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Biomedical subjects

C C Cook

Publications and source records attributed to C C Cook.

At least 19 recordsLinked to original sources
PubMed2001

Selecting patients for combined femorofemoral bypass grafting and iliac balloon angioplasty and stenting for bilateral iliac disease.

PURPOSE: This study examines the selection of patients for combined femorofemoral bypass (FFB) grafting and iliac balloon angioplasty (IBA) and stenting for bilateral iliac occlusive disease (successively or simultaneously) and the correlation of the length and location of stenoses of the donor iliac artery to the success of FFB grafts. METHODS: Forty-one patients with long iliac occlusion and significant contralateral iliac stenosis were treated with combined FFB grafting and IBA and stenting, which were performed simultaneously or percutaneously within 1 to 2 days before surgery. Stenting was performed for suboptimal IBAs. IBA/graft patency was evaluated by duplex scanning/ankle-brachial index at 1, 3, 6, and 12 months and every 12 months thereafter. A life-table analysis of patency was performed, according to the length of stenosis as classified by the Society of Cardiovascular Interventional Radiology (group A, < 3 cm and 3-5 cm; group B, > 5 cm). RESULTS: Indications for surgery were limb salvage (22%), rest pain (44%), and claudication (34%). The mean follow-up time was 34.1 months. Perioperative complications were 7% for group A versus 62% for group B (P = .0007) with no perioperative deaths or amputations. Stenting was needed in 12 of 13 patients (92%) in group B versus four of 28 patients (14%) in group A (P < .0001) and in 11 of 12 external iliac artery lesions versus five of 29 common iliac artery lesions (P < .0001). The overall early success rate was 100% for group A and 62% for group B (P = .0028). The primary patency rates at 1, 2, and 3 years were 96%, 85%, and 85% for group A, respectively, and for group B were 46%, 46%, and 31%, respectively (P < .01). The secondary patency rates for group A at 1, 2, and 3 years were 100%, 96%, and 87%, respectively; and for group B were 62%, 54%, and 27%, respectively (P < .001). The overall primary and secondary patency rates for common iliac and external iliac artery lesions were similar (72% and 72% versus 67% and 75%, respectively). The overall limb salvage rates were 96% for group A and 85% for group B. Seven of 13 patients (54%) of group B, in contrast with 0 of 28 patients in group A, had to undergo a revision of the procedure within 30 days (P < .01). CONCLUSION: Combined use of IBA and stenting and FFB grafting is effective and durable and can be performed simultaneously, if the donor iliac stenosis length is 5 cm or less. Percutaneous transluminal angioplasty/stenting of stenoses of 5 cm or more fail to support FFB grafting in most patients; therefore, their combination should be questioned.

Aged↗
PubMed1999

Psychiatric aspects of alcohol misuse.

Alcohol and psychiatric disorder have a complicated relationship. Certain important psychiatric syndromes arise from the toxic effects of alcohol and thiamine deficiency. Liver disease and hypoglycaemia are also associated with their own psychiatric syndromes. Many psychiatric patients also turn to alcohol as an easily available 'medication'.

Alcohol Amnestic Disorder↗
PubMed1997

Knowledge and experience of drug use amongst church affiliated young people.

A large and growing proportion of young people in the UK are using drugs. Research from the US suggests a protective effect of church affiliation or 'religiosity', but this has not been investigated in British young people. In the present study, the prevalence of drug use was estimated amongst 7666 church affiliated young people in the UK in 1995, using a self report questionnaire survey. In the 12-16 year old age group, 23.4% had been offered at least one of a list of drugs, and 9.7% had tried such drugs. In those aged 17-30 years the figures were 46.1% and 23.3%, respectively. These figures are perhaps slightly less than, those obtained in secular surveys. Those who gave more positive responses to questions on Christian commitment were less likely to have been offered any of the listed drugs, or to have used them, as compared with those who gave no such responses. A lifetime history of ever having smoked demonstrated a far stronger association, with smokers being 15-20 times more likely to have used one of the listed drugs.

Adolescent↗
PubMed1997

The efficacy of disulfiram: a review of outcome studies.

Twenty-four studies of outcome following oral disulfiram and 14 following implanted disulfiram were identified for review from MEDLINE and PsycINFO databases and by manual searching for the period 1967-95. The methodological rigour of these studies was generally poor, albeit not as poor as that of earlier studies (not reviewed here). An overall assessment of the results of research in this field is hampered by the diversity of both the methods used and the subject populations studied. However, it is clear that support for the general use of oral disulfiram is equivocal, mostly being found in the form of reduced quantity of alcohol consumed and a reduced number of drinking days. Evidence for an effect in increasing the proportion of patients who achieve abstinence is surprisingly lacking. Where it is prescribed, disulfiram use should be supervised and it should be employed as one part of a comprehensive treatment programme. There is no good evidence in favour of implanting disulfiram tablets, but the possibility of a depot injection is intriguing.

Administration, Oral↗
PubMed1997

Alcohol and aviation.

