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Biomedical subjects

M Cohen

Publications and source records attributed to M Cohen.

At least 1,171 records · Page 65Linked to original sources
PubMedDate not supplied

Hyperlexia: a variant of aphasia or dyslexia.

We report five patients with hyperlexia who presented for evaluation in the Learning Disabilities Clinic at the Medical College of Georgia over a two year period. Analysis of the data from the neurologic and neuropsychologic evaluations indicates that the primary and essential cognitive deficit in these children is a disorder in speech and language involving a severe deficit in their ability to comprehend language whether it be spoken or written, as opposed to a dyslexia syndrome involving only recognition and/or comprehension of written language. This finding is in contrast to the Nosology of Disorders of Higher Cerebral Function proposed by the Child Neurology Society which views hyperlexia as a variant of the language disorder subtype of dyslexia.

Aphasia↗
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Salivary composition in diabetic patients.

Salivary composition and flow rate were examined in 35 patients with insulin-dependent diabetes mellitus (IDDM) and compared to 31 healthy controls. Significantly lower whole-saliva flow rate was observed in the IDDM patients, but was not correlated with the subjective complaint of xerostomy. Glucose concentration was significantly higher in the parotid saliva of the IDDM patients. Potassium concentration was significantly higher in whole and parotid, resting and stimulated saliva, as was total protein concentration in resting whole and in stimulated parotid saliva of the diabetics. No significant difference between diabetics and healthy controls was found in sodium and IgA concentration or in amylase activity. The significantly higher glucose, lower flow rate, and higher potassium and protein concentrations indicate that salivary glands are affected in IDDM. The subjective complaint of dry mouth, often present in diabetics, while not correlated with salivary flow rate, might reflect qualitative changes in salivary composition and/or altered mucosal perception. Salivary glucose concentration, although significantly higher in the diabetics, was not significantly correlated with serum glucose, preventing the use of saliva for monitoring blood sugar.

Amylases↗
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Communication disorders in the 22Q11.2 microdeletion syndrome.

The 22q11.2 microdeletion syndrome is a genetic disorder that is being recognized with increasing frequency. Confirmation of the diagnosis can be made using fluorescence in situ hybridization. Many medical and developmental problems are present in children with this syndrome. Communication disorders are among the most common features of this syndrome and include articulation, language, resonance, and voice problems. The purpose of this paper is to provide a description of the communicative and developmental features in a sample of children with the 22q11.2 microdeletion syndrome seen for evaluation. Because communication and feeding disorders may be presenting features of this syndrome, speech and language pathologists must be familiar with this syndrome and its various characteristics. Awareness of these features and a multidisciplinary approach are necessary for the identification and treatment of the complex communicative and medical problems present in this population.

Adolescent↗
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Prior aspirin use in unstable angina predisposes to higher risk: the aspirin paradox.

BACKGROUND: Aspirin is the most widely prescribed agent used in prevention of coronary thrombosis. Thus, many patients presenting with acute coronary syndromes have a history of aspirin usage. METHODS: To assess response to medical therapy in patients taking aspirin prior to admission with an acute coronary syndrome, we reviewed outcomes data from the Efficacy and Safety of Subcutaneous Enoxaparin in Non-Q-wave Coronary Events (ESSENCE) and Platelet Receptor Inhibition in Ischemic Syndrome Management in Patients Limited by Unstable Signs and Symptoms (PRISM-PLUS) studies. RESULTS: Patients with acute coronary syndromes who had taken aspirin prior to enrollment were less likely to have non-Q-wave myocardial infarction on admission (ESSENCE: 16.0% vs. 29.2%, p<0.001; PRISM-PLUS: 34.2% vs. 57.7%, p<0.001). However, prior aspirin users were more likely to be failed by standard medical therapy with unfractionated heparin than non-prior aspirin users (ESSENCE: 21.5% vs. 16.5%, p=0.017; PRISM-PLUS: 23.5% vs. 12.1%, p<0.001). Prior aspirin users received greater benefit from both enoxaparin (21.5% vs. 16.8%, p=0.009) and tirofiban with unfractionated heparin (23.5% vs. 16.0%, p=0.007) than from unfractionated heparin alone. Non-prior aspirin users presented with higher rates of non-Q-wave myocardial infarction. CONCLUSIONS: Prior aspirin users admitted with acute coronary syndromes may have a more benign presentation, but are more likely to be failed by medical therapy with unfractionated heparin and should be considered as a high-risk group. Enoxaparin or the combination of tirofiban and unfractionated heparin are both more effective than unfractionated heparin in this group.

Aged↗
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The effect of continuous subcutaneous insulin infusion on insulin binding to erythrocytes in diabetes mellitus.

