Effects of vitamin D supplementation on symptoms of depression in overweight and obese subjects: randomized double blind trial.

OBJECTIVES: The objective of the present study was to examine the cross-sectional relation between serum 25-hydroxyvitamin D [25-(OH) D] levels and depression in overweight and obese subjects and to assess the effect of vitamin D supplementation on depressive symptoms. DESIGN: Cross-sectional study and randomized double blind controlled trial of 20,000 or 40,000 IU vitamin D per week versus placebo for 1 year. SETTING: A total of 441 subjects (body mass index 28-47 kg m(-2), 159 men and 282 women, aged 21-70 years) recruited by advertisements or from the out-patient clinic at the University Hospital of North Norway. MAIN OUTCOME MEASURES: Beck Depression Inventory (BDI) score with subscales 1-13 and 14-21. RESULTS: Subjects with serum 25(OH)D levels < 40 nmol L(-1) scored significantly higher (more depressive traits) than those with serum 25(OH)D levels > or = 40 nmol L(-1) on the BDI total [6.0 (0-23) versus 4.5 (0-28) (median and range)] and the BDI subscale 1-13 [2.0 (0-15) versus 1.0 (0-29.5)] (P < 0.05). In the two groups given vitamin D, but not in the placebo group, there was a significant improvement in BDI scores after 1 year. There was a significant decrease in serum parathyroid hormone in the two vitamin D groups without a concomitant increase in serum calcium. CONCLUSIONS: It appears to be a relation between serum levels of 25(OH)D and symptoms of depression. Supplementation with high doses of vitamin D seems to ameliorate these symptoms indicating a possible causal relationship.

Risk factors for aneurysmal subarachnoid haemorrhage: the Tromsø study.

OBJECTIVES: To conduct a population based case-control study with premorbid registration of potential risk factors to address the difficulty in identifying risk factors for aneurysmal subarachnoid haemorrhage (SAH). SAH is rare in prospective studies, and retrospective studies may have a selection bias. METHODS: The Tromsø health study is a population based survey of risk factors for cardiovascular disease in 27 161 subjects. 26 cases of aneurysmal SAH were identified in which risk factors were registered before the bleeding. Four age and sex matched controls were selected for each case. A backward logistic regression analysis was conducted and odds ratios (ORs) for significant risk factors were calculated. Systolic and diastolic blood pressure, cigarette smoking habits, serum concentrations of lipoproteins, body mass index, and coffee consumption were analysed. RESULTS: The crude annual incidence rate of aneurysmal SAH was 8.84/100 000 population. The proportion of current smokers was significantly (p = 0.003) higher in patients with SAH (73.1%) than in controls (41.3%). Drinking more than five cups of coffee per day was more common among patients (85%) than controls (59%) (p = 0.004). Mean (SD) systolic blood pressure was higher (p = 0.017) in patients (154.0 (32.5)) than in controls (136.3 (23.3)). Regression analysis showed that cigarette smoking (p = 0.04), systolic blood pressure (p < 0.0001), and coffee consumption (p = 0.004) were independent risk factors for SAH. The OR of current smokers versus never smokers was 4.55 (95% confidence interval (CI) 1.08 to 19.30) and the OR of drinking more than five cups of coffee a day was 3.86 (95% CI 1.01 to 14.73). The OR of an increase in systolic blood pressure of 20 mm Hg was 2.46 (95% CI 1.52 to 3.97). CONCLUSIONS: Cigarette smoking and hypertension are significant independent risk factors for aneurysmal SAH. A high coffee consumption may also predispose patients to aneurysmal SAH.

Prophylactic hyperdynamic postoperative fluid therapy after aneurysmal subarachnoid hemorrhage: a clinical, prospective, randomized, controlled study.

OBJECTIVE: To investigate the role of prophylactic hyperdynamic postoperative fluid therapy in preventing delayed ischemic neurological deficits attributable to cerebral vasospasm. METHODS: We designed a prospected, randomized, controlled study and included 32 patients with subarachnoid hemorrhage. Sixteen patients received hypervolemic hypertensive hemodilution fluid therapy; the other 16 patients received normovolemic fluid therapy. All patients were monitored for at least 12 days, with clinical assessments, transcranial Doppler recordings, single-photon emission computed tomographic (SPECT) scanning, and routine computed tomographic scanning. For fluid balance monitoring, a number of blood samples were obtained on a daily basis and continuous central venous pressure and mean arterial blood pressure measurements were performed for both groups. All patients received intravenous nimodipine infusions between Day 1 and Day 12. End points of this study were clinical outcomes, clinically evident and transcranial Doppler sonography-evident vasospasm, SPECT findings, complications, and costs. Clinical examinations (using the Glasgow Outcome Scale) performed 1 year after discharge, together with neuropsychological assessments and SPECT scanning, were the basis for the evaluation of clinical outcomes. RESULTS: No differences were observed between the two groups with respect to cerebral vasospasm (as observed clinically or on transcranial Doppler recordings). When regional cerebral blood flow was evaluated by means of SPECT analysis performed on Day 12 after subarachnoid hemorrhage, no differences were revealed. One-year clinical follow-up assessments (with the Glasgow Outcome Scale), including SPECT findings and neuropsychological function results, did not demonstrate any significant group differences. Costs were higher and complications were more frequent for the hyperdynamic therapy group. CONCLUSION: Neither early nor late outcome measures revealed any significant differences between the two subarachnoid hemorrhage treatment models.

The regulated-breathing method for stuttering: an experimental evaluation.

The regulated-breathing method of Azrin and Nunn (1974) appears to be one of the most promising treatments of stuttering in adults. Their study, however, has some methodological limitations. In particular no operational definition of stuttering is provided, and all measures of stuttering are based on self-report. The present study is an experimental evaluation of the regulated-breathing method. Thirty-two subjects were randomly assigned either to treatment or to a waiting-list control group. The treatment was completed during one single session of 2-3 hours. Both frequency of stuttering and rate of speech were measured before and after treatment, and on follow-ups 2, 3 and 8 months later. The dependent variables were assessed under conditions of both phrase reading and spontaneous speech. Both obtrusive and unobtrusive measures of speech were recorded. At the 8 month follow-up, stuttering in the treatment group was significantly less than in the control group, and also significantly less than before treatment.