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Biomedical subjects

M C Cooper

Publications and source records attributed to M C Cooper.

At least 19 recordsLinked to original sources
PubMed2000

Effects of nonsteroidal anti-inflammatory drugs on post-operative renal function in adults.

BACKGROUND: Nonsteroidal anti-inflammatory drugs (NSAIDs) can play a major role in the management of acute pain in the peri-operative period. However, there are conflicting views on whether NSAIDs are associated with adverse renal effects. OBJECTIVES: The primary objective of this review was to determine the effects of NSAIDs on post-operative renal function in adults. SEARCH STRATEGY: Electronic searches for relevant randomised and quasi-randomised controlled trials in Cochrane Controlled Trials Register, MEDLINE and EMBASE were performed. Attempts were also made to identify trials from citation lists of relevant trials, review articles and clinical practice guidelines. Hand-searching of conference abstracts published in major anaesthetic journals was also performed. SELECTION CRITERIA: The inclusion criteria were randomised or quasi-randomised comparisons of individual NSAIDs with either each other or placebo for treatment of post-operative pain, with relevant post-operative renal outcome measures, in adult surgical patients. DATA COLLECTION AND ANALYSIS: Of the 14 trials that fulfilled the selection criteria for this review, eight trials were relevant with sufficient data for meta-analysis. The data was extracted independently by two reviewers. The primary outcome measure was creatinine clearance within the first two days after surgery. Secondary outcome measures included serum creatinine, urine volume, urinary sodium level, urinary potassium level, fractional excretion of sodium, fractional excretion of potassium, need for dialysis and need for diuretic or dopamine treatment for renal insufficiency. Weighted mean differences for continuous outcomes and relative risk for dichotomous outcomes were estimated. MAIN RESULTS: As a group, NSAIDs reduced creatinine clearance by 18ml/min (95%CI: 6 to 31) and potassium output by 38mmol/day (95%CI: 19 to 56) on the first day after surgery compared to placebo. Serum creatinine clearance increased on the second day after surgery by 15umol/L (95%CI: 2 to 28) compared to placebo. No significant reduction in urine volume during the early post-operative period was found. There was no significant difference in serum creatinine in the early post-operative period between patients receiving ketorolac and diclofenac in one trial. No cases of post-operative renal failure requiring dialysis were described. REVIEWER'S CONCLUSIONS: NSAIDs caused a clinically unimportant transient reduction in renal function in the early post-operative period. NSAIDs should not be withheld from adults with normal pre-operative renal function because of concerns about post-operative renal impairment.

Adult↗
PubMed1998

Ethical decision making in nephrology nursing for end-of-life care: a responsibility and opportunity.

This article describes the ethical significance of working with ESRD patients with a focus on end-of-life decision making. The ethical aspects of patient advocacy are explored and suggestions are offered for helping patients make ethically sound and caring end-of-life decisions. A model for ethical decision making is outlined, along with guidance from the ANA Code of Ethics and suggestions from the ANA Position Statements on Care and Comfort in Dying Patients, Euthanasia, and Assisted Suicide.

Decision Making↗
PubMed1998

Measurement of soluble transferrin receptor in serum of healthy adults.

The concentration of soluble transferrin receptor (sTfR) in serum is reported to be useful in the diagnosis of iron deficiency, especially for patients with concurrent chronic disease, where routine tests of iron status are compromised by the inflammatory condition. A new diagnostic assay for sTfR is calibrated against natural plasma sTfR, thus minimizing calibration discrepancies that result from differences between the analyte and the cellular transferrin receptor used in other assays. Use of the new assay to measure sTfR concentrations in 225 healthy, hematologically normal adults provided a reference interval against which pathological samples could be compared. There was no difference in the reference intervals for men and women and no correlation of [sTfR] with the age of the subject. Black subjects had significantly higher concentrations than nonblacks, and people living at high altitude had higher concentrations than those living closer to sea level. These differences were additive.

Age Factors↗
PubMed1998

Technology and care in a bone marrow transplant unit: creating and assuaging vulnerability.

