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Biomedical subjects

D Cohen

Publications and source records attributed to D Cohen.

At least 613 records · Page 34Linked to original sources
PubMed1985

Physician compliance in the management of hypertensive patients.

The aim of the present study was to investigate prospectively the value of different forms of intervention in the quality of diagnosis and treatment of essential hypertension in an Outpatient Clinic. In a first phase (phase 0) 115 patients with a blood pressure of greater than or equal to 140/greater than or equal to 90 mmHg at the initial visit in our Outpatient Clinic were registered. After a 3 months period the charts of these patients were reviewed. This review revealed that 61 (53%) of these patients were not followed by the treating physicians and that half of the patients who had an elevated blood pressure at the second visit and thereby an indication for therapy were not treated. In a first intervention the results of this investigation were discussed with the treating physicians and the necessity for an improved management of patients with essential hypertension was pointed out. After this intervention 116 patients with a blood pressure greater than or equal to 140/greater than or equal to 90 mmHg were again followed for 3 months without knowledge of the treating physicians (phase 1). The chart review of these patients revealed no improvement in the management of the patients, 57% of these 116 patients were again not followed by the treating physicians and 48% of the patients identified by a follow-up visit as hypertensives were not treated. Thereafter a second intervention took place which included a nurse who scheduled 295 patients with an initial blood pressure of greater than or equal to 140/greater than or equal to 90 mmHg automatically for a follow-up visit.(ABSTRACT TRUNCATED AT 250 WORDS)

Attitude of Health Personnel↗
PubMed1985

[Detection of polymorphism of HLA class II genes using synthetic oligonucleotides].

The recent sequence determination of exons of various HLA class II genes has allowed us to study the polymorphism of coding sequences of these genes on a sample of HLA-DR typed unrelated individuals. From this sequence determination have emerged polymorphic hypervariable areas. A 24-mer oligonucleotide has been synthetized, which corresponds to the first hypervariable region of the beta 1 domain of a DR-beta molecule. This oligonucleotide hybridized only with the DNA from DR3 or DR5 individuals tested, even under stringent conditions of washing. However, the existence of strong linkage disequilibrium among the 3 or 4 DR genes of the D region does not allow us to conclude that this sequence is epitope-specific.

Genes, MHC Class II↗
PubMed1985

Cyclosporine and short ischaemia: a new model of experimental acute renal failure in rats.

To determine whether a mild episode of ischaemia may be a factor in the production of cyclosporine (Cys) toxicity, right nephrectomy was performed in three groups of Charles River rats: I. Ischaemia (left renal pedicle clamping) for 20 minutes, without treatment; II. Ischaemia of 20 minutes, followed by IP Cys 60 mg/kg BW/day; III. Sham (no ischaemia) followed by Cys as in Group II. The rats were sacrificed after four days. Cys plus ischaemia produced a lower creatinine clearance (136 +/- 15 microliter/min/100g BW, p less than 0.001) and a higher FENa per cent (0.94 +/- 0.14, p less than 0.05), FEK (1.07 +/- 0.02, p less than 0.01) compared with ischaemia alone creatinine clearance 261 +/- 39, FENa per cent 0.61 +/- 0.08, FEK 0.54 +/- 0.08, FEH2O -0.04 +/- 0.005. Histology showed more vacuolisation of tubular epithelial cells in the Cys plus ischaemia group than in the ischaemia alone group.

Acute Kidney Injury↗
PubMed1985

Pericardial meshing: an effective method for prevention of pericardial adhesions and epicardial reaction after cardiac operations.

Cardiac reoperations, particularly for coronary revascularization, are becoming more frequent and carry increased risk of damage to the heart during resternotomy. We experimentally evaluated a pericardial meshing technique to facilitate primary pericardial closure. In 18 mongrel dogs, an 8 by 5 cm pericardial flap was fashioned through a left thoracotomy. A standardized procedure for induction of pericardial adhesions was carried out in all animals. Animals were divided into three groups of six animals each: Group I (control)--the pericardial flap was primarily resutured; Group II--the flap was meshed and then resutured; and Group III--the flap was replaced by a pericardial substitute. Animals were put to death 8 weeks postoperatively and the pericardial space was examined for adhesions and epicardial reaction. The extent of adhesions and epicardial reaction was graded as: 0--none; 1--minimal; 2--moderate; and 3--severe. Both in Group I and Group III severe pericardial adhesions (grade 2-3) and epicardial reactions (grade 2-3) were formed, which obscured the underlying coronary anatomy. In Group II pericardial adhesions and epicardial reactions were none to minimal (grade 0-1) and the underlying coronary anatomy was not obscured. The meshed pericardium was completely regenerated by normal pericardium within several weeks. This study demonstrates that pericardial meshing facilitates primary tension-free pericardial closure. Free drainage of intrapericardial blood is achieved. A complete anatomic layer between heart and sternum is restored. Pericardial meshing is superior to the pericardial substitutes examined, as adhesions and epicardial reactions are significantly reduced, and the coronary anatomy is readily identifiable.

