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Biomedical subjects

E Siegel

Publications and source records attributed to E Siegel.

At least 19 recordsLinked to original sources
PubMed1991

Inhibition of sucrose- and starch-induced glycaemic and hormonal responses by the alpha-glucosidase inhibitor emiglitate (BAY o 1248) in healthy volunteers.

The absorbable deoxynojirimycin derivative emiglitate (BAY o 1248) is a potent competitive inhibitor of small intestinal alpha-glucosidases in man. In two similar randomized, placebo-controlled, double blind investigations, the efficacy, duration of action and tolerability of single doses of 10, 20 and 40 mg emiglitate have been assessed in healthy male volunteers after repeated sucrose or maize-starch loads at 08.00, 12.00 and 17.00 h. Even at the lowest dose used, emiglitate almost abolished the glycaemic (-88%) and hormonal responses after the first sucrose meal, simultaneously evoking significant hydrogen evolution (mean peak H2-concentration greater than 100 ppm), which was not related to the dose, and which induced unacceptable symptoms of carbohydrate malabsorption, i.e. at the dosages tested, the inhibition of glycaemic and hormonal responses was at the expense of intolerable gastrointestinal adverse effects. Flattening of postprandial responses of blood glucose, serum insulin and gastric inhibitory polypeptide was still apparent after a second sucrose load 4 h later, demonstrating long-lasting inhibition of alpha-glucosidase activity. After starch, the dose dependency of inhibition emerged more clearly than after sucrose, i.e. the reduction was less pronounced. However, emiglitate led to significant reduction of the glycaemic and hormonal rises after both the first and second starch meals. Symptoms of carbohydrate malabsorption were absent after 10 mg and were negligible with 20 mg or 40 mg emiglitate. Breath hydrogen concentration increased gradually, indicating slight but significant carbohydrate malabsorption after the highest dose of the alpha-glucosidase inhibitor. The results show that a single morning dose of 20-40 mg emiglitate might be useful in the control of postprandial hyperglycaemia after breakfast and lunch.(ABSTRACT TRUNCATED AT 250 WORDS)

1-Deoxynojirimycin↗
PubMed1991

Prenatal records: a national survey of content.

The uses of prenatal records extend well beyond management of patient care. They are also vehicles for communication, quality assurance, financial compensation, and legal documentation. To serve each of these functions, records should be systematic and detailed. This nationwide study was conducted to assess the extent to which prenatal records in current use include sufficient detail to serve these functions. A random sample of 2746 physicians who listed obstetrics and gynecology, obstetrics, or maternal-fetal medicine as a primary or secondary specialty in the American Medical Association file were contacted by mail and were requested to submit a blank copy of their prenatal records. The records of 969 respondents were examined for the presence or absence of 53 items that corresponded to the five functions identified above. The items of interest were present in 1% to 98% of the records. More than 90% included items of traditional medical-obstetric significance. The percentages of records with items of more contemporary relevance (e.g., cigarette smoking, risk-assessment checklists, psychological stress) were found in lower percentages of the records. Stratified and logistic regression analyses revealed that the most systematic and detailed records were commercially available, were used by physicians in hospital and government program-based practices, and were used by physicians who had completed medical school less than or equal to 15 years before the survey. The findings suggest that physicians who do not use commercially available forms or those who are in private or health maintenance organization practice or have been practicing for more than 15 years should reconsider their prenatal records in light of the functions they will serve in the 1990s and beyond.

Communication↗
PubMed1991

Inhibition of glycemic and hormonal responses after repetitive sucrose and starch loads by different doses of the alpha-glucosidase inhibitor miglitol (BAY m 1099) in man.

In two randomized, placebo-controlled, double-blind studies, the efficacy, duration of action and tolerability of a single morning dose of 25, 50, and 100 mg miglitol (BAY m 1099), an absorbable inhibitor of intestinal alpha-glucosidases, were assessed after repetitive sucrose or maize-starch loads (50 g of carbohydrates in 400 ml of water each at 08.00, 12.00, and 17.00 h). With sucrose, miglitol reduced the postprandial rise in blood glucose, serum insulin and serum gastric inhibitory polypeptide concentrations at any dosage. This effect was dose-dependent and confined to the first carbohydrate load in the morning, thus indicating the duration of alpha-glucosidase inhibition of less than 4 h. Sucrose malabsorption, indicated by breath hydrogen responses, occurred dose-dependently with 50 and 100 mg, but not with 25 mg of miglitol. Similarly, symptoms of carbohydrate malabsorption were absent with 25 mg of the inhibitor and mild to moderate after 50 and 100 mg of miglitol. With starch as the substrate, BAY m 1099 led to a significant amelioration of glycemic and hormonal rises after the first meal, but not thereafter. A numerical dose dependency was recognized, but this was not significant at the 5% level. Symptoms of carbohydrate malabsorption were absent with 25 mg and negligible with 50 mg BAY m 1099, but occurred almost regularly with the 100-mg dose. Breath hydrogen concentrations increased gradually with the dose of miglitol administered. A single morning dose of 25-100 mg of miglitol thus may be useful for the control of postprandial hyperglycemia after breakfast. Due to the duration of action of less than 4 h, this substance should be given with the three main meals.

