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Biomedical subjects

J Cox

Publications and source records attributed to J Cox.

At least 181 records · Page 10Linked to original sources
PubMed1989

Holiday travel: immunisation.

More people travel abroad each year, but they often receive conflicting advice about immunisation from travel agents, embassies, doctors and nurses. Published guidelines should be followed carefully to avoid risk of litigation.

Health Promotion↗
PubMed1989

Endomyocardial fibrosis in the child.

Endomyocardial fibrosis is a rare disease in children and has been mainly observed in tropical Africa, seldom in Europe. Its precise aetiology remains unknown. New surgical procedures have recently led to better survival. Four children, a 5 year old Swiss boy and 3 African girls, aged 12 to 14 years, were submitted with global heart failure class III to IV of the NYHA classification. Two patients had eosinophilia on admission. A third had a history of transient eosinophilia. The echocardiographic examination showed a very typical picture. In 3 patients (2 f and 1 m) both ventricles were involved; in one girl only the left ventricle. Decreased ventricular distensibility with impaired filling of the left and/or right ventricle was present in all. Diastolic pressures ranged between 24 and 35 mmHg; the systolic function was satisfactory in 3 children (ejection fraction [EF] of 44 to 61%) and severely decreased in the fourth (EF 10%). Three patients underwent endocardectomy: both ventricles in 1 case, only the left in 2 cases. Mitral valve repair by means of the Carpentier ring was done once, valve replacement once (Starr-Edwards prothesis). One child died; the 2 surviving patients showed a distinct improvement in their clinical state and are now in class II of the NYHA classification. Echocardiographic and catheter investigations show, however, persistence of the restrictive cardiomyopathy. Thus, surgical intervention must be considered a palliative procedure in these cases. The diagnosis can clearly be made nowadays with bidimensional and Doppler echocardiography.

Adolescent↗
PubMed1989

Hereditary site-specific colon cancer in a Canadian kindred.

A large kindred with colorectal cancer unaccompanied by polyposis coli and characterized by autosomal dominant inheritance has been identified in eastern Canada. Ten family members from three successive generations have presented 17 documented colorectal cancers. The clinical features of the kindred are characteristic of hereditary site-specific colon cancer (HSSCC) (Lynch syndrome I): absence of multiple polyposis, autosomal dominant inheritance, onset of colorectal cancer at an early age and a high incidence of synchronous and metachronous colorectal cancers. A unique feature of this family is the high incidence of sporadic adenomatous polyps in affected members and their relatives. Patients with HSSCC have been managed by means of segmental colectomy followed by annual colonoscopic surveillance. All five patients with localized (Dukes' stage A or B) cancer at initial diagnosis were alive and free of disease after 2 to 12 years of follow-up, although three had required further colonic resection for metachronous carcinomas. Five young family members without cancer have had sporadic adenomatous polyps removed and are being followed with annual colonoscopy. It is not known whether polypectomy will alter the subsequent incidence of colon cancer. Subtotal colectomy is recommended for patients with HSSCC because of the high incidence of multiple lesions. An aggressive screening protocol, including colonoscopy, is recommended for all adult first- and second-degree relatives of patients with HSSCC. Identification of a biomarker, which is currently being sought in this kindred, would help identify those at greatest risk of development of cancer and allow earlier intervention.

Adenocarcinoma↗
PubMed1989

Interventional radiology in the gallbladder.

This article is a pictorial review of the current status of interventional radiology of the gallbladder. The indications and technical aspects of various procedures are presented. Specifically discussed are: (1) needle puncture for percutaneous biopsy, withdrawal of bile for culture, or imaging of the biliary tract; (2) catheter insertion for decompression or abscess drainage; and (3) gallstone management via contact dissolution, fragmentation and basketing, or contact lithotripsy. The management of vagal hypotension and bile leak, the major complication of these procedures is also discussed.

Catheterization↗
PubMed1989

Two-monthly depot gonadotropin releasing hormone agonist (buserelin) for treatment of prostatic cancer.

The agonist analogues of gonadotropin-releasing hormone provide an alternate medical therapy for prostatic cancer. Current methods of administration of these analogues by daily injection or nasal spray is sub-optimal in an elderly population. We have performed a pharmacological and endocrine evaluation of a new depot preparation of one such analogue, buserelin, active for 2 months. Thirty patients with advanced symptomatic prostatic cancer were treated. Serum testosterone was suppressed for the duration of treatment which ranged up to 14 months. The release characteristics of the depot were consistent and showed minimal variation between patients. This 2-month preparation of buserelin offers and advantage to the patient with prostatic cancer, over current treatment regimens.

Adult↗
PubMed1989

Neuraminidase pretreatment of donor lymphocytes and graft-versus-host disease.

Treatment of murine CBA splenocytes with Vibrio cholerae neuraminidase (VCN) prior to engraftment into cyclophosphamide (CY) immunosuppressed Balb/c x CBA mice reduced the incidence of acute lethal graft-versus-host disease (GvHD) and delayed mortality in the later phase of the disease. In the same model, pretreatment of donor splenocytes with VCN also reduced splenomegaly. Engraftment of F1 mice with CBA cells was clearly demonstrated at day 30 after infusion. Treatment of spleen cells with VCN did not compromise their ability to protect mice against irradiation-induced lethality. Furthermore, enzyme treatment was found to have no adverse effects on helper (TH-) and B-cell activity or on suppressor (TS-)cell function in adoptive transfer assays. Therefore, whereas the mechanism of the effect of the VCN preparation remains to be established, it is clear that the treatment provides protection against GvHD.

