576
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577
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Baldwin LM, Hart LG, Oshel RE, Fordyce MA, Cohen R, Rosenblatt RA. Hospital peer review and the National Practitioner Data Bank: clinical privileges action reports. JAMA 1999; 282:349-55. [PMID: 10432032 DOI: 10.1001/jama.282.4.349] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
CONTEXT The National Practitioner Data Bank (NPDB) is believed to be an important source of information for peer review activities by the majority of those who use it. However, concern has been raised that hospitals may be underreporting physicians with performance problems to the NPDB. OBJECTIVE To examine variation in clinical privileges action reporting by hospitals to the NPDB, changes in reporting over time, and the association of hospital characteristics with reporting. DESIGN Retrospective cohort study of privileges action reports to the NPDB between 1991 and 1995, linked with the 1992 and 1995 databases from the Annual Survey of Hospitals conducted by the American Hospital Association. SETTING AND PARTICIPANTS A total of 4743 short-term, nonfederal, general medical/surgical hospitals throughout the United States that were continuously open between 1991-1995 and registered with the NPDB. MAIN OUTCOME MEASURES (1) Reporting of 1 or more privileges actions during the 5-year study period and (2) privileges action reporting rates (numbers of actions reported per 100000 admissions). RESULTS Study hospitals reported 3328 privileges actions between 1991 and 1995; 34.2% reported 1 or more actions during the period. The range of privileges action reporting rates for these hospitals was 0.40 to 52.27 per 100000 admissions, with an overall rate of 2.36 per 100000 admissions. The proportion of hospitals reporting an action decreased from 11.6% in 1991 to 10.0% in 1995 (P=.008). After adjustment for other factors, urban hospitals had significantly higher reporting than rural hospitals (adjusted odds ratio [OR], 1.21 [95% confidence interval [CI], 1.02-1.43]), while members of the Council of Teaching Hospitals of the Association of American Medical Colleges had significantly lower reporting than nonmembers (adjusted OR, 0.54 [95% CI, 0.40-0.73]). There were notable regional differences in reporting, with the east south Central region having the lowest rate per 100000 admissions (1.49 [95% CI, 1.33-1.65]). CONCLUSIONS The results of this study indicate a low and declining level of hospital privileges action reporting to the NPDB. Several potential explanations exist, 1 of which is that the information reported to the NPDB is incomplete.
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578
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Vardy D, Barenholz Y, Cohen R, Zvulunov A, Biton A, Klaus S, Frankenburg S. Topical amphotericin B for cutaneous leishmaniasis. ARCHIVES OF DERMATOLOGY 1999; 135:856-7. [PMID: 10411171 DOI: 10.1001/archderm.135.7.856] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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579
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Demedts M, Cohen R, Hawkinson R. Switch to non-CFC inhaled corticosteroids: a comparative efficacy study of HFA-BDP and CFC-BDP metered-dose inhalers. Int J Clin Pract 1999; 53:331-8. [PMID: 10695095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/15/2023] Open
Abstract
Inhaled corticosteroids, such as beclomethasone dipropionate (BDP), recommended for the treatment of persistent, mild, moderate, or severe asthma, have traditionally been administered via chlorofluorocarbon (CFC) propellant. The imminent phasing out of CFCs from pharmaceutical preparations due to the Montreal Protocol means patients will have to switch to a CFC-free alternative. One such preparation is hydrofluoroalkane-BDP (HFA-BDP), a press-and-breathe metered-dose inhaler. This 8-week, open-label, multicentre study assessed asthma control in patients switching from CFC-BDP to HFA-BDP (QVAR). Patients with asthma, stabilised on 400-1600 micrograms/day CFC-BDP, were randomised to HFA-BDP (354 patients; 75%) at half their current daily dose of CFC-BDP, or to CFC-BDP (119 patients; 25%). HFA-BDP efficacy was found to be equivalent to that of CFC-BDP in that no statistically significant difference was observed between the two groups in the mean change from baseline in a.m. PEF (95% CI within +/- 11 l/min). No statistically significant differences were observed between the two groups for increased asthma symptoms or acute asthma episodes. We conclude that asthma control was maintained over 8 weeks, with few asthma exacerbations, in patients switching from previous CFC-BDP therapy to HFA-BDP at half the dose.
