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Biomedical subjects

D Cooper

Publications and source records attributed to D Cooper.

At least 37 records · Page 2Linked to original sources
PubMed1992

Use of a novel technique of cutaneous lavage for diagnosis of Lyme disease associated with erythema migrans.

OBJECTIVE: Determining the microbial cause of cellulitis is often difficult. In this study, a novel two-needle lavage technique was used to culture Borrelia burgdorferi from the skin of suspected erythema migrans lesions. DESIGN: The yield of lavage cultures for B burgdorferi was compared with that of a 2-mm skin biopsy sample. SETTING: A Lyme disease diagnostic center located in an area in which Lyme disease is epidemic. PATIENTS: Forty-five patients with suspected erythema migrans who had not been treated with antimicrobial agents. INTERVENTION: Cutaneous lavage of the advancing edge of a suspected primary erythema migrans lesion was done for all 45 participants, 33 of whom also had a skin biopsy of the same lesion at an identical (14) or an adjacent (19) site. MAIN OUTCOME MEASURES: Growth of B burgdorferi in in vitro culture. RESULTS: Lavage fluid cultures grew B burgdorferi in 13 (29%) of the 45 cases (95% confidence interval [CI], 16% to 44%). Among the 33 cases in which both lavage and skin biopsy cultures were done, the yield of lavage culture was less than that of biopsy culture (P less than .09, 12/33 vs 20/33). If contaminated cultures are excluded, this difference is significant (P less than .05, 12/30 vs 20/27). CONCLUSION: Cutaneous lavage is a new diagnostic technique for recovery of B burgdorferi from erythema migrans lesions that has potential applicability to other types of cutaneous infections.

Biopsy↗
PubMed1992

Growth of the normal human lower urinary tract from 12 to 21 weeks gestation.

Normal development of the human lower urinary tract was studied between the 14th and 20th week of gestation using 3 modes of fixation. Fixation by direct distension provides a high degree of reproducibility of parameters used to study the growth of the fetal bladder. Using this method, fetuses ranging from 12 to 21 weeks gestation were studied. Results obtained demonstrate that the length of the bladder, the inter-ureteric distance, and the distance between the apex of the trigone and the distal tip of the urethra occur in a linear mode. Furthermore, the rate of growth of the male urethra was evidently higher when compared to that of the female from the 12th week of gestation. Data from this work can be used for a more accurate assessment of cases with abnormal lower urinary tract development.

Female↗
PubMed1992

Photosensitivity, abnormal porphyrin profile, and sideroblastic anemia.

Cutaneous photosensitivity in a 43-year-old man with idiopathic sideroblastic anemia associated with an abnormal porphyrin profile is reported. This condition was associated with elevated free erythrocyte porphyrin, plasma protoporphyrin, urine porphyrins (predominantly coproporphyrin), stool porphyrins (predominantly protoporphyrin), decreased ferrochelatase activity, and deletion of portions of the long arms of chromosomes 18 and 20. Five other patients with sideroblastic anemia and abnormal porphyrin profiles have been described; all but one of these patients had photosensitivity. The porphyrin profile of this patient is similar to that of three other previously described patients.

Adult↗
PubMed1992

Antithyroid drug effects on function and growth of FRTL-5 cells.

Although antithyroid drugs (ATDs) are known to exert their effects by inhibiting iodide organification within the thyroid follicular cell, a full understanding of their mechanisms of action is lacking. In this study the effects of methimazole (MMI) and propylthiouracil (PTU) on thyrotropin (TSH) and thyroid-stimulating immunoglobin (TSI)-stimulated cAMP production and growth in FRTL-5 cells was investigated. MMI, but not PTU, inhibited TSH-stimulated cAMP production, but only at the very highest concentration (10(-3) M): 0.3 +/- 0.01 vs 0.79 +/- 0.13 pmol/micrograms protein (p < 0.01). Neither MMI nor PTU inhibited TSI-stimulated cAMP production at any dose. Neither MMI nor PTU exhibited an inhibitory effect on TSH- or TSI-stimulated cell growth, as measured by [3H]-thymidine incorporation. These observations suggest that high concentrations of MMI may act to control thyroid function by inhibiting receptor-mediated cAMP production. Although decreases in thyroid gland size frequently occur during ATD therapy, neither MMI nor PTU exhibited any effect on TSH- or TSI-stimulated thyroid cell growth.

Animals↗
PubMed1992

The management of acute laryngo-tracheo-bronchitis (croup): a consensus view.

The management of croup relies upon the traditional clinical skills of observation and examination. Parental involvement is essential and the appropriate reassurance of the patient is important. Endotracheal intubation is required only in a small percentage of children whose airway is compromised to such a degree as to produce fatigue and/or near occlusion.

Adrenal Cortex Hormones↗
PubMed1992

Diagnosis of early Lyme disease by polymerase chain reaction amplification and culture of skin biopsies from erythema migrans lesions.

