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Biomedical subjects

M Cooper

Publications and source records attributed to M Cooper.

At least 109 records · Page 6Linked to original sources
PubMed1996

Implications of the emerging home systems technologies for rehabilitation.

This paper gives a review of the current and anticipated developments in Integrated Home Systems and raises the implications these have in the field of rehabilitation. Firstly, the systems under consideration are defined and their development world-wide outlined. An overview of the European Home Systems Specification is given. The implications of this technology for rehabilitation are then raised considering: environmental control in the home; how people with degenerative conditions may be more readily able to remain in their homes as condition progresses; and remote health monitoring. The expectation that the initial impact will be in the area of environment control is stated, and a closer look at this field is made comparing current with anticipated systems. An outline is given of the TIDE Project HS-ADEPT (Home Systems--Access for Disabled and Elderly People to this Technology). The key findings of the survey of users made at the outset of the project, relevant to this paper, are given. The ongoing work of the project is described in brief. The continuing developments in Integrated Home Systems and in particular the issue of standards are noted. Concluding comments are offered in the hope of stimulating the necessary interdisciplinary discussion if this technology is to realize its full potential in the field of rehabilitation.

Electronics, Medical↗
PubMed1996

Surgical management of brachioaxillary-subclavian vein occlusion.

OBJECTIVE: The possibility of using RING PTFE graft as venous bypass to preserve arteriovenous graft function and reduce upper extremity swelling. METHODS: Twenty-two patients with stenosis/occlusion of the brachial-axillary-subclavian vein segment in haemodialysis patients (n = 19) and patients with penetration injury (n = 3) who were not candidates for balloon angioplasty were treated with ring PTFE venous bypass in renal patients and jugular to axillary vein transposition for trauma patients and followed for 10-87 months (mean 31) using venography, Doppler analysis and Duplex scanning. RESULTS: There was no death or neurologic deficit resulting from the venous bypass. Resolution of swelling occurred in 8-48 h. 19/22 (86%) of the bypasses and 3/3 transpositions remained patent after a mean follow-up of 31 months (10-87) months. The attrition was due to AV graft occlusion (n = 2) and infection requiring graft removal (n = 1). CONCLUSIONS: Ring PTFE graft is an acceptable venous bypass for brachial-axillary-subclavian stenosis/occlusion to reduce arm swelling and preserve the function of AV grafts in patients with lesions not amendable with balloon angioplasty or thrombolytic therapy. Jugular-axillary transposition is inappropriate for renal patients.

Adult↗
PubMed1996

Obsessive-compulsive disorder: effects on family members.

A study of 225 family members of individuals with obsessive-compulsive disorder explored the greatest concerns of family members, examining the extent to which they found different kinds of OCD-linked behavior disturbing, and various resources helpful. Services to enhance family functioning are discussed.

Adolescent↗
PubMed1996

Predictors of the progression of renal insufficiency in patients with insulin-dependent diabetes and overt diabetic nephropathy. The Collaborative Study Group.

We designed a prospective, double-blind controlled trial to determine predictors of loss of renal function in patients with insulin dependent diabetes and established nephropathy. A total of 409 insulin-dependent diabetic patients with established nephropathy enrolled in a trial on the effect of Captopril on the rate of progression of renal disease. Baseline demographic, clinical (history and physical) and laboratory parameters were analyzed as risk factors for time to progression. Dichotomous characteristics were compared by Fisher's exact test and continuous characteristics with the Wilcoxon rank-sum test. Univariate proportional hazards regression analysis was used to estimate relative risk of nephropathy progression, and bivariate proportional hazard regression to identify interactions with the treatment group assignment. Multivariate proportional hazard regression was employed to determine which characteristics were independent risk factors. We found that a number of demographic and clinical characteristics were significantly associated with nephropathy progression even after adjustment for treatment group. However, after multivariate analysis, the risk factors that independently predicted progression were onset of IDDM later in life, parental diagnosis of IDDM, the presence of edema, increased mean arterial pressure, and an abnormal electrocardiogram. Likewise, a number of laboratory characteristics were also predictive of nephropathy progression. A low hematocrit, high blood sugar, and higher protein excretion predicted nephropathy progression as did a higher serum creatinine, particularly in the face of a normal serum albumin. In conclusion, this study identifies a number of clinical and laboratory risk factors that can predict which patients with insulin-dependent diabetes with established nephropathy are more likely to sustain a clinically important decrease in renal function over a median follow-up of three years.

