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Biomedical subjects

R Cohen

Publications and source records attributed to R Cohen.

At least 703 records · Page 39Linked to original sources
PubMedDate not supplied

Antiemetic efficacy of single-dose oral granisetron (1 mg vs 2 mg) with moderately emetogenic chemotherapy.

PURPOSE: To compare the efficacy of oral granisetron, 1 mg and 2 mg, administered as one dose in patients who receive moderately emetogenic chemotherapy. PATIENTS AND METHODS: Chemotherapy-naïve patients, scheduled to receive intravenous cyclophosphamide (500 to 1200 mg/m2) or carboplatin (> or = 300 mg/m2), were stratified by dexamethasone/methylprednisolone use (+ DEX, n = 92) or nonuse (- DEX, n = 5). Patients were randomized to one dose of either 1 mg (n = 48) or 2 mg (n = 49) of granisetron administered 60 minutes before chemotherapy. Known important prognostic variables (gender, age, alcohol) were well balanced between groups. RESULTS: Using the most rigorous criterion of total control (no emetic episodes, no nausea, no rescue therapy during the first 24 hours), response rates were 54.2% (26/48) and 57.1% (28/49) in patients receiving 1 mg and 2 mg of granisetron, respectively (95% confidence interval, -0.17, 0.23). Total control rates in patients who received 1 mg and 2 mg of granisetron + DEX were also comparable: 57.8% (26/45) and 55.3% (26/47), respectively. Response rates were similar for the parameters of nausea, emesis, and complete response (no emetic episodes, no more than mild nausea, no antiemetic rescue). Among all patients, one (2.1%) who received 1 mg of granisetron and three (6.1%) who received 2 mg experienced severe nausea. The proportions of 1- and 2-mg-treated patients who received rescue therapy within the first 24 hours were 31.3% (15/48) and 34.7% (17/49), respectively. Reported adverse experiences were generally mild in severity. DISCUSSION: The results of this trial demonstrate good control of emesis with a single 1-mg dose of oral granisetron, with efficacy that compares favorably with that of a 2-mg dose.

Administration, Oral↗
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Performance on the Hooper Visual Organizational Test in patients diagnosed with subcortical vascular dementia: relation to naming performance.

OBJECTIVE: To examine the performance of individuals with vascular dementia (VaD) on the Hooper Visual Organization Test (HVOT) and to determine the influence of naming on HVOT performance in this population. BACKGROUND: The HVOT is commonly administered to assess visuospatial perception among neurologic patients, but the test requires verbal identification of stimuli as well as spatial ability. Previous studies have examined the influence of naming on the HVOT, but the issue has not been systematically addressed in individuals with subcortical VaD. METHOD: Individuals with a diagnosis of VaD were administered the HVOT, three additional measures of visuospatial function (Block Design and Picture Completion subtests of the Wechsler Adult Intelligence Scale-Revised, Rey-Osterrieth Complex Figure Test copy trial), and the Boston Naming Test (BNT). RESULTS: On average, the VaD patients performed poorly compared with normative data on each of the cognitive measures, with the most pronounced deficit evident on the BNT. Regression analyses revealed that more than 60% of the variance in performance on the HVOT was accounted for by performance on the Block Design subtest of the Wechsler Adult Intelligence Scale-Revised; performance on the BNT did not contribute significantly. CONCLUSIONS: The results suggest that VaD patients perform below expectations on the HVOT and that the measure is robust to naming deficits in this population.

Brain↗
PubMedDate not supplied

Cognitive and neurologic predictors of functional impairment in vascular dementia.

OBJECTIVE: The purpose of this study is to investigate associations between executive dysfunction, neuroimaging findings, and functional impairment in patients with vascular dementia (VaD). METHODS: Twenty-nine VaD patients completed the Dementia Rating Scale and underwent MRI scanning to generate quantitative ratings of subcortical hyperintensities (SH) and cortical volume. Patients' caregivers completed items from the Lawton and Brody Activities of Daily Living Questionnaire, designed to measure instrumental activities of daily living (IADLs). The authors hypothesized that performance on the Initiation/Perseveration (IP) subscale, a measure of executive abilities, and SH would significantly predict levels of IADLs. RESULTS: A hierarchical multiple-regression analysis revealed that IP and SH accounted for 42% of the variance in IADLs; IP alone accounted for 28%, and SH accounted for 14% beyond the contribution made by IP. CONCLUSION: Findings indicate that specific cognitive and neuropathological factors are associated with functional impairment in VaD.

Activities of Daily Living↗
PubMedDate not supplied

Prognostic significance of p53 and ras p21 protein expression in surgically treated non-small cell lung carcinoma.