Current laboratory diagnosis of Lyme disease relies on tests for the detection of antibodies to Borrelia burgdorferi, the etiologic agent of the disease. These tests are often unreliable because of a lack of sensitivity and specificity and test-to-test variability. The purpose of this study was to evaluate the sensitivity and specificity of polymerase chain reaction (PCR) amplification for detection of B. burgdorferi in skin biopsy specimens. Forty-six 2-mm skin biopsy samples were obtained from 44 patients with a clinical diagnosis of erythema migrans, 9 of whom were receiving antibiotic therapy at the time of biopsy. Specimens were ground in BSK medium with separate aliquots taken for culture and PCR. Of the specimens from the untreated group, 57% (21 of 37) were positive by culture and 22% (8 of 37) were culture negative; 22% (8 of 37) of the cultures were uninformative because of contamination. By comparison, 22 (59%) of 37 specimens were positive by PCR amplification. Of 21 culture-positive samples, 13 (62%) were also positive by PCR analysis. Thus, the sensitivity of the PCR was 59 to 62%, based on either a clinical or cultural diagnosis of untreated Lyme disease. None of the nine specimens from antibiotic-treated patients grew in culture, whereas two of the nine were positive by PCR analysis. Given the complexity and time required for culture, PCR is a promising technique for the diagnosis of early Lyme disease.

Base Sequence↗
PubMed1992

A computer-aided socket design procedure for above-knee prostheses.

A computer-aided socket design procedure (CASD) has been developed whereby an above-knee socket shape can be created based on anthropometric measurements taken from an amputee. The anthroometric measurements are used to select a subset of three reference shapes from a Reference Shape Library stored in the computer in the form of three-dimensional numerical data. Transformation procedures then scale the reference shapes at each cross-sectional level to match the amputee's cross-sectional areas. Blending of the three shapes is determined by tissue mass weighting factors, to yield a single custom socket configuration, known as the "basic socket shape." Subsequent graphical procedures in the CASD system allows further sculpting of the shape in the form of interactive adjustments of the numerical data to reach the socket shape desired by the prosthetist. The resultant shape data can then be transferred to a computer numerically controlled (CNC) milling machine to carve a model of the socket shape.

Artificial Limbs↗
PubMed1992

To what extent do interactive pictures promote recall?

In four experiments, a total of 352 subjects viewed word pairs alone or accompanied by pictures, after which they were given a cued-recall test. Although Exps. 1 and 2 showed that recall of brand names was similar with separate and with interactive pictures, it was argued that the latter provided a cue enabling subjects to combine the separate components mentally. In Exp. 3, recall of both low concrete nouns and brand names was enhanced with interactive pictures and the effect was replicated in Exp. 4 with subjects who were learning English. These results offer hope to advertisers who wish to use interactive pictures whose relationship to their names is indirect.

Adolescent↗
PubMed1991

Urbanisation and women's health in Khayelitsha. Part I. Demographic and socio-economic profile.

Demographic and socio-economic data and information on migration patterns and urban/rural links was collected from 722 households in the formal housing area and the serviced and the unserviced site areas of Khayelitsha; 659 women and 61 men were interviewed. Thirty-eight per cent of the population were aged under 15 years and 77% under 35 years. There was a predominance of females in the 5-35-year age group. There was a mean of 4.9 persons per household, and 93.5% of sites contained 1 dwelling. Of the 659 female respondents, 7% had received no formal education, 39% had primary school education, and 54% had secondary school education. Unemployment among women was 45%. Domestic service accounted for 66.2% of formal employment. Of all women 86% were unskilled, 71.9% had been born in a 'homeland', and 69.7% had migrated to an urban area before 1985. Ties to the rural areas were strong, particularly in the 'shack' areas. 'New arrivals' to an urban area were young, mostly unemployed, and lived in the worst environmental conditions. In the unserviced 'shack' areas, 47.5% of women had migrated to an urban area in the last 5 years. There are important target areas for a study of the health effects of urbanisation and for possible interventions. This study tends to confirm the 'quadruple' oppression of women in Khayelitsha, on the basis of race, social class and gender and as new arrivals in an urban environment.

Adolescent↗
PubMed1991

Urbanisation and women's health in Khayelitsha. Part II. Health status and use of health services.

A study was conducted among women in Khayelitsha to determine the relationship between urbanisation, health status and use of health services; 722 households were visited, and 659 female respondents provided information on acute and chronic illness for the 3,229 individuals who were members of their households. In addition, they provided information concerning their reproductive health, AIDS awareness, knowledge of cervical smears and use and knowledge of health services. Acute illness was reported for 4.3% of the study population, the commonest complaints being diarrhoea, abdominal pain and upper respiratory infections; 4.4% reported chronic illness, the commonest complaints being hypertension and tuberculosis; 16.2% of women reported gynaecological illness; 86% had of heard of AIDS (although their knowledge of transmission and prevention was poor); and 45% had heard of cervical smears. Patterns of illness and knowledge and use of health services vary in the different areas of residence of Khayelitsha. This appears to be related to urbanisation, age, and environmental and socio-economic factors.