The article describes the experience of technologically induced vulnerability and the inherent uncertainty of patients undergoing bone marrow transplantation. Examples of care by nurses, as perceived by patients and their family members, are offered. The relationship between the iatrogenic vulnerability and suffering of patients and the nursing response of care is explored. The claim is made that a caring response by nurses enables patients to make meaning of their choice to undergo simultaneously life-saving and life-threatening bone marrow transplantation.

Adaptation, Psychological↗
PubMed1995

Can a zero defects philosophy be applied to drug errors?

The literature reveals that errors of drug administration are a widely distributed and common occurrence. The frequency of errors and their underlying causes are discussed, and the literature is surveyed to determine reasons for mistakes and possible remedial measures. Ideas are drawn from industrial sources to describe a model of preventing mistakes at source, by making errors impossible. The ideas of Crosby and Shingo are discussed and a 'zero defects philosophy' is described and developed. This paper attempts to determine if this quality model developed and used in industry can be transferred to the health service, and concludes that it needs adaptation and cautious application. Recommendations are made for improved practices and improvements, both clinical and managerial. The author recommends a multidisciplinary review of all practices and systems to develop a radically different procedure with no drug errors as its aim. It is questioned whether this is possible in the present health service environment, as this would require sustained management commitment to both the idea and the quality system. However, the author believes that some of the principles can be applied as individual quality initiatives.

Data Collection↗
PubMed1994

Violence: changing the paradigm in New Jersey.

Physicians must assist in making violence a major statewide public health issue. The medical profession with its concern for patients has a natural interest in seeing that the victims of violence are treated effectively. Physicians must help uncover the root causes of violence.

Child↗
PubMed1993

The intersection of technology and care in the ICU.

In this article the author describes the paradoxical nature of the relationship between technology and care in the ICU. Although technology enhances care by expanding the repertoire of competent nurses' responses to the patient, it simultaneously alienates nurse and patient, hence inhibiting care. This occurs when nurses and patients have different understandings of technology and when the nurse identifies with the values imposed by technology at the expense of acknowledging her own and the patient's vulnerability.

Critical Care↗
PubMed1991

Principle-oriented ethics and the ethic of care: a creative tension.

Research to date in the field of nursing ethics has overlooked the nature of the guiding moral framework in nursing practice, while focusing primarily on the moral reasoning and moral behaviors among nurses. This research depicts two moral frameworks--a principle-oriented ethic and the ethic of care--as they are experienced by practicing critical care nurses. The interdependence of these two frameworks as they inform the moral experience of the nurse is demonstrated in the analysis of a complex nurse narrative that depicts the nurse's moral struggle.

Beneficence↗
PubMed1990

Reconceptualizing nursing ethics.

This paper offers a comparative analysis of four central concepts of moral theory--autonomy, moral posture, universal vs. particular, and the role of rules and principles. These concepts are compared as they function in traditional rule-and-principle ethics and the more recently explicated ethic of care. Implications of the distinctiveness of these two extant frameworks for the development of nursing ethics are set out. In conclusion, the claim is made that an inclusive approach to these different moral visions which places them in a mutually informative relationship holds the potential to enrich and enliven the developing nursing ethic.

Choice Behavior↗
PubMed1989

Structural changes in the megakaryocytes of patients infected with the human immune deficiency virus (HIV-1).

Although immune mechanisms are known to be partially responsible for the thrombocytopenia of patients infected with HIV-1, an understanding of the mechanism underlying this disorder is incomplete. A casual observation that bone marrow biopsies of HIV-infected individuals seem to exhibit an unusually large number of denuded megakaryocyte nuclei (DN-MK) prompted a study comparing MK of 20 HIV-seropositive individuals with those of 10 patients with HIV-negative idiopathic thrombocytopenic purpura and 10 hematologically normal subjects. In normal marrows the number of DN-MK average 2.1 +/- 0.5 SE per 10 low power field. In patients with ITP the average number was 6.5 +/- 1.4 SEM, whereas HIV-ITP marrows had an average of 42.5 +/- 3.7 SEM. Electron microscopy of AIDS megakaryocytes exhibited ballooning of the peripheral zone to an extent not seen by us in any other myelodysplastic syndromes. These observations support the concept that the pathophysiology affecting MK/platelets in HIV-infection should not be equated with the destructive process underlying other immune thrombocytopenias.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Covenantal relationships: grounding for the nursing ethic.

