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Biomedical subjects

D L Cohen

Publications and source records attributed to D L Cohen.

At least 55 records · Page 3Linked to original sources

Informed consent policies governing medical students' interactions with patients.

When medical students become involved in patient care, concerns are raised that have ethical and possibly legal implications. In order to determine compliance with the guidelines of the U.S. government and the Joint Committee on Accreditation of Hospitals pertaining to informed consent, the authors conducted a study of hospital administrators, medical school department chairpersons, and medical school deans (with response rates ranging from 82.3 to 95.1 percent) concerning policies on student involvement in patient care. The results show that only 37.5 percent of all responding teaching hospitals specifically informed patients that students would be involved in care. Only 51 percent of the responding medical schools that specifically gave their students instruction or guidance on initial patient interaction as a matter of policy insisted that their students introduce themselves as students and clarify their role in patient care. The authors conclude that medical educators' compliance with the ethical requirements of informed consent is incomplete.

Disclosure↗

Are malaria films requested appropriately? A study of all film requests in one health district.

In a 12-month period 238 patients had blood films examined for malaria parasites in a London district general hospital. All the available medical records of these patients were studied. The ethnic origin and country from which the patients had travelled were typical of an area with a large immigrant population. 27 of the films were positive. 39 were judged to have been requested inappropriately, usually because an adequate travel history had not been taken. Imported malaria is an important problem in this health district and contributes significantly to the laboratory workload.

Clinical Laboratory Techniques↗

Use of CAT scanning in the diagnosis and management of hepatic artery aneurysm.

Hepatic artery aneurysms occur infrequently and are often difficult to diagnose. Non-invasive procedures such as ultrasound or computer assisted tomography have not been considered suitable for definitive diagnosis and angiography is usually required. A patient is described in whom a mycotic hepatic artery aneurysm developed during the course of subacute bacterial endocarditis. The definitive diagnosis was made using computer assisted tomography with intravenous contrast enhancement and angiography was undertaken only as a prelude to transcatheter embolisation. The same technique was used to monitor progress after embolisation precluding the need for follow up angiography. As 80% of patients with hepatic artery aneurysm present for the first time after aneurysm rupture, the mortality associated with this condition is high. More widespread use of intravenous contrast enhanced tomography for abdominal examination in patients with unexplained abdominal pain might result in earlier diagnosis of this condition.

Adolescent↗

Malaria in Brent: successful treatment in the community.

40 cases of malaria seen in an 18 month period were reviewed. The clinical diagnosis was made by the general practitioner or casualty officer in 85%, and 45% of these were treated and discharged without further referral. In an area where a high awareness of malaria exists, uncomplicated Plasmodium vivax infection can be treated safely in the community. Primaquine should be given for the exo-erythrocyte stage and patients screened for glucose-6-phosphate dehydrogenase deficiency before this.

Adolescent↗

An intracranial metastasis from a PRL secreting pituitary tumour.

A 70-year-old man developed panhypopituitarism and was found to have hyperprolactinaemia and a locally invasive pituitary tumour. The visual fields were unaffected and therefore the patient was treated with hormone replacement only. After 3.5 years during which time the pituitary tumour had not enlarged further, the patient developed a mass in the left cerebello-pontine angle. This mass was subsequently shown to be entirely separate from, but histologically identical to, the pituitary tumour and the cells of both contained PRL. Evidence was obtained to show that the tumour had spread by a vascular route. This is the second reported case of a malignant prolactinoma.

Adenoma, Chromophobe↗

The production of alpha-amylase in batch and chemostat culture by Bacillus stearothermophilus.

The production of alpha-amylase (alpha-1,4-glucan 4-glucanohydrolase; EC 3.2.1.1) by a strain of Bacillus stearothermophilus isolated from leaf litter was investigated in a tryptone-maltose medium at 55 degrees C in batch and chemostat culture. Amylase production was growth-limited and restricted to the exponential phase in batch culture. The enzyme yield was reduced by 40% when the culture pH was maintained at pH 7.2. Amylase production in chemostat culture was influenced by the growth rate throughout the dilution rate range used.

Amylases↗