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Biomedical subjects

B Cooper

Publications and source records attributed to B Cooper.

At least 217 records · Page 12Linked to original sources
PubMedDate not supplied

Medicare managed care: past, present, and future.

Medicare managed care enrollment has mushroomed in the past few years, tripling from 1993 to 1997. The payment rates have allowed plans to offer valuable extra benefits to beneficiaries at little or no additional cost; employers have provided inducements for their retirees to enroll; and many of the new Medicare beneficiaries are already in managed care plans when they enter the program. The Balanced Budget Act of 1997 and other factors could cause enrollment trends to change in either direction. More kinds of plans, including physician service organizations and preferred provider organizations, may be more attractive; new educational efforts may make more beneficiaries aware of managed care plans; and employers may continue to move their retirees into managed care. On the other hand, lower than expected Medicare payment rates to the plans may reduce the additional benefits they offer; consumer dissatisfaction with managed care is growing; and employers are dropping retiree benefits altogether. The future of Medicare managed care is hard to predict.

History, 20th Century↗
PubMedDate not supplied

Subthreshold affective disorders: a useful concept in psychiatric epidemiology?

OBJECTIVE: In recent years an extensive literature has grown up around the concepts of subthreshold, subsyndromal, minor and brief recurrent affective disorder and their applications in population-based research. The aim of this short review is to examine the definitions and current status of these proposed categories with special reference to depression, and to assess their potential contribution to psychiatric epidemiology. METHOD: A Medline search was carried out for the period 1965-1999, based on the above four terms. Relevant references found in all identified publications were also followed up. RESULTS: In great measure these constructs have been developed as a response to deficiencies in the DSM classification system and to a lesser extent in the ICD. The groups are all defined by having fewer criterial symptoms, or a shorter duration of symptoms, than the 'official' diagnostic categories. Use of these definitions has resulted in widely varying prevalence estimates. CONCLUSION: Improved methods are badly needed for classifying all those persons in the wider community who are in need of medical treatment and help for psychological disorder, but do not satisfy operational criteria laid down in the official guidelines. This cannot, however, be achieved simply by lowering operational thresholds in these systems. Further research on clinical and psycho-social characteristics of the common mental disorders is called for, and in many societies a favourable setting is that of primary health care, where a move towards pragmatic, comprehensive classification of community health problems is already under way.

Depressive Disorder↗
PubMedDate not supplied

Effects of spinal dorsal column transection on the response of monkey anterior parietal cortex to repetitive skin stimulation.

