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Biomedical subjects

W V Vieweg

Publications and source records attributed to W V Vieweg.

At least 19 recordsLinked to original sources
PubMed1998

Nefazodone and depression.

Nefazodone is a fourth-generation antidepressant with novel serotonergic actions. It is a potent antagonist of synaptic 5-HT(2) receptors and a moderate blocker of synaptic 5-HT reuptake. Its mild synaptic blockade of norepinephrine is of little clinical importance. Besides its effectiveness in depression, nefazodone is effective in depression-related anxiety. Of all the antidepressants, nefazodone is least likely to induce sexual dysfunction. This drug increases sleep efficiency and reduces the number of nighttime awakenings. Nefazodone, compared with many other antidepressants, is unlikely to induce a withdrawal syndrome if abruptly stopped.

Journal Article↗
PubMed1997

Measuring and estimating daily urine volume in psychiatric patients: strengths and weaknesses.

We collected daily urine volumes (DUV) from 24 nonpolydipsic psychiatric patients and eight polydipsic schizophrenic patients. At 7 AM and 4 PM, we collected spot urine samples and measured urine creatinine concentration (UCr). Using morning weight and the UCr measurements, we compared actual DUV with estimated DUV using 3 methods to estimate DUV currently available in the literature. Each method of estimating DUV was superior among the polydipsic patients compared with the nonpolydipsic patients. We discuss the strengths and weaknesses of trying to estimate DUV in psychiatric patients. One method was simple but less accurate. The two remaining methods gave similar results but one method was substantially easier to use than the other.

Antimanic Agents↗
PubMed1997

The Charles Bonnet syndrome: a review.

The Charles Bonnet syndrome (CBS) derives from complex visual hallucinations. Neurologists, ophthalmologists, and psychiatrists have studied this entity for many years. Despite interest in CBS recently in contemporary American medical literature, investigators have not agreed upon a universal definition of this entity. This article reviews the current literature on CBS and related phenomena, offers specific criteria to define this syndrome, and suggests future work in this area.

Adult↗
PubMed1995

Increased disorderliness and amplified basal and pulsatile aldosterone secretion in patients with primary aldosteronism.

To investigate the pathophysiology of altered aldosterone secretion in patients with primary aldosteronism, the pulsatile mode of in vivo aldosterone and cortisol release was examined by quantitative deconvolution analysis in 5 normal subjects (controls) and 10 patients with aldosterone-producing adenomas (APA) under conditions of sodium (150 meq/day) balance. Episodic release of aldosterone and cortisol was assessed by sampling blood at 10-min intervals for 24 h. A waveform-independent deconvolution algorithm was used to calculate endogenous aldosterone and cortisol secretion rates on a sample by sample basis in each subject. There were no differences in the number of aldosterone or cortisol secretory bursts per day or their mean interpulse intervals between normal subjects and patients with primary aldosteronism. A 24-h rhythmicity in serum aldosterone concentrations was maintained in APA patients. Patients with primary aldosteronism had significantly higher (P < 0.01) aldosterone mean secretory rates, mean mass of aldosterone secreted per burst, maximal aldosterone secretion rates attained within each burst, and mean basal (nadir) aldosterone secretion rates. A recently introduced regularity statistic, approximate entropy (ApEn), was used to test for orderliness (small ApEn) vs. randomness (large ApEn) in the aldosterone time series. ApEn was significantly larger for the APA patients (1.433 +/- 0.148) than for normal subjects (0.306 +/- 0.098; P < 0.001), with complete group segmentation yielding 100% sensitivity and specificity. In contrast, a scale-invariant form of this measure, normalized ApEn, showed no significant distinction between tumoral and normal aldosterone release patterns. These ApEn findings taken together are consistent with the deconvolution results from an entirely distinct perspective, reinforcing an amplitude difference, but no frequency difference, between normal subjects and APA patients. Unexpectedly, patients with APA had significantly lower mean cortisol secretory rates, reduced cortisol secretory burst mass, and attenuated maximal cortisol secretory rates than normal subjects (P < 0.01). Plasma cortisol and aldosterone concentrations in patients remained positively correlated over short time lags. In summary, the present findings demonstrate that in normal subjects and patients with APA, both aldosterone and cortisol are secreted in a burst-like mode. The presence of substantial basal aldosterone release and increased irregularity of serial aldosterone concentrations distinguishes APA from normal subjects.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1994

Treatment strategies in the polydipsia-hyponatremia syndrome.

The clinician must first identify the patient at risk of developing water intoxication and its complications including seizures, coma, and death. In the polydipsic patient, behavioral approaches correcting or limiting polydipsia may prevent progression to dilutional hyponatremia. Drugs that oppose the central release or renal action of antidiuretic hormone will usually normalize morning serum sodium concentration in patients with the polydipsia-hyponatremia syndrome. The clinician can monitor such patients by observing diurnal changes in body weight. Specific interventions derive from specific weight changes. For the symptomatic patient suffering from water intoxication, intravenous administration of saline raising the serum sodium concentration to the 120-mmol/L range, followed by fluid restriction to further correct hyponatremia, will almost always successfully correct hyponatremia and protect against central pontine myelinolysis.

