Urinary Steroids in the Measurement of Aging and of Atherosclerosis †Marmorston, Jessie; Griffith, George C.; Geller, Paul J.; Fishman, Eugene L.; Welsch, Federico; Weiner, John M.
doi: 10.1111/j.1532-5415.1975.tb00894.xpmid: 1176748
ABSTRACT Several studies conducted by the authors' group have shown that urinary steroid measurements are a valuable aid in differentiating the normal aging process, the pronounced aging associated with increased risk to coronary heart disease, and the deviations associated with myocardial infarction. Data are presented on 428 men in the age range of 30–70 years. The study design most effective in elucidating aging and disease patterns involves selection of subjects from a wide age range. Data on persons identified as clinically normal can be used to describe physiologic aging. Once this is determined, data on persons with disease can be used to identify abnormalities of aging associated with the clinical conditions studied. This approach offers a potential method for differentiating between aging effects and disease effects. The foregoing findings led to the development of an Index of Aging in males, based on combined serum lipid and urinary steroid values. This Index may be a means of differentiating between normal aging and the deviations seen in atherosclerosis and myocardial infarction. Current studies are directed toward extending these observations.
Glucocorticoid Therapy in Sepsis/Shock Caused by Gram‐Negative Microorganisms †Seneca, Harry; Grant, John P.
doi: 10.1111/j.1532-5415.1975.tb00895.xpmid: 1176749
ABSTRACT A review of the literature reveals that glucocorticoids have: 1) a protective effect both in vitro and in vivo against bacterial endotoxins and exotoxins, and 2) a protective or therapeutic effect in sepsis/shock caused by Gram‐negative microorganisms. At the Columbia Presbyterian Medical Center, the 1968–1973 mortality rate for general sepsis/shock due to Gram‐negative organisms was 16.6 percent and for urologic sepsis/shock 15.3 percent. This low rate was the result of early diagnosis and early use of massive dosages of glucocorticoids (hydrocortisone, methylprednisolone, dexamethasone), beta‐adrenergic isoproterenol, and bactericidal antibiotics (gentamicin, kanamycin, carbenicillin, cephalothin‐cefazolin, ampicillin).
Lipidemia—A Multigeneration Predictability Study †Woldow, Asher
doi: 10.1111/j.1532-5415.1975.tb00896.xpmid: 1176750
ABSTRACT This study involved a 1st generation of 194 aged residents at the Philadelphia Geriatric Center plus 2nd and 3rd generations of 357 and 306 offspring, respectively. Serum cholesterol levels (including type of abnormality) and triglyceride levels were determined. The results suggest that hyperlipidemia at all ages is related to a familial genetic problem. The data on each generation, starting even with the 80‐year‐old parents, could be used to predict lipid abnormalities in each succeeding generation. However, when comparing the 1st generation with the 3rd generation, predictability was lacking, probably because of the inclusion of two sets of spouses and many environmental factors that altered the situation. In the 2nd generation, 40 per cent of the subjects had an elevated lipid level compared to 30 per cent in the 1st and 3rd generations. The higher concentrations in the 2nd generation probably reflected increased risk factors such as improper diets, smoking, hypertension, obesity and stress at that age level. Hyperlipidemia in the aged apparently is not just a metabolic degenerative abnormality. It should be treated, as in younger people. Data on risk factors such as a high blood lipid level may help not only the aged, but succeeding generations.
Combination Drug Therapy for the Psychogeriatric Patient: Comparison of Dosage Levels of the Same Psychotropic Drugs, Used Singly and in CombinationFracchia, J.; Sheppard, C.; Canale, D.; Ruest, E.; Cambria, E.; Merlis, S.
doi: 10.1111/j.1532-5415.1975.tb00897.xpmid: 809497
ABSTRACT The dosage levels for a number of frequently prescribed psychotropic drugs, used singly or in combination, were determined in 902 long‐term psychogeriatric hospital patients. The data failed to support the hypothesis that physicians prescribe lower dosages when combination therapy is used. Rather, the tendency was toward higher dosages under these circumstances.
Hepatic Infarction Associated with Terminal Hemorrhagic Necrotizing Enteropathy (THNE): Case ReportIshii, Toshiharu; Hosoda, Yasuhiro; Yakumaru, Kazuhiro
doi: 10.1111/j.1532-5415.1975.tb00898.xpmid: 1176751
ABSTRACT A case of hepatic infarction associated with terminal hemorrhagic necrotizing enteropathy (THNE) in an 84‐year‐old woman with cardiac failure is presented. The autopsy showed hepatic infarction, THNE, fibrous endocarditis, generalized arteriosclerosis, myocardial hypertrophy, liver congestion, and other findings as described. Both rare infarctions (hepatic and intestinal) seemed to have originated not only as a result of impaired systemic circulation due to cardiac failure, but also from liver congestion due to peripheral circulatory deficiency through the portal vein. The circulatory correlation between these infarcts of the liver and intestine is discussed.
Pelvic Distress in the Aged PatientPaulson, George W.
doi: 10.1111/j.1532-5415.1975.tb00899.xpmid: 1176752
ABSTRACT Unexplained pelvic distress or pain was observed in the 4 patients of this report (3 women and 1 man), and also in 6 other patients during a 10‐year period of neurologic practice. In each of the 4 reported cases, the discomfort was interpreted as sexual. It is suggested that this may be a valid entity and that, as with trigeminal neuralgia and postherpetic neuralgia, it is truly limited to aged patients. The mechanism, incidence and significance are unknown.
A Psychogeriatric Assessment Program. II. Clinical and Laboratory Findings †Hontela, S.; Müller, H. F.; Grad, B.; Derkevorkian, K.
doi: 10.1111/j.1532-5415.1975.tb00900.xpmid: 1176753
ABSTRACT In a Psychogeriatric Assessment Program, the statistical evaluation of clinical and laboratory data related to thyroid function in 80 patients led to the conclusion that: 1) differences in thyroid function between psychogeriatric patients of the organic and functional types were only slight, as determined by clinical symptoms and thyroxine blood levels, and 2) factor analysis for 53 selected variables indicated that loading for “gross disturbance of psychobiologic function” may be related to the symptom complex of hyperthyroidism/hyperadrenergism, and particularly to psychobiologic symptoms rather than purely somatic symptoms of hyperthyroidism. In comparison with a group of 60 healthy old people, the psychogeriatric patients showed many more signs of hyperactivity and other characteristics of this symptom complex. The results supported the preliminary impression of an energetic (hyperthyroid‐sympathicotonic) reaction to mental decline, accompanied by plasma corticosteroid and electroencephalographic changes.