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813 results on '"Cohen, JD"'

1. Preimplantation sex selection via in vitro fertilization: time for a reappraisal

Author

Vitaly A. Kushnir, MD, Eli Y. Adashi, MD, MS, and I. Glenn Cohen, JD

Subjects
In vitro fertilization, preimplantation genetic testing, sex selection, Diseases of the genitourinary system. Urology, RC870-923, Gynecology and obstetrics, RG1-991
Abstract

In recent years, there has been rapid increase in the availability of elective sex selection via genetic testing of preimplantation embryos created through in vitro fertilization. We explore the standing of this ethically controversial practice in the context of a changing legal landscape after the Dobbs v Jackson Women’s Health decision by the US Supreme Court.

Published
2023
Full Text
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2. Machine learning to detect the SINEs of cancer.

Author

Douville, C, Lahouel, K, Kuo, A, Grant, H, Avigdor, BE, Curtis, SD, Summers, M, Cohen, JD, Wang, Y, Mattox, A, Dudley, J, Dobbyn, L, Popoli, M, Ptak, J, Nehme, N, Silliman, N, Blair, C, Romans, K, Thoburn, C, Gizzi, J, Schoen, RE, Tie, J, Gibbs, P, Ho-Pham, LT, Tran, BNH, Tran, TS, Nguyen, TV, Goggins, M, Wolfgang, CL, Wang, T-L, Shih, I-M, Lennon, AM, Hruban, RH, Bettegowda, C, Kinzler, KW, Papadopoulos, N, Vogelstein, B, Tomasetti, C, Douville, C, Lahouel, K, Kuo, A, Grant, H, Avigdor, BE, Curtis, SD, Summers, M, Cohen, JD, Wang, Y, Mattox, A, Dudley, J, Dobbyn, L, Popoli, M, Ptak, J, Nehme, N, Silliman, N, Blair, C, Romans, K, Thoburn, C, Gizzi, J, Schoen, RE, Tie, J, Gibbs, P, Ho-Pham, LT, Tran, BNH, Tran, TS, Nguyen, TV, Goggins, M, Wolfgang, CL, Wang, T-L, Shih, I-M, Lennon, AM, Hruban, RH, Bettegowda, C, Kinzler, KW, Papadopoulos, N, Vogelstein, B, and Tomasetti, C

Abstract

We previously described an approach called RealSeqS to evaluate aneuploidy in plasma cell-free DNA through the amplification of ~350,000 repeated elements with a single primer. We hypothesized that an unbiased evaluation of the large amount of sequencing data obtained with RealSeqS might reveal other differences between plasma samples from patients with and without cancer. This hypothesis was tested through the development of a machine learning approach called Alu Profile Learning Using Sequencing (A-PLUS) and its application to 7615 samples from 5178 individuals, 2073 with solid cancer and the remainder without cancer. Samples from patients with cancer and controls were prespecified into four cohorts used for model training, analyte integration, and threshold determination, validation, and reproducibility. A-PLUS alone provided a sensitivity of 40.5% across 11 different cancer types in the validation cohort, at a specificity of 98.5%. Combining A-PLUS with aneuploidy and eight common protein biomarkers detected 51% of the cancers at 98.9% specificity. We found that part of the power of A-PLUS could be ascribed to a single feature-the global reduction of AluS subfamily elements in the circulating DNA of patients with solid cancer. We confirmed this reduction through the analysis of another independent dataset obtained with a different approach (whole-genome sequencing). The evaluation of Alu elements may therefore have the potential to enhance the performance of several methods designed for the earlier detection of cancer.

Published
2024

4. Detection of rare mutations, copy number alterations, and methylation in the same template DNA molecules.

Author

Wang, Y, Douville, C, Cohen, JD, Mattox, A, Curtis, S, Silliman, N, Popoli, M, Ptak, J, Dobbyn, L, Nehme, N, Dudley, JC, Summers, M, Zhang, M, Ho-Pham, LT, Tran, BNH, Tran, TS, Nguyen, TV, Bettegowda, C, Papadopoulos, N, Kinzler, KW, Vogelstein, B, Wang, Y, Douville, C, Cohen, JD, Mattox, A, Curtis, S, Silliman, N, Popoli, M, Ptak, J, Dobbyn, L, Nehme, N, Dudley, JC, Summers, M, Zhang, M, Ho-Pham, LT, Tran, BNH, Tran, TS, Nguyen, TV, Bettegowda, C, Papadopoulos, N, Kinzler, KW, and Vogelstein, B

Abstract

The analysis of cell-free DNA (cfDNA) from plasma offers great promise for the earlier detection of cancer. At present, changes in DNA sequence, methylation, or copy number are the most sensitive ways to detect the presence of cancer. To further increase the sensitivity of such assays with limited amounts of sample, it would be useful to be able to evaluate the same template molecules for all these changes. Here, we report an approach, called MethylSaferSeqS, that achieves this goal, and can be applied to any standard library preparation method suitable for massively parallel sequencing. The innovative step was to copy both strands of each DNA-barcoded molecule with a primer that allows the subsequent separation of the original strands (retaining their 5-methylcytosine residues) from the copied strands (in which the 5-methylcytosine residues are replaced with unmodified cytosine residues). The epigenetic and genetic alterations present in the DNA molecules can then be obtained from the original and copied strands, respectively. We applied this approach to plasma from 265 individuals, including 198 with cancers of the pancreas, ovary, lung, and colon, and found the expected patterns of mutations, copy number alterations, and methylation. Furthermore, we could determine which original template DNA molecules were methylated and/or mutated. MethylSaferSeqS should be useful for addressing a variety of questions relating genetics and epigenetics.

Published
2023

5. Detection of low-frequency DNA variants by targeted sequencing of the Watson and Crick strands

Author

Cohen, JD, Douville, C, Dudley, JC, Mog, BJ, Popoli, M, Ptak, J, Dobbyn, L, Silliman, N, Schaefer, J, Tie, J, Gibbs, P, Tomasetti, C, Papadopoulos, N, Kinzler, KW, Vogelstein, B, Cohen, JD, Douville, C, Dudley, JC, Mog, BJ, Popoli, M, Ptak, J, Dobbyn, L, Silliman, N, Schaefer, J, Tie, J, Gibbs, P, Tomasetti, C, Papadopoulos, N, Kinzler, KW, and Vogelstein, B

Abstract

Identification and quantification of low-frequency mutations remain challenging despite improvements in the baseline error rate of next-generation sequencing technologies. Here, we describe a method, termed SaferSeqS, that addresses these challenges by (1) efficiently introducing identical molecular barcodes in the Watson and Crick strands of template molecules and (2) enriching target sequences with strand-specific PCR. The method achieves high sensitivity and specificity and detects variants at frequencies below 1 in 100,000 DNA template molecules with a background mutation rate of <5 × 10-7 mutants per base pair (bp). We demonstrate that it can evaluate mutations in a single amplicon or simultaneously in multiple amplicons, assess limited quantities of cell-free DNA with high recovery of both strands and reduce the error rate of existing PCR-based molecular barcoding approaches by >100-fold.

