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Biomedical subjects

D J Cooper

Publications and source records attributed to D J Cooper.

89 records · Page 5Linked to original sources
PubMed1981

Admissions to hospital of children with sickle-cell anaemia: a study in south London.

Admissions to hospital of 171 children with sickle-cell anaemia, genotype Hb SS, were reviewed over a 20-year period. Altogether 887 admissions occurred in 797 patient-years. The commonest cause of admission was painful vaso-occlusive crisis. Appreciable morbidity also resulted from pulmonary disease, infection, and anaemic episodes. The complications resulting in the most severe illness were acute splenic sequestration, pneumococcal meningitis, and some episodes of erythroid hypoplasia resulting in very low haemoglobin concentrations. Most deaths occurred in children aged under 5. Mortality and morbidity could be reduced by measures including prophylaxis of pneumococcal infections and more active treatment of seemingly minor illness in children with sickle-cell anaemia.

Adolescent↗
PubMed1980

Fetal activity in 100 normal third trimester pregnancies.

The incidence of fetal breathing movements (FBM), fetal trunk movements (FTM), and total fetal activity (TFA) was assessed in 100 normal pregnancies between 28 weeks and term. One 30-minute recording was made from each patient between 0900 and 1700 hours. The mean incidences of FBM, FTM and TFA were respectively 37 +/- 26 (SD) per cent, 18 +/- 10 per cent, and 53 +/- 24 per cent. The mean breathing rate was 48 +/- 12 per minute, and the mean nunber of movements per 30-minute study period was 29 +/- 15. There was a slightly higher incidence of FBM postprandially, but this failed to reach statistical significance. The mean incidence of FBM was lower before 31 weeks and after 40 weeks, compared to that between 31 and 40 weeks, when the values of FBM and FTM were constant. The breathing rate was directly related to gestational age. The mean number of movements per 30-minute study period was inversely related to gestational age, but the duration of movements increased progressively towards term, so that the incidence of FTM was constant throughout the third trimester. There was only one recording of TFA below 10 per cent.

Adolescent↗
PubMed1980

The aminoglycoside antibiotics.IV. Synthesis of aminodeoxy analogs of neamine.

An efficient synthesis of the key 3',4'-galacto epoxide intermediate 4 obtained from the known 5,6-O,O'-cyclohexylidene-N,N'-bis-(methoxycarbonyl)-4-O-[2,6-bis(methoxycarbony lamino)-alpha-D-glucopyranosyl]-2-deoxystreptamine (5) is described. Treatment of this epoxide with sodium azide, followed by reduction and acetylation, yielded the protected4'-amino-4'-deoxyneamine 18 (3',4'-diequatorial), whereas treatment with ammonia followed by acetylation yielded the protected 3'-amino-3'-deoxyneamine analog 19 with a diaxial configuration of its 3' and 4' positions. Reaction of the previously described protected 3',4'-allo epoxide 3 with sodium azide yielded separable mixtures of the protected 3'-amino-3'-deoxyneamine 14 and the protected diaxial 4'-amino-4'-deoxyneamine isomer 13, the ratios of products depending on the solvent temperature. Structural assignments for 13, 14, 18 and 19 were based on their PMR spectra. An additional 4'-amino-4'-deoxyneamine analog (24) with an axial configuration as its 4' position was also prepared by azide displacement of an approximately protected 4'-methanesulfonyl neamine intermediate 10. The five protected isomers were deblocked to yield a series of aminodeoxyneamine analogs (15, 16, 20, 21 and 25), all of which were less active in vitro than neamine against a group of Gram-positive and Gram-negative bacteria.

Bacteria↗
PubMed1977

The aminoglycoside antibiotics. I. Synthesis and biological evaluation of an analog of gentamicin.

The synthesis of 2-deoxy-4-O-(2,6-diamino-2,3,4,6-tetradeoxy-alpha-D-erythrohexopyranosyl)-6-O-(3-deoxy-3-methylamino-alpha-D-xylopyranosyl)-D-streptamine (1), an analog of gentamicin A, from diideoxyneamine and methyl 3-methylamino-3-deoxy-beta-D-xylopyranoside is described. The product was characterized by its 13C nmr spectrum and was found to exhibit broad spectrum antibacterial activity.