Aviation accidents due to alcohol consumption by aircrew appear to be rare, especially in commercial aviation. However, a small proportion of general aviation accidents are attributable to alcohol use by aircrew, and aircrew are not well informed about the metabolism of alcohol and its effects on performance. Furthermore, there is evidence that aircrew performance may be impaired by alcohol consumption even after their Blood Alcohol Concentration has returned to "zero" (i.e. < 5 mg/dl). Accidents caused by impairment of aircrew performance by alcohol may therefore not be attributed to alcohol use at all. Aviation safety relies upon faultless human performance and is thus highly sensitive to alcohol-related impairment of performance. This paper provides a review of research regarding aircrew alcohol consumption, impairment of aircrew performance by alcohol, incidence of aviation accidents attributable to alcohol use by aircrew, and other related subjects.

Accidents, Aviation↗
PubMed1997

Alcohol policy and aviation safety.

Aviation provides an environment which is almost uniquely unforgiving of mistakes. Accordingly, impairment of aircrew performance by alcohol can, and occasionally does, lead to catastrophic mistakes. That such disasters are rare, is a credit to the responsibility of aircrew themselves and to the effectiveness of aviation industry policies. Similarly, maintenance of this exemplary record depends upon continued attention to alcohol policy in the future. The aviation industry thus provides a useful model for the study of alcohol policies within a safety critical environment. Surprisingly, this model appears not to have been subjected to critical research and evaluation. Based upon previous research on alcohol and aviation, and in consideration of findings from the wider field of alcohol policy, suggestions are made here as to a promising framework for future alcohol policy formation in the aviation environment.

Aerospace Medicine↗
PubMed1996

A genetic linkage study of the D2 dopamine receptor locus in heavy drinking and alcoholism.

BACKGROUND: Reports of an association between restriction fragment length polymorphisms (RFLPs) at the dopamine D2 receptor (DRD2) locus and alcoholism have suggested involvement of that locus in the aetiology of alcoholism. METHOD: Sib pair linkage analyses were conducted in families multiply affected by alcoholism, using both the Taql 'A' RFLP and a microsatellite repeat polymorphism at the DRD2 locus. RESULTS: The 'Identical By Descent' analysis provided significant evidence of an effect of the DRD2 locus on the liability to develop heavy drinking (P < 0.0016) and Research Diagnostic Criteria alcoholism (P < 0.0003) in the first sample of families studied. However, this result was explicable by the segregation of alleles in a single large sibship, and it was not replicated in a second sample of families. CONCLUSIONS: The results do not support linkage between the DRD2 locus and alcoholism in most of the families studied. It remains possible that this locus influences the predisposition to alcoholism in some families.

Alcoholism↗
PubMed1994

Quantitative analysis of a drug in an animal feed employing sample preparation by supercritical fluid extraction.

A pharmaceutical agent has been quantified in a rat feed matrix wherein sample preparation was achieved by supercritical fluid extraction. Spiking levels ranged from 0.0335% to 1.12%. Pure carbon dioxide, solid phase trapping on stainless steel with acetonitrile and liquid chromatographic assay yielded recoveries greater than 90% with relative standard deviations less than 5% in all cases except for the lowest spiking level. In this case recovery was 89.6% with an RSD of 9.6.

Animal Feed↗
PubMed1994

The D2 dopamine receptor gene and alcoholism: a genetic effect in the liability for alcoholism.

Three of five recent association studies have demonstrated an increased frequency of the A1 allele of the TaqI Restriction Fragment Length Polymorphism (RFLP) of the DRD2 locus in alcoholics compared to controls. One of three family studies has shown preliminary results in favour of linkage of this locus with alcoholism and heavy drinking. The possible mechanism of a genetic effect of the DRD2 locus in alcoholism remains open to speculation, but many involve personality characteristics such as impulsiveness or spontaneity. The applications of the findings of research in this field offer much potential for the prevention and treatment of alcoholism, but also raise certain ethical issues when applied to screening programmes. Future research will be assisted by the development of new, and more informative, genetic markers which are now available at this locus.

Alcoholism↗
PubMed1991

Trace element and vitamin deficiency in alcoholic and control subjects.

A wide range of trace elements and vitamins was studied in alcoholic patients admitted for detoxification and in healthy controls. Alcoholic subjects were found to be deficient relative to controls in magnesium and vitamin E, while a relative excess of serum iron and copper, and sweat nickel, was noted. A surprisingly wide range of deficiencies, as compared with standard laboratory ranges, was seen in the control group. This finding emphasizes the need for adequate control groups in nutritional studies of alcoholism, the insufficiency of an adequate diet alone to guarantee adequate nutrition, and the likely high prevalence of undetected nutritional deficiency in the general population. Further research is required on the clinical benefits of nutritional supplementation as part of the treatment of alcoholism, and the value of conventional supplements as a routine treatment is questioned.

Adult↗
PubMed1991

Problem drinking and family history.

Data on SADQ, GHQ, disciplinary, financial and relationship problems were collected from 103 problem drinkers and 96 controls. Problem drinkers were significantly more severely affected than controls on all measures except financial problems. Of the problem drinkers, 55% had a positive family history, and this group were more severely affected on SADQ, GHQ and financial problem measures than family history negative subjects. The most severely affected group were those with a positive family history who also reported significant childhood problems, and the least affected were those without a family history who did not report significant childhood problems.

Alcoholism↗