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Biomedical subjects

C C Cook

Publications and source records attributed to C C Cook.

35 records · Page 2Linked to original sources
PubMed1988

Another trial that failed.

A double-blind comparison of clonidine and lofexidine in the management of the opioid withdrawal syndrome encountered several difficulties of a non-scientific nature which eventually forced termination of the trial. There were, for example, problems with research beds, self-discharges, staff attitudes, access to haematological monitoring, and worries about exposure to staff to human immunodeficiency virus. The trial collapsed when the manufacturers stopped making lofexidine on commercial grounds and the charitable foundation which was backing the trial withdrew its support. Some of the insecurities of medical research may have little to do with scientific merit.

Attitude of Health Personnel↗
PubMed1987

Syringe exchange.

Explore the source record for details and available documents.

Acquired Immunodeficiency Syndrome↗
PubMed1979

Effect of supplements on the nutrient intake of children.

Daily intakes of nutrients were calculated from records of food eaten at home, as school lunches, and morning milk, of boys and girls in second and sixth grades. Vitamin/mineral supplementations were also calculated. Comparisons were made (with and without supplementation) with the Recommended Dietary Allowances (RDAs). Analyses of variance between sexes and between grade levels showed second graders consumed better diets than sixth and boys better diets than girls. Although many received supplements, intakes of several nutrients were below the 67 per cent level. The milk program played a significant role in calcium consumption. Excessive amounts of vitamin A and ascorbic acid were consumed by some children.

Aging↗
PubMedDate not supplied

A survey of the current clinical practice of psychiatrists and accident and emergency specialists in the United Kingdom concerning vitamin supplementation for chronic alcohol misusers.

Although it is well known that B-vitamin deficiencies directly affecting the brain are common in alcohol misuse, no concise guidelines on the use of vitamin supplements in alcohol misusers currently exist in the UK. The purpose of this study was to assess current practice and opinion among UK physicians. Questionnaires were completed by a total of 427 physicians comprising Accident and Emergency (A&E) specialists and psychiatrists, with a response rate of 25%. The main findings were that vitamin deficiency was perceived as being uncommon amongst alcohol misusers (<25%) and there was no consensus as to which B vitamins are beneficial in treatment or the best method of administration of B-vitamin supplementation. The majority of psychiatrists favoured oral administration for prophylaxis against the Wernicke-Korsakoff syndrome in chronic alcohol misusers and parenteral therapy in patients with signs of Wernicke-Korsakoff syndrome. Whilst only just over half the A&E specialists expressed a preference, most favoured parenteral therapy in both cases. Most respondents did not currently have a unit policy/protocol on the management of vitamin supplementation in chronic alcohol misusers. Overall, the findings suggest that there is wide variation in current practice and highlight the need for guidelines in this area.

Administration, Oral↗
PubMedDate not supplied

Alcohol withdrawal and hypokalaemia: a case report.

A case is presented where a 25-year-old man developed a serious hypokalaemia (K(+) 2.2 mmol/l) during alcohol withdrawal, despite intravenous saline treatment and normal feeding. As hypokalaemia can be symptom-free, we want to draw attention to the combination of vomiting, malnutrition and alcohol withdrawal, as these can cause lethal complications. We therefore recommend that potassium serum level should be routinely monitored during alcohol withdrawal, even when this is being managed in the community.

Adult↗
PubMedDate not supplied

Prevention and treatment of Wernicke-Korsakoff syndrome.

Wernicke's encephalopathy (WE) is both common and associated with high morbidity and mortality and yet there is evidence that appropriate and effective prophylaxis and treatment are often not given. Effective treatment and prophylaxis may only be achieved by use of parenteral vitamin supplements, since oral supplements are not absorbed in significant amounts. Although there are rare anaphylactoid reactions associated with the use of parenteral thiamine preparations, the risks and consequences of inadequate prophylaxis and treatment, in appropriately targeted groups of patients, are far greater. It is therefore proposed that all in-patient alcohol withdrawal should be covered by prophylactic use of parenteral thiamine, that there should be a low threshold for making a presumptive diagnosis of WE, and that there is a need for guidelines to assist physicians in appropriate management of this common clinical problem.

Ambulatory Care↗
PubMedDate not supplied

Parenteral thiamine and Wernicke's encephalopathy: the balance of risks and perception of concern.

Wernicke's encephalopathy, a disorder with significant mortality and high morbidity, is common amongst alcohol-dependent patients. Thiamine deficiency appears to play a key role in its aetiology, and parenteral high-dose thiamine is effective in prophylaxis and treatment. Unfortunately, reports of rare anaphylactoid reactions have led to a dramatic reduction in the use of parenteral thiamine, and it is possible that this change in treatment has led, or will lead, to an increase in morbidity and mortality. There is a need for education of doctors who treat alcohol-dependent patients, in order to ensure appropriate use of parenteral thiamine in prophylaxis and treatment of this disorder.

Attitude of Health Personnel↗
PubMedDate not supplied

B Vitamin deficiency and neuropsychiatric syndromes in alcohol misuse.

Alcohol misuse and alcohol withdrawal are associated with a variety of neuropsychiatric syndromes, some of which are associated with significant morbidity and mortality. B vitamin deficiency is known to contribute to the aetiology of a number of these syndromes, and B vitamin supplementation thus plays a significant part in prophylaxis and treatment. In particular, the Wernicke Korsakoff syndrome (WKS). due to thiamine deficiency, is a common condition in association with alcohol misuse, and is associated with high morbidity and mortality. Nicotinamide deficiency may result in a rarer condition, alcoholic pellagra encephalopathy, which often has a similar clinical presentation to WKS. This review considers the role of B vitamins in the aetiology and treatment of neuropsychiatric syndromes associated with alcohol misuse, with particular emphasis on WKS.

Alcohol Amnestic Disorder↗