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Biomedical subjects

M Cooper

Publications and source records attributed to M Cooper.

At least 127 records · Page 7Linked to original sources
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↗
PubMed1995

Epilepsy and employment--employers' attitudes.

The aim of this study was to examine the possible causes of employment difficulties amongst people with epilepsy by interviewing employers. It was hoped that the outcome of the study would complement the research already carried out in this field by concentrating on the attitudes and policies of employers. Due to the time limit it was decided that a small number (five) of local employers should be approached requesting an interview. The employers were randomly selected but were all large companies within varying industries. All employers approached agreed to participate in the study and interviews were arranged with welfare recruitment staff. The interviews were limited to 45 minutes and concentrated on three main issues for discussion: disclosure, unemployment and improved relationship between employers and people with epilepsy. The outcome of the interviews was that the employers appeared to be rather unaware of the employment problems faced by people with epilepsy. As epilepsy is generally not a registered disability employers are unable to monitor their company's recruitment and promotion methods. It seems that line managers are left to decide on the employment of people with epilepsy often without even general awareness training on equal opportunities. Consequently their need to meet targets and their personal attitude to epilepsy determine the employment chances for people with epilepsy. Only with legislations protecting the interests of people with epilepsy can the unemployment figures be brought in line with the general population.

Adult↗
PubMed1995

Development of a training model for ultrasound-guided invasive procedures in fetal medicine.

Training in ultrasound-guided procedures in fetal medicine is currently available in a few major fetal medicine units. Unlike elective surgical procedures, cordocentesis is usually performed without sedation as an outpatient procedure and active supervision of the trainee intensifies the anxiety already felt by the patient. In addition, the complication rate is higher in the initial few procedures or when the procedure is not regularly practiced. We have developed a comprehensive method of training for transabdominal invasive procedures using a medical model that simulates the in vivo situation.

Cordocentesis↗
PubMed1995

Applying the codependency model to a group for families of obsessive-compulsive people.

Obsessive-compulsive disorder places formidable burdens on family members who are drawn into bizarre enabling behaviors to pacify their ill relatives. Some families exhibit a high tolerance for inappropriate behavior and evidence characteristics similar to those seen in families of alcoholics. This article applies the codependency group model to families of obsessive-compulsive people based on a definition of codependency that views these families as normal, feeling people who are trying to cope with unremitting stress. Clinical vignettes illustrate how these families are similar to families of alcoholics in their management of emotions and in their dysfunctional behaviors. Recommendations are offered for practitioners who work with families of mentally ill people.

Adult↗
PubMed1994

Microalbuminuria in diabetes.

This statement summarises current understanding of the role of microalbuminuria in diabetic nephropathy and describes its natural history and clinical relevance. It outlines core facts and makes recommendations for the management of patients with persistent microalbuminuria.

Albuminuria↗
PubMed1994

Surprising activity of flutamide withdrawal, when combined with aminoglutethimide, in treatment of "hormone-refractory" prostate cancer.

BACKGROUND: The best treatment for patients with "hormone-refractory" metastatic prostate cancer is unclear, particularly in patients for whom suramin and hydrocortisone have failed. PURPOSE: We investigated a combination of flutamide withdrawal and aminoglutethimide in suramin- and hydrocortisone-pretreated patients with "hormone-refractory" prostate cancer. METHODS: Twenty-nine patients with metastatic prostate cancer were treated with simultaneous flutamide withdrawal and aminoglutethimide (250 mg given orally four times daily). All patients were taking flutamide at the time of entry, and previous treatments with medical or surgical castration, flutamide, suramin, and hydrocortisone had failed in all of these patients. Because of suramin-induced adrenal insufficiency, all patients had previously received, and continued to receive, physiological doses of hydrocortisone. Treatment of all non-surgically castrated patients had previously failed; however, these patients continued to receive depot leuprolide. RESULTS: In 14 (48%) of 29 patients, the prostate-specific antigen (PSA) decreased by more than 80% for 4 or more weeks. Improvements in anemia, thrombocytopenia, soft-tissue masses, bone scans, and symptoms were also noted. Factors associated with response included prolonged flutamide pretreatment, a markedly elevated pretreatment PSA, and the absence of soft-tissue disease. CONCLUSIONS: Flutamide withdrawal, when combined with the simultaneous administration of aminoglutethimide, is a therapeutically active approach in patients with "hormone-refractory" prostate cancer. IMPLICATIONS: On the basis of these and additional data, we hypothesize that prolonged exposure to flutamide results in the selective proliferation of cancer cells containing a mutant androgen receptor that aberrantly recognizes flutamide metabolites and nonandrogenic steroids as androgenic stimuli.

Aged↗
PubMed1994

Critical pathway methodology: effectiveness in congenital heart surgery.

Critical pathway methodology has been demonstrated to provide producible reduction in average length of stay (ALOS) in adults in certain diagnostic-related groups and operations such as coronary artery bypass grafting. The efficacy of this approach in congenital heart surgery was explored. Two hundred eighty-six consecutive patients from a health maintenance organization treated by a single surgeon since the institution of diagnostic-related group coding at that health maintenance organization constituted the study group. One hundred fourteen patients were treated at a university hospital without critical pathway methodology (group 1) and 172, subsequently at the health maintenance organization institution using the methodology (group 2). Operation/lesion, age, and diagnostic-related group matching was possible in 61 pairs. Examination of the ALOS Hospital (operative and postoperative days) for the entire cohort revealed a 43.8% reduction in ALOS Hospital (p < 0.0001) and a 39.0% reduction in ALOS Intensive Care Unit (p < 0.0001). There was also significant reduction in ALOS Hospital and ALOS Intensive Care Unit in the operation/lesion-matched subsets. Outcome measures including operative and late mortality, readmission, unscheduled emergency room and clinic visits, and health maintenance organization family assessment survey demonstrated no improvement in outcome with increased hospital stay. Thus, critical pathway methodology when used in patients undergoing a congenital heart operation produces a significant reduction in hospital stay and intensive care unit stay as well as quality patient care with uniformity of outcome.

Adolescent↗