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Biomedical subjects

D Cooper

Publications and source records attributed to D Cooper.

At least 163 records · Page 9Linked to original sources
PubMed1989

Fixed combinations of low-molecular weight or unfractionated heparin plus dihydroergotamine in the prevention of postoperative deep vein thrombosis.

A prospective, double-blind, randomized, controlled clinical trial compared the efficacy and safety of fixed combinations of low-molecular weight heparin or standard unfractionated heparin plus dihydroergotamine mesylate in the prevention of deep vein thrombosis in high-risk patients undergoing elective major abdominal surgery. Two hundred patients, with a mean age of 66.6 years and almost half with malignancy, were allocated to receive either 5,000 IU unfractionated heparin plus 0.5 mg dihydroergotamine mesylate twice daily or 1,500 IU low-molecular weight heparin plus 0.5 mg dihydroergotamine mesylate once daily together with one placebo injection per day. Treatment was commenced 2 hours preoperatively and continued for at least 7 days. The incidence of deep vein thrombosis, determined by radiolabelled fibrinogen uptake and phlebography, was 11 percent in the unfractionated heparin plus dihydroergotamine mesylate group and 11.4 percent in the low-molecular weight heparin and dihydroergotamine mesylate group. Neither these figures nor those for major proximal thrombi proved significantly different. Of the four parameters used to assess hemorrhagic complications, only the decrease in postoperative hemoglobin levels in the low-molecular weight and dihydroergotamine mesylate group reached statistical significance. These results indicate that once-daily prophylaxis with a combination of low-molecular weight heparin and dihydroergotamine is safe, effective, and convenient in high-risk patients undergoing major abdominal surgery.

Adult↗
PubMed1989

Comparison of collagen gene sequences in Ascaris suum and Caenorhabditis elegans.

The nucleotide sequences of a 3060-bp fragment containing almost the entire coding sequence of one Ascaris suum collagen gene, and a 3019-bp pair fragment containing the 3' end of another A. suum collagen gene have been determined. The polypeptides encoded by these genes show a striking similarity to two Caenorhabditis elegans cuticular collagens, both in the position of the triple-helical regions and in the position of cysteine residues. The results of Northern blot hybridisation experiments together with dot blot analysis of RNA isolated from different adult worm tissues suggest that one of these genes is expressed in the adult nematode and that it encodes a protein of approximately 30 kDa.

Amino Acid Sequence↗
PubMed1989

Some phenomena of medical students' diagnostic problem-solving.

This paper introduces a perspective on medical problem-solving that derives from recent studies of content-related learning. Results from a study of fourth-year medical students' approaches to understanding a data base of significant facts about a patient (a problem synthesis) are presented. By analysing data collected in interviews, we obtain categories of description that portray the qualitatively different ways in which the information in diagnostic problems is handled by these students. Two major categories describe the variability in approach: 'ordering' and 'structuring'. The latter category contains elements that most clinical teachers would regard as desirable; the former represents a less satisfactory approach. We provisionally identify two diagnostic strategies within each of these categories. The perspective has implications for improving instruction and assessment.

Clinical Clerkship↗
PubMed1989

Uteroplacental Doppler flow velocity waveforms in the second trimester. A complex circulation.

Continuous wave Doppler ultrasound was used to examine the uteroplacental circulation of an unselected group of 977 [corrected] women between 16 and 24 weeks gestation. Reference ranges for resistance index (RI) were determined and throughout this gestation range there was a significant fall in RI with increasing gestation. The RI was lower from placental than non-placental sites and from distal 'arcuate' than proximal 'uterine' sites. There is a need to define fixed standardized sites for sampling and for normal ranges to account for variables such as placental site.

Blood Flow Velocity↗
PubMed1989

Oligohydramnios.

Explore the source record for details and available documents.

Abnormalities, Multiple↗
PubMed1989

[High-resolution eye movement recording in the assessment of neurologic complications in HIV-1 infection].

HIV-1 related brain disease gives rise to widespread eye movement abnormalities that include impairment of fixation, saccadic speed and accuracy, antisaccadic generation and smooth pursuit function. Quantitative high resolution recording of eye movements is a valuable, non-invasive technique both for measuring the severity and progression of the AIDS dementia complex and the early detection of neurologic dysfunction in asymptomatic HIV-seropositive subjects or in patients with AIDS. In particular, it may be of use in neurologically at-risk patients requiring antiviral therapy and in monitoring the neurologic responses to such treatment.

AIDS Dementia Complex↗
PubMed1988

Eye movement abnormalities as a predictor of the acquired immunodeficiency syndrome dementia complex.

Using infrared oculography, we recorded the eye movements in a group of patients with acquired immunodeficiency syndrome (AIDS), with or without the AIDS dementia complex (ADC). Our aim was to determine whether the severity of dementia could be correlated with abnormalities of eye movement and whether eye movement abnormalities could be detected prior to the onset of clinical dementia. Abnormalities of eye movement were present in seven of seven patients with mild, moderate, or severe ADC and in six of seven AIDS or asymptomatic human immunodeficiency virus-seropositive patients without clinical dementia, but at risk for ADC. The eye movement abnormalities detected included disturbances of both saccadic and smooth-pursuit function, and their severity correlated strongly with the severity of dementia. The abnormalities were qualitatively similar to those that occur in Alzheimer's disease but quantitatively less severe. Recording of eye movements may be a valuable, noninvasive technique for the early detection of neurologic dysfunction in asymptomatic patients who are seropositive for human immunodeficiency virus or in patients with AIDS, even prior to other clinical evidence of ADC. In particular, it may be of use in selecting high-risk patients requiring antiviral therapy and in monitoring the neurologic response to such treatment.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Toward a more valid and reliable Health Locus of Control Scale.

