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Biomedical subjects

M A Cooper

Publications and source records attributed to M A Cooper.

At least 55 records · Page 3Linked to original sources
PubMed1998

The relationships of body temperature to weight gain, feed consumption, and feed utilization in broilers under heat stress.

Commercial broiler males were used to evaluate body temperature response to heat stress and its relationship to gain, feed consumption, and feed conversion ratio. Individual gain, feed consumption, and feed conversion ratio were obtained from 28 to 49 d in a heat stress environment (32 C) and compared to a 21 C environment. Body temperatures were measured at 28, 35, and 42 d, then daily from 43 to 48 d, and correlated with 28 to 49 d gain, feed consumption, and feed conversion ratio. Feather cover was measured at 51 d of age as a percentage of BW. Initial 28-d body temperature was not significantly different between 21 and 32 C. Body temperature was significantly higher in the 32 C environment after 7 d of heat stress and was significantly higher than at 21 C at all points through 21 d of heat stress, with mean differences ranging from 0.5 to 1.0 C. Feather weight as a percentage of BW was significantly greater in the 21 C environment (6.22%) than the 32 C environment (5.03%). Mortality was not affected by the heat stress environment. Correlations between body temperature and gain, feed consumption, and feed conversion ratio were low and nonsignificant for most periods in the 21 C environment. In the 32 C environment, body temperature was significantly correlated with gain, feed consumption, and feed conversion ratio after 7 d of heat stress, with mean correlations of -0.40 for gain, -0.31 for feed consumption, and 0.24 for feed conversion ratio in Replicate 1 and -0.44 for gain, -0.40 for feed consumption, and 0.43 for feed conversion ratio in Replicate 2.

Aging↗
PubMed1998

Fungal colonisation and fluconazole therapy in acute liver disease.

BACKGROUND/AIMS: Fungal infection, particularly with Candida spp., has been identified as an important cause of morbidity and mortality in patients with acute liver failure. Fungal colonisation of superficial mucosal sites usually precedes invasive infection. We investigated colonisation patterns in patients with acute liver disease receiving fluconazole therapy in order to investigate the possibility of emergence of fluconazole-resistant C. albicans or other species. METHODS: During a 6-month study period, we studied all patients referred to our unit with acute liver disease by twice-weekly sampling and mycological analysis of specimens from superficial mucosal and other sites as appropriate. Patients were treated with prophylactic antimicrobials including 100 mg fluconazole daily in accordance with our usual protocol. RESULTS: Twenty-two patients with acute liver disease were studied, eight of whom underwent transplantation. Eighteen patients were colonised by fungi at presentation, and six developed secondary colonisation during fluconazole therapy. Four of these patients (all transplanted) became colonised by resistant species; one of these was Aspergillus fumigatus, which led to death. There were no other invasive fungal infections identified during the study period, and no fluconazole-resistant C. albicans were identified. CONCLUSIONS: Resistance to fluconazole is unlikely to develop in C. albicans during short-term fluconazole prophylaxis in acute liver disease, and in this study we did not find evidence of invasive disease from other Candida spp. during fluconazole therapy. However, in patients at particularly high risk, other strategies are required to prevent infection with Aspergillus spp.

Antifungal Agents↗
PubMed1997

Environmental injuries.

Environmental injuries and illnesses can happen in home, work, or recreational settings. The variety and severity of these injuries might require the clinician to call on skills from internal medicine, emergency medicine, and toxicology. Diseases of thermoregulation are hypothermia and hyperthermia. In each instance, treatment is based on the need to restore the patient's core temperature to normal and on monitoring for complications. The victim of a fire might suffer inhalation injury in addition to burns, and it is more likely that the inhalation injury will be fatal. Oxygen deprivation and inhalation of irritant or asphyxiant chemicals contribute to injury. Toxic plants can be the source of poisoning emergencies, especially in children. Misinformation and myths that surround common plants can create diagnostic problems (i.e., which plants really are toxic and require emergency measures). Venomous marine organisms can cause a wide range of injury, from cutaneous eruption to fatal envenomation. Most are encountered in a recreational setting, such as water sports, but keepers of home aquariums are subject to stings from venomous fish. Lightning injury can present many diagnostic and treatment dilemmas. An important point in this regard is that lightning injury and high-voltage electrical injury are different in pathology and require different approaches for treatment. A discussion of electrical, chemical, and thermal burns makes such differences apparent.

