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Biomedical subjects

J N Cooper

Publications and source records attributed to J N Cooper.

At least 19 recordsLinked to original sources
PubMed1992

Cost of screening for colorectal cancer: results of a community mass screening program and review of the literature.

Colorectal cancer is the second most common form of cancer in the United States, but controversy exists over the feasibility, benefits, and methods of screening. We conducted a large-scale, community-based screening program to determine the cost of screening for colorectal cancer. Based on detailed cost analysis, we arrived at a cost of $15,233 per case of colon cancer diagnosed through mass screening, and $7611 per polyp discovered. These figures are much higher than those previously reported in less detailed studies. Other studies currently under way will determine whether morbidity and mortality are decreased by screening. Our data add the information necessary to determine the cost-effectiveness of mass screening for colon cancer, and will be useful in designing future strategies for the secondary prevention of colorectal cancer.

Adult↗
PubMed1989

Detection and surveillance of colorectal cancer.

Colorectal cancer is the second most common cause of cancer in the United States. The overall mortality rate approaches 60%. However, the detection of early lesions results in a mortality rate of 20% or less. Therefore, if improvement in survival is to occur, increased efforts need to be focused not only on primary prevention but also on early detection of malignant lesions and the eradication of potentially malignant lesions. There is no universal consensus as to how this can be accomplished. The purpose of this article is to serve as a guideline, providing a practical basis for improving early detection and management of colorectal cancer and its precursors.

Adult↗
PubMed1989

Clostridial bloodstream infections.

In a ten-year review at a large community teaching hospital clostridia accounted for less than 1% of all positive bloodstream isolates (26 episodes in 25 patients). All but one of the isolates were clinically significant. Twenty-two patients (88%) had a serious underlying medical condition, and 17 of the episodes (65%) were associated with a bowel source; twelve patients (48%) died of their infection. Clostridial bloodstream infections are particularly clinically significant in patients with serious underlying disease.

Adolescent↗
PubMed1987

Imaging and hepatocellular carcinoma.

When attempting to establish a diagnosis of HCC, the clinician may now choose from a variety of imaging techniques. This choice depends on the availability of technology, the experience and skill of the interpreting physician, and cost. At times, a single study may be all that is necessary to establish the diagnosis, but, at other times, multiple techniques may be necessary. There is no doubt that rapid technologic improvements will continue to alter our diagnostic approach to this disease.

Angiography↗
PubMed1985

Massive bleeding due to arterial-enteric fistula from an ingested toothpick.

A 62-year-old man developed massive lower gastrointestinal tract bleeding. Upper endoscopy and superior mesenteric arteriography initially failed to disclose a cause of bleeding. On rebleeding, intra-arterial vasopressin infusion during repeated arteriography caused reflux of dye into the iliac vessels to allow visualization of an arterial-enteric fistula. Exploratory laparotomy subsequently revealed perforation of the small bowel and common iliac artery by a toothpick which had been swallowed.

Arterial Occlusive Diseases↗
PubMed1977

Chest pain: coronary or esophageal?

Although it is often relatively easy for the clinician to differentiate between the heart and the esophagus as sources of chest pain, there remains a substantial minority of patients in whom this task is difficult. We have attempted to review points of differential significance which can be elicited through assessment of the patient's symptoms. Diagnostic studies for the detection of esophageal disorders have been reviewed, and the relative usefulness of these studies has been emphasized. As the result of advancements in diagnostic techniques as well as better understanding of esophageal pathophysiology, the clinician is now capable of accurately identifying the esophagus as the source of chest pain.

Angina Pectoris↗
PubMedDate not supplied

Disseminated zygomycosis: report of four cases and review.

We present four cases of disseminated zygomycosis that illustrate the characteristic clinical syndromes and natural history of this infection. The zygomycetes affect individuals immunosuppressed by age, drug therapy, or underlying disease. A previous splenectomy or deferoxamine therapy may be an additional factor in the development of disseminated zygomycosis. Clinical syndromes reflect vascular invasion and organ infarction. Diagnosis requires consideration of risk factors followed by biopsy of the affected organ for culture and for demonstration of broad nonseptate hyphae in tissue sections. Despite advances in the management of many bacterial and fungal infections in the immunosuppressed host, the results of therapy for disseminated zygomycosis remain dismal.

Adult↗
PubMedDate not supplied

Plasma cortisol and beta-endorphin immunoreactivity in human obesity.

The relationship of the endogenous opioid system and the hypothalamic-pituitary-adrenal axis to obesity was studied. Morning levels of plasma cortisol and beta-endorphin immunoreactivity in obese patients before diet treatment were found to be no different from those in matched family members of normal weight. In 32 untreated obese patients, no relationship between weight or body mass index (a measurement of obesity) and plasma levels of beta-endorphin immunoreactivity or cortisol was found. However, plasma cortisol levels were significantly correlated with obese patient ratings on the depression subscale of the General Health Questionnaire. Dexamethasone administration failed to suppress plasma beta-endorphin levels in untreated obese patients, but this finding has been reported in normal subjects in whom a similar assay methodology was used; it suppressed plasma cortisol levels in 29 of 32. The three patients resistant to suppression also suffered from benign essential hypertension. Plasma beta-endorphin immunoreactivity was unchanged, but cortisol levels significantly decreased as weight was lost on a 400-calorie/day modified protein fast. Patients who failed to complete the 6-month diet program had significantly increased plasma beta-endorphin levels compared to those who successfully completed the program.

Adult↗
PubMedDate not supplied

Group therapy during a modified fasting diet: themes and process.

Individuals restricted to 400 calories per day were treated with weekly group therapy. The process involved development of group cohesiveness due to a commonly shared experience. The group was unable to accept that weight control meant severe caloric limitation. Themes of dependency and pairing tended to distract the group from their basic task of tolerating severe caloric limitation. Behavioral techniques as well as fostering of insight did not appear effective. Explanations for such a group format are discussed.

Adult↗