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Biomedical subjects

C Cooper

Publications and source records attributed to C Cooper.

At least 523 records · Page 29Linked to original sources
PubMed1986

Bacterial arthritis in the elderly.

The clinical and microbiological features of bacterial arthritis in 21 elderly patients presenting to hospitals in an English health district over the decade 1973-1982 are reviewed. Differences from bacterial arthritis in younger patients include the high prevalence (71%) of underlying joint disease, infections more commonly affecting the hip (38%), absence of constitutional features of toxaemia and delay in diagnosis. Outcome in elderly patients is markedly worse, with an appreciable mortality attributable to the condition.

Aged↗
PubMed1986

Etoposide pharmacokinetics in patients with normal and abnormal organ function.

Precise guidelines for dose modification of etoposide in patients with hepatic dysfunction have not been determined. Etoposide pharmacokinetics were determined in 17 patients. Nine patients had bilirubin less than or equal to 1 mg/dL and eight had bilirubin ranging from 1.9 to 23 mg/dL. Twelve patients received etoposide 100 mg/m2 days 1, 3, and 5, in combination with cisplatin 70 mg/m2 or iproplatin 225 mg/m2 on day 1. Five patients received only one dose of etoposide. Etoposide was measured using a published high pressure liquid chromatography (HPLC) method which also quantitates picro etoposide and its hydroxy acid. Systemic clearance, Vdss and t1/2 beta averaged (+/- SD) 21.4 (+/- 7.4) mL/min/m2, 10.7 (+/- 4.1) L/m2, and 8.1 (+/- 2.8) hours in the nine patients with bilirubin less than or equal to 1 mg/dL, and 22.4 (+/- 9.6) mL/min/m2, 13.6 (+/- 11.3) L/m2, and 8.4 (+/- 3.9) hours in the eight patients with bilirubin 1.9 to 23.0 mg/dL. Stepwise multiple linear regression analysis of liver and renal function tests and other patient-specific variables identified creatinine clearance as the strongest predictor of etoposide systemic clearance (r2 = 40.8). Serum albumin was identified as the next strongest predictor, improving the r2 to 57.3%. Cumulative biliary excretion of unchanged etoposide and glucuronide or sulfate conjugates over 48 hours accounted for less than 3% of the dose in six patients studied. Toxicity occurred in patients with normal and abnormal bilirubin and was unrelated to etoposide clearance. Patients with total bilirubin 1.9 to 23 mg/dL, but creatinine clearance greater than 30 mL/min/m2 had etoposide clearance within the range for patients with normal liver function (16.8 to 35 mL/min/m2). Although these patients did not have reduced etoposide clearance, the major routes of etoposide non-renal elimination remain to be clearly defined. Additional patients should be evaluated to establish more precise guidelines for dosing etoposide in patients with abnormal liver function.

Adult↗
PubMed1985

Reversibility of acute renal failure in elderly patients with the nephrotic syndrome.

Acute renal failure may occur in the nephrotic syndrome due to minor glomerular changes, especially in the elderly. We describe five cases and review the literature. Previous renal damage due to ischaemia and drugs may be important in pathogenesis. We stress the importance of active management of these cases, as the renal lesions are reversible and recovery can be expected.

Acute Kidney Injury↗
PubMed1985

Ultrasound evaluation of the normal fetal upper airway and esophagus.

Because congenital anomalies of the fetal neck may alter the normal anatomy of the upper airway, a prospective evaluation of the fetal trachea, hypopharynx, and esophagus was undertaken in 50 consecutive fetuses of 18 to 38 menstrual weeks. The cervical trachea was visualized in 47 of 50 fetuses (94 per cent) and had an average internal diameter of 2.6 mm with a range of 2 to 4 mm. The average diameter of the hypopharynx was 5.5 mm on parasagittal section (range 4-8 mm) and 7.1 mm when imaged in the coronal plane (range 4-10 mm). The configuration of the fetal hypopharynx and larynx varied with fetal respiration and swallowing in a characteristic manner. In no case was a persistent fluid collection observed in the region of the cervical esophagus, suggesting that the fetal esophagus is collapsed in the resting state.

Esophagus↗
PubMed1985

Condylomata acuminata in women: the effect of concomitant genital infection on response to treatment.

316 women with genital warts were studied to relate treatment response to concomitant genital infection at presentation. There was a highly significant difference between the response patterns of those patients who presented with warts alone, and those presenting with other infections (most commonly candidiasis and non-specific vaginitis). The diagnosis and treatment of associated infections hastens the response of warts to cytotoxic therapy, but there appears to be a subgroup amongst women presenting with warts alone, who require a considerably longer course of treatment. The relevance of these findings to the pathogenesis and management of genital warts is discussed.

Candidiasis, Vulvovaginal↗
PubMed1985

Vanishing lung tumor.

The case of a patient with a lung mass that disappeared after therapy with furosemide and digoxin is presented.