Animals↗
PubMed1988

Cell-specific immuno-probes for the brain of normal and mutant Drosophila melanogaster. I. Wildtype visual system.

We have screened antibodies for immunocytochemical staining in the optic lobes of the brain of Drosophila melanogaster. Seven polyclonal antisera and five monoclonal antibodies are described that selectively and reproducibly stain individual cells and/or produce characteristic staining patterns in the neuropile. Such antisera are useful for the cellular characterization of molecular and structural brain defects in visual mutants. In the wildtype visual system we can at present separately stain the following: the entire complement of columnar "T1" neurons; a small set of presumptive serotonergic neurons; some 3000 cells that contain and synthesize gamma-amino butyric acid (GABA); and three groups of cells that bind antibodies to Ca2+-binding proteins. In addition, small groups of hitherto unknown tangential cells that send fine arborizations into specific strata of the medulla, and two patterns of characteristic layers in the visual neuropile have been identified by use of monoclonal antibodies generated following immunization of mice with homogenates of the brain of Drosophila melanogaster.

Animals↗
PubMed1988

Effectiveness and tolerance of pre- and postexposure treatment with purified inactivated rabies vaccine prepared on Vero cell line.

The results are reported of a field trial which was designated to demonstrate the inocuity and efficacy of the purified inactivated rabies vaccine (PVRV), produced on Vero cells by the Institut Mérieux, Lyon, France in pre- and postexposure treatment in man. Four sex and age matched groups of veterinary students and medical personnel received the vaccine. The vaccine was given according to WHO recommendations for pre- and postexposure regimens. The 82 volunteers were divided into four groups and vaccinated as follows. Group IA consisted of 27 individuals, receiving injections on days 0, 7 and 21. Group IB consisted of 29 individuals, injected on days 0, 28 and 56. Group II consisted of 16 individuals, receiving a postexposure schedule of vaccinations on days 0, 3, 7, 14, 28 and 90. Group III consisted of 10 subjects, all of whom had been previously immunized with various antirabies vaccines and received one single booster inoculation of this vaccine. Serum samples were taken on the days of vaccination and 14 days later in all groups and in addition on day 70 in group IA. Neutralizing antibodies against the rabies virus were determined in the rapid fluorescent focus inhibition test (RFFIT). In conclusion it can be stated that, regardless of the schedule of prophylactic immunization, three 0.5 ml inoculations of PVRV result in very high titres of virus neutralizing antibodies and a single vaccination in previously immunized individuals is sufficient to raise the amount of antibodies to a high level. Due to the high purity of the product the vaccine is very well tolerated by the vaccinees.

Adult↗
PubMed1988

The clinical and endocrine assessment of three different antiandrogen regimens combined with a very long-acting gonadotrophin-releasing hormone analogue.

Tumor flare is reported in up to 40% of patients treated with gonadotrophin-releasing hormone analogues for prostate cancer. In order to investigate the optimal way to eliminate tumor flare, we have treated patients with one of three different antiandrogen regimens used in combination with gonadotrophin-releasing hormone (GnRH) agonist. The early results of this study are presented here. Thirty patients with advanced symptomatic disease were randomized to receive either cyproterone acetate 50 or 100 mg three times daily or flutamide 250 mg three times daily given for 1 week before and during the first month of GnRH agonist treatment. The endocrine profiles of these patients were compared with those of historic controls treated with depot agonist alone. Three patients treated with low-dose cyproterone acetate and one with flutamide developed a transient exacerbation of their disease. No patients treated with the higher-dose cyproterone acetate regimen developed tumor flare. No patients treated with cyproterone acetate had an increase in serum testosterone above baseline following depot GnRH agonist implantation. All patients treated with flutamide had increases in serum testosterone, but this did not significantly increase further with implantation. This study suggests that all patients receiving GnRH agonist treatment should be pretreated with cyproterone acetate 100 mg three times daily for 1 week before implantation and for the first treatment month.

Aged↗
PubMed1988

Performance-based measurements among elderly drivers and nondrivers.

Although driving is an important ability for maintaining independence in the later years, clinical factors that determine driving status are unknown. Aged male veterans (mean age, 70 years) were recruited from an outpatient clinic (N = 143), including 77 frequent drivers, 41 infrequent drivers, and 25 who drove rarely or not at all. There were 116 (84%) who completed a comprehensive performance-based assessment. There were no significant differences between the three groups in age, formal cognitive testing, or prevalence of stroke history. However, there were significant differences in grip strength, reaction time, static visual acuity, dynamic visual acuity, and peripheral vision. Using stepwise ordinal logistic regression, dynamic visual acuity, nondominant hand grip strength, and total horizontal peripheral visual field were significantly associated with driving frequency (P less than .05), and together explained approximately 45% of the variance. Subtle motor and visual deficits that can be detected by a performance-based assessment may play an important role in determining driving frequency in the elderly.

Activities of Daily Living↗