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Biomedical subjects

S Coker

Publications and source records attributed to S Coker.

13 recordsLinked to original sources
PubMed1996

An evaluation of the efficacy of supervised cognitive behavioral self-help bulimia nervosa.

Eighty two patients with bulimia nervosa were managed by providing them with supervision in the use of a highly structured cognitive behavioral self-help manual. Their progress was assessed in an open clinical trial. The 67 patients who completed the course of self-help experienced considerable benefit; the frequency of bulimic episodes and self-induced vomiting decreasing by 80% and 79%, respectively. Compared to those who benefited, those who had a poor outcome or dropped out of treatment were more than twice as likely to have had anorexia nervosa in the past and were somewhat more likely to have a personality disorder. Three-quarters of those who persisted with the programme of supervised self-help were followed up a year after commencing treatment. Clinical gains were well maintained: almost two thirds were abstinent with respect to both bulimic episodes and self-induced vomiting. It would seem appropriate that, as part of a stepped care approach to the management of bulimia nervosa, supervised cognitive behavioral self-help should routinely be the first line treatment.

Adolescent↗
PubMed1996

Permutation distribution estimation applied to the comparison of the profile of the activity of two antianginal drugs.

The comparison of the anti-ischemic activity of trimetazidine and propranolol was evaluated by multiple end points (clinical, exercise test, and ambulatory electrocardiogram [ECG] monitoring criteria) in 149 male patients with effort angina who received either trimetazidine 20 mg tid or propranolol 40 mg tid during a period of 3 months. The distribution of the standardized differences between the two treatments for each variable was obtained by a permutation method. The medians (estimation of the actual difference between the two treatments) and the 5, 25, 75 and 95% quantiles were represented on the same diagram for all end points. The pattern of the standardized distribution of the differences showed a similar activity of both drugs on symptoms and nitrates consumption, on exercise tolerance and increase in ischemic threshold at exercise, and on ischemia recorded at ambulatory ECG monitoring. Conversely, only propranolol decreased heart rate and rate pressure product at rest as well as at exercise, underlining the difference in the mode of action of the two drugs. This descriptive technique is an attractive method to evaluate the differences between drugs considering multiple criteria favouring the estimation of these differences together with their variability.

Angina Pectoris↗
PubMed1994

Hypercholesterolemia in bulimia nervosa.

Patients with bulimia nervosa may present with serum cholesterol levels higher than the recommended range. Giving advice on dietary modification to reduce cholesterol levels runs contrary to the cognitive behavioral strategies used to treat bulimia nervosa. This would not be a problem if it were found that cholesterol levels fell with clinical improvement in the eating disorder.

Adult↗
PubMed1994

Onset of bulimia nervosa in a 64-year-old woman.

A woman aged 64 years presented with recent onset bulimia nervosa following the death of her husband. Her eating disorder was successfully treated with a course of cognitive-behavioral therapy.

Age of Onset↗
PubMed1994

Self-help for bulimia nervosa: a preliminary report.

Eighteen patients with DSM-III-R bulimia nervosa were treated by providing them with supervision in the use of a self-help manual based on the cognitive behavioral treatment for the disorder. The patients were assessed before beginning the self-help program, and again 4 to 6 months later, using standardized measures of psychopathology. The findings were encouraging. At follow-up one half of the patients had ceased bulimic episodes and self-induced vomiting, and most of the remainder had made significant improvements. These preliminary findings, together with related published work, suggest that supervised self-help might be an appropriate first line treatment for patients with bulimia nervosa and that for many patients it could be sufficient.

Behavior Therapy↗
PubMed1994

Early diagnosis of spinal cord arteriovenous malformation in a 7-year-old child.

Spinal cord arteriovenous malformations (AVMs) are relatively uncommon in the pediatric age group. Early diagnosis is rarely made and the resulting complications arising from the AVM may have devastating long-lasting neurologic sequelae. Early diagnosis requires a high degree of clinical suspicion. We report the case of spinal cord AVM in a child who presented with two episodes of "neck stiffness" without headache in whom the prompt diagnosis and treatment prevented neurologic sequelae.

Arteriovenous Malformations↗
PubMed1993

Patients with bulimia nervosa who fail to engage in cognitive behavior therapy.

Although cognitive behavioral treatment is the treatment of choice in bulimia nervosa, patients' response is variable. A minority of patients do not respond at all and some never engage in treatment. This paper concerns the latter group. A case series of six such patients with whom treatment could not be initiated is compared with a group who received a full course of treatment. The group with whom treatment could not begin were found to have a longer history of disorder, to report excessive laxative abuse, to have more severe depressed mood and a greater dissatisfaction with their body weight. In addition, they were more likely to have abused psychoactive substances, engaged in episodes of self-harm, and have a lower self-esteem. They were also more likely to be diagnosed as having borderline personality disorder. Patients presenting with the wide range of difficulties characteristic of this group require a more intensive form of treatment than standard outpatient cognitive behavior therapy.

Adolescent↗
PubMed1993

Pediatric Miller Fisher syndrome requiring intubation: a case report.

In 1956, C. Miller Fisher described a clinical syndrome of ophthalmoplegia, ataxia, and areflexia. This syndrome, which now bears his name, shares certain features with the Guillain-Barré syndrome (GBS) and generally follows a benign, restricted clinical course, especially in the pediatric population. The authors report a pediatric case of Miller Fisher syndrome (MFS) who subsequently required intubation and mechanical ventilation.

Ataxia↗
PubMed1990

The construction and preliminary validation of a scale for measuring eating disorders.

The present paper reports on the construction and validation of a new scale for measuring eating disorders, the Eating Habits Questionnaire (EHQ), which is designed to assess not only existing disorders but also the likelihood of developing such disorders. The EHQ was initially validated on a large sample of university students, followed by further tests of reliability and validity amongst a number of both eating-disordered and normal comparison groups. Factor analysis of the initial item pool produced a 57-item, three-factor structure concerned with weight and dieting, restrained eating patterns, and overeating. Concurrent validation confirmed anticipated relationships with existing self-report scales, and the EHQ was found to be both internally consistent and stable over time. The new scale distinguished reliably between diagnosed eating-disordered patients and normal subjects, and results indicated that around 5% of undiagnosed female undergraduates scored in the same range as the patient population.

Adult↗
PubMed1987

Neonatal posterior fossa subdural hematoma.

Hemorrhage into the posterior fossa is a rare neurosurgical emergency in neonates. CT scanning is diagnostic. Blood layering under the apex of the tentorium cerebelli, however, may resemble a dilated vascular structure, and the rigidity of the pressured tentorium may prevent upward transmission of increased intracranial pressure, resulting in a soft fontanelle.

Cranial Fossa, Posterior↗