Showing papers by "Cyrus Cooper published in 1987"

Severe atypical molluscum contagiosum infection in an immunocompromised host

Abstract: SUMMARY A case of severe mollucum contagiosum in a patient with treated thymnma is described. This unusual complication of immunosupprossion is discussed and the literature on the subject reviewed.

Striated intramural gallbladder lucencies on US studies: Predictors of acute cholecystitis

Abstract: Ultrasound scans of 51 consecutive patients with gallbladder wall thickening were reviewed, and specific sonographic features were correlated with surgical and clinical follow-up. Two patterns of thickening were identified as specific indicators of the presence or absence of acute cholecystitis. "Striated" wall thickening, consisting of several alternating, irregular, discontinuous, lucent and echogenic bands, was seen in eight of 13 patients (62%) with acute cholecystitis. This pattern was not encountered in any of the patients who did not have acute cholecystitis. Conversely, "three-layer" thickening, consisting of a single circumferential lucent zone between two relatively uniform echogenic layers, was seen in only one of 13 patients (8%) with acute cholecystitis but in 11 of 38 patients (29%) with other diagnoses. Other abnormalities, including the presence of intramural echogenic foci and wall irregularities, were more frequently seen in patients with acute cholecystitis but were not as helpful. Use ...

Current topics in rheumatology: epidemiology of the rheumatic diseases

Abstract: This is the book of the BBC TV series, which I missed. It describes itself as \"a journey through the faces of medicine\" and asks \"fundamental questions such as: What is illness? What effect does the mind have on the body? Why do placebos so often work?-interesting enough questions but rather ambitious, even offputting, for a short popular book that also aims to describe the diversity of systems of medical practice. The descriptive parts of the book are excellent, giving examples of the practice and history of Ayurveda, Unani, acupuncture, homeopathy, and many more medical systems through case histories and direct observation. Persistent themes are that alternative practitioners gather their patients from scientific medicine's failures and that the strengths of other medical systems are their human qualities. The book acknowledges the null hypothesis as scientific medicine's greatest strength, allowing change in both practice and theory, but it casts the scientific doctor in the role of an uncaring technician who, having probed an organ or system, withdraws without understanding the patient and his illness. Balint is not on the recommended reading list, and I get the feeling that the authors are out of touch with the amount of \"whole person medicine\" training received and practised by primary care doctors in this and other countries. An \"open clinic\" (run by one of the authors) is described which integrates the knowledge, skills, and attitudes of different therapists. A new patient can expect to be seen by seven staff on the first day (a \"scientific\" doctor, psychologist, psychiatrist, social worker, physiotherapist, a 'yin-yang' doctor, and a masseuse) -a sledge-hammer approach for most people's problems? But the book ducks the main issue: by which standard(s) should an alternative therapy be judged? The authors say that each system is independent and should not be viewed within the context of another system. Yet they do just this, citing examples of double-blind, randomised, controlled trials in the field of phytotherapie, as the French call herbalism, comparisons with historical controls in assessing 'guided imagery' for cancer patients, and a before and after comparison of pain scores for the open clinic patients, presumably to make it all more 'believable' to a lay audience. But the examples are too brief to be convincing. The book is at its worst when grappling with a 'fundamental question' but these do not dominate. It is a quick and worthwhile read for both doctors and patients.

Epiphyseal Ossification Centers in the Assessment of Fetal Maturity: Sonographic Correlation with the Amniocentesis Lung Profile

Abstract: The epiphyseal ossification centers of the distal femur (DFE) and proximal tibia (PTE) appear and enlarge during the third trimester of pregnancy. Late in the third trimester, the epiphysis of the proximal humerus (PHE) begins to ossify in some fetuses. Using the amniocentesis lung profile to determine the value of sonographic epiphyseal visualization as a predictor of pulmonary maturity, we studied 50 fetuses prospectively and compared the sonographic epiphyseal findings with results from the amniocentesis lung profiles. Nine fetuses with a visible PHE had a mature amniocentesis lung profile (accuracy of positive prediction = 100%), and then fetuses with an immature amniocentesis lung profile had no visible PHE (conegativity = 100%). Fetuses in which the combined DFE and PTE diameters were greater than 11 mm or in which the DFE and the PTE diameters were similar in size (DFE less than or equal to 1 mm larger than PTE) also yielded positive results. Copositivity and accuracy of prediction of an immature amniocentesis lung profile, on the other hand, were low (22%-25%) for the same epiphyseal parameters. These data suggest that antenatal visualization and measurement of the epiphyseal ossification centers of the fetal knee and shoulder may help to identify fetuses that would have a mature amniocentesis lung profile.

Fatal cardiac tamponade complicating anticoagulant therapy in rheumatoid arthritis.

Abstract: Haemopericardium with tamponade is a rare complication of anticoagulant therapy. A case of fatal haemopericardium is described in a patient with rheumatoid pericarditis in whom the precipitating factor appeared to be intravenous anticoagulant therapy.