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Biomedical subjects

J B Cookson

Publications and source records attributed to J B Cookson.

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

Hemobilia treated by nasobiliary catheterization.

Hemobilia results in obstructive jaundice because blood clots may obstruct the bile duct. Decompression relieves jaundice, promotes clot lysis, and may encourage cessation of bleeding. We report a case of hemobilia that followed needle biopsy of the liver and was managed nonoperatively with an endoscopically placed nasobiliary catheter.

Adult↗
PubMed1986

Bone tuberculosis: results and experience in Leicestershire.

Management of tuberculosis falls to the thoracic physician and includes extrapulmonary sites. We have conducted a survey of notification of bone tuberculosis in Leicestershire from 1978 to 1983 inclusive. Eighty-one cases were notified, 75 were traced and 69 confirmed tuberculosis (mean age 40.2 years, 39 male, 54 from the Indian sub-continent (ISC)). Mean length of symptoms was 8.4 months, the commonest being pain and swelling. The diagnosis was established by evidence of bone involvement plus at least one of the following: positive Heaf test (54/56), positive culture at bone sites for Mycobacterium tuberculosis (45/47), or suggestive histology (30/34). There were no resistant organisms. Chemotherapy (mean duration 16.2 months) was well tolerated. Spine was the site most often involved (37 patients, 34 ISC), with abscess formation common (17 patients). Four who presented with spinal cord compression received a mean of 8 months' bed rest, three required decompression and one died. No patient developed new neurological signs on treatment. Fourteen others received an average of 2.3 months' bed rest. In this predominantly ISC immigrant population, spinal tuberculosis is common but does not progress to cord compression on treatment. For those without cord compression the course and outcome were similar whether or not they were treated with bed rest.

Adolescent↗
PubMed1985

Thoracic lymphadenopathy in Asians resident in the United Kingdom: role of mediastinoscopy in initial diagnosis.

Although the incidence of superficial glandular tuberculosis is high in Asian immigrants, a clinical diagnosis without biopsy has previously been shown to be inaccurate in 22% of cases. The role of diagnostic mediastinoscopy and biopsy in thoracic lymphadenopathy was therefore evaluated in 41 consecutive Asian patients. Tuberculosis was diagnosed by histological examination or culture (or both) of gland biopsy material in 24 (59%). A further 12 patients, however, also received antituberculous chemotherapy, with a response in 10 cases. If these are included, 34 (83%) were finally considered to have tuberculosis. The symptoms and ages of the patients with tuberculosis were similar to those typically seen in caucasians with sarcoidosis. Six had tuberculous bilateral hilar lymphadenopathy. In only four cases (10%) was a positive diagnosis other than tuberculosis established; in two (lymphoma and thymoma) mediastinoscopy confirmed preoperative suspicions, and saved only two more (with sarcoidosis and vascular anomaly) from unnecessary antituberculous treatment. Complications included severe haemorrhage (1) and chronic tuberculous sinus in the endoscopy tract (2). Mediastinoscopy is unlikely to change management in most patients, produces an appreciable amount of morbidity, and should be reserved for cases in which there is additional clinical doubt. Any future decline in the prevalence of tuberculosis in Asians may, however, require its further evaluation.

Adolescent↗
PubMed1980

Prevalence of asthma in Rhodesian Africans.

The prevalence of asthma in a small African town has been assessed using two questionnaires. The first was put to 9768 subjects aged 5 years and older and the second, more detailed, questionnaire to random selections of these subjects grouped according to their replies. The overall prevalence of asthma was 1.40%. In those under 20 years of age it was 1.20% and in adults, 1.57%. This adult rate is similar to those in developed countries but that in children is lower. The relative paucity of childhood asthma is compatible with the suggestion that infestation with parasites may protect against the disease.

Adolescent↗
PubMed1978

Prevalence of chronic bronchitis in Rhodesian Africans.

