[Care of chronically ill geriatric patients with the cooperation of relatives]

In the first stage of the project "assistance of relatives for the care of chronically ill people" in context of the National Research Programme No 8 (Economy and efficacy of the Swiss Health System) a representative random sample of elderly longterm patients was arranged in Basle and the situation regarding their relatives investigated. Altogether 473 relatives were contacted. Finally 343 interviews with next-of-kin were held and as many questionnaires filled out. The main aim of the questioning in the first part of the study was to know who would be able to participate in the care at the hospital on a part-time basis. Basing on the results, it may be presumed that about 30% of the relatives of chronically ill patients who have regular personal contact with them are ready and willing to participate actively in a co-operative model set-up of a nursing institution. In the second stage the way should be paved for the management of a pilot-station. During the research programme between 1983 and 1985, the model-idea should be examined for its practicability. Afterwards it can be judged if the basic idea of the project evidences a real progress or remains a social-medical utopia.

A controlled long-term study with ergoloid mesylates (Hydergine) in healthy, elderly volunteers: results after three years

A long-term clinical comparison of the effects of ergoloid mesylates and placebo on 148 healthy elderly volunteers of both sexes was analyzed after three years of study. At that point, 99 subjects (53 receiving ergoloid mesylates and 46, placebo) were still being treated under double-blind conditions, while the remainder either had dropped out or continued to participate under open conditions. Many subjects in both groups were healthier after the three years than they had been at the onset of the study: subjective symptoms such as tiredness and dizziness were reduced, performances on tests of intelligence were improved, and some abnormal laboratory values had normalized. Blood pressures increased on the average during the investigational period and pulse rates became slower. The ergoloid mesylate regimen was well tolerated objectively and subjectively. Additional medical and psychologic improvements were noted in the group treated with ergoloid mesylates concerning cardiovascular parameters, cholesterol levels, subjective symptoms, and performances on tests of intelligence. These intermediate findings are interpreted as showing a preventive effect of ergoloid mesylates against some of the debilitating physical and psychologic concomitants of aging.

Structural comparison of a homologous neuron in gryllid and acridid insects

The fast extensor tibiae (FETi) motor neuron is responsible for exciting the extensor tibiae muscle to produce most of the force for jumping in acridids. Because of its relatively large size and crucial role in jumping, FETi has been studied in an ever-increasing number of orthopteran species. Here we describe the structure of the metathoracic FETi neuron in six species of acridids and in two species of gryllids. The morphology of FETi within the respective groups is essentially equivalent, but marked differences are apparent between acridid and gryllid FETis. There are similarities in the size and location of the cell body and the course of the neurite through the ganglion. Differences are found in the number of large branches, density of branching, and the volume of neuropil receiving branches. We propose that the gryllid FETi is an intermediate form between slow extensor tibiae motor neurons involved in walking and acridid fast extensor tibiae motor neurons specialized for jumping.

[A rehabilitation unit for geriatric amputees (author's transl)]

Elderly leg amputees are patients with the most somatic, emotional and social problems requiring rehabilitation assistance. Expensive artificial limbs often cannot be used because many detailed questions are left to chance. In order to coordinate the rehabilitation of these patients in an optimal manner and utilise the invested means efficiently, a specialised rehabilitation centre was organised at the Medizinisch-Geriatrische Klinik I of the Felix-Platter-Spital Basle and its mode of organisation was intentionally designed to be simple and flexible. The rehabilitation team consists of staff members of the Orthopedic and Geriatric Department of the hospital. From 1974-1978, 59 geriatric amputees aged 60-90 years were cared for and 75% could later be discharged to their own homes. In spite of the advanced age and various illnesses of these patients, the results of the rehabilitation unit are encouraging. However, prime importance should be given to finding a suitable milieu after dismissal.

Central projections of fibers in the auditory and tensor nerves of cicadas (Homoptera: Cicadidae)

The auditory and tensor nerves of cicadas are mixed nerves containing both afferent and efferent elements. In 17-year cicadas, and in Okanagana rimosa, the auditory nerve contains afferents from body hairs, from the detensor tympani-chordotonal organ, and some 1300--1500 afferents from the hearing organ. Within the fused metathoracic-abdominal ganglionic complex the receptors from both the auditory and tensor nerves form a neuropilar structure that reveals the metameric organization of this complex. A few fibers run anteriorly, projecting into the meso- and prothoracic ganglia. Within the ganglionic complex a division of auditory nerve afferents into a dense intermediate and a more diffuse ventral neuropile is observed. In addition, a dorsal motor neuropile is outlined by arborizations of the timbal motor neuron. This neuron is one of several efferent cell types associated with the auditory nerve, and there is an indication that several efferent fibers innervate the timbal muscle. There is anatomical evidence for a possible neuronal coupling between the bilaterally symmetrical large timbal motor neurons. In general, central projections from the auditory and tensor nerves support evidence of a structural "layering" within the CNS of insects.

On-line cardiac output by digital computer

Many devices for fast cardiac output calculations employ special assumptions and departures from the Stewart-Hamilton method. These assumptions and departures can cause substantial errors. This publication describes an on-line computer system for evaluating dye-dilution curves according to the classical Stewart-Hamilton method. Dilution curves are smoothed, using a digital filter to eliminate heartbeat noise. Recirculation is removed using the constant ratio property of exponentials. The quality of the curves is evaluated by determining the length of the base line, the extent and the fit to an exponential downslope, and a figure of merit based on the five tanks-in-series model. Dilution curves, the logarithmic form, and the exponential ratios are displayed on a CRT for visual checks. Comparison of cardiac outputs obtained by this on-line system with results obtained by hand calculations showed a mean difference of 150 ml. Repeated evaluation of one electronically simulated dye curve resulted in SD = 10 ml for computer results and SD = 200 ml for hand calculations.