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Biomedical subjects

H Cohen

Publications and source records attributed to H Cohen.

At least 19 recordsLinked to original sources
PubMed2006

Interlimb transfer of grasp orientation is asymmetrical.

One the most fundamental aspects of the human motor system is the hemispheric asymmetry seen in behavioral specialization. Hemispheric dominance can be inferred by a contralateral hand preference in grasping. Few studies have considered grasp orientation in the context of manual lateralization and none has looked at grasp orientation with natural prehension. Thirty right-handed adults performed precision grasps of a cylinder using the thumb and index fingers, and the opposition axis (OA) was defined as the line connecting these two contact points on the cylinder. Subjects made ten consecutive grasps with one hand (primary hand movements) followed by ten grasps with the other hand (trailing movements). Differences between primary and trailing grasps revealed that each hemisphere is capable of programming the orientation of the OA and that primary movements with the right hand significantly influenced OA orientation of the trailing left hand. These results extend the hemispheric dominance of the left hemisphere to the final positions of fingers during prehension.

Adult↗
PubMed2006

Can oral anticoagulation be managed using telemedicine and patient self-testing? A pilot study.

We report a feasibility study of patient self-testing telemedicine for anticoagulant management using TOPCARE (Telematic Homecare Platform in Cooperative Health Care Provider Networks, developed by the European Commission for a user-friendly information society). TOPCARE comprises a Home Telematic Box (TOPCARE BOX), a central database held on a remote server and secure computer terminals in the anticoagulant clinic. The TOPCARE BOX transmits encrypted International Normalized Ratio (INR) results from the CoaguChek S monitor (Roche Diagnostics) via the patient's telephone line to the database, which is accessed by health-care professionals via the Internet. The database displays the patient's anticoagulant record, highlighting out of range results, overdue tests and quality control results. The database can also send information back to the TOPCARE box, although currently only the next test date can be transmitted. 23 patients, on long-term oral anticoagulation were recruited from the hospital anticoagulant clinic. After completing a nurse-led training course, patients tested their INR weekly on a CoaguChek S and transmitted their results via the TOPCARE BOX. The nurse specialist accessed the patient's results, electronically entered the date of the next test. Changes in warfarin dose were telephoned. Four patients dropped out early in the study and 19 patients received TOPCARE BOXs of which nine were fully functional. Unintentional software misconfiguration meant that remaining 10 TOPCARE BOXs were nonfunctional (these were later reconfigured but not reintroduced into the study). Patients successfully transmitted 222 results over a 5-month period using the TOPCARE system. Early server problems were resolved, but intermittent problems with database access persisted and five results were not received by the server. Although concerns were raised regarding technical problems, feedback from patients and staff was favourable and the system thought to be user-friendly. In conclusion, this pilot study showed that telemedicine is a feasible option for anticoagulant management, but that the technology requires thorough testing prior to installation.

Administration, Oral↗
PubMed2006

Prevalence of fibromyalgia syndrome in migraine patients.

Fibromyalgia syndrome (FMS) is a chronic pain syndrome of unknown aetiology characterized by diffuse pain over more than 3 months and tenderness in specific sites named tender points. The aim of this study was to assess the prevalence and severity of FMS among patients suffering from episodic migraine. Ninety-two consecutive patients (20 male, 72 female) fulfilling the International Headache Society criteria for migraine with and without aura from a tertiary headache clinic were evaluated. A headache and generalized pain history was recorded, tender points were evaluated by thumb palpation. The diagnosis of FMS was made based on the 1990 American College of Rheumatology classification criteria for FMS. Sixteen (22.2%) of the female patients and none of the male patients were diagnosed as suffering from FMS. Migraine severity and characteristics were similar to other female migraine patients. Patients suffering from migraine-FMS had lower quality of life scores and higher levels of mental distress. A high incidence of FMS was found among female migraine patients but not in males. The coexistence of FMS should be considered when choosing a prophylactic migraine therapy.

Adult↗
PubMed2005

Organization-induced charge redistribution in self-assembled organic monolayers on gold.