Aged↗
PubMed1985

Simultaneous turnover of normal and dysfunctional C1 inhibitor as a probe of in vivo activation of C1 and contact activatable proteases.

Simultaneous turnover of normal and dysfunctional C1-inhibitor (C1-INH) was carried out in 10 normal subjects and 13 patients with rheumatoid arthritis as a measure of the in vivo activation of C1 and the contact activatable enzymes. In the first series of experiments, dysfunctional protein We was used in simultaneous turnover studies in five normal subjects and nine patients. The fractional catabolic rate of the dysfunctional C1-INH, We, (FCR(d)) was unchanged in both groups but the fractional catabolic rate of the normal C1-INH (FCR(n)) was faster in the patients compared to the controls, in particular patients with vasculitis. The enzyme-dependent catabolism defined as FCR(n-d) X concentration of C1-INH X plasma volume, was raised in the patient group, and correlated with disease activity score (r = 0.83, P less than 0.05). Neither FCR(n) nor FCR(d) was dependent on C1-INH concentration. The latter was higher in the patients (206 mg/l compared with 155 mg/l) indicating a very high synthetic rate in the patients (280.81 micrograms/kg/h compared with 179.77 micrograms/kg). In the second series of turnovers in six patients and five normal subjects, another dysfunctional C1-INH, at, was used. The FCR of C1-INH was slower than C1-INH (We) (1.88%/h compared with 2.7%/h). Enzyme-dependent catabolism of C1-INH in these patients were raised and also correlated with disease activity score (r = 0.82, P less than 0.05).

Adult↗
PubMed1984

Ultrasonic characteristics of frozen liver.

The recent development of new ultrasound probes has made real-time intraoperative monitoring of cryosurgery, and thermocouple placement a possibility. It is shown that frozen tissue and thermocouple needles have acoustic characteristics that enable them to be easily visualized by ultrasound examination. Further in vivo animal studies are needed to examine temperature characteristics of visualized cryolesions, to develop scanning techniques, and to correlate ultrasonic findings with histologic changes in tissue.

Animals↗
PubMed1984

The effect of relative hypoxemia on the pattern of breathing movements in fetal lambs.

To determine whether there is a causal relationship between transient, modest hypoxemia and fetal breathing movements (FBM), we first raised fetal descending aortic PO2 (PaO2) from 17.3 +/- 0.8 (SE) to 24.9 +/- 1.8 mm Hg by administering 50% O2 in N2 to a plastic bag over the ewe's head for 26.5 +/- 3.8 min, then changed to 21% O2 in N2. Fetal PaO2 returned to control levels over the next 5 min. In 4 of 20 experiments on 11 fetal lambs (121-142 days gestation), FBM were absent when the change in maternal inspired O2 concentration was made, and did not occur in the following 5 min. In 16 trials, FBM were present for 2.0-24.1 min prior to the change to 21% O2. In 4 of these, FBM ceased within 2.1 +/- 0.7 min of the change, i.e., before PaO2 had fallen to control levels. In the remaining 12, FBM continued for 4.7-15.9 (mean = 8.6 +/- 1.0) min after the change to 21% O2, and the amplitude of FBM increased significantly (P less than 0.01) from 5.4 +/- 0.7 to 9.5 +/- 1.4 mm Hg over the first 4 min. Thereafter amplitude declined to the end of the breathing episodes. It is concluded that transient, modest reductions in vascular PO2 during episodes of FBM are a stimulus for FBM. However, it appears that transient hypoxemia cannot stimulate FBM from apnea.

Animals↗
PubMed1984

Production of prostaglandins and thromboxane by isolated cells from intracranial tumours.

Tumour cell-rich platelet-free preparations were isolated from 21 fresh samples of human intracranial tumours using enzymic digestion, followed by discontinuous density gradient centrifugation on Percoll and (14 preparations) adherence on plastic. Of the disaggregated cells 79.8 to 97.7% (mean 86.2%) were tumour cells, and mean cell viability was 82.6%. All the tumours produced prostaglandin (PG), E2, F2 alpha, 6 oxo F1 alpha and Thromboxane B2 during 16 hours of incubation but the amount varied widely. Highest production of PGE2 and TXB2 per 10(5) cells was by the eight meningiomas in which the prostanoid profile closely resembled that of circulating monocytes.

6-Ketoprostaglandin F1 alpha↗
PubMed1984

A double-blind controlled trial of bovine brain gangliosides in amyotrophic lateral sclerosis.

We conducted a double-blind controlled study of the effect of brain gangliosides in amyotrophic lateral sclerosis. Nineteen patients received intramuscular gangliosides (40 mg/d) for 6 months, and 21 received placebo. The deterioration rates for approximately 120 clinical and electrophysiologic parameters of neuromuscular function were analyzed, but no statistically significant beneficial effect of the drug was demonstrated. However, the large coefficient of variation for each item indicated that a sample size of several hundred patients would have been necessary to exclude the possibility that the drug produced a 25% slowing of progression of the disease.

Amyotrophic Lateral Sclerosis↗