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Biomedical subjects

E Cook

Publications and source records attributed to E Cook.

13 recordsLinked to original sources
PubMed1992

Transdermal clonidine as an adjunct to enalapril: an evaluation of efficacy and patient compliance.

This four-center, 20-week, open-label study evaluated transdermal clonidine as an adjunct to enalapril 10 mg daily and demonstrated patterns of compliance. Seventy-four mildly to moderately hypertensive patients (mean seated blood pressure, 150/101 mm Hg) received enalapril 10 mg once daily as initial monotherapy. In 66 patients, the seated diastolic blood pressure remained greater than or equal to 90 mm Hg at the trough blood levels of enalapril. Transdermal clonidine (3.5 cm2, 7.0 cm2, or 10.5 cm2, equivalent to 0.1 mg, 0.2 mg, and 0.3 mg clonidine/day, respectively) then was added as needed to achieve blood pressure control. Forty-eight patients achieved diastolic blood pressures less than 90 mm Hg on concomitant therapy; 44 patients completed 8 weeks of maintenance dosing with a mean blood pressure of 134/85 mm Hg. Oral compliance, as measured by an electronic device that was actuated each time the medication vial was opened, varied from 48 to 140%. Compliance with the transdermal clonidine regimen was excellent; the patch was worn as directed during 96% of the patient-weeks of therapy. The authors conclude that blood pressure can be controlled by a combination of transdermal clonidine and enalapril in patients that do not adequately respond to enalapril monotherapy. Patients poorly complying with oral regimens may be candidates for a trial of transdermal clonidine monotherapy.

Administration, Cutaneous↗
PubMed1991

Winning at losing.

Explore the source record for details and available documents.

Community Health Nursing↗
PubMed1990

Pharmacokinetics, pharmacodynamics, and minimum effective clinical dose of intravenous nicardipine.

Nicardipine hydrochloride was administered intravenously to two groups of hypertensive patients: one group of 37 patients with mild to moderate hypertension and one group of 20 patients with severe hypertension. In the first group, doses of 0.5, 1, 2, and 4 mg/hr, as well as placebo, were infused for 48 hours in a double-blind fashion. Blood pressure and heart rate were monitored for this period and for the 24 hours after the infusion was discontinued. Significant decrements in blood pressure were noted with all doses; 4 mg/hr produced lowering that was greater than all other doses; 1 and 2 mg/hr produced lowering that was greater than 0.5 mg/hr but that were not different from each other. Excellent correlation of blood pressure reduction and plasma level was observed and linear kinetics existed. In the severe hypertensive patients, 1, 2, 4, 5, and 8 mg/hr were infused to established minimal and ineffective doses. One milligram per hour was an ineffective dose; 4, 5, and 8 mg/hr all produced significant reductions over the course of the study that were undistinguishable from each other. Two milligrams per hour produced modest reductions in blood pressure. Blood pressure reduction also correlated with plasma levels in the severe hypertensive group.

Analysis of Variance↗
PubMed1990

Nicardipine in severe hypertension: oral therapy following intravenous treatment.

Nicardipine is an investigational dihydropyridine calcium-channel blocker. In the present study, 21 patients with severe hypertension were treated with oral nicardipine, alone or in combination with beta-blockers and diuretics for 4-5 weeks, following initial control of their blood pressure with intravenous nicardipine. Each of the 21 patients had a satisfactory response to intravenous nicardipine which was administered as an infusion following initial blood pressure lowering. At 1 h prior to discontinuation of the intravenous treatment, oral nicardipine therapy was begun as a 40 mg dose. Oral nicardipine, 40 mg t.i.d., was continued for the remainder of hospitalization and for a 4-5-week outpatient follow-up period. The dose of oral nicardipine was downtitrated and additional antihypertensive drugs, beta-adrenergic blocking agents and/or diuretics, were added to maintain blood pressure in an acceptable range. Compared to baseline, mean supine systolic blood pressure was lowered significantly (p less than 0.001) by 57 mmHg at the end of intravenous maintenance and by 50 mmHg at the end of oral treatment. Likewise, significant (p less than 0.001) decreases in diastolic blood pressure of 43 and 32 mmHg, respectively, were observed for the same time periods. At the end of oral treatment, 6 patients remained on nicardipine monotherapy, 8 patients were on two-drug therapy and 7 patients required three-drug therapy. Side-effects were mild except for a moderate headache reported in one patient during intravenous treatment. From these observations we conclude that oral nicardipine is a useful new agent for initial, single treatment of chronic severe hypertension, although a significant number of patients eventually need additional antihypertensive therapy.

