in these patients.
Management of Incarcerated Vaginal Pessaries
Authors: POMA PEDRO A. 
Published: April 2015

ABSTRACTUterine procidentia is relatively common among white multiparous women. The incidence increases with age in association with other predisposing factors. Conservative management of uterine prolapse is rare today, perhaps due to definitive results with surgical therapy and the high incidence of earlier hysterectomy. Still, physicians should become familiar with pessary use and its complications. Three conservatively managed cases of pessary incarceration are reported. Applications of estrogen cream improved the condition of the vagina, permitting removal of the incarcerated pessary a few days later. Careful instruction of patients and relatives about follow‐up care can prevent such complications.
Chlorpropamide‐Induced Syndrome of Inappropriate Antidiuretic Hormone Secretion
Authors: TANAY A. , FIREMANN Z. , YUST I. , ABRAMOV A. L. 
Published: April 2015

ABSTRACTThe Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH) is a rare but serious complication of chlorpropamide therapy. In 2 elderly women who had diabetes mellitus, the SIADH developed two months after the chlorpropamide dosage had been increased to 500 mg daily. The syndrome disappeared after withdrawal of the drug. In one of these patients, re‐administration of chlorpropamide resulted in recurrence of the SIADH. A review of the current literature disclosed certain common denominators, i.e., most of the patients are elderly women whose dosage of chlorpropamide was increased shortly before the development of the SIADH.
Exercise and Skeletal Health
Authors: ALOIA JOHN F. 
Published: April 2015

ABSTRACT:Involutional osteopenia contributes to older persons' susceptibility to fractures of the hip, spine and wrist. Experimental evidence is reviewed that supports the hypothesis that involutional bone loss can be prevented by physical exercise. Weightlessness and immobilization result in accelerated bone loss. In cross‐sectional studies measuring total body potassium (TBK), both muscle mass and bone mass in normal humans have remained strikingly constant. The usual decrease in total body calcium (TBCa) and TBK with increasing age was not observed in a cross‐sectional study of marathon runners. Localized hypertrophy of bone and muscle has been reported for a variety of occupations and sports. Two prospective studies have demonstrated an increment in bone mass after a program of physical exercise. It would seem that certain involutional changes in body composition (loss of TBCa and TBK) can be prevented by increased physical activity, but the effectiveness of specific types and durations of exercise should be investigated.
Screening for Hypertension in an Elderly Population: Report from the Dunedin Program
Authors: HALE WILLIAM E. , MARKS RONALD G. , STEWART RONALD B. 
Published: April 2015

ABSTRACT:Hypertension detection and follow‐up programs have recently received increased attention. The authors studied the effect of screening for hypertension in a geriatric screening program for a large ambulatory elderly population in Dunedin, Florida, over a three‐year period. Of the 4,247 participants initially screened, 39 percent had some form of hypertension, and 15.6 percent of these had not received any form of treatment. At the time of the first year follow‐up, the proportion of participants with treated, controlled hypertension had increased from 14.7 to 21 percent. These data lend support to the value of hypertension screening among persons over 65 years of age.
First‐Year Medical Students and the Aging Patient: A Curricular Model*
Authors: JARVIK LISSY F. , ROSS CLAIRE , KLESSIG JILL , HOFF PAMELA 
Published: April 2015

ABSTRACT:First‐year medical students at UCLA are introduced to the special health problems of the elderly by a process in which they interview symptomatic volunteers at both extended care and ambulatory care facilities. In addition, they interview healthy elderly volunteers to gain information on gerontology and lifespan development, with supplementation from selected readings, films, lectures and panels. This curricular model seems effective in reducing prejudice about the aged and in training future physicians to render humane competent care in the field of geriatrics.
The Role of Vaginal Hysterectomy in the Aged Woman
Authors: Ellenbogen Adrian , Agranat Avi , Grunstein Stephen 
Published: April 2015

