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Biomedical subjects

L Weiner

Publications and source records attributed to L Weiner.

At least 91 records · Page 5Linked to original sources
PubMed1985

Antihypertensive and metabolic effects of nifedipine and labetalol alone and in combination in primary hypertension.

In a randomised, double-blind, cross over trial, 25 patients with mild to moderate primary hypertension were given nifedipine 20-40 mg twice daily and labetalol 200-400 mg twice daily after a 4 week period on placebo, followed by the two drugs in combination. The BP during placebo therapy was 164/108 mmHg supine and 159/110 mmHg standing. After monotherapy with nifedipine for 6 weeks the supine BP was reduced by 18/13 mmHg and the standing BP by 20/12 mmHg; with labetalol the corresponding figures were 26/15 mmHg and 28/21 mmHg, respectively. The combined therapy induced a larger fall in BP, by 36/22 mmHg supine and by 39/24 mmHg standing; in 21 of 23 patients the BP became normal. The heart rate (HR) decreased during labetalol treatment alone and on the combined therapy. With nifedipine alone, the HR was unchanged in the supine position and increased on standing. Nifedipine increased plasma renin activity (PRA) and urinary aldosterone excretion (uA), whereas labetalol reduced both. During combination therapy, PRA and uA remained unchanged. There was a slight fall in HDL-cholesterol during treatment with labetalol alone and in combination with nifedipine. The fasting blood glucose increased slightly during treatment with each of the drugs, but neither caused a change in the concentrations of glycosylated haemoglobin A1, serum insulin, C-peptide, or plasma glucagon. Adverse effects as a rule were well tolerated and were related to the pharmacological effects of the drugs. Only 2 patients left the trial, both during labetalol treatment.

Adult↗
PubMed1985

Alcohol and pregnancy: a clinical perspective.

Exposure of the fetus at any gestational stage to high concentrations of alcohol can adversely affect growth, morphology, and neurophysiologic development. Sustained heavy drinking can result in the fetal alcohol syndrome. Cessation of heavy drinking during pregnancy will benefit both mother and child. Primary health care providers can effectively identify and treat women at risk.

Alcoholism↗
PubMed1984

Muscarinic cholinergic receptors in the rat deep cerebellar nuclei: a quantitative autoradiographic study.

The distribution of muscarinic cholinergic receptors within the rat deep cerebellar nuclei was analyzed using in vitro receptor binding of [3H]quinuclidinylbenzilate (QNB) in conjunction with autoradiography. The highest density of QNB binding sites occurred in the lateral cerebellar (dentate) nucleus. Interpositus nuclei displayed an intermediate density of muscarinic cholinergic binding sites with the posterior interpositus nucleus demonstrating higher binding than the anterior nucleus. The fastigial (medial) cerebellar nucleus exhibited the lowest levels of QNB binding among the four cerebellar nuclei. These results indicate that muscarinic cholinergic receptors are present in the deep cerebellar nuclei and that differences in receptor density occur among the four nuclear groups.

Animals↗
PubMed1983

Treatment experience with pregnant problem drinkers.

Therapy for heavy drinking was integrated with routine prenatal care at Boston City Hospital's women's clinic. Of 49 pregnant problem drinkers who participated in at least three counseling sessions, 33 (67%) reduced alcohol consumption before the third trimester. Therapeutic success was achieved with some of the heaviest drinkers. The desire to have a healthy baby was a powerful motivating force. Supportive counseling focused on reduction of alcohol consumption and potential benefits to the fetus. Guilt-provoking criticism was avoided. Referrals were made when women did not respond within two weeks. Planning of treatment strategies was facilitated by classification into social, symptom, and alcohol-dependence phases. Primary providers who are knowledgeable, interested, and accepting can successfully treat pregnant patients at risk from alcohol. Examinations of two cohorts of newborns have previously demonstrated benefits to offspring when heavy drinking ceased before the third trimester.

Alcohol Drinking↗
PubMed1983

Atenolol and metoprolol: comparison of effects on blood pressure and serum lipoproteins, and side effects.

