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Biomedical subjects

M R Cohen

Publications and source records attributed to M R Cohen.

At least 19 recordsLinked to original sources
PubMed1992

Absence of H(+)-ATPase in cortical collecting tubules of a patient with Sjogren's syndrome and distal renal tubular acidosis.

Distal urinary acidification abnormalities may arise from transepithelial voltage defects, permeability defects, or proton-secretory defects, but tests to determine the cellular mechanisms underlying secretory abnormalities have not previously been reported. A patient with Sjogren's syndrome and distal renal tubular acidosis due to a secretory defect is described, whose kidney biopsy was examined by fluorescent immunocytochemistry with an antibody to the M(r) 31,000 subunit of the mammalian kidney vacuolar H(+)-ATPase and was compared with normal human kidney. Staining with the anti-H(+)-ATPase antibody in normal human kidney was detected in the brush border microvilli and subvillar invaginations of the proximal tubule and in intercalated cells in the collecting duct. A biopsy sample from the patient was devoid of any anti-H+-ATPase staining in the intercalated cells. Staining was also absent from the proximal tubule brush border microvilli but was present in the subvillar invaginations. Although autoantibodies to normal human kidney membrane proteins were detected in the serum by immunoblot analysis, no immunocytochemical evidence for anti-intercalated cell autoantibodies was observed in the patient's serum. This report demonstrates that the basis for the proton secretory defect in some patients with distal renal tubular acidosis is likely the absence of H(+)-ATPase in the intercalated cells. It also illustrates the potential diagnostic utility of anti-H(+)-ATPase antibodies in the classification of distal renal tubular acidoses.

Acidosis, Renal Tubular↗
PubMed1992

What should a pharmacy manager do when a serious medication error occurs? A panel discussion.

Questions related to medication errors were discussed by a panel of hospital department managers. When a serious medication error occurs, the manager has a responsibility to help the employee, the patient, and the patient's family cope with its effects, as well as a responsibility to prevent such errors from recurring. The difficulty of dealing with medication errors may be compounded when the legal system and the news media get involved. Therefore, a system for handling a serious error should be in place before that error occurs. It is also necessary to decide whether to use medication error reports in the employee evaluation process; this could make employees reluctant to report their errors. Ultimately, pharmacy managers are responsible for medication errors that occur, and repercussions have varied from nothing to reprimands to termination. Past errors, if they are reported, can be used to improve the system in which they occurred and to educate other health-care professionals. Therefore, pharmacists need to cooperate with other health-care professionals in documenting medication error reports. A national reporting system is needed so that medication error information can be shared on a large scale without placing the people involved in legal jeopardy. Sharing information about medication errors is necessary to prevent future occurrences; mechanisms are needed to facilitate such sharing.

Legislation, Medical↗