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Biomedical subjects

M Cohen

Publications and source records attributed to M Cohen.

At least 91 records · Page 5Linked to original sources
PubMed2001

Monitoring of the infrared radiation emitted from skin layers during CO2 laser resurfacing: a possible basis for a depth navigation device.

CO2 laser resurfacing is very accurate, but it is not free of complications such as scarring. The objectives of the present study were to evaluate the pattern of the infrared (IR) radiation emitted from skin layers and to use this pattern to distinguish between these layers during resurfacing. A CO2-resurfacing laser (Sharplan SilkTouch) was used for the de-epithelialisation of skin. A silver halide optical fibre delivered the radiation emitted from the skin during resurfacing to an IR photonic detector. Time-dependent curves of the signals emitted from the skin layers were statistically evaluated and showed significant differences between the epidermis and the dermal layers. Similar results were obtained during in-vivo and ex-vivo measurements. The difference between the skin layers emission may be used for depth navigation during laser resurfacing.

Analysis of Variance↗
PubMed2001

Percutaneous transpouch management of a ureteral stone and ureteral-pouch stricture in a pelvic kidney.

Stones in pelvic kidney collecting systems have not been routinely managed percutaneously in most urologic practices. Especially challenging is the management of stones in a pelvic kidney collecting system positioned posteriorly to a urinary diversion. In the present case, a 32-year-old man with a pelvic kidney and continent urinary diversion presented with fever and hydronephrosis. Drainage of the kidney was obtained percutaneously by way of an anterior approach through-and-through the urinary diversion. The patient was found to have both a ureteral stone and a ureteral-pouch anastomotic stricture on subsequent imaging. We were able to successfully treat both these problems endoscopically through a solitary percutaneous access.

Adult↗
PubMed2001

Transcriptional repression, apoptosis, human disease and the functional evolution of the nuclear lamina.

The number and complexity of genes encoding nuclear lamina proteins has increased during metazoan evolution. Emerging evidence reveals that transcriptional repressors such as the retinoblastoma protein, and apoptotic regulators such as CED-4, have functional and dynamic interactions with the lamina. The discovery that mutations in nuclear lamina proteins cause heritable tissue-specific diseases, including Emery-Dreifuss muscular dystrophy, is prompting a fresh look at the nuclear lamina to devise models that can account for its diverse functions and dynamics, and to understand its enigmatic structure.

Animals↗
PubMed2001

Diagnostic and operative transvaginal hydrolaparoscopy for infertility and pelvic pain.

STUDY OBJECTIVE: To review our experience with diagnostic and operative transvaginal hydrolaparoscopy (THL), a procedure that is less invasive than operative laparoscopy. DESIGN: Prospective, observational cohort study (Canadian Task Force classification II-2). SETTING: Private institute and university-affiliated hospital. PATIENTS: Twenty-nine women with infertility and 11 with pelvic pain. INTERVENTIONS: Diagnostic and operative THL. MEASUREMENTS AND MAIN RESULTS: Thirty-five (88%) diagnostic THLs were performed in the office and the other five were done in hospital for insurance reasons; all six operative THLs were performed in the office under conscious sedation. The procedure was conclusive (all organs seen) in 37 patients (93%). Based on THL, no further surgical intervention was recommended in 18 (62%) infertile women and 5 (45%) of those with pain. Further surgical intervention was required in 5 (56%) of 9 infertility patients with a previous normal hysterosalpingogram (HSG) and 6 (32%) of 19 infertility patients with no previous HSG. CONCLUSION: Transvaginal hydrolaparoscopy can be performed in the office with minimal pain, with a conclusive examination anticipated in 93% of cases. The procedure is more accurate than HSG and similar to laparoscopy.

Endometriosis↗
PubMed2001

Attachment stability and emotional and behavioral regulation from infancy to preschool age.

Relations between attachment and child emotional and behavioral regulation were studied longitudinally in a sample of 223 children from urban, low-income families. Attachment in the Strange Situation at 12 and 18 months was scored using the infant classification system and at 24 months was scored using a preschool classification system. Only modest stability was found in attachment whether within or across classification systems, with the percentage of insecure attachments consistently increasing over time. Results indicated both concurrent and predictive associations with indices of child regulation based on observer ratings or maternal report. However, only the 24-month classification predicted maternal report of externalizing and internalizing behavior problems at age 3.5 years. with additional variance accounted for by selected measures of child emotional and behavior regulation from the same assessment. Attachment security (B) and atypical attachment classifications (D, A/C, and AD) appear to provide the most consistently useful information about child functioning. Results are discussed in terms of continuity and change from the perspective of developmental psychopathology.

