PubMed Health⌕ Search

Biomedical subjects

R E Little

Publications and source records attributed to R E Little.

At least 19 recordsLinked to original sources
PubMed1992

Analysis of facial shape in children gestationally exposed to marijuana, alcohol, and/or cocaine.

The association between fetal marijuana and/or alcohol exposure and facial features resembling fetal alcohol syndrome was investigated in a sample of 80 children. Standardized lateral and frontal facial photographs were taken of 40 children, 5 to 7 years of age, whose mothers reported frequent use of marijuana during the first trimester of pregnancy and 40 children whose mothers reported no use of marijuana during pregnancy. The marijuana-exposed and unexposed children were group-matched on alcohol exposure prior to and during pregnancy, sex, race, and age at the time of assessment. The photographs were assessed clinically by a study staff dysmorphologist and morphometrically by computerized landmark analysis. Fetal alcohol syndrome-like facial features were not associated with prenatal marijuana exposure in this study sample. No consistent patterns of facial features were identified among the marijuana-exposed group. Maternal consumption of two or more ounces of alcohol per day, on average, in early gestation was found to be associated with fetal alcohol syndrome-like facial features identified both clinically and morphometrically. Cocaine use reported by 13 of the 80 women was independently associated with mild facial dysmorphic features of hypertelorism and midfacial flattening. The results demonstrate the usefulness of this diagnostic technique for quantifying anomalies apparently unique to fetal alcohol syndrome and for targeting clusters of anomalies in new conditions for future evaluation.

Alcohol Drinking↗
PubMed1991

The effects of maternal drinking in the reproductive period: an epidemiologic review.

The major effects of maternal alcohol use during pregnancy are decreased fetal growth, morphologic abnormalities, and CNS impairment. If all three of these are present, with a characteristic facies in the infant, fetal alcohol syndrome (FAS) is diagnosed. FAS occurs only with heavy or alcoholic drinking. The individual components of the syndrome exhibit a dose-response association with ethanol intake in many, but not all studies. Discrepancies in maternal drinking and pregnancy outcome reflect the myriad difficulties of these investigations. Drinking "before" pregnancy also has been linked to decrements in fetal development, possibly because before pregnancy may include the periconceptional period. However, women who are usually abstainers before pregnancy appear to have infants at higher risk of some adverse pregnancy outcomes than women who are light drinkers. Future studies need to construct careful drinking histories to address this and other questions that deal with parents' ethanol use and reproductive health.

Alcohol Drinking↗
PubMed1991

Gestational duration and birthweight in white, black and mixed-race babies.

Using the 1983 United States population of single live births, birthweight and gestational duration were compared for babies of these different parental racial groups: both parents White, mother White-father Black, mother Black-father White, both parents Black. The four groups differed significantly with respect to the usual sociodemographic variables. Mean birthweight and mean gestational duration decreased in that order from the White-White reference group, and conversely there were increasing trends for low birthweight and preterm delivery. Adjustment for the usual sociodemographic variables did not alter these trends appreciably. Group differences were more strongly related to the mother's race than to the father's, and the trends were related to the mother's race. Because the father's race was significant, genetic factors are probably of some importance. The evidence from this study, together with the often-demonstrated relationships between low birthweight and preterm delivery with sociodemographic variables, and the short-term downward secular trends in low birthweight, support the concept that non-genetic maternal factors are more important for these abnormal outcomes. But because neither the usually utilised sociodemographic variables nor genetic factors seem to explain much of the group differences, new approaches are necessary to understand why, irrespective of ethnic group, some women are at excess risk for suboptimal birth outcome.

Adolescent↗
PubMed1990

Drinking and smoking at 3 months postpartum by lactation history.

A spontaneous decrease in maternal drinking and smoking often occurs during pregnancy. The present study was conducted to determine if these lower levels of maternal drinking and smoking during pregnancy persist into the postpartum period, and if so, to determine if they are related to breastfeeding. Drinking and smoking were estimated in three cohorts of postpartum women who had been followed since pregnancy. The first group never breastfed their infants; the second group breastfed for less than 1 month; the third group breastfed for more than three months. (Women who weaned between one and three months were not studied). Drinking and smoking in all three groups decreased sharply during pregnancy but rose again in the 3 months after delivery, though not to levels that were reported before conception. Usual drinking in the third month postpartum did not differ significantly among the three lactation groups. However, women who were still nursing were less likely to report occasional episodes of heavy drinking (binges) in this month than women who had weaned early or never breastfed. Women nursing in the third month postpartum were also significantly less likely to smoke during the month; if smoking, they were less likely to smoke heavily. These differences in postpartum drinking and smoking were not due entirely to habits before conception or to the influence of other potentially confounding variables.

Alcohol Drinking↗
PubMed1990

Torsade de pointes and T-U wave alternans associated with arsenic poisoning.

