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Biomedical subjects

L Cooper

Publications and source records attributed to L Cooper.

103 records · Page 6Linked to original sources
PubMedDate not supplied

Rehabilitation from the other side: a patient's perspective.

Many rehabilitation nurses deal regularly with spinal cord injured patients, but rarely are those patients themselves nurses. This article offers a frank an realistic view of the rehabilitation process from the perspective of its author, a nurse who sustained a spinal cord injury in December 1977.

Adaptation, Psychological↗
PubMedDate not supplied

Validity of the Composite International Diagnostic Interview (CIDI) psychosis module in a psychiatric setting.

This study aimed to test the procedural validity of the psychosis module of the Composite International Diagnostic Interview (CIDI) by comparing it with diagnostic checklists completed by experienced clinicians. Seventy-five subjects were interviewed using the interviewer-administered version of the CIDI. Their clinician(s) then completed diagnostic checklists for DSMIV and ICD10 diagnoses of schizophrenia. Agreement was measured at the diagnostic, criterion and subcriterion levels. The validity standard (diagnostic checklist) was shown to be reliable with interrater agreement between the clinicians for the diagnosis of schizophrenia being excellent (kappa = 0.82 for DSMIV and kappa = 0.71 for ICD10). The agreement between the CIDI and the clinician checklists varied with sensitivities for DSMIV subcriteria ranging from 0.18 (negative symptoms) to 0.93 (bizarre delusions) and specificities ranging from 0.38 (catatonia) to 0.95 (disorganised speech). A similar pattern was found for ICD10 subcriteria: sensitivity varied from 0.19 (neologisms) to 0.90 (persistent delusions) and specificity varied from 0.39 (catatonia) to 0.95 (negative symptoms). The poorest levels of agreement were found for symptoms requiring interviewer judgement. The CIDI showed good agreement with clinician checklist diagnoses when the criteria were based on questions asked of the subjects. When the interviewer was required to make judgement of behaviours, the agreement between the CIDI and the clinician checklists was lower, resulting in overall poor agreement between the CIDI and the clinician checklists. Suggestions for improving the validity of the psychosis module of the CIDI are made.

Adult↗
PubMedDate not supplied

Risk factors associated with chronic fatigue syndrome in a cluster of pediatric cases.

After seven pediatric cases of chronic fatigue syndrome (CFS) were diagnosed in a farming community in upstate New York, a questionnaire regarding symptoms and potential risk factors of CFS was distributed to all students enrolled in the same school district. Twenty-one students with symptoms of CFS were identified. Two controls per case matched for age and sex were randomly selected from questionnaire respondents. Health status was verified for all subjects by telephone, and diagnosis of CFS was confirmed by a physician. Information was collected on the following factors: symptoms of CFS among other family members; history of allergy/asthma; consumption of raw milk, raw eggs, raw cheese, or raw meat; water supply; exposure to animals; home heating source; proximity to farmland/orchards; tick bite; blood transfusion; camping; and appendicitis. Logistic-regression analyses indicated that the best model (characterized by symptoms among other family members, recent ingestion of raw milk, and history of allergy/asthma) produced significant estimates of relative risk (P less than .05) of 35.9, 44.3, and 23.3, respectively, for the three factors (corrections were made for the effect of the other covariates). These data suggest that a combination of host and environmental factors, including an infectious agent or agents, are involved in the etiology of CFS.

Adolescent↗
PubMedDate not supplied

Concussion history in elite male and female soccer players.