Bacteria↗
PubMed1977

Assessment and resection of carcinoma at the gastroesophageal junction.

In a five year retrospective study of 70 patients, the roentgenologic and surgical assessments of carcinoma at the gastroesophageal junction have been compared to the histologic findings of the resected specimens. Although the lesion was demonstrated roentgenologically in all patients, no reliable indication of its limits could be obtained, and spread was seriously underestimated by both preoperative barium studies and direct examination at operation. It is suggested that the lack of roentgenologic evidence may have encouraged an inadequate surgical approach and, thus, contributed to incomplete resection and the high immediate mortality. There is, at present, no satisfactory method by which spread can be defined, either before or at operation, and neither the preoperative barium studies nor his operative assessment should influence the surgeon to limit the resection.

Adenocarcinoma↗
PubMed1974

Mucin histochemistry of mucous carcinomas of breast and colon and non-neoplastic breast epithelium.

Although epithelial mucin has been demonstrated in ordinary mammary duct carcinomas, it is formed profusely in the uncommon mucous carcinomas. A histochemical study of mucous carcinomas of the breast and colon showed that both types produce similar mucins, viz, acid and neutral, although the mammary carcinomas produce more neutral mucin and small amounts of sulphated mucins are produced by colonic tumours. Similar studies on sections of normal breast and cystic mammary dysplasia have shown that intracellular neutral mucin was present in the ducts and lobules, and that intracellular acid mucin was present within cells of the terminal ducts and lobules. It was demonstrated enzymatically that the acid mucins produced by the normal and neoplastic tissues is sialic acid. Hence it can be shown that the mucin produced by mucous carcinomas is of epithelial rather than connective tissue type. It is contended that mucous carcinoma of breast arises by metaplasia of duct cells that have already undergone malignant change and not from the lobules of the breast.

Adenocarcinoma, Mucinous↗
PubMedDate not supplied

Toombak use and cigarette smoking in the Sudan: estimates of prevalence in the Nile state.

BACKGROUND: Survey data on the prevalence of use of oral snuff (toombak) and cigarette consumption according to various demographic factors are needed in the Sudan. METHODS: A house to house cross-sectional survey of a random population sample of 4,535 households was performed. Of the 23,367 household members identified, 21,648 (92.6%) eligible individuals were questioned about tobacco use. RESULTS: Among children and adolescents (4-17 years) prevalence of tobacco use was quite low (2%, range 1-2%), but there was an abrupt increase up to 25% in late adolescence. Among the adult population aged 18 years and older the prevalences of toombak use (34%) and cigarette smoking (12%) among males were significantly higher than among females (2.5 and 0.9%, respectively). The prevalence of toombak use among the male population aged 18 years and older was significantly higher in the rural than in the urban areas (35% vs 24%), while cigarette smoking had a higher prevalence in urban areas (18% vs 12%). The highest rates of toombak use were found in rural areas among the male population ages 30 years and older (mean 46.6%, range 45-47%). CONCLUSIONS: In view of the high prevalence of tobacco use, especially of toombak, among the population surveyed, there is an urgent need to educate the public on the health consequences of these habits.

Adolescent↗
PubMedDate not supplied

Statistical and methodological issues in the evaluation of case management studies.

For the past 3 years, the nursing case management team at North Shore University Hospital in Manhasset, NY, has been involved in a project to implement more than 50 clinical pathways, which provide a written "time line" for clinical events that should occur during a patient's hospital stay. A major objective of this project was to evaluate the efficacy of these pathways with respect to a number of important outcomes, such as length of stay, hospital costs, quality of patient care, and nursing and patient satisfaction. This article discusses several statistics-related issues in the design and evaluation of such case management studies. In particular, the role of a research approach in implementing and evaluating hospital programs, the choice of a comparison (control) group, the exclusion of selected patients from analysis, and the problems of equating pathways with diagnosis-related groups are addressed.

Case Management↗