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Biomedical subjects

T Mendelson

Publications and source records attributed to T Mendelson.

16 recordsLinked to original sources
PubMed1999

Perceived social support among depressed elderly, middle-aged, and young-adult samples: cross-sectional and longitudinal analyses.

BACKGROUND: A number of studies have concluded that the perceived quality of support is more strongly associated with mental health than with the actual structure of personal networks. This study examined clinical, historical, and phenomenological variables associated cross-sectionally and longitudinally with perceived social support. METHODS: Participants included elderly, middle-aged, and young-adult depressed samples derived from the Duke Clinical Research Center for the Study of Depression in Late Life. RESULTS: Cross-sectional multivariate analyses revealed that perceived social support was: (1) for the elderly associated with pessimistic thinking, being divorced, having strange ideas, the degree of social interaction, and instrumental support; (2) for middle-age associated with dysthymia, divorce, pessimistic thoughts, social interaction, and instrumental support; and (3) among young adults with instrumental support only. Longitudinal multivariate analyses indicated that only perceived social support at Time 1 predicted perceived social support 1 year later among elderly and middle-aged subjects, whereas only instrumental support predicted perceived social support 1 year later among the young-adult sample. LIMITATIONS: The small number of subjects among the young-adult sample limit conclusions regarding this group. In addition, only patients provided data. Future studies should consider using multiple informants to enhance the accuracy of reported social support. CONCLUSIONS: Our findings indicate that in addition to whatever else they do for depressed patients, clinicians must endeavor to address relationship or social support difficulties, especially in the elderly.

Adult↗
PubMed1999

Correlates of suicidal ideation among an elderly depressed sample.

BACKGROUND: Suicidal ideation has been shown to be strongly associated with suicide completion and elders take their own lives more than any other age group. METHODS: The present study examined clinical and phenomenological correlates of suicidal ideation among an elderly sample (n = 167) derived from subjects enrolled in the Duke Clinical Research Center for the Study of Depression in Late Life. RESULTS: Bivariate results indicated that clinical variables associated with psychomotor retardation, a history of dysthymia, a previous psychiatric in-patient stay, and being a 'younger' elder were related to greater suicidal ideation. Multivariate analyses indicated that feeling guilty, sinful, or worthless was associated with over six times greater odds of having suicidal thoughts. LIMITATIONS: Findings are based on correlational analyses, and thus, the direction of causality cannot be inferred. CONCLUSIONS: This study provides evidence for clinicians of some of the 'red flags' associated with the presence of suicidal ideation among depressed older adults.

Aged↗
PubMed1999

New onset and remission of suicidal ideation among a depressed adult sample.

BACKGROUND: Previous research has demonstrated that suicidal ideation often predicts suicide completion. METHODS: The present study examined clinical and phenomenological variables associated with the presence, development and remission of suicidal ideation among depressed adults. The sample (n = 81) was derived from subjects enrolled in the Duke Clinical Research Center for the Study of Depression in Late Life. RESULTS: Greater pessimistic thinking at baseline predicted the development of suicidal ideation one year later and the older a person was when he or she first experienced depression, the more likely he or she was to report remission from suicidal ideation one year following onset. LIMITATIONS: Longitudinal analyses were based on relatively small samples. Variables that were not significant in these analyses might be in a larger sample. CONCLUSIONS: The longitudinal design of this study mitigates limitations associated with cross-sectional or retrospective designs and advances our understanding of a clinical profile associated with the development and remission of suicidal thoughts.

Adolescent↗
PubMed1998

Preventive health services and access to care for male veterans compared with their spouses.

The Veterans Health Administration is exploring ways to reform the current Veterans Affairs (VA) system in accordance with the changing health care environment of managed care. One proposal is for the VA to enlarge its patient base by expanding eligibility to include spouses of veterans. To compare reported preventive health care services received by male veterans and their spouses and to measure whether spouses would choose to receive their medical care through a VA medical center, we randomly selected 230 married male veterans and mailed self-administered questionnaires to be completed by them and their spouses; 170 (74%) eligible subjects completed the questionnaire. The mean age of the veterans and spouses was 73.6 and 67.4 years, respectively. Veterans reported significantly higher rates of receipt of recommended preventive services than their spouses in all 5 areas assessed, including blood pressure measurement; influenza, pneumococcal, and tetanus vaccinations; and serum cholesterol measurement. Veterans were significantly more satisfied than their spouses with their current health care. Finally, 83% (95% confidence interval, 77% to 89%) of spouses reported that they would choose to receive their medical care at the VA medical center is allowed to do so. These findings suggest that spouses of male veterans represent a sizable group that could be incorporated in the VA system, especially given their strong desire to do so.

