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Biomedical subjects

H Cohen

Publications and source records attributed to H Cohen.

At least 55 records · Page 3Linked to original sources
PubMed2001

Pseudotumor deltoideus: a previously undescribed anatomic variant at the deltoid insertion site.

A spectrum of eccentric bone irregularities were observed in the humeral deltoid tuberosity region of five patients. Patients were referred for associated pain or for the incidental radiographic findings. The lesions are characterized radiographically by a relative lucency at or adjacent to the deltoid tuberosity, variably increased uptake on the bone scan, and mild cortical irregularity or adjacent eccentric marrow abnormality on MRI and CT. The term pseudotumor deltoideus is coined for these previously undescribed anatomic variants. Imaging studies and extended clinical follow-up in these patients support an inactive or indolent process that may be managed conservatively. The potential etiology and role of these cortical irregularities as tumor simulators is emphasized.

Adult↗
PubMed2001

Distinction of well-differentiated liposarcoma from lipoma in two patients with multiple well-differentiated fatty masses.

This case report describes the features of gadolinium-enhanced MRI in well-differentiated liposarcoma with histologic correlation and addresses the usefulness of this imaging technique in distinguishing well-differentiated liposarcoma from lipoma. Gadolinium-enhanced MRI revealed significantly enhanced signal in well-differentiated liposarcoma in a background of multiple well-differentiated benign fatty masses by showing the increased vascularity in the septa of well-differentiated liposarcoma. Although such signal enhancement can be seen in some types of benign lipomatous tumors with increased blood vessels, this technique is helpful in selection of biopsy site, especially in a clinical setting of multiple fatty masses.

Adult↗
PubMed2001

General practitioners' and patients' models of obesity: whose problem is it?

Primary care literature emphasises the importance of agreement and shared models in the consultation. This study compared general practitioners' (GPs') and patients' models of obesity. Questionnaires concerning beliefs about the causes, consequences and solutions to obesity were completed by 89 general practitioners (GPs) and 599 patients from practices across UK. In terms of causes, the results showed that the patients were more likely to attribute obesity to a gland/hormone problem, slow metabolism and stress than the GPs, whereas the GPs were more likely to blame eating too much. In terms of consequences, the patients rated difficulty getting to work more highly whereas the GPs regarded diabetes as more important. For the solutions to obesity, the two groups reported similar beliefs for a range of methods, but whereas the patients rated the GP and a counsellor as more helpful, the GPs rated the obese person themselves more highly. It is argued that patients show a self serving model of obesity by blaming internal uncontrollable factors for causing obesity yet expecting external factors to solve it. In contrast, GPs show a victim blaming model by attributing both cause and the solution to internal controllable factors. Such differing models have implications regarding the form of intervention likely to be used in primary care and indicate that whereas patients would prefer a more professional based approach, GPs would prefer a more patient-led one. Further, the results suggest that even if an intervention could be negotiated, success rates would be low as either the patient or the GP would be acting in contradiction to their beliefs about the nature of obesity.

Adult↗
PubMed2001

Anti-beta 2 glycoprotein 1 and anti-annexin V antibodies in women with recurrent miscarriage.

While it has been established that anti-phospholipid antibodies (aPL) are associated with recurrent miscarriage (RM), the importance of anti-beta2 glycoprotein 1 (GP1) IgG and anti-annexin V IgG antibodies as risk factors for RM is undefined. We have investigated the prevalence of anti-beta2 GP1 IgG and anti-annexin V IgG antibodies in 54 aPL-positive and 48 aPL-negative women with RM. The prevalence of IgG anti-beta2 GP1 antibodies was not significantly different in persistently aPL-positive women with RM (7%), aPL-negative women with RM (6%) and the normal parous control group (3%). Anti-annexin V IgG antibody prevalence was significantly increased in aPL-positive women with RM compared with aPL-negative women with RM (P = 0.01). The elevations were found in 35%, 19% and 16% of aPL-positive women with RM, aPL-negative women with RM and the control group respectively. No women showed positivity for both anti-beta2 GP1 IgG and anti-annexin V antibodies. Anti-beta2 GP1 IgG antibodies do not appear to be contributory to the investigation of women with RM. Anti-annexin V antibody positivity, although associated with aPL positivity in women with RM, is not an independent risk marker.