Affect↗
PubMed2001

Are children more accurate than adults? Spontaneous use of metaphor by children and adults.

This study examined an observation in which children outscored adults on a series of test questions, which included unusual items such as, "Do you see with your ears?" We assumed that the adults were treating the questions metaphorically because the literally correct answer was so obvious, an assumption consistent with Grice's theory. In Study 1, we tested this assumption by manipulating pretest and test items so as to suggest, or not suggest, a metaphorical or factual response. In Study 2, we used a similar manipulation involving the order of questions of various sorts and we more directly tested the Gricean hypothesis by giving college students a reason to treat the question literally. The results replicated the previous finding in which college students' scores were lower than those of children, and the condition effects suggested that the college students' performance was due to their responding metaphorically.

Adult↗
PubMed2001

Enoxaparin in unstable angina/non-ST-segment elevation myocardial infarction: treatment benefits in prespecified subgroups.

BACKGROUND: Two large-scale phase III clinical trials, the Efficacy and Safety of Subcutaneous Enoxaparin in Non-Q-wave Coronary Events (ESSENCE) trial and the Thrombolysis in Myocardial Infarction (TIMI) 11B study, have shown the low-molecular-weight heparin, enoxaparin, to be more effective than unfractionated heparin (UFH) in reducing the risk of death and severe cardiac events in patients with rest unstable angina and/or non-ST-segment elevation myocardial infarction (NSTEMI). However, patients with NSTEMI acute coronary syndromes are a heterogeneous group. METHODS: A meta-analysis using pooled data from ESSENCE and TIMI 11B was performed to examine the efficacy of enoxaparin in different patient subgroups. In addition, a statistical model was developed to test which factors best predicted an enhanced treatment effect. RESULTS: Enoxaparin was more effective than intravenous dose-adjusted UFH in reducing the incidence of the composite endpoint (including death, myocardial infarction or recurrent angina prompting urgent revascularization) in the majority of subgroups at 43 days after randomization. Univariate analyses revealed that there was a greater benefit with enoxaparin in patients with ST-segment deviation or elevated cardiac enzyme markers on admission, women, nonsmokers and patients with characteristics indicative of higher cardiac risk, including prior percutaneous coronary interventions, being at least 65 years old, prior angina and prior aspirin use. Multivariate statistical modelling of treatment effect revealed that ST-segment depression and electrocardiographic changes were the best predictors of an enhanced treatment effect. CONCLUSIONS: These data reinforce previous evidence suggesting that enoxaparin administered subcutaneously twice daily may be considered as an alternative to intravenous UFH in the acute treatment of a broad range of patients with unstable coronary artery disease.

Adult↗
PubMed2001

Accuracy of diagnoses of HIV-related oral lesions by medical clinicians. Findings from the Women's Interagency HIV Study.

OBJECTIVE: To determine if medical clinicians are as accurate as dental clinicians in recognizing diagnostic characteristics of HIV-related oral lesions. METHODS: In 355 HIV-infected participants at five Women's Interagency HIV Study sites, we paired oral examinations conducted within 7 days of each other by dental and medical clinicians. We used the former as a gold standard against which to evaluate the accuracy of the latter. We assessed the accuracy of the medical clinicians' findings based both on their observations of abnormalities and on their descriptions of these abnormalities. RESULTS: Dental clinicians diagnosed some oral abnormality in 38% of participants. When "abnormality" was used as the medical clinicians' outcome, sensitivities were 75% for pseudomembranous candidiasis and 58% for erythematous candidiasis, but only 40% for hairy leukoplakia. When a precise description of the abnormality was used as their outcome, sensitivities were 19%, 12% and 20%, respectively. CONCLUSIONS: Medical clinicians recognize that HIV-related oral abnormalities are present in 40-75% of cases, but less often describe them accurately. Low sensitivity implies that the true associations of specific oral lesions with other HIV phenomena, such as time until AIDS, must be stronger than the literature suggests.

AIDS-Related Opportunistic Infections↗
PubMed2001

A spontaneously occuring mammary gland ductal carcinoma in situ in a rhesus macaque (Macaca mulatta) and a review of spontaneous mammary gland tumors in rhesus monkeys.