The effect of continuous subcutaneous insulin infusion (CSII) on glycaemic control and insulin binding to erythrocytes was studied in six diabetic patients. A marked improvement in blood glucose control during CSII was observed in these patients previously on conventional therapy. Specific 125I-insulin binding to erythrocytes of the diabetics before the institution of CSII was significantly lower than that of age-, weight- and sex-matched nondiabetic subjects, 6.5 +/- 0.1% vs. 9.8 +/- 0.3% (P less than 0.05). After 4-6 months of CSII, insulin binding was restored to normal levels. This normalization in insulin binding to erythrocytes of patients on CSII was due to a 35% increase in active binding sites, together with a small change in binding affinity.

Adult↗
PubMedDate not supplied

Body composition in HIV-infected women.

Although loss of lean body mass is a common complication of human immunodeficiency virus (HIV) infection that can occur across the disease trajectory, few studies have characterized the body composition of HIV-infected women. We used bioelectrical impedance analysis to characterize the body composition of HIV-infected (n = 56) and uninfected (n = 12) women who were matched on percentage of ideal body weight. The HIV-infected women did not differ from the uninfected women by height-adjusted fat mass or body cell mass. Intergroup comparisons among the HIV-infected women showed that underweight women had significantly less fat mass than did normal-weight women but did not significantly differ with respect to body cell mass. Among all HIV-infected women, CD4(+) lymphocyte count was positively correlated with fat mass (r = 0.32, P = 0.01) but not with body cell mass. No significant correlations were found between any body-composition parameter and plasma viral load. Our findings suggest that, unlike men, HIV-infected underweight women show a preferential loss of fat mass and a relative preservation of body cell mass. This altered pattern of weight loss may relate to higher premorbid fat stores in women and/or hormonal differences.

Adipose Tissue↗
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Effect of proximal articular set angle-correcting osteotomies on the hallucal sesamoid apparatus: a cadaveric and radiographic investigation.

A cadaveric and radiographic study was undertaken to demonstrate the change in intersesamoidal crista architecture after an osteotomy that corrects the proximal articular set angle (PASA). Three cadaveric first metatarsals with hallux valgus deformity were utilized. Separate Kirschner wires representing the longitudinal axis bisection, PASA, and the long axis of the crista were placed into each specimen. After osteotomy, the metatarsal heads were translated laterally, rotated parallel to the transverse plane to correct PASA, and impacted. The relationship between the crista and the long axis of the metatarsal was determined. A deviation in the alignment between the intersesamoidal crista and the long axis of the metatarsal following the osteotomy was observed. The radiographic portion of this study correlated intermetatarsal angle, PASA, and tibial sesamoid position with intersesamoidal crista appearance on sesamoidal axial radiographs. Radiographic parameters in 19 patients (34 feet) were compared and two distinct patterns were evident: 1) A proximal articular set angle greater than 15 degrees was associated with complete crista erosion in 10 feet (91% of this subgroup); 2) a tibial sesamoid position greater than three was associated with partial or complete erosion in 17 feet (100% of this subgroup). A higher deviation of PASA and increased displacement of the sesamoidal apparatus correlated with crista erosion. These findings suggest that the crista fails to adapt with PASA as hallux valgus progresses and undergoes erosion instead. This study suggests that when correcting the PASA, misalignment of the sesamoid apparatus may lead to sub-first metatarsal arthrosis.

Cadaver↗
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Surgical management of the acute calcaneal joint depression fracture: the VAMC Miami experience.

Thirty-two patients with acute calcaneal fractures presented to the Veterans Affairs Medical Center, Miami, Florida, from October 1985 through March 1994. Twenty-three of these patients were open-reduced, and nine were immobilized in a short leg nonweight-bearing cast for a minimum period of 6 weeks. Of the 23 patients who had open reduction with internal fixation, 74% reported excellent results, 13% reported good results, 4% had fair results, and 9% had poor results. Of the nine patients who did not undergo open-reduction internal fixation, three subsequently developed poor results, two developed fair results, three developed good results, and one had no complaints. Of these nine patients, three ultimately underwent successful hindfoot arthrodesis. This article reviews the current literature and discusses the experiences of the Podiatry Service in the VA Medical Center in Miami, Florida, with respect to the surgical management of the acute calcaneal joint depression fracture.

Adult↗
PubMedDate not supplied

The surgical dilemma of the malunited calcaneal joint depression fracture: the VAMC Miami experience.

During the period of October 1985 through March 1995, 25 patients presented to the Veterans Affairs Medical Center, Miami with a chief complaint of chronic pain status post calcaneal joint depression fracture. Their acute injury was treated conservatively at this and various other institutions. Nine patients were managed conservatively with orthotics, University of California Biomechanics Laboratory braces (UCBLs), shoe modification, or prosthetics. Sixteen patients underwent hindfoot fusions. Good to excellent results were obtained in 15 of the 16 fusions. The remaining patient, having an isolated subtalar fusion, was later diagnosed with multiple sclerosis. Proper evaluation of the chronic pain patient is critical when mapping out an appropriate treatment plan. Hindfoot arthrodesis with soft tissue decompression is a successful tool in eliminating chronic pain due to malunited depression fractures.

Aged↗
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Reconstruction of the diabetic Charcot foot incorporating bone grafts.