BACKGROUND AND OBJECTIVE: The prognosis of surgically treated non-small cell lung carcinoma (NSCLC) varies even after careful selection of the patients; the conventional grading and staging system is often deficient in determining which cases will profit best from surgery. Additional techniques are needed to permit better prognostic evaluation. METHODS: In this research, 2 markers of cellular proliferation, p53 and ras (p21) proteins were examined. The material used was from the same series reported previously which were immunostained with different cytokeratin markers for the same purpose. Immunohistochemical stainings of p53 and p21 were performed on the paraffin sections of 88 NSCLC specimens: 45 squamous cell, 22 adeno- and 21 large or undifferentiated carcinomas. RESULTS: At stage I, positive or negative stains of p53 and p21 provided no prognostic information since they had similar 5 year survival rates of approximatively 50% which is similar to the mean predicted survival rate for stage I. In this group as well, there was no significant difference in immunostaining, either in relation to the histological type or grade of the tumors. At stage III-IV, we found a trend, which, however, was not statistically significant, between positive immunostains of p53 and p21 proteins and longer survival. CONCLUSIONS: These results vary from our previous study on the expression of the differentiation marker cytokeratin 18, which showed that positive staining of tumor cells was associated with a statistically significant poorer prognosis at stage I regardless of histological types.

Aged↗
PubMedDate not supplied

[Palpebral edema with fever and Streptococcus sanguis septicemia].

A case of facial cellulitis complicated by regional thrombophlebitis and septicemia is reported in a 6 year-old girl. Streptococcus sanguis, a bacterial agent, unusually responsible for cellulitis, was isolated from 5 blood cultures. This child had no immunosuppression or endocarditis or dental infection. She had been previously given a non-steroidal anti-inflammatory agent, which was potentially responsible for the diffusion of infection.

Anti-Inflammatory Agents, Non-Steroidal↗
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Estimation of the prevalence of diabetes mellitus in Israel based on hypoglycemic drug supply and consumption.

In recent years, the estimation of drug utilization has become an efficient instrument for the evaluation of health services. The Defined Daily Dose (DDD) method, standardized by the WHO, using consumption data, provides a basis for comparison of morbidity between different places and over different periods of time. The aim of this study was to validate the estimated prevalence of Diabetes Mellitus in Israel obtained by the DDD method. We compared this estimate with data from medical records and from medication cards for the chronically ill. The study focused on Kupat Holim insurees, aged 30 years and older, registered in three Beer Sheva primary care clinics in 1985. By the DDD method we predicted 319 cases of diabetes; record review and medication cards disclosed 353 and 379 cases respectively. Most of this discrepancy was due to oral treated cases of diabetes by the DDD approach. For insulin treated, diabetes the DDD method predicted 108 cases as compared to 102 and 125 by chart and medication review. Because the review of medical records is expensive and medication cards for chronic patients are not always available, the DDD approach is a cheap, efficient and simple way to estimate prevalence of diabetes. Improved knowledge of prevalence may serve as a basis for monitoring therapeutic practices and therefore improving the quality of health services.

Adult↗
PubMedDate not supplied

Small cell undifferentiated carcinoma of the parotid gland. Cytologic, histologic, immunohistochemical and ultrastructural features of a neuroendocrine variant.

A case of primary small cell undifferentiated carcinoma (SCUC) of the parotid gland, diagnosed initially by fine needle aspiration (FNA) cytology and confirmed by histology, immunohistochemistry and transmission electron microscopy (TEM), is presented. The FNA cytologic features that enabled an accurate diagnosis of this rare salivary gland tumor included nuclear granularity and markedly angular nuclear molding of numerous small cells that were usually present as large syncytia in an inflammatory background. Numerous mitotic figures were also present in this vascular lesion. These features were also evident in the surgical specimens. Immunohistochemistry demonstrated neuron-specific enolase positivity while TEM demonstrated intracytoplasmic neurosecretory granules in this case, indicating a neuroendocrine derivation for this neoplasm instead of the more usual origin of salivary gland SCUCs in ductal epithelial or myoepithelial tissue.

Aged↗
PubMedDate not supplied

Effects of small variations in insulin and glucagon levels on plasma aminoacids concentrations.