1-Deoxynojirimycin↗
PubMed1991

Characteristics of maternal employment during pregnancy: effects on low birthweight.

BACKGROUND: Although maternal employment is considered a risk factor for low birthweight (LBW), the manner in which employment might affect birthweight is poorly understood. In this analysis, selected characteristics of employment during pregnancy were examined for effects on pregnancy outcomes. METHODS: Work characteristics included the number of hours per week, physical activities, and environmental conditions. The outcomes of interest were fetal growth retardation (less than 2500 grams at term) and preterm delivery (less than 37 weeks). The study population consisted of 2711 non-Black, married mothers who participated in the 1980 National Natality Survey (NNS). The NNS data were merged with data from the 1977 revision of The Dictionary of Occupational Titles (DOT) from which measures of occupational physical activities and environmental exposures were obtained. Logistic regression was used in the analysis. RESULTS: Those who worked 40 or more hours per week were more likely than women who worked fewer hours to have a low birthweight delivery at greater than or equal to 37 weeks. No physical or environmental characterics of work were associated with low birthweight or preterm delivery. CONCLUSIONS: Non-Black married American women may face a risk of delivering low-birthweight babies at or near term only if they work 40 or more hours each week. However, the lack of risk associated with other characteristics of work may be a function of measurement error in the DOT data source or of low levels of exposure in the analysis population.

Adult↗
PubMed1990

Work-related physical exertion and risk of preterm, low birthweight delivery.

Although many women work during pregnancy, the effect of maternal job experience on pregnancy outcome is controversial. We investigated whether work-related physical exertion increases a woman's risk of delivering a preterm, low birthweight infant. We studied 773 employed, pregnant women included in the National Longitudinal Survey of Labor Market Experience, Youth Cohort (NLSY), a nationally representative sample of young adults. Data concerning work status, job title during pregnancy, and other factors affecting the outcome of pregnancy were obtained from the NLSY. Assessment of physical exertion was based on job title, using an established catalogue of occupational characteristics. Women in jobs characterised by high physical exertion experienced a higher rate of preterm, low birthweight delivery, defined as maternal report of delivery more than 3 weeks early and birthweight under 2,500 g (adjusted RR = 5.1, 95% CI = 1.5, 17.7). These findings support a policy of limiting work-related physical exertion during pregnancy.

Adolescent↗
PubMed1990

Work-related psychosocial stress and risk of preterm, low birthweight delivery.

We investigated whether work-related psychologic stress--defined as work characterized by both high psychologic demands and limited control over the response to these demands--increases a woman's risk of delivering a preterm, low birthweight infant. We studied 786 employed pregnant women included in the National Longitudinal Survey of Labor Market Experience, Youth Cohort (NLSY), a nationally representative sample of 12,686 young adults. Data concerning work status, job title, and other factors affecting pregnancy outcome were obtained from the NLSY. Assessment of job experience was based on job title, using an established catalogue of occupation characteristics. After accounting for the physical exertion entailed in a job, occupational psychologic stress as measured by job title was not associated with preterm, low birthweight delivery for the sample as a whole (Relative risk = 1.16, 95% confidence interval .45, 2.95). For those women who did not want to remain in the work force, work-related stress increased their risk of experiencing this outcome (RR = 8.1, 95% CI 1.5, 50.2). Personal motivation toward work, as well as the physical effort of work, should be considered in evaluating the impact of a job's psychologic characteristics on pregnancy outcome.

Adult↗
PubMed1990

Comparison of multiple sclerosis and head trauma patients: a neuropsychological pilot study.

