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This is the author's fourth revision of a geriatrics bibliography. Approximately one-third of the previous references have been replaced by more current or more detailed articles. Because the literature pertinent to geriatrics has continued to grow ever more rapidly, it has been necessary to omit many informative articles from the bibliography. Preference is given to recent publications; almost all of the references date from the past four years. Some articles were selected to highlight current controversies or changes in viewpoint. An occasional unreferred article is cited to amplify geriatric aspects of common diseases. Most of the references deal specifically with an elderly patient population, though few use a multidisciplinary approach. Studies of the elderly are confounded by concomitants of aging frequent but not universal in our society: inactivity, obesity, malnutrition, and psychosocial trauma. The articles cited concern primarily medical ailments of the elderly but legal, ethical, and sociologic topics are also covered. The references are divided into categories. The first set deals with some possible causes of aging, the second with physiologic decline accompanying aging, the third with the atypical and nonspecific characteristics of illness among geriatric patients, the fourth with the elderly and society, and the fifth with care options. The remainder of the references are cited by pertinent medical specialty. Within each category, references are divided by disease process. Articles are further subgrouped by aspects of those diseases such as evaluation or therapy.
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PMID:Geriatrics. An updated bibliography. 355 91

Forty-two patients with proven intra-abdominal sepsis were studied in a prospective clinical trial. The following parameters were evaluated: (1) Nine parameters on admission: age, sex, obesity, malnutrition, history of cardiac, respiratory or renal disease, diabetes mellitus and malignant neoplasia. Four of these parameters had a prognostic value (p less than 0.05): age 65 years, diabetes mellitus and cardiac disease. (2) Thirty parameters representing the functional status of six organic systems during sepsis: respiratory, cardiovascular, nervous, kidneys, blood coagulation, liver. Six of these parameters had a prognostic values: PEEP 0-10 cm H2O to keep PaO2 greater than 60 mmHg (p less than 0.001), serum creatinine greater than 3.6 mg/dl (p less than 0.01), prothrombin time greater than 15'' or platelet count less than 100,000/mm3 (p less than 0.001), need of vasoconstrictive drug to keep arterial pressure greater than 100 mmHg (p less than 0.001), bilirubin greater than 3 mg/dl (p less than 0.01) and mental confusion. The combination of these ten statistically significant prognostic criteria for each patient showed that the mortality was 0 with 0-2 criteria, 36% with 3-5 criteria, 94% with 6-8 criteria and 100% with 8-10 criteria. Patients with more than five of these criteria had a significant higher mortality risk (p less than 0.001).
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PMID:Prognostic criteria in intra-abdominal sepsis. 367 39

While deficient exercise performance of sick children results from hypoactivity and detraining, it can also be caused by specific pathophysiological factors. These can affect one or more components of physical fitness. A low maximal aerobic power will result from a low maximal stroke volume, as in aortic stenosis or cardiomyopathy; a low maximal heart rate, as in congenital complete heart block or intake of beta-blockers; a low O2 content of the arterial blood, as in anemia or advanced cystic fibrosis; and a high O2 content of mixed-venous blood, as in muscle atrophy or severe malnutrition. A high O2 cost of locomotion, as in advanced obesity or cerebral palsy, will cause the patient to exert at a high percentage of his maximal aerobic power and thus fatigue easily. A subnormal muscle strength, as in progressive muscular dystrophy or juvenile rheumatoid arthritis, is sometimes the primary factor that limits the walking ability or other daily functions. Recent data suggest that local muscle endurance, as assessed by the Wingate anaerobic test, is particularly deficient in some neuromuscular diseases. Examples are muscular dystrophies and spastic cerebral palsy. The ratio of peak anaerobic power to peak aerobic power seems lower in such patients than in able-bodied controls.
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PMID:Pathophysiological factors which limit the exercise capacity of the sick child. 372 7

Undernutrition limited to the first two weeks (trimesters) of pregnancy in rats produces a delayed-onset enhancement of body weight and food intake in male but not female offspring. Adiposity measures (fat cell size, fat pad weight and carcass lipid content) however, were enhanced only in male offspring of previously deprived mothers maintained on a high-fat diet. Previous work had shown that although these adiposity differences are enhanced by this diet, hyperphagia was eliminated when animals were switched to the high-fat diet as adults. The current study demonstrates that if offspring of deprived animals are exposed to the high-fat diet early in life, hyperphagia ensues. Adipocyte number, and circulating triglyceride levels were unaffected by our nutritional manipulation.
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PMID:The effect of diet on food intake and adiposity in rats made obese by gestational undernutrition. 374 96

Nutritional and metabolic assessment using anthropometric, biochemical, immunological, and indirect calorimetric techniques was performed on 17 healthy paraplegic males with a mean age of 44.2 +/- 14.6 years and mean duration of injury of 17.8 +/- 12.3 years. Significant differences in energy expenditure were observed; only 29.4 percent were normometabolic [measured resting energy expenditure: (MREE) 90-110 percent of predicted resting energy expenditure (PREE)], 35.3 percent were hypermetabolic (MREE greater than 110 percent of PREE) and 35.3 percent were hypometabolic (MREE less than 90 percent of PREE). Obesity (weight greater than 110 percent ideal body weight) was maximum in hypometabolic patients (83.3 percent) due to the imbalance between caloric intake and energy expenditure (p less than 0.05). None of the patients had normal values for all four objective measurements of nutritional assessment (albumin, transferrin, total lymphocyte count, and cutaneous hypersensitivity). Mild malnutrition was evidenced in 47 percent of patients; 53 percent of patients demonstrated some index of moderate malnutrition. We conclude that nutritional therapy based on measurements of energy expenditure instead of predictive equations will benefit these patients. A larger long-term study is needed to determine the ideal predictive measurements of nutritional assessment with their optimal cutoff values applicable to the spinal cord-injured patient.
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PMID:Assessment of nutritional and metabolic status of paraplegics. 383 61