A spontaneous mammary gland ductal carcinoma in situ was diagnosed in a 6-8-year-old female rhesus macaque (Macaca mulatta). To our knowledge, this is only the tenth case of spontaneous mammary gland tumors to be reported in rhesus monkeys. Despite the paucity of case reports, several theories exist to explain the occurrence of mammary tumors. The Mason Pfizer monkey virus, a type D retrovirus similar to the virus that causes simian acquired immunodeficiency syndrome, has been implicated as a possible etiologic agent. Because this virus has been isolated from normal primate mammary tissue, it is unlikely to be the sole etiologic agent. Other theories include the tumorogenic effects that androgens, growth hormones, irradiation, and aging have on the mammary gland.

Animals↗
PubMed2001

Living under a "dormant" canopy: a molecular acclimation mechanism of the desert plant Retama raetam.

Desert plants are exposed to a combination of environmental stress conditions, including low water availability, extreme temperature fluctuations, high irradiance and nutrient deprivation. Studying desert plants within their natural habitat may therefore reveal novel mechanisms and strategies that enable plants to resist stressful conditions. We studied the acclimation of Retama raetam, an evergreen stem-assimilating desert plant, to growth within an arid dune ecosystem. Retama raetam contained two different populations of stems: those of the upper canopy, exposed to direct sunlight, and those of the lower canopy, protected from direct sunlight. During the dry season, stems of the upper canopy contained a very low level of a number of essential proteins, including the large and small subunits of rubisco, ascorbate peroxidase and the D1 subunit of the reaction centre of photosystem II. However, RNA encoding these proteins was present; cytosolic transcripts were associated with polysomes, while chloroplastic transcripts were not. Upon water application, as well as following the first rainfall of the season, these "photosynthetically suppressed" stems recovered and accumulated essential proteins within 6-24 h. In contrast, stems of the lower canopy contained the essential proteins throughout the dry season. We suggest that R. raetam uses an acclimation strategy of "partial plant dormancy" in order to survive the dry season. "Dormancy", as evident by the post-transcriptional suppression of gene expression, as well as the suppression of photosynthesis, was induced specifically in stems of the upper canopy which protect the lower canopy by shading.

Adaptation, Physiological↗
PubMed2001

Sexually transmitted infections and associated socio-demographic and behavioural factors in women seeking primary care suggest Madagascar's vulnerability to rapid HIV spread.

OBJECTIVES: To examine sexually transmitted infections (STIs) and associated socio-demographic and behavioural factors in women seeking care for genital discharge syndrome in Antananarivo, Madagascar. METHODS: One thousand and sixty-six consecutive symptomatic women were interviewed and examined; bacterial vaginosis (BV), vulvovaginal candidiasis, trichomoniasis (TV), cervical infection (CI) due to chlamydial or gonococcal infections, and syphilis seroreactivity were determined by laboratory diagnosis. Associations between STIs and individual characteristics were evaluated using bivariate and logistic regression analyses. RESULTS: The prevalence of BV, TV, CI, and syphilis seroreactivity was, respectively, 85%, 16%, 49%, 16% in 94 prostitutes; 70%, 18%, 30%, 13% in 96 occasional sex traders; and 53%, 24%, 17%, and 4% in 876 general women. CI was independently and positively associated with a symptomatic partner, new sex partner in last 3 months, unfaithful partner, prostitution, joblessness and being < 25 years old. Syphilis was associated with low schooling, young age at coital debut, sex trading, and > 1 sex partner in the previous 3 months. CONCLUSIONS: These high STI rates and associated characteristics suggest the local vulnerability to rapid HIV spread and show the need for prevention efforts that involve youth, prostitutes, occasional sex traders, sex clients, and men who have concurrent sexual partnerships.

Adult↗
PubMed2001

Washington State hospital survey 2000: gloves, handwashing agents, and moisturizers.

Hand dermatitis as a result of frequent exposure to water and cleansing agents is a significant problem in the health care industry. In developing prevention efforts to address this problem, it is necessary to make appropriate recommendations for moisturizers that are compatible with latex gloves and/or handwashing agents that contain chlorhexidine gluconate (CHG). Infection control personnel or employee health nurses in all 106 Washington hospitals were interviewed to determine what types of gloves, handwashing agents, and moisturizers are in current use in the hospital setting. The interview also addressed awareness of skin care issues involving the compatibility of moisturizers with latex gloves and handwashing agents that contain CHG. Latex gloves were available in 90% of the hospitals. Handwashing agents containing CHG were available in 33% of the hospitals. Moisturizers were supplied for the nursing personnel in 61% of the hospitals; most of these moisturizers were compatible with latex gloves and agents containing CHG. Seventy-four percent of the infection control personnel were aware of the compatibility issues of petroleum-based moisturizers with latex gloves, and 48% were aware of the need to avoid the use of anionic moisturizers in combination with CHG handwashing agents.