Published
2021

6. Prognostic significance of postsurgery circulating tumorDNAin nonmetastatic colorectal cancer: Individual patient pooled analysis of three cohort studies

Author

Tie, J, Cohen, JD, Lo, SN, Wang, Y, Li, L, Christie, M, Lee, M, Wong, R, Kosmider, S, Skinner, I, Wong, HL, Lee, B, Burge, ME, Yip, D, Karapetis, CS, Price, TJ, Tebbutt, NC, Haydon, AM, Ptak, J, Schaeffer, MJ, Silliman, N, Dobbyn, L, Popoli, M, Tomasetti, C, Papadopoulos, N, Kinzler, KW, Vogelstein, B, Gibbs, P, Tie, J, Cohen, JD, Lo, SN, Wang, Y, Li, L, Christie, M, Lee, M, Wong, R, Kosmider, S, Skinner, I, Wong, HL, Lee, B, Burge, ME, Yip, D, Karapetis, CS, Price, TJ, Tebbutt, NC, Haydon, AM, Ptak, J, Schaeffer, MJ, Silliman, N, Dobbyn, L, Popoli, M, Tomasetti, C, Papadopoulos, N, Kinzler, KW, Vogelstein, B, and Gibbs, P

Abstract

Studies in multiple solid tumor types have demonstrated the prognostic significance of ctDNA analysis after curative intent surgery. A combined analysis of data across completed studies could further our understanding of circulating tumor DNA (ctDNA) as a prognostic marker and inform future trial design. We combined individual patient data from three independent cohort studies of nonmetastatic colorectal cancer (CRC). Plasma samples were collected 4 to 10 weeks after surgery. Mutations in ctDNA were assayed using a massively parallel sequencing technique called SafeSeqS. We analyzed 485 CRC patients (230 Stage II colon, 96 Stage III colon, and 159 locally advanced rectum). ctDNA was detected after surgery in 59 (12%) patients overall (11.0%, 12.5% and 13.8% for samples taken at 4-6, 6-8 and 8-10 weeks; P = .740). ctDNA detection was associated with poorer 5-year recurrence-free (38.6% vs 85.5%; P < .001) and overall survival (64.6% vs 89.4%; P < .001). The predictive accuracy of postsurgery ctDNA for recurrence was higher than that of individual clinicopathologic risk features. Recurrence risk increased exponentially with increasing ctDNA mutant allele frequency (MAF) (hazard ratio, 1.2, 2.5 and 5.8 for MAF of 0.1%, 0.5% and 1%). Postsurgery ctDNA was detected in 3 of 20 (15%) patients with locoregional and 27 of 60 (45%) with distant recurrence (P = .018). This analysis demonstrates a consistent long-term impact of ctDNA as a prognostic marker across nonmetastatic CRC, where ctDNA outperforms other clinicopathologic risk factors and MAF further stratifies recurrence risk. ctDNA is a better predictor of distant vs locoregional recurrence.

Published
2021

7. The Power of Shared Vision : How to Cultivate Staff Commitment & Accountability

Author

Michael H. Cohen, JD, MBA and Michael H. Cohen, JD, MBA

Subjects
Responsibility, Employee motivation
Abstract

The Power of Shared Vision addresses how to develop goals that unite people around a common cause and secure employee ownership of changes that improve the quality of their work. Learn to create a retribution-free communication environment where people can communicate their needs without fear of retribution. Leaders will help team members distinguish problems that can be solved from those work realities that are outside of their control. Understand the reasons why some employees cannot or will not meet job-related expectations and what leaders can do to close the performance gap.

Published
2015

8. DUO Registry Group. Functional impairment of systemic scleroderma patients with digital ulcerations: results from the DUO Registry

