Search PubMed⌕ Search

Biomedical subjects

M A Cohen

Publications and source records attributed to M A Cohen.

At least 55 records · Page 3Linked to original sources
PubMed1999

Effects of categorization and discrimination training on auditory perceptual space.

Psychophysical phenomena such as categorical perception and the perceptual magnet effect indicate that our auditory perceptual spaces are warped for some stimuli. This paper investigates the effects of two different kinds of training on auditory perceptual space. It is first shown that categorization training using nonspeech stimuli, in which subjects learn to identify stimuli within a particular frequency range as members of the same category, can lead to a decrease in sensitivity to stimuli in that category. This phenomenon is an example of acquired similarity and apparently has not been previously demonstrated for a category-relevant dimension. Discrimination training with the same set of stimuli was shown to have the opposite effect: subjects became more sensitive to differences in the stimuli presented during training. Further experiments investigated some of the conditions that are necessary to generate the acquired similarity found in the first experiment. The results of these experiments are used to evaluate two neural network models of the perceptual magnet effect. These models, in combination with our experimental results, are used to generate an experimentally testable prediction concerning changes in the brain's auditory maps under different training conditions.

Adolescent↗
PubMed1999

Utilizing routine sonohysterography to detect intrauterine pathology before initiating hormone replacement therapy.

OBJECTIVE: To assess the utility of performing routine sonohysterography in conjunction with endometrial thickness measurement for detecting intrauterine pathology in asymptomatic postmenopausal women. DESIGN: Asymptomatic postmenopausal women (n = 60, mean age 52.7 +/- 4.5 years, amenorrhea > or = 6 months, follicle stimulating hormone > or = 40 mIU/mL) were evaluated with sonohysterography followed by endometrial biopsy before initiating hormone replacement therapy. RESULTS: Hyperplasia was detected in 5 of 22 (22.7%) patients with endometrial thickness of > 5 mm and in 0 of 38 (0.0%) patients with endometrial thickness of < or = 5 mm. When sonohysterography was performed, intracavitary pathology was discovered in 14 of 38 (36.8%) patients with endometrial thickness of < or = 5 mm (10 polyps, three submucosal myomas, and one septate uterus) and 14 of 22 (63.6%) patients with endometrial thickness of > 5 mm (nine polyps, four submucosal myomas, and one Asherman's syndrome). CONCLUSIONS: Endometrial thickness of < or = 5 mm excludes hyperplasia but does not eliminate other intrauterine pathology that may be discovered by sonohysterography.

Aged↗
PubMed1998

Preoperative galactography increases the diagnostic yield of major duct excision for nipple discharge.

BACKGROUND: Although most nipple discharge is due to a benign etiology, approximately 10-15% is due to breast carcinoma. The standard management of nipple discharge includes major duct excision, and although this procedure may eliminate future nipple discharge, a specific etiology is not always found. This study investigates the utility of preoperative galactography in targeting the causative lesion. METHODS: During 1994-1996, 46 cases of major duct excision were identified from operating room records. All patients presented with spontaneous nipple discharge from a single duct. In 16 patients both a diagnostic galactogram and a preoperative galactogram with methylene blue were performed to localize the causative lesion and to enable intraoperative identification. Data were obtained by retrospective chart review. Statistical significance was determined by Fisher's exact test. RESULTS: Preoperative galactography was obtained in 7 of 31 patients (23%) with bloody nipple discharge and 9 of 15 patients (60%) with guaiac negative discharge. All patients undergoing preoperative galactography were found to have either a filling defect and/or duct cutoff (n = 13) or duct ectasia (n = 3). All patients with a filling defect and/or duct cutoff on galactogram were found to have a carcinoma or papilloma at surgery. In the three patients with duct ectasia observed on galactogram, the diagnosis was confirmed at surgery. All patients who underwent preoperative galactography were found to have specific pathology that accounted for the nipple discharge versus 20 of 30 patients (67%) who did not undergo preoperative galactography (P = 0.009). CONCLUSIONS: Although major duct excision for nipple discharge may eliminate the presenting symptomatology, a pathologic correlate is not always found. The data from the current study show that localizing the causative lesion by preoperative galactography increases the likelihood that specific pathology will be found at surgery, and suggests that preoperative galactography may be helpful in the evaluation and management of patients presenting with spontaneous nipple discharge. Cancer 1998;82:1874-80. 1998 American Cancer Society.

Adult↗
PubMed1998

Emerging trends in the finance and delivery of long-term care: public and private opportunities and challenges.