Administration, Oral↗
PubMed1988

Chemical synthesis, cloning and expression in mammalian cells of a gene coding for human tissue-type plasminogen activator.

A 1610-bp DNA duplex coding for human tissue-type plasminogen activator has been chemically synthesized using the phosphoramidite procedure, adapted for a custom-built gene synthesizer. The synthesizer, which was designed for both simplicity and speed, permits the rapid construction of relatively large genes and compares favorably in speed with alternative cDNA isolation procedures. The plasminogen activator gene has been expressed in mammalian cells and shown to produce authentic protein by an immuno-activity assay.

Base Sequence↗
PubMed1988

Slow brain potentials, imagery and hemispheric differences.

On the basis of Lang's (1979) theory of emotional imagery three experiments were conducted to investigate the relationship between slow cortical potentials (SP) and emotional imagery. According to the assumptions of Lang's theory and our model (Rockstroh et al., 1982) of SP-function imagery ability should be related to a person's capacity to generate and suppress preparatory activity in cortical networks "on demand." In order to test this hypothesis subjects in Experiment I were trained to regulate right- versus left-hemispheric SP-differentiation within an instrumental learning paradigm. Thirty-four subjects were reinforced for achieving maximal SP-differences between electrode locations C3-C4 over a 6 s interval across 120 trials. Success in the SP-regulation task correlated significantly (r = .37) with the capacity for vivid imagery as measured with the Questionnaire for Mental Imagery (QMI). In Experiment II instructions to imagine right- versus left-hand movements were introduced successively over 5 sessions of SP-self-regulation. Imagery clearly modified right- versus left-hand EMG-differentiation but had no influence on cortical SP-differentiation. Experiment III tested the influence of already achieved SP-regulation at the vertex on the perceived vividness of emotional images introduced after the SP-biofeedback training. Again, clear effects of imagery content on autonomic variables (HR, SCR) were found. However, SP-amplitude and SP-polarity had no effect on perceived vividness, arousal or emotional content. It may be concluded from the results of Experiment II and III that SPs either are not the crucial parameter to represent the cortical efferent outflow component of imagery, or that the dual task of SP-self-regulation and imagery prevented covariations to show up. Experiment I, on the other hand, points toward a positive relation of imagery-ability as a trait-variable and brain-self-regulation abilities.

Brain↗
PubMed1986

Life satisfaction of the elderly American Indian.

This study examined the life satisfaction of 58 elderly American Indians and its relationship to selected external and internal environmental factors. Elderly Indians were 51-85 years of age and resided on two midwestern reservations. Data were collected through use of the Life Satisfaction Index Z-scale (LSI-Z), the Oars Multi-dimensional Functional Assessment Questionnaire (OARS) and a semi-structured interview schedule. Findings indicated that life satisfaction tended to be high. Six internal environmental variables explained 40% of the variance in life satisfaction scores. A higher correlation was found between self-perception of life satisfaction and mental health than objective ratings on these two variables. This study suggests that variables associated with the internal environment may be useful as indicators of life satisfaction in elderly reservation American Indians and that subjective measures of life satisfaction may be more predictive of mental health than objective measures.

Aged↗
PubMed1986

Effect of opiate-receptor blockade on normoglycemic and hypoglycemic glucoregulation.

