177 people aged 65 or over, chosen at random from larger representative samples of elderly people living at home in Newcastle upon Tyne, were given the Weschler Adult Intelligence Scale (WAIS) or a shortened form of it, and followed up for 7 years or till death. Discriminated function analysis showed that the power of the test score to predict death occurring within 2 years was not explained away by its correlations with age, sex, social class or physical disability. Exclusion of clinically diagnosed chronic brain syndromes reduced but did not abolish the relationship found to exist between test score and outcome. The ascertainment of impaired cognitive functioning has important applications in the assessment of prognosis and in the planning of care of elderly people.

Aged↗

PubMed1977

A visual tracking machine.

The Visual Tracking Machine is an easily constructed device used for perceptual training with adults and children-with the following diagnoses: cerebral vascular accident, traumatic head injury, cerebral palsy, mental retardation, and spina bifida. It offers activities for the following purpose: development of visual attention and eyemotility, stimulation to cross the midline, compensation iraining for homonymous hemianopsia, one-side neglect, eye-hand coordination, and motor planning. The machine features control over smoothness, speed, and direction of movement of a visual stimulus, eliminates a potentially distracting background, spans the whole visual field, motivates the patient by offering the opportunity for many challenging games, and offers variability in task difficulty. It is sturdily built, relies only on manual power, and is not prone to mechanical breakdown. Used successfully during a one-year trial period, it appears to be a potentially useful adjunct to perceptual training programs. A description of its construction and materials needed are included. Other devices promoting tracking are reviewed in terms of function, source, and availability.

Adult↗

PubMed1976

[Experiments on the medicamental treatment of the noise-induced cochlear damage. Part I. The effect of dipyridamol and allopurinol on the RMP of the cochlea (guinea pig) after noise (author's transl)].

Dipyridamol has in addition to a coronardilatating effect an ati-thrombotic one too. Moreover it facilitates the release of O2 from haemoglobin by increase of the concentration of 2,3-diphosphoglycerate in the erythrocytes. Allopurinol causes a potential resynthesis of ATP in the cells by inhibition of the metabolism of uric acid. Both substances therefore seemed to be suitable for a medicamental therapy of the noise-induced cochlear damage. The expected favourable effect of Dipyridamol and Allopurinol on the organ of Corti after sound exposure (RMP-measurement before and after exposure to pure tone 120 dB SPL) however had not been confirmed by experiment on animals (guinea pig).

Allopurinol↗

PubMed1976

The characteristics of old people receiving and needing domiciliary services: the relevance of psychiatric diagnosis.

A sample of 447 people aged 65 years and over, randomly selected from electoral rolls, were visited in their homes, independently, by a medical social worker and a psychiatrist. Twelve per cent were receiving domiciliary services from the Local Authority and a further 20% were considered to require them. The types of services received and recommended are described and the medical, social and psychiatric services of those receiving services, in need of them, and the remainder are compared. The high priority for the support of persons with chronic brain syndrome and their relatives is emphasized. Functional psychiatric symptoms were found by the psychiatrist, in a high proportion of those considered by the medical social worker to need services. Psychiatric assessment and treatment which might reduce the need for social services in some cases, would be greatly assisted by the development of a reliable screening device for the use of the primary care team.

Activities of Daily Living↗

PubMed1976

Hospital mortality in patients with acute myocardial infarction: five-year experience.

Mortality during the hospitalization period was analyzed in a sample of 786 patients with acute myocardial infarction [AMI], admitted to the coronary care unit within a five-year period from a catchment area of 200 000 urban inhabitants. The total mortality during the hospitalization period amounted to 19.2%. The prognostic significance of certain clinically meaningful phenomena was appraised on the basis of their association to the mortality. It was demonstrated that the factors decisive for the prognosis of a patient with AMI are age, previous myocardial infarction, extent and localization of the ischaemic lesion apparent from the ECG tracing, and, in addition, presence of the atrioventricular and intraventricular conduction defects, especially if combined with anterior myocardial infarction. Patients with a high cumulation of these prognostic factors exhibited severe signs of mechanical heart failure, which is the mechanism of death in practically all of the deceased patients under the present possibilities of treatment.

Acute Disease↗

PubMed1975

Disposition of beta-methyldigoxin in man.

The time course of radioactivity in plasma and the excretion in urine and faeces over 7 days were determined in 12 healthy subjects after single oral and intravenous doses of a solution of 3H-beta-methyldigoxin. 62.2 +/- 2.1 and 29.0 +/- 5.2 per cent of the dose were excreted in urine and faeces, respectively, within 7 days of intravenous administration, compared with 55.2 +/- 2.8 and 28.6 +/- 5.7 per cent after oral administration. This indicates almost complete absorption of the glycoside when given in solution. 12 hours after its administration a pseudo-distribution equilibrium was reached and the average half life of tritiated compounds was 1.3 days. By 48 - 96 hours after treatment the average half life was 2.8 days. O-demethylation was revealed as the main metabolic degradation step in man. The rate of Demethylation was higher after oral than i.v. administration. Thus, only 31% of the radioactivity excreted in the urine consisted of unchanged beta-methyl-digoxin after oral administration compared to 51% after i.v. dosing. Only traces of bis- and monoglycosides were excreted in urine, but there were considerable amounts in faeces, where they accounted for more than 35% of the total excretion. Up to 40% of the radioactivity in plasma and urine consisted of polar conjugates during the first 12 hours after administration of beta-methyldigoxin. The mono- and bisglycosides were identified as the main products of conjugation. During the 7 days approximately 15% of the administered dose was metabolized by splitting off glycosidic bonds and conjugation to polar compounds.

Administration, Oral↗

PubMed1975