Literature is sparse concerning the topic of Charcot foot reconstruction incorporating various types of bone grafts and internal fixation. No concrete, methodical approach has yet been established to dictate under what conditions bone grafting would be applicable in Charcot joints. It is the intent of the authors to convey, through limited experience, an approach to the surgical reconstruction of the diabetic Charcot foot using bone grafting and internal fixation as it applies to the Sanders and Mrdjenovich patterns 2 and 3. Three case studies are presented with emphasis on the biomechanical examination, computerized tomography, radiographic appearance, patterns of bone and joint destruction, and types of bone grafts using internal fixation.

Bone Transplantation↗
PubMedDate not supplied

Bivalent hapten-bearing peptides designed for iodine-131 pretargeted radioimmunotherapy.

Pretargeting with bispecific antibodies has been used successfully for tumor detection and is now considered for radioimmunotherapy. The advantages of bivalent haptens have been demonstrated in this context. A series of bivalent molecules allowing efficient labeling with radioactive iodine has been designed for use with this new technology. They were based on the histamine-hemisuccinate hapten and prepared by solid phase peptide synthesis. Simultaneous binding of two antibody molecules to one bivalent hapten was possible with low steric hindrance when the two hapten groups were attached to the lateral chains of lysine residues separated by a single amino acid. Bispecific antibodies to the hapten and to carcinoembryonic antigen were shown to mediate specific binding of the haptens to tumor cells in vitro. These experiments demonstrated that the bivalent hapten AG3.0, with a lysyl-D-tyrosyl-lysine connecting chain, possessed the best binding properties. This peptide was used to target iodine-125 to human colon cancer xenografts in nude mice. High tumor uptake and tumor to normal tissue ratios were observed. This peptide thus appears as a good candidate for further development. Asymmetric bivalent haptens, with one histamine-hemisuccinate and one diethylenetriaminepentaacetic acid group, have also been prepared and shown to be capable of binding simultaneously two specific antibody molecules. These peptides should be useful to target radioiodine to cells characterized by the expression of two different antigenic markers.

Animals↗
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Mapping of an endogenous retroviral sequence to human chromosome 18.

The application of recombinant DNA technologies has allowed the detection of at least three families of moderately repetitive DNA segments in the human genome that are homologous to retroviruses previously isolated from mice and primates. One of these DNA segments has been shown by nucleotide sequence comparisons to be distantly related to both Moloney murine leukaemia virus (MoMuLV) and the endogenous baboon retrovirus and to have the sequence organization characteristic of an integrated retrovirus. Isolation of the homologous locus from chimpanzee DNA indicated that the integration event preceded the evolutionary divergence of chimpanzees and man. Here we have used a panel of rodent x human somatic cell hybrids to assign the chromosomal localization of this segment, called ERV1 (endogenous retrovirus-1), to human chromosome 18 (HSA 18).

Chromosome Mapping↗
PubMedDate not supplied

Non-prescription complementary treatments used by rheumatoid arthritis patients attending a community-based rheumatology practice.

BACKGROUND: Over 80% of rheumatoid arthritis (RA) patients have used some type of complementary medicine (CM) at some time. Little is known about RA patients' perceptions of the efficacy, hazards and costs associated with CM use relative to physician-prescribed medicine. These data may be helpful in better understanding patients' needs and in improving their care. AIMS: To determine the prevalence and features of CM use among RA patients attending a community-based private rheumatology practice. CM was defined as treatment that was initiated by the patient, excluding treatment that had been prescribed or specifically recommended by their doctor. telephone-administered questionnaire was used to survey a stratified random sample of 200 RA patients who had attended the practice within the preceding year. The main outcome measures were: (i) CM use in the past year, (ii) patient expenditure on CM, (iii) patients' perceptions of CM and (iv) characteristics of patients using CM. RESULTS: One hundred and six patients responded (response rate 53%) and 101 completed the interview. Seventy-four patients (73.3%) had used some form of CM in the past year. There were 68 (67.3%) patients who had utilized complementary therapies and 32 patients (31.7%) who had consulted a complementary practitioner for their RA. The most commonly used treatments were dietary (64 instances) and behavioural/cognitive therapies (45 instances). Prescription medicine was considered more beneficial than either form of CM, and users and non-users of CM held a similar perception of the efficacy of prescription medicine. The median amount spent on RA treatment per month was $A7 (range 0-91) for complementary treatments, $A26 (1-270) for complementary practitioners and $A7 (0-80) for prescription medicine. Women were more likely to have consulted a CM practitioner (OR = 1.5; 95% CI: 1.2-1.9), as were patients who were not receiving a pension (OR = 1.7; 95% CI: 1.1-2.6). CONCLUSIONS: This study confirmed that CM use is prevalent among RA patients attending a community-based private rheumatology practice. Despite lesser perceived benefit, patients spent at least as much money on CM as they did on prescription medicine. These findings suggest that there are other factors motivating the use of alternative treatments.

Arthritis, Rheumatoid↗