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Biomedical subjects

M Cohen

Publications and source records attributed to M Cohen.

At least 595 records · Page 33Linked to original sources
PubMed1990

Early ambulation after 5 French diagnostic cardiac catheterization: results of a multicenter trial.

Because earlier ambulation and discharge after cardiac catheterization may result in the increased utilization of outpatient facilities, a prospective five center clinical pilot trial assessing the safety and outcome of early ambulation after routine left heart catheterization was performed in 287 patients. Catheterization routines at each clinical center were unchanged throughout the study. After the diagnostic catheterization using 5 French (F), preformed, large lumen catheters and arterial puncture compression (mean 15 min, range 5 to 52), 260 patients were ambulated by a physician at a mean time of 2.6 h (range 1.8 to 3.1) after catheterization. Follow-up examination or a phone call 24 to 72 h later was performed to assess late results. The mean age of the patients was 58 years (range 25 to 91); 166 (58%) were men. Left ventricular ejection fraction was 54 +/- 15%. One hundred twenty-seven patients (44%) received intravenous heparin (1,500 to 5,000 U as an intravenous bolus) and 136 (47%) received aspirin. Major complications included transient ischemic attack (one patient) and ventricular tachycardia requiring cardioversion during ventriculography (two patients). A small hematoma (less than 5.0 cm) after ambulation occurred early (from compression to standing) in 14 patients (5%; 9 received heparin, 8 were taking aspirin) and later (after standing to 72 h) in 9 patients (3%; 2 receiving heparin, 2 taking aspirin). Five patients with a hematoma had studies with a 6F sheath. No patient required surgical intervention for early or late hematoma. Only three patients (1%) needed a 7F or 8F catheter because of suboptimal 5F coronary angiography.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1990

Section 47 and its use with mentally disordered people.

This paper reports a survey of implementations of Section 47 of the National Assistance Act (1948) in four Regional Health Authorities between 1983 and 1986. The majority of those compulsorily removed from their homes under the Section were elderly people in poor physical health suffering from a major psychiatric disorder. The initial mortality was very high, and 41 per cent of the sample died within three months of removal. There is no mechanism for appeal or review for people removed under Section 47. The Mental Health Act (1983), which does have these safeguards, could have been used in many of these instances, but was not because of misunderstandings about its scope and poor liaison between geriatric and psychiatric services. It is recommended that the Mental Health Act should be used where it is appropriate and that Section 47 should be reformed to provide an equivalent protection of civil liberties.

Aged↗
PubMed1990

Pediatric digital chest imaging.

The Philips Computed Radiography system performs well with pediatric portable chest radiographs, handling the throughout of a busy intensive care service 24 hours a day. Images are excellent and routinely provide a conventional (unenhanced) image and an edge-enhanced image. Radiation dose is decreased by the lowered frequency of repeat examinations and the ability of the plates to respond to a much lower dose and still provide an adequate image. The high quality and uniform density of serial PCR portable radiographs greatly enhances diagnostic content of the films. Decreased resolution has not been a problem clinically. Image manipulation and electronic transfer to remote viewing stations appear to be helpful and are currently being evaluated further. The PCR system provides a marked improvement in pediatric portable chest radiology.

Child↗
PubMed1990

Human proviral mRNAs down regulated in choriocarcinoma encode a zinc finger protein related to Krüppel.

RNA transcripts of the HERV-R (ERV3) human provirus that are abundant in placenta but absent in choriocarcinoma contain nonproviral genomic sequences at their 3' ends. We report here the isolation of cDNA clones of these genomic sequences. The transcripts encode a Krüppel-related zinc finger protein consisting of a unique leader region and more than 12 28-amino-acid finger motifs.

Amino Acid Sequence↗
PubMed1990

Insights into the pathogenetic mechanisms of unstable angina.