Burns↗
PubMed1995

Urinary iron speciation in nephrotic syndrome.

In nephrotic syndrome, iron is presented to the tubule fluid in a nonreactive form in association with transferrin as a result of the glomerular protein leak. At an alkaline pH, iron remains bound to transferrin throughout the nephron and is excreted as such in the urine. As urine pH decreases below 6, iron is dissociated from transferrin. In the dissociated form, iron exists in the urine in a soluble, ultrafiltrable, and labile state. It is suggested that iron is maintained in this state by chelation to a relatively small organic compound, such as citrate. This non-transferrin-bound iron is capable of catalyzing bleomycin degradation of DNA, suggesting that this labile form of iron is able to catalyze free radical formation and cause tubule cell injury. Urine from proteinuric states represents one of the few, if not only, biologic fluids containing large amounts of reactive iron species. This may explain the mechanism by which proteinuric states cause tubulointerstitial disease and renal failure.

Animals↗
PubMed1995

Surgical management of subclavian vein obstruction, including six cases of subclavian vein bypass.

BACKGROUND: The indications are still being developed for the various procedures available to treat thrombotic and nonthrombotic subclavian vein obstruction. This article explores our experience with the surgical options, primarily with chronic venous occlusion, but also with acute thrombosis. METHODS: Twelve patients presented with acute or chronic venous thrombosis or nonthrombotic venous obstruction. Treatment included thrombolysis, vein patch angioplasty, thrombectomy, first rib resection, venolysis, and/or subclavian vein bypass by either jugular vein transposition or prosthetic axillojugular bypass. RESULTS: Six patients experienced relief of all symptoms; the other six have had relief from pain but continue to have occasional swelling. CONCLUSIONS: On the basis of our anecdotal experiences and those of others, the following protocol has been developed. After acute thrombosis, lytic therapy is recommended. If successful, first rib resection and venolysis should be considered; if unsuccessful and the patient has significant symptoms, immediate thrombectomy is indicated. If patency is established, rib resection and venolysis should follow. Persistent stenosis is treated by angioplasty, either with a vein patch or percutaneously. Complete occlusion is managed by jugular vein transposition or axillojugular bypass. Temporary arteriovenous fistulas accompany all open venous repairs.

Adolescent↗
PubMed1995

Emergent care of lightning and electrical injuries.

High-voltage electrical injuries may be devastating, with extensive burns, cardiac arrest, amputations, and long, complicated hospitalizations. Low-voltage injuries, after other pathologic and high-voltage sources are ruled out, tend to be rather benign acutely although they may have significant long-term morbidity, including chronic pain syndromes. Lightning injuries affect 800 to 1000 persons per year. In lightning injury, cardiac arrest is the main cause of death, burns tend to be superficial, ad injuries often are what one would expect of short-circuiting or overloading the body's electrical systems (tinnitus, blindness, confusion, amnesia, cardiac arrhythmias, and vascular instability). Although high-voltage injuries may require the services of trauma surgeons, in general, therapy for low-voltage and lightning injury is supportive and involves cardiac resuscitation for the more seriously injured and supportive care for the less severely injured. Long-term problems from sleep disturbances, anxiety attacks, pain syndromes, peripheral nerve damage, fear of storms (for lightning patients), and diffuse neurologic and neuropsychologic damage may occur in both electrical and lightning patients. Other sequelae--such as seizures or severe brain damage from hypoxia during cardiac arrest and spinal artery syndrome from vascular spasm--are indirect results of electrical and lightning injury.

Clinical Laboratory Techniques↗
PubMed1995

Practice satisfaction, occupational stress, and attrition of emergency physicians. Wellness Task Force, Illinois College of Emergency Physicians.

