摘要:

ABSTRACTTen patients with severe dementia due to Alzheimer's disease (AD) or multi‐infarct dementia (MID) or both, were treated with the precursor amino acids of the neurotransmitters serotonin and dopamine. The precursor amino acids (PAA) were given orally in a preparation that included tyrosine (4 gm daily) and 5‐hydroxytryptophan (5‐HTP) (800 mg daily), plus carbidopa (100 mg daily) as an aromatic amino‐acid decarboxylase inhibitor. Diagnosis was established by an electroencephalogram, brain scan, computerized axial tomographic scan, and in one case by necropsy findings. Serial clinical evaluations and measurements of neuropsychologic function were performed. Levels of homovanillic acid (HVA) and 5‐hydroxyindoleacetic acid (5‐HIAA) were determined before and after administration of probenecid. Side effects of the PAA therapy were diarrhea, drowsiness, nausea, vomiting and agitation, all of which were controlled by reducing the dosage. One patient with MID and one with AD + MID showed clinical and psychologic improvement, but the others did not improve. Analysis of the cerebrospinal fluid for HVA and 5‐HIAA before and after the probenecid test indicated some improvement in the metabolic turnover of these acid metabolites of serotonin and dopamine after administration of their precurso

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1977.tb00640.x

年代:1977

数据来源: WILEY

摘要:

ABSTRACTPlasma glucose and insulin responses to orally administered glucose were determined in rats of varying ages and weights. The results indicated that glucose tolerance tends to deteriorate as rats grow from 1 month to 9 months of age. This change in glucose tolerance was associated with an increase in the response of plasma insulin to glucose, consistent with the hypothesis that the decline in glucose tolerance is due to a loss of normal insulin sensitivity. The changes in glucose and insulin responses could not be explained entirely on the basis of the associated weight gain. They seemed to be at least partially secondary to either age or an age‐related factor other than obesit

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1977.tb00641.x

年代:1977

数据来源: WILEY

摘要:

ABSTRACTTo evaluate the effect of sublingual nitroglycerin (N) and chewable isosorbide dinitrate (I) in patients with angina pectoris, 12 subjects underwent treadmill exercise to the point of onset of angina. At that juncture, N or I or placebo (P) was administered and walking was continued until moderately severe angina recurred. For those patients who completed the initial 10‐minute exercise period, testing was repeated until moderately severe angina recurred or until a total test time of three hours elapsed. Retesting ensured that each patient was tested separately with N, I and P within a two‐week period. Within the I group, four patients experienced the onset of angina relief (AR) at 10 minutes (′) 6 seconds (″) ± 3′ 4″ with a mean recurrence time (RT) of 154′ 3″ ± 4′ 27″ (P ≤ 0.05), for a significant difference. Within the N group, six patients had AR of 8′ 3″ ± 1′ 1″ with an RT of 49′ 39″ ± 1′ 15″ (P ≤ 0.01), for a significant effect. Within the P group, only one patient experienced AR. For all other patients in each group, testing was terminated because of moderately severe angina in the 5–8′ period of the first test. In comparing subgroups for RT during I therapy (4 patients) versus N therapy (6 patients), a significant difference was noted (154′ 3″ ± 27″ versus 49′ 39″ ± 1′ 15″) (P<0.05). The data suggest a possible benefit of I in selected patients. The effect may last as long as three to four hours. There is also an enhanced benefit of N with the patient in the upright position. This effect may last as long as 40–50′. Treadmill testing is recommended with nitrate administration to determin

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1977.tb00642.x

年代:1977

数据来源: WILEY

摘要:

ABSTRACTThe incidence of polypharmacy was investigated in a 200‐bed long‐term care facility. One hundred residents were drawn at random for the study. The average number of drugs prescribed per patient was 3.33, and the average number of pills was 6.34 daily. The most frequently prescribed drugs were the analgesics, followed in order by antihypertensive agents, cardiotonic preparations and antimicrobials. The literature is reviewed with respect to the incidence, causes and end‐results of polypharmacy. It is recommended that long‐term care facilities develop enlightened and aggressive pharmacy committees to monitor and evaluate drug use routinely in an institutional

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1977.tb00643.x

年代:1977

数据来源: WILEY

摘要:

ABSTRACTAt the Bel‐Air Psychiatric Clinic, Geneva, Switzerland, the technique of ultrasonic Doppler flowmetry was used to examine the internal carotid arteries of 30 aged patients — 10 with cerebral degenerative dementia, 10 with cerebrovascular dementia, and 10 without dementia. An index of cerebrovascular resistance was calculated. Apparently this index can distinguish a group of vascular dementias from a group of degenerative dement

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1977.tb00644.x

年代:1977

数据来源: WILEY

摘要:

ABSTRACTReactivation of tuberculosis in old age has been reported by several authors. This article confirms these findings and presents another 5 examples. Lack of adequate chemotherapy during the first clinical episode may be an important factor in reactivation, especially in debilitated patients.

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1977.tb00645.x

年代:1977

数据来源: WILEY

摘要:

ABSTRACTA 91‐year‐old man had been treated for iron‐deficiency anemia for four years before admission to the Geriatric Unit of the Hasharon Hospital because of cardiac insufficiency and epigastric pain. In the Unit, laboratory studies revealed, in addition to hypochromic anemia, a high level of plasma iron and a reduced iron‐binding capacity. The low reticulocyte count in the peripheral blood despite hyperplasia in the bone‐marrow erythrocyte series, the rapid disappearance of radioactive iron from the plasma, and the impaired erythrocytic uptake of iron were all indicative of ineffective erythropoiesis. The findings suggested the possibility of sideroblastic anemia, and examination of bone‐marrow aspirates stained for iron confirmed thi

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1977.tb00646.x

年代:1977

数据来源: WILEY

摘要:

ABSTRACTIdiopathic hemochromatosis is an iron‐storage disease more common in men than in women. It is characterized clinically by diabetes mellitus, cirrhosis of the liver, pigmentation of the skin and cardiac failure. The diagnosis may be overlooked when the presenting symptoms do not follow the pattern. A case is reported which was diagnosed after an onset that featured neurologic symptom

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1977.tb00647.x

年代:1977

数据来源: WILEY

摘要:

ABSTRACTIn reviewing the literature on treatment approaches with the psychiatric elderly, a large number of studies were found which espouse comprehensive rehabilitation programs that usually require supplementation of existing personnel and expansion of facilities. Although some agencies and institutions are fortunate in securing the needed funds for such program implementation, most others face the reality of limited personnel and funding cutbacks. This paper briefly reviews modalities which do not demand additional expenditures for specialized facilities in the treatment of chronically ill geropsychiatric patients.

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1977.tb00648.x

年代:1977

数据来源: WILEY

摘要:

ABSTRACTA program of balanced physical fitness incorporated into a medical “team” approach to treatment contributed significantly to the general health of elderly ambulatory patients. Each week for eleven months, 13 patients were given one hour of balanced exercise and encouraged to perform it for two additional hours per week. Initial differences favoring the control group (13 subjects) in their general state of health were reversed during the exercise program. Physicians’ single‐blind assessment of the two groups resulted in significantly better health ratings for the patients who had received the therapeutic exercise program than for those who did not part

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1977.tb00649.x

年代:1977

数据来源: WILEY