Several beta-blockers increase VLDL-TG and decrease HDL-cholesterol concentrations. The underlying mechanism is not yet clear. Some studies have suggested that the effect is less pronounced during treatment with selective beta-blockers. The effects of 2 such drugs, metoprolol 200 mg/day and atenolol 50 mg/day, have been compared in 50 hypertensive patients (WHO Stage I-II), mean age 47 years. Serum lipoproteins were determined in 20 patients before treatment and after treatment with either drug for 3 months. Both drugs were equally effective in reducing blood pressure. After atenolol the initial VLDL-cholesterol concentration of 1.04 mmol/l had not changed, but it rose to 1.29 mmol/l after metoprolol (p less than 0.05). The HDL-cholesterol concentration 1.42 mmol/l did not fall during atenolol treatment, but during metoprolol there was a small reduction to 1.31 mmol/l (p less than 0.05). Hyperlipoproteinaemia is common in hypertensive patients, 40% of the present group had hypertriglyceridaemia and 25% had hypercholesterolaemia. Thus, atenolol 50 mg was found not to affect lipoproteins, whereas metoprolol 200 mg increased the VLDL concentration in 75% of the patients.

Adult↗
PubMed1983

Alcohol consumption by pregnant women.

Demographic and behavioral characteristics, including use of alcohol, were investigated among 1711 women registering for prenatal care at Boston City Hospital. During personal interviews, 9% reported drinking heavily, 37% moderately, and 53% rarely or not at all. The women who drank heavily differed from the rest of the pregnant population on several traits, including age, education, use of cigarettes, marijuana and other drugs, parity, and association with others who drank heavily. Multiple regression analysis revealed that these traits had little predictive power for whether a woman was a heavy drinker. A systematic drinking history remains the most practical method in identifying problem drinkers.

Adult↗
PubMed1983

Patterns of alcohol consumption and fetal development.

Effects of heavy, moderate, and rare alcohol consumption on fetal development were analyzed in a prospective study of 469 mother-infant pairs. Differential effects of heavy drinking in early and late gestation were evaluated by separate analysis of neonates born to women who reduced consumption before the third trimester. Using chi 2 analysis, multiple regression, and matched sets, statistically significant associations (P less than .01) were observed between sustained heavy drinking and both intrauterine growth retardation and congenital anomalies. These associations were independent of eight other risk factors. No differences were observed between offspring of rare and moderate drinkers. Infants born to women who reduced heavy drinking did not differ in growth from offspring of rare and moderate drinkers but demonstrated a higher frequency of abnormalities. Sustained heavy drinking represents a major risk; reduction in midpregnancy can benefit the newborn. Identification and therapy of heavy drinking are important components of prenatal care.

Abnormalities, Drug-Induced↗
PubMed1982

Behavioral evaluation of fetal alcohol education for physicians.

Assessment of clinical behavior has been neglected in evaluating alcohol training for professionals. Inclusion of a systematic drinking history in patient charts provides a sensitive yet simple behavioral marker. At Boston City Hospital, a Ten Question Drinking History (TQDH) was incorporated into a prenatal intake procedure and used to monitor staff behavior. Utilization of the TQDH, measured for six time periods, ranged from 92% to 33%. Obstetrical staff was more likely to complete the TQDH when the alcoholism research staff was visible in the clinic and readily available for consultation and referral.

Alcohol Drinking↗
PubMed1981

Identifying and treating pregnant patients at risk from alcohol.

Heavy alcohol consumption during pregnancy has been associated with retardation of fetal growth and abnormal fetal development. Pregnant women whose offspring are at risk because of alcohol abuse can be identified and counselled by health professional providing prenatal care. Offspring born to women who had been drinking heavily and subsequently abstained from or reduced their intake of alcohol before the third trimester demonstrated improvements in growth and in regulation of sleep-awake states. The existing health care delivery system can be modified in a cost-effective manner to treat pregnant women who are problem drinkers. Physicians' attitudes and behaviour are critical for the success of this strategy.

Alcoholism↗
PubMed1981

Isolation of cytomegalovirus from the amniotic fluid during the third trimester.

A case is presented in which cytomegalovirus was isolated from the amniotic fluid at 36 weeks' gestation in a pregnancy complicated by cytomegalovirus hepatitis at 10 weeks of gestation. Abnormalities noted in the newborn infant included an undescended testis, right equinovarus, and hypotonia. All cultures revealed cytomegalovirus. Subsequent immunoglobulin studies, chest x-ray film, and bone films were all normal.

Adolescent↗
PubMed1981

The antidiabetic effect and pharmacokinetic properties of glipizide. Comparison of a single dose with divided dose regime.