Anti-Infective Agents, Local↗
PubMed2001

Radial artery harvesting for coronary bypass operations: neurologic complications and their potential mechanisms.

OBJECTIVES: We sought to determine the incidence of self-reported neurologic hand complications after radial artery harvest for coronary artery bypass grafting. METHODS: Between February 20, 1996, and December 31, 1999, 615 patients underwent coronary bypass operations with radial arteries. A scripted telephone interview was performed, collecting data on perceived thumb weakness and sensation abnormalities in the distribution of the radial nerve in 560 patients. The average time to follow-up interview was 14.5 +/- 9 months. RESULTS: Neurologic complications were reported in 30.1%, decreased thumb strength in 5.5%, and any sensation abnormality in 18.1% of patients. There was a high rate of symptom improvement over an average of 8.7 +/- 7.5 months, such that only 12.1% of patients reported symptoms without any improvement. Associations between thumb weakness and sensory abnormalities imply median nerve damage in some patients. There were statistically significant associations between neurologic complications and diabetes, peripheral vascular disease, elevated creatinine levels, smoking, and number and site of radial artery harvest. CONCLUSIONS: The overall rate of self-reported neurologic complications after radial artery harvest was higher than previously reported. These symptoms may be attributable to radial and median nerve injury caused by trauma and devascularization. These data have important implications not only in attempting to improve harvesting techniques but also in guiding informed consent before coronary artery bypass grafting.

Aged↗
PubMed2001

Tracheotomy in severe TBI patients: sequelae and relation to vocational outcome.

The aim of the present study was to find the influence of performing tracheotomy on outcome of severe TBI patients. TBI patients, many of them intubated during the very acute phase post-injury, who remain unconscious for more than a few days, undergo tracheotomy to provide a reliable long term artificial airway. Tracheotomy, although being a simple elective surgical procedure, may have a negative influence on the rehabilitation process. Tracheotomy was performed in 25% (n=69) of 277 consecutive severe TBI patients admitted to the rehabilitation department during 3 years. In seven patients (10%), tracheotomy was performed immediately after injury due to cranio-facial trauma, in 18 patients (29%) due to respiratory disturbances, in 42 patients (55%) after prolonged intubation, and in two patients (6%) due to combined problems. Forty-five per cent of patients with tracheotomy suffered from respiratory disturbances and 8.6% from complications of tracheotomy. Longer periods of unconsciousness and mechanical ventilation were significantly associated with respiratory complications (p<0.0001 and p<0.001, respectively). However, presence of tracheotomies per se, did not affect vocational rehabilitation.

Adolescent↗
PubMed2001

Nuclear relocalization of the pre-mRNA splicing factor PSF during apoptosis involves hyperphosphorylation, masking of antigenic epitopes, and changes in protein interactions.

The spatial nuclear organization of regulatory proteins often reflects their functional state. PSF, a factor essential for pre-mRNA splicing, is visualized by the B92 mAb as discrete nuclear foci, which disappeared during apoptosis. Because this mode of cell death entails protein degradation, it was considered that PSF, which like other splicing factors is sensitive to proteolysis, might be degraded. Nonetheless, during the apoptotic process, PSF remained intact and was N-terminally hyperphosphorylated on serine and threonine residues. Retarded gel migration profiles suggested differential phosphorylation of the molecule in mitosis vs. apoptosis and under-phosphorylation during blockage of cells at G1/S. Experiments with the use of recombinant GFP-tagged PSF provided evidence that in the course of apoptosis the antigenic epitopes of PSF are masked and that PSF reorganizes into globular nuclear structures. In apoptotic cells, PSF dissociated from PTB and bound new partners, including the U1--70K and SR proteins and therefore may acquire new functions.

Active Transport, Cell Nucleus↗
PubMed2001

The decision-making process for requests for late termination of pregnancy in Israel.

This article outlines and reflects on the current procedure in Israel for requesting late pregnancy terminations and the subsequent decision-making processes. The study population consisted of 183 women who requested late termination of pregnancy (LTP) in Israel during the years 1995-97. The main causes for requests were fetal anomalies and late application. Eighty-two percent of requests were approved, and approval could be predicted by the week of gestation and the reason for application. Ethical dilemmas are described. The need to enhance professional support for women who request LTP, whether they receive approval or not, should be addressed by the health system and social workers in health care.

Abortion, Therapeutic↗