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Biomedical subjects

J Hamilton

Publications and source records attributed to J Hamilton.

At least 181 records · Page 10Linked to original sources
PubMed1984

Withdrawal phenomena in subjects with essential hypertension on clonidine or tiamenidine.

The incidence and pathogenesis of withdrawal phenomena with the centrally acting drugs clonidine (CLON) and tiamenidine (TIAM) were evaluated. Thirty subjects with hypertension on hydrochlorothiazide (HCTZ) were randomized to TIAM or CLON. Blood pressure and integrated plasma catecholamine levels fell equally in response to both drugs. On withdrawal, blood pressure and pulse rose in both groups with no difference between them. Three subjects had symptoms of withdrawal, four had blood pressure overshoot above pretreatment levels of 10 mm Hg or more, and eight had a rise in blood pressure of 30 mm Hg systolic or 20 mm Hg diastolic. There was no difference between TIAM and CLON in these effects. There was a direct correlation between blood pressure rise and increase in integrated plasma norepinephrine levels. We conclude that the incidence of withdrawal phenomena in subjects on TIAM or CLON is infrequent and that there is a direct relationship between the rise in blood pressure and the loss of suppression of catecholamines by these drugs.

Adult↗
PubMed1984

Analysis of emotional status during the hospital treatment of a borderline patient.

This single case study illustrates a methodology for identifying recurrent pathological emotional states in a hospitalized, borderline patient. Parallel therapeutic inputs are delineated and examined in terms of patient-specific responses. The results indicate that ratings of nursing notes recorded across three periods of hospitalization can reliably isolate the patient's most salient and debilitating emotional states. State-specific therapeutic interventions are extracted and their effectiveness noted. The analyses illustrate clinical phenomena which are congruent with what is known about borderline symptomatology. In addition, the study locates therapeutic errors which often occur when working with difficult patients.

Adult↗
PubMed1983

Presleep cognitions and attributions in sleep-onset insomnia.

This research examined the role of cognitive factors (attributions about the causes of sleep difficulties and presleep cognitive activity) in sleep-onset insomnia. Thirty-four subjects, including 13 mild to extreme insomniacs, were interviewed and then spent 5 consecutive nights in a sleep laboratory. In a multiple regression paradigm predictor measures included attribution ratings of sleep difficulty, perceived control of presleep cognitive content, and affect associated with presleep cognitions. Criterion measures included laboratory measured objectives and subjective sleep-onset latency, a score presenting the difference between objective and subjective laboratory measures of sleep-onset latency, interview-measured subjective sleep-onset latency, and degree of overall concern and presleep concern about initiating sleep. The results of multiple regression analyses suggested that the content of presleep cognitions and the attributions of sleep difficulties were significantly associated with several subjective measures of sleep-onset latency or concern with initiating sleep. None of the predictor measures was significantly associated with objectively measured sleep-onset latency. Implications for cognitive theories of sleep-onset insomnia and for the psychophysiologic-subjective dimension of insomnia are discussed.

Adolescent↗
PubMed1983

Cardiac arrhythmias after abrupt clonidine withdrawal.

Abrupt clonidine withdrawal may be associated with sharp marked increases in catecholamine levels, heart rate, and blood pressure, which may induce nausea, vomiting, and palpitations. Relatively little information is available on the incidence of cardiac arrhythmias in this setting. With continuous ambulatory ECG recordings, we determined the incidence of arrhythmias in seven male hypertensive patients (without active heart disease) after abrupt clonidine withdrawal. Serious ventricular arrhythmias, including brief ventricular tachycardia, developed in two patients who had greater increases in mean systolic blood pressure (28 +/- 3 vs 10 +/- 8 mm Hg) and double product (552 +/- 681 vs 333 +/- 195) than the others. The differences were not significant. Ventricular arrhythmias were not related to age, dose, withdrawal symptoms, initial blood pressure, urinary norepinephrine levels, or ECG abnormalities. We conclude that serious ventricular arrhythmias may be relatively common but unpredictable during clonidine withdrawal, even in patients with no clinically apparent heart disease. The triggering of ventricular arrhythmias should be added to the list of components of clonidine withdrawal syndrome.

Adult↗
PubMed1983

Group meetings for parents in a children's burns unit.

Thermal injuries in childhood occur mainly in the first three years of life and often lead to hospital admission: most are due to scalds in the home. The distress and anxiety of parents bears on the management of the young sick child in hospital, on his subsequent recovery at home and on the welfare of the whole family. To help parents, a weekly meeting was held with a small group of staff in the Burns Unit at which there was free and open discussion of all problems and worries connected with the child's accident. This paper describes the working of the group and the contribution it made to the care of 149 children admitted with burns and scalds during one year.

Burn Units↗
PubMed1982

Pulmonary function in hypertensive patients treated with pindolol: a report of two studies.

Pulmonary function was measured serially in two separate randomized trials of pindolol in the treatment of essential hypertension. Patients with overt obstructive airways disease were excluded. In study 1, 131 hypertensive patients were randomized to placebo (31) and 15 mg (33), 30 mg (33), and 60 mg (34) of pindolol. Pulmonary function was measured before and at weeks 8 and 15 of active medication. Bronchospasm--a 20% increase in forced expiratory volume in 1 second (FEV1) after isoprenaline--developed in three patients on active treatment and one on placebo. In eight patients on pindolol and one on placebo, bronchospasm ceased. Compared to placebo, no deterioration in pulmonary function occurred with pindolol and in three tests--maximum voluntary ventilation (MVV) (L/min), MVV%, midexpiratory flow rate (MEFR) (L/min)--significant improvement occurred. In study 2, 14 hypertensive patients were randomized to pindolol (mean dose 50 mg/day), 15 to propranolol (mean 360 mg/day), and 14 to chlorthalidone (mean 107 mg/day). Pulmonary function was measured after 3 weeks of placebo and again after 6 weeks of active treatment. While propranolol produced slight deterioration in pulmonary function, pindolol and chlorthalidone produced slight but significant improvement (p less than 0.05) with maximum MEFR (L/sec). Pulmonary function tests measured after isoprenaline were significantly worse in patients on propranolol compared to those on placebo, but were unchanged in patients on pindolol or chlorthalidone. The conclusions are: (1) Pindolol in antihypertensive doses does not produce airways obstruction and some improvement in pulmonary function may occur. (2) In comparable doses, pindolol has a positive effect on pulmonary function and propranolol a negative effect which, when summated, is statistically significant. (3) Propranolol, but not pindolol, appears to block the bronchodilator effects of isoprenaline. The lack of pulmonary function impairment may be due to intrinsic sympathomimetic activity properties of pindolol.

Chlorthalidone↗