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Biomedical subjects

J Cox

Publications and source records attributed to J Cox.

At least 109 records · Page 6Linked to original sources
PubMed1997

Systemic lupus erythematosus complicating complement type 2 deficiency: successful treatment with fresh frozen plasma.

We report a man who presented in 1981 at the age of 30 with cutaneous lupus erythematosus (LE), which was resistant to a range of treatments over the subsequent 11 years. In 1991 he suffered fits, dysphasia and agitated depression, and in 1992 a severe septicaemic illness. Systemic LE was diagnosed, and investigation showed homozygous complement type 2 deficiency (C2d). Over a period of 30 months he has received 6 weekly fresh frozen plasma. Since starting this treatment his cutaneous disease has resolved and his depression, verbal fluency and psychomotor scores improved. We have not observed any adverse effects to this treatment and suggest it should be considered in similar patients.

Adult↗
PubMed1996

An association between snowfall and ED presentation of cardiac arrest.

Studies from several cities have reported increased cardiovascular mortality associated with snowfall; whether this weather also results in increased emergency department (ED) presentation of cardiac arrests is not known. A retrospective review was conducted of cardiac arrest patients presenting to a New England ED during the months of October through May, from 1991 to 1994. Comparing daily frequency of cardiac arrest patients with climactic data, a 27% increase was observed in the frequency of cardiac arrest presentation to the ED on days with snowfall (P = .0004). ED physicians and staff should anticipate an increased frequency of cardiac arrest patients on days with snowfall.

Emergencies↗
PubMed1996

High rate of prolonged remissions following combined modality therapy for patients with localized low-grade lymphoma.

PURPOSE: Involved field (IF) radiation can cure as many as 40% to 50% of patients with stage I-II low-grade lymphoma. We sought to improve these results by prospectively evaluating the combination of IF radiation and chemotherapy consisting of 10 courses of cyclophosphamide, vincristine, prednisone, and bleomycin, with doxorubicin added in a risk-adapted manner (COP/CHOP-Bleo). PATIENTS AND METHODS: From 1984 until December 1992, 91 patients, median age 56 years (range 28 to 77 years), with clinical stage I-II low-grade lymphoma were treated. No patients were excluded on the basis of age or organ function. RESULTS: A complete response was attained in 99% of evaluable patients. Treatment-related toxicity was mild, and no deaths occurred during therapy. With a median follow-up of 60 months, there have been only 16 relapses. The actuarial freedom from relapse rate at five years is 82% (95% confidence interval 71% to 89%) and at 10 years is 73%. At five years the overall survival rate is 90% (95% confidence interval 81% to 95%) and at ten years it is 82%. Of the clinical features examined, only older age (> 56 years; p = 0.07) was associated with shorter survival. No features examined were predictive of disease relapse. CONCLUSION: The combination of IF radiation and risk-adapted COP/CHOP-Bleo chemotherapy is well-tolerated, produces a very high rate of complete remission, and with a median follow-up of five years, has produced lower rates of relapse and better overall survival than has been reported for IF radiation alone in patients with clinically-staged I-II low-grade lymphoma.

Adult↗
PubMed1996

Percutaneous endoscopic gastrostomy.

Percutaneous endoscopic gastrostomy (PEG) is now the technique of choice for patients requiring long-term enteral feeding. It is a good method for feeding patients with neurological dysphagia and can safely be kept in situ for long periods. PEG feeding requires a multidisciplinary approach, involving doctors, nurses, pharmacists, speech therapists, dieticians and carers. The insertion of a PEG, which requires two operators and two endoscopy nurses, is described in full. Feeding can commence after a few hours. Various types of feed and feed-ing patterns are described and their relative merits discussed. Although psychological problems may occur following PEG insertion, the procedure is usually well accepted by patients.

Contraindications↗
PubMed1996

Can one induce premenstrual symptomatology in women with prior hysterectomy and bilateral oophorectomy?

Nine women who had undergone hysterectomy and oophorectomy and who previously suffered from severe premenstrual syndrome (PMS) were given estrogen and progesterone in a naturalistic single-blind paradigm. The 13-item Beck Depression Inventory, Spielberger State Anxiety Inventory, Menstrual Distress Questionnaire and the Daily Ratings Form of the Premenstrual Assessment Form were all given daily. Estradiol and progesterone concentrations were estimated. When results from all subjects were considered together, these measures were not correlated with hormonal status. However, individual subjects showed correlations between some symptom scores and serum progesterone concentrations. We conclude that women diagnosed as having PMS do not respond in a uniform fashion to ovarian hormones. Further quantitative studies are needed to relate these individual differences to the syndrome of PMS.

Drug Therapy, Combination↗
PubMed1996

A multicenter double-blind comparison of nefazodone and paroxetine in the treatment of outpatients with moderate-to-severe depression.

BACKGROUND: The efficacy, safety, and tolerance of nefazodone and paroxetine in the treatment of depressed outpatients were compared in a randomized, double-blind parallel group study at 20 centers in the United Kingdom and Republic of Ireland. METHOD: The study population comprised 206 outpatients meeting DSM-III-R criteria for a moderate-to-severe nonpsychotic major depressive episode. Patients considered to be at serious risk of suicide were excluded from participation in the study. After a drug-free baseline phase of 1 to 4 weeks, patients were randomly assigned to treatment with either nefazodone or paroxetine. Outcome measures for efficacy included the Clinical Global Impressions scales, Hamilton Rating Scale for Depression, Hamilton Rating Scale for Anxiety, Montgomery-Asberg Depression Rating Scale, and Patient Global Assessment scale. Tolerance and safety were assessed using spontaneously reported adverse events, vital signs, and laboratory investigations. RESULTS: There were no significant differences between the groups in clinical outcome. Analysis of the efficacy measures revealed a consistent and continuous improvement in both groups. A similar proportion of patients in each group discontinued treatment owing to adverse events: 15 (14%) in the nefazodone group and 13 (13%) in the paroxetine group. CONCLUSION: Nefazodone and paroxetine have similar efficacy and tolerability in the treatment of outpatients with major depression.

Adult↗
PubMed1995

Induction of protective cytotoxic T cells to murine cytomegalovirus by using a nonapeptide and a human-compatible adjuvant (Montanide ISA 720).

The use of synthetic peptides representing cytotoxic T-cell (CTL) epitopes for human vaccination requires the identification of a suitable adjuvant formulation. A single immunization with Montanide ISA720/tetanus toxoid/YPHFMPTNL protected mice against murine cytomegalovirus and induced epitope-specific CTL. Such formulations will find application in peptide-based CTL anti-viral vaccines.

Adjuvants, Immunologic↗