Author

Guillevin, L, Hunsche, E, Denton, Cp, Krieg, T, Schwierin, B, Rosenberg, D, Matucci Cerinic, M, DUO Registry Group Collaborators Raffier, B, Hirschi, M, Trautinger, F, Schmidt, P, Stetter, M, Hundstorfer, M, Reinhart, V, Monshi, B, Pirkhammer, D, Richter, L, Hamberger, N, Metz, S, Feldmann, R, Semmelweis, K, Lackner, K, Tomi, N, Kolle, H, Hafner, F, Brodmann, M, Kuen Spiegel, M, Minmair, G, Heil, Pm, Broil, H, Holzer, G, Illmer, X, Rintelen, B, Sautner, J, Takacs, M, Thun, M, Zemanova, I, Soukup, T, Smrzova, A, Bohmova, J, Prochazkova, L, Nemec, P, Fojtik, Z, Suchy, D, Becvar, R, Olsen, Ab, Sondergaard, Kh, Luosu jarvi, R, Vidqvist, Kl, Madaule, S, Beneton, N, Maillard, H, Charlanne, H, Granelbrocard, F, Hachulla, E, Hatron, Py, Jourdain, N, Lambert, M, Launay, D, Morell, S, Woijtasik, G, Skowron, F, Zenone, T, Dadban, A, Lok, C, Ferrandiz, D, Magybertrand, N, Moiton, Mp, Taieb, A, Balquiere, S, Belin, E, Droitcourt, C, Julien, S, Prey, S, Boulon, C, Constans, J, Doutre, Ms, Kostrzwewa, E, Richez, C, Greco, M, Misery, L, Sassolas, B, Collet, E, Berthier, S, Leguy Seguin, V, Imbert, B, Carpentier, P, Blaise, S, Couraud, A, Doeffel Hantz, V, Spars, A, Bezanahary, H, Boussely, N, Dumonteil, S, Fauchais, Al, Goudran, G, Loustaud Ratti, V, Manea, P, Vidal, E, Coppere, B, Desmursclavel, H, Girard Madoux MH, Hot, A, Ninet, J, Granel, B, Cohen, Jd, Keynote, A, Khau van Kien, A, Le Quellec, A, Riviere, S, Rullier, P, Bessis, D, Farcas, C, Bravetti, V, Moline, T, Wahl, D, Zuily, S, Granel Brocard, F, Agard, C, Durant, C, Fuzibet, Jg, Queyrel, V, Berezne, A, Mouthon, L, Cabane, J, Tiev, K, Toledano, C, Lazareth, I, Michon Pasturel, U, Priollet, P, Reguiai, Z, Cazaletslacoste, C, Jego, P, Letremy, A, Perlat, A, Duval Modeste AB, Chatelus, E, Chiffot, H, Sibillia, J, Sordet, C, Adoue, D, Couret, B, Moulis, G, Pugnet, G, Sailler, L, Diot, E, Gaches, F, Farge, D, Keshtmand, H, Frances, C, von Elling, A, Bora, D, Ebel, J, Ahmadi Simab, K, Klein, E, Hahn, K, Schulze, K, Rasche, C, Riemekasten, G, Lee, Hh, Deuschle, K, Mattat, K, Becker, M, Worm, M, Mensing, C, Klings, D, Mensing, H, Messall, J, Zuper, R, Eilbacher, P, Saar, P, Kaufmann, P, Hallermann, C, Schmidt, K, Wahn, H, Schildt, K, Schuart, T, Kaczmarczyk, A, Kellner, C, von Oelhafen, J, Baron von Bildering, P, Kunze, S, Kleiner, Hj, Alsheimer, B, Schuetz, N, Miirker Hermann, E, Gottl, Kh, Weiss, E, Reischel, N, Kern, S, Goettl, Kh, Goetheuniversitiitsklinikum, Jw, Himsel, A, Henkemeier, U, Schwarting, A, Hazenbiller, A, Nichelmann, V, Rumbaur, C, Boesenberg, I, Schmeiser, T, Mueller Ladner, U, Unholzer, A, Starz, H, Welzel, J, Plaumann, K, Stoeckl, F, Sperling, S, Podda, M, Wagner, N, Rapprich, H, Niedermeier, A, Messer, G, Sardy, M, Bekou, V, Dill MUller, D, Wlodarz, M, Belloni, B, Huettig, B, Ziai, M, Hein, R, Kneitz, C, Federow, I, Schneider, K, Semmler, M, Hapke, S, Metzler, C, Stein, T, Enderlein, M, Kayser, M, Werthmann, M, Guenther, Cu, Neul, S, Hellmich, B, Loeffler, C, Pflugfelder, J, Karaenke, P, Mueglich, C, Tony, Hp, Marina, P, Popp, M, Mittag, M, Baumann, C, Scheib, Eg, Brand, H, Wilhelm, Hu, Bohm, J, Dyballa, J, Boehm, J, Taggeselle, J, Luthke, K, Wuerzburg, I, Niefanger, K, Mayer, L, Drabek, J, Harmuth, W, Dietl, S, Moritz, D, Gause, A, Gaubitz, M, Hallecker, A, Krupp, E, Rumpel, H, Moosig, F, Frey, P, Kahl, S, Linke, M, Merk, B, Bloching, Hh, Ochs, W, Kurthen, R, Eiden, E, Guertler, I, Aries, Pm, Kirchberg, S, Jahnke, K, Mettler, S, Toeller, S, Zwenger, S, Langer, He, Deininger, F, Hartmann, F, Neeck, G, Neek, G, Wernitzsch, H, Meier, L, Herr, U, Meier, U, Aaig, W, Bruckner, L, Sheikh, N, Wollenhaupt, J, Krog, B, Wollersdorfer, E, Hall, R, Diehm, C, Tiggers, C, Peters, J, Kirschke, J, Schroeder, Jo, Zeuner, R, Uhlig, S, Barth, S, Huegel, R, Glaeser, R, Schaefer, C, Monshausen, M, Mengden, T, Funkert, A, Blank, N, Lupaschko, S, Voss, B, Megahed, M, Sadeghlar, F, Seidel, M, Wasmuth, Jc, Kreuter, A, Vosswinkel, J, Pfoehler, C, Gerber, A, Haust, M, Hoff, Np, Mota, R, Akanay Diesel, S, Homey, B, Katzemich, A, Erfurt Berge, C, Sticherling, M, Beyer, C, Distler, J, Mitchell, A, Freundlieb, C, Rushentsova, U, Hermanns, G, Blaschke, S, Fiene, M, Wessel, C, Norgauer, J, Rabe, B, Schuster, J, Scholz, J, Kremer, K, Robakidze Torbahn, M, Moinzadeh, P, Dohse, A, Muhlack, A, Schultz, L, Schult, S, Frambach, Y, Kruse, S, Kettenbach, A, Fell, I, Schweda, K, Steinbrink, K, Podobinska, M, Fieri beck, G, Schanz, S, Pfeiffer, C, Hassel, R, Herrgott, I, Sunderkoetter, C, Guenzel, J, Athanassiou, P, Dimitroulas, T, Settas, L, Kritikos, I, Tsifetaki, N, Garyfallos, A, Vasilopoulos, D, Boura, P, Kamali, S, Aslanidis, S, Vlachoyannopoulos, P, Galanopoulo, V, Sakkas, L, Koutroubas, A, Elezoglou, T, Galanopoulos, N, Grier, A, Murray, M, O'Rourke, M, Del Papa, N, Maglione, W, Zeni, S, Foti, R, Benenati, A, De Vita, S, Ferraccioli, G, Grassi, W, de Angeli, R, Pomponio, G, Mussi, A, Colonna, L, Airo, P, Zingarelli, S, Scorza, R, Serverino, A, Puppo, F, Negrini, S, Roma, I, Salsano, F, Triolo, G, Mazzuca, S, Carignola, R, Gatti, S, Lunardi, G, Riccieri, V, Salvarani, C, Bajocchi, G, Varcasia, G, Marasini, B, Belloll, L, de Luca, R, Stisi, S, Bellissimo, S, Fusaro, E, Pellerito, R, Cozzi, F, Rizzo, M, Bartoluzzi, A, Trotta, F, Cantatore, F, Corrado, A, Ferri, Claudio, Colaci, M, Malavolta, N, Mule, R, Galeazzi, M, Lapadula, G, Mathieu, A, Vacca, A, Giacomelli, Roberto, Cipriani, Paola, Montecucco, Cm, Codullo, V, Bucci, R, Battaglia, E, Valentini, G, Cuomo, G, Terlizzi, N, Serafino, L, Reumatologia, Uo, Bombardieri, S, Della Rossa, A, Doveri, M, Perricone, R, de Mattia, M, Pallotta, S, Groenendael, Jh, Seys, P, Goekoop, Rj, Han, Kh, Wlarvens, M, Bonte Mineur, F, de Bois MH, de Beus WM, van Zeben, D, Vonk, M, Knaapen, Hk, Smit, A, Bootsma, H, Ton, E, Voskuyl, A, Dutmer, Ea, Stalk, Jn, Madland, Tm, Seip, M, Hoffmann Vold AM, Bitter, H, Stocklund Thomsen, R, Resende, C, Ponte, C, Martinho, S, Silva, F, Ferreira, P, Grilo, A, Riso, N, Santos, C, Camara, I, Costa, J, Alves, J, Oliveira, S, Almeida, I, Silva, I, Cordeiro, A, Coelho, P, Lukac, J, Dolnicar, As, Espinosa, G, Mejia, Jc, Ramos, M, Plasin Rodriguez MA, Mera, A, Blanco, Js, Diaz, Jj, Losada, L, Perez, E, Maneiro, Jr, Caamano, M, Fermindez, S, Insua, Sa, Barbado, J, Fonseca, Em, Nufio, Fj, Castellvi, I, Garcia de Ia Pena, P, Bellido, D, Paulino, M, Garcia, Pv, Salas, V, Minguez, Md, Sanchez, Ma, Urrego, C, Martin, I, Rueda, A, Calvo, J, Ripoll, Mm, Torres, Mc, Corteguera, M, Maceiras, F, Cruz, J, Mosquera, Ja, Gomez, R, Area, B, Carrio, I, Rubio, M, Castellvi Barranco, I, Santos, P, Simeon, Cp, Fonollosa, V, Egurbide, Mv, Garcia de Vicuna, R, Vicente, E, Villaverde, V, Fernandez, C, Garcia, E, Uson, J, Miguelez, R, Callejas, Jl, Ortego, N, Roman, J, Alegre Sancho JJ, Robles, A, Rios, Jj, Bonilla, Mg, Sanchez Andrade, A, Vazquez, Tr, Miranda, Ja, Saez, L, Zea, A, De la Puente, C, Martinez, Fg, Aguirre, Ma, Collado, P, Cruz, A, Crespo, M, Sanchez Roman, J, Castillo, Mj, Garcia, Am, Muniz, G, Hedin, Pj, Stahl, C, Bracin, T, Nordin, A, Albertsson, K, Rydvald, Y, Thorsson, C, Hermansson, E, Maurer, B, Verner, D, Schmidt Bosshard, R, Hall, F, Murphy, K, Lamb, J, Anderson, M, Moots, R, Buch, M, Bissell, L, Madhok, R, Hampson, R, D'Cruz, D, Choong, Lm, Gordon, P, Dobson, J, Salerno, R, Nisar, M, Williams, C, Wilcox, L, Denton, C, Ochiel, R, Ngcozana, T, Parker, L, Vincent, R, Mchugh, N, Cole, S, Brown, S, James, J, Herrick, A, Manning, J, Moore, T, Faizal, A, Skyes, H, Smythe, A, and Hamilton, A.