ABSTRACTThe results of vaginal hysterectomy in 85 women over the age of 65 were reviewed. All the patients' complaints were attributable to uterine prolapse but the frequency of occurrence was not proportional to the given patient's degree of disability. Spinal anesthesia was used the most frequently, as it is usually not contraindicated in the elderly. Certain postoperative complications were encountered, but these did not cause prolongation of the hospital stay. No postoperative deaths occurred. Most of the patients showed complete improvement in terms of personal activity. It is concluded tht vaginal hysterectomy for uterine prolapse is a safe and beneficial operation in the elderly and is preferable to the more limited procedures employed years earlier.
Changes in Endocrine Activities Relative to Obesity in Patients with Essential Hypertension*
Authors: Hiramatsu Kunihide , Yamada Takashi , Ichikawa Kazuo , Izumiyama Tomio , Nagata Hajime 
Published: April 2015

ABSTRACTThe possible role of obesity in the development of hypertension was investigated in two study groups. In a population study of 961 subjects, 739 were found to be normotensive and 222 hypertensive. The prevalence of hypertension was 18.7 percent in the nonobese, and 33.2 percent in the obese subjects. Systolic and diastolic blood pressures increased progressively with the increase of relative body weight in both normotensive and hypertensive subjects. In addition, an endocrinologic study was made of 97 patients with essential hypertension; in 82, plasma renin activity (PRA) was inversely correlated with the increase of relative body weight but not with urinary Na excretion. Despite this decrease of PRA, the level of serum aldosterone was not influenced by relative body weight. Thus, the aldosterone/PRA ratio increased progressively with the increase of relative body weight. Thiazide therapy normalized this inappropriately high ratio, and reduced body weight and blood pressure. Restriction of dietary calories and salt intake had a similar effect. With a high‐salt intake in an obese subject, the aldosterone/PRA ratio is unduly increased. Apparently aldosterone contributes to the additional retention of sodium and water and thereby promotes hypertension in the presence of an expanded fluid volume.
Injury in Late Life
Authors: HOGUE CAROL C. 
Published: April 2015

Epidemiologic studies show that injury is a nonrandom event of considerable consequence to older people. Even though children have the highest injury rates for all injuries combined, the elderly have the highest death rates and the highest dysfunction and disability rates from falls, fires and contact with hot substances, and vehicular crashes.There are notable race and sex differences in injuries in the elderly. Women have higher rates of injury from falls than men. Men have higher injury rates from burns and motor vehicle crashes (including pedestrian injuries), and for each of the three categories of injury men have higher death rates than women. Before the age of 75, nonwhite males have the highest rates of death from injury. At 75, however, white males cross over to have a much higher rate of death from injury than do nonwhite males.More than half the deaths due to unintentional injury in persons 65 and older are caused by falls. White men have the highest death rates from falls, followed by white women. More than a fourth of the injury fatalities for people 65 and older are from motor vehicle crashes. More than 9.3 per cent of all licensed drivers are 65 or older. Older drivers drive fewer miles than other people, and they tend to limit their driving to daytime and to relatively less stressful conditions. Nonetheless, when miles driven by drivers over 64 are taken into account, the relatively small number of crashes is equivalent to a crash rate exceeded only by the under‐25 age group. Pedestrian deaths account for more than a third of motor vehicle deaths to people 65 and older. The death rate from burns is higher in the elderly than in any other age group, including young children. In the event of thermal injury, old people are much less likely to survive.Diminished ability to perceive hazard and to respond effectively contributes to higher injury rates among the elderly, as does lower injury threshold.
Alcohol Excess and the Senile Squalor Syndrome
Authors: KAFETZ KALMAN , COX MARIA 
Published: April 2015

