PubMed Health⌕ Search

Biomedical subjects

J Cookson

Publications and source records attributed to J Cookson.

35 records · Page 2Linked to original sources
PubMed1992

Carbamazepine versus lithium in the prophylaxis of bipolar affective disorder.

A 12-month double-blind trial of carbamazepine vs lithium, given as sole treatment for the prophylaxis of bipolar affective disorder, was carried out in 31 patients. All were previously stable on lithium; 15 were switched over to carbamazepine and 16 remained on lithium. Although the overall relapse rate was similar in the 2 groups (6 on carbamazepine, 8 on lithium), nearly all the relapses in carbamazepine occurred in the first month, probably precipitated by lithium withdrawal. Two patients on carbamazepine developed a rash and were withdrawn. More side effects were noted during the early stages on carbamazepine. Patients on lithium tended to gain weight (+4 kg) compared with carbamazepine (-3.1 kg). It is concluded that carbamazepine is as effective as lithium in the prophylaxis of bipolar affective disorder; changeover from lithium to carbamazepine should be done slowly.

Adult↗
PubMed1990

A database tool for centralized analysis of untoward health care events.

Most risk management systems are designed to identify the "who," "what," and "where" of untoward health care events. This approach fails to identify the root causes, the "how" and "why." These are likely to appear only when aggregated around a high risk "what"; they are actually more prevalent than the data would indicate. This paper describes a system that focuses on the early identification of trends and patterns in the "how" and "why" of untoward events. Awareness of these can provide a basis for improved clinical practice and professional risk avoidance, before intersection with a high risk "what" produces an untoward medical event.

Hospitals, Military↗
PubMed1989

Carbamazepine compared to haloperidol in acute mania.

In a double-blind, between-patient clinical trial carbamazepine (CBZ) (n = 8) was compared to haloperidol (HP) (n = 9) in patients presenting with mania (DSM III). Seven patients on HP and 2 on CBZ failed to complete 4 weeks treatment. In 4 of the HP group this was because of extrapyramidal side-effects (EPS). Two patients on CBZ and 2 on HP were withdrawn because of lack of efficacy. Statistically significant clinical improvement was seen in both groups within the first 2 weeks of treatment with HP acting more quickly. In addition to EPS which occurred in HP patients, drowsiness was experienced in 4 on CBZ and 3 on HP, and gastrointestinal symptoms in 3 on CBZ. No serious haematological changes, nor abnormalities in clinical chemistry occurred in either group. We conclude that CBZ appears to be a potentially useful drug in the treatment of acute mania.

Acute Disease↗
PubMed1988

Predictions of linear T-cell and B-cell epitopes in proteins encoded by HIV-1, HIV-2 and SIVMAC and the conservation of these sites between strains.

An important consideration in the design of vaccines to prevent HIV-1 infection effective against different strains is the amino acid sequence conservation of antigenic determinants. Even one amino acid change can destroy the antigenicity of a site for the antibody or T-cell receptor. The comparisons of predicted T- and B-cell epitopes between human HIV-1, HIV-2 and monkey SIVMAC AIDS viruses are presented. The three major gene products (env, gag and pol) were examined. A number of epitopes were identical between strains of HIV-1. Our analysis highlights the problem of designing an effective HIV-1 and HIV-2 vaccine and also the problem of testing human vaccines in monkey models.

Amino Acid Sequence↗
PubMed1987

Prediction of antigenic determinants and secondary structures of the major AIDS virus proteins.

Criteria for the design of peptide vaccines to prevent AIDS are presented. The best vaccine candidates contain both B and T lymphocyte-defined epitopes in regions conserved in sequence between viral isolates. We propose that attention should focus on proteins specified by the gag and, possibly, pol genes in addition to the env gene envelope glycoproteins being actively studied. The predictions of B- and T-epitopes are refined by consideration of secondary structure prediction and inter-isolate sequence variability to suggest peptides from env, gag and pol that would be the best vaccine candidates.