Animals↗
PubMed1985

Characteristics and indices of reproduction in Dorper sheep.

In seventeen adult Dorper ewes imported from South Africa into Israel and nine of their primiparous, first-generation daughters born in Israel, characteristics and indices of reproduction were determined during the period of April 1982 to April 1984. This study showed that, during the period from April 1982 to January 1984, three lambings occurred in the adult ewes; the lengths of the oestrous cycles for adult and primiparous ewes were 17.6 +/- 1.1 and 16.6 +/- 1.2 days, respectively; the number of services per ewe in oestrus were 3 +/- 1 services; the average length of pregnancy was 146-147 days; the lambing intervals were 6.2 +/- 0.46 and 7.7 +/- 0.62 months from the first to second lambing and the second to third lambing, respectively; of 17 ewes, 3 had twins in all 3 lambings (17.6%) and 4 had twins in only the first 2 lambings (23.5%). The sex ratio recorded in 70 lambs of adult ewes (in three lambings) was 41 males to 29 females (41:29). A high percentage of fecundity (137.2%) and prolificity (149%), an unrestricted breeding seasons, a short lambing interval and a short postweaning anoestrus period, recommend this breed of sheep as commercially advantageous for arid zones.

Animals↗
PubMed1984

Segregation of HLA-DR2 among affected and non-affected offspring of 66 families with type 1 (insulin-dependent) diabetes.

Segregation of HLA-DR2 among affected and unaffected offspring was studied in 66 HLA-genotypes families with Type 1 diabetes in whom at least one parent carried DR2. The frequency of DR2-positive parents (21%) was not different from that of control families (29%). Among the diabetic probands, the gene frequency of DR2 was significantly decreased compared with control subjects (0.05 versus 0.17, p less than 0.001) as were DR5 (0.07 versus 0.17, p less than 0.01) and DR7 (0.06 versus 0.13, p less than 0.003). Twenty probands carried DR2, in 11 or whom (55%) it was found in combination with either DR3 or DR4. The nine cases who carried another DR allele included one who was DR2 homozygous. Transmission of DR2 was reduced in affected offspring, and random in unaffected siblings, compared with the expected ratio. However, when the DR2 transmission was analysed separately for parents bearing DR2 with DR3, DR4 or another DR allele, it appeared that DR2 transmission to affected offspring was random when the parents carried neither DR3 or DR4, the transmission deficit being due to over-transmission of DR3 and DR4. The haplotype analysis showed that the haplotype A3, Cw7, B7, GfS, DR2, found in 19% of "non-diabetic" DR2 haplotypes was practically absent among "diabetic" DR2-haplotypes (4%). In conclusion, population and segregation analysis could not demonstrate a specific protective effect of DR2.

Diabetes Mellitus, Type 1↗
PubMed1984

Clusters of HLA class II beta restriction fragments describe allelic series.

Eighty-eight HLA haplotypes have been investigated for the presence or absence of 52 restriction fragments generated by four restriction enzymes (EcoRI, EcoRV, HindIII, BamHI), and detected by a DQ beta cDNA probe. Correlation analysis showed several sets of positively associated fragments forming 11 clusters. They constitute three different allelic series. The first coincides with DR alleles, the second with DQ alleles, and within the third, one cluster coincides with DRw53 (MT). As shown by comparative hybridization, most fragments belonging to the DR- as well as the DQ-related series correspond to DQ beta genes. In contrast, the MT-related series corresponds to DR beta genes. The evolutionary significance of these restriction fragment clusters is discussed.

Alleles↗
PubMed1984

Class II HLA-DC beta-chain DNA restriction fragments differentiate among HLA-DR2 individuals in insulin-dependent diabetes and multiple sclerosis.

