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Biomedical subjects

D Cooper

Publications and source records attributed to D Cooper.

At least 199 records · Page 11Linked to original sources
PubMed1988

Early detection of intrauterine pregnancy with ultrasound.

Vaginal scanning is a relatively new technique for scanning early pregnancy. In a consecutive series of 27 patients on an in vitro fertilization program (and therefore certain dates of ovulation) we have demonstrated that pregnancies may be seen within the uterus even before 5 weeks amenorrhoea and have documented their size. Ultrasound examination at this early stage may be of clinical value, particularly in patients suspected of having an ectopic pregnancy.

Female↗
PubMed1988

Characterization of the acute clinical illness associated with human immunodeficiency virus infection.

The clinical and serologic features and immune status of 39 homosexual men who had seroconversion to human immunodeficiency virus positivity were compared with 26 homosexual men who remained seronegative during a six-month period. An acute clinical illness occurred in 92.3% of seroconverted subjects and 40% of controls. The duration of illness was significantly greater in the seroconverters than the controls (10 + 4.4 days). A general practitioner was consulted by 87.2% of the seroconverters because of the illness, including 12.8% who were admitted to hospital, compared with 20% of controls. The most frequently reported symptoms in the seroconversion group were fever (76.9%); lethargy and malaise (66.7%); anorexia, sore throat, and myalgias (56.4% each); headaches and arthralgias (48.7% each); weight loss (46.2%); swollen glands (43.5%); retro-orbital pain (38.5%); and dehydration and nausea (30.8% each). Lymphadenopathy developed in 75% of seroconverters compared with 4% of controls. Changes in T-cell subsets were not found in controls, but the number of T4+ cells and the T4+/T8+ ratio decreased significantly in seroconverters.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Panic anxiety and hyperventilation in patients with chest pain: a controlled study.

We studied the relation between mood disorder and hyperventilation (hypocapnia) before and during exercise treadmill testing in 113 chest pain patients attending a cardiac clinic and 30 healthy controls. In most patients end-tidal PCO2 (PCO2) rose in the normal way on exercise but in a subset of 24 (21 per cent) there was no rise: these patients with initial hyperventilation had significantly higher anxiety scores than those with a normal exercise-induced rise in PCO2. Two of the 24 had ischaemic heart disease and 10 (42 per cent) complained of recent panic anxiety compared with 12 (13 per cent) of the 89 with normal rise in PCO2 (p less than 0.05). Rates of psychiatric morbidity were similar in patients with 'typical' and 'atypical' chest pain. Resting hypocapnia occurred more often in patients with panic anxiety than in either anxious or non-anxious patients without panic. Panic patients also reported more symptoms of breathlessness and hyperventilation-related complaints than those without panic. Our findings confirm the important association between panic and hyperventilation in patients with chest pain. Furthermore, patients with exercise-induced hyperventilation are more likely to have a psychiatric than a cardiac disorder. Early detection and treatment of these patients may reduce the potential morbidity associated with unnecessary invasive investigations.

Adult↗
PubMed1987

Studies of the active site of cytochrome P-450scc with a high-affinity spin-labeled inhibitor.

The intramolecular site of P-450scc for conversion of cholesterol to pregnenolone involves a substrate site, an active site, and a site for transmission of electrons. The substrate site was studied with a high-affinity, high-potency nitroxide spin-labeled inhibitor of cholesterol side-chain cleavage. This substance, 17 alpha-hydroxy-11-deoxycorticosterone nitroxide (SL-V), has an affinity comparable to that of the most active substrate inhibitors ever reported and 2-50 times greater than that of the natural substrate cholesterol. Competition experiments with cholesterol and its analogues confirmed that SL-V binds reversibly to the substrate site. Titration experiments showed a single binding site on the P-450 molecule. The substrate site is on the apoprotein and has little or no direct interaction with the heme. Spin-spin interactions between the Fe3+ and side-chain or A-ring spin-labeled groups could not be demonstrated, which is consistent with carbons 22 and 20 being closest to the heme iron. We postulate that substrate disrupts a histidine nitrogen coordination with the heme iron and induces conformational changes in the apoprotein. These changes lead to increased affinity for iron-sulfur protein.

