Measurement of nicotine intake in pregnant women--associations to changes in blood cell count.

Self-reported information about smoking is imprecise and subject to bias, with accuracy varying according to circumstances. Biochemical assessment gives much clearer indications of the effects of tobacco intake on physiological parameters. As part of a randomized controlled trial, a new point-of-care test for smoking was used as a tool to reduce smoking in pregnancy. Measurements of nicotine metabolites in urine were related to a physiological effect of smoking, notably changes to blood parameters, assessed as a routine part of antenatal care. One hundred and eighty-seven pregnant women attending outpatient antenatal care were initially questioned by a midwife about smoking habits and later questioned by the investigators, during which the test was performed and the results relayed back to the patient. Self-reported smoking habit and cigarette consumption, either reported to midwives or the investigators, were shown to be poor indicators of the effects of smoking on blood parameters. The biochemical assessment of nicotine intake was significantly related to white blood count, haemoglobin concentration, haematocrit, mean cell volume, and mean cell haemoglobin. Red cell count, mean cell haemoglobin concentration, and platelet count were unrelated to nicotine metabolite measurements. We concluded that the new test was a reliable measure of nicotine intake in pregnancy and the results correlated with smoking-related changes to haematological parameters.

Alcohol consumption in patients with colorectal adenomatous polyps.

The risk of developing colorectal adenomatous polyps is probably increased by a variety of dietary and environmental factors. We found an association with current alcohol and cigarette consumption. The risk of polyps was increased three times in drinkers who did not smoke and two times in smokers who did not drink, with those who both drank and smoked having 12 times the risk of total abstainers. Since colonic adenomatous polyps are generally regarded as premalignant lesions, these results lend support to the view that alcohol consumption may be an important factor in the pathogenesis of colorectal neoplasia, thus reinforcing the proposed polyp/carcinoma sequence in colorectal carcinogenesis. The role of smoking, however, is less clear particularly since the lack of association of colorectal carcinoma and smoking has been reported in many other studies.

In vitro mucus glycoprotein production by colonic tissue from patients with ulcerative colitis.

Colonic mucus production was measured in vitro by means of incorporation of tritiated glucosamine using biopsy material from patients with ulcerative colitis and compared with data from patients with Crohn's disease, colonic carcinoma, colonic polyps and patients with apparently normal colonic mucosae. Mucus production was significantly decreased (p less than 0.03) in all patients with ulcerative colitis, and in particular in patients with inactive disease when compared with normal subjects. In patients with active disease mucus production was not significantly different from normal subjects. The radiolabelled material was characterised by gel filtration and ion exchange liquid chromatography as mainly high molecular weight glycoproteins. These results indicate that the quantitative character of colonic mucus is abnormal in inactive ulcerative colitis.

A paradoxical fall in urine dopamine output when patients with essential hypertension are given added dietary salt.

The effect of dietary sodium on the urine dopamine excretion of eight hypertensive patients and six matched controls was studied under metabolic balance conditions over a 2 week period during which dietary sodium intake was increased from 20 to 220 mmol/day. The control group showed the expected increase in dopamine excretion in response to sodium but the hypertensive patients showed an initial fall followed by a return to baseline values. Neither group showed a rise in blood pressure but the hypertensive patients showed a greater weight gain on salt loading, although this change was not significant. The cumulative sodium balance was greater and more prolonged in the hypertensive patients, although this difference also did not attain statistical significance. This defect in dopamine mobilization may be important in relation to renal sodium handling by patients with essential hypertension.

The protective effect of gamma-glutamyl L-dopa on the glycerol treated rat model of acute renal failure.

gamma-Glutamyl L-dopa, a renal pro-drug for dopamine, was administered to rats before and after injection of glycerol, and to a control group which received water in place of glycerol. A third group of rats was given glycerol but no gamma-glutamyl L-dopa. The plasma creatinine in rats given gamma-glutamyl L-dopa and glycerol was significantly lower than in rats receiving glycerol alone. The fall in urine creatinine excretion, and polyuria, after glycerol was reduced by gamma-glutamyl L-dopa and the natriuresis abolished. gamma-Glutamyl L-dopa given alone caused a 4000-fold increase in urine dopamine excretion, associated with a natriuresis. The administration of gamma-glutamyl L-dopa reduces the severity of renal failure produced by glycerol.

Urine dopamine during normotensive and hypertensive pregnancies and the puerperium.

Urinary excretion of dopamine, sodium and creatinine have been studied during pregnancy and the puerperium in three groups of women, normotensive, pre-eclamptic and those exhibiting gestational hypertension. Differences in the pattern of dopamine and salt excretion are evident in the two hypertensive groups and lend support to the concept that women who develop gestational hypertension have a defect in the mobilisation of dopamine similar to that observed in males with essential hypertension.

Urine dopamine in normal and hypertensive pregnancies.

Dopamine output in urine was determined in two groups of women with hypertension in pregnancy. A highly significant elevation of urine dopamine was detected in those women with pre-eclampsia compared with that in matched control subjects. In contrast, no difference in urine dopamine output was detected between a group of multigravidae with hypertension in pregnancy and matched control subjects.

Urine free dopamine in normal primigravid pregnancy and women taking oral contraceptives.

1. Urine free dopamine was estimated at predetermined points of the menstrual cycle in normal volunteer subjects and in women taking a combined oral contraceptive. 2. There was no alteration in 24 h urine dopamine during the normal menstrual cycle but, in contrast, combined oral contraceptives produced a fall which recovered premenstrually. 3. In 19 primigravid subjects 24 h urine free dopamine was estimated at monthly intervals throughout pregnancy and at the time of the postnatal examination. 4. Urine dopamine was elevated throughout pregnancy when compared with postnatal values. Women receiving an oral progestogen contraceptive at the time of the postnatal examination showed a further fall in urine dopamine.