By use of the opiate antagonist naloxone, we have examined the hormonal and metabolic responses to opiate-receptor blockade under basal conditions and during insulin-induced hypoglycemia in normal dogs. Naloxone treatment had no measurable effect on glucose concentration, turnover, and norepinephrine levels, but stimulated plasma epinephrine, glucagon, and cortisol and inhibited insulin release. Insulin (7 mU X kg-1 X min-1) decreased plasma glucose to 42 +/- 4 mg/dl due to an initial decrease in glucose production and an increase in glucose disappearance. Glucose production then increased, and plasma glucose plateaued. After 50 min of insulin infusion, epinephrine levels increased 26-fold (P less than 0.05), norepinephrine and glucagon 3-fold (P less than 0.02), and cortisol 4-fold (P less than 0.01). Similarly, plasma beta-endorphin and adrenocorticotropin (ACTH) were elevated (6-fold, P less than 0.01, and 16-fold, P less than 0.05, respectively). When naloxone was given during insulin-induced hypoglycemia, there was earlier release of epinephrine, glucagon, beta-endorphin, ACTH, and cortisol as well as a greater release of glucagon (P less than 0.001) and cortisol (P less than 0.0001). This resulted in a greater increase in glucose production (P less than 0.01), thus lessening the insulin-induced hypoglycemic excursion. In conclusion, in the dog, endogenous opiates may play a small role in the regulation of basal insulin and glucagon release and can inhibit the pituitary-adrenal axis under basal conditions and during hypoglycemia. Thus increased glucose production in response to insulin-induced hypoglycemia is consistent with the excessive response of counterregulatory hormones during opiate-receptor blockade.

Adrenocorticotropic Hormone↗
PubMed1986

Lack of toxicity of oral and intrapulmonary group B streptococcal lipoteichoic acid.

Lipoteichoic acid (LTA) was prepared from type III group B streptococci and administered by topical oral application or intravenous or intratracheal injection in weanling and adult white New Zealand rabbits. Tritiated [3H]LTA in tissues and body fluids was measured by scintillation spectrometry. Five minutes to 120 h after intravenous injection of 10 mg (17 x 10(6) dpm) of [3H]LTA, none was present in blood. Combined urine and fecal excretion peaked at 24 h and decreased over 5 days. There was no effect on collagen-induced platelet aggregation. [3H]LTA concentrations were greatest in colon, bone, stomach, and skin 1 day after intravenous injection. After a 5-mg oral dose (8.5 x 10(6) dpm) in an adult animal, fecal excretion peaked at 24 h and decreased after 4 days. No systemic absorption was noted. No [3H]LTA was found in any of seven tissues examined at autopsy 3 days after 1 to 5 mg/kg oral doses in weanling animals with normal or traumatized buccal mucosa. No effect was noted on platelet aggregation or serum complement, there was no increase in the incidence of nephrocalcinosis and the buccal mucosa remained histologically normal. Intratracheal injection of 0.5 to 2.5 mg/kg of LTA resulted in no tachypnea or alteration in blood gases. All animals remained healthy after LTA administration. The absence of toxicity and absorption in animals suggests that studies could be performed in humans to evaluate the safety and efficacy of oral LTA.

Administration, Inhalation↗
PubMed1975

Allocation of attention and the locus of adaptation to displaced vision.

Experimental subjects were exposed to prism-induced visual displacement of a target whose location was correctly given by proprioceptive-kinesthetic information. Control subjects were exposed alternately to visual displacement or proprioceptive-kinesthetic location information. During the adaptation period, experimental subjects in the visual attention condition performed a localization task that directed them to attend selectively to the visual modality; experimental subjects in the proprioceptive attention condition attended selectively to the proprioceptive modaltiy; control subjects performed the task on the basis of the available modality. Measures of adaptation and aftereffect were secured separately in each of the two modalities. These confirmed the predictions that the shifts in the experimental conditions would be confirmed to localization tests dependent on the unattended modality and that control subjects would not exhibit adaptation. We proposed that allocation of attention determines situational dominance and that dominance determines the locus of adaptation. The findings were compared to those reported by Canon (1970) and were applied to a reassessment of the "visual capture" phenomenon.

Adaptation, Physiological↗
PubMed1975

Some health aspects of high-energy society.

The intensive use of inanimate energy in industrialized or high-energy society has subsidized research, development, and higher education and has brought about changes in nutrition and life-style that have led to great advances in public health and medicine. The emergence of high-energy society, however, has brought with it a new set of health problems, within which the direct effects of measurable pollution may turn out to be more easily dealt with than some of the indirect and hard-to-calculate consequences of high energy use. High-energy society is critically dependent on energy-intensive transport systems, and these systems in turn are dependent upon a continual supply of petroleum products. In the short-term, the aorta of any industrialized nation is its petroleum-supply network. In the longer run, high-energy society faces the depletion and exhaustion of all the nonrenewable resources on which it has fed. Even if technology provides adequate substitute energy systems, high-energy society may deteriorate socially from inability to cope with affluence.

Environmental Pollution↗