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Biomedical subjects

R P Cohen

Publications and source records attributed to R P Cohen.

10 recordsLinked to original sources
PubMed1983

General medicine consultation. Lessons from a clinical service.

The 564 consultations performed by a general medicine consultation service during its first year were analyzed in order to provide a concrete definition of this new academic domain. Of the consultations, 52 percent were for patients on the surgical service. Among these patients, the most common reason for consultation was the preoperative management of chronic illness, specifically, hypertension, diabetes, and angina; 47 percent of such patients had two or more chronic illnesses. The service recommended cancellation of planned surgery in 2 percent and postponement in 9 percent of the 210 patients seen preoperatively. Patients on the psychiatric service accounted for 47 percent of the consultations. In this group, diagnostic issues were the most common reasons for consultation, that is, abdominal pain, dementia, and the suspicion of thyroid disease. Only 12 percent of the patients were seen for prognostic reasons, usually related to the planned use of electroconvulsive therapy or tricyclic antidepressants. The service was evaluated by the referring physicians who rated the service favorably on its "mechanics," as well as on its qualitative performance. However, complaints of triviality were voiced when the average length of the list of recommendations seemed disproportionate to the complexity of the problems. The service was also evaluated by the residents who had provided consultations. From their perspective, the service was more successful in teaching the "art" of consultation than the "science." This experience provides an operational definition of the work facing a general medicine consultation service as well as data useful in focusing future educational programs and research efforts.

Family Practice↗
PubMed1979

Hypoxemia after thoracentesis. A predictable and treatable condition.

Hypoxemia was observed at 20 minutes and two hours postprocedure in 15 patients who had a thoracentesis. The hypoxemia resolved after 24 hours. No effect on pH, PaCO2, or bicarbonate ion was observed. The degree of hypoxemia was correlated directly with the volume of fluid removed. Oxygen therapy was found to reverse this effect. Hypoxemia that follows thoracentesis may be caused by several factors, the most important being frank pulmonary edema.

Adult↗
PubMed1979

Eosinophilia, elevated immunoglobulin E level and chronic enteritis due to intestinal helminthiasis.

Recurrent urticaria, abdominal pain, peripheral eosinophilia, hyperimmunoglobulin E and small bowel abnormalities on roentgenograms prompted evaluation of a 36 year old man for intestinal parasitism. Evidence for helminthiasis as the cause of his symptoms included changing antibody titers to helminth antigens and a dramatic response to therapy. Helminth larvae or eggs were not recovered. Diagnosis of strongyloidiasis, the most likely cause of the illness, is discussed.

Adult↗
PubMed1979

Primary cutaneous cryptococcosis.

Cryptococcal infections in immuno-compromised patients are of major importance. Current opinion holds that cutaneous cryptococcal infections in these patients indicate disseminated disease. In our renal transplant patient with primary cutaneous cryptococcosis, intravenously administered antifungal chemotherapy resulted in resolution of the disease and appears to have prevented disseminated infection.

Adult↗
PubMedDate not supplied

Evidence for adrenergic neurons in a memory access pathway.

Injection of a beta-adrenergic blocker, propranolol, in rats within 5 min after training of a step-dowm passive avoidance response had no effect on performance either 2 or 6 hr later, however, when testing occurred 1, 3 or 7 days after training and injection a significant performance decrement was observed. If drug injection was postponed until 1 or 3 days after training and testing was conducted 2 hr later, again poor avoidance performance was obtained. No support for a state-dependency explanation [14] of the propranolol amnesia could be found. The amnesia that followed beta-adrenergic receptor block was identical to that previously reported when norepinephrine biosynthesis was reduced [9] and supports the hypothesis of a role for adrenergic neurons in memory formation and retrieval that is different from cholinergic neurons [4,10].

Animals↗