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Biomedical subjects

J Copeland

Publications and source records attributed to J Copeland.

102 records · Page 6Linked to original sources
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A qualitative study of barriers to formal treatment among women who self-managed change in addictive behaviours.

Alcohol and drug abuse and dependence are common disorders in our society, and the vast majority of those who recover do so without formal treatment. Although this phenomenon appears to be more common among women than men there has been no gender-sensitive research. This qualitative study explored the barriers to formal treatment seeking among women who self-managed change in their alcohol and other drug dependence. The principal barriers identified included social stigma and labelling; lack of awareness of the range of treatment options, concerns about childcare, the perceived economic and time costs of residential treatment, concerns about the confrontational models used by some treatment services, and stereotypical views of clients of treatment services. A number of recommendations were made regarding program reach and content.

Adult↗
PubMedDate not supplied

Computed tomography of adrenal abscess.

We present a patient with a progressively enlarging adrenal mass detected by CT which extended to the renal hilum and inferior vena cava. Pathologic evaluation revealed an adrenal abscess containing purulent debris.

Abscess↗
PubMedDate not supplied

Assessment of the older person in the community.

The Cross-National Geriatric Community study is being conducted by the United States-United Kingdom Cross-National Project. Semi-structured interviews have been completed with over 850 community residents over the age of sixty-five years randomly selected from the metropolitan regions of New York and London. The assessment techniques described in this section may be of interest not only to other research workers conducting geriatric community surveys but also to health professionals concerned with the clinical examination of the older ambulatory patient and the early detection and appropriate referral of the need for health and social services.

Aged↗
PubMedDate not supplied

Preneoplastic lesions of the prostate-clinical, pathological and molecular biological aspects.

Needle biopsy is the mainstay of definitive diagnosis of prostate cancer (PCA). While prostate-specific antigen (PSA) screening has facilitated early diagnosis of PCA, it has also resulted in an increase in the proportion of prostate biopsies showing various preneoplastic lesions (PNLs). At times such lesions are the sole finding in the limited amount of tissue available for assessment in an individual biopsy. Hence accurate identification of these lesions is important to avoid errors in the diagnosis of prostatic malignancy and in patient management. Furthermore, some interesting observations have been made regarding the molecular biological aspects of various PNLs during the last decade. In parallel with anatomic and physiological differences in various human races, racial differences have also been observed regarding the incidence of prostatic intra-epithelial neoplasia. This review focuses on prostatic intraepithelial neoplasia (PIN), atypical adenomatous hyperplasia (AAH) and atypical prostatic glands or atypical small acinar proliferation (ASAP) as putative preneoplastic lesions of the prostate. These lesions are reviewed with reference to their overall incidence, histopathological findings, histological differential diagnosis, clinical significance and molecular biological aspects.

Biopsy, Needle↗
PubMedDate not supplied

Diabetes and heart transplantation.

Diabetes mellitus remains a relative contraindication to heart transplantation. From June 1985 to December 1987, 71 patients underwent heart transplantation. Fifty-seven patients were nondiabetic, and nine had preexisting diabetes mellitus. Four patients were insulin dependent and three were not. All operative survivors (66) from these two groups were compared for survival and numbers of rejection and infection. Actuarial survival in the group with diabetes mellitus was 100% and 97.7% in the group without diabetes. Immunosuppression was maintained with cyclosporine, azathioprine, and low-dosage prednisone. In the group with diabetes two patients were maintained without prednisone. Selected diabetic patients can have successful transplantations. There is no significant difference in survival between the diabetic and nondiabetic patient. There is a tendency toward more rejections and fewer infections among the diabetic patients. In our experience diabetes mellitus is not a contraindication to heart transplantation.

Diabetes Complications↗
PubMedDate not supplied

Seeing is believing.

Explore the source record for details and available documents.

Dental Care↗
PubMedDate not supplied

Pediatric retransplantation.

Previous studies have attempted to outline the efficacy of heart retransplantation in adults. A limited number of these retransplantation procedures have been performed in children; however, no study to date has evaluated the risk of heart retransplantation in this specific patient population. We conducted a retrospective review of 17 pediatric (non-neonatal) heart transplant recipients who subsequently underwent heart retransplantation. Thirteen male and four female patients underwent retransplantation at four different institutions between 1974 and 1992. Patient age at the time of primary transplantation ranged from 2 to 19 years (mean, 12.5 years) and from 3 to 30 years (mean, 16 years) at retransplantation. The time interval between transplantation procedures ranged from 2 days to 15.6 years and was not predictive of patient outcome. Follow-up after retransplantation ranged from 1 day to 11 years (mean, 2.8 years). All patients were New York Heart Association class 3 or class 4 at the time of retransplantation. After retransplantation all survivors were New York Heart Association class 1. No patient had mechanical device implantation or extracorporeal membrane oxygenation bridge-to-transplantation at primary transplantation or retransplantation. The indication for retransplantation was transplant coronary artery disease (TxCAD) in seven patients (41.2%), acute rejection in four (23.5%), chronic rejection in one (5.8%), chronic rejection associated with TxCAD in four (23.5%), and intraoperative donor organ failure in one (5.8%). No significant difference occurred in linearized rates of rejection or infection or in actuarial freedom from rejection or infection when secondary grafts were compared with primary grafts in patients undergoing retransplantation.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

Immediate cardiac allograft failure. ECMO versus total artificial heart support.

Optimal support for immediate cardiac allograft failure is unknown. With the introduction of heparin bonded extracorporeal membrane oxygenated circuits, prolonged cardiopulmonary support is possible. The authors report a case that involved 2 days of right atrial to ascending aorta extracorporeal membrane oxygenated support after immediate donor organ failure prevented the patient from exiting bypass. Continued deterioration in cardiac function led to an attempt at conversion to a total artificial heart as a bridge to retransplant. However, this procedure resulted in transbronchial exsanguination and recipient death. The autopsy showed pulmonary thrombosis with infarction and hemorrhage. The authors recommend caution in the use of extracorporeal membrane oxygenated support for patients with immediate and profound graft failure because of the increased risk of stasis thrombosis and pulmonary infarction due to sluggish pulmonary and left atrial blood flow. Instead, institution of total artificial heart or biventricular support may be preferable as the risks of thrombus and infarction are less.

Adolescent↗