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580
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Beressi N, Beressi JP, Cohen R, Modigliani E. Lymphocytic hypophysitis. A review of 145 cases. ANNALES DE MEDECINE INTERNE 1999; 150:327-41. [PMID: 10519020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
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581
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Annarelli CC, Fornazero J, Cohen R, Bert J, Besse J. Colloidal Protein Solutions as a New Standard Sensor for Adhesive Wettability Measurements. J Colloid Interface Sci 1999; 213:386-394. [PMID: 10222078 DOI: 10.1006/jcis.1999.6153] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Wetting experiments are carried out for the investigation of the interfacial interactions that take place when various solid materials are in contact with protein colloidal solutions. These materials are chosen because they are widely used in the field of orthopedic surgery. Contact angles (sessile drop) and surface tension (du Nouy's ring method) are measured in standardized conditions which take into account the various parameters disturbing wetting phenomena. An original cumulative deposits method (CDM) described here permits observation of the evolution of the wettability and allows estimation of the protein adhesion rate. Two families of materials emerge according to their behavior when they are in contact with the protein solution. One set (a chromium cobalt alloy and two polyethylenes) presents no detectable adhesion. The other set (stainless steel, zirconia, alumina, virgin and nitrogen implanted titanium alloy) shows a cumulative adhesion of proteins. We propose to adopt a BSA buffered solution as a referential sensor to characterize solid surfaces. From the CDM, the practical parameter P*, called the adhesive wettability power, can be used in order to analyze and classify biomaterials. Copyright 1999 Academic Press.
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582
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Cohen R, Navel M, Grunberg J, Boucherat M, Geslin P, Derriennic M, Pichon F, Goehrs JM. One dose ceftriaxone vs. ten days of amoxicillin/clavulanate therapy for acute otitis media: clinical efficacy and change in nasopharyngeal flora. Pediatr Infect Dis J 1999; 18:403-9. [PMID: 10353511 DOI: 10.1097/00006454-199905000-00002] [Citation(s) in RCA: 64] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To compare the efficacy and the safety of a single intramuscular dose of ceftriaxone, 50 mg/kg, vs. a 10-day course of amoxicillin/clavulanate (amox/clav) therapy, 80 mg/kg/day of amoxicillin: 10 mg/kg/day of clavulanate in three divided doses, in children with acute otitis media (AOM) and to evaluate the changes in nasopharyngeal flora after treatment. METHODS In a prospective, comparative, open randomized, multicenter trial, children were scheduled to return for visits on Days 12 to 14 (main end point) and Days 28 to 42 after the beginning of treatment for AOM. A nasopharyngeal swab for bacterial culture was obtained before the treatment and at Days 12 to 14. RESULTS Between February, 1995, and May, 1996, 513 children with a mean age of 14.2 +/- 6.7 months were enrolled. All the patients were evaluable for the safety and intent-to-treat analyses and 463 for the per protocol efficacy. At Days 12 to 14 clinical success was obtained in 186 of the 235 children (79%) given ceftriaxone and in 188 of the 228 children (82.5%) treated with amox/clav. Among the patients with clinical success on Days 12 to 14, the success was maintained at Days 28 to 42 for 108 of 183 (59%) patients in the ceftriaxone group and 103 of 187 (55%) patients in the amox/clav group. Before the antibiotic treatment the percentages of children carrying Streptococcus pneumoniae (59.1%), Haemophilus influenzae (39.4%), Moraxella catarrhalis (55.7%) and the rate of penicillin-resistant S. pneumoniae (52.2%) were comparable between the 2 groups. At Days 12 to 14 the carriage of S. pneumoniae and M. catarrhalis was significantly different between the patients treated with ceftriaxone, 43.9 and 42.2, respectively, and the patients treated with amox/clav, 17.4 and 11.1%, respectively. Among the children carrying S. pneumoniae at Days 12 to 14, the percentage of penicillin-resistant strains reached 63.4% in the ceftriaxone treatment group and 83.0% in the amox/clav treatment group, (P = 0.02). Adverse events (mainly diarrhea) related to the study medication were reported more frequently (P < 0.0001) in the amox/clav treatment group. CONCLUSIONS In an area with a high rate of penicillin-resistant S. pneumoniae, a single dose of ceftriaxone is as efficient as a 10-day course of amox/clav in the treatment of AOM in young children. There was for the two regimens an increased rate of penicillin-resistant strains among the pneumococci carried, whereas the chance for a child to carry a penicillin resistant S. pneumoniae did not increase after treatment.