Published
2013

9. Observation of a novel relaxation process associated with electronic transitions from deep (D) defects in hydrogenated amorphous silicon

Author

Rasmussen Rj, Thomas M. Leen, and Cohen Jd

Subjects
Amorphous silicon, chemistry.chemical_classification, Physics, Statistics::Theory, Statistics::Applications, Relaxation process, General Physics and Astronomy, Electron, Molecular electronic transition, chemistry.chemical_compound, chemistry, Atomic electron transition, Relaxation (physics), Atomic physics, Inorganic compound, Spin-½
Abstract

Junction capacitance transient measurements were employed to study the thermal emission of electrons trapped in deep (D) defects in lightly n-doped a-Si:H samples. We conclude that a novel defect relaxation process occurs upon a change of change state of the defect such that an electron's thermal release rate is inversely proportional to its residence time in the defect. Supplemental spin transient measurements indicate that both ${\mathit{D}}^{\mathrm{\ensuremath{-}}}$/${\mathit{D}}^{0}$ and ${\mathit{D}}^{0}$/${\mathit{D}}^{+}$ transitions must be involved. A good fit to our data is obtained if we assume a non-Markovian process for the ${\mathit{D}}^{0}$/${\mathit{D}}^{+}$ transition.

Published
1992

10. The White House Conferences on Aging

Author

Mpa Elias S. Cohen Jd

Subjects
White (horse), business.industry, Community organization, Medicine, Public administration, Life-span and Life-course Studies, business, Gerontology, Demography
Abstract

White House Conferences on Aging are anachronistic, expensive, and inefficient methods of developing debate and consensus on complex issues. To be effective, they need to derive their force from well-articulated expressed needs delivered by the President. Furthermore, to be effective in today's society, any such effort must combine state-of-the-art telecommunications technology combined with well-known techniques of community organization. Neither of those preconditions exist at the present time. It is suggested that the effort be better conducted by a nongovernmental coalition adequately funded and committed to a limited number of goals and to combined modern telecommunications technology and community organization.

Published
1990

11. Experimental evidence for zero-correlation-energy deep defects in intrinsic hydrogenated amorphous silicon

Author

Cohen Jd and Essick Jm

Subjects
Materials science, Condensed matter physics, Band gap, Fermi level, General Physics and Astronomy, Charge (physics), Electron, Molecular physics, law.invention, symbols.namesake, law, Metastability, symbols, sense organs, skin and connective tissue diseases, Spectroscopy, Spin (physics), Electron paramagnetic resonance
Abstract

Depletion-width-modulated ESR spectroscopy together with junction-capacitance techniques yield the total spin and charge change associated with the emission of electrons from deep defects (D) in intrinsic a-Si:H samples. The predominant transition is from the D 0 to D + charge state near midgap. However, the magnitude of spin to charge change agrees with a nearly zero value of correlation energy between the singly and doubly occupied charge states

Published
1990

12. Radiosensitization of C6 glioma by thymidine and 41.8°C hyperthermia

Author

Cohen Jd, Manucher J. Javid, and Robins Hi

Subjects
Hyperthermia, Radiosensitizer, Cell growth, business.industry, Metabolite, Pharmacology, medicine.disease, chemistry.chemical_compound, chemistry, Glioma, Immunology, medicine, Radiosensitivity, business, Thymidine, Nucleoside
Abstract

✓ The cytotoxic, antiproliferative, and radiosensitizing effects of thymidine (a nucleoside metabolite) were studied using the C6 glioma cell line in vitro. Radiosensitization by a combination of thymidine and 41.8°C hyperthermia was also evaluated. Thymidine concentrations above 100 µg/ml completely inhibited C6 proliferation while concentrations of 100 to 1000 µg/ml (for up to 24 hours) decreased C6 cell survival to as little as 7.4% compared to untreated control cells. Radiosensitivity was enhanced by the administration of thymidine alone (400 µg/ml × 24 hours before irradiation); sensitization by 41.8°C hyperthermia alone (1 hour ending immediately before irradiation) was less pronounced. Thymidine and hyperthermia together produced greater radiosensitization than did heat alone or thymidine alone. These data support the further investigation of thymidine as a neuro-oncology radiosensitizer.

Published
1990

15. The Practice of Integrative Medicine : A Legal and Operational Guide

Author

Michael H. Cohen, JD, MBA, Mary Ruggie, PhD, Marc S. S. Micozzi, MD, PhD, Michael H. Cohen, JD, MBA, Mary Ruggie, PhD, and Marc S. S. Micozzi, MD, PhD

Subjects
Integrative medicine
Abstract

Successfully Incorporate Integrative Medicine in a Wide Variety of SettingsPractitioners, facilities, and researchers encounter repeated requests from patients regarding the use of complementary and integrative medicine (CIM) and there are few who do not know the benefits of its use. But the legal aspects of prescribing or denying CIM treatment are new and harder to navigate, requiring the guidance of lawyers, policy makers, and other practitioners. Based on interviews with over 20 health care providers and facilities who have successfully combined integrative medicine in their practices, this book outlines the pitfalls, legal road-blocks, and benefits of bringing complementary and integrative medicine into daily health care routines.Discover:What forces are driving the shift toward Integrative careThe key legal issues governing individuals vs. institutionsHow established CIM institutions chose specific therapies, gained funding, and solved staffing issuesThe regulations for credentialing and how to comply

Published
2007

16. Sensitization of C6 glioma to carboplatin cytotoxicity by hyperthermia and thymidine

Author

Cohen Jd, Robins Hi, and M J Javid

Subjects
Hyperthermia, Cancer Research, endocrine system diseases, Cell Survival, Antineoplastic Agents, urologic and male genital diseases, Carboplatin, chemistry.chemical_compound, Chemosensitization, Glioma, Tumor Cells, Cultured, Medicine, Animals, Cytotoxicity, neoplasms, Sensitization, Dose-Response Relationship, Drug, business.industry, Drug Synergism, Hyperthermia, Induced, medicine.disease, Combined Modality Therapy, female genital diseases and pregnancy complications, medicine.anatomical_structure, Neurology, Oncology, chemistry, Immunology, Cancer research, Drug Therapy, Combination, Neurology (clinical), business, Thymidine, human activities, Nucleoside
Abstract

Thymidine (a nucleoside metabolite) and 41.8 degrees C hyperthermia were used to sensitize C6 glioma cells to carboplatin cytotoxicity in vitro. Clinically achievable thymidine concentrations (0, 200, 400, or 1000 micrograms/ml X 24 hours) significantly enhanced carboplatin killing. Clinically achievable hyperthermia exposures (40.5 or 41.8 degrees C X 1 hour) also enhanced carboplatin killing; 41.8 degrees C was more effective than was 40.5 degrees C. Thymidine and 41.8 degrees C hyperthermia together enhanced carboplatin killing significantly more than did the thymidine-carboplatin or hyperthermia-carboplatin combinations. These results illustrate the concept of 'combination chemosensitization' for simultaneously addressing the divergent drug resistance mechanisms of malignant gliomas.

