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Biomedical subjects

W Cooper

Publications and source records attributed to W Cooper.

17 recordsLinked to original sources

The power of group purchasing.

There are four issues facing provincial GPO's, independent GPO's, health care organizations and vendors: co-operation; commitment; compliance; and competition. Co-operation: Hospitals have traditionally competed with each other for scarce resources and, as a result, have managed their operations in isolation. However, group purchasing provides hospitals willing to work together with an opportunity to significantly increase their purchasing power with vendors, thereby substantially reducing costs. Commitment: The success of GPO's depends on the commitment to contracts by the members. The American experience indicates that commitment of smaller, more focused organizations is easier to control and maintain. Some provincial GPO's have difficulties ensuring commitment from members; therefore, they have not achieved their full potential. Compliance: Hospital compliance with committed volumes negotiated in the corporate contract is essential to ensuring the continued strength of the group's purchasing power. GPO's require mechanisms for ensuring compliance. Smaller GPO's with a common vision and a mutual understanding of the benefits to be realized from compliance will be more successful. Competition: Independent, national GPO's, like Medbuy, may be perceived to pose a threat to provincial GPO's. However, this competition should be viewed positively because it encourages all GPO's to work harder to provide higher quality services that will ultimately benefit the hospital membership. The group purchasing concept is valuable to provide reduced costs to groups through higher volume purchases. Canadian GPO's are evolving and now offer Canadians provincial, interprovincial and independent GPO alternatives. Health care organizations must study these options and decide which alternative would be most beneficial for their particular situation.(ABSTRACT TRUNCATED AT 250 WORDS)

Canada

Return of ovarian function following spontaneous abortion.

Assays of first morning urine samples for oestrone-3-glucuronide, LH and pregnanediol-3-glucuronide, were used to study endocrine function and return to ovulation in 18 subjects following spontaneous miscarriage. On the basis of the endocrine data, ovulation occurred in all 18 women in the cycle prior to first menses at a mean of 29 days post-partum (range 13-103 days) with one subject conceiving in that cycle. Compared with the second cycle, the first cycle after spontaneous abortion had similar levels of follicular phase peak ovulatory oestrone excretion but lower levels during the late luteal phase (P less than 0.02), lower levels of peak LH (50.5 IU/g creatinine (C) cf. 68.8 IU/g C; P less than 0.04) and lower late secretory peak pregnanediol (4.6 mg/g C cf. 6.1 mg/g C; P less than 0.02). The mean luteal phase length of 12.9 days in the first cycle was shorter than the mean of 14.4 days in the second cycle (P less than 0.02). These data show that, although there is some disturbance of endocrine function in the first cycle after spontaneous abortion, the majority of women have a rapid return to ovulation, making the early use of contraception necessary for those wishing to avoid conception.

Abortion, Spontaneous

Simpler times.

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Economics, Medical

Sulpiride and the potentiation of progestogen only contraception.

A progestogen (norethisterone) and a dopamine antagonist (sulpiride) were given alone and in combination to volunteers to examine their effects on excretion of ovarian steroids. Compared with non-treatment cycles (n = 15), contraception with a progestogen alone (n = 10) was associated with increased excretion of oestrone and partial suppression of excretion of pregnanediol, suggesting partial luteinization of unruptured follicles. By contrast, the combination of norethisterone and sulpiride (n = 9) suppressed both ovarian steroids to basal values, the suppression being even greater than with sulpiride alone (n = 5). These results suggest that a combination of a progestogen with a dopamine antagonist might have a role in contraception.

Adult

Impairment of isoproterenol, H2 histamine, and prostaglandin E1 response of human granulocytes after incubation in vitro with live influenza vaccines.

The release of the lysosomal enzyme beta-glucuronidase from granulocytes follows incubation in vitro with complement-activated zymosan particles. Release of beta-glucuronidase is inhibited by isoproterenol, histamine, and prostaglandin E1. This in vitro model was used to study the effect of incubating a live, bivalent (A + B) influenza vaccine on the granulocyte response to the agonists described. After incubation in vitro with the live, bivalent influenza vaccine, there was a significantly impaired granulocyte reponse to all 3 agonists. The change in the response of polymorphonuclear leukocytes to isoproterenol was similar to an impairment in beta-adrenergic response found during respiratory infections in vivo. The viral-induced changes in the granulocyte response to isoproterenol may reflect similar alteration in other tissues, such as variable control of the airways and provide one explanation for the occurrence of airway dysfunction during respiratory infections.

Adult

The sexual spectrum.

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Disorders of Sex Development

Hypertension in radiation nephritis. Report of a patient with unilateral disease, elevated renin activity levels, and reversal after unilateral nephrectomy.

A patient received intensive radiation to the right renal area for abdominal Hodgkin's disease and approximately ten years later severe hypertension developed. The presence of radiation nephritis with a severely shrunken right kidney was demonstrated and this was accompanied by a substantial increase in renin activity from the right kidney. Treatment with propranolol hydrochloride temporarily lowered the blood pressure and peripheral renin activity levels. Subsequent right nephrectomy resulted in a decrease in renin activity and a reversal of the hypertension. The data implicate a renin angiotensin mechanism as probable cause of hypertension in radiation nephritis.

Adult

The effects of cosmic Particle radiation on pocket mice aboard Apollo XVII: V. Preflight studies on tolerance of pocket mice to oxygen and heat. Part I. physiological studies.

Tests were carried out on pocket mice to ascertain their tolerance to elevated oxygen pressures alone and to a combination of hyperoxta and heat in excess of that expected during the flight of the mice on Apollo XVII. the mice withstood oxygen partial pressures up to 12 pst at normal room temperature (24 degrees C, 75 degrees F) over a period of 7 days. A few mice previously exposed to increased PO2 died in the course of exposure to an oxygen pressure of 10 pst or 12 psi (517 mm or 620 mm Hg) for 13 d in ambient heat of 32 degrees C (90 degrees F). Supplemental vitamin E and physiological saline loading given prior to exposure had no apparent protective effect. The overall conclusion was that the pocket mice which were to go on Apollo XVII could readily survive the ambient atmosphere to which they would be exposed.

Adaptation, Physiological

The effects of cosmic particle radiation on pocket mice aboard Apollo XVII: X. Results of ear examination.

In the five pocket mice flown on Apollo XVII, no evidence was found that the inner ear had been damaged, though poor fixation precluded detailed study. On the other hand, the middle ear cavity was involved in all the mice, hemorrhage having occurrred in response to excursions in pressure within the canister that housed the mice during their flight. The same occurred in flight control mice which had been subjected to pressure excursions of much the same magnitude. A greater degree of exudation into air cells and greater leukotaxis were noted in the flight animals than in the control animals. There was no increase in leukocyte population along the paths of the 23 cosmic ray particles registered in the subscalp dosimeters that traversed the middle ear cavities of the flight mice. The increased exudation and the greater response by leukocytes in the flight mice may have been causally related to the lesions found in their olfactory mucosa but there were no data in support of this possibility.

Animals