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Biomedical subjects

N J Cooke

Publications and source records attributed to N J Cooke.

At least 19 recordsLinked to original sources
PubMed2001

Tracheobronchial involvement with Crohn's disease.

We report the case of a young woman with Crohn's disease of the bowel who presented with a purulent tracheobronchitis and life-threatening upper airway obstruction. Fibreoptic bronchoscopy demonstrated severe tracheal and upper bronchial pseudotumours and stenosis. The role of recent discontinuation of corticosteroids, for quiescent inflammatory bowel disease, in the development of endobronchial disease and the dramatic response in airway patency after reintroduction of prednisolone in this rare complication of Crohn's disease are discussed.

Adult↗
PubMed2000

Measuring team knowledge.

Multioperator tasks often require complex cognitive processing at the team level. Many team cognitive processes, such as situation assessment and coordination, are thought to rely on team knowledge. Team knowledge is multifaceted and comprises relatively generic knowledge in the form of team mental models and more specific team situation models. In this methodological review paper, we review recent efforts to measure team knowledge in the context of mapping specific methods onto features of targeted team knowledge. Team knowledge features include type, homogeneity versus heterogeneity, and rate of knowledge change. Measurement features include knowledge elicitation method, team metric, and aggregation method. When available, we highlight analytical conclusions or empirical data that support a connection between team knowledge and measurement method. In addition, we present empirical results concerning the relation between team knowledge and performance for each measurement method and identify research and methodological needs. Addressing issues surrounding the measurement of team knowledge is a prerequisite to understanding team cognition and its relation to team performance and to designing training programs or devices to facilitate team cognition.

Cognitive Science↗
PubMed1996

Compliance with oral corticosteroids during steroid trials in chronic airways obstruction.

BACKGROUND: Corticosteroid trials are an important part of the assessment of patients with chronic airways obstruction, but false negative results will occur if the treatment is not taken. To determine compliance low dose phenobarbitone has been used as a marker. METHODS: Thirty six patients referred to a chest clinic for assessment of their airways obstruction were studied. They were instructed to take eight capsules (each containing 5 mg prednisolone and 0.5 mg phenobarbitone) per day for two weeks. The response was assessed by home peak flow monitoring and clinic spirometric tests. Plasma phenobarbitone levels were measured after the trial to enable calculation of the dose to plasma concentration ratio (level to dose ratio, LDR) and the result was compared with the reference range for fully compliant individuals. RESULTS: Five patients defaulted from follow up, 23 had LDR values within the expected range, and eight had low LDR values consistent with poor compliance. The nine patients with steroid responsive disease (> 20% improvement in peak flow or spirometric parameters) all had LDR values in the expected range. CONCLUSION: Excluding those who defaulted whose compliance must be questionable, eight (26%) patients did not fully comply with the steroid trial. Not all patients who fail to respond to a two week home steroid trial have a steroid "unresponsive" disease.

Adult↗
PubMed1995

A comparison of 'abruptly stopping' with 'tailing off' oral corticosteroids in acute asthma.

Systemic corticosteroids are almost universally used in the treatment of severe acute asthma but the optimum length of treatment with corticosteroids following recovery from an acute attack of asthma is not established. Thirty-five patients admitted with acute asthma and treated with oral prednisolone 40 mg daily in addition to bronchodilator therapy until full recovery, with stable peak expiratory flow recordings (PEF) within 15% of their previous best PEF or predicted PEF were studied. They were all discharged home on regular inhaled corticosteroids and regular or as required use of bronchodilators and randomized to receive either prednisolone 40 mg daily or placebo for the first 14 days. Median PEF values increased from 31% predicted on admission to hospital to 71% predicted on discharge from hospital in the active treatment group (19 patients) and from 32-73% in the placebo group (16 patients). There was no difference between the two groups in the median values of the forced expiratory volume in one second, forced vital capacity, total lung capacity or diurnal variation in PEF either at the time of discharge from hospital or at 14 and 28 days after discharge from hospital. This study suggests that there is no need to reduce prednisolone gradually following recovery from an exacerbation of asthma, provided systemic corticosteroid treatment is continued until a satisfactory and stable PEF is achieved.

Acute Disease↗
PubMed1994

Constructing naive theories of motion on the fly.