Arsenic intoxication is a common form of heavy metal poisoning. Although arsenic-induced circulatory collapse, seizures, and syncope are well known, the potential for serious ventricular arrhythmias is less well recognized. Reported in this study are two cases of arsenic poisoning causing torsade de pointes. Furthermore, marked prolongation of the QT-U interval and the rarely observed phenomenon of T-U wave alternans are demonstrated. Thus, arsenic intoxication may be complicated by prolongation of the QT-U interval and torsade de pointes. T-U wave alternans occurs in the presence of a long QT-U interval and may be an electrocardiographic warning sign of torsade de pointes.

Adult↗
PubMed1989

Maternal alcohol use during breast-feeding and infant mental and motor development at one year.

The detrimental effects of maternal drinking during pregnancy on fetal health have been documented. The consequences for infants of maternal drinking during breast-feeding are unknown, but research in animals suggests that the infant could be affected by exposure to alcohol through the mother's milk. In a study of 400 infants born to members of a health maintenance organization, we investigated the relation of the mother's use of alcohol during breast-feeding to the infant's development at one year of age. Mental development, as measured by the Bayley Mental Development Index (MDI), was unrelated to maternal drinking during breast-feeding. However, motor development, as measured by the Psychomotor Development Index (PDI), was significantly lower in infants exposed regularly to alcohol in breast milk (after alcohol exposure during gestation was controlled for), with a dose-response relation (P for linear trend, 0.006). The infants of breast-feeding mothers who had at least one drink daily had a mean PDI score of 98, whereas the infants exposed to less alcohol in breast milk had a mean PDI score of 103 (95 percent confidence interval for the difference of the two means, 1.2 to 9.8). The effect was more pronounced when mothers who supplemented breast-feeding with formula were excluded from the analysis. The association persisted even after we controlled for more than 100 potentially confounding variables, including smoking and other drug use during pregnancy and in the postpartum period. We conclude that ethanol ingested through breast milk has a slight but significant detrimental effect on motor development, but not mental development, in breast-fed infants.

Adult↗
PubMed1989

Dietary cravings and aversions in the postpartum period.

Although food cravings and aversions are commonly experienced by pregnant women, the degree to which they persist in the postpartum period is unknown. This study examines this issue in both lactating and nonlactating women. A random sample of 463 subjects was selected from all prenatal patients receiving care at a large health maintenance organization (HMO). Even though almost all of the subjects reported craving some food or beverage during the last trimester of pregnancy and half reported some aversion, those phenomena dropped markedly in the postpartum period. Evaluation of dietary quality as related to food cravings revealed no clear association; that is, the data provided no evidence to support the hypothesis that cravings are caused by dietary deficiencies or that they result in significantly augmented intake of key nutrients found in those foods. Overall, food cravings and aversions do not continue into the postpartum period at a higher rate than one would expect in the adult female population; manifestation of food cravings/aversions is not related to dietary quality.

Female↗
PubMed1989

Arrhythmias after orthotopic cardiac transplantation. Prevalence and determinants during initial hospitalization and late follow-up.

The prevalence of arrhythmias after orthotopic cardiac transplantation in the era of cyclosporine immunosuppression is unknown. Accordingly, we analyzed telemetry data from the initial hospitalization period for 33 cardiac transplant procedures and from 100 hospital readmissions in 23 long-term survivors. Prevalence of arrhythmias was analyzed in relation to immunosuppressive regimen, occurrence of acute rejection, and other clinical and hemodynamic variables. Atrial and ventricular arrhythmias were recorded in 55% and 79% of patients during initial hospitalization and in 39% and 43% of long-term survivors, respectively. Compared with cyclosporine-treated patients, atrial (24% vs. 88%, p less than 0.001) and ventricular (65% vs. 94%, p = 0.085) arrhythmias during the initial hospitalization were more prevalent in patients receiving azathioprine. There was no difference in the prevalence of arrhythmias during initial hospitalization between patients experiencing acute rejection and those who did not. Potential associations between arrhythmia occurrence and a prolonged donor heart ischemic time (p = 0.022), elevated pulmonary arterial pressure (p = 0.01), and a lower ejection fraction (p = 0.009) were noted. These data suggest that arrhythmias occur in the majority of patients during the initial hospitalization for transplantation, even in those who never experience acute rejection. Ventricular arrhythmias are common in patients treated with either immunosuppressive regimen; however, atrial arrhythmias are less prevalent in patients receiving cyclosporine. Arrhythmias tend to occur in the setting of altered hemodynamics.

Adult↗
PubMed1987

Father's drinking and infant birth weight: report of an association.

Parents' drinking in the month prior to conception was ascertained for 377 infants born to members of a health maintenance organization. If the father had an average of two or more drinks daily, or had at least five drinks on one occasion, a decrease of 137 gm in infant birth weight was predicted, by means of regression analysis. This result was independent of maternal drinking, although infants whose mothers were regular drinkers weighed less at birth. The lower mean birth weights of infants of regular-drinking fathers was not due to parents' smoking, maternal use of caffeine, marijuana, or other drugs, or 21 other measured variables. This is the first report of an association in humans between father's drinking prior to conception and decreased infant birth weight. However, interpretation of this finding is difficult because the biological mechanisms that might underlie it are obscure.

Alcohol Drinking↗
PubMed1987

Mother's and father's birthweight as predictors of infant birthweight.

Mothers' and fathers' birthweights are each significantly related to their infants' birthweight, even after control for 31 potentially confounding variables. The relationship is stronger for mothers and daughters than for other parent-offspring pairs. Parents' birthweights together account for 2% of the variance in sons', and 5% of the variance in daughters' birthweights. There are interactions of maternal birthweight with maternal adult weight, pregnancy weight gain, and parity; the predicted effect of maternal birthweight on infant birthweight is enhanced when the mother weighs more, gains more weight during pregnancy, or is multiparous. Race and parents' drinking and smoking also modify the predicted effect of parents' birthweights. The correlation between mother and offspring birthweights has been attributed to the mother's own uterine experience and its effect on her later reproductive performance. However, the significant relationship of father and infant birthweights reported in this paper suggests that the fetal genes also play some role in determining size at birth.

Adolescent↗
PubMed1987

Genetic and environmental influences on human birth weight.

Path-analytic techniques were used to demonstrate a significant influence of both fetal genes and maternal environment on birth weight in a sample of infants born to primarily white, middle-class, nonsmoking mothers. If the mother smoked before conception, however, the expression of the fetal birth-weight genes in males was significantly reduced. Multiparity was associated with an increase in genetic variance. This is the first report that genetic influences on birth weight are dependent on the environmental conditions imposed on the fetus by the mother.

Alcohol Drinking↗
PubMed1986

Agreement between laboratory tests and self-reports of alcohol, tobacco, caffeine, marijuana and other drug use in post-partum women.

The agreement between self-reported consumption of several drugs and laboratory tests used to detect their use is examined. Post-partum women (N = 108) enrolled in a research study participated in a detailed interview covering alcohol and caffeine ingestion, tobacco smoking and use of marijuana and other psychoactive drugs. They also kept a 4-day record of their use of these substances. Blood and urine samples were taken and a physical exam done at the close of the record period. Laboratory tests to detect use of alcohol, tobacco, caffeine, marijuana and other drugs were carried out and the results compared to self-reported drug use in the interview and the record. The degree of agreement depended on the drug taken, the test used and the pattern of drug use in the sample. Sporadic or infrequent consumption related poorly to laboratory tests, especially those that were designed as screening tools. Regular consumption could be identified with greater accuracy. However, the group associations evident between self-reports of drug use and laboratory results were not sufficient to guarantee that subjects were correctly classified. Error in both self-report and the decision made from laboratory values must be taken into account in determining the confidence that should be placed in the data and the conclusions drawn from it.

Adult↗
PubMed1986

Fetal growth and moderate drinking in early pregnancy.

Heavy maternal drinking during pregnancy has consistently been linked to decreased intrauterine growth, but the effect of smaller amounts of alcohol is less clear. In this study, the relationship between fetal growth and "moderate" drinking by low-risk, nonsmoking prenatal patients is explored. The sample consists of 144 women seen for the first time at the prenatal clinic of University College Obstetrics Hospital, London, England, between July 1979 and May 1980 and meeting the following criteria: white, aged 19-35 years, 8-16 weeks gestation at first prenatal visit, nonsmoker, nonalcoholic, lower middle class or higher, and in general good health. Average daily consumption of 10 g of ethanol (about one drink) in the week prior to recognition of pregnancy is related to a decrease in infant birth weight of 225 g, after adjustment for gestational age, sex of child, and maternal age, weight, height, pregnancy weight gain, social class, gravidity, and parity. In addition, consumption of this amount in the week before first prenatal visit is related to a comparable decrease in birth weight for male but not for female infants. These findings suggest that risk of decreased intrauterine growth begins very early in pregnancy, and that fetal response to later alcohol use may vary with sex of the child.

Alcohol Drinking↗
PubMed1986

Osteomyelitis of the ilium secondary to external pelvic fixation.

Orthopedic surgeons commonly rely on external pelvic fixation in the treatment of pelvic fractures. Superficial pin tract infections have been reported with the use of this fixation, but we found no deep, chronic infections documented in the literature. We report here the case of a 24-year-old man with chronic bilateral iliac osteomyelitis following external pelvic fixation.

Adult↗
PubMed1986

Birthweight and gestational age: mothers' estimates compared with state and hospital records.

Birthweight and gestational age estimates made by research subjects were compared with values obtained from birth certificates and hospital records. Ninety-one per cent of mothers' estimates of their infant's birthweight and 88 per cent of their estimates of infant gestational age agreed with the delivery record. When the same mothers estimated their own and their husband's birthweight, only 44 per cent were in agreement with birth certificate values; however, 78 per cent were in agreement with the pounds portion of the weight. Agreement of mothers' estimates of her own and her husband's gestational age with birth certificates was no better than chance.

Birth Certificates↗