Black or African American↗
PubMed1991

Usefulness of the automatic implantable cardioverter defibrillator in improving survival of patients with severely depressed left ventricular function associated with coronary artery disease.

Clinical outcome was analyzed among a group of 39 consecutive patients with coronary artery disease, left ventricular (LV) ejection fractions less than 30% and arrhythmias that required an automatic implantable cardioverter defibrillator (AICD) in an attempt to better define the role of the device in patients with severely depressed LV function. Twenty-nine (74%) were survivors of out-of-hospital cardiac arrest and 10 (26%) had ventricular tachycardia that was refractory to electrophysiologically guided antiarrhythmic therapy. The study group had the following demographic characteristics: 90% were men, mean age was 64 years (range 41 to 79) and mean LV ejection fraction was 21 +/- 4%. Concomitant pharmacotherapy included antiarrhythmic drugs 31 (79%), vasodilators in 22 (56%) and digoxin in 20 (51%). There was no statistical difference in baseline characteristics between survivors and nonsurvivors. Patients were followed for a mean of 24 months (range 2 to 72) from implantation. The difference between actuarial survival--77% at 1 year and 72% at 2 years--and projected survival without the AICD (patients who survive without appropriate device discharge)--30% at 1 year and 21% at 2 years--was significant (p less than 0.01 and less than 0.05 at 1 and 2 years, respectively). This study suggests that the AICD improves survival in patients with coronary artery disease despite severely depressed LV function.

Adult↗
PubMed1991

Symptoms analysis for the diagnosis of genuine stress incontinence.

OBJECTIVE: To determine the accuracy of an analysis of symptoms alone for the diagnosis of genuine stress incontinence. DESIGN: A comparison of results of symptoms analysis with urodynamic findings. SETTING: A gynaecological video-urodynamic unit. SUBJECTS: 252 consecutive patients referred for urodynamic investigations. INTERVENTIONS: A questionnaire of 20 symptoms of lower urinary tract dysfunction, midstream specimen of urine, pad testing, uroflowmetry, and video-cystourethrography. MAIN OUTCOME MEASURES: Using the urodynamic diagnosis as the 'gold standard', the accuracy of discriminant function analysis of symptoms was determined. RESULTS: Symptoms analysis achieved a correct classification of 81% with a false positive rate of 16%. Use of an accumulative probability curve defines patients who fall into the equivocal range. CONCLUSIONS: All women presenting with incontinence should undergo preoperative urodynamic studies.

Female↗
PubMed1991

Doppler investigation of uteroplacental blood flow resistance in the second trimester: a screening study for pre-eclampsia and intrauterine growth retardation.

OBJECTIVE: To assess the screening properties of a mid-trimester uteroplacental Doppler scan in a normal unselected population. DESIGN: A cross-sectional study measuring an averaged resistance index (AVRI) from four sites (left and right uterine and arcuate arteries) with continuous wave Doppler ultrasound. SETTING: Routine booking ultrasound, King's College Hospital, London. SUBJECTS: 977 women at 16-24 weeks gestation. MAIN OUTCOME MEASURES: Intrauterine death, birthweight, pregnancy-induced hypertension (PIH), antepartum haemorrhage. RESULTS: There was a 96.5% follow-up. Pregnancies with high AVRI values had a higher prevalence of proteinuric hypertension, placental abruption, small-for-gestational-age babies, and fetal loss. When AVRI was greater than 95th centile, the overall risk of pregnancy complications was 67%, and the risk of a severe complication was 25%. However, the sensitivity of the test for these complications was only 13% and 21% respectively. The risk for an individual woman with a high AVRI of developing a complication was increased by up to 9.8 times. CONCLUSION: Although Doppler screening does detect a unifying defect leading to perinatal death, pre-eclampsia, growth retardation and placental abruption, the predictive values do not yet justify its introduction as a routine test.

Female↗
PubMed1991

Screening for alcoholism in a psychiatric hospital.

The prevalence of alcoholism is generally underestimated in patients in private practices, general hospitals and psychiatric institutions. Even though the World Health Organization has advocated the concurrent use of laboratory test results and questionnaires for screening, these methods are seldom used together. In this study, patients admitted consecutively to the North Bay Psychiatric Hospital were screened for alcoholism using the Michigan Alcoholism Screening Test (MAST) and gamma-glutamyl-transferase plasma level. Unexpectedly, 56.7% of the entire sample were identified as possible alcoholics; of these, 73.5% were men and 26.5% were women. When rates for men and women were looked at separately, it was found that 66.2% of the men and 40.6% of the women were alcoholic. Participants who tested positive on one or both of the screening tests were offered a more complete evaluation of their drinking behaviour. A diagnosis of alcoholism was confirmed in 88.2% of the patients who agreed to participate further. The question remains whether the high prevalence rates found are a function of the particular sample studied (i.e., patients in a hospital which typically serves a socially disadvantaged sector of the population) or reflects a feature of the general population in this catchment area. A study is currently underway in general hospitals of North Eastern Ontario in an attempt to answer this question.

Adolescent↗