This is the second annual revision of the Geriatrics Bibliography. Approximately two thirds of the old references have been replaced by more current or more detailed articles. The bibliography has been expanded to include several additional topics and over 200 new references. Since the literature pertinent to geriatrics is growing ever more rapidly, it has been necessary to omit many informative articles from the bibliography. Almost all of the references date from the past four years. Preference is given to recent publications, since they provide a list of the important earlier articles. Some articles were selected to highlight current controversies or changes in viewpoint. An occasional review article is cited to amplify geriatric aspects of common diseases. Most of the references deal specifically with an elderly patient population, studies of which, it will be noted, are confounded by questions of "normal" aging as opposed to the concomitants of aging frequent in our society: inactivity, obesity, malnutrition, and psychosocial trauma. A few articles concern diseases remarkably common in the aged but for which no adequate study specifically from a geriatric viewpoint exists; e.g., monoclonal gammopathy, Paget's disease, pulmonary emboli. The references are divided into categories. The first (I) set deals with some possible causes of aging, the second (II) with physiologic decline accompanying aging, the third (III) with the atypical and nonspecific characteristics of illness among geriatric patients, and the fourth (IV) with non-physician services available to the elderly, including ethical quandaries. The remainder of the references are cited by pertinent medical specialty. Within each category, references are divided by disease process. Articles are further subgrouped by aspects of those diseases such as evaluation or therapy.
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PMID:Geriatrics: a selected up-to-date bibliography. 388 Jul 82

A randomized, prospective trial was conducted of 93 patients with operatively confirmed intra-abdominal sepsis. The study compared clindamycin-gentamicin and chloramphenicol-gentamicin for treatment of carefully stratified patient groups. Malnutrition, age over 65 years, shock, alcoholism, gastrointestinal tract bleeding, steroid administration, diabetes, obesity, and organ malfunction were present with equal frequencies in each group. The duration of antibiotic treatment averaged 8 1/2 days, and the average length of postoperative hospitalization was 29 days. Study antibiotics were changed for bacteriologic reasons in 11 patients taking clindamycin-gentamicin and 12 patients taking chloramphenicol-gentamicin (25% of the total), and two patients in the clindamycin-gentamicin group had a minor adverse reaction. Initial satisfactory clinical responses were obtained in 59 (63%) patients. Twenty-five patients (27%) subsequently developed unsatisfactory courses, but 48 (52%) patients remained well through the 30-day period. Septic-related mortality occurred in 18 (19%) patients, and two (2%) patients had unrelated deaths. There were no significant differences between the study regimens by the outcome criteria evaluated.
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PMID:Stratified outcome comparison of clindamycin-gentamicin vs chloramphenicol-gentamicin for treatment of intra-abdominal sepsis. 389 87

Prevalence of diabetes and increasing incidence mainly concern the type II diabetes, the etiopathogenesis of which is finally still unclarified. While the behaviour of the insulin secretion of type II diabetes is clarified as far as possible, research of the last years concentrates to disturbances of the insulin binding at the receptor, of the insulin efficiency after receptor binding as well as to the complicated interrelations between insulin secretion and peripheral effectiveness. On the one hand, metabolic sequels of malnutrition and obesity as well as decreasing muscle activity and muscle mass, on the other hand the genetic disposition plays an important role. Recently, insights into disturbed intracellular biochemical courses could be obtained and newer approaches for therapy could be found out. Significant could be the separation into perhaps still reversible findings in the manifestation of the irreversible late findings at the level of postreceptors after longer course of diabetes at least for the type IIb (adipose type). The diversity of etiopathogenetic factors demands substandardizations which would give only beginnings for prevention and optimized differential therapy. It cannot be denied that type II diabetes and arteriosclerosis partly have common genetic and exogenic causes.
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PMID:[Type 2 diabetes--etiopathogenetic aspects]. 391 10

A display of the different nutritional problems in Mauritania, such as they could be studied under the working medical conditions in this country. This study shows the coexistence, into a low life level country, of nutritional deficiency diseases, and obesity induced diseases, especially frequent among the mature women. This reality emphasizes the complexity of the mechanisms responsible for the nutritional diseases, and advocates for a global action to improve the nutritional status of a population. This supposes to integrate all the known data, including social and cultural knowledges.
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PMID:[Survey of nutritional pathology in Mauritania]. 392 5

In a population of 473 inpatients, a profile of nutritional status from obesity to marasmic-kwashiokor was observed. Thirty-two per cent of the population were overweight or obese (n = 153), forty-five per cent were of normal weight (n = 211), 8% were at risk of protein-energy malnutrition (n = 39), and 15% (n = 70) had grades of protein-energy malnutrition from marasmus to marasmic-kwashiokor. The implications for improved nutritional support services for hospitalised patients are discussed.
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PMID:Nutritional status in hospital inpatients: implications for nutritional support services. 393 66


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