Physiological processes and dynamics in the disposition of small and large doses of biologically active and inactive 131-I-insulins in the rat.
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Biomedical subjects
Publications and source records attributed to J L Izzo.
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OBJECTIVE: The purpose of this study was to determine whether cognitive appraisals of stress level and hypertensive responses to ambulatory ophthalmic surgery can be ameliorated by patient-selected music. METHODS: We studied 40 elderly individuals requiring ophthalmic surgery, 20 in an experimental group (mean age, 74 years) and 20 in a control group (mean age, 77 years). All patients had an established resting blood pressure <140/90 mm Hg. In the experimental group self-selected music was provided by headphones throughout the preoperative, surgical, and postoperative periods. In the control group patients had neither headphones nor music. All patients received similar (weight-determined) doses of alfentanil and midazolam during surgery. Heart rate, blood pressure, and patient-reported stress and coping levels were the dependent variables. RESULTS: In both groups, blood pressure values were normal (approximately 129/82 mm Hg) during screening examinations 1 week before surgery. On the day of surgery both groups displayed increased preoperative blood pressures (approximately 159/92 mm Hg) associated with increases in heart rate (by approximately 17 beats/min). Intraoperative blood pressures in the experimental group returned quickly to screening baseline values, whereas the control group experienced persistent elevations in intraoperative blood pressure similar to preoperative levels. Over the course of the surgical experience, patients with music reported significant reductions in perceived stress and increases in coping abilities (p < .001), whereas those without music did not. CONCLUSIONS: The perceived stress of ambulatory surgery in geriatric patients is associated with a clinical hypertensive response that is ameliorated by self-selected perioperative music, which also decreases perceived stress and increases patients' sense of personal control and well-being.
Hypertension is a syndrome in which dysfunction of the blood vessels and of neuroendocrine systems play a major role. Arteriosclerosis and atherosclerosis are distinct processes in arterial disease. Arteriosclerosis begins with thickening and hardening of the arterial wall, with loss of elasticity. Atherosclerosis is an inflammatory process that begins with endothelial dysfunction, and leads to vascular occlusion. The endothelial dysfunction that causes atherosclerosis and coronary artery disease results from an imbalance between nitric oxide and angiotensin-II. This balance becomes tipped toward angiotensin-II in the presence of hypertension. When arteries stiffen as a result of hypertension and aging, they are not able to store blood volume properly, systolic blood pressure rises, and pulse pressure widens. Because the tissue renin-angiotensin system is responsible for promoting the adverse structural arterial changes, inhibition of angiotensin-converting enzyme (ACE) is effective in restoring the health of both large and small arteries by blocking angiotensin and by increasing bradykinin.
The effects of isradipine 2.5 mg and 5 mg on the disposition of theophylline were investigated in a placebo-controlled, randomized, three-way, crossover trial. Eleven healthy, nonsmoking men each received a treatment of placebo, and isradipine 2.5 mg and 5 mg every 12 hours for 6 consecutive days. On the morning of day 6, 2 hours after the isradipine dose, theophylline (solution) 5.0 mg/kg was administered orally, and blood samples were collected over 24 hours. A 2-week washout period separated treatment sequences. Plasma samples were analyzed for theophylline using high-performance liquid chromatography. Using a two-way analysis of variance, no significant changes in apparent theophylline clearance were observed between placebo, and isradipine 2.5 and 5 mg (0.815 +/- 0.164, 0.870 +/- 0.212, and 0.827 +/- 0.164 ml/min/kg, respectively; p = 0.136). Similarly, no significant change in volume of distribution was noted. These findings suggest that isradipine at recommended dosages does not impair theophylline metabolism.