In 13 patients with maturity-onset diabetes mellitus which did not respond to diet therapy alone, serum concentration of glipizide, blood glucose (B-G) concentration, serum immunoreactive insulin (S-IRI) and plasma glycerol (P-G) were monitored hourly over 12 hours after placebo, an initial dose of glipizide (5 mg p.o.) and long-term treatment with glipizide (range 7.5--20 mg, mean 10.4), which produced fasting B-G of less than 8 mmol/l. During the long-term treatment, glipizide was given in a random, cross-over pattern, either as a single dose in the morning or as a three-part divided dose regime, in the same total daily amount. The duration of the immediate effects of glipizide on B-G, S-IRI and S-IRI/B-G was 9, 4.5 and 6.5 hours, respectively. The mean apparent half-life of glipizide was 4.1 hours, the mean distribution volume 0.13 l/kg and the mean plasma clearance 0.023 l/kg x h. The area under the concentration curve from 7.30 a.m. to 7.30 p.m. was 15% higher after the single dose regime. The serum levels of glipizide at 10 hours were only 30% lower than after the three-part divided dose regime. There were no significant differences between the single and divided dose regimes as regards B-G, S-IRI and S-IRI/B-G, although the mean B-G for the 12-hour period was somewhat lower after the former than after the latter (7.0 against 8.7 mmol/l).

Aged↗
PubMed1981

Maternal alcohol consumption and newborn assessment: methodology of the Boston City Hospital prospective study.

This paper describes the methods of the Maternal Health and Child Development of Project at the Boston City Hospital which explored the impact of maternal drinking prior to and during pregnancy on fetal development. Between February 1977 and October 1979, of 3222 women who delivered single infants, 1690 were interviewed in hospital after delivery and their babies examined by a pediatrician who was unaware of the interview results. The 1690 mother-infant pairs of whom both interview and exam are available did not systematically differ from the 272 for whom the interview only or 824 for whom the exam only was conducted. Interviews were also collected prenatally in the Boston City Hospital's Women's Clinic, from 470 women whose infants were examined. Maternal and infant characteristics are described. Heavy drinkers were much more likely to smoke cigarettes and to have used psychoactive drugs than lighter drinkers. Heavy drinkers also differed from non-heavy drinkers on several other factors which may influence fetal development.

Adolescent↗
PubMed1981

Strategies for prevention of fetal alcohol effects.

The effects of alcohol on the fetus include a wide range of problems; the complete fetal alcohol syndrome is the extreme end of the spectrum. At critical doses alcohol has the potential for multiple adverse effects on the maternal--placental--fetal system. Variability of outcome probably is related to individual differences in drinking patterns as well as in biologic susceptibility. At Boston City Hospital Prenatal Clinic, therapy was provided for pregnant women who reported drinking heavily. Reduction in maternal alcohol consumption before the third trimester was associated with improved neonatal outcome. The obstetrician's office is a potential site for prevention programs. A 10-question drinking history enables physicians to identify pregnant women at risk. Supportive counseling focused on reduction of alcohol use can be integrated with regular prenatal care. Pregnant women who do not respond promptly should be referred to specialized treatment programs. This strategy has the potential to improve the health of both mother and infant.

Alcohol Drinking↗
PubMed1980

Reduction of alcohol consumption during pregnancy with benefits to the newborn.

Among a group of 69 pregnant women who drank heavily, 25 reduced alcohol consumption before the third trimester. Infants born to these women showed less growth retardation than did infants born to 44 women who continued to drink heavily throughout the pregnancy. Analysis of other risk factors showed little effect on outcome when third trimester drinking patterns were held constant, Identification and counseling of heavy-drinking pregnent women should provide benefits for both the mother and her newborn.

Alcohol Drinking↗
PubMed1979

Effects of maternal drinking on neonate state regulation.

Sleep-awake state distribution during inter-feed intervals over a 24-hour period on the third day of life was investigated by means of a continuous non-intrusive bassinet sleep monitor. 31 infants were studied: 14 born to mothers who drank heavily throughout pregnancy (group A), eight whose mothers modified their heavy drinking (group B) and nine whose mothers never were heavy drinkers (group C). Over the 24-hour period, group A infants slept less than those in group B. In comparison with group C, group A infants had a larger proportion of quiet sleep episodes interrupted by awake or unclassified epochs, and were more restless, with more frequent major body movements. These pilot observations suggest that heavy maternal consumption of alcohol, when continued throughout pregnancy, is associated with a disturbance of sleep-awake state distribution. Successful therapy of heavy drinking during pregnancy may improve the physiological competence of the newborn to regulate sleep-awake states and facilitate interaction between mother and infant.

Adolescent↗