This paper reports the comparison of multiple sclerosis and head trauma patients on a battery of neuropsychological tests. Age-matched groups of 4 multiple sclerosis and 4 head trauma patients were administered the Wechsler Adult Intelligence Scale--Revised (WAIS-R), the Weschler Memory Scale (WMS) and Category and Tail Making Tests (TMT) from the Halstead Reitan Neuropsychological Test Battery. Statistically significant results between groups were found on all variables with the strongest difference on the Category test and WMS (p less than .01). The concept of cortical vs. subcortical dementia could be used to explain these differences between groups of multiple sclerosis and head trauma patients.

Craniocerebral Trauma↗
PubMed1990

Home visitors and child health: analysis of selected programs.

The relationships between selected child health outcomes and programmatic interventions using home visitors are analyzed. The following features of seven programs are systematically reported: program characteristics; description of the home visitors; program objectives, sample size, and research design; outcome measures and reported data. A number of issues such as funding and long-term viability, use of professional or paraprofessional visitors, visitor selection and supervision, and evaluation of home visitor programs require clarification and are discussed. It is concluded that home visitor programs can contribute to child health outcomes such as increased birth weight, improved prenatal care, improved maternal-infant interaction, and improved use of community resources. Pediatricians can be supportive of such programs at many levels: becoming aware of the existence and range of services of home visitor programs in their area that serve families with children and referring families to those programs; being available to advise programs that are in the planning stages; providing advocacy at the local, state, and national level for the funding and development of such programs; and taking the initiative to join multidisciplinary efforts to develop new programs.

Alabama↗
PubMed1990

Infant mortality: a practical approach to the analysis of the leading causes of death and risk factors.

The analysis of infant mortality data provides an opportunity for developing preventive strategies to improve this indicator of a population's health. All infant deaths in North Carolina during a 5-year period (1980 through 1984) were analyzed using the International Classification of Diseases, 9th revision (ICD-9), and a system for linked birth and death records that allows the analysis of birth certificate information on deaths. Causes of death were aggregated based on common etiology such as prematurity or obstetric-related conditions rather than the more traditional organ system taxonomy of the ICD-9 codes. Analyses were carried out separately for very low birth weight (less than or equal to 1500 g), moderately low birth weight (1501 through 2500 g), and normal birth weight (greater than 2500 g) babies. Maternal characteristics identified from the birth certificate were also compared with the different causes of death. Prematurity-related conditions accounted for 37.5% of all deaths, ranking far above the 17.4% for congenital anomalies and 12.9% for sudden infant death syndrome. For normal birth weight babies, sudden infant death syndrome ranked first, followed by congenital anomalies and nonperinatal infections. For the moderately low birth weight babies, congenital anomalies ranked first, with sudden infant death syndrome second and prematurity-related conditions third. For the very low birth weight babies, prematurity-related conditions accounted for nearly 70% of the deaths, with obstetric conditions and congenital anomalies ranking second and third, respectively. Maternal risk factors identified an overrepresentation of nonwhite, unmarried, and young teenage mothers and mothers with less than adequate prenatal care.(ABSTRACT TRUNCATED AT 250 WORDS)

Birth Certificates↗
PubMed1989

Acylation of proteins by myristic acid in isolated mitochondria.

Isolated and highly purified mitochondria from rat liver were incubated with [1-14C]myristate, solubilized in boiling sodium dodecyl sulfate, and analyzed by polyacrylamide gel electrophoresis and autoradiography. Six to eight protein bands were found to be radioactively labeled. If the mitochondria were heated for 5 min at 95 degrees C prior to incubation with this fatty acid, no labeling was observed. By preexposing the mitochondria to unlabeled fatty acids of varying chain lengths, the extent of labeling by [1-14C]myristate was reduced in a chain length-dependent manner, exhibiting maximal inhibition at lauric acid. Reversibility of the labeling was demonstrated by chasing the incorporated radioactivity with unlabeled fatty acids of varying chain length, resulting in a maximal displacement of the tracer again by lauric acid. Fractionation of the labeled mitochondria into mitochondrial matrix and inner mitochondrial membrane components before or after labeling showed that the modified proteins are located inside the inner mitochondrial membrane. In both cases, the pattern of labeling was different from the one observed with intact mitochondria. The labeled bands in the gel were sensitive to alkaline methanol or hydroxylamine treatment. The radioactivity recovered after this treatment co-migrated with myristic acid on thin layer chromatography plates. The chain length specificity and the rapid reversibility of the observed acylation argue for a new type of reaction, different from the acylation observed in whole cells. The possible involvement of the acylated proteins in the regulation of oxidative phosphorylation is discussed.