The prevalence of chronic bronchitis in the African population of a small township in Rhodesia was estimated using two questionnaires, both based on those of the British Medical Research Council. The first, a screening questionnaire, was put to 9768 subjects aged 5 years and above and the second, a more detailed questionnaire, to random selections of these grouped according to their replies. Repeat interviews were used to assess the accuracy of the questionnaires. The overall prevalence of chronic bronchitis was 1.12%. This is much lower than most other surveys elsewhere. There was little evidence of an increase in prevalence with age, and rates were not significantly different in the two sexes. The prevalence of complications and of other chest symptoms was correspondingly low. The proportion of bronchitics who smoked was not significantly higher than in the controls. Amounts smoked, however, were generally much lower than in other populations, and this, together with low levels of pollution, probably account for the prevalence findings.

Adolescent↗
PubMed1977

Experience with a tuberculosis antigen test in Rhodesia.

Experience with a new serological method for the diagnosis of tuberculosis is reported in a predominantly black population. We have found that in only 69% of 167 patients was there agreement between serology and the presence or absence of tuberculosis. Both false positive and false negative results were common. Of 47 healthy controls, 80% were positive. These results are less satisfactory than previous studies but differences in the reading of the results seems an unlikely explanation. Differences in the populations studied may be an important factor.

Agglutination Tests↗
PubMed1976

Normal values for ventilatory function in Rhodesian Africans.

Forced vital capacity, forced expiratory volume in 1 sec and peak expiratory flow were measured in 141 African men and 102 African women aged 20 and above. Prediction formulae relating each measurement to height and age were drawn up and are presented. Rhodesian Africans have lower values for these measurements than subjects in some Europen and North American series, but broadly similar values to those of Africans elsewhere.

Adult↗
PubMed1976

Allergy and parasites: the measurement of total and specific IgE levels in urban and rural communities in Rhodesia.

Eighty adult asthmatics living in an African city had a significantly higher serum IgE level (799 u/ml) than the control group (350 u/ml). A high proportion (78.7%) of the asthmatics had demonstrable circulating mite-specific IgE antibodies. The rural population of a filariasis endemic region was investigated and although no allergic subjects were identified, the group had a significantly higher IgE level (1613 u/ml) than the asthmatics and also showed a relatively high incidence of grass pollen-specific IgE antibodies (35%). The discrepancy between clinical history and laboratory results supports the mast cell saturation hypothesis and suggests: (a) an explanation for the susceptibility to allergy of African and Asian immigrants to Great Britain, and (b) a practical approach for preventing allergic reactions in vivo.

Adolescent↗
PubMed1976

Identification of allergen-specific IgE antibodies in the sera of African asthmatics.

Of eighty African asthmatics, sixty-three had significant levels of specific IgE against the house dust mite dermatophagoides pteronyssinus. By contrast, grass-specific IgE was found in six patients and mould-specific IgE in none. Sixty-three patients also had symptoms predominantly during the rainy season. Positive skin tests against D. pteronyssinus correlated well with the presence of mite-specific IgE, as did the size of these skin test weals with the amount of specific IgE. For grass pollen and moulds there was no such relationship. There was no correlation between a history of sensitivity to house dust and either skin tests or specific IgE against D. pteronyssinus. The results support previous findings that it is allergy to house dust mite and not to grass pollens or moulds which is important in producing the seasonal symptoms in our patients.

Adult↗
PubMed1975

Seasonal asthma and the house-dust mite in tropical Africa.

The relationship between seasonal asthma and sensitivity to the house-dust mite has been investigated in a country with large seasonal variations in relative humidity. Of seventy-eight African asthmatics, 64.1% gave a history probably suggestive of sensitivity to house-dust, and 55.1% a history strongly suggestive of such sensitivity. On skin testing, 35.9% had strong reactions to the house-dust mite Dermatophagoides pteronyssinus, compared with 1.9% of fifty-one matched controls without symptoms of chest disease. Few had either a history or skin tests suggestive of pollen or mould sensitivity. Most of the asthmatics were worse during the hot, wet season when the humidity is highest. This is also the time when in-patient asthmatics are most numerous. D. pteronyssinus grows well in warm, damp conditions and it is suggested that sensitivity to this mite may play a significant role in the marked seasonal changes seen in our asthmatic patients.

Adolescent↗