OBJECTIVE: To define sources of job satisfaction and stress among emergency physicians and assess self-projected career longevity. DESIGN: A survey containing questions regarding emergency medicine (EM) practice satisfaction was mailed to 1,317 diplomates of the American Board of Emergency Medicine (ABEM). Specific sources of practice satisfaction and dissatisfaction, self-reported burnout or impairment, and plans for remaining in the specialty were assessed. Data were compared between two groups of physicians, namely, those residency-trained in EM and those attaining certification through the practice or special category tracts. RESULTS: Of the physicians returning the survey, 25.2% stated that they felt burned out or impaired and 23.1% planned to leave the practice of EM within five years. Perceptions of burnout/impairment and plans to stop practice were associated with less overall practice satisfaction but were not significantly different between the two groups of physicians. Burnout/impairment was linked with psychiatric, drug, or alcohol problems and the feeling that EM had contributed to that problem. CONCLUSION: This study confirms the relatively high levels of projected attrition in EM and supports the perception that stress and burnout are associated with the specialty. Differences in job satisfaction and stress between those ABEM diplomates who were residency-trained in EM and those who became eligible for the board examination through practice or special-category eligibility appear minor.

Adult↗
PubMed1995

Maintenance chemotherapy with daily oral etoposide following salvage therapy in patients with germ cell tumors.

PURPOSE: To evaluate the role of maintenance daily oral etoposide (VP-16) chemotherapy for germ cell patients who had a response to salvage therapy. PATIENTS AND METHODS: Thirty-seven patients were entered onto this trial, and 34 were fully assessable. This was as heavily pretreated patient population, with a median of two prior salvage regimens. The salvage treatment that immediately preceded oral VP-16 consisted of autologous bone marrow transplantation in 14 patients (41%), surgery in 10 (29%), and standard-dose salvage chemotherapy in 10 (29%). Daily oral VP-16 was administered at a dose of 50 mg/m2 for 21 consecutive days every 4 weeks for three cycles. RESULTS: The major toxicity with daily oral VP-16 was leukopenia. Three patients had grade III and two grade IV leukopenia. Two of these patients had granulocytopenic fever. Other grade III toxicities included thrombocytopenia (n = 1) and mucositis (n = 2). Twenty-three patients started daily oral VP-16 while in complete remission (CR) following salvage therapy. Seventeen (74%) remain continuously disease-free, with a median follow-up time of 36 months (range, 26 to 49) from initiation of daily oral VP-16. Eleven patients started daily oral VP-16 while in partial remission (PR) following salvage therapy. Three of these 11 patients converted to CR, but all three subsequently relapsed. CONCLUSION: Maintenance oral VP-16 was well tolerated in this heavily treated patient population. Results in this poor-risk population were encouraging.

Administration, Oral↗
PubMed1995

Marked enzymuria after bone marrow transplantation: a correlate of veno-occlusive disease-induced "hepatorenal syndrome".

During the first month after bone marrow transplantation, approximately 15% of patients develop acute renal failure (ARF). This usually occurs in the setting of hepatic veno-occlusive disease (VOD). Prior clinical data have suggested that this form of ARF has a hemodynamic basis, analogous to the hepatorenal syndrome (HRS). If so, then proximal tubular injury would not be expected. To directly test this hypothesis, enzymuria (N-acetyl-beta-D-glucosaminidase [NAG]) was quantitated in the following groups of patients within the first 35 days after BMT: (1) VOD+ARF (serum creatinine level > 1.5 mg/dL; N = 10); (2) VOD with relatively normal renal function (serum creatinine level < 1.5 mg/dL; N = 11); and (3) patients without hepatic or renal complications (BMT controls; N = 12). For comparison, NAG was also quantitated in the following groups of non-BMT patients: (1) toxic/ischemic acute tubular necrosis (ATN) (N = 10); (2) jaundice without azotemia (N = 5); and (3) HRS (N = 6). Urine samples from eight healthy subjects established normal NAG concentrations (2.5 +/- 0.5 microU/mg urinary creatinine; mean +/- SE). All non-BMT patients with ATN had markedly elevated NAG levels (61 +/- 12; P < 0.001), validating the test as a marker of tubular damage. NAG concentrations were significantly elevated in all of the control BMT patients (24 +/- 3; P < 0.01), and the presence of VOD was associated with further striking increments (approximately 50 times normal). However, the degree of enzymuria was virtually identical for VOD patients with (125 +/- 27) and without (122 +/- 17) ARF. Jaundice in a non-BMT setting was associated with only mild NAG elevations (11 +/- 2). However, striking enzymuria was noted in all HRS patients (61 +/- 20), equaling the levels seen with ATN. The following conclusions were derived: (1) subclinical tubular injury, as defined by enzymuria, appears to be ubiquitous after BMT; (2) VOD dramatically increases the extent of enzymuria; (3) the degree of enzymuria in VOD patients is not correlated with renal dysfunction, implying that the associated ARF has a large hemodynamic component; and (4) HRS and ATN manifest comparable degrees of enzymuria, suggesting that substantial tubular damage exists in both of these forms of ARF.

