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Biomedical subjects

R Kohn

Publications and source records attributed to R Kohn.

At least 37 records · Page 2Linked to original sources
PubMed1994

Occupational asthma following kapok exposure.

Whether a distinct kapok allergen exists or whether the fiber's allergenicity is due to contamination by other allergens has never been resolved. Several years ago, we evaluated a patient who appeared to develop occupational asthma to kapok. We performed an environmental assessment, cross-shift spirometric testing of the patient's co-workers, and the first reported bronchoprovocation challenge with kapok. The disappearance of the patient's asthma following cessation of kapok exposure, with now 7 years of follow-up, our inability to incriminate any other agent, and the patient's positive specific bronchoprovocation challenge strengthen the evidence, but do not prove definitively, that kapok fiber itself is allergenic.

Adult↗
PubMed1994

Jews and their intraethnic differential vulnerability to affective disorders, fact or artifact? I: An overview of the literature.

The observation that Ashkenazim have higher rates of affective disorders than either Sephardi or Oriental Jews was reanalyzed from the available literature. Statistical reanalysis of these studies was consistent with rates being elevated for Ashkenazim. The results of these treatment-based studies, however, suffer from biases due to differential help-seeking patterns, lack of accounting for readmission rates, diagnostic unreliability, misuse of frequency ratios relative to other disorders and failure to control for confounding variables. As a result of these causes for biases and in the absence of a true incidence or prevalence study serving as a basis for these observations, the assumption that Ashkenazim are at an increased risk for affective disorders is questionable and may be a mere result of methodological artifacts.

Bipolar Disorder↗
PubMed1993

Comparison of voluntary and blinded human immunodeficiency virus type 1 (HIV-1) seroprevalence surveys in a high prevalence sexually transmitted disease clinic population.

To compare the seroprevalence of and risk factors for human immunodeficiency virus infection (HIV) among patients attending a public sexually transmitted disease clinic, the authors conducted both voluntary and blinded seroprevalence surveys between June 1989 and August 1990. For the voluntary survey, every twenty-fifth patient attending the clinic for a new problem was invited to receive anonymous testing for HIV antibody. For the blinded survey, sera obtained for syphilis serologies from 2,297 (86%) of the 2,682 patients attending the clinic for a new problem were tested for HIV antibody after all personal identifiers were removed. Of the 946 eligible patients, 631 (66.7%) agreed to participate in the voluntary survey. Black men were significantly less likely to participate than other men and women (p < 0.0001). The prevalence of HIV antibody was 25% greater in the blinded survey than in the voluntary survey (15.2% and 11.4%, respectively, p < 0.05). This difference was due primarily to black homosexual/bisexual men, who had a 12.7-fold greater risk of HIV infection in the blinded survey than in the voluntary survey. These results suggest that blinded seroprevalence surveys may provide a better prevalence estimate of HIV infection than voluntary surveys. The greater risk for HIV infection observed among homosexual and bisexual black men, who were tested only in the blinded serosurvey, suggests that efforts to increase voluntary testing for HIV infection in this group should be developed.

Adolescent↗
PubMed1993

An epidemiological study of mental disorders in a 10-year cohort of young adults in Israel.

This is an overview of a two-phase epidemiological study of mental disorders among young adults in a ten-year birth cohort (1949-58) conducted in Israel. A sample of 4914 Israel-born offspring of Jewish immigrants was obtained by full probability sampling procedures and screened for caseness using psychometric symptom scales from the Psychiatric Epidemiology Research Interview (PERI). Those screened positive and almost a fifth of the negatives (N = 2741) were interviewed by psychiatrists using the Schedule for Affective Disorders and Schizophrenia, Israel version (SADS-I), in order to determine prevalence rates of specific disorders as defined by the Research Diagnostic Criteria (RDC). The completion rates for each interview phase were 94.5% and 90.7% respectively. Six-month prevalence rates are presented by gender, ethnic origin, and education. Approximately one-fifth of the birth cohort met current RDC criteria for a disorder at the definite level, excluding the RDC category of 'other psychiatric disorder'. Generalized anxiety disorder and major depressive disorder were the most commonly found types. The striking findings centre on alcoholism and drug use disorder which were exceedingly rare, and the unusually similar rates of major depression for males and females. The results from this study are discussed in comparison with those obtained from other epidemiological studies.

