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J Cooper

Publications and source records attributed to J Cooper.

601 records · Page 34Linked to original sources
PubMedDate not supplied

Use of Bartonella antigens for serologic diagnosis of cat-scratch disease at a national referral center.

BACKGROUND: Bartonella henselae (formerly the genus Rochalimaea) has recently been isolated from patients with cat-scratch disease and their cats, and since September 1992 the Centers for Disease Control and Prevention has offered an indirect fluorescent antibody assay for Bartonella-specific antibody. METHODS: Physicians submitted serum samples from patients suspected of having cat-scratch disease or other Bartonella-associated illness and completed a questionnaire that recorded clinical information. Indirect fluorescent antibody assay was performed with the use of antigen derived from three Bartonella species: B henselae, Bartonella quintana, and Bartonella elizabethae. RESULTS: During 16 months, 3088 serum samples were received. The largest numbers of specimens and the highest percentages positive (titer, > or = 64) were observed in the fall and winter. Clinical histories of the first 600 patients for whom serum samples and completed information forms were received were examined in detail; seropositivity was significantly associated with cat contact, cat age of less than 1 year, cat scratch, presence of an inoculation papule, and regional adenopathy. Of 91 patients whose illness met a strict clinical definition of cat-scratch disease, 86 (95%) had titers of 64 or greater to either B henselae or B quintana. A fourfold rise or fall in titer was observed in 87 of 132 patients with paired serum samples. CONCLUSIONS: The indirect fluorescent antibody assay for Bartonella-specific antibody is sensitive for the diagnosis of cat-scratch disease. Redefinition of cat-scratch disease on the basis of cause and use of this assay as a diagnostic criterion is recommended.

Adolescent↗
PubMedDate not supplied

Mapping a conserved conformational epitope from the M protein of group A streptococci.

The carboxyl terminus of the M protein of group A streptococci (GAS) is highly conserved and contains epitopes that have been shown to induce opsonic antibodies and protection against GAS infection. This region of the protein can also stimulate T cells, which can react in vitro with heart antigens. Since different segments of the carboxyl terminus may be involved in immunity to GAS and in the pathogenesis of autoimmune disease (rheumatic heart disease), it is important to precisely define critical epitopes. However, the M protein is known to be a coiled coil, and a critical immunodominant antibody-binding epitope within this region (peptide 145, a 20-mer with the sequence LRRDLDASREAKK-QVEKALE) is shown here to be conformational. Thus, small synthetic overlapping peptides of 8-12 amino acids in length that span peptide 145 (p145) were unable to capture antibodies present in p145-immune mouse sera or in endemic human sera, even though antibodies raised to these small peptides coupled to diphtheria toxoid could bind the smaller peptides and, in some cases, p145. A series of mutated peptides in which every residue of p145 was sequentially altered also failed to identify critical residues for antibody binding. We thus devised a strategy to produce chimeric peptides in which small peptides copying the M protein sequence were displayed within a larger 28-mer peptide derived from the sequence of the GCN4 leucine zipper DNA binding protein of yeast. A 12-amino-acid window of the p145 sequence was inserted into the GCN4 peptide in such a way as to preserve any potential helical structure. The window was moved along one residue at a time to give a series of peptides representing p145. Circular dichroism demonstrated that these larger chimeric peptides and p145, but not a shorter 12-mer peptide, displayed alpha-helical potential in 50% trifluoroethanol. Certain chimeric peptides efficiently captured antibodies specific for p145 and thus enabled us to map the minimal antibody-binding sequence. RRDLDASREAKK, referred to as J(1)2. The chimeric peptide containing this sequence, referred to as J2, was able to inhibit opsonization of GAS by human antisera containing anti-peptide 145 antibodies. The T-cell response from p145-immunized responder B10.BR mice to J2 and J(I)2 was much lower than the response to p145 and mapped to a different peptide.

Animals↗
PubMedDate not supplied

Improving compliance with glaucoma eye-drop treatment.

Many older patients attending ophthalmic out-patient clinics have been prescribed eye drops for long-term use to treat glaucoma but do not continue with their treatment. This review looks at chronic simple glaucoma, the problems of compliance with long-term medical treatment in older people and the current and future treatment of glaucoma. Recommendations are made on the nurses' role in supporting these patients.

Aged↗
PubMedDate not supplied

MedClaims: electronic submission of direct billing claims.

In 1994 the Australian Health Insurance Commission introduced MedClaims, an electronic system for submission of "direct billing" medical claims. This report contains a description of MedClaims, how it has progressed since its implementation in 1994, its current status, and future directions. To provide a complete picture of MedClaims and the environment in which it operates, this report also contains an overview of Medicare, the federally funded health insurance system in Australia.

Australia↗
PubMedDate not supplied

Direct fast track admission to a coronary care unit.

An audit of thrombolytic therapy for acute myocardial infarction (AMI) in 1992-93 showed that door to needle time had a median delay of 100 min. After discussion, we devised a new 'fast track' procedure. General practitioners (GPs) were given minimum criteria for diagnosing probable AMI and advised how to admit patients directly to the coronary care unit (CCU) after discussion with a senior CCU nurse. The hospital admitted 180 patients with MI between 1 July 1993 and 30 June 1994, 96 of whom received thrombolysis. Of the 11 admitted by the fast track procedure, eight received thrombolysis (median delay, 13.5 min; range, 5-30 min; p < 0.05 when compared with non-fast track patients). Four other patients were fast tracked to the CCU from other medical wards (time to thrombolysis, 6-12 min). In the following year to 30 June 1995 there were 158 admissions with MI, of whom 85 (54%) received thrombolysis. Four patients were admitted by the fast track procedure. Although the fast track procedure shortened the time to thrombolysis, the service was underused. A postal audit of local practices showed that 18% of GPs were still unaware of the service, in spite of newsletters, postgraduate meetings and direct contact. Most GPs (90%) said they would use the service in the future, but 25% stated later that they would not use it. Twenty per cent of non-fast track AMI patients were admitted by deputising doctors.

Adult↗