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Biomedical subjects

J Webster

Publications and source records attributed to J Webster.

At least 271 records · Page 15Linked to original sources
PubMed1983

The prediction of choice in infant feeding: a study of primiparae.

A random sample of 617 white Caucasian primiparae was identified from notifications made to the Leeds Area Health Authority over a 12-month period. Of these, 534 were interviewed regarding personal characteristics, events during pregnancy, and their experience of infant feeding. Significant associations between these factors and the mode of infant feeding initially used are described.From discriminant analysis of two half-populations, weightings were derived for each significantly associated variable, and discriminant scores were calculated for each participant. The distributions of these scores were similar in both half-populations, suggesting that the weightings were stable and thus have potential predictive importance. Further analysis showed that, from all the significant variables, the choice of two (maternal age-group at confinement and age at leaving school) correctly predicted 79 per cent of mothers who will choose to bottle-feed. The potential clinical yield of using these two factors is discussed, and a simple predictive tool for use in everyday practice is presented.

Adult↗
PubMed1982

Atenolol and metoprolol once daily in hypertension.

The effect of once-daily dosage of the two most widely prescribed cardioselective beta-adrenoceptor antagonists used to treat hypertension--namely, atenolol and metoprolol--was studied in nine carefully selected hypertensive outpatients. Each patient received atenolol 50 mg/day, atenolol 100 mg/day, metoprolol 100 mg/day, and metoprolol 200 mg/day in a sustained-release formulation (as Lopresor SR) according to a randomised sequence. After three weeks' treatment with each drug given once daily comparisons of the treatments 24 hours after dosing showed no important differences between 50 and 100 mg atenolol/day. Metoprolol, as both the standard and the slow-release formulations, had some limitations in controlling systolic blood pressure and heart rate. These results suggest that the recommendations for the treatment of hypertension with these cardioselective beta-adrenoceptor antagonists should be reconsidered since doses smaller than those recommended are almost as effective and much cheaper.

Adult↗
PubMed1982

An instrument to measure nurses' knowledge of behavioral methods with chronic pain patients.

A 32-item multiple-choice questionnaire is described to assess nurses' knowledge of behavioral methods with chronic pain patients. The instrument was designed to assess knowledge across four areas: (a) behavioral principles, terms, and facts about pain patients, (b) application of behavioral methods to decrease negative pain behavior, (c) application of behavioral methods to increase positive well behavior, and (d) when, and with which pain patients to apply behavioral methods. Factor analyses identified two basic factors measured by the instrument. These included general knowledge of behavioral methods with chronic pain patients and the ability to differentially apply these methods in various medical circumstances. Further analysis revealed that the instrument contained adequate internal consistency, reliability and validity.

Behavior Therapy↗
PubMed1981

Progressive and self-induced relaxation training: their relative effects on subjective and autonomic arousal to fearful stimuli.

Compared progressive relaxation training (PRT), self-induced relaxation training (SRT), and a rest quietly (RQ) control condition on measures of tonic physiological arousal and phasic physiological and subjective reactions to fearful stimuli. The Mutilation Anxiety Questionnaire was used to identify 48 male and female participants for the two training assessment sessions. Evaluation of tonic reductions in sympathetic arousal indicated: In session one, PRT and SRT were equivalent; in session two, PRT was superior to SRT. Evaluation of subjective response to fearful stimuli favored PRT/SRT over RQ for low, moderately stressful stimuli; PRT was superior to SRT for the most stressful stimuli. An analysis of reported practice between sessions indicated a negative relationship between practice of relaxation skills and response to stressful tonic physiological arousal and attenuating subjective response to stressful stimuli. The interaction between the cognitive and physiological systems and its implication for therapy are discussed.

Adult↗
PubMed1981

Forearm ischaemia as a test of prostacyclin production: studies in normal subjects and in patients with diabetes mellitus.

Plasma levels of 6-oxo-PGF1 alpha, the hydrolysis product of prostacyclin, were significantly reduced in men with proliferative diabetic retinopathy, compared with normal controls. Male diabetics with background or no retinopathy formed an intermediate group with plasma levels of 6-oxo-PGF1 alpha lower than controls and higher than patients with proliferative retinopathy. Forearm ischaemia increased plasma levels of 6-oxo-PGF1 alpha by 30% in normal subjects. The increase occurred during arterial occlusion and was diminished by pretreatment with aspirin. The increase after ischaemia may reflect increased prostacyclin production. In diabetic patients forearm ischaemia produced an increase in plasma 6-oxo-PGF1 alpha similar to that seen in control subjects.

6-Ketoprostaglandin F1 alpha↗
PubMed1981

Cimetidine-a clinical and pharmacokinetic study.

