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Biomedical subjects

A D Cohen

Publications and source records attributed to A D Cohen.

At least 37 records · Page 2Linked to original sources
PubMed2000

[Use of civilian emergency departments by the Israel Defense Force for emergency care for soldiers].

Many physicians, civilian as well as in military, feel that some referrals of soldiers to civilian emergency departments are inappropriate and that soldiers should receive medical attention within their military units. We therefore evaluated referrals of soldiers to our emergency department. 707 referral letters from military physicians and the corresponding emergency room discharge letters were evaluated. Most soldiers were referred for mild trauma (45.0%) or miscellaneous diseases (52.9%); 22 (3.1%) were hospitalized. It appears that some military physicians use the civilian hospital emergency department as a surrogate for an outpatient specialty clinic and for x-ray and laboratory services. This is in contrast to the designated functions of the emergency department which are to provide emergency and trauma services and to evaluate the need for hospitalization of referred patients.

Emergencies↗
PubMed2000

Vaccination of seronegative volunteers with a human immunodeficiency virus type 1 env/rev DNA vaccine induces antigen-specific proliferation and lymphocyte production of beta-chemokines.

There is a pressing need to test novel vaccine concepts in an effort to develop an effective vaccine for human immunodeficiency virus (HIV) type 1. A phase I clinical study was done to test the immunogenicity of an HIV env/rev DNA vaccine, which was administered intramuscularly to HIV-1-seronegative persons. Subjects received 3 doses of vaccine at a single concentration (100 or 300 microgram) at 0, 4, 8, and 24 weeks. In at least 1 of multiple assays, the 6 subjects who received the 300-microgram dose had DNA vaccine-induced antigen-specific lymphocyte proliferative responses and antigen-specific production of both interferon-gamma and beta-chemokine. Furthermore, 4 of 5 subjects in the 300 microgram-dose group responded to both the rev and env components of the vaccine. The responses did not persist within inoculated individuals and scored in different individuals at different times in the trial. This study supports that HIV-1 DNA vaccine antigens can stimulate multiple immune responses in vaccine-naive individuals, and it warrants additional studies designed to enhance DNA vaccine immunogenicity.

AIDS Vaccines↗
PubMed2000

Prolactin serum level in patients with breast cancer.

BACKGROUND: Previous studies have suggested that prolactin may serve as an indicator of disease progression in breast cancer. OBJECTIVES: To evaluate the use of PRL as a serum tumor marker in patients with breast cancer. METHODS: PRL serum level was determined in 99 breast cancer patients and compared with CA 15-3 serum level. RESULTS: Elevated serum level of PRL (> 20 ng/ml) was found in 8 of 99 patients (8.1%). A stratified analysis of prolactin levels according to therapy revealed that PRL levels was increased in 8 of 55 untreated patients (14.5%), but not in patients who received hormonal or chemotherapy in the 3 months preceding the test (0/42 patients, P = 0.009). However, mean PRL level was similar in patients with no evidence of disease activity and in patients with active disease (10.2 vs. 8.2 ng/ml, NS). In comparison, CA 15-3 mean level was significantly lower in patients with no evidence of disease as compared to patients with active disease (18.2 vs. 144.7 units/ml, P < 0.001). PRL level was increased in 6 of 60 patients (10%) with no evidence of disease and in 2 of 39 (5.2%) with active disease (NS). In comparison, CA 15-3 level was increased in 3 of 60 patients (5%) with no evidence of disease and in 24 of 39 (61.5%) with active disease (P < 0.001). CONCLUSIONS: PRL levels are decreased following hormonal or chemotherapy in patients with breast cancer and there is no correlation between PRL serum level and the state of disease. Further studies are needed to clarify a possible clinical significance of hyperprolactinemia in a subset of patients with breast cancer.

Adult↗
PubMed1999

HIV-1 DNA vaccines and chemokines.