Adult↗
PubMed1993

Telephone vs face-to-face interviewing in a community psychiatric survey.

This study compared telephone with face-to-face interviewing in a community psychiatric survey. Two groups of women were investigated, Holocaust survivors and Europe-born respondents who were in prestate Israel during World War II. Both were administered the Psychiatric Research Interview Demoralization Scale and a short item scale investigating World War II experiences. Results showed a high compliance rate to the telephone mode. The subjects' scores in the two modes were highly correlated. Telephone interviewing seems to be a reliable and efficient method in areas with a well-developed network of subscribers.

Community Psychiatry↗
PubMed1993

[Antibiotic therapy in the intensive care unit].

The results of antibiotic treatment administered to 78 patients within one year are reported. Due to the nosocomial nature of the infections, the serious overall condition of the patients and the associated diseases, the prognosis remained unfavourable despite adequate antibiotic treatment. In the group of patients on dialysis ofloxacin and ciprofloxacin proved effective. Patients with exacerbation of chronic bronchitis responded well to doxycycline. In the treatment of infections of the urinary tract, the known favourable effect of cotrimoxazol was confirmed. Of the group of 78 patients with transitory or permanent cardiostimulation, 18 received antibiotic treatment. In 6 of them with transitory cardiostimulation antibiotics were given as a prophylactic measure, 4 patients developed febrile conditions after implantation of the cardiostimulator and 8 patients received antibiotics due to infections of the respiratory and urinary tract. After implantation of the cardiostimulator 60 patients (77%) did not require antibacterial treatment. (Ref. 5.)

Anti-Bacterial Agents↗
PubMed1992

Chlamydia trachomatis infection in women: a need for universal screening in high prevalence populations?

Chlamydia trachomatis is the most prevalent sexually transmitted bacterial pathogen. Nevertheless, selective, rather than universal, screening for chlamydia has been recommended, largely because testing is expensive and requires considerable technical expertise. A total of 1,348 women in four family planning clinics in San Francisco, California, were screened from March 1987 to January 1988 to identify criteria for selective screening. Of these, 9.2% had a positive chlamydia test using direct fluorescence. Logistic regression analysis identified five factors associated with infection: age less than 25 years, cervical friability, single marital status, a new sexual partner within the past 3 months, and lack of barrier contraceptive use. No single risk factor or combination of risk factors had both a high sensitivity and a high positive predictive value for infection. While screening all women who were unmarried would detect 93% of those with chlamydia, the positive predictive value of 10.7% was not much higher than the overall prevalence. Conversely, screening all women with cervical friability, which had a positive predictive value of 23.2%, would only detect 11% of those with chlamydia. On the basis of the authors' findings, selective screening should not be used in high prevalence populations in which all women are at risk and should be screened for chlamydia.

Adolescent↗
PubMed1992

Age and the dexamethasone suppression test: results from a broad unselected patient population.

We examined the relationship between age and postdexamethasone serum cortisol concentration in 676 psychiatric inpatients with a variety of DSM-III diagnoses. Regardless of diagnosis, patients 65 years and older had significantly higher nonsuppression rates than those below age 65 (64% vs. 34%). The correlation between age and cortisol level was moderate, but significant. Aging is associated with increasing nonsuppression rates to dexamethasone, and this change is augmented by an affective disorder diagnosis. Levels of nonsuppression and age-cortisol correlations vary depending on dose of dexamethasone, diagnosis, and gender.

Adolescent↗
PubMed1992

Endogenous digitalis-like factor in patients with acute myocardial infarction.