The pattern of 14C-2-deoxyglucose (2DG) labeling in anterior parietal cortex was evaluated in three groups of experimental subjects: (1) subjects in which all spinal pathways projecting at short latency to the contralateral hemisphere were intact, (2) subjects with either unilateral or bilateral transection of the dorsal column pathway, and (3) subjects in whom a two-stage tractotomy (dorsal column isolation) restricted short-latency mechanoreceptor drive to that conveyed via the dorsal column pathway. Macaca fascicularis and Macaca arctoides monkeys were studied. When the spinal cord pathways projecting at short latency to contralateral anterior parietal cortex were intact, controlled vibrotactile or skin brushing stimuli evoked one or, more rarely, several loci of maximal 2DG uptake (typically 1.5-2.5 mm in diameter) in the topographically appropriate location(s) within area 3b and/or area 1. The labeling at each locus of maximal 2DG uptake extended continuously across layers II-VI. Each locus of maximal 2DG uptake was bordered on one or more sides by irregularly shaped zones of below-background 2DG uptake that could extend without interruption from area 3b into area 3a, and/or from area 1 into area 2. In the absence of skin stimulation, little or no above-background 2DG uptake occurred at any locus within areas 3b and 1 of subjects in which the dorsal column pathway on the opposite side of the spinal cord was intact. In subjects with a complete transection of the spinal dorsal column the global 2DG pattern evoked by a repetitive skin stimulus in contralateral anterior parietal cortex was a near mirror image of the pattern evoked by the same stimulus in intact subjects. In the absence of the dorsal column path, neither 10-25 Hz vibrotactile nor brushing stimulation evoked above-background uptake at the topographically appropriate location(s) within contralateral area 3b and/or area 1. Instead, a prominent region of below-background 2DG uptake occupied the topographically appropriate location in area 3b and/or area 1, and the region of suppressed 2DG uptake was bounded by one or more regions of above-background 2DG uptake that extended from areas 3b or 1 into area 3a and/or into area 2. When a two-stage spinal tractotomy prevented stimulus-evoked short-latency input from reaching contralateral anterior parietal cortex via pathways other than the dorsal column, the 2DG activity patterns evoked in contralateral cortex by either brushing or vibrotactile stimuli were similar to the patterns obtained when the somatosensory pathways on the opposite side of the spinal cord were intact. A neural network model was developed to evaluate the hypothesis that the observed cortical effects of dorsal column transection might be attributable, at least in part, to inhibitory interactions among anterior parietal cortical regions that receive their principal input from different spinal cord pathways. The model incorporated known features of (1) the cortical projection of spinal somatosensory pathways, (2) anterior parietal intrinsic and long-distance horizontal connectivity, and (3) certain neurotransmitter/receptor systems characteristic of sensory neocortex. Simulations of the model network provided results consistent with the idea that repetitive skin stimuli evoke maladaptive, time-dependent corticocortical interactions within anterior parietal cortex contralateral to a dorsal column lesion. The observations indicate that corticocortical interactions account for the (1) near mirror-image pattern (relative to the normal Mexican hat-like pattern) of anterior parietal stimulus-evoked 2DG uptake observed in subjects with a dorsal column lesion, (2) unusual time-dependent response properties of individual area 3b and 1 neurons or neuron populations deprived of dorsal column input (Dreyer et al., 1974; Vierck et al., 1990a; Makous and Vierck, 1994), and (3) abnormal time-dependent characteristics of tactile perception in monkeys with dorsal colum

Acoustic Stimulation↗
PubMedDate not supplied

Neospora caninum infection in English Springer Spaniel littermates. Diagnostic evaluation and organism isolation.

Progressive paraparesis developed in four male English Springer Spaniel pups from a litter of five during the first 10 weeks of life. Two of the pups, which had the earliest onset of neurologic signs, were euthanatized without further workup. However, a detailed investigation was completed on the remaining two littermates at 12 weeks of age. Both pups had progressive paraparesis for 3 to 4 weeks before presentation, with one dog developing subsequent asymmetric pelvic limb extensor rigidity. Based on results from neurologic examination, cerebrospinal fluid (CSF) analysis, electrophysiology, and muscle/nerve biopsy, a presumptive diagnosis of protozoal polyradiculitis and polymyositis was made. Necropsy of the most severely affected pup confirmed the clinical diagnosis of inflammatory nerve root and muscle disease but no organisms were found. To increase the potential yield of organisms, the second pup was placed on immunosuppressive doses of corticosteroids and euthanatized 2 weeks later. Numerous organisms were found in lesions in muscle and the central nervous system. Organisms grew in tissue culture and were isolated from the peritoneal fluid of gerbils inoculated with infected tissue. Organisms were not isolated from inoculated mice, guinea pigs, rabbits, and hamsters. No parasites were seen in feces or tissues of three cats fed infected dog tissues. Serologic testing demonstrated a strong positive titer to Neospora caninum in both pups, and electron microscopy showed the characteristic morphology of this parasite.

Animals↗
PubMedDate not supplied

Cortical, subcortical, and brainstem dysfunction: a correlation in dyslexic children.

A group of dyslexic students was examined by a central auditory test (CAT) battery including competing sentences, binaural fusion, filtered speech, and compressed speech. Auditory evoked brainstem responses (BSER) were measured in conjunction with the CAT data. The auditory tests indicate a high degree of failure in those areas requiring sophisticated integration, coordination, and identification of the modified speech stimuli. The BSER did not identify a significant abnormality. The cortical and subcortical areas of integration are proposed as the multicentric sites of impairment in the hearing function found in dyslexic students.

Adolescent↗