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583
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Cohen R. [The place of glycopeptides in outpatient pediatrics]. Presse Med 1999; 28:821. [PMID: 10325944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/12/2023] Open
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584
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Cohen R. International standards to protect internally displaced persons. REFUGEE SURVEY QUARTERLY 1999. [DOI: 10.1093/rsq/18.1.38] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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585
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Dockhorn R, Aaronson D, Bronsky E, Chervinsky P, Cohen R, Ehtessabian R, Finn A, Grossman J, Howland W, Kaiser H, Pearlman D, Sublett J, Ratner P, Settipane G, Sim T, Storms W, Webb R, Drda K, Wood C. Ipratropium bromide nasal spray 0.03% and beclomethasone nasal spray alone and in combination for the treatment of rhinorrhea in perennial rhinitis. Ann Allergy Asthma Immunol 1999; 82:349-59. [PMID: 10227333 DOI: 10.1016/s1081-1206(10)63284-x] [Citation(s) in RCA: 46] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Perennial rhinitis is a common condition that affects up to 10% to 20% of the population. Multiple agents are frequently administered since no single agent provides complete relief. Studies assessing the benefit/risk of combined therapy are important especially for newly approved agents such as ipratropium bromide nasal spray 0.03%, a topical anticholinergic agent, approved specifically for the treatment of rhinorrhea in allergic and non-allergic perennial rhinitis. OBJECTIVE To compare the efficacy and safety of the combined use of ipratropium bromide nasal spray 0.03% (42 microg per nostril tid) and beclomethasone dipropionate nasal spray (84 microg per nostril bid) against that of either active agent alone for the treatment of rhinorrhea. DESIGN Multicenter, 6-week, double-blind, randomized active- and placebo-controlled, parallel trial. SETTING Allergist and general practitioner clinical practices. PATIENTS Five hundred thirty-three patients with perennial rhinitis (279 allergic and 274 non-allergic), 8 to 75 years of age, who had at least a mild degree of severity of rhinorrhea for a minimum of 2 hours per day during the 1 week screening period as well as congestion or sneezing also of at least mild severity. INTERVENTION Either (1) ipratropium bromide nasal spray 0.03% (42 microg per nostril tid) plus beclomethasone dipropionate nasal spray (84 microg per nostril bid), (2) ipratropium bromide nasal spray 0.03% (42 microg per nostril tid) alone, (3) beclomethasone dipropionate nasal spray (84 microg per nostril bid) alone, or (4) vehicle [matching placebo nasal spray for the ipratropium bromide (2 sprays per nostril tid)] or beclomethasone dipropionate (2 sprays per nostril bid). MAIN OUTCOME MEASURE Severity and duration of rhinorrhea, and patient and physician global assessment of control of rhinorrhea. RESULTS Ipratropium bromide nasal spray plus beclomethasone nasal spray was more effective than either active agent alone or vehicle in reducing the average severity and duration of rhinorrhea during 4 weeks of treatment. The advantage of ipratropium bromide plus beclomethasone nasal spray was evident by the first day of combined treatment and continued throughout the 2-week treatment period. Ipratropium bromide nasal spray had a faster onset of action during the first week of treatment and reduced the duration of rhinorrhea more than beclomethasone. Beclomethasone nasal spray was more effective in reducing the severity of congestion and sneezing than ipratropium. In patients who had not responded well to a nasal steroid prior to participation in the study based on a questionnaire administered at screening, ipratropium bromide was as effective in the steroid non-responders as steroid responders, whereas beclomethasone was more effective in steroid responders. Combined active therapy was well tolerated with no increase in adverse events over that seen previously with ipratropium bromide or beclomethasone nasal spray alone. CONCLUSIONS The combined use of ipratropium bromide nasal spray with beclomethasone dipropionate nasal spray is more effective than either active agent for the treatment of rhinorrhea, and does not result in a potentiation of adverse drug reactions. Ipratropium bromide nasal spray 0.03% alone should be considered in patients for whom rhinorrhea is the primary symptom, and its use in combination with a nasal steroid should be considered in patients where rhinorrhea is one of the predominant symptoms, or in patients with rhinorrhea not fully responsive to other therapy.
