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Biomedical subjects

H H Whitman

Publications and source records attributed to H H Whitman.

10 recordsLinked to original sources
PubMed1989

Isolated pulmonary hypertension in the grandchild of a kindred with scleroderma (systemic sclerosis): "neonatal scleroderma"?

We report a small kindred in which the father and daughter with positive antinuclear antibodies (ANA) (proband) had diffuse cutaneous and visceral scleroderma (systemic sclerosis, SSc), antitopoisomerase autoantibodies and shared the HLA-A23 C- B- DR5 DRw52 DQw3 haplotype. The ANA- granddaughter (daughter of the proband) was noted to have severe isolated pulmonary hypertension within the first 6 months of life, and had the other maternal HLA-A1 Cw8 B14 DR1 DQw1 haplotype, which included a B1, B2 duplication of the C4B allele. All 3 members shared DRw52. The possibility that neonatal pulmonary hypertension represents an isolated autoimmune disease or a hitherto undescribed neonatal syndrome is proposed and the immunogenetic autoantibody implications are discussed.

Antibodies, Antinuclear↗
PubMed1984

Hemodynamic effects of nifedipine versus hydralazine in primary pulmonary hypertension.

The acute hemodynamic effects of both sublingual nifedipine (N) and intravenous hydralazine (Hy) were studied in 5 patients with primary pulmonary hypertension to ascertain whether the capacity for pulmonary vasodilatation was generalized or drug-specific, and to determine which of the 2 agents had preferential pulmonary vasodilatory effects. For the group as a whole, neither N nor Hy produced changes in heart rate, mean pulmonary capillary wedge or right atrial pressures. Both N and Hy reduced mean systemic arterial pressure (before N 90 +/- 8 mm Hg, after N 76 +/- 7 mm Hg, p less than 0.01; before Hy 92 +/- 11 mm Hg, after Hy 68 +/- 8 mm Hg, p less than 0.05), and decreased systemic vascular resistance (before N 1,558 +/- 645 dynes s cm-5, after N 1,192 +/- 430 dynes s cm-5, p less than 0.05; before Hy 1,700 +/- 415 dynes s cm-5, after Hy 957 +/- 285 dynes s cm-5, p less than 0.05). In addition, N administration resulted in an increased cardiac output (before N 4.5 +/- 2.0 liters/min, after N 4.8 +/- 2.0 liters/min, p less than 0.01); Hy administration was associated with a more varied effect on cardiac output (before Hy 4.0 +/- 1.0 liters/min, after Hy 5.3 +/- 1.8 liters/min, p less than 0.10, difference not significant [NS]).(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Pressure↗
PubMed1982

Variable response to oral angiotensin-converting-enzyme blockade in hypertensive scleroderma patients.

Twelve scleroderma patients with hypertension, seven of whom had malignant hypertension and renal failure of scleroderma renal crisis, were treated with captopril. The first dose lowered mean pressure in all patients by 21.3 mmHg; in 6 patients it relieved encephalopathy. Blood pressure was controlled in all patients. Two of 7 patients with scleroderma renal crisis had improvement in renal function; the 5 patients who did not have malignant hypertension improved or stabilized. Despite good pressure control, however, renal failure developed in 5 patients with scleroderma renal crisis. The data indicated that captopril is effective antihypertensive therapy in scleroderma and, when given early, may prevent renal failure and death.

Administration, Oral↗
PubMed1982

Hemodynamic effects of captopril in pulmonary hypertension of collagen vascular disease.

Captopril 12.5 to 50 mg as a single dose was given to six patients with pulmonary hypertension secondary to collagen vascular disease. Total pulmonary resistance was decreased in four patients from 19% to 39%, but mean pulmonary artery pressure (63 +/- 15 mm Hg) was not decreased, probably because of the concurrent increase in cardiac output from 21% to 52% (2p less than 0.05). The systemic arterial pressure was slightly decreased due to the decrease in total systemic resistance. Control plasma renin activity ranged from 0.15 to 16 ng/ml/hr and was increased during captopril from 19% to 356%. These results, although preliminary, suggest that captopril may be beneficial in certain patients with pulmonary hypertension secondary to collagen vascular disease.

Adult↗
PubMedDate not supplied

Group therapy for families facing a cancer crisis.

The impact of the cancer diagnosis and its effects on the lives of patients and family members can put a serious strain on intra-family relationships. This paper describes how to initiate, lead and analyze supportive group therapy meetings for families of individuals with cancer based on our experiences in conducting more than 600 group sessions over the last 12 years. We have found that most families can benefit from multiple-family therapy sessions and that highly-stressed families can benefit significantly from both multiple- and single-family therapy meetings. Discussed is the need for therapists to be alert to non-verbal as well as verbal communications of families and the need for different interacting techniques for each type of therapy group. The meetings aim to overcome family members' resistance to discussing the emotional distress caused by the disease and to encourage them to bring into the open conflicts from the past, anxieties about the present, and fantasies regarding the future.

Communication↗