The Multidimensional Health Locus of Control Scale was administered in conjunction with a back care program offered to staff at a psychiatric hospital (N = 82). Validity and reliability of the alternate forms were examined, as was the addition of Forms A and B. The factor structure failed to replicate the original multidimensional construct; hence, suggestions are made to return to the earlier internal/external model and to add the alternate forms to increase reliability.

Adolescent↗
PubMed1988

Correlation of urethral physiology and skin collagen in postmenopausal women.

Connective tissue collagen is thought to contribute to the generation of urethral pressure. It has been previously shown that skin collagen and urethral pressure are oestrogen dependent. This study demonstrates a correlation between urethral pressure measurements and skin collagen content. It is suggested that the beneficial effect of oestrogens on urethral function may be mediated by collagen.

Collagen↗
PubMed1988

Effects of extracorporeal shock wave lithotripsy on cardiac pacemakers and its safety in patients with implanted cardiac pacemakers.

UNLABELLED: Effects of extracorporeal shock wave lithotripsy (ESWL) were studied on 15 pacemakers (standard single chamber n = 5, dual chamber n = 6, rate responsive single chamber [Activitrax] n = 4). In-vitro testing involved suspending the pacemakers in a bath of degassified, deionized water firmly taped to a platform at the point of maximal pressure, i.e., second focal point (F2), where they received pressure shocks (means = 1300) from the HM3 Dornier lithotriptor. The pacemakers, programmed to their most sensitive setting, were continuously pacing at nominal outputs (atrial and ventricular pacing in the DDD mode). All units were assessed by a pacing system analyzer before and after the study, then underwent destructive analysis. During standard single chamber pacing (VVI) the pacing stimulus triggered ESWL. For dual chamber devices, ESWL was triggered by the atrial paced event which induced inhibition of the ventricular output in two pacemaker. This was eliminated by reprogramming to a less sensitive setting. The pacemaker can, hermetic seal and internal circuitry were undamaged in all units. Two rate responsive single chamber pacemakers had their activity sensing piezoelectric elements shattered when placed at F2. Two other units placed 5 cm from F2 were stimulated to their maximum upper programmed pacing rate with ESWL therapy, but were otherwise unaffected. Subsequent to this study, six patients with pacemakers programmed to the VVI (five), DDD (one) modes implanted in the thorax underwent successful ESWL without pacemaker or arrhythmic event. CONCLUSIONS: (A) It is generally safe for patients implanted with standard single chamber devices in a ventricular application to undergo ESWL without modifying the pacing/sensing parameters. (B) Patients implanted with dual chamber devices who pace in the atrium should be reprogrammed to the VVI mode during ESWL. (C) Patients with piezoelectric activity sensing rate responsive single chamber pacemakers should have this feature programmed off during ESWL and, if implanted in the abdomen, probably should not undergo ESWL.

Aged↗
PubMed1988

Mortality, morbidity, growth and development of babies weighing 501-1,000 grams and 1,001-1,500 grams at birth.

During the five-year period, January 1980 to December 1984, 149 babies of extremely low birthweight (ELBW; 501-1,000 g) and 296 of very low birthweight (VLBW; 1,001-1,500 g) were admitted to King's College Hospital, Neonatal Intensive Care Unit. The survival rates were 51.7% and 82.8% respectively. There were more peri- and postnatal problems in the ELBW babies than the VLBW babies and these differences were highly significant. All surviving babies born between January 1980 and December 1982 were followed up until aged two. The ELBW children had a higher incidence of neuro-developmental sequelae than those of VLBW especially when both major and minor problems were considered. Their developmental quotients were lower at one and two years. Significantly more ELBW children were of short stature and low weight (less than 3rd centile). By two years of age the differences between ELBW and VLBW children in stature and mean DQ had lessened.

Child Development↗
PubMed1988

Supplemental calories improve essential fatty acid deficiency in cystic fibrosis patients.

Fatty acid composition of plasma lipids was analyzed in malnourished cystic fibrosis patients undergoing 6 months of nutritional rehabilitation. There were three males and five females (mean age 15.1 yr); five patients had pancreatic insufficiency. Nutritional rehabilitation in seven of eight patients was accomplished by nocturnal nasogastric infusion of a high-carbohydrate semisynthetic diet, in addition to daily meals. One patient received high-energy food supplements as snacks in addition to regular meals. All patients were moderately to severely malnourished on entry to the study and showed significant improvement over the 6 months in (means +/- SE) energy intake (96 +/- 8.0 to 126 +/- 11% recommended daily allowance) and body composition (80 +/- 4 to 90 +/- 4% ideal body weight). Daily intakes of linoleic acid were not significantly different before or during nutritional rehabilitation either as an absolute amount (383 +/- 45 to 557 +/- 124 mg/kg/day) or as a percentage of total calories (4.50 +/- 0.40 to 4.73 +/- 0.14%). In comparison to the controls, the relative percentage of plasma cholesterol ester fatty acids of the CF patients on entry into the study showed a marked decrease of linoleic acid (52.7 +/- 1.0 versus 42.3 +/- 2.7%) with elevated palmitoleic (2.34 +/- 0.2 versus 5.64 +/- 0.7%) and oleic (18.7 +/- 1.0 versus 25.2 +/- 1.4%) acids; a pattern consistent with essential fatty acid deficiency. However, this pattern is not truly characteristic of a pure linoleic acid deficiency as the metabolites of linoleic acid were not decreased.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
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↗