Affinity Labels↗
PubMed1987

Binding the elderly: a prospective study of the use of mechanical restraints in an acute care hospital.

Little information exists on the use of mechanical restraints among nonpsychiatric inpatients. This prospective study evaluates their use among consecutive medical and surgical admissions to an acute care hospital. Daily direct observation of patients and hospital record review provided data on potential predictors of restraint, reasons for their application, complications, and outcome. Cox regression analysis was used to calculate relative risk of restraint while adjusting for duration of hospitalization as well as other variables. Restraints were applied to 37 (17%) of the 222 study patients. Restrained patients were eight times more likely to die during hospitalization (24% v 3%; P less than 0.01). Abnormal mental status exam, diagnosis of dementia, surgery, and presence of monitoring and support devices (eg, intravenous lines) were statistically significant independent predictors of restraint. Mechanical restraint is a common occurrence among nonpsychiatric inpatients particularly those with impaired mentation, requirement for surgery, or intensive medical intervention. Identification of medical and surgical patients at risk for restraint may reduce the use of these devices by concentrating surveillance and prevention on this group.

Aged↗
PubMed1986

Compliance with topical pilocarpine treatment.

Using an unobtrusive eyedrop medication monitor, we measured compliance with topical pilocarpine treatment in a sample of 184 patients. The eyedrop monitor recorded electronically the date and time of each pilocarpine administration over a four- to six-week period. The subjects administered a mean +/- S.D. of 76.0% +/- 24.3% of the prescribed pilocarpine doses. Eleven patients (6%) took less than one quarter and 28 patients (15.2%) took less than one half of the prescribed administrations. In contrast, when the subjects were interviewed they reported taking a mean +/- S.D. of 97.1% +/- 5.9% of the prescribed pilocarpine doses. As determined by the monitor, 45 patients (24.5%) had at least one day per month with no administrations of pilocarpine; 56 subjects (30.4%) compressed the doses during the daytime hours, leaving an interval between the night dose and the morning dose the next day of 12 hours or more. The rate of compliance was significantly higher (P less than .0001) in the 24-hour period preceding the return appointment than in the entire observation period.

Aged↗
PubMed1986

Monoclonal antibody analysis of bovine epithelial keratins. Specific pairs as defined by coexpression.

We have characterized the keratin proteins of various bovine epithelial tissues by one- and two-dimensional gel electrophoresis, coupled with the immunoblot technique using AE1, AE2, AE3, AE5, CA20, BE14, and 6.11 monoclonal antikeratin antibodies. The results indicate that all known bovine keratins can be divided into two subfamilies. The "acidic" (Type I) subfamily consists of 41-, 43-, 45-, 46-, 50-, 54-, 56-, and 56.5-kDa keratins, all of which have a pI of less than 5.6, and most of them are recognized by our AE1 antibody, whereas the "neutral-to-basic" (Type II) subfamily consists of 55-, 57-, 58-, 62-65-, 66-, and 67-kDa keratins, all of which have a pI of greater than 6.0 and are recognized by our AE3 antibody. Tissue distribution data and cell culture studies show that, within the two subfamilies, keratins with similar "size ranks" form a "pair" as defined by frequent co-expression. Furthermore, within most "keratin pairs," the basic keratin is larger than the acidic one by 8-10 kDa. These results provide further support for the concepts of "keratin subfamilies" and keratin pairs and are consistent with the possibility that the acidic and basic members of at least some keratin pairs may interact specifically during in vivo tonofilament assembly and/or function. Immunoblotting data derived from the use of several monospecific antibodies show that although the size, charge, and pattern of expression of most bovine keratins are similar to those of the human counterparts, there are important exceptions to this rule.