Adolescent↗
PubMed1996

Growth of short children during and after discontinuation of growth hormone therapy.

We have attempted to evaluate the relationship between spontaneous growth hormone (GH) secretion and the response to GH therapy as well as the effect of discontinuation of GH therapy on further growth. The 24-h integrated concentration of GH (ICGH) was determined in 150 short children (< 2 SD for age) with a GH response to clonidine stimulation of more than 10 mcg/L. The patients were treated with GH for 4 yr and were observed for 1 yr following cessation of GH treatment. Twenty-two out of 52 patients who had an ICGH of less than 3.2 mcg/L (group LICGH) and 28 out of 60 patients who had an ICGH of more than 3.2 mcg/L (group NICGH) were followed without GH therapy. Only patients who remained prepubertal throughout the study were included in the analysis. The growth response of the LICGH to GH was better than that of the NICGH children. Patients regained normal growth velocity 6-12 months after discontinuation of GH therapy. Three children of the LICGH subsequently developed classic GH deficiency. These studies demonstrate that short-term GH therapy can improve the growth channel. Children with a low ICGH grow better on GH than children with a normal ICGH. Children with a low ICGH need continued observation and retesting when growth velocity is low.

Body Height↗
PubMed1996

Disposition and bioavailability of ceftazidime after intraperitoneal administration in patients receiving continuous ambulatory peritoneal dialysis.

This study investigated the disposition and bioavailability of ceftazidime when it was given intraperitoneally. Seven patients were given 1 gm of ceftazidime intravenously, and 1 wk later, the same dose was given intraperitoneally. After both intravenous and intraperitoneal dosing, serum and peritoneal dialysate samples were obtained at set time intervals over a 24-h period. High-performance liquid chromatography was used to determine the ceftazidime concentrations in the serum and dialysate samples. Inspection of the concentration versus time data after intraperitoneal dosing demonstrated that serum ceftazidime concentrations reached therapeutic (> 8 micrograms/mL) levels within 30 min and remained in the therapeutic range for the entire 24-h period. Simulation of a variety of ceftazidime dosing regimens using the mean pharmacokinetic parameters from this population of patients suggests that a regimen of 1.5 gm administered intraperitoneally every 24 h produces trough serum drug concentrations (approximately 40 micrograms/mL) similar to those achieved with a standard regimen of 1.0 gm given intravenously every 24 h in patients undergoing continuous ambulatory peritoneal dialysis. It was concluded that the intraperitoneal dosing of ceftazidime in these patients is an equally effective and a more convenient alternative to its administration.

Aged↗
PubMed1996

Organ specificity of antihypertensive therapy on ocular albumin vascular clearance and albuminuria in the hypertensive diabetic rat.