A number of key trends are emerging in long-term care related to financing, new models of service delivery, and shifts in consumer expectations and preferences. Taken together, changes occurring in these areas point to a rapidly transforming long-term care landscape. Financing responsibility is shifting away from the federal government to states, individuals, and their families; providers are integrating and managing acute and long-term care services and adding new services to the continuum of care; and consumers are thinking more seriously about how to plan and pay for their future care needs, as well as how to independently navigate the long-term care system.

Community Participation↗
PubMed1998

Bacterial eradication by clinafloxacin, CI-990, and ciprofloxacin employing MBC test, in-vitro time-kill and in-vivo time-kill studies.

Bactericidal activities of clinafloxacin, CI-990 and ciprofloxacin were examined and compared for a small collection of gram-positive and gram-negative pathogens. In-vitro antimicrobial activities were measured by MIC, MBC and time-kill studies; in-vivo efficacy of each drug was assessed in an acute lethal mouse infection model that monitored median protective dose, eradicative dose and time-kill in blood. In general, for all test methods, activity of clinafloxacin exceeded that of CI-990, which in turn exceeded that of ciprofloxacin. Improvement in clinafloxacin and CI-990 activity over ciprofloxacin was more apparent against gram-positive cocci; differences were less noticeable against Escherichia coli and Pseudomonas aeruginosa. Clinafloxacin activity was notably high against Staphylococcus aureus and, against ciprofloxacin-resistant strains, this high activity was maintained in vitro and measurable activity was demonstrated in vivo.

Animals↗
PubMed1998

Intraarticular morphine in the multimodal analgesic management of postoperative pain after ambulatory anterior cruciate ligament repair.

UNLABELLED: Reconstruction of the anterior cruciate ligament (ACL) is associated with a considerable degree of postoperative pain. Our customary multimodal approach to postoperative analgesia after ambulatory ACL surgery includes perioperative nonsteroidal antiinflammatory drugs, pre- and postincisional intraarticular (I.A.) bupivacaine (B), and postoperative cryotherapy using an external cooling system. This study was designed to determine whether the addition of I.A. morphine (MS) provides improved postoperative analgesia. One hundred patients scheduled for elective ambulatory ACL repair received our standard multimodal therapy. After surgery, patients were randomized to one of four study groups. Group 1 received 30 mL of 0.25% B I.A. Group 2 received 30 mL of normal saline I.A. and 5 mg of MS I.A. Group 3 received 30 mL of 0.25% bupivacaine I.A. and 5 mg of MS I.V.. Group 4 received 30 mL of 0.25% B I.A. and 5 mg of MS I.A. The addition of I.A. B postoperatively provided prolonged analgesia and decreased postoperative pain and analgesic requirements. The addition of MS to I.A. B did not provide additional postoperative analgesia. We conclude that patients undergoing ambulatory ACL repair using our standard multimodal analgesic regimen failed to receive additional postoperative analgesia when MS was added to the I.A. B. IMPLICATIONS: Patients receiving a multimodal analgesic regimen of perioperative nonsteroidal antiinflammatory drugs, intraarticular bupivacaine, and external cooling did not receive any additional analgesia from intraarticular morphine.

Adult↗
PubMed1998

Palatoplasty: Furlow's double reversing Z-plasty versus intravelar veloplasty.

OBJECTIVE: To evaluate the efficacy of Furlow's double reversing z-plasty (Furlow) versus intravelar veloplasty with longitudinal closure including palatal muscle reorientation (IVV). DESIGN: Retrospective, single-institution, single-surgeon comparison. PATIENTS: One hundred nineteen consecutive cleft palate patients were enrolled; 34 syndromic and 9 language-impaired patients were removed from speech and reoperation analysis. Furlow and IVV groups were similar with respect to sex and mean age at primary repair. INTERVENTIONS: One surgeon performed all surgery and one of two speech pathologists conducted language and speech evaluations at 3 years of age without prior knowledge of the surgical technique utilized. OUTCOME MEASURES: Outcome measures included frequency of palatal fistulae, speech abnormalities, and need for secondary pharyngoplasty procedures. RESULTS: Patients who had undergone IVV demonstrated a 34% higher incidence of hoarseness, nasal escape, and hypernasality at 3 years of age than did Furlow patients. These same patients likewise required significantly more secondary pharyngoplasty procedures. No significant difference was noted between fistulae frequencies. CONCLUSIONS: These findings suggest that Furlow palatoplasty may provide a better clinical outcome than intravelar veloplasty.

Cleft Palate↗
PubMed1998

Occupational skin diseases in Washington State, 1989 through 1993: using workers' compensation data to identify cutaneous hazards.