People often make erroneous predictions about the trajectories of moving objects. McCloskey (1983a, 1983b) and others have suggested that many of these errors stem from well-developed, but naive, theories of motion. The studies presented here examine the role of naive impetus theory in people's judgments of motion. Subjects with and without formal physics experience were asked to draw or select from alternatives the trajectories of moving objects that were presented in various manners. Results from two experiments indicate that both trajectory judgments and explanations were affected by specific response and display features of the problem. In addition, these data provide little evidence that naive impetus theory plays a significant role in subjects' performance; instead, they suggest that motion judgments and explanations are constructed on the fly from contextual cues and knowledge that is not necessarily naive.

Attention↗
PubMed1993

Ecology of Haemophilus influenzae and Haemophilus parainfluenzae in sputum and saliva and effects of antibiotics on their distribution in patients with lower respiratory tract infections.

Nine patients with lower respiratory tract infections were used to study in detail the effect of ampicillin or erythromycin on the colonization patterns of Haemophilus influenzae and Haemophilus parainfluenzae in sputum and saliva. H. influenzae was isolated from purulent sputum of eight patients before the start of treatment. Ampicillin was more effective than erythromycin at clearing H. influenzae from sputum and in decreasing purulence. By careful characterization of multiple strains, the changes in biotype distribution and antibiotic susceptibility patterns were shown. Five biotypes of H. influenzae were associated with chest infection, with type II predominating. Mixed biotype infections occurred in five patients. Most saliva contained multiple biotypes of H. parainfluenzae. Neither antibiotic selected resistant haemophili in saliva or sputum. After treatment with ampicillin, the mucoid sputum was colonized with ampicillin-susceptible H. parainfluenzae biotypes previously found in saliva. We postulate that as inflammation decreases at the bronchial mucosa, the ampicillin concentration drops, allowing ampicillin-susceptible oral H. parainfluenzae isolates to seed the residual mucoid sputum.

Ampicillin↗
PubMed1993

Pancoast syndrome: an unusual presentation of adenoid cystic carcinoma.

We report on a patient with primary pulmonary adenoid cystic carcinoma presenting with Pancoast syndrome. Pancoast syndrome has not previously been described with this tumour. Other unusual features of this case include the peripheral origin and mediastinal involvement, with lack of proximal endobronchial spread.

Adult↗
PubMed1991

Salmeterol rash.

Explore the source record for details and available documents.

Adrenergic beta-Agonists↗
PubMed1989

Prescribing of nebulized bronchodilators--can we change bad habits?

The accuracy of prescriptions for bronchodilator drugs was monitored before and after an educational circular to the medical staff of five medical wards. The circular contained model prescriptions for beta-agonists alone and combined with ipratropium bromide. There was a significant improvement overall in the accuracy of prescribing.

Albuterol↗
PubMed1988

The use of high dose inhaled beclomethasone dipropionate as a means of assessing steroid responsiveness in obstructive airways disease.

The use of high dose inhaled beclomethasone dipropionate (BDP) as a means of assessing steroid responsiveness in chronic obstructive airways disease (COAD) was assessed in 22 patients in a study involving three consecutive 2-week periods of placebo, inhaled BDP (1500 micrograms daily), and oral prednisolone (30 mg daily). Five of the 22 patients were considered steroid responsive following the course of oral corticosteroids and in each case this responsiveness had been identified by inhaled BDP therapy. It is concluded that high dose inhaled BDP (1500 micrograms daily) may be used to assess corticosteroid responsiveness in COAD.

Administration, Inhalation↗
PubMed1987

Audit of work-load of physicians with a special interest in respiratory medicine.

A 6-month prospective survey was undertaken to assess the work-load of two consultant general physicians with special interest in respiratory medicine, one in a teaching hospital (TH) and the other in a district general hospital (DGH). The two firms dealt with similar numbers of inpatients of whom half had non-respiratory disease. Eighty per cent of the outpatient work of both firms was respiratory disease. The TH firm saw more referrals from other consultants and referred more patients, especially to other physicians. Practical procedures performed, the proportion of patients seen by the consultant at first attendance and the range of both respiratory and general medical conditions seen by the two firms was similar.

England↗