DNA vaccines have a demonstrated ability to induce humoral and cellular immune responses in animal models and humans. The technology, although it dates back to the 1950's, has had an insurgence of interest within the past few years following concurrent research papers. The basic technology is being applied broadly to viral, bacterial and parasitic infections. It has also been demonstrated that genes delivered via plasmid expression vectors result in expression of functional proteins in the inoculated host. Further, injection of plasmids encoding cytokine, chemokine or co-stimulatory molecules, also referred to as immunomodulatory plasmids can lead to the further expansion of this technology to include directed immunology. We have been developing DNA technology specifically with a focus as a vaccine against HIV-1 infection. We report that such vaccines can stimulate immune responses in a variety of relevant animal systems including humoral and cellular responses as well as the production of beta-chemokines. We describe that the beta-chemokines can both modulate the immune response induced by DNA vaccines and be modulated by the DNA vaccines in the murine and chimpanzee models as well as in humans.

AIDS Vaccines↗
PubMed1999

The diagnostic role of the in vitro drug-induced interferon-gamma release test in Stevens-Johnson syndrome.

BACKGROUND: Drug-related T-cell activity in cutaneous drug reactions may be assessed by in vitro cytokine release tests. The diagnostic role of in vitro drug-induced interferon-gamma (IFN-gamma) release was evaluated in a patient with Stevens-Johnson syndrome. CASE REPORT: Stevens-Johnson syndrome was diagnosed in a 58-year-old man, treated with colchicine (1 mg daily for 39 days) and allopurinol (300 mg daily for 13 days). Based on a clinical-epidemiologic score, allopurinol was more likely to be the causative agent. In vitro drug-induced IFN-gamma release test was conducted on this patient and on two controls, using an enzyme-linked immunoabsorbent assay (ELISA) technique. Increased IFN-gamma release was observed following an in vitro challenge of the patient's lymphocytes with allopurinol, but not following in vitro challenge with colchicine. An in vitro challenge with allopurinol in two control patients, treated with allopurinol without adverse drug reactions, did not induce a significant increase in IFN-gamma release. CONCLUSIONS: The role of allopurinol as the drug responsible for the induction of Stevens-Johnson syndrome in our patient was confirmed by in vitro allopurinol-induced IFN-gamma release, which may indicate a drug-specific immune response.

Allopurinol↗
PubMed1999

Evaluating peats for their capacities to remove odorous compounds from liquid swine manure using headspace "solid-phase microextraction".

This paper reports on research designed to investigate the capacities of different highly characterized peats to remove odorous compounds from liquid swine manure (LSM). Peat types representing a wide range of properties were tested in order to establish which chemical and physical properties might be most indicative of their capacities to remediate odors produced by LSM. Eight percent slurries (of peat/LSM) were measured for odor changes after 24 hours using odor panel and GC/MS-Solid-phase microextraction (GC/MS-SPME) analysis. The GC/MS-SPME and odor panel results indicated that, although all peats tested in this study were found to be effective at removing odor-causing compounds found in LSM, some peats tended to work better than others. Overall, the peats that were the most effective at removing odor-causing compounds tended to have lower bulk densities, ash contents, fulvic acids contents, and guaiacyl lignins contents, and higher water holding capacities, hydraulic conductivities, "total other lignins" contents, hydrogen contents, carbon contents, and total cellulose contents. GC/MS-SPME analysis was found to be a reasonably inexpensive and efficient way of conducting this type of research. It allows one to identify a large number of the odor-causing compounds found in LSM, and more importantly, to detect with some precision specific differences in the amounts of these compounds between peat types.

Animals↗
PubMed1999

Systemic and mucosal immunity is elicited after both intramuscular and intravaginal delivery of human immunodeficiency virus type 1 DNA plasmid vaccines to pregnant chimpanzees.

DNA vaccines encoding human immunodeficiency virus type 1 (HIV-1) env/rev and gag/pol were delivered intravaginally (IVAG) and intramuscularly (IM) to 2 pregnant chimpanzees. Vaccination was well tolerated and each chimpanzee developed antibodies (up to 1 year later) to both vaccines. Placental transfer of anti-Env and anti-Gag IgG was demonstrated in both maternal/infant pairs. Specific IgG was also demonstrated in saliva, vaginal, and rectal washes after IVAG immunization. Predominantly anti-HIV-1 IgA was detected in the milk of both mothers after both IM and IVAG immunization. Cellular responses included Gag-specific proliferation of lymphocytes and cytotoxic T lymphocytes against both antigens. These data suggest a strategy for induction of mucosal and systemic responses after both IM and IVAG delivery of DNA vaccines in a primate model and could ultimately be useful in lowering maternal-to-fetal transmission of HIV-1, perinatally and through breastfeeding.