Patients with unstable angina and/or non-Q-wave infarction constitute a group that is at high risk for progression to acute myocardial infarction or sudden death. Furthermore, in spite of maximal medical therapy, a large fraction of these patients experience recurrent episodes of myocardial ischemia prompting surgical revascularization or coronary angioplasty. In prior studies of patients with unstable angina, the incidence of myocardial infarction within 1 month of hospitalization was 8-13%, and the incidence of death was about 4%. Between 3 months and 1 year after presentation, the cumulative rate of infarction or death increased to 10-14 and 8-10%, respectively. That is, most recurrent ischemic events occur within the first 3 months after the onset of symptoms. In the subset of patients with pain at rest or with electrocardiographic changes at the time of admission, the prognosis is even worse. The rate of myocardial infarction or death in such patients ranged between 14 and 21% during the first 3-4 months after onset of symptoms. Crossover to surgical therapy because of recurrent ischemic pain was also common, occurring in 30-50% of the patients at 3 months. Recent advances in understanding the pathophysiology of these two syndromes suggest that an aggressive antithrombotic regimen could be of great benefit in preventing progression to acute coronary occlusion and death. Pathologic investigations strongly suggested that plaque fissuring and subsequent overlying thrombosis were the major components in the process of unstable angina progressing to myocardial infarction and/or sudden death. This hypothesis has been substantiated by recent pathologic studies of patients who died shortly after the onset of unstable angina. Examination of the coronary arteries revealed not only plaque fissuring with superimposed layers of thrombus in the majority of the cases, but also evidence of distal thromboembolism from these foci. In vivo coronary arteriography in patients with unstable angina highlighted the progression of prior coronary stenoses, even to total occlusion, and the eccentric and irregular angiographic morphology of the ischemia-producing lesions. Furthermore, intracoronary thrombus is often seen at these sites, especially when arteriography is carried out soon after rest pain. These observations also suggested that plaque rupture may have occurred. Intraoperative angioscopy has revealed ruptured plaques in patients with progressive unstable angina, while those with rest pain had complicating thrombi. Patients with unstable angina also have biochemical evidence of activation of both the coagulation systems and platelets.(ABSTRACT TRUNCATED AT 400 WORDS)

Angina, Unstable↗
PubMed1990

Management of attention deficit hyperactivity disorder (ADHD). A continuing dilemma for physicians and educators.

The American Academy of Pediatrics (AAP) has recommended that the initial treatment of attention deficit hyperactivity disorder (ADHD) should be educational and behavioral. The authors surveyed the directors of special education in the United States to determine whether these services are available to children with ADHD. They determined that the diagnosis of ADHD qualifies a child for services in only 1 out of 51 departments of special education surveyed. ADHD and classroom underachievement qualifies a child for special education services in 2 out of 51 departments. Thus, in most areas of the United States, special educational services are not available to meet the guidelines of the AAP.

Attention Deficit Disorder with Hyperactivity↗
PubMed1990

Diabetic ketoacidosis. Neurologic collapse during treatment followed by severe developmental morbidity.

Diabetic Ketoacidosis (DKA) remains the leading cause of death in children with type 1 diabetes mellitus. Complications occurring during DKA treatment include cerebral edema and neurologic collapse. Developmental outcomes following neurologic deterioration during DKA have varied from no sequelae to severe developmental disabilities. A total of three children developed neurologic deterioration during treatment of DKA at Buffalo Children's Hospital between 1984 and 1987. The authors treated aggressively for cerebral edema. Characteristic findings on the computed tomography (CT) scans and magnetic resonance imaging (MRI) of the brain included hemorrhagic infarctions of the thalami, basal ganglia and lentiform nuclei. The authors conducted developmental follow-up examinations between 1-1/2 - 3 years following recovery from DKA coma. Although they noted significant recoveries over time, developmental disabilities persisted. The clinical courses and neuroradiographic findings of these patients are compatible with sequelae of central brain stem herniation and cytotoxic brain injury. Continued efforts are needed in the prevention and early detection of clinically significant cerebral edema during treatment of DKA.

Brain Diseases↗
PubMed1990

Tenoxicam compared with diclofenac in patients with ankylosing spondylitis.

A randomized study was performed on 24 patients with ankylosing spondylitis to compare the efficacy and tolerability of 20 mg tenoxicam daily with 50 mg diclofenac twice daily. There were 6 withdrawals from the group taking tenoxicam and 4 from the diclofenac group. Depression in 1 patient taking tenoxicam was the only significant adverse event. Both drugs were otherwise well tolerated. Tenoxicam and diclofenac were rated as good or excellent by 27% and 55% of patients, respectively. Global assessment, pain and duration of morning stiffness were improved with both drugs but this improvement was not statistically significant and there was no statistically significant difference between the two groups. This study confirms that tenoxicam is effective and well tolerated but larger numbers would be required to detect a small difference between groups.

