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Biomedical subjects

R Westlund

Publications and source records attributed to R Westlund.

4 recordsLinked to original sources

A brief depression scale for use in the medically ill.

OBJECTIVE: Using items from two existing depression scales, we have sought to develop a brief self-rated instrument for detecting major depressive disorder (M.D.D.) in medically ill, hospitalized patients. METHOD: Forty-two items from the Geriatric Depression Scale (G.D.S.) and Carroll Depression Scale were administered to 559 men under age 40 or over age 70 consecutively admitted to the hospital. Eighty-two M.D.D.'s were diagnosed in this group by structured psychiatric interview. After eliminating 12 items confounded by medical illness, 11 items were selected using regression analysis, correlation with the total score, and factor analysis. The 11-item scale includes an assessment of the five DSM-III-R criteria for M.D.D. which are least confounded by medical illness (mood, suicidal intent, guilt or worthlessness, concentration, and psychomotor agitation). The scale was then tested in 78 medical inpatients who were later assessed for M.D.D. using a structured psychiatric interview. RESULTS: Ten out of twelve M.D.D.'s were identified (83% sensitivity) and depression excluded in 51 of 66 non-depressed subjects (77% specificity) (compared with 82% sensitivity and 76% specificity for the 30-item G.D.S.). Scores on the 11-item scale were also correlated with the G.D.S. (.92), the Zung Depression Scale (.58), and the C.E.S.-D (.67). CONCLUSION: The 11-item scale is a practical tool for clinicians who screen patients for depression and for investigators who need a brief measure of depression in studies involving medical inpatients.

Adult

The metabolic effects of calcium supplementation in the elderly.

Because the value of calcium supplementation in age-related bone loss is controversial, we conducted a study to examine the effects of six months of calcium supplementation on parathyroid hormone (PTH) and other indices of bone metabolism. Calcium carbonate (1.2 grams elemental calcium/day) or placebo was administered for 6 months to a group of 42 healthy, ambulatory men and women with a mean age of 71. Fasting blood samples and 2-hour urine collections were performed at baseline and at 1 and 6 months. The decline in serum PTH levels from baseline in the calcium-supplemented group was significant in comparison with the placebo group changes (for the calcium group: 40.9 pg/mL at baseline to 34.0 pg/mL at 1 month and 33.2 at 6 months). This drop in PTH was associated with a decline in 1,25 OH-Vitamin D levels from a mean of 38.3 pg/mL to 30.4 pg/mL at 1 month and 31.9 at 6 months. During calcium supplementation, no changes were observed in serum bone Gla protein values. A decline in urinary hydroxyproline excretion was observed at 6 months, but this did not reach significant levels. The present study demonstrates suppression of PTH levels with calcium supplementation, an effect which lasts at least 6 months. This change was accompanied by a decrease in serum 1,25 OH-Vitamin D. The lack of significant changes in either serum bone gla protein or urine hydroxyproline excretion fails to support any significant change in bone turnover occurring with this decrease in PTH.

Administration, Oral

The Ocutech Vision Enhancing System (VES): utilization and preference study.

An NIH-sponsored user and prescriber preference trial was conducted comparing a new low vision telescope system, the Ocutech Vision Enhancing System (VES) to two conventional Keplarian spectacle telescope systems in a controlled cross-over clinical study performed at four independent low vision clinics. Fifty-five visually impaired individuals, 18-81 years of age, with both previous and no telescope experience, were followed for 8-16 weeks. The experimental and control devices were compared on a series of subject-selected visual tasks using a standardized clinical protocol. Subjects were trained in the use of the systems with standardized clinical methods. The data shows a statistically significant preference of the new design by both patient and clinician with the overriding factors relating to appearance, weight, adjustability and the fit of the frame.

Adolescent