AIDS Vaccines↗
PubMed1999

Longitudinal melanonychia associated with hydroxyurea therapy in a patient with essential thrombocytosis.

Occurrence of skin lesions during long-term therapy with hydroxyurea are well described, but there have been only a few case reports of longitudinal melanonychia associated with hydroxyurea treatment. We report herein longitudinal melanonychia associated with hydroxyurea therapy in a subject with essential thrombocytosis. The prolonged time lapse (1 year) between initiation of hydroxyurea therapy and the onset of the longitudinal melanonychia should be noted.

Aged↗
PubMed1999

Phenytoin-induced severe cutaneous drug reactions: suspected interactions with corticosteroids and H2-blockers.

BACKGROUND: Cutaneous drug reactions are attributed usually to one culprit drug, however, some CDRs may be associated with drug interactions. OBJECTIVES: To present a case series of four patients with phenytoin-induced severe CDRs, including toxic epidermal necrolysis (2 patients), exanthematous eruption (1 patient) and hypersensitivity syndrome (1 patient). In all patients the reactions appeared following the combined intake of phenytoin, corticosteroids and H2-blockers. CONCLUSIONS: Our case series may imply the role of drug interactions between phenytoin, corticosteroids and H2-blockers in the induction of severe CDRs.

Administration, Topical↗
PubMed1998

Modulating the immune response to genetic immunization.

Genetic immunization, also known as DNA or polynucleotide immunization, is a novel strategy for vaccine development in which plasmid DNA encoding either individual or a collection of antigens is directly administered to a host. Such immunization leads to host expression of the delivered foreign gene, resulting in the induction of a specific immune response against the in vivo produced antigen. DNA immunization has been shown to induce protective immune responses in several infectious disease and cancer experimental model systems. Furthermore, DNA vaccines have recently entered the clinic for analysis as both prophylactic and therapeutic agents. Although the mechanisms of immunity to DNA have not yet been fully elucidated, it has become apparent that the immune response achieved by DNA vaccination is quite malleable, and can be manipulated by altering the conditions under which the vaccine is administered. Either through changing the method or location of immunization, altering the number of immunostimulatory sequences in the plasmid, altering the immunization regimen, or coadministering genes for cytokines or costimulatory molecules, one can modulate both the magnitude and orientation of the subsequent immune response. Through maximization of this feature of DNA immunization, we will likely be able to design vaccines and immunotherapeutic agents that are tailored to the correlates of protection for a particular disease, resulting in a new generation of more focused and effective immune stimulating agents.

Adjuvants, Immunologic↗
PubMed1996

Vaccine-induced autoimmunity.

The current review summarizes case reports attributing autoimmune diseases and phenomena to various vaccines and suggests potential mechanisms. It has to be emphasized that the demonstration of a temporal relationship does not necessarily attribute autoimmunity to a vaccine. The subject is complicated by the fact that one vaccine may cause more than one autoimmune phenomenon, and a particular immune process may be caused by more than one vaccine. Furthermore, vaccines differ in their pathogenic influence on the immune system. There is no doubt that the new recombinant hepatitis B virus vaccine is different from mumps, measles and rubella vaccines in its ability to trigger autoimmunity, probably by completely different mechanisms. The data summarized here suggest that some vaccines may in rare cases induce autoimmune disorders. The subject of the vaccine-autoimmunity relationship is still obscure; reports have been rare, no laboratory experimentation on this topic has been undertaken, and there are few animal models. For the time being no conclusions can be drawn. Since vaccines are an important prophylactic intervention, the risk-benefit ratio clearly leans towards the advantages of infectious disease prevention. Vaccination routines should not be changed in the healthy population or for patients with known autoimmune disorders. Laborious clinical and laboratory studies should be initiated in order to evaluate the new emerging subject of vaccine-induced autoimmunity.

Antigen-Antibody Complex↗