Published
1990

17. Letter to the editor

Author

Kornguth S, Robins Hi, Cohen Jd, and M J Javid

Subjects
Cancer Research, Pathology, medicine.medical_specialty, Wistar Furth Rats, Neurology, Oncology, business.industry, medicine, Neurology (clinical), business, C6 glioma
Published
1990

18. Effects of the implantation of oxygen, nitrogen, and carbon on the density of states of n-type hydrogenated amorphous silicon

Author

Michelson Ce and Cohen Jd

Subjects
Amorphous silicon, Materials science, Analytical chemistry, Oxygene, Infrared spectroscopy, chemistry.chemical_element, Oxygen, Nitrogen, chemistry.chemical_compound, Ion implantation, chemistry, Density of states, computer, Carbon, computer.programming_language
Abstract

On utilise la spectroscopie transitoire de niveau profond, la photocapacitance d'impulsion de tension transitoire, et le profil de capacite du niveau d'entrainement. On utilise egalement la spectroscopie infra-rouge a transformation de Fourier pour evaluer les changements correspondant dans les liaisons a la suite de l'implantation

Published
1990

19. Cytokine Induction in Humans by 41.8 C WholeBody Hyperthermia

Author

H. I. Robins, C. L. Schmitt, F. D'oleire, David R. Spriggs, and Cohen Jd

Subjects
Hyperthermia, Cancer Research, Cytokine, Text mining, Oncology, business.industry, medicine.medical_treatment, medicine, Cancer research, business, medicine.disease
Published
1993

23. Efficacy of nonpharmacologic interventions in adults with high-normal blood pressure: results from phase 1 of the Trials of Hypertension Prevention. Trials of Hypertension Prevention Collaborative Research Group

Author

Whelton, PK, primary, Kumanyika, SK, additional, Cook, NR, additional, Cutler, JA, additional, Borhani, NO, additional, Hennekens, CH, additional, Kuller, LH, additional, Langford, H, additional, Jones, DW, additional, Satterfield, S, additional, Lasser, NL, additional, and Cohen, JD, additional

Published
1997
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24. Prevention of Heart Failure by Antihypertensive Drug Treatment in Older Persons With Isolated Systolic Hypertension

Author

Barry R. Davis, Robert H. McDonald, Henry R. Black, Blaufox, Eleanor Schron, William B. Applegate, Sylvia Wassertheil-Smoller, Berkson Dm, Clifton R. Lacy, Horace M. Perry, John B. Kostis, Cohen Jd, Curb Jd, Jeffrey A. Cutler, Kenneth G. Berge, Richard H. Grimm, and W M Smith

Subjects
medicine.medical_specialty, Heart disease, medicine.drug_class, business.industry, Systolic hypertension, General Medicine, medicine.disease, Prehypertension, Surgery, Blood pressure, Heart failure, Internal medicine, medicine, Cardiology, Chlorthalidone, Myocardial infarction, Antihypertensive drug, business, medicine.drug
Abstract

Context. —Heart failure is often preceded by isolated systolic hypertension, but the effectiveness of antihypertensive treatment in preventing heart failure is not known. Objective. —To assess the effect of diuretic-based antihypertensive stepped-care treatment on the occurrence of heart failure in older persons with isolated systolic hypertension. Design. —Analysis of data from a multicenter, randomized, double-blind, placebo-controlled clinical trial. Participants. —A total of 4736 persons aged 60 years and older with systolic blood pressure between 160 and 219 mm Hg and diastolic blood pressure below 90 mm Hg who participated in the Systolic Hypertension in the Elderly Program (SHEP). Intervention. —Stepped-care antihypertensive drug therapy, in which the step 1 drug is chlorthalidone (12.5-25 mg) or matching placebo, and the step 2 drug is atenolol (25-50 mg) or matching placebo. Main Outcome Measures. —Fatal and nonfatal heart failure. Results. —During an average of 4.5 years of follow-up, fatal or nonfatal heart failure occurred in 55 of 2365 patients randomized to active therapy and 105 of the 2371 patients randomized to placebo (relative risk [RR], 0.51; 95% confidence interval [CI], 0.37-0.71;P Conclusion. —In older persons with isolated systolic hypertension, stepped-care treatment based on low-dose chlorthalidone exerted a strong protective effect in preventing heart failure. Among patients with prior MI, an 80% risk reduction was observed.

Published
1997

31. Extubation outcome following a spontaneous breathing trial with automatic tube compensation versus continuous positive airway pressure.

Author

Cohen JD, Shapiro M, Grozovski E, Lev S, Fisher H, and Singer P

Abstract

OBJECTIVE: We hypothesized that the additional use of automatic tube compensation (ATC) during a spontaneous breathing trial with continuous positive airway pressure (CPAP), by minimizing respiratory work, would result in more patients undergoing successful extubation. DESIGN: Prospective, randomized, controlled study. SETTING: A ten-bed, general intensive care department at a tertiary-care hospital. PATIENTS: Adult patients (n=99) who had undergone mechanical ventilation for >24 hrs and met defined criteria for a weaning trial. INTERVENTIONS: Patients were randomized to undergo a 1-hr spontaneous breathing trial with either ATC with CPAP (ATC group, n=51) or CPAP alone (CPAP group, n=48). ATC was provided by commercially available mechanical ventilators. Patients tolerating the spontaneous breathing trial underwent immediate extubation. The primary outcome measure was successful extubation, defined as the ability to maintain spontaneous breathing for 48 hrs after discontinuation of mechanical ventilation and extubation. MEASUREMENTS AND MAIN RESULTS: There were no significant differences in demographic, respiratory, or hemodynamic characteristics between the two groups at the start of the spontaneous breathing trial. There was a trend for more patients in the ATC group to tolerate the breathing trial and undergo extubation (96% vs. 85%; p=.08). The rate of reintubation was 14% in the ATC group and 24% in the CPAP group (p=.28). Significantly more patients in the ATC group thus met the criteria for successful extubation (82% vs. 65%; p=0.04). CONCLUSION: This is the largest single-center study to date assessing the use of commercially available ATC and suggests that this might be a useful mode for performing a spontaneous breathing trial preceding extubation in a general intensive care population. [ABSTRACT FROM AUTHOR]

Published
2006
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32. Metabolic syndrome: risk factor distribution and 18-year mortality in the multiple risk factor intervention trial.

Author

Eberly LE, Prineas R, Cohen JD, Vazquez G, Zhi X, Neaton JD, Kuller LH, Multiple Risk Factor Intervention Trial Research Group, Eberly, Lynn E, Prineas, Ronald, Cohen, Jerome D, Vazquez, Gabriela, Zhi, Xin, Neaton, James D, and Kuller, Lewis H

Abstract

Objective: To examine the long-term association of metabolic syndrome with mortality among those at high risk for cardiovascular disease (CVD).Research Design and Methods: A total of 10,950 Multiple Risk Factor Intervention Trial (MRFIT) survivors were followed for mortality an additional median 18.4 years (1980-1999). Proportional hazards models examined multivariate-adjusted risks associated with Adult Treatment Panel III-defined metabolic syndrome conditions, with BMI substituted for waist circumference.Results: At MRFIT annual visit 6, 4,588 (41.9%) men, mean age (+/-SD) 53.0 +/- 5.9 years, had metabolic syndrome and 6,362 did not. Comparing men with metabolic syndrome to men without, adjusted hazard ratios (HRs) were 1.21 (95% CI 1.13-1.29), 1.49 (1.35-1.64), and 1.51 (1.34-1.70) for 18-year total, CVD, and coronary heart disease mortality, respectively. Among men with metabolic syndrome, elevated glucose (1.54 [1.34-1.78]) and low HDL cholesterol (1.45 [1.17-1.54]) were most predictive of CVD mortality, followed by elevated BMI (1.34 [1.17-1.54]), elevated blood pressure (1.25 [0.98-1.58]), and elevated triglycerides (1.06 [0.86-1.30]). In contrast, for men without metabolic syndrome, the HR for low HDL cholesterol was 1.02 (0.86-1.22). Among metabolic syndrome men with no nonfatal CVD event, smokers with elevated LDL cholesterol showed higher CVD mortality (1.79 [1.22-2.63]) compared with nonsmokers without elevated LDL cholesterol; this additional risk was even greater for metabolic syndrome men with a nonfatal CVD event (2.11 [1.32-3.38]).Conclusions: Metabolic syndrome is associated with an increased risk of mortality. Among those with metabolic syndrome, risk is further increased by having more metabolic syndrome conditions, by cigarette smoking, and by elevated LDL cholesterol. Primary prevention of each metabolic syndrome condition should be emphasized, and presence of each condition should be treated in accordance with current guidelines. [ABSTRACT FROM AUTHOR]

Published
2006
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33. A calcium antagonist vs a non-calcium antagonist hypertension treatment strategy for patients with coronary artery disease. The International Verapamil-Trandolapril Study (INVEST): a randomized controlled trial.