PURPOSE: The contributions of hypertension and diabetes to microvascular dysfunction in the kidney and eye were investigated. Two indices of microvascular dysfunction, urinary albumin excretion rate (AER) and albumin vascular clearance (AVC) in the eye, were studied in control and streptozocin diabetic Wistar Kyoto (WKY) and spontaneously hypertensive rats (SHR). METHODS: Studies were performed on four groups of untreated rats--nondiabetic and diabetic WKY and nondiabetic and diabetic SHR--and on three groups of diabetic SHR treated with a converting enzyme inhibitor (perindopril), a calcium-channel blocker (lacidipine), or triple therapy (hydrochlorothiazide, reserpine, and hydralazine). In all rats, AER and AVC were measured at 16 weeks. RESULTS: There was a progressive increase in both parameters in the order WKY, diabetic WKY, SHR, and diabetic SHR. When compared with nondiabetic WKY, diabetic SHR showed an approximately 30-fold increase in AER and an approximately threefold increase in AVC. Treatment of diabetic SHR with perindopril or triple therapy normalized AER compared to an equihypotensive dose of lacidipine, which had no effect. By contrast, the three antihypertensive regimens showed a different order of efficacy in preventing increases in ocular AVC. In diabetic SHR, the increase in retinal AVC was prevented largely by lacidipine, whereas the other two antihypertensive regimens showed lesser effects [AVC expressed as percentage nondiabetic WKY: untreated diabetic SHR 278% +/- 47%, lacidipine 93% +/- 10% (P < 0.001), triple therapy 132% +/- 37% (P < 0.05), and perindopril 167% +/- 9% (P < 0.05)]. Lacidipine also prevented the increase in AVC of the anterior and posterior uvea. By contrast, increases in AVC observed in the diabetic SHR were not prevented by perindopril in the posterior uvea or by triple therapy in the anterior uvea. Thus, hypertension and diabetes increased ocular AVC and AER, and effective antihypertensive therapy substantially prevented changes in both parameters. However, despite equivalent levels of blood pressure control for each regimen, discordant effects were noted on AVC and AER. Perindopril was associated with significantly lower AER than lacidipine, whereas lacidipine was more potent in preventing increases in ocular AVC. CONCLUSIONS: Results of this study suggest that different antihypertensive regimens in the diabetic rat may exert organ-specific effects on the retina and kidney despite equivalent effects on systemic blood pressure. These data also raise the possibility that retinal microvascular dysfunction in diabetes is ameliorated more readily by calcium-channel blockade than by converting-enzyme inhibition, whereas the reverse applies to renal microvascular dysfunction, as reflected by albuminuria.

Albuminuria↗
PubMed1996

Cardiovascular-radical outcome method is effective in complex congenital cardiac lesions.

BACKGROUND: The cardiovascular-radical outcome method is a proactive process of patient care that uses standard critical pathway methodology to reduce negative variation while encouraging positive variation to accelerate recovery. Its effectiveness in patients with complex congenital heart disease is explored. METHODS: Two hundred fourteen consecutive patients with congenital heart disease were cared for using the cardiovascular radical outcome method. Age ranged from 2 days to 19 years (median age, 3 years). Cardiovascular radical outcome method data were compared with the pathway plan data for each patient. RESULTS: Survival was 99% (211 patients) with an overall reduction in stay of 156 days (0.74 day/patient) (p < 0.0001). Only 10 patients (5%) exceeded the pathway plan; 201 (95%) reached the planned length of stay (critical pathway method), and 127 patients (60%) had a shorter length of stay than expected by the critical pathway method. One hundred forty-eight patients (70%), including 95 (64%) with more complex conditions, had a length of stay of 3 days and 18% achieved a 2-day length of stay, the maximal response. The process was most effective in the most complex groups, although preoperative comorbidities influenced outcomes. Outcome assessment demonstrated minimal morbidity and excellent family satisfaction. CONCLUSIONS: The radical outcome method is effective in reducing the length of stay of patients with complex congenital heart disease. The power is in the process rather than the plan, and the method provides optimal patient care and family satisfaction.

Adolescent↗
PubMed1996

Suicide following homicide in the family.

Previous research has established that perpetrators of homicide-suicide share more characteristics with those who commit suicide than they do with those who commit homicide without suicide. This article examines the characteristics of victims, perpetrators and the circumstances leading to the homicide of a sample of familial homicide-suicides and familial homicides in southwest British Columbia. A familial homicide was defined as one in which the victim and perpetrator were related directly or indirectly through blood or an intimate relationship. Suicide only occurred following the killing of an intimate partner and/or offspring. Consistent with an evolutionary perspective, homicides followed by suicide were most often attributable to male proprietariness (manifested by killing former intimate partners or offspring following an intimate separation) or mental illness. By contrast, none of the murders which occurred as a result of violence by the victim, child abuse, family conflict, or financial/criminal motives was followed by suicide.

