Search PubMed⌕ Search

Biomedical subjects

M S Cook

Publications and source records attributed to M S Cook.

5 recordsLinked to original sources

Case study. Risperidone-Induced neuroleptic malignant syndrome in an adolescent.

Neuroleptic malignant syndrome (NMS) is a potentially fatal complication of neuroleptic therapy, characterized by fever, rigidity, mental status changes, and autonomic instability. Although NMS was previously associated with the use of high-potency neuroleptics, cases have begun to emerge with atypical neuroleptics. This article presents a risperidone-induced case in the youngest patient to date, raising issues concerning our perceptions, the safety of newer neuroleptics, and treatment of NMS.

Adolescent↗

Inaccuracies in digoxin measurement.

Six commercial digoxin immunoassay kits were evaluated for their accuracy of calibration and their extent of interference by digoxin-like immunoreactive substance (DLIS). Calibration accuracy was investigated with digoxin reference standards in pooled human serum. The Abbott and Becton Dickinson kits underestimate while the other kits overestimate digoxin concentration. The magnitude of this bias generally increases with increasing concentration of digoxin. Sera from digoxin-free patient populations with potential DLIS interference--pregnant women, newborns, hypertensives, and uremics--were analyzed with each kit. Healthy subjects not on digoxin therapy served as controls. Groups with DLIS interference, as exemplified by a significant difference of p less than 0.05 from controls, are: Abbott--newborns and pregnant women; Becton Dickinson--newborns and pregnant women; Dade--no difference; Dupont--newborns, uremics, pregnant women, and hypertensives; Kallestad--newborns; and Syva--newborns. The limitations of each individual digoxin method should be realized for DLIS interference and bias, and patient results from that method should be interpreted accordingly.

Adult↗

Improved nuclear fluorescence screening technique.

Three separate screening studies have tested the sensitivity and specificity of quantitative fluorescence image analysis for detecting bladder cancer. Nuclear intensity (NI) measurements of fluorescent dye-stained epithelial cells from voided urine and bladder washings were compared with routine Papanicolaou (Pap) cytology results, and findings were verified against pathological biopsy diagnoses. The NI cytology method detected the pathologically confirmed tumors earlier and with greater specificity than did conventional cytology. In the study of 140 clinically symptomatic patients in Oklahoma, the NI method detected 91.1% (31 of 34) of the pathologically confirmed grades 1 and 2 tumors and 100% of 18 grades 3 and 4 tumors. Pap cytology detected only 47% (16 of 34) of low-grade and 78% (14 of 18) of high-grade tumors. Comparable results were obtained in a study of symptomatic patients in Mississippi and the method has been employed in the screening of a high-risk occupationally exposed cohort in Georgia.

2-Naphthylamine↗