Author

Pepine CJ, Handberg EM, Cooper-DeHoff RM, Marks RG, Kowey P, Messerli FH, Mancia G, Cangiano JL, Garcia-Barreto D, Keltai M, Erdine S, Bristol HA, Kolb HR, Bakris GL, Cohen JD, Parmley WW, INVEST (International Verapamil-Trandolapril Study) Investigators, Pepine, Carl J, Handberg, Eileen M, and Cooper-DeHoff, Rhonda M

Abstract

Context: Despite evidence of efficacy of antihypertensive agents in treating hypertensive patients, safety and efficacy of antihypertensive agents for coronary artery disease (CAD) have been discerned only from subgroup analyses in large trials.Objective: To compare mortality and morbidity outcomes in patients with hypertension and CAD treated with a calcium antagonist strategy (CAS) or a non-calcium antagonist strategy (NCAS).Design, Setting, and Participants: Randomized, open label, blinded end point study of 22 576 hypertensive CAD patients aged 50 years or older, which was conducted September 1997 to February 2003 at 862 sites in 14 countries.Interventions: Patients were randomly assigned to either CAS (verapamil sustained release) or NCAS (atenolol). Strategies specified dose and additional drug regimens. Trandolapril and/or hydrochlorothiazide was administered to achieve blood pressure goals according to guidelines from the sixth report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC VI) of less than 140 mm Hg (systolic) and less than 90 mm Hg (diastolic); and less than 130 mm Hg (systolic) and less than 85 mm Hg (diastolic) if diabetes or renal impairment was present. Trandolapril was also recommended for patients with heart failure, diabetes, or renal impairment.Main Outcome Measures: Primary: first occurrence of death (all cause), nonfatal myocardial infarction, or nonfatal stroke; other: cardiovascular death, angina, adverse experiences, hospitalizations, and blood pressure control at 24 months.Results: At 24 months, in the CAS group, 6391 patients (81.5%) were taking verapamil sustained release; 4934 (62.9%) were taking trandolapril; and 3430 (43.7%) were taking hydrochlorothiazide. In the NCAS group, 6083 patients (77.5%) were taking atenolol; 4733 (60.3%) were taking hydrochlorothiazide; and 4113 (52.4%) were taking trandolapril. After a follow-up of 61 835 patient-years (mean, 2.7 years per patient), 2269 patients had a primary outcome event with no statistically significant difference between treatment strategies (9.93% in CAS and 10.17% in NCAS; relative risk [RR], 0.98; 95% confidence interval [CI], 0.90-1.06). Two-year blood pressure control was similar between groups. The JNC VI blood pressure goals were achieved by 65.0% (systolic) and 88.5% (diastolic) of CAS and 64.0% (systolic) and 88.1% (diastolic) of NCAS patients. A total of 71.7% of CAS and 70.7% of NCAS patients achieved a systolic blood pressure of less than 140 mm Hg and diastolic blood pressure of less than 90 mm Hg.Conclusion: The verapamil-trandolapril-based strategy was as clinically effective as the atenolol-hydrochlorothiazide-based strategy in hypertensive CAD patients. [ABSTRACT FROM AUTHOR]

Published
2003
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34. Torsades de pointes, a potential complication of diuretic-induced hypokalemia and hypomagnesemia in patients with congestive heart failure: conference presentation of a generic patient.

Author

Cohen JD, Blumenthal R, Horn HR, Weintraub H, and Weglicki W

Abstract

Background: Despite improvements in care, the prognosis for patients with congestive heart failure (CHF) remains poor. Fifty percent of patients with CHF suffer from arrhythmia and sudden cardiac death. This may be attributable in part to the use of medications that contribute to electrolyte imbalance.Objective: This article presents a case report of a woman with CHF due to left ventricular systolic dysfunction.Results: The case report involved a 52-year-old white woman with a history of paroxysmal atrial fibrillation, atypical chest pain, and dyslipidemia. Her medical treatment had included the use of furosemide (a loop diuretic), digoxin, and sotalol; she subsequently developed torsades de pointes (TdP). An electrocardiogram showed normal sinus rhythm; the QTc interval was 530 msec. Levels of digoxin, K+, and Mg2+ were 1.8 ng/mL, 3.5 mEq/L, and 1.5 mEq/L, respectively. Results of a Holter monitor recording suggested that the hypomagnesemia and hypokalemia, interacting with the digoxin and sotalol, potentiated the development of a prolonged QT interval. To ensure the TdP did not recur, an IV bolus of Mg2+ was administered and oral triamterene therapy was added to the patient's current medications. These additions appeared to correct the electrolyte imbalance.Conclusion: This case exemplifies the importance of recognizing and managing electrolyte imbalance in the treatment of patients with CHF. [ABSTRACT FROM AUTHOR]

Published
2002
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35. Ischemic Digital Ulcers Affect Hand Disability and Pain in Systemic Sclerosis

Author

Mouthon, Luc, Carpentier, Patrick H., Lok, Catherine, Clerson, Pierre, Gressin, Virginie, Hachulla, Eric, Bérezné, Alice, Diot, Elisabeth, Khau Van Kien, Aurélie, Jego, Patrick, Agard, Christian, Duval-Modeste, Anne Bénédicte, Sparsa, Agnès, Puzenat, Eve, Richard, Marie-Aleth, Lok, C, Thuillier, D, Le Clec’h, C, Duchêne, F, Puzenat, E, Prey, S, Solanilla, A, Bourgault-Villada, I, Boulogne, Le Hello, C, Bienvenu, B, Berthier, S, Muller, G, Remond, B, Carpentier, P, Damade, R, Beneton-Benhard, N, Maillard, H, Barcat, D, Hachulla, E, Hatron, PY, Sparsa, A, Doffoel-Hantz, V, Fauchais, AL, Geffray, L, Coppéré, B, Jullien, D, Granier, F, Harle, JR, Granel, B, Richard, MA, Maurier, F, Cohen, JD, Khau Van Kien, A, Granel-Brocard, F, Agard, C, Queyrel, V, Corondan, A, Bérezné, A, Mouthon, L, Crickx, B, Picard Dahan, C, Eguia, B, Francès, C, Emmerich, J, Fiessinger, JN, Mathian, A, Lazareth, I, Michon-Pasturel, U, Viallard, JF, Wierzbicka-Hainaut, E, Fleuret, C, Léonard-Lefèbvre, F, Reguiai, Z, Jego, P, Perdriger, A, Modeste Duval, AB, Bonnin, A, Chatelus, E, Poindron, V, Diot, E, Bica-Chicinas, D, Roger, M, Wahl, D, and Zuily, S

Abstract

Objective.Ischemic digital ulcers (DU) are frequent and severe complications of systemic sclerosis (SSc). The purpose of our study was to assess the effect of DU on hand disability and pain in patients with SSc.Methods.The Evaluation of the Impact of Recurrent Ischemic DU on Hand Disability in Patients with SSc (ECLIPSE) is a prospective, multicenter, noninterventional study with a 2-year followup. Patients with SSc who experienced at least 1 DU in the previous year and received bosentan therapy were included between October 2009 and March 2011. This cohort is described at the time of inclusion.Results.There were 190 patients (132 females) from 53 centers. Mean age ± SD was 43 ± 15 years at SSc diagnosis and 53 ± 15 years at inclusion. In 105 patients (56.2%), DU were the first non-Raynaud symptoms of SSc. The mean time interval between the occurrence of Raynaud phenomenon and the first DU episode was 6.6 ± 9.1 years. The mean numbers of active DU and fingers affected per patient for both hands were 2.3 ± 1.8 and 2.2 ± 1.6, respectively. Presence of active DU at inclusion was significantly associated with pain and impaired hand function: Visual Analog Scale for pain (0 to 10) was 6.2 ± 2.6 versus 2.5 ± 2.4 (p < 0.0001) and Cochin Hand Function Scale for hand disability (0 to 90) was 38 ± 20 versus 25 ± 19 (p < 0.0001), respectively.Conclusion.DU represent a major sign of SSc, often affecting multiple fingers and both hands. They are significantly associated with pain and hand disability.