Aged↗
PubMed1993

Primary aortoduodenal fistula caused by severe atherosclerosis, not by aneurysm.

Primary aortoduodenal fistula is an uncommon cause of massive upper gastrointestinal hemorrhage usually due to pressure erosion of an abdominal aortic aneurysm into the third portion of the duodenum. This report describes a case of a 59-year-old man who died of massive gastrointestinal hemorrhage due to a primary aortoduodenal fistula. This case is unique in that the fistula formed as a result of complex atherosclerotic disease of the abdominal aorta, with adventitial chronic inflammation and foreign body reaction against atheromatous plaque, and not from an aneurysm. We were unable to identify any other reports of aortoduodenal fistulas developing spontaneously in the absence of aneurysmal disease of the aorta.

Aorta, Abdominal↗
PubMed1985

Herpes simplex virus type 2 encephalitis in two homosexual men with persistent lymphadenopathy.

Within a 5-month period, 2 homosexual men with persistent lymphadenopathy developed clinical findings consistent with herpes simplex virus (HSV) encephalitis. These signs included abrupt change in mental status, seizures, cerebrospinal fluid pleocytosis, and localized electroencephalographic abnormalities showing temporal lobe involvement. Initial computed tomographic scans were unremarkable. Treatment with adenine arabinoside was instituted and temporal lobe biopsies were performed. Although virus-specific antigens were detectable in only 1 patient, cultures of biopsy tissue from both patients yielded HSV type 2 organisms. Spiking fevers persisted and the patients failed to improve, prompting administration of acyclovir. Both patients recovered gradually after their second course of antiviral therapy and survived with severe neurological deficits. These patients should raise concerns about an increased incidence of type 2 encephalitic illness among homosexual men with persistent lymphadenopathy or acquired immune deficiency syndrome. In addition, the importance of using HSV type 2 antibody in the immunofluorescence test of brain biopsy tissue for rapid diagnosis of the disease is emphasized.

Adult↗
PubMed1982

Developmental profiles for the brainstem auditory evoked potential.

Brainstem auditory evoked potentials (BAEP's) were recorded from 641 subjects in eleven age groups ranging from birth through adulthood, including three levels of prematurity, in order to establish an age-specific normative data base. The amplitude and latency values for waves 1-6, interwave differences for 3-1, 5-3, 5-1 and the amplitude ratios for 5/3 and 5/1 were then converted to percentile scores to permit construction of age-related BAEP profile report forms. Visual inspection of the printed output reveals the proportion of subjects falling above and below a given individual across all BAEP measures. This simple format is useful for general screening purposes as well as plotting maturational changes in healthy or high risk infants.

Adult↗
PubMed1981

Maturational effects on the middle components of the averaged electroencephalic response.

Middle component AERs to brief click stimuli were recorded from 60 subjects in four age groups to assess age effects on waveform, latency, and amplitude. Replicable responses similar in waveform to those recorded in adults were observed in 3 - 4-year-old children, full-term newborns, and premature infants tested as early as the 31st postconceptional week. Latencies and amplitudes were compared across ages and significant age effects were evident for amplitude but not latency. Amplitudes of components Po, Pa and Pb were found to increase until 3 - 4 years of age and decline in adulthood. Response amplitudes for premature infants differed significantly from those of adults, but newborns' responses did not differ from either group. Only the responses of 3 - 4-year-old children were clearly differentiated from those of all other groups in this respect. Significant age effects on latency were found only for Po, which is postulated to be synonymous with Wave V of the brainstem response. The absence of a trend for decreasing latency as a function of age in the middle components is surprising in that both early (brainstem) and late (cortical) responses demonstrate this effect. This finding raises questions about the generator sources for middle components.

Adult↗
PubMed1981

Binaural interactions in the short-latency evoked potentials of neonates.

Short-latency evoked potentials to monaural and binaural clicks were recorded from scalp electrodes on healthy full-term neonates and on normally hearing adults. Binaural interaction (BI) was measured by summing the average monaural responses obtained from each ear (L+R) and subtracting the binaural response (B) from the monaural sum (BI=L+R-B). Consistent BI was apparent following stimulation with moderate level clicks in all cooperative infants. As in the adult, BI occurred during waves IV, V and VI, where there were systematic amplitude differences between the L+R and B waveforms. Peak latencies of the waves were not significantly affected. However, peak latencies were longer in neonates than in adults, reflecting maturational changes in the response. Similarly, peak latencies in the BI waveforms were also prolonged for the neonates. These results indicate that: (1) BI is present at or soon after birth; (2) the gross response properties of BI are similar in infants and adults; (3) BI occurs during specific waves in the response, independent of age, and (4) the assessment of BI may prove useful in estimating the functional integrity of brain stem structures in infants.

Audiometry, Evoked Response↗
PubMed1980

Differential development of brainstem potentials in healty and high-risk infants.

Maturation along the brainstem acoustic pathway, as well as the integrity of these structures, has been shown to be reflected in brainstem evoked potential recordings. Trajectories formed from repeated sequential measurements of several brainstem response variables reveal distinct developmental curves for healthy and high-risk infants. Longitudinal analysis offers a means of determining temporary or permanent maturational effects on the central nervous system in early life.

Age Factors↗
PubMed1980

Contrasts in brainstem function between normal and high-risk infants in early postnatal life.

Brainstem auditory evoked potentials (BAEPs) were recorded from healthy and high-risk infants at selected ages throughout their first year of life. Amplitude and latency measurements of peaks I, III and V were treated in a series of multivariate analyses of variance. Significant main effects for age (newborn, 3 wk, 6 wk, 3 mth, 6 mth and 1 yr), group (healthy, risk) and peaks (amplitude and latency of BAEP waves I, III and V) were observed. In addition, the interaction between these factors proved statistically significant. As expected, the pattern of response amplitude and latency for the various peaks differed as a function of age. Moreover, healthy and risk infants revealed different maturational trends. These results indicate that infants born 'at risk' but free of severe auditory deficits and major neurological difficulties can be distinguished from healthy (age-matched) controls in terms of the BAEP throughout the first postnatal year.

Brain Stem↗
PubMed1979

Brain stem evoked potential findings in children with otitis media.

Sixty-three children from 2 to 12 years of age were studied by means of brain stem evoked potentials (BEP) and otoscopic evaluation in a preliminary assessment of the sensitivity of BEP latency measures to middle ear abnormality. Wave I proved to be the most sensitive component; 81.25% of subjects with acute suppurative otitis media and 62.50% of subjects with secretory otitis media demonstrated latencies prolonged by more than 1 SD beyond the values observed in normal control subjects. Of the same subject groups, 86.21% and 93.31% demonstrated wave I latencies within normal limits upon retesting after the otitis had resolved. The BEP technique permitted identification of several subjects with abnormal audiometric findings despite normal otoscopy. There are implications for use of the BEP as a clinical adjunct to traditional methods of auditory assessment.

Acute Disease↗
PubMedDate not supplied

Scalp-recorded frequency-following responses in neonates.

Low-frequency tone bursts (250, 500 and 1 000 Hz) were used to elicit frequency-following responses (FFRs) from full-term, healthy neonates. Easily identifiable FFRs were recorded from all well babies with stimulation at low-to-moderate levels (30-45 dB HLn). The amplitude and threshold values of neonatal FFRs were not significantly different from those of normally hearing adults. As in the adult, neonatal FFRs elicited by tone burst stimuli of 250 and 500 Hz were of greater amplitude and were observed at lower stimulus levels than FFRs recorded at higher frequency stimuli. At stimulus levels of 65 dB HLn, latency to the first peak in the FFR decreased as a function of increasing stimulus frequency. Neonatal FFRs evoked by tone bursts of 250 and 500 Hz exhibited significantly longer latencies compared to FFR recordings obtained from adults. These results suggest that: (1) Low-frequency basilar membrane sensitivity in neonates can be assessed as early as the first day of life. (2) The response properties of the FFR recorded from neonates were similar to the response properties of the FFR recorded from the adult. (3) For infants who fail conventional brainstem-evoked response screening procedures and/or for infants who are born "at risk", the FFR holds great promise as an assessment technique to determine the integrity of the low-frequency-sensitive regions of the cochlea and auditory brainstem.

Adult↗