Abortion, Habitual↗
PubMed2001

Epilepsia Verminosa.

Epilepsy is a major public health threat in the developing world, with much higher prevalence and incidence rates than those observed in developed countries. At present, one of the most common causes for epilepsy worldwide is the parasitic worm, Taenia solium, and the associated neurocysticercosis (NCC) that may often result from this infestation. Worm infestation was already recognized as a cause of epilepsy by the middle of the 18th century. Helminths and their effects on health were a daily medical concern in the 18th and 19th centuries--with prevailing views ranging from the beneficial effects of the presence of adult worms in the gut, to considering them as culprits for a wide variety of diseases. A number of cases followed longitudinally by various nineteenth-century French physicians showed that there was good reason to believe that the verminous influence on seizures was real, as the expulsion of the T. solium often coincided with a notable amelioration of symptoms. Several theories were proposed to account for how the worms could lead to Epilepsia nervosa, including notions of competition for nutritional resources between the host and the parasite, and irritation of the medulla and of peripheral nerve endings predisposing to epileptiform episodes. Recently, after almost a century of quiet, interest in the neurological effects of helminths has been rekindled, due in part to the growing number of cases in the United States with NCC-related neurological disorders. In this article, we review the history of our understanding of the relationship between seizure disorders and parasitic worms, and we relate this history to contemporary epidemiologic and public health issues in developing countries.

Developing Countries↗
PubMed2001

Factor V Leiden and acquired activated protein C resistance among 1000 women with recurrent miscarriage.

Activated protein C (APC) resistance, both in its congenital form, due to the factor V Leiden mutation, and in its acquired form, are important risk factors for systemic venous thrombosis. In view of the suspected thrombotic aetiology of some cases of recurrent miscarriage, the prevalence of APC resistance was determined among 1111 consecutive Caucasian women with a history of either recurrent early miscarriage (three or more consecutive pregnancy losses at <12 weeks gestation; n = 904) or a history of at least one late miscarriage (>12 weeks gestation; n = 207). A control group of 150 parous Caucasian women with no previous history of adverse pregnancy outcome was also studied. Acquired APC resistance was significantly more common among both women with recurrent early miscarriage (8.8%: 80/904; P = 0.02) and those with late miscarriage (8.7%: 18/207; P = 0.04) compared with controls (3.3%: 5/150). In contrast, the frequency of the factor V Leiden allele was similar among (i) women with recurrent early miscarriage (3.3%:60/1808; 58 heterozygotes and one homozygote), (ii) those with late miscarriage (3.9%:16/414; 14 heterozygotes and one homozygote) and (iii) the control group (4.0%:12/300; 12 heterozygotes). Acquired but not congenital APC resistance (due to the factor V Leiden mutation) is associated with both early and late miscarriage.

Abortion, Habitual↗
PubMed2001

Vitamin B(6) in the treatment of tardive dyskinesia: a double-blind, placebo-controlled, crossover study.

OBJECTIVE: The authors' goal was to conduct a double-blind trial of vitamin B(6) in the treatment of tardive dyskinesia in patients with schizophrenia. METHOD: Fifteen inpatients with schizophrenia who met research diagnostic criteria for tardive dyskinesia were randomly assigned to treatment with either vitamin B(6) or placebo for 4 weeks in a double-blind crossover paradigm. The Extrapyramidal Symptom Rating Scale was used to assess patients weekly. RESULTS: Mean scores on the parkinsonism and dyskinetic movement subscales of the Extrapyramidal Symptom Rating Scale were significantly better in the third week of treatment with vitamin B(6) than during the placebo period. CONCLUSIONS: Vitamin B(6) appears to be effective in reducing symptoms of tardive dyskinesia.

Adult↗
PubMed2001

Association of autonomic dysfunction and clozapine. Heart rate variability and risk for sudden death in patients with schizophrenia on long-term psychotropic medication.

BACKGROUND: Antipsychotic medications cause a wide range of adverse effects and have been associated with sudden death in psychiatric patients. AIMS: To supply power spectral analysis of heart rate variability as a tool to examine the arrythmogenic effects of neuroleptics. METHOD: Heart rate analysis was carried out in patients with schizophrenia on standard doses of neuroleptic monotherapy -- 21 were on clozapine, 18 on haloperidol and 17 on olanzapine -- and in 53 healthy subjects. RESULTS: Patients with schizophrenia on clozapine had significantly higher heart rate, lower heart rate variability and lower high-frequency and higher low-frequency components compared with patients on haloperidol or olanzapine and matched control subjects. Prolonged QTc intervals were more common in patients than controls. CONCLUSIONS: Patients treated with neuroleptic medications, especially clozapine, showed autonomic dysregulation and cardiac repolarisation changes. Physicians should be aware of this adverse reaction.