Published
2014
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37. Mortality following ventricular arrhythmia suppression by encainide, flecainide, and moricizine after myocardial infarction. The original design concept of the Cardiac Arrhythmia Suppression Trial (CAST).

Author

Epstein AE, Hallstrom AP, Rogers WJ, Liebson PR, Seals AA, Anderson JL, Cohen JD, Capone RJ, Wyse DG, Epstein, A E, Hallstrom, A P, Rogers, W J, Liebson, P R, Seals, A A, Anderson, J L, Cohen, J D, Capone, R J, and Wyse, D G

Abstract

Objective: To test the hypothesis that in survivors of myocardial infarction, the suppression of ventricular premature depolarizations improves survival free of cardiac arrest and arrhythmic death.Design: International, prospective, multicenter, randomized, placebo-controlled trial.Setting: University and community hospitals.Patients: A total of 3549 patients with myocardial infarction and left ventricular dysfunction.Intervention: Administration of encainide, flecainide, moricizine, or placebo to suppress ventricular premature depolarizations.Main Outcome Measures: Overall survival and survival free of cardiac arrest or arrhythmic death were compared in patients randomized to long-term, active antiarrhythmic drug therapy vs corresponding placebo, using the stratified log rank statistic.Results: At 1 year from the time of randomization to blinded therapy, 95% of placebo-treated patients vs 90% of active drug-treated patients remained alive (P = .0006). Similarly, at 1 year, 96% of placebo-treated patients vs 93% of active drug-treated patients remained free of cardiac arrest or arrhythmic death (P = .003).Conclusions: The suppression of asymptomatic or mildly symptomatic ventricular arrhythmias after myocardial infarction does not improve survival and can increase mortality. Treatment strategies designed solely to suppress these arrhythmias should no longer be followed. [ABSTRACT FROM AUTHOR]

Published
1993
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38. New CAD risk factors: interesting, but how useful?

Author

Carney RM, Cohen JD, and Rosenson R

Abstract

Homocysteine, Lp(a), infectious agents, emotional state--these and other factors have all been linked to an increased risk of coronary artery disease. Should you be screening patients for more than the traditional risk factors? If so, what can you do with this information? [ABSTRACT FROM AUTHOR]

Published
1998

39. Who really needs cholesterol-lowering drugs?... cholesterol update.

Author

Cohen JD, Pearson TA, and Weart CW

Abstract

Many hypercholesterolemic patients -- not just those with a history of heart disease -- may benefit from the cholesterol-lowering statins. But older drugs still have crucial roles. And, most important, so does diet. [ABSTRACT FROM AUTHOR]