Adult↗
PubMed1995

Cloning and characterisation of the gene encoding the ribosomal protein S5 (also known as rp14, S2, YS8) of Saccharomyces cerevisiae.

The protein sequence derived from a cloned yeast gene and partial cDNA has high sequence identity to 40S ribosomal subunit S5 proteins of higher eukaryotic origin. The open reading frame of the gene is flanked by consensus sequence motifs characteristic of ribosomal protein genes and the pattern of transcription of the gene in yeast cells subjected to nutritional shift or temperature shock is also typical of a ribosomal protein gene. The gene is single copy and essential for viability. The predicted sequence of the N-terminus of the protein identifies it as a phosphorylated ribosomal protein variously known as rp14, S2 or YS8, the least basic of the non-acidic ribosomal proteins of Saccharomyces cerevisiae.

Amino Acid Sequence↗
PubMed1995

The expression of the imprinted H19 and IGF-2 genes in human bladder carcinoma.

The imprinted H19 gene is highly expressed in human embryos, fetal tissues and is nearly completely shut off in adults. However, it is reexpressed in a number of tumors including bladder carcinoma, demonstrating that H19 RNA is an oncofetal RNA. Tumors induced by injection of bladder carcinoma cell lines express H19 in contrast to the cells before injection. These observations support the notion of a positive correlation between H19 expression and bladder carcinoma. Loss of imprinting of H19 and IGF-2 was observed in samples of human bladder carcinoma.

Animals↗
PubMed1995

Identification and characterization of Uss1p (Sdb23p): a novel U6 snRNA-associated protein with significant similarity to core proteins of small nuclear ribonucleoproteins.

The SDB23 gene of Saccharomyces cerevisiae was isolated in a search for high copy-number suppressors of mutations in a cell cycle gene, DBF2, SDB23 encodes a 21,276 Da protein with significant sequence similarity to characterized mammalian snRNP core proteins. Examination of multiple sequence alignments of snRNP core proteins with Sdb23p indicates that all of these proteins share a number of highly conserved residues, and identifies a novel motif for snRNP core proteins. Sdb23p is essential for cell viability and is required for nuclear pre-mRNA splicing both in vivo and in vitro. Extracts prepared from Sdb23p-depleted cells are unable to support splicing and have vastly reduced levels of U6 snRNA. The stability of U1, U2, U4 and U5 spliceosomal snRNAs is not affected by the loss of Sdb23p. Antibodies raised against Sdb23p strongly coimmunoprecipitate free U6 snRNA and U4/U6 base-paired snRNAs. These results establish that SDB23 encodes a novel U6 snRNA-associated protein that is essential for the stability of U6 snRNA. We therefore propose the more logical name USS1 (U-Six SnRNP) for this gene.

Amino Acid Sequence↗
PubMed1995

Sacral edema: computed tomographic and anatomical observations.

Sacral edema is a widely recognized clinical sign. Hitherto there has been no method of radiological confirmation, nor has the anatomy of this sign been well described. In a prospective study of 100 patients referred for abdominopelvic computed tomography (CT), 17 showed radiological evidence of sacral edema. It was demonstrated clinically in 12 of these 17 patients, leaving five patients with apparent CT evidence of sacral edema in whom this was not demonstrated clinically. In two patients with clinical evidence of sacral edema, their tissue planes in this region appeared normal on CT. The edema fluid accumulates in an intermediate plane of fibrous tissue within the subcutaneous fatty layer of the trunk. In those 17 patients with CT evidence of edema, the center of the fluid accumulation was situated over the lumbar rather than the sacral spine, suggesting that the term "sacral" edema is something of a misnomer.

Adolescent↗