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Biomedical subjects

L Weinstein

Publications and source records attributed to L Weinstein.

At least 73 records · Page 4Linked to original sources
PubMed1988

Fever of unknown origin.

The evaluation of an FUO is a significant test of all a physician's clinical skills. The ultimate goal of the physician is to reach a diagnosis and to cure the patient in the best possible situation. Despite such pressure both externally and self-imposed, a physician needs to meticulously follow the patient and logically pursue the available diagnostic tests. To "shotgun" the process, except in the most urgent situation, is to ultimately create more frustration, confusion, and despair among the physician and his patient.

Connective Tissue Diseases↗
PubMed1988

Factor VIII: von Willebrand factor patterns in the plasma of patients with pre-eclampsia.

Elevation of the factor VIII protein to coagulant ratio previously has been reported to predict the severity of pre-eclampsia. Abnormal levels and patterns of factor VIII: von Willebrand factor (VIII/vWF) have been reported in thrombotic thrombocytopenia purpura (TTP). Severe pre-eclampsia shares many features with this syndrome. Nine primigravid patients with pre-eclampsia were evaluated by assays for factor VIII/vWF protein and coagulant activity and were compared to nine normal primigravid (controls). The patients and controls were indistinguishable by factor VIII antigen/coagulant activity ratios. Pre-eclamptic patients also had unremarkable factor VIII patterns on crossed immunoelectrophoresis. The evaluation of factor VIII/vWF multimeric patterns showed four patients with abnormal patterns in the pre-eclamptic patients and three abnormal patterns in the controls. These patterns were not analogous to the factor VIII abnormalities found in TTP.

Adolescent↗
PubMed1988

The development of scales to measure the experience of self-participation in sleep.

Recent literature suggests that how the self is represented is a cardinal aspect of the dream experience. A review of studies of phasic-tonic distinctions within rapid eye movement (REM) sleep revealed that increasing self-participation marked awakenings from phasic intervals. Five scales specifically designed to measure absorption in dreaming were compared with three scales previously shown to discriminate phasic from tonic awakenings within REM sleep. Eight reports per night (two stage REM, six stage 2) were collected from each of 20 subjects on 4 baseline nights. Awakenings were controlled for time into the REMP and time of night, correcting the methodological flaws of previous studies in this area. Scales developed to measure self-participation were able to discriminate phasic from tonic awakenings better than those already in the literature. Results are discussed in terms of the psychometric properties of the individual scales.

Affect↗
PubMed1988

Oxygen saturation in the supine hypotensive syndrome.

This study used recently available, continuous noninvasive monitoring techniques to evaluate positional variations in pulse, blood pressure, and maternal oxygen saturation in 42 women undergoing fetal nonstress testing in the third trimester. Ten nonpregnant women were similarly evaluated with the automatic sphymomanometer and pulse oximeter. Six of 42 pregnant women (14.3%) developed the supine hypotensive syndrome (defined as a mean blood pressure decrease of 15 mmHg and a sustained increase in pulse of 20 beats per minute) when in the supine position. Nine of them (21.4%) met at least one of the criteria, but the majority (27 of 42, 64.3%) met neither criterion. None of the ten nonpregnant subjects had hypotension or tachycardia, although nine demonstrated blood pressure elevation after assuming the supine position. Significant oxygen desaturation did not occur in any patient, although three of six hypotensive patients had a transient 3-5% desaturation after supine rest. This study confirms that a significant percentage of patients in the third trimester are affected to some degree by supine hypotension. However, significant oxygen desaturation does not appear to occur.

Adolescent↗
PubMed1988

Malpractice--the syndrome of the 80s.

The current malpractice situation exists for the following reasons: 1) society's belief that all wrongs must have a reason and that the wrong must be put right, 2) the pervasive lottery mentality, 3) the inability of many individuals to accept responsibility for themselves or their actions, and 4) an increasing incidence of true medical negligence. The physician who gives careful detail to practice style, who constantly attempts to upgrade his skills and knowledge, and who prepares himself when involved in the inevitable legal quagmire will survive during this difficult time to practice the healing arts.

Attitude↗
PubMed1987

A volunteer program for helping families in a critical care unit.

When patients are critically ill, their families suffer extreme emotional distress, often without the support of staff who must focus first on patients' needs. This article describes a social work program that has successfully used volunteers in a critical care unit to facilitate communication between family members and staff, lessen the family's sense of isolation, and provide responsive services in a crisis-oriented setting.

Adult↗
PubMed1987

The anatomy of an obstetrical service.

Major technologic advancements have occurred in obstetrics allowing health care providers to offer improved perinatal outcome for the mother and child. However, because of rapid scientific progress, simple methods of improving health care are often overlooked. The study analyzed the anatomy of one year's deliveries at the authors' institution in an attempt to determine if changes in nursing or physician staffing would allow for a better perinatal outcome for their patients.

Abortion, Spontaneous↗
PubMed1987

Fetal pulmonary maturity and antenatal diagnosis of respiratory distress syndrome.

The clinical entity of hyaline membrane disease affords one the opportunity to study a disease from the cellular, biochemical, anatomical, and clinical standpoint, and to be able to formulate a theory on its pathogenesis. Recent refinements in methodology give the clinician a valuable tool in diagnosing and hopefully preventing hyaline membrane disease. In the setting where early delivery is unavoidable, the potential for pharmacologic intervention exists, and hopefully, long-term studies will prove the benefit of steroid therapy.

Adrenal Cortex Hormones↗
PubMed1987

Efficacy of a continuous estrogen-progestin regimen in the menopausal patient.

The major concern with the use of unopposed estrogen is its neoplastic effect on the endometrium. Progestins used to oppose the estrogen may be associated with vaginal bleeding and reversal of estrogen's protective changes in serum lipoprotein concentrations. A study was performed in which all postmenopausal women received conjugated equine estrogen for days 1-28; with group I receiving 2.5 mg medroxyprogesterone acetate for days 1-28, group II receiving 5 mg medroxyprogesterone acetate for days 1-28, and group III receiving 5 mg medroxyprogesterone acetate for days 17-28. Pre- and postdrug evaluations of the endometrium revealed atrophic changes after therapy with continuous combined estrogen-progestin. Pre- and poststudy evaluation of serum lipoprotein concentrations demonstrated significant declines in cholesterol and low-density lipoprotein cholesterol within groups I and III, and no change in group II. All patients kept a weekly diary recording any vaginal bleeding or change in vasomotor symptoms. The results suggest that a continuous regimen of 0.625 mg conjugated equine estrogen with 2.5 mg medroxyprogesterone acetate is beneficial as a primary hormonal replacement therapy for the postmenopausal patient.

Aged↗