To determine the effect in normal subjects of small variations of insulin and glucagon on plasma aminoacids concentrations we suppressed endocrine pancreas secretion with somatostatin and measured aminoacids levels during a sequential insulin infusion in the absence (control test, low glucagon level) or in the presence (normal glucagon concentration) of a replacement glucagon infusion. Insulin infusion rates were 0.05, 0.09, 0.15 and 0.30 mU.kg-1.min-1 during the control test and 0.09, 0.15, 0.30 and 0.40 mU.kg-1.min-1 during the replacement test. During the control test, glucagon decreased (p less than 0.01) and insulin levels were successively 8.2 +/- 0.4, 10.1 +/- 0.7, 11.9 +/- 0.14 and 18.5 +/- 0.8 mU.l-1. The only effect on insulin was to decrease branched-chain aminoacids (BCAA). BCAA were inversely related to insulinemia (p less than 0.01). A significant decrease was obtained for an insulin level of 11.9 +/- 0.4 mU.l-1, a value intermediate between those decreasing glycerol (10.1 +/- 0.7 mU.l-1) and stimulating total body glucose uptake (18.5 +/- 0.8 mU.l-1). During the test with glucagon replacement glucagon was maintained at its initial value. Insulin levels were successively 8.3 +/- 0.3, 11.9 +/- 0.3, 19.7 +/- 0.6 and 26.7 +/- 0.5 mU.l-1. Insulin decreased always BCAA but also threonine, proline, tyrosine, methionine and total aminoacid levels. BCAA were always inversely related to insulin levels (p less than 0.01) but the slope of the relationship was modified and more insulin was needed to decrease BCAA concentration.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

[Otorhinolaryngologic surgery in patients with coagulopathy].

A personal experience of ORL surgery in patients suffering from bleeding disorders is presented. 26 patients have been submitted to different surgical procedures, fibrin glue being used in all of them. Treatment results were as satisfactory as those in normal patients.

Blood Coagulation Disorders↗
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Non-invasive assessment of carotid arteries: a comparison of techniques used in two laboratories.

Fifty-one patients were examined non-invasively in two different laboratories and underwent angiography for carotid artery disease. Results of the two examinations and angiography were compared. In one laboratory continuous wave Doppler ultrasonography of the accessible extracranial arteries was used; in the other laboratory spectral analysis of the Doppler signals and angioscan imaging of the bifurcation was carried out. Accuracy of the two examinations (when compared with angiography) were similar for stenoses of more than 50%; spectral analysis and angioscan were better than continuous wave Doppler in detection of less than 50% stenoses.

Arterial Occlusive Diseases↗
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Metabolic studies in lipoatrophic diabetes: mechanism of hyperglycemia and evidence of resistance to insulin of lipid metabolism.

We determined in 5 control subjects and in one patient with total congenital lipoatrophy (LA) the effect of insulin infusion on glucose flux and some aspects of lipid metabolism. In the post-absorptive state LA had moderate hyperglycemia (9.2 versus 3.80 +/- 0.07 mmol.l-1) and hyperinsulinemia (19 vs 12 +/- 3 mU.l-1) and a massive increase in glucose production (7.51 mg.kg.-1.min-1) and disappearance (7.40 mg.kg-1.min-1) rates (control subjects: 2.29 +/- 0.14 mg.kg-1 min-1). Raising peripheral insulin levels to 28 +/- 3 mU.l-1 suppressed endogenous glucose production in the control subjects whereas in LA significant (2.01 mg.kg-1.min-1) production persisted even when peripheral insulinemia was raised to 58 mU.l-1. Insulin infusion in control subjects increased progressively glucose utilization to a final value of 15.7 +/- 0.7 mg.kg-1.min-1 (corresponding plasma insulin: 482 +/- 44 mU.l-1). Insulin infusion in LA initially lowered glucose level near to normal values and exogenous glucose was infused for an insulin infusion rate of 10 mU.kg-1.min-1; at this insulin infusion rate glucose utilization rate (6.52 mg.kg-1.min-1) was decreased relative to control subjects in spite of higher insulin levels (750 mU.l-1). NEFA, glycerol and ketone bodies (KB) levels were decreased to undetectable levels by insulin infusion in the normal subjects whereas NEFA and glycerol were decreased only in part and KB were not modified in LA. In addition glycerol and KB appearance rates determined in LA were not suppressed by insulin infusion as expected.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

Radiofrequency and microwave radiation in the microelectronics industry.

The microscopic precision required to produce minute integrated circuits is dependent on several processes utilizing radiofrequency and microwave radiation. This article provides a review of radiofrequency and microwave exposures in microelectronics and of the physical and biologic properties of these types of radiation; summarizes the existing, relevant medical literature; and provides the clinician with guidelines for diagnosis and treatment of excessive exposures to microwave and radiofrequency radiation.

Animals↗
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Percutaneous chemical lumbar sympathectomy with alcohol with computed tomography control.

Percutaneous chemical lumbar sympathectomy with alcohol (PCLSA) using computed tomography (CT) control was performed in 8 patients suffering from advanced peripheral arterial occlusive disease. PCLSA under CT guidance was found to be a simple and safe procedure. The use of CT control added precision in the guidance of needle placement. Positive results were obtained in all patients, without significant morbidity. PCLSA may be an alternative to surgical sympathectomy.

Adult↗