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Biomedical subjects

S Cobb

Publications and source records attributed to S Cobb.

At least 37 records · Page 2Linked to original sources
PubMed1987

The measurement of C-reactive protein and immune complexes in endocarditis caused by coagulase-negative staphylococci.

Coagulase-negative staphylococci are a major cause of early endocarditis following the insertion of prosthetic heart valves but rarely cause endocarditis in natural valves. From a 2-year prospective study we report seven cases: six with endocarditis related to prosthetic valves and one with endocarditis related to a natural valve. Each isolate of coagulase-negative staphylococcus was identified biochemically (six Staphylococcus epidermidis; one Staphylococcus hominis) and characterised by bacteriophage typing. Six isolates were also examined for slime production and for extracellular toxins and enzymes: all produced toxin but enzyme and slime production was variable. Concentrations of immune complexes and C-reactive protein in the serum were measured in six of the patients. Our results suggest that measuring C-reactive protein may be useful but measuring immune complexes is not helpful and takes more time.

Antigen-Antibody Complex↗
PubMed1987

Blunt traumatic dissection of the internal carotid artery treated by balloon occlusion.

An extensive traumatic intimal dissection of the internal carotid artery was successfully managed by permanent occlusion of the vessel with percutaneously-placed, inflatable balloons in a young patient who had suffered transient ischemic neurological attacks despite anticoagulation. This technique has not been previously reported for treatment of dissection. Review of 34 published reports of symptomatic intimal dissection associated with non-penetrating trauma to the head and neck revealed that most did not have a direct injury to the carotid region and that development of symptoms was often delayed. Only 50% of these patients had onset of neurological symptoms within six hours of the episode of trauma, while 33% remained asymptomatic for more than one week before complications occurred. In 15 patients who were treated surgically, only nine (60%) achieved full recovery. Operative repair was considered unduly hazardous in our patient because of extension of the spiral dissection to the base of the skull. Successful use of percutaneous balloon occlusion of the carotid in this patient suggests that this technique should be considered a worthy alternative for management of selected cases.

Adult↗
PubMed1986

Glaucoma treatment with once-daily levobunolol.

Although twice-daily instillation of topical beta-blockers is the standard regimen for treatment of increased intraocular pressure, once-daily therapy might improve patient compliance and provide greater safety. In a three-month, double-masked clinical trial, 92 patients with open-angle glaucoma or ocular hypertension received levobunolol 0.5% or 1% or timolol 0.5% once daily, in both eyes. Overall mean decreases in intraocular pressure were significantly greater in the groups treated with levobunolol than in the group treated with timolol. Intraocular pressure decreases averaged 7.0 mm Hg with levobunolol 0.5%, 6.5 mm Hg with levobunolol 1%, and 4.5 mm Hg with timolol. The intraocular pressures of 72% (18 of 25 patients) of those treated with levobunolol 0.5%, 79% (22 of 28 patients) of those treated with levobunolol 1%, and 64% (16 of 25 patients) of those treated with timolol were successfully controlled during the study. Heart rate and blood pressure decreases were minimal with both levobunolol and timolol. Study results indicated that once-daily treatment with levobunolol and, to a lesser extent, timolol is sufficient to control intraocular pressure successfully and safely.

Actuarial Analysis↗
PubMed1986

Inhibition of complement-mediated solubilisation of antigen-antibody complexes by serum factor(s) in patients with various connective tissue diseases.

Control of immune complex formation is important to limit disease resulting from their deposition in tissues. Any inhibition of immune complex solubilisation is thus significant in the pathogenesis of immune complex diseases. More than half of our patients with various rheumatic connective tissue diseases were demonstrated to have serum inhibition of immune complex solubilisation (12/16 rheumatoid arthritis, 22/37 systemic lupus erythematosus, 16/29 primary Sjogren's syndrome, and eight of nine with mixed connective tissue disease). This serum inhibitory activity did not correlate well with serum levels of IgM rheumatoid factor or circulating immune complexes, and its nature remains to be elucidated.

Antibodies, Antinuclear↗
PubMed1981

A general model for preventive intervention in clinical practice.

A five-stage collaborative project to develop curriculum and associated instructional materials in preventive medicine has been initiated by the Association of Teachers of Preventive Medicine in cooperation with the Center for Educational Development in Health at Boston University. As part of the first stage, a general model delineating physician responsibilities in the preventive dimension of clinical practice was developed and analyzed in terms of requisite attitudes, knowledge, and skills. The model is based on a theoretical matrix modified by consideration of optimal physician performance in three tracer conditions (lung cancer, gonorrhea, and hypertension) and the results of a Delphi survey among a sample of 50 primary care practitioners. Competency in planning a practice-based program of prevention and the ability to assist patients in modifying patterns of behavior emerged as significant determinants of physician effectiveness in preventive intervention.

Competency-Based Education↗
PubMed1980

Electrical wiring configurations and childhood leukemia in Rhode Island.

The study of the relationship between childhood leukemia and electric power line configurations in the greater Denver, Colorado, area by Wertheimer and Leeper (Am J Epidemiol 109:273-284, 1979) was repeated in Rhode Island, focusing on leukemia (age at onset, 0-20 years; year of onset, 1964-1978). The addresses of 119 leukemia patients and 240 controls were studied by mapping power lines within 50 yards (45.72 m) of each residence. The shortest distance between each power line and the point of the residence closest to it was found; the number and types of wires in each power line were noted. Exposure weights were assigned each type of wire using Wertheimer and Leeper's median field strength reading for each. Assuming that the strength of the field decreases with the square of the distance from its source, and that fields generated by different wires grouped in the same power line are simply additive, a summary value of relative exposure was calculated for each address. Quartile exposure values for controls were used to group patient exposures. Contrary to Wertheimer and Leeper's results, no relationship was found between leukemia and electric power line configurations.

Child↗
PubMed1980

The experience of losing a job: some effects on cardiovascular functioning.

Men whose jobs were abolished because of a permanent plant closing were followed for 2 years as they went through the phases of anticipation, plant closing, unemployment, and reemployment. Changes in serum cholesterol, blood pressure, body weight, cigarette smoking, and pulse rate were examined in relation to these stages of the job loss experience. In general, these indicators revealed a good deal of sensitivity to the stages, as well as to the difference in the rural-urban setting of the plants and to levels of social support. However, overall cardiovascular risk never exceeded the levels for controls and any "stress' effects were found to be self-limiting.

Adult↗
PubMed1975

Epilogue: meditations on psychosomatic medicine.

Presented are some personal views on the state of psychosomatic medicine as a science. It is suggested that the field needs more precision in language including exorcism of value judgments from certain dimensions, less circularity in stress-strain reasoning, more complex hypotheses, more emphasis on social support as a central variable and more acceptance of divergent research styles.

Attitude of Health Personnel↗