The authors examined endogenous digitalis-like factor (DLF) concentrations in the serum and urine in 65 patients with acute myocardial infarction. Radioimmunoassay was used for the examination and patients' data were analyzed in detail in relation to sex, risk factors and acute myocardial infarction complications. The concentrations of digitalis-like factor found in the serum of men (0.317 +/- 0.026 micrograms/l) and women (0.256 +/- 0.057 micrograms/l) with acute myocardial infarction were much higher compared with values of healthy men (0.009 +/- 0.004 micrograms/l) and women (0.015 +/- 0.012 micrograms/l). This finding is in agreement with data published by others and suggests a role of DLF in the pathogenesis of myocardial infarction.

Adolescent↗
PubMed1991

12-month outcome of patients with major depression and comorbid psychiatric or medical illness (compound depression).

OBJECTIVE: Inpatients with major depressive illness often have coexistent nonaffective psychiatric and/or medical conditions. The authors' objective is to address the following questions: 1) What is the effect of comorbid illness on the severity of major depression and associated psychosocial factors? 2) How does the course of depression differ for patients with and without concurrent illness? 3) Do patients with compound depression differ in rate of recovery and time to recovery from patients with pure depression? METHOD: The subjects were 78 patients with a DSM-III diagnosis of major depression who were consecutively admitted to an acute care university-affiliated psychiatric hospital; 37 of these patients had major depression only and 41 had major depression compounded by a coexisting axis I, II, or III condition. The patients were studied while hospitalized and for 12 months after hospital discharge. Instruments used included the Modified Hamilton Rating Scale for Depression, the Global Assessment Scale, and the Social Readjustment Rating Scale. RESULTS: Patients with compound depression reported significantly poorer functioning over the 12-month follow-up period and had lower recovery rates than the patients with pure depression. There were no differences in recovery rates between men and women with compound depression, but significantly more men than women with pure depression recovered. CONCLUSIONS: Compound depression is a common clinical occurrence, the course of illness is more difficult for patients with compound depression than for patients with pure depression, and the recovery rate of patients with compound depression is lower than that of patients with pure depression.

Adult↗
PubMed1990

Mental health attitudes and practices of Soviet immigrants.

A survey of mental health knowledge, attitudes and help-seeking practices was conducted with 415 Soviet immigrants to Israel. The purpose of the study was two-fold: to provide data for mental health services and outreach programs designed for this immigrant group and to obtain a "proxy window" into these attitudes and behaviors in the Soviet Union itself. The results show that almost 20% of the immigrants reported consultation to formal agents in Israel and about half of these reported similar consultation in the USSR. An almost equal proportion consulted the family. Univariate and multivariate analysis show that demoralization, marital status, and religiosity were significantly associated with help-seeking. The second part of the survey explored Soviet immigrant attitudes to mental illness and the mentally ill by means of case vignettes and social situations, respectively. The respondents were able to detect abnormal behavior, but did not label it as psychopathology. Their overall tolerance of such behavior was low. These attitudes did not change over time nor seem to be influenced by reported abuses of psychiatry in the USSR.

Adult↗
PubMed1989

[Acute myocardial infarct in a 15-year-old patient].

The authors present the case-history of a 15-year-old sportsman with acute "non Q" myocardial infarction. The disease is associated with excessive physical strain and subsequent protracted paroxysm of supraventricular tachycardia with severe hypotension. The paper is supplemented by ECG tracings and laboratory findings, echocardiographic, scintigraphic, coronarographic and other examinations. Pathological changes of the coronary arteries, or preexisting metabolic disease or myocardial disease, valvular defects or congenital anomalies were not confirmed. The authors draw attention to the possible occurrence of myocardial infarction also in very young subjects as a result of excessive physical strain along with other possible pathogenetic mechanisms.

Adolescent↗
PubMed1989

Psychiatric presentations of intracranial cysts.