Behavior Therapy↗
PubMed1992

Temporal pattern of renin and aldosterone secretion in men: effects of sodium balance.

To investigate the pulsatile nature of basal and stimulated renin and aldosterone secretion, we sampled blood for plasma renin activity (PRA) and plasma aldosterone concentration at 10-min intervals for 24 h in nine normal supine human male subjects after equilibration in high- and low-sodium balance states. We evaluated serial hormonal measures by a quantitative waveform-independent deconvolution technique designed to compute the number, amplitude, and mass of underlying secretory bursts and simultaneously to estimate the presence and extent of basal secretion. For both PRA and aldosterone: 1) burstlike release accounted for greater than or equal to 60% of total secretion and tonic release for less than 40%; 2) there was an 80- to 85-min interpulse interval unchanged by sodium intake; 3) sodium restriction engendered an increase in plasma hormone concentrations by increasing the amount and maximal rate of hormone secreted per burst; 4) low dietary sodium also induced increases in basal hormone secretory rates, suggesting that there may be two regulatory processes driving renin and aldosterone secretion; and 5) PRA was significantly coupled to plasma aldosterone concentration by a 0-, 10-, or 20-min aldosterone lag time in both high- and low-sodium balance. We conclude that both renin and aldosterone are released via a predominantly burstlike mode of secretion; PRA and plasma aldosterone concentrations are positively coupled by a short time lag (0-20 min); and sodium restriction achieves an increase in mean PRA and plasma aldosterone concentration by selective amplitude enhancement of individual hormone secretory bursts and by increased tonic (interburst) basal secretory rates.

Adult↗
PubMed1992

Risk-taking behavior of college students and social forces.

We surveyed 1,900 first-year students at the University of Virginia 1 month after arrival. We looked at drinking and driving practices. Men drank more and they drank more often than women. Our data suggest that in defining frequent heavy drinkers, one should consider body weight. We now define frequent heavy drinking as five or more drinks in a row at least weekly for men, and for women we use three to four drinks or more in a row at least weekly. Frequent heavy drinkers and dangerous drivers appeared disproportionately among students planning to join fraternities and sororities. We believe correction of alcohol abuse and addiction by college students must focus, at least in part, on social organizations, especially fraternities and sororities. Also, we must attend to characterologic features that predispose to alcohol abuse and dependence and dangerous driving practices.

Adolescent↗
PubMed1991

The link between fluid intake and weight gain in psychosis.

Diurnal weight gain was found to be abnormal among 44 of 77 institutionalized chronically psychotic patients. All patients were weighed and urine samples obtained weekly for 3 weeks at 7 A.M. and 4 P.M. Diurnal weight gain was normalized as a percentage by subtracting the 7 A.M. weight from the 4 P.M. weight, multiplying the difference by 100, and then dividing the result by the 7 A.M. weight. Normalized diurnal weight gain (NDWG) was 2.504 +/- 1.266% for the 44 study patients with abnormal findings, .631 +/- .405% for the 16 acutely psychotic controls, and .511 +/- .351% for 29 normals. Urine excretion was related (r = .476, p = .001) to NDWG in the subgroup of study patients with abnormal NDWG, consistent with the observation that their fluid intake exceeded fluid excretion in the afternoon.

Adult↗
PubMed1991

Alcohol and cocaine use among first-year college students.

We surveyed 1528 first-year students at the University of Virginia, 1 month after their arrival on campus, who had used alcohol at some time in their lives. Our survey was designed to identify alcohol and cocaine use, and related psychosocial patterns. Men drank more and more often than women. Our data suggest that body weight should be considered in defining those who drink heavily and often. We define 'frequent heavy drinking' as five or more drinks in a row each week for men and three to four drinks or more in a row each week for women. Frequent heavy drinkers, cocaine users, and students with psychosocial problems appeared disproportionately among students planning to join fraternities and sororities. Although first-year students used cocaine infrequently, its users followed the patterns of frequent heavy drinkers. We believe efforts to correct alcohol and cocaine misuse by college students should be directed, in part, at social organizations such as Greek-letter societies. Also, we must attend to psychosocial features that predispose to alcohol and cocaine misuse.

Adolescent↗
PubMed1991

Virginia's experience with state-university collaboration.

The development of an active collaboration between the department of behavioral medicine and psychiatry of the University of Virginia School of Medicine and Western State Hospital is described. The collaboration includes clinical research and opportunities for training residents and medical students. University faculty provide clinical and administrative leadership at all levels of the hospital's organization. The hospital's clinical functioning has improved through direct involvement of university faculty in patient care, and its recruitment of physicians and psychologists has increased due to expansion of academic opportunities and program improvements. The authors use examples from the collaboration experience to illustrate key issues, such as strong leadership, sufficient resources, and an understanding of systems factors, that are necessary to overcome resistance to change.

Academic Medical Centers↗