Biomedical subjects
J Coope
Publications and source records attributed to J Coope.
Menopause: diagnosis and treatment.
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Hypertension in general practice: what is to be done?
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A trial of treatment of hypertension in the elderly in general practice.
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Postmenopausal osteoporosis.
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Practising prevention. Hypertension.
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Trainees' corner: Managing chronic disease. Hypertension.
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Is oestrogen therapy effective in the treatment of menopausal depression?
Fifty-five depressed menopausal patients took part in a randomized double-blind cross-over trial using ;Harmogen' (piperazine oestrone sulphate) and placebo. The Beck depression inventory, hot flush counts, and patients' subjective assessment of well-being were used to assess clinical status. Hormonal, biochemical and coagulation profiles were carried out. Hot flushes improved significantly on oestrogen compared with placebo. Depression scores and well-being showed significant and equal improvement on oestrogen and placebo. Significant improvement in flushes in patients on placebo was observed in the first half of the trial but did not occur in the second half, in patients who had previously taken oestrogen. No significant changes occurred in biochemistry. Coagulation tests showed acceleration of the prothrombin time in patients taking ;Harmogen' compared with those on placebo. Piperazine oestrone sulphate is a relatively weak but safe oestrogen preparation, effective in treatment of vasomotor symptoms but no more effective than placebo in the treatment of depression.
Symptoms in middle life and the menopause.
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Trial of synthetic steroid for preventing postmenopausal osteoporosis.
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A double-blind cross-over study of piperazine oestrone sulphate and placebo with coagulation studies.
A double-blind trial of piperazine oestrone sulphate was performed over a period of 14 months on 55 menopausal women complaining of depressiona and hot flushes. Depression was not affected but the hot flushes were significantly lessened by the oestrogen treatment. After three months of piperazine oestrone sulphate there were no significant accelerations of prothrombin time or increases in factors VII or X but, after six months, there was an acceleration in the prothrombin time. After 14 months those who received piperazine oestrone sulphate for the first six months showed a significant increase in alpha 1-antitrypsin and factor VIIR:AG. Oestrone piperazine sulphate appears to produce less marked changes in coagulation than oestrogen-containing oral contraceptives or conjugated equine oestrogens.
Mania Sakhalinosa: an episode in the life of Dr. Anton Chekhov.
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How much do patients know? A multiple choice question paper for patients in the waiting room.
A questionnaire about knowledge of personal preventive medicine, treatment, and the appropriate use of health services was put to a population of patients attending their doctors' surgeries. The population was probably biased toward the younger and those willing to fill in such a questionnaire. The results showed a social class gradient in knowledge and a distressing degree of ignorance on some topics. Suggestions are made for using the method in a positive educational way in practices, and for further studies with improved methods.
A study of the effectiveness of propranolol in menopausal hot flushes.
A prospective, double-blind, randomized comparison of propranolol, 40 mg three times daily, and matching placebo showed propranolol to be no more effective than placebo in controlling hot flushes in a group of 25 perimenopausal women. Other menopausal symptoms, such as insomnia and palpitations, were equally unaffected. However, a very close correlation was found between the daily atmospheric temperature and the number of flushes occurring in the group.
Oestrogens for menopausal flushing.
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Conjugated equine oestrogens and blood clotting: a follow-up report.
A follow-up study of blood clotting and platelet aggregation was performed on 21 women who had received long-term hormone replacement treatment with conjugated equine oestrogens. The prothrombin time and factor VII and X values were significantly accelerated after three months, but there was no further increase with continual administration for 18 months. After 12 to 18 months' treatment, however, thrombin-induced platelet aggregation (Chandler's tube) was also significantly accelerated, which suggested a widening spectrum of effect. No overall acceleration of "intrinsic" clotting (partial thromboplastin time and thromboelastography) was found during the study, but the relatively small numbers may have been responsible. Further efforts are therefore required to find formulations and doses of oestrogens which, while relieving menopausal symptoms, cause less acceleration of blood clotting and platelet aggregation.