This article is in reaction to recent articles in Advances In Nursing Science by Yarling and McElmurry and Bishop and Scudder, which interpret the nursing ethic as grounded in the social reform of the institution or in the role of the nurse on the health care team. It is argued here that covenantal relationships between the nurse and the patient provide a more substantial foundation for the nursing ethic. Arising from the moral principle of fidelity, this model furnishes guidance for the nurse, a link for the nursing ethic with traditional moral theory, and, most important, a grounding in the unique experience of the nurse-patient relationship.

Contracts↗
PubMed1987

Lymphomas associated with the acquired immune deficiency syndrome (AIDS): a study of 35 cases.

An increased incidence of lymphoid neoplasias is associated with the states of immune deficiency both congenital and acquired. Thirty-five cases of lymphoma in males at high risk for AIDS were diagnosed in one community hospital in New York City within the past 2 years. The mean age of these patients was 39.6 years; 34 were homosexual, and one was an intravenous drug abuser. There were four Hodgkin and 31 non-Hodgkin lymphomas of various histologic types but almost all of high-grade categories. The proportion of extranodal lymphomas, the involvement of the gastrointestinal tract, central nervous system, bone marrow, and myocardium were significantly higher than in the lymphomas of the general population. The phenotypes were B-cell and non-B-non-T-cell types without any T-cell lymphomas. All patients had reversed helper-suppressor T-cell ratios, and all those tested had circulating HTLV-III and antilymphocyte antibodies. Nine patients have had previous lymph node biopsies showing the lesions of AIDS-related lymphadenopathies that were often directly associated with lymphoma. A variety of severe opportunistic infections and Kaposi sarcoma affected these patients. All lymphomas associated with immune deficiency were highly aggressive, involved multiple organs, and responded poorly to treatment resulting in early deaths.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Lymphomas of AIDS.

Explore the source record for details and available documents.

Acquired Immunodeficiency Syndrome↗
PubMed1985

Lymphomas in men at high risk for acquired immune deficiency syndrome (AIDS). A study of 21 cases.

An increased incidence of lymphoid neoplasias is associated with the states of immune deficiency, both congenital and acquired. Twenty-one cases of lymphoma in men at high risk for Acquired Immune Deficiency Syndrome (AIDS) were diagnosed in one community hospital in New York City within the last 2 years. The mean age of these patients was 39.6 years, 20 were homosexual, and 1 was an intravenous drug abuser. There were 3 Hodgkin's and 18 non-Hodgkin's lymphomas of various histologic types, but almost all of high-grade categories. The proportion of extranodal lymphomas, the involvement of the gastrointestinal tract, central nervous system, bone marrow, and myocardium were significantly higher than in the lymphomas of the general population. The phenotypes were B-cell and non-B-non-T-cell types without any T-cell lymphomas. All patients had reversed helper-suppressor T-cell ratios and all those tested had circulating HTLV-III antibodies. Seven patients have had previous lymph node biopsies performed, showing the lesions of AIDS-related lymphadenopathies that often were directly associated with lymphoma. A variety of severe opportunistic infections and Kaposi's sarcoma affected these patients. All lymphomas in this group were highly aggressive, involved multiple organs, and responded poorly to treatment, resulting in early deaths.

Acquired Immunodeficiency Syndrome↗
PubMed1974

The effect of erythropoietin on colonial growth of erythroid precursor cells in vitro.

A method is described for the colonial growth, in semi-solid medium, of erythropoietin-responsive erythroid cell precursors. The erythroid cell precursors were isolated by immune hemolysis from fetal mouse liver. Both the number of precursor cells triggered to proliferate and differentiate, and the size of the erythropoietic colonies formed, are directly dependent upon the concentration of erythropoietin included in the culture.

Animals↗