Adult↗
PubMed2001

Characterization of a rat uterine cell line, U(III) cells: prolactin (PRL) expression and endogenous regulation of PRL-dependent genes; estrogen receptor beta, alpha(2)-macroglobulin, and decidual PRL involving the Jak2 and Stat5 pathway.

Decidualization of endometrial stroma in the rat induces the expression and secretion of rat decidual PRL (rdPRL). Recently, we have generated a nontransformed rat uterine stromal cell line (U(III)) that decidualizes spontaneously in culture. In this report, we have established by immunocytochemistry, RT-PCR, Western blot analysis, labeled amino acid incorporation and RIA that these cells express the rat PRL messenger RNA as well as synthesize and secrete PRL. We have also cloned by RT-PCR a 403-bp complementary DNA fragment whose sequence is identical with that of rat pituitary PRL. In addition, U(III) cells express the PRL receptor (PRL-R) long form, all the components involved in the PRL signal transduction pathway, estrogen receptor beta (ER beta) and alpha(2)-macroglobulin (alpha(2)-MG), which are known to be PRL-regulated genes. However, when U(III) cells were treated with PRL, no regulation of these genes was observed. Moreover, in these cells, the PRL signaling components: the tyrosine kinase Jak2 and the transcription factor Stat5 were endogenously phosphorylated and their phosphorylation states were not enhanced in the presence of exogenous PRL. To examine whether the endogenously secreted PRL affects the expression of PRL-regulated genes, U(III) cells were treated with either an anti-PRL receptor antibody or a Jak2 inhibitor, AG490. The anti-PRL receptor antibody decreased alpha(2)-MG expression. AG490 inhibited Jak2 and Stat5 phosphorylation, prevented Stat5 binding to its DNA consensus sequence, and also caused a dose-dependent down-regulation of alpha(2)-MG and ER beta expression. In contrast, AG490 enhanced PRL mRNA levels. In summary, we have established that the U(III) stromal cells of uterine origin produce PRL. Furthermore, we have shown for the first time that decidual PRL may act locally to activate the Jak2/Stat5 pathway and up-regulate important genes involved in decidual growth and placentation.

Amino Acid Sequence↗
PubMed2001

Vascular transformation of lymph node sinuses.

Vascular transformation of lymph node sinuses is an uncommon condition and only isolated cases have been reported. It is characterized by conversion of nodal sinuses into capillary-like channels, often accompanied by fibrosis. Venous or lymphatic obstruction is thought to be the underlying mechanism, and in most cases factors that may contribute to lymphovascular obstruction can be identified such as tumour in the vicinity, vascular thrombosis, heart failure, previous surgery or radiotherapy. Most cases involve abdominal lymph nodes, and head and neck involvement is rare. We present two cases of vascular transformation of lymph node sinuses presenting only as cervical lymphadenopathy, without an obvious cause of lymphovascular obstruction.

Adult↗
PubMed2001

Pyogenic liver abscesses due to Klebsiella pneumoniae in a diabetic patient.

Pyogenic liver abscess due to Klebsiella pneumoniae is a rare clinical entity. It has emerged as an important infection complication in diabetics and its incidence in diabetics without intraabdominal or biliary tract infections is increasing. We present herein a case of multiple pyogenic liver abscesses due to K. pneumoniae in a diabetic patient and discuss clinical course, treatment and possible reasons for association between K. pneumoniae liver abscess and diabetes.

Diabetic Ketoacidosis↗
PubMed2001

Abnormal sympathovagal balance in men with fibromyalgia.