HLA-DR2 allele is negatively associated with insulin-dependent diabetes and positively associated with multiple sclerosis (MS). A 2.2-kilobase-pair EcoRI DNA restriction fragment detected with a beta-chain HLA-DC cDNA probe was found to be strongly correlated with HLA-DR2 in the normal population, but was absent in HLA-DR2 insulin-dependent diabetic patients. This fragment was found in HLA-DR2 multiple sclerosis patients with the same frequency as in controls. A beta-chain HLA-DC 12-kilobase-pair BamHI fragment might differentiate multiple sclerosis patients from healthy individuals.

DNA Restriction Enzymes↗
PubMed1984

Immunocytochemical localization of opsin in the cell membrane of developing rat retinal photoreceptors.

Mature retinal rod photoreceptors sequester opsin in the disk and plasma membranes of the rod outer segment (ROS). Opsin is synthesized in the inner segment and is transferred to the outer segment along the connecting cilium that joins the two compartments. We have investigated early stages of retinal development during which the polarized distribution of opsin is established in the rod photoreceptor cell. Retinas were isolated from newborn rats, 3-21 d old, and incubated with affinity purified biotinyl-sheep anti-bovine opsin followed by avidin-ferritin. At early postnatal ages prior to the development of the ROS, opsin is labeled by antiopsin on the inner segment plasma membrane. At the fifth postnatal day, as ROS formation begins opsin was detected on the connecting cilium plasma membrane. However, the labeling density of the ciliary plasma membrane was not uniform: the proximal cilium was relatively unlabeled in comparison with the distal cilium and the ROS plasma membrane. In nearly mature rat retinas, opsin was no longer detected on the inner segment plasma membrane. A similar polarized distribution of opsin was also observed in adult human rod photoreceptor cells labeled with the same antibodies. These results suggest that some component(s) of the connecting cilium and its plasma membrane may participate in establishing and maintaining the polarized distribution of opsin.

Age Factors↗
PubMed1984

Control of bleeding in extrahepatic portal hypertension--the reverse splenorenal shunt and portal-azygos disconnection.

Variceal bleeding in children with extrahepatic portal hypertension is best controlled by an effective decompressive shunt. Both the standard and central splenorenal shunts require splenectomy which is undesirable in childhood, and alternative shunts such as the mesocaval shunt and the distal splenorenal shunt are also technically difficult with a similar risk of shunt thrombosis. The reverse splenorenal shunt first described in 1962 by Erlik uses the proximal portion of the left renal vein which was initially anastomosed to the portal vein. It can be anastomosed to any of the major tributaries of the portal system. In the technique described, the proximal end of the renal vein is joined to the side of the splenic vein continuity. It is preferable for this to be done as an elective planned procedure. Massive continuing haemorrhage which is not responding to conservative management can be controlled by portal-azygos disconnection with gastric transection. This procedure will control major variceal haemorrhage for several years and allow a decompressive shunt to be performed under optimal conditions and after appropriate preoperative investigations.

Child↗
PubMed1984

Phases of change in the patient with Alzheimer's dementia: a conceptual dimension for defining health care management.

Since the progressive nature of Alzheimer's disease and related disorders of later life gradually imposes a series of significant limitations upon the patient, a successful clinical management program rests upon a conceptualization of changes in the patient. Postulating psychologic reactions helps professionals to understand and respond to the patient's needs and feelings at different stages of the disease. The phases discussed here provide the basis for defining treatment goals and management plans, selecting therapeutic strategies, identifying needed resources, and evolving innovative approaches to patient care.

Adaptation, Psychological↗
PubMed1984

Poor outcome and low platelet MAO activity in chronic schizophrenia.

Platelet monoamine oxidase (MAO) activity was significantly lower among 21 chronic schizophrenic patients, 19 of whom were receiving stable doses of antipsychotic medication, than among 16 control subjects. Poor ego functioning and poor outcome were significantly correlated with low MAO activity; current dose of major tranquilizer was negatively but not significantly correlated. The degree of psychopathology, rather than presence or absence of specific symptom constellations, was the significant characteristic of patients with low enzyme levels. This finding is in accordance with those of earlier studies of schizophrenic patients as well as with recent findings in nonschizophrenic samples.

Adult↗