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586
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Rössner P, Rockstroh B, Cohen R, Wagner M, Elbert T. Event-related potential correlates of proactive interference in schizophrenic patients and controls. Psychophysiology 1999; 36:199-208. [PMID: 10194967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
Performance and event-related potentials (ERPs) were examined in a proactive interference (PI) task with 15 male schizophrenic patients and 15 matched healthy controls. Within a paired-associate task, 30 pairs of semantically unrelated words (A-B) were presented twice, followed by cued recall, in which the paired-associate B had to be named upon cue A. Subsequently, 50% of the A-words were paired with new words (A-C) and presented in random order together with 15 novel pairings (D-E). Slower responses and poorer recall of C- than of E-words in the final recall indicated PI in both groups. During acquisition, the paired-associates (C/E) evoked larger P3 and positive slow wave in controls than in patients. During recall, cues (A/D) evoked a slow wave with predominating anterior negativity in controls and posterior positivity in patients. The group-specific ERP pattern suggests deviant encoding and retrieval processes in schizophrenic individuals.
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587
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Tolcher AW, Sugarman S, Gelmon KA, Cohen R, Saleh M, Isaacs C, Young L, Healey D, Onetto N, Slichenmyer W. Randomized phase II study of BR96-doxorubicin conjugate in patients with metastatic breast cancer. J Clin Oncol 1999; 17:478-84. [PMID: 10080588 DOI: 10.1200/jco.1999.17.2.478] [Citation(s) in RCA: 174] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE BMS-182248-1 (BR96-doxorubicin immunoconjugate) is a chimeric human/mouse monoclonal antibody linked to approximately eight doxorubicin molecules. The antibody is directed against the Lewis-Y antigen, which is expressed on 75% of all breast cancers but is limited in expression on normal tissues. Preclinical xenograft models demonstrated significant antitumor activity, including cures. A randomized phase II design was chosen to estimate the activity of the BR96-doxorubicin conjugate in metastatic breast cancer in a study population with confirmed sensitivity to single-agent doxorubicin. PATIENTS AND METHODS Patients with measurable metastatic breast cancer and immunohistochemical evidence of Lewis-Y expression on their tumor received either BR96-doxorubicin conjugate 700 mg/m2 IV over 24 hours or doxorubicin 60 mg/m2 every 3 weeks. Patients were stratified on the basis of prior doxorubicin exposure, visceral disease, and institution. Cross-over to the opposite treatment arm was allowed with progressive or persistently stable disease. RESULTS Twenty-three patients who had received a median of one prior chemotherapy regimen were assessable. There was one partial response (7%) in 14 patients receiving the BR96-doxorubicin conjugate and one complete response and three partial responses (44%) in nine assessable patients receiving doxorubicin. No patient experienced a clinically significant hypersensitivity reaction. The toxicities were significantly different between the two treatment groups, with the BR96-doxorubicin conjugate group having limited hematologic toxicity, whereas gastrointestinal toxicities, including marked serum amylase and lipase elevations, nausea, and vomiting with gastritis, were prominent. CONCLUSION The BR96-doxorubicin immunoconjugate has limited clinical antitumor activity in metastatic breast cancer. The gastrointestinal toxicities likely represent binding of the agent to normal tissues expressing the target antigen and may have compromised the delivery of the immunoconjugate to the tumor sites.