OBJECTIVE: It is possible that there are differences in clinical manifestations between men and women with fibromyalgia syndrome (FM), especially in autonomic dysfunction; we assessed the interaction between the sympathetic and parasympathetic systems in postural change in men with FM using power spectral analysis (PSA) of heart rate variability (HRV), and investigated the pathogenesis of the orthostatic intolerance. METHODS: We studied 19 men with FM and 19 controls matched for age and sex. A high resolution electrocardiogram was obtained in supine and standing postures during complete rest. Spectral analysis of R-R intervals was done by the fast Fourier transform algorithm. RESULTS: PSA of HRV revealed that men with FM at rest are characterized by sympathetic hyperactivity and concomitantly reduced parasympathetic activity. During postural changes, male patients demonstrated an abnormal sympathovagal response. These results provide the physiological basis for the orthostatic intolerance in men with FM. CONCLUSION: This report of autonomic dysfunction in men with FM revealed an abnormal autonomic response to orthostatic stress. This abnormality may have implications regarding the symptoms of FM.

Adult↗
PubMed2001

[Escherichia coli eradication from the blader urine by amoxicillin-sulbactam. Intrinsic activity of the inhibitor].

RATIONALE: At urine concentrations obtained after the oral administration of amoxicillin-sulbactam (500/500 mg) this combination inhibits roughly 90% of Escherichia coli and Proteus mirabilis strains. AIMS: To administer amoxicilin-sulbactam 875/125 mg and to determine: a) minimum inhibitory concentration (MIC) of sulbactam for E. coli and P. mirabilis; b) urine inhibitory titres power (UIT) against amoxicillin-resistant E. coli or P. mirabilis; c) urine concentrations of sulbactam; and to verify whether sulbactam 125 mg as single drug, attains a high enough UIT to support the intrinsic action of the inhibitor; and to compare the activity of amoxicillin-sulbactam and amoxicillin-clavulanate and that of sulbactam and clavulanate. METHODS: Twelve healthy volunteers received a single oral dose of amoxicillin-sulbactam 875/125 mg or amoxicillin-clavulanate 875/125 mg, according to a randomized cross-over design. Urine samples were drawn at: 0 (basal), 2, 4, and 6 hours after dosing. Urine pH, specific gravidity and UIP were assessed. Thirty nine strains isolated from urine samples were used: 30 TEM-1 producing E. coli strains and 3 extended spectrum CTX-M-2 betalactamase-producing E. coli; and 6 P. mirabilis resistant to both combinations. In 6 healthy volunteers, sulbactam 125 mg was administered orally and UIT against E. coli (MIC amoxicillin > 2048 mg/l) was assessed. RESULTS AND DISCUSSION: MIC-90 for amoxicillin plus sulbactam or clavulanate were similar to those for sulbactam or clavulanate alone, without any difference attributable to the chemical composition of the urine. The activity of amoxicillin plus the inhibitors could be due, not only to the inhibition of betalactamase but also to the intrinsic effect of the inhibitor. Both combinations showed an equivalent inhibitory activity. Two-hour UIT remained high for the entire 6-h evaluation period. Sulbactam concentration far exceed sulbactam MIC for the 6h-period, inhibiting urine E. coli. We disagree with the cut-off limit proposed for intermediate values of NCCLS, which, for these antimicrobial are 16/8, a value lower than those obtained in urine samples after the administration of betalactamase inhibitors. This may be an explanation for the beneficial effect of amoxicillin-sulbactam in the recovery of uncomplicated lower urinary tract infections in women when the involved strains were considered resistant by diffusional methods.

Adult↗
PubMed2001

Mechanisms of action of the anti-atherogenic effect of magnesium: lessons from a mouse model.

Magnesium (Mg) fortification of drinking water succeeded in inhibition of atherogenesis development in a transgenic model of atherosclerosis-prone mice fed a high-cholesterol content diet. In order to delineate possible mechanisms of action of the anti-atherogenic effect of Mg, the involvement of LDL oxidation was studied. We determined the susceptibility of LDL to Cu+2 oxidation, anti-oxidized LDL antibody levels, and liver content of retinol and retinyl-palmitate. In order to study another possible mechanism we tested platelets interaction with extracellular matrix in both male and female mice with or without Mg fortification of drinking water. No difference was found in susceptibility of LDL to undergo oxidation. Female mice that received Mg had decreased anti-oxidized LDL antibody levels compared with control female mice, while there was no significant difference among male groups. On the other hand, only in the male group with Mg was a higher content of retinol and retinyl-palmitate found in the livers. Platelets coverage area on extracellular matrix was similar between groups. These results suggest that Mg might affect LDL oxidation, and thus atherogenesis.

Animals↗