1 The effect of six months therapy with cimetidine (800 mg or 1600 mg/day) and subsequent withdrawal was studied in 19 patients with duodenal ulceration. 2 The overall rates of healing were 63% and 79% of patients after 3 and after 6 months of treatment respectively. The longer course (6 months) or the higher dose (1600 mg) did not result in significantly increased rates of ulcer healing. 3 Abrupt withdrawal of cimetidine resulted in the recurrence of severe symptoms in 15 patients (79%). 4 Pharmacokinetic studies showed the mean elimination half-life of cimetidine to be 100 +/- 25 min, the total body cimetidine clearance 652 +/- 223 ml/min, the mean volume of distribution at steady state 65 +/- 181 and the overall bioavailability 78%. 5 Long term cimetidine treatment does not result in drug accumulation or changes in its pharmacokinetic profile. 6 Inter-individual differences in clinical and endoscopic response to cimetidine cannot be explained by pharmacokinetic differences.

Cimetidine↗
PubMed1981

Withdrawal of long-term therapy with atenolol in hypertensive patients.

1 The offset of effects on blood pressure and heart rate after cessation of long-term therapy (19 +/- 3.6 months) with atenolol (200 mg once/daily) was studied in six hypertensive patients. 2 Withdrawal of atenolol resulted in a gradual return of lying, standing and post-exercise systolic and diastolic blood pressure levels and heart rate towards the baseline value. The offset of effect greatly exceeded the time for elimination of atenolol. 3 No significant differences in the pharmacokinetic profile of atenolol were evident between the values obtained following chronic dosing and an acute single-dose study. 4 The lack of clinical evidence of increased cardiac adrenergic sensitivity or rebound hypertension following withdrawal of atenolol contrasts with reports of a withdrawal syndrome following cessation of therapy with propranolol. Nevertheless until the mechanism of the propranolol-withdrawal syndrome is better understood caution is required when stopped therapy with atenolol in patients with severe coronary artery disease.

Adult↗
PubMed1980

Attenuation of hypotensive effect of propranolol and thiazide diuretics by indomethacin.

The effects of 100 mg indomethacin daily for three weeks on blood pressure and urinary excretion of prostaglandin F2 alpha were studied in a double-blind, placebo-controlled comparison of two groups of patients with essential hypertension, eight receiving propranolol and seven thiazide diuretics. Compared with placebo, adding indomethacin to the patients' established antihypertensive treatment increased blood pressure by 14/5 Hg supine and 16/9 mm Hg erect in the patients receiving propranolol, and by 13/9 mm Hg supine and 16/9 mm Hg erect in the patients receiving thiazide diuretics (all p less than or equal to 0.05). The excretion of the major urinary metabolite of prostaglandin F2 alpha was reduced by 67% in the propranolol-treated patients and by 57% in those receiving a thiazide diuretic. Body weight increased by 0 . 8 kg (propranolol) and 1 . 1 kg (thiazide diuretic) when indomethacin was given, but there were no significant changes in creatinine clearance, urinary sodium excretion, or packed cell volume in either treatment group. These results suggest that products formed by the arachidonic acid cyclo-oxygenase contribute to the regulation of blood pressure during treatment with both propranolol and thiazide diuretics. Inhibition of the cyclo-oxygenase with indomethacin partially antagonises the hypotensive effect of these drugs.

Adult↗
PubMed1980

Atenolol, sustained-release oxprenolol, and long-acting propranolol in hypertension.

The effect of once-daily atenolol, sustained-release oxprenolol (a new formulation of oxprenolol presented as a compressed tablet in a waxed matrix), and long-acting propranolol (a new formulation presented as spheriods in a capsule) was studied in a double-blind crossover trial in 23 carefully selected hypertensive outpatients. After a run-in period with matching placebo each patient received atenolol (100 mg/day), sustained-release oxprenolol (160 mg/day), long-acting propranolol (160 mg/day), and placebo according to a randomised sequence. After four weeks' treatment with sustained-release oxprenolol blood pressure in the two to four hours before the next dose was not significantly lower than after placebo. The effectiveness of atenolol and of the new formulation of propranolol in reducing blood pressure was confirmed. These results suggest that the present formulation of sustained-release oxprenolol should be reconsidered.

Adult↗
PubMed1980

Antihypertensive action of bendroflumethiazide: increased prostacyclin production?

A within-patient randomized, double-blind, crossover study was performed to investigate mechanisms of action of bendroflumethiazide in mild essential hypertension. Significant reductions in lying, standing, and postexercise blood pressure were seen after both 3 days and 10 wk treatment with bendroflumethiazide 10 mg daily. Plasma levels of 6-oxo-PGF1 alpha, the chemical hydrolysis product of prostacyclin, were increased by both 3 days and 10 wk therapy with bendroflumethiazide. This raises the possibility that thiazides may reduce peripheral resistance by increasing prostacyclin biosynthesis.

Adult↗
PubMed1980

Circulating prostacyclin concentrations may be increased by bendrofluazide in patients with essential hypertension.

1. A within-patient randomized double-blind crossover study was performed on mechanisms of action of bendrofluazide in mild essential hypertension. Significant reductions in lying, standing and post-exercise blood pressure were seen after both 3 days and 10 weeks treatment with bendrofluazide (10 mg daily). 2. Plasma levels of 6-oxo-prostaglandin F1 alpha, the chemical hydrolysis product of prostacyclin, were significantly increased by both 3 days and 10 weeks therapy with bendrofluazide. This raises the possibility that thiazides may reduce peripheral resistance by increasing prostacyclin biosynthesis.

Bendroflumethiazide↗