Animals↗
PubMed1986

Nutritional rehabilitation of malnourished patients with cystic fibrosis.

We examined the effect of nutritional rehabilitation in cystic fibrosis patients with severe disease. Thirteen malnourished patients (seven males, six females, age 7-27 yr) were studied over 7-16 mo. Oral supplementation was attempted initially in 12 patients (mean duration 6.7 mo); only 2 patients gained weight, 2 withdrew, and 1 died. The remaining 7 patients failed to achieve adequate weight gain and were commenced on nasogastric supplementation with a semisynthetic formula. An additional patient was entered without a prior period of oral supplementation because of the severity of malnutrition. Weight gain was achieved in 7 of 8 patients with nasogastric supplementation (mean duration 6.4 mo). Weight gain was associated with an increase in lean body mass, total body fat, and height velocity. While pulmonary function and biochemical parameters were unchanged, patient well-being improved and episodes of pneumonia decreased.

Adolescent↗
PubMed1986

Exposure of intravenous drug users to AIDS retrovirus, Sydney, 1985.

A survey of a cohort of 200 intravenous (IV) drug users drawn from five drug referral agencies was conducted in Sydney in 1985 and revealed only one heterosexual male with antibodies to AIDS retrovirus (ARV). Contact tracing of sexual and needle-sharing partners resulted in the referral of a further four out of six at-risk individuals seropositive for ARV. This study indicates that ARV has now reached the IV drug-using population and could be spread further among IV drug users by sexual contact and by needle-sharing. We conclude that exposure to ARV among IV drug users is in its earliest stages in Australia. There is an urgent need to introduce measures such as contact tracing and screening of IV drug users to prevent further spread of ARV in this risk group.

Adult↗
PubMed1986

Prognosis of the very low birthweight baby in relation to gender.

The effects of gender on mortality and morbidity of all neonates weighing less than 1500 g admitted to King's College Hospital Neonatal Intensive Care Unit during 1980-82 (n = 271) were examined. Very low birthweight boys had a significantly higher mortality and more postnatal complications than girls. The higher incidence of respiratory distress syndrome and pulmonary interstitial emphysema in boys was associated with increased mortality in the first year. Surviving boys had significantly more problems, including lower Apgar scores at five minutes, more frequent apnoeic attacks and bradycardic episodes, transient tachypnoea, neonatal anaemia, and lower blood calcium and phosphate concentrations. Surviving children were followed up at 1 and 2 years of age. Development of boys at 1 year was significantly delayed compared with girls in all fields save locomotor. Although at 2 years some of the differences had diminished, those in language and personal social skills were more pronounced. More than twice as many boys as girls had major neurodevelopmental disorders.

Child Development↗
PubMed1986

Identification of fentanyl derivatives.

An interpretative approach to the identification of fentanyl homologs and analogs is presented. The techniques employed are liquid/liquid extractions; capillary gas chromatography; and infrared, mass, and nuclear magnetic resonance spectral characterization. Spectral data are presented for eight fentanyl derivatives of clandestine origin.

Chemical Phenomena↗
PubMed1985

Ultrasound in the diagnosis of jaundice--a review.

A retrospective study of 92 jaundiced patients undergoing ultrasound examination was undertaken to assess the clinical utility of this test. The patients were graded according to the likelihood of biliary obstruction. In those in whom biliary obstruction was proven to be present, the sensitivity of ultrasound to detect the obstruction was 91% and the test specificity was 100%. In patients who had undergone cholecystectomy no increase in the diameter of the common duct was observed. Liver function tests proved to be unreliable in discriminating between extrahepatic obstructive jaundice and other forms of jaundice. Ultrasound scanning is a useful screening test in the diagnosis of the jaundiced patient. However, follow-up is suggested for those with a negative result of this test but in whom biliary obstruction is suspected. An approach to the investigation of the jaundiced patient should include early ultrasound examination in those with possible biliary obstruction.

Adolescent↗