Published
1996

46. Functional impairment of systemic scleroderma patients with digital ulcerations: results from the DUO Registry

Author

Guillevin, L, Hunsche, E, Denton, Cp, Krieg, T, Schwierin, B, Rosenberg, D, Matucci-Cerinic, M, Raffier, B, Hirschi, M, Trautinger, F, Schmidt, P, Stetter, M, Hundstorfer, M, Reinhart, V, Monshi, B, Pirkhammer, D, Richter, L, Hamberger, N, Metz, S, Feldmann, R, Semmelweis, K, Lackner, K, Tomi, N, Kolle, H, Hafner, F, Brodmann, M, Kuen-Spiegel, M, Minmair, G, Heil, Pm, Broil, H, Holzer, G, Illmer, X, Rintelen, B, Sautner, J, Takacs, M, Thun, M, Zemanova, I, Soukup, T, Smrzova, A, Bohmova, J, Prochazkova, L, Nemec, P, Fojtik, Z, Suchy, D, Becvar, R, Olsen, Ab, Sondergaard, Kh, Luosu jarvi, R, Vidqvist, Kl, Madaule, S, Beneton, N, Maillard, H, Charlanne, H, Granelbrocard, F, Hachulla, E, Hatron, Py, Jourdain, N, Lambert, M, Launay, D, Morell, S, Woijtasik, G, Skowron, F, Zenone, T, Dadban, A, Lok, C, Ferrandiz, D, Magybertrand, N, Moiton, Mp, Taieb, A, Balquiere, S, Belin, E, Droitcourt, C, Julien, S, Prey, S, Boulon, C, Constans, J, Doutre, Ms, Kostrzwewa, E, Richez, C, Greco, M, Misery, L, Sassolas, B, Collet, E, Berthier, S, Leguy-Seguin, V, Imbert, B, Carpentier, P, Blaise, S, Couraud, A, Doeffel-Hantz, V, Spars, A, Bezanahary, H, Boussely, N, Dumonteil, S, Fauchais, Al, Goudran, G, Loustaud-Ratti, V, Manea, P, Vidal, E, Coppere, B, Desmursclavel, H, Girard-Madoux, Mh, Hot, A, Ninet, J, Granel, B, Cohen, Jd, Keynote, A, Khau van Kien, A, Le Quellec, A, Riviere, S, Rullier, P, Bessis, D, Farcas, C, Bravetti, V, Moline, T, Wahl, D, Zuily, S, Granel-Brocard, F, Agard, C, Durant, C, Fuzibet, Jg, Queyrel, V, Berezne, A, Mouthon, L, Cabane, J, Tiev, K, Toledano, C, Lazareth, I, Michon-Pasturel, U, Priollet, P, Reguiai, Z, Cazaletslacoste, C, Jego, P, Letremy, A, Perlat, A, Duval-Modeste, Ab, Chatelus, E, Chiffot, H, Sibillia, J, Sordet, C, Adoue, D, Couret, B, Moulis, G, Pugnet, G, Sailler, L, Diot, E, Gaches, F, Farge, D, Keshtmand, H, Frances, C, von Elling, A, Bora, D, Ebel, J, Ahmadi-Simab, K, Klein, E, Hahn, K, Schulze, K, Rasche, C, Riemekasten, G, Lee, Hh, Deuschle, K, Mattat, K, Becker, M, Worm, M, Mensing, C, Klings, D, Mensing, H, Messall, J, Zuper, R, Eilbacher, P, Saar, P, Kaufmann, P, Hallermann, C, Schmidt, K, Wahn, H, Schildt, K, Schuart, T, Kaczmarczyk, A, Kellner, C, von Oelhafen, J, Baron von Bildering, P, Kunze, S, Kleiner, Hj, Alsheimer, B, Schuetz, N, Miirker-Hermann, E, Gottl, Kh, Weiss, E, Reischel, N, Kern, S, Goettl, Kh, Goetheuniversitiitsklinikum, Jw, Himsel, A, Henkemeier, U, Schwarting, A, Hazenbiller, A, Nichelmann, V, Rumbaur, C, Boesenberg, I, Schmeiser, T, Mueller-Ladner, U, Unholzer, A, Starz, H, Welzel, J, Plaumann, K, Stoeckl, F, Sperling, S, Podda, M, Wagner, N, Rapprich, H, Niedermeier, A, Messer, G, Sardy, M, Bekou, V, Dill-MUller, D, Wlodarz, M, Belloni, B, Huettig, B, Ziai, M, Hein, R, Kneitz, C, Federow, I, Schneider, K, Semmler, M, Hapke, S, Metzler, C, Stein, T, Enderlein, M, Kayser, M, Werthmann, M, Guenther, Cu, Neul, S, Hellmich, B, Loeffler, C, Pflugfelder, J, Karaenke, P, Mueglich, C, Tony, Hp, Marina, P, Popp, M, Mittag, M, Baumann, C, Scheib, Eg, Brand, H, Wilhelm, Hu, Bohm, J, Dyballa, J, Boehm, J, Taggeselle, J, Luthke, K, Wuerzburg, I, Niefanger, K, Mayer, L, Drabek, J, Harmuth, W, Dietl, S, Moritz, D, Gause, A, Gaubitz, M, Hallecker, A, Krupp, E, Rumpel, H, Moosig, F, Frey, P, Kahl, S, Linke, M, Merk, B, Bloching, Hh, Ochs, W, Kurthen, R, Eiden, E, Guertler, I, Aries, Pm, Kirchberg, S, Jahnke, K, Mettler, S, Toeller, S, Zwenger, S, Langer, He, Deininger, F, Hartmann, F, Neeck, G, Neek, G, Wernitzsch, H, Meier, L, Herr, U, Meier, U, Aaig, W, Bruckner, L, Sheikh, N, Wollenhaupt, J, Krog, B, Wollersdorfer, E, Hall, R, Diehm, C, Tiggers, C, Peters, J, Kirschke, J, Schroeder, Jo, Zeuner, R, Uhlig, S, Barth, S, Huegel, R, Glaeser, R, Schaefer, C, Monshausen, M, Mengden, T, Funkert, A, Blank, N, Lupaschko, S, Voss, B, Megahed, M, Sadeghlar, F, Seidel, M, Wasmuth, Jc, Kreuter, A, Vosswinkel, J, Pfoehler, C, Gerber, A, Haust, M, Hoff, Np, Mota, R, Akanay-Diesel, S, Homey, B, Katzemich, A, Erfurt-Berge, C, Sticherling, M, Beyer, C, Distler, J, Mitchell, A, Freundlieb, C, Rushentsova, U, Hermanns, G, Blaschke, S, Fiene, M, Wessel, C, Norgauer, J, Rabe, B, Schuster, J, Scholz, J, Kremer, K, Robakidze-Torbahn, M, Moinzadeh, P, Dohse, A, Muhlack, A, Schultz, L, Schult, S, Frambach, Y, Kruse, S, Kettenbach, A, Fell, I, Schweda, K, Steinbrink, K, Podobinska, M, Fieri beck, G, Schanz, S, Pfeiffer, C, Hassel, R, Herrgott, I, Sunderkoetter, C, Guenzel, J, Athanassiou, P, Dimitroulas, T, Settas, L, Kritikos, I, Tsifetaki, N, Garyfallos, A, Vasilopoulos, D, Boura, P, Kamali, S, Aslanidis, S, Vlachoyannopoulos, P, Galanopoulo, V, Sakkas, L, Koutroubas, A, Elezoglou, T, Galanopoulos, N, Grier, A, Murray, M, O'Rourke, M, Del Papa, N, Maglione, W, Zeni, S, Foti, R, Benenati, A, De Vita, S, Ferraccioli, G, Grassi, W, de Angeli, R, Pomponio, G, Mussi, A, Colonna, L, Airo, P, Zingarelli, S, Scorza, R, Serverino, A, Puppo, F, Negrini, S, Roma, I, Salsano, F, Triolo, G, Mazzuca, S, Carignola, R, Gatti, S, Lunardi, G, Riccieri, V, Salvarani, C, Bajocchi, G, Varcasia, G, Marasini, B, Belloll, L, de Luca, R, Stisi, S, Bellissimo, S, Fusaro, E, Pellerito, R, Cozzi, F, Rizzo, M, Bartoluzzi, A, Trotta, F, Cantatore, F, Corrado, A, Ferri, C, Colaci, M, Malavolta, N, Mule, R, Galeazzi, M, Lapadula, G, Mathieu, A, Vacca, A, Giacomelli, R, Cipriani, P, Montecucco, Cm, Codullo, V, Bucci, R, Battaglia, E, Valentini, G, Cuomo, G, Terlizzi, N, Serafino, L, Reumatologia, Uo, Bombardieri, S, Della Rossa, A, Doveri, M, Perricone, R, de Mattia, M, Pallotta, S, Groenendael, Jh, Seys, P, Goekoop, Rj, Han, Kh, Wlarvens, M, Bonte-Mineur, F, de Bois MH, de Beus WM, van Zeben, D, Vonk, M, Knaapen, Hk, Smit, A, Bootsma, H, Ton, E, Voskuyl, A, Dutmer, Ea, Stalk, Jn, Madland, Tm, Seip, M, Hoffmann Vold AM, Bitter, H, Stocklund Thomsen, R, Resende, C, Ponte, C, Martinho, S, Silva, F, Ferreira, P, Grilo, A, Riso, N, Santos, C, Camara, I, Costa, J, Alves, J, Oliveira, S, Almeida, I, Silva, I, Cordeiro, A, Coelho, P, Lukac, J, Dolnicar, As, Espinosa, G, Mejia, Jc, Ramos, M, Plasin Rodriguez MA, Mera, A, Blanco, Js, Diaz, Jj, Losada, L, Perez, E, Maneiro, Jr, Caamano, M, Fermindez, S, Insua, Sa, Barbado, J, Fonseca, Em, Nufio, Fj, Castellvi, I, Garcia de Ia Pena, P, Bellido, D, Paulino, M, Garcia, Pv, Salas, V, Minguez, Md, Sanchez, Ma, Urrego, C, Martin, I, Rueda, A, Calvo, J, Ripoll, Mm, Torres, Mc, Corteguera, M, Maceiras, F, Cruz, J, Mosquera, Ja, Gomez, R, Area, B, Carrio, I, Rubio, M, Castellvi Barranco, I, Santos, P, Simeon, Cp, Fonollosa, V, Egurbide, Mv, Garcia de Vicuna, R, Vicente, E, Villaverde, V, Fernandez, C, Garcia, E, Uson, J, Miguelez, R, Callejas, Jl, Ortego, N, Roman, J, Alegre-Sancho, Jj, Robles, A, Rios, Jj, Bonilla, Mg, Sanchez Andrade, A, Vazquez, Tr, Miranda, Ja, Saez, L, Zea, A, De la Puente, C, Martinez, Fg, Aguirre, Ma, Collado, P, Cruz, A, Crespo, M, Sanchez-Roman, J, Castillo, Mj, Garcia, Am, Muniz, G, Hedin, Pj, Stahl, C, Bracin, T, Nordin, A, Albertsson, K, Rydvald, Y, Thorsson, C, Hermansson, E, Maurer, B, Verner, D, Schmidt Bosshard, R, Hall, F, Murphy, K, Lamb, J, Anderson, M, Moots, R, Buch, M, Bissell, L, Madhok, R, Hampson, R, D'Cruz, D, Choong, Lm, Gordon, P, Dobson, J, Salerno, R, Nisar, M, Williams, C, Wilcox, L, Denton, C, Ochiel, R, Ngcozana, T, Parker, L, Vincent, R, Mchugh, N, Cole, S, Brown, S, James, J, Herrick, A, Manning, J, Moore, T, