Showing papers by "Deborah Grady published in 1991"

1,25-dihydroxyvitamin D3 and muscle strength in the elderly : a randomized controlled trial

Abstract: An unexplained loss of muscle strength occurs with aging. Vitamin D deficiency can cause myopathy and administration of 1,25-dihydroxyvitamin D3 [1,25-(OH2)D3] to persons with low serum concentrations can improve strength. To test the hypothesis that the weakness associated with aging is in part due to inadequate serum concentrations of [1,25-(OH2)D3], we conducted a randomized, controlled, double blinded trial in 98 men and women volunteers over 69 yr old. Treatment consisted of 0.25 micrograms 1,25-(OH)2D3, orally, twice per day or identical placebo for 6 months. Leg muscle strength of the quadriceps was measured with an isokinetic dynamometer. There was no difference between the two groups at 1 week, 1 month, or 6 months of treatment in any of the measures of muscle strength. We conclude that oral administration of 0.5 micrograms 1,25-(OH)2D3/day does not improve muscle strength in older persons. Further research is needed to determine the etiology of the decline in muscle strength associated with aging.

Risk Stratification of Ambulatory Patients Suspected of Pneumocystis Pneumonia

Abstract: To determine whether aspects of clinical history, physical examination, and laboratory studies improve the diagnostic accuracy of the chest roentgenogram in the diagnosis ofPneumo cystis cariniipneumonia (PCP), we followed up 302 consecutive patients with respiratory symptoms and risk factors for human immunodeficiency virus. Of the 279 patients (92%) with follow-up information available, 31 (11%) were diagnosed with PCP. Only 68% of patients with PCP had typical chest roentgenograms. Regression analysis identified four independent predictors of PCP: diffuse or perihilar infiltrates, presence of mouth lesions, lactate dehydrogenase level more than 220 U/L, and erythrocyte sedimentation rate 50 mm/h or more. Using these four predictors, patients could be stratified into low-, intermediate-, and high-risk groups for PCP. We suggest that examination of the mouth, chest roentgenogram, lactate dehydrogenase level, and erythrocyte sedimentation rate be part of the evaluation of ambulatory pa tients with respiratory symptoms at risk for human immunodefi ciency virus. (Arch Intern Med. 1991;151:105-110)