OBJECTIVES: This study sought to characterize occupational dermatoses and cutaneous hazards. METHODS: Workers' compensation claims filed for skin disease in the Washington State Fund were analyzed for 1989 through 1993; incidence rates for industries and employers were calculated, and cutaneous hazards associated with the highest rates were identified. RESULTS: A total of 7445 claims were filed for skin disorders, principally contact dermatitis; 675 (9.1%) involved more than 3 missed work-days. The rate of accepted skin disorder claims was 1.0 per 1000 full-time employee-years. The highest incidence rates (4.6 to 30.7 accepted claims per 1000 full-time employee-years) were in certain manufacturing industries (plastics related, concrete products, aircraft parts, sporting goods, and boat building), wholesale farm product raw materials, automotive glass replacement, and beauty shops. Seven of the 10 employers with the highest incidence rates (19.6 to 85.5 accepted claims per 1000 full-time employee-years) used fiber-reinforced plastics (composites) and exposed workers to epoxy and other resin systems associated with contact dermatitis. CONCLUSIONS: Workers' compensation data identify known and emerging workplace cutaneous hazards and show promise for targeting prevention efforts.

Dermatitis, Occupational↗
PubMed1998

Early life and later determinants of adult disease: a 50 year follow-up study of the Newcastle Thousand Families cohort.

The relative contribution of socioeconomic, behavioural and biological factors operating in fetal and infant life, childhood and adulthood to risk for cardiovascular disease, respiratory diseases and non-insulin-dependent diabetes in middle age has become an important research issue. All 1142 babies born in Newcastle upon Tyne in May and June 1947 were recruited into a prospective cohort study of child health (the 'Thousand Families' study) and followed in great detail to the age of 15 y, with a brief further follow up at age 22 y. Children from poorer families were at greatest risk of severe respiratory tract infection in infancy. Children from professional and managerial families were on average taller and heavier throughout childhood than those from semi- and unskilled manual social classes. Repeated infections in early childhood greatly increased the risk of developing chronic respiratory disease by age 15 y. This paper outlines a new investigation designed to trace surviving members of this cohort and to chart the relationships between their socioeconomic circumstances, lifestyles, experiences and health from birth through to the present day. Existing data on socioeconomic circumstances and infections in infancy and childhood, infant nutrition, birthweight and physical development to age 22 y will be linked to information gained from a new study. This comprises a postal questionnaire survey of study members' adult health, socioeconomic circumstances and lifestyle, and a hospital based clinical examination including heart and lung function, glucose tolerance, blood lipids and anthropometric measurements at age 49-51 y. Out of a target sample of 979 people for whom sufficient data are available on the first year of life, 866 (88%) have been traced and 649 are still resident in the North of England. Those study members who have been traced are highly representative of the original cohort. The Thousand Families cohort provides a unique opportunity for detailed epidemiological study because of the wealth of data available on infant and childhood socioeconomic and family circumstances, all of which was collected prospectively. In addition, there has been comparatively little loss to follow-up since 1948.

Chi-Square Distribution↗
PubMed1997

Pelvic computed tomography of breast carcinoma patients. Should it routinely be added to abdominal computed tomography?

BACKGROUND: This study was conducted to determine if pelvic computed tomography (CT) should routinely be appended to abdominal CT in the workup of patients with breast carcinoma. METHODS: The abdominal-pelvic CTs of 139 breast carcinoma patients (195 exams) were reviewed. Scans were grouped by indication and whether pelvic pathology was known before CT. Pelvic CT results were correlated with their effect on patient management. RESULTS: Among the 119 patients without pre-CT evidence of pelvic disease, a nonosseous pelvic metastasis was identified in only 1; this patient also had liver metastases and management was not changed. No unsuspected pelvic CT finding altered therapy for breast carcinoma. However, three patients underwent surgery for asymptomatic masses discovered on pelvic CT; all were benign. CONCLUSIONS: Pelvic CT is unlikely to affect the management of patients with breast carcinoma by detecting occult metastatic disease.

Abdominal Neoplasms↗
PubMed1997

Is there a causal relationship between alcohol use and violence? A synthesis of evidence.

This chapter reviews the evidence bearing on the question of whether those individuals who consume alcohol have an increased probability of subsequent violent behavior. Four bodies of relevant research are examined: experimental studies with animals, experimental studies with humans, individual-level correlational studies, and macro-level correlational studies. All these research approaches provide some evidence of an association between alcohol consumption and violent behavior, but no firm conclusion can be drawn about whether alcohol plays a causal role in such behavior. Various limitations, deficiencies, and ambiguities of available research that contribute to this state of affairs are discussed.

Alcohol Drinking↗