Eight patients with intracranial cysts presenting with primary psychiatric diagnoses were studied. The cysts were visible on computed tomography (CT) and magnetic resonance imaging (MRI), and they produced neurologic, electroencephalographic (EEG), and neuropsychologic abnormalities. Descriptions of psychiatric manifestations associated with intracranial cysts are rare, and their potential neuropsychiatric significance has been minimized. This study demonstrates that intracranial cysts can cause neuropsychiatric symptoms, that surgical intervention may resolve the psychiatric manifestations in selected cases, and, in cases not warranting surgery, that psychopharmacological therapy to treat the behavioral manifestations is indicated. These cases mandate consideration of intracranial cysts in the diagnostic and therapeutic formulation of atypical neuropsychiatric disorders.

Adult↗
PubMed1989

Somatic symptoms among older Soviet immigrants: an exploratory study.

This exploratory study investigates the overlap of somatization and depressive symptoms among older Jewish-Soviet immigrants to the United States. It has been suggested that this group has depression often masked by somatic complaints. In order to test this hypothesis fifty-five respondents completed the Symptom Checklist 90, PERI Demoralization Scale and the Social Support Network Inventory. The somatization subscale was found to be significantly higher among older Soviet immigrants than in a depressed group, yet the depression subscale was significantly lower. Compared to a group of normal controls both the depression and somatization subscales were significantly elevated. Somatization, depression, and demoralization were elevated in Soviet immigrants. The results of this study are discussed in the context of the available literature on cross-cultural psychiatry and somatization. The clinical relevance of these findings is highlighted.

Acculturation↗
PubMed1986

[Binding of lead and copper ions to ethanol-insoluble substances from cooking potatoes].

The binding of Pb2+- and Cu2+-ions to ethanol-insoluble substances from three sorts of raw or cooked table potatoes in aqueous suspension is investigated. Moreover, analogous tests on the binding of Pb2+-ions to glucose-6- and glucose-1-phosphate as well as to phosphoric acid are performed. The determination of the free cations in the equilibrium solutions is directly carried out by means of ion-specific electrodes in consideration of the pH-influence. In view of nutrition physiology raw and cooked potatoes are capable, as well as vegetables, of binding Pb2+ and Cu2+ ions, due to their content of pectins with an esterification degree found to be in the range of 50-56% and 42-48%, respectively. The binding capacity of the ethanol-insoluble substances does not only base on their content of pectin-carboxyl groups but also on other macromolecular components. Among the metabolic degradation products of potato starch only free phosphoric acid is capable of binding Pb2+ ions.

Copper↗
PubMed1985

[The distribution of free and esterified carboxyl groups within the pectin molecule after the action of pectin esterase from Aspergillus niger and oranges].

By reaction of pectin esterase (PE) from Aspergillus niger and oranges as well as lye, with 95% esterified citrus and apple pectin we prepared series of preparations with degrees of esterification between 35 and 77%. In these partial deesterified pectins the form of distribution of the free and esterified carboxyl groups has been determined from the activity coefficient gamma Ca2+ of the calcium counterions in the solutions of the corresponding calcium pectinates, from the electrostatic free enthalpy delta (Gel/N)KCa of the ion exchange Ca2+----2K+ in these systems as well as from the relative activity of the polygalacturonase reacting with sodium pectinate. The PE from A niger hydrolyzes the esterified carboxyl groups more or less randomly, in a manner similar to the effect of lye on pectin. On the other hand PE from oranges brings about block-like groupings of free carboxyl groups in the pectin molecule. The study revealed different reaction mechanisms of the pectin deesterification by pectin esterases from Aspergillus species and higher plants.

Aspergillus niger↗
PubMed1985

Management of limited rhino-orbital mucormycosis without exenteration.

Eight cases of rhino-orbital mucormycosis managed successfully without exenteration were reviewed. The favorable outcome was attributable to early diagnosis and management of focal areas of fungus infection. Treatment included: correction of diabetic ketoacidosis or other concomitant metabolic derangement; wide local excision and debridement of all involved and devitalized oral, nasal, sinus, and orbital tissue, while establishing adequate sinus and orbital drainage; daily irrigation and packing of the involved orbital and paranasal areas with amphotericin B; and intravenous amphotericin B. This represents the largest reported series of rhino-orbital mucormycosis survivors without mutilating surgery and with unaltered visual acuity.

Adult↗