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Biomedical subjects

N A Posner

Publications and source records attributed to N A Posner.

16 recordsLinked to original sources
PubMed1997

Screening for postpartum depression. An antepartum questionnaire.

OBJECTIVE: To develop and evaluate a questionnaire used antepartum to screen for postpartum depression. STUDY DESIGN: Demographic and clinical data, based on previously identified variables, were obtained from 106 second-trimester gravidas (sample I) by interview, self-administered questionnaire and medical record review. The Beck Depression Inventory (BDI) was administered at 1, 6 and 12 weeks postpartum (PP). Statistical analysis, including stepwise linear regression with maximum r-squared improvement, identified a subset of the 24 most predictive variables. This antepartum questionnaire (APQ) was validated retrospectively in the original sample and prospectively in a second group of 99 women (sample II). RESULTS: In both sample populations the APQ had acceptable sensitivity (80-82%) and specificity (78-82%). The incidence of postpartum depressive symptoms (PPDS) rose from 10% to 17% by six weeks without an appreciable decline at 12 weeks (15%). The percentage of women showing more than mild depressive symptoms increased with PP time from 30% at 1 week to 47% at 12. CONCLUSION: The APQ is now available for screening and evaluating early therapeutic intervention in PPDS.

Adolescent↗
PubMed1990

Postpartum depressive disorders: changing trends.

For centuries, there has been speculation regarding the etiology of postpartum depression. An improved diagnostic classification has emerged, however, as the universality of the syndrome has been recognized and the role of hormonal, genetic, and obstetric variables considered. In addition, different cultures have different perceptions of the needs of the new mother. The emphasis in investigative work now appears to be in the psychosocial and psychodynamic areas. Our recent research focused on identification of risk factors early in pregnancy, including a history of depression, separation from one or both parents in childhood or adolescence, poor parental emotional support in childhood and adulthood, poor relationship with husband or partner, economic problems, and dissatisfaction with amount of education. We suggest that physicians, nurses, and mental health professionals be aware of the emotional status of their patients, familiarize themselves with the risk factors, and initiate a program of careful postpartum follow-up. These measures will help to improve recognition and management of the woman at risk for postpartum depression.

Depressive Disorder↗
PubMed1984

Glycosylated fetal hemoglobin. Correlation with hyperglycemia and birth weight in infants of diabetic mothers.

Glycosylated fetal hemoglobin levels were measured in umbilical cord blood of normal infants and infants of diabetic mothers. The glycosylated fraction proved to be a stable compound; its level remained unchanged over a 19-day period. Exposure of fetal and adult hemoglobins to the same concentrations of glucose in vitro resulted in similar levels of glycosylated hemoglobins, suggesting that both types of hemoglobin are about equally reactive with glucose. Levels of glycosylated hemoglobin were significantly increased above normal in umbilical cord blood of infants of both Class A and Class B diabetic mothers. A significant relationship was found between macrosomia, reflected in birth weight ratios, and glycosylated hemoglobin from fetal erythrocytes in infants of diabetic mothers. While these data are consistent with the conclusion that glycosylated fetal hemoglobin levels are a function of fetal blood glucose concentrations in utero during the 2 mo before delivery, it is not known whether the glycosylated hemoglobin contributes to the abnormalities other than macrosomia found in infants of diabetic mothers.

Birth Weight↗
PubMed1984

The circumcision controversy: an update.

One constructive feature has come out of all of the circumcision controversy. It has made us aware that neonatal circumcision is not a simple procedure and that it should not be regarded as "routine." It is a surgical procedure and it should be taught as one. The authors of this article wrote a review article on circumcision in 1981 and Dr. Grossman has recently published a book designed to teach proper circumcision technique, and to familiarize the operator with the common congenital anomalies as well as the prevention and treatment of the complications of circumcision. The advocacy of neonatal circumcision cannot be considered as a cut and dried issue. For some, it has an absolute religious indication, which transcends current medical logic. For others the available facts still allow for a decision based on one's perception of those facts. If one has the perception that there is value in improving local hygiene, or that the loss of the prepuce will allow for an earlier discovery of a penile lesion, or that circumcision actually does cause a decrease in the incidence of penile or cervical cancer, or group conformity is important, then one might well advocate neonatal circumcision. If, however, one sees the potential values as insignificant in light of the lack of hard data relating circumcision to penile or cervical cancer, and that if one is concerned with the "rape of the phallus," then one is against routine neonatal circumcision. But, this individual must be aware that a small percentage of males will need a circumcision at a later time in life, when technical and psychological problems may lead to an increased morbidity. The decision of the physician, and the advice given to the new parents, at present, appears to be more subjective than the advice concerning RhoGAM, or DPT immunization, although it occasionally is given with as much certainty. We are dealing with the art of medicine rather than science. On this basis, rather than deride each other for positions taken, and religious considerations aside, we would do much better to develop better scientific studies to answer the scientific questions. Today's tendency to make decisions on evaluation of the risk:benefit ratio is clearly difficult if both are not adequately quantitated. Until these are available the decision of whether or not to circumcise must result from an objective discussion between the doctor and the parents of newborn males.(ABSTRACT TRUNCATED AT 400 WORDS)

Bible↗
PubMed1982

Simplifying the intravenous glucose tolerance test.

When used for classifying pregnant patients as normal or abnormal in terms of carbohydrate intolerance, the k value computed from a two-sample intravenous glucose tolerance test (IVGTT) (10 and 60 minutes) is reliable except in a zone of +/- 0.10 k points from the appropriate lower limit of normal. Retesting with six samples obtained in one hour may be required for patients with values within the doubtful range, +/- 0.10 of the lower limit of normal. Considerable savings can be realized nevertheless with the use of this test as compared with doing a full, seven-sample test on each subject. Our results suggest that the abbreviated IVGTT be used more widely as a routine screening procedure for diabetes rather than being restricted to use on suspect populations. One can make a direct conversion of blood sugar readings into k with the use of a table presented in the paper.

Adult↗
PubMed1975

Changes in carbohydrate tolerance during long-term oral contraception.

An intravenous glucose tolerance test (GTT) was given to 116 women--82 nondiabetic subjects (NDS) and 34 diabetes suspects--before they received Ovulen for oral contraception. Subjects were followed for 1 to 4 years during Ovulen therapy. Twenty women using an intrauterine device showed no changes in glucose tolerance. Prompt, significant decline in tolerance was noted in NDS, persisting for the duration of the study. At least one abnormal test, indicating chemical diabetes, was noted in 13 per cent of the NDS. Similarly, prompt decline in tolerance, although not statistically significant, was observed in the suspect group. Fifteen per cent of suspects had at least one abnormal test. Chemical diabetes persisted during Ovulen therapy in suspects but not in NDS. No overt diabetes occurred. Based on greater concern regarding suspects, a procedure for monitoring carbohydrate tolerance is proposed for this group.

Adult↗