Acetylglucosaminidase↗
PubMed1994

Familial occurrence of testicular cancer.

The etiology of testicular cancer is unknown. Familial testicular cancer is a rare entity that adds further information to research regarding the genetic influence on germ cell tumors. We report on 5 brothers, including 2 identical triplets and 1 fraternal brother, with testicular cancer and discuss the epidemiological factors. It appears that environmental and genetic factors must be considered.

Adult↗
PubMed1992

In-vitro activity of PD 131628, a new quinolone antimicrobial agent.

The in-vitro activity of PD 131628, the active metabolite of the prodrug PD 131112, was compared with that of ciprofloxacin and members of other groups of antimicrobial agents against 701 recent clinical isolates and strains with known mechanisms of resistance. The MIC90s of PD 131628 against the Enterobacteriaceae were between 0.008 and 0.5 mg/L; PD 131628 was one- to four-fold more active than ciprofloxacin against these strains and was four-fold more active than ciprofloxacin against Pseudomonas aeruginosa. Against the Gram-positive species tested, PD 131628 was two- to four-fold more active than ciprofloxacin, inhibiting all strains of Staphylococcus aureus and Streptococcus pneumoniae with 0.5 mg/L or less. PD 131628 was very active against Neisseria spp., Haemophilus influenzae and Moraxella catarrhalis, with MIC90s ranging from 0.004 to 0.008 mg/L. Organisms with decreased susceptibility to other quinolones had decreased susceptibility to PD 131628, but there was no cross-resistance between this class of antimicrobial and other classes. The protein binding of PD 131628 was at most 25% across a broad range of concentrations. The addition of 70% human serum had little effect on the MICs, but caused a two- to eight-fold increase in MBCs.

Anti-Infective Agents↗
PubMed1992

In-vitro activity of tosufloxacin, a new quinolone antibacterial agent.

The in-vitro activity of tosufloxacin (A-61827) was compared with that of temafloxacin, ciprofloxacin and selected members of other groups of antimicrobial agents, against 684 recent distinct clinical isolates and strains with known mechanisms of resistance. Against members of the Enterobacteriaceae, ciprofloxacin was slightly more active than tosufloxacin, which was more active than temafloxacin. The MIC90 of tosufloxacin for all species of Enterobacteriaceae, Pseudomonas aeruginosa and Acinetobacter spp. was less than or equal to 1 mg/L. Tosufloxacin was slightly more active than temafloxacin, and four to eight fold more active than ciprofloxacin, against the Gram-positive species tested. The MIC90 of tosufloxacin for Staphylococcus aureus was 0.12 mg/L, and for Streptococcus pneumoniae was 0.5 mg/L. All strains of Neisseria spp., Haemophilus influenzae and Moraxella catarrhalis were inhibited by tosufloxacin at a concentration of less than or equal to 0.12 mg/L. Tosufloxacin was the most active quinolone against the anaerobic organisms tested. Cross resistance between quinolones was seen, but not between quinolones and other groups of antimicrobials. The protein binding of tosufloxacin across a range of concentrations averaged 60%. Human serum at a concentration of 70% decreased the bactericidal activity of tosufloxacin by about four-fold.

4-Quinolones↗