Acylation↗
PubMed1989

Multilayered distribution of peptidoglycan in the periplasmic space of Escherichia coli.

When a staining technique using phosphotungstic acid (PTA) in 10% (w/v) chromic acid was applied to cells of Escherichia coli, the periplasmic space was seen as a dark 15-nm-thick layer of uniform appearance and constant width. Our observations are consistent with peptidoglycan being the main material stained. Isolated sacculi as well as purified peptidoglycan (protein free) were also stained by the same procedure, the thickness of the peptidoglycan being 8.8 +/- 1.8 and 6.6 +/- 1.5 nm, respectively. The increased thickness of the PTA-stained layer in stationary phase cells correlated well with the increased thickness of isolated sacculi or purified peptidoglycan and with the increased amount of peptidoglycan in such cells. Thickness measurements on isolated peptidoglycan were compatible with a two to three layer structure for material from exponential phase cells and with a four to five layer structure for that from stationary phase cells. Furthermore, the results indicated an uneven distribution of peptidoglycan material in the periplasmic space, the peptidoglycan spanning the space from the inner to the outer membrane.

Chromates↗
PubMed1989

Variations in UDP-N-acetylglucosamine and UDP-N-acetylmuramyl-pentapeptide pools in Escherichia coli after inhibition of protein synthesis.

The pool levels of the nucleotide precursors of peptidoglycan were analyzed after inhibition of protein synthesis in various Escherichia coli strains. In all cases UDP-N-acetylglucosamine (UDP-GlcNAc) and UDP-N-acetylmuramyl-pentapeptide (UDP-MurNAc-pentapeptide) cell pools increased upon treatment with chloramphenicol or tetracycline. Similar results were observed after the treatment of K-12 strains with valine. Since the intermediate nucleotide precursors did not accumulate after the arrest of protein synthesis and since a feedback mechanism was unlikely, the increases of the UDP-MurNAc-pentapeptide pool appeared as a consequence of that of the UDP-GlcNAc pool by the unrestricted functioning of the intermediate steps of the pathway. The highest increase (sixfold) of UDP-GlcNAc was observed with strain K-12 HfrH growing in minimal medium and treated with chloramphenicol. When a pair of isogenic Rel+ and Rel- strains were considered, both the UDP-GlcNAc and UDP-MurNAc-pentapeptide pools increased upon treatment with chloramphenicol or valine. However, the UDP-GlcNAc pool of the Rel+ strain was at a high natural level, which increased only moderately (20%) after the addition of valine. The increase of the UDP-GlcNAc pool after the various treatments could be due to an effect on some upstream step by an unknown mechanism. The possible correlations of the variations of the precursor pools with the rate of synthesis and extent of cross-linking of peptidoglycan were also considered.

Bacterial Proteins↗
PubMed1988

Why we know so little about prenatal care nationwide: an assessment of required methodology.

Policymakers, advocates, providers, recipients, and health services researchers all would agree that too little is known about the nature and effects of specific components of prenatal care. In the process of designing a national, longitudinal study of pregnancy and childbirth, we surfaced some methodological dilemmas that help to explain why so little is known. This article explores two of the major problems: (1) selecting a valid scientific sample of pregnant women and (2) collecting data from providers and women. From this analysis, seven methodological questions, which should be investigated through empirical field studies, are identified. Those field studies are essential if future research into the content of prenatal care is to achieve an acceptable level of methodological rigor.

Data Collection↗
PubMed1987

Prednisolone acetate-gentamicin combination following cataract surgery.

One-hundred-eleven patients participated in a 21-day, open-label study to evaluate the therapeutic efficacy and safety of a prednisolone acetate 1%-gentamicin 0.3% ophthalmic suspension to control inflammation and prevent infection after cataract surgery. Beginning the day after surgery, the medication was instilled qid for the next 21 days. No postoperative infection was noted, and postoperative inflammation, which was mild immediately after surgery, decreased steadily during follow-up. The results of this study suggest that a prednisolone acetate-gentamicin combination used for three weeks after cataract surgery is safe and has a positive therapeutic effect on postoperative inflammation and infection.

Adult↗
PubMed1986

Boric acid toxicity.

Although boric acid was widely used therapeutically in the past and resulted in significant toxicity, the past few years have seen a decline in its usage. Ninety-nine per cent boric acid powder is now being used as a household pesticide. Physicians therefore should be aware of the potential for boric acid toxicity.

Absorption↗