Amino Acid Sequence↗
PubMed1987

The development of new drugs for the treatment of schizophrenia.

Currently available anti-psychotic drugs owe much of their efficacy in schizophrenia to their ability to block dopamine receptors in specific areas of the brain. This article reviews the mechanisms action and side effects of drugs used for schizophrenia, and describes approaches to the development of new treatments.

Animals↗
PubMed1986

The effects of methylamphetamine on mood and appetite in depressed patients: a placebo-controlled study.

Methylamphetamine given intravenously as a single 15 mg dose led to a pronounced elevation of mood in 7 out of 21 depressed patients compared to a control injection of sterile water administered on another occasion in random order under double-blind conditions. All 7 responders experienced an increase of VAS self-ratings of hunger in contrast to what has been observed in normal subjects who show a decrease in hunger after amphetamine. The implications of these findings are discussed in the light of monoamine theories of depression and appetite control.

Adult↗
PubMed1986

Inhibitory actions of loperamide on absorptive processes in rat small intestine.

Mucosal loperamide caused a dose dependent reduction in the absorption of actively transported hexoses and amino acids, together with the associated rise in short circuit current. Na+ and fluid movement were also inhibited. Serosal application of the drug was without effect on these processes. The passive movement of fructose across the gut was not affected by loperamide which is therefore unlikely to act by reducing tissue permeability. In low Na+ conditions the inhibitory actions of loperamide on glycine absorption were reduced. Loperamide reduced basal Na+ transport although it did not affect the stimulation of Na+ absorption caused by mannose. Loperamide had no effect on the total ATPase activity nor on the Na+, K+-ATPase activity of mucosal homogenates. The effects of loperamide were not mimicked by morphine nor were they antagonised by naloxone and hence do not seem to involve an opiate receptor. It is concluded that loperamide exerts its inhibitory effects by an interaction with the Na+ sites of the nutrient carriers.

Animals↗
PubMed1984

The relationship of dopamine receptor blockade to clinical response in schizophrenic patients treated with pimozide or haloperidol.

Pimozide and haloperidol were found to be equally effective in the treatment of acute schizophrenia in a double-blind clinical trial involving 22 patients. Drug plasma levels measured by radioimmunoassay (RIA) did not correlate with clinical response following either drug. Nor was there any correlation between clinical response and the dopamine receptor blocking activity of either drug as measured by radio receptor assay (RRA). Following pimozide plasma prolactin (PRL) levels correlated with clinical change, although the time courses of response of PRL and clinical response were dissimilar. There was no correlation between PRL and clinical response to haloperidol. RRA and RIA values correlated highly following pimozide but not haloperidol. Our findings lead us to conclude that the RRA technique reflects the plasma level of a drug rather than its central dopamine blocking activity. We also consider that the clinical response to antipsychotic drugs in schizophrenia may be less directly linked to dopamine receptor blockade than has previously been supposed.

Acute Disease↗
PubMed1981

Double-blind comparative clinical trial of pimozide and chlorpromazine in mania. A test of the dopamine hypothesis.

Pimozide (PMZ), a relatively specific dopamine (DA) receptor blocking drug, was compared to chlorpromazine (CPZ) in a double-blind, between-patient clinical trial in mania. The trial lasted 14 days. Twenty-three patients who fulfilled Feighner's criteria for mania entered the trial (one patient entering on two separate occasions). Both drugs led to clinical improvement, with a significant effect being noted within 24 hours. According to one of the two rating scales used, initial improvement was greater with chlorpromazine, probably due to its greater sedative effect. By 7 days both drugs were equally effective. Sedative side effects were more frequent in patients on CPZ; extrapyramidal side effects were more frequent with PMZ. The finding that the relatively specific DA receptor blocking drug PMZ was as effective as CPZ in the treatment of mania is consistent with the view that hyperactivity of central DA pathways is involved in the pathogenesis of this condition.

Adult↗