ABSTRACT:Two patients are described who fit the category of the senile squalor syndrome, i.e., the deterioration into squalor and self‐neglect by a patient not subject to dementia or serious physical impairment. It is suggested that alcoholism may be an important predisposing factor.
A Dose‐response Study with Dihydroergotoxine Mesylate in Cerebrovascular Disturbances
Authors: YOSHIKAWA MASAMI , HIRAI SHUNSAKU , AIZAWA TOYOZO , KUROIWA YOSHIGORO , GOTO FUMIO , SOFUE ITSURO , TOYOKURA YASUO , YAMAMURA HIDEO , IWASAKI YOSHIO 
Published: April 2015

Basic pharmacologic evidences have suggested the effects of dihydroergotoxine mesylate (DEM) on neurotransmitters. In its clinical use, however, various therapeutic effects and side effects are observed when the dose is changed, because of the complexity of this compound and the delicate mechanism of neurotransmitters in the brain, especially when modified by aging and vascular lesions.In order to investigate the optimal dose, a double‐blind study in 550 patients with cerebrovascular disorders was carried out at 68 centers under observation by experienced specialists. Dihydroergotoxine mesylate in sublingual tablets, 3 mg daily, and in oral tablets, 6 mg daily, respectively, was given for 12 weeks, and therapeutic effects at those doses were compared by a double‐blind method. In utility ratings for subjective and psychiatric symptoms, the effects in the oral tablet group at a daily dose of 6 mg were significantly superior to those in sublingual tablet group at a daily dose of 3 mg. There was no significant difference between those two groups in the comparison of side effects.These results show that the daily oral administration of 6 mg of DEM is more suitable for the improvement of subjective and psychiatric symptoms due to cerebrovascular disorders than is the daily sublingual administration of 3 mg. These results suggest that, despite much complexity in the neurohumoral transmitter mechanism in the brain, relatively simple dose‐dependent efficacy of the drug in the range of the therapeutic doses was confirmed for many subjective and psychiatric symptoms of patients with cerebrovascular disorders.
Book Reviews
Authors: Barzel Uriel S. 
Published: April 2015

Book reviewed in this article:Geriatric Emergencies: Brady's Series in Emergency Medicine. By Schwartz G, Bosker G, Grigsby JW. Bowie, Maryland, Robert J. Brady, Co.The Biomedical Basis of Gerontology. By Hall DA. LittletonDying Dignified: The Health Professional's Guide to Care. By Gonda TA, Ruark JE.Essentials of Clinical Neurology. By Weisberg LA, Strub RL, and Garcia CA.Nutrition in Gerontology: Vol. 26, Aging Series. Edited by Ordy JM, Harman D, Alfin‐Slater RB.Laboratory Medicine in Clinical Practice: Practical and Efficient Use of the Laboratory in Patient Management. Edited by Mandell HN. John Wright‐P.S.G.Long‐term Care: Perspectives from Research and Demonstrations. Edited by Vogel RJ, Palmer HC.Arteriosclerotic Brain Disease. Edited by Crepaldi G, Fellin R, Olsson AG, Toffano G.The Mind and Mood of Aging: Mental Health Problems of the Community Elderly in New York and London. By Gurland B, Copeland J, Kuriansky J, Kelleher, M, Sharpe L, Dean LL.
The Lack of Benefit of Modest Sodium Restriction in the Institutionalized Elderly
Authors: HADLER MORRIS H. 
Published: April 2015

ABSTRACT:Modest restriction of sodium intake is commonly prescribed in hypertensive or fluid‐retaining states in the elderly. In recent years this intervention is generally adjunctive to pharmacologic therapy. Its utility was tested by comparison of baseline serum urea nitrogen (BUN) and creatinine levels, weight, and mean blood pressure with these determinations six months after the daily dietary sodium intake was changed from 2 g to 4 g in 38 institutionalized elderly persons. No difference was discernible. In elderly persons in institutions, where diuretic therapy is common and the validity of diagnoses is not tested daily, the modest restriction of sodium intake may accomplish little more than reducing the payability of food.