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588
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Abstract
BACKGROUND Gonadotropins and sex hormones are intimately related to the stability of affective states. Patients with affective disorders may demonstrate abnormal levels of sex hormones and gonadotropins. It is therefore possible that affective disorder patients may experience mood dysregulation by synthetic sex hormones and gonadotropins like lupron. METHODS A case report of a young woman with a history of endometriosis and a past history of irritability and depression is described. Treatment of the endometriosis with lupron induced a manic episode. RESULTS The lupron-induced mania was successfully treated with a mood-stabilizing agent, lithium carbonate. CONCLUSIONS Patients with a history of affective disorder may develop manic episodes when treated with Lupron. Mood-stabilizing agents are helpful in ameliorating this unwanted effect.
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589
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Lukatela K, Malloy P, Jenkins M, Cohen R. The naming deficit in early Alzheimer's and vascular dementia. Neuropsychology 1999. [PMID: 9805326 DOI: 10.1037//0894-4105.12.4.565] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Patients with early Alzheimer's disease (AD) were compared to normal controls and patients with early vascular dementia (VaD) on their naming errors using the Boston Naming Test (H. Goodglass & E. Kaplan, 1983). All naming errors were classified into three general error categories: visuoperceptual, semantic, and phonemic. Semantic errors were further classified into coordinate errors (responses that belong to the same semantic category as the target words), superordinate errors (responses that belong to a broader semantic category than the target word), and functional-circumlocutory errors (circumlocutions and responses that functionally describe the target word). The findings indicated that AD participants display more overall naming errors than VaD participants, although the pattern of general errors was similar between the patient groups. However, the qualitative difference between the patient groups was observed within the semantic errors because the AD group made more superordinate errors.
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590
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Trouillas J, Chevallier P, Remy C, Rajas F, Cohen R, Calle A, Hooghe-Peters EL, Rousset B. Differential actions of the dopamine agonist bromocriptine on growth of SMtTW tumors exhibiting a prolactin and/or a somatotroph cell phenotype: relation to dopamine D2 receptor expression. Endocrinology 1999; 140:13-21. [PMID: 9886801 DOI: 10.1210/endo.140.1.6450] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Dopamine (Da) and Da agonists are known to inhibit secretion and proliferation of normal and tumoral PRL cells, through receptors of D2 subtype. Because of the lack of an experimental model, the relationship between bromocriptine (BR) sensitivity and D2 receptor expression is poorly documented. Such a relationship was analyzed using five lineages of spontaneous transplantable rat pituitary tumors (SMtTW) exhibiting different PRL/GH phenotypes. From plasma PRL and GH concentrations of rats bearing the tumors and tumor messenger RNA contents, tumors were classified as PRL (SMtTW2), somatotroph (SMtTW10), or somatomammotroph (SMtTW5) tumors. Two lineages (SMtTW3 and SMtTW4) represented variants producing PRL and GH but with a high predominance of PRL. With the exception of SMtTW4 tumors, which were malignant, all the tumors were benign and differed in their growth rate. Hormone production and growth of tumors with a PRL or a somatomammotroph phenotype were reduced by about 90% under BR treatment, whereas somatotroph tumors and the PRL malignant tumors were totally insensitive to BR. D2 receptor messenger RNA was present in all BR-sensitive tumors and was not detected in BR-resistant tumors. In conclusion, using five lineages of SMtTW tumors that are representative of the most frequent tumors encountered in human pituitary pathology, we found a full concordance between tumor responses to BR and the expression of D2 receptor by the tumors. The identification of a tumor lineage with a malignant phenotype, secreting high amounts of PRL and presenting a resistance to BR, supports the idea that Da-resistant prolactinomas are aggressive tumors.
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591
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Olivier C, Portier H, Cohen R, Schlemmer B, Boucot I, Graph I. Rhumatisme Articulaire Aigu (Raa) En France: Resultats D'une Enquete Nationale (1995–1997). Arch Pediatr 1999. [DOI: 10.1016/s0929-693x(99)80531-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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592
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Tongu M, Borges M, Giovedi M, Cohen R, Almeida G. Reliability of echographic examination for the study of optic nerve cupping. Arq Bras Oftalmol 1999. [DOI: 10.5935/0004-2749.19990010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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593
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Rakotoariiaona A, Séaume H, Blanchard B, Cohen R, Bouillié C. Méningite à pneumocoque résistant à la Pénicilline G. Echec de l'association Vancomycine Céfotaxime? Arch Pediatr 1999. [DOI: 10.1016/s0929-693x(99)81606-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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594
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Cohen R, Levy C, Boucherat M, Langue J, de La Rocque F. Comparaison De L'evolution, Des Caracteristiques Cliniques Et Microbiologiques Des Patients Ayant Une Otite Moyenne AiguÈ (Oma) En Fonction De Leur Mode De Garde: Creche, Nourrice Ou Domicile. Arch Pediatr 1999. [DOI: 10.1016/s0929-693x(99)81570-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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595
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Corn M, Cohen R. Real-time measurement of sub-PPM concentrations of airborne chemicals in semiconductor manufacturing. JOURNAL OF EXPOSURE ANALYSIS AND ENVIRONMENTAL EPIDEMIOLOGY 1998; 3 Suppl 1:37-49. [PMID: 9857292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Real-time mass spectroscopy (ICAMS) can provide hourly or daily estimates of employee exposure. Field calibration of the unit indicated essentially linear response from 0.01 (Cellosolve Acetate) and 0.03 ppm (Diglyme) to 1 ppm in semiconductor cleanrooms. The instrument can be programmed for 4 minute readings on a single compound, or for rotation among several chemicals, each requiring 4 minute dwell times for analysis. In contrast to full shift personal sampling methods to measure exposure, ICAMS offers insights into the occurrence of peak exposures. In addition, in the occupational environment ICAMS results can be integrated to estimate full-shift within a zone exposures. Thus, the ICAMS extends measurement sensitivities below those currently available and offers a viable alternative to personal sampling in the semiconductor industry.
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596
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Mastorakos DP, Milman PJ, Cohen R, Goldenberg SP. An unusual complication of a biliary stent-small bowel perforation of an incarcerated hernia sac. Am J Gastroenterol 1998; 93:2533-5. [PMID: 9860420 DOI: 10.1111/j.1572-0241.1998.00712.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
We present a case of small bowel perforation after migration of an endoscopically inserted biliary stent inside an incarcerated hernia sac. A review of the literature revealed no other report of stent morbidity associated with hernias. The management and implications are discussed.
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597
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Stern L, Zohar J, Cohen R, Sasson Y. Treatment of severe, drug resistant obsessive compulsive disorder with the 5HT1D agonist sumatriptan. Eur Neuropsychopharmacol 1998; 8:325-8. [PMID: 9928925 DOI: 10.1016/s0924-977x(97)00092-8] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The serotonergic system has been implicated in both the aetiology and pharmacological treatment of obsessive compulsive disorder. In pharmacological challenge tests, mCPP, a 5-HT agonist, with an affinity for 5HT2C as well as 5HT1A and 5HT1D receptors, was associated with a transient exacerbation of obsessive compulsive symptoms. Chronic administration of mCPP was found to bring about some relief of these symptoms. Sumatriptan is an antimigraine agent, which interacts most potently with 5HT1D receptors. In the cases to be presented, we report the effects of chronic administration of Sumatriptan to three severe, treatment resistant, OCD patients. Following chronic administration of sumatriptan, these patients, who have been resistant to any former pharmacological treatment, responded with an improvement in their depression and a modest reduction in their obsessive compulsive symptoms.
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598
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Mastorakos DP, Milman PJ, Cohen R, Goldenberg SP. An unusual complication of a biliary stent-small bowel perforation of an incarcerated hernia sac. Am J Gastroenterol 1998. [PMID: 9860420 DOI: 10.1016/s0002-9270(98)00593-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
We present a case of small bowel perforation after migration of an endoscopically inserted biliary stent inside an incarcerated hernia sac. A review of the literature revealed no other report of stent morbidity associated with hernias. The management and implications are discussed.
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599
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Krivitzky A, Nguyen G, Gaudouen Y, Legrand M, Cohen R. [Atenolol/nifedipine combination: efficacy and tolerability of low dose synergistic bitherapy in the treatment of arterial hypertension]. Drugs 1998; 56 Suppl 2:31-43. [PMID: 9813740 DOI: 10.2165/00003495-199856002-00004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
During recent decades, undeniable progress has been made with regard to the management of arterial hypertension. Larger numbers of patients are aware they have hypertension, receive treatment and benefit from this therapy. Furthermore, significant reductions have been observed in morbidity and mortality resulting from cardiovascular diseases. The objectives of hypertension treatment have been formulated on the basis of results of extensive epidemiological studies. Only a few patients receiving monotherapy actually achieve and maintain acceptable blood pressure levels. The complex pathogenesis of essential hypertension, the implications of nervous and humoral counter-regulatory effects, the heterogeneous character of individual responses to any given class of antihypertensive treatment and the onset of adverse effects all account for these failures. The search for a simple, effective and well-tolerated treatment based on a low dose combination of 2 classes of antihypertensive agents is consequently legitimate. The fixed combination of atenolol 50 mg and sustained release nifedipine 20 mg enables patients to benefit from the antihypertensive synergy of a beta-blocker and a calcium antagonist (dihydropyridine). Several open-ended or double-blind, controlled studies have shown that this combination produces a more marked antihypertensive effect than the individual components used alone or other reference monotherapies. Furthermore, it has been shown that this effect persists throughout the entire 24-hour period; this has been confirmed by 24-hour blood pressure monitoring. Short and medium term tolerability is significantly improved: the side effects commonly associated with the 2 drugs when used alone are reduced with the combination formulation since the 2 active substances have different and complementary mechanisms of action. In addition, long term studies have shown that therapeutic efficacy and tolerability remain stable and have even been seen to improve over a 12-month period. The fixed combination of atenolol-nifedipine has a role in strategies for the treatment of mild to moderate hypertension, particularly under the following conditions: when first-line monotherapy has failed to attain specific clearly defined objectives, including stabilised blood pressure levels together with acceptable tolerability. when patient compliance is jeopardised as a result of undesirable side effects. when the vascular burden is aggravated through lack of attention to individual risk factors in hypertensive patients. In more serious forms of hypertension, the atenolol-nifedipine combination can replace sequential monotherapies or other combination treatments that have failed to comply with the various criteria of therapeutic efficacy. Controlling arterial hypertension commonly requires polytherapy with 3 or even 4 different drugs in conjunction with particularly strict rules governing hygiene and diet. The addition of the fixed combination of atenolol-nifedipine simplifies the treatment of patients with arterial hypertension by limiting the daily doses and reducing laboratory monitoring.
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Hayes-Jordan A, Idowu O, Cohen R. Ectopic pancreas as the cause of gastric outlet obstruction in a newborn. Pediatr Radiol 1998; 28:868-70. [PMID: 9799321 DOI: 10.1007/s002470050485] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
This case of ectopic pancreas found in the pre-pyloric channel of a 2-day-old infant is unique. A review of the literature reveals no other cases of symptomatic ectopic pancreas in an infant of this age. In this patient, signs and symptoms were consistent with pyloric stenosis. Upper gastrointestinal study and esophagogastroduodenoscopy (EGD) revealed the diagnosis. This case is examined and the literature is reviewed.
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