The charge redistribution that occurs within dipolar molecules as they self-assemble into organized organic monolayer films has been studied. The extent of charge transfer is probed by work function measurements, using low-energy photoelectron spectroscopy (LEPS), contact potential difference (CPD), and X-ray photoelectron spectroscopy (XPS), with the latter providing fine details about the internal charge distribution along the molecule. In addition, two-photon photoelectron spectroscopy is applied to investigate the electronic structure of the adsorbed layers. We show that charge transfer acts to reduce the dipole-dipole interaction between the molecules but may either decrease or increase the molecule-to-surface dipole moment.

Journal Article↗
PubMed2005

Nonlinear analysis of RR interval in euthymic bipolar disorder.

BACKGROUND: The bipolar affective disorder is long been speculated to have an autonomic involvement. Nonlinear analysis of heart rate variability has recently been shown to be a reliable noninvasive test for quantitative assessment of the central sympathovagal interaction that modulates cardiovascular autonomic function. METHODS: We studied 32 euthymic bipolar patients and 24 controls. A high-resolution electrocardiogram was obtained during complete rest. Nonlinear analysis (Poincare plot, largest Lyaponuv exponent, minimal embedding dimension, symbolic dynamic) was used. RESULTS: There wasn't a statistically significant difference in the nonlinear analysis of the heart rate variability, between the euthymic bipolar patients and controls, in the rest situation. CONCLUSION: The nonlinear analysis of heart rate variability didn't support the notation that there is a disturbance in the autonomic nerves system of bipolar patients in the euthymic state.

Adult↗
PubMed2005

Procedures for the outpatient management of patients with deep venous thrombosis.

Although deep venous thrombosis (DVT) is now widely managed on an outpatient basis, at a practical level there remains a potential for uncertainty as to which patient might prove suitable and in particular in regard to the lines of responsibility of each department involved in the delivery of clinical care. This guideline sets out recommendations for the standardization of the outpatient management of patients with DVT.

Ambulatory Care↗
PubMed2005

Thrombotic thrombocytopaenic purpura in HIV-infected patients.

Thrombotic thrombocytopaenic purpura (TTP) results from deficiency of von Willebrand factor-cleaving protease (vWF-cp) activity. Eight HIV-infected patients presented with TTP, representing 12.5% of all TTP treated at this centre. In four patients presentation with TTP revealed underlying HIV infection, the other four patients were previously known to be HIV infected, with plasma exchange and highly active antiretroviral therapy (HAART) all recovered. Normalization of vWF-cp activity was associated with recovery. Relapse occurred in two patients who discontinued HAART against medical advice, suggesting that HIV has a causal role in this condition. Given the clear benefit from HAART in addition to plasma exchange, these data suggest that all patients presenting with TTP should undergo HIV testing.

Antiretroviral Therapy, Highly Active↗
PubMed2004

The anticardiolipin assay is required for sensitive screening for antiphospholipid antibodies.

The importance of testing for anticardiolipin antibodies (aCL) in the diagnosis of antiphospholipid syndrome (APS) in patients with thrombosis has recently been challenged (ISTH SSC meeting, Boston 2002). We have analyzed the antiphospholipid serology of 123 patients with persistent antiphospholipid antibodies (aPL) attending our hematology department. The cohort was tested for anti-beta(2)-glycoprotein I (beta(2)-GPI) antibodies and aCL of IgG and IgM class and for lupus anticoagulant (LA). Ninety-six of these patients fulfilled Sapporo clinical criteria for APS and 70 of these patients had venous and/or arterial thrombosis. Patients with LA plus anti-beta(2)-GPI antibodies had significantly higher levels of IgG aCL and anti-beta(2)-GPI antibodies than those exhibiting positivity for only LA or anti-beta(2)-GPI antibodies (P < 0.05). Patients with aCL IgG levels over 60 GPLU were found in all cases to be positive for LA and anti-beta(2)-GPI antibodies; 25.2% (31/123) of all patients and 26.04% (25/96) of patients fulfilling Sapporo clinical criteria for APS were positive for aCL only. The mean IgG aCL level in the Sapporo clinical criteria positive patients who had aCL only was 11.5 GPLU (normal < 5 GPLU). These data indicate that omission of aCL testing from the clinical investigation of APS could lead to a failure to diagnose the syndrome in a proportion of patients.

Antibodies, Anticardiolipin↗