A unique feature of soccer is the purposeful use of the head for controlling, passing, and shooting a soccer ball. Some concern has been expressed in the literature on the cumulative effects of heading on soccer players. Certain neurophysiologic and neuropsychologic changes have been reported in current or retired players, with heading being blamed. A major factor that could influence some of the findings is a player's history of concussive episodes, which are known to influence brain function. These episodes can occur during aspects of the game other than heading. We interviewed all male and female soccer players (N = 137, average age = 20.5 years) who competed at the U.S. Olympic Sports Festival in 1993. The mechanisms of injuries, frequency, and sequelae were determined. There were 74 concussions in 39 male players (grade I = 50) and 28 concussions in 23 female players (grade I = 19). For the men, 48 of the 74 episodes were from collisions with another player. For the women, 20 of 28 were from such collisions. Headaches, being "dazed," and dizziness were the most common symptoms reported. Based on concussion history, the odds are 50% that a man, and 22% that a woman, will sustain a concussion within a 10-year period. The data indicate that concussions from player-to-player contact are a frequent hazard in soccer. Head injuries incurred this way may be more of an influence for published findings of physiologic and psychologic deficiencies than routine heading of the soccer ball.

Adult↗
PubMedDate not supplied

The unusual spectrum of neuroendocrine lung neoplasms.

Neoplasms of the lungs showing neuroendocrine differentiation are classified histologically into the following groups: (1) carcinoid, (2) atypical carcinoid (well-differentiated neuroendocrine carcinoma and malignant carcinoid, (3) small cell neuroendocrine carcinoma (small cell undifferentiated carcinoma and oat cell carcinoma), and (4) large cell neuroendocrine carcinoma (atypical endocrine tumor of the lung and intermediate neuroendocrine carcinoma). Nine examples of neuroendocrine lung carcinomas are discussed that have unusual histologic features that make it difficult to assign them to one of the above groups, have unusual immunohistochemical features, have unusual ultrastructural features, or exhibit a biologic behavior different from what one would have predicted from their morphologic appearance. The findings in these nine cases suggest that the present classification of neuroendocrine lung neoplasms may be too precise and that these neoplasms, like other nonneuroendocrine pulmonary tumors, exhibit a wider morphologic and biologic spectrum than previously appreciated.

Adenocarcinoma↗
PubMedDate not supplied

A multicenter 12-month evaluation of single-tooth implants restored 3 weeks after 1-stage surgery.

The time-intensive, multi-step process of dental implant therapy limits patient acceptance. This 3-year prospective multicenter study sought to determine the safety of an expedited therapy that consisted of loading unsplinted maxillary anterior single-tooth implants 3 weeks after 1-stage surgical placement, and determination of the peri-implant cortical bone and mucosal responses to the expedited procedure. Fifty-two patients missing 1 or 2 maxilliary anterior teeth were enrolled in a study approved by the Institutional Committee on Human Subjects Research and based on strict inclusion and exclusion criteria. Astra Tech ST implants placed in a 1-stage procedure were restored 3 weeks later with ST abutments and a provisional crown (baseline); 7 to 9 weeks later, a porcelain-fused-to-metal or all-ceramic crown was cemented. Radiographic and clinical examinations were made at baseline and at 6 and 12 months. Implant survival was recorded. Cortical bone responses and peri-implant mucosal responses were evaluated. Fifty-eight implants were placed. During the 3-week period after implant placement, 4 patients were dismissed because of smoking cigarettes (a protocol deviation), and 1 patient was excluded because of deviation in loading time. Of the remaining 53 implants, 2 failed before definitive crown cementation. The resultant 96.2% survival rate was independent of implant length, tooth position, and bone quality/quantity. The mean change in marginal bone level was 0.4 mm at 12 months. The number of surfaces with plaque decreased from 3.4% at baseline to 0.5% at 12 months. The surfaces with inflammation also decreased. A mean gain in papilla length of 0.61 mm occurred, and a gain in buccal gingiva (x = 0.34 mm) was observed. A high success rate with positive tissue responses was achieved for maxillary anterior unsplinted single-tooth implants placed in a 1-stage surgery and restored at 3 weeks. This 2-component system is suited to a single-stage, rapid loading protocol for esthetic single-tooth replacement.

Adaptation, Physiological↗
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↗