Adult↗
PubMed1990

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Contract Services↗
PubMed1990

Differential binding of P. aeruginosa and S. aureus to corneal epithelium in culture.

Adherence of bacteria to corneal epithelium is a prerequisite for corneal infection. We used two methods to study the binding of Pseudomonas aeruginosa and Staphylococcus aureus to rabbit corneal epithelial cells in culture. In the first method, rabbit corneal epithelial cells grown on glass slides were incubated with P. aeruginosa or S. aureus (10(7) CFU/ml) at room temperature for 90 min, and the bacterial binding to the epithelial cells was examined by light microscopy. Both P. aeruginosa and S. aureus bound to epithelial cells. P. aeruginosa was bound to the cell periphery whereas S. aureus was bound randomly to the cell surface. In the second method, suspension cultures of corneal epithelial cells were used. In contrast to the findings in cultures on slides, binding pattern with cells in suspension was similar for both species and resembled that for S. aureus in cultures on slides. A much greater number of P. aeruginosa (186 +/- 11 bacteria/epithelial cell) than S. aureus (30 +/- 1.5 bacteria/epithelial cell) bound to epithelial cells grown on glass slides. In contrast, a similar number of P. aeruginosa (25 +/- 5.1) and S. aureus (20 +/- 4.7) bound to epithelial cells grown in suspension cultures. Using either method, Escherichia coli and Streptococcus pyogenes did not bind significantly (less than 5/cell) to corneal epithelial cells. The above methods should prove useful for characterization of bacterial binding to corneal epithelial cells in culture.

Animals↗
PubMed1990

Effect of intramuscular vitamin E on mortality and intracranial hemorrhage in neonates of 1000 grams or less.

A randomized, double-blind study to determine the effect of intramuscular vitamin E on mortality and intracranial hemorrhage (ICH) was performed. One hundred forty-nine neonates with birth weights less than or equal to 1000 g and less than or equal to 24 hours of age were grouped by weight (501 to 750 g and 751 to 1000 g) and randomized to treatment or control. The treatment group received intramuscular injections of vitamin E (dl-alpha-tocopherol) on days 1, 2, 4, and 6 of life. The control group received intramuscular injections of placebo on the same schedule. All neonates initially received oral vitamin E (100 mg/kg/day dl-alpha-tocopheryl acetate), which was subsequently adjusted to keep serum levels at 0.5 to 3.5 mg/dL. Ultrasonographic examinations of the head were performed as possible on days 1, 5 to 7, and 12 to 14. Hemorrhage was defined as mild if less than or equal to grade II ICH, or severe if grade III or IV. No significant differences in neonatal or total hospital mortality between groups were found. However, all ICH, as well as severe ICH, were significantly less in the vitamin E-treated 501 to 750-g subgroup (all ICH: 60% vs 29%; severe ICH: 32% vs 4%). When survivors were analyzed separately, a significant decrease in severe ICH was seen in the vitamin E-treated neonates (25% vs 5%). Necrotizing enterocolitis and sepsis did not occur more frequently in the neonates treated with intramuscular injections of vitamin E. Other than two cases of mild induration at injection sites, no deleterious side effects of treatment were identified. Vitamin E may have a role in the prevention of severe ICH in premature neonates weighing between 501 and 750 g.

Administration, Oral↗
PubMed1990

Management of insulin dependent diabetes.

Modern management of patients with insulin-dependent diabetes mellitus (IDDM) is a specialised area, usually undertaken as a team effort by general practitioner, diabetes specialist, diabetes educator and dietitian. Treatment includes that of associated problems, early intervention and management of foot problems and of sick days.

Clinical Protocols↗
PubMed1990

[Computerized electroencephalographic monitoring in anesthesia].

The computerized electroencephalogram monitor provides a simple interpretation of the standard EEG trend. In the operating room, this compact EEG monitor is convenient and the trend is easy to read for a non-specialist user. EEG monitoring is especially indicated in carotid endarterectomy for the detection of ischemic event during surgery. The use of this monitor should be recommended for high risk patients (cardiac surgery, cerebral aneurysm surgery, controlled hypotension) to determine the adequate depth of anesthesia and to perform a stress-free anesthesia when the anesthetic drug is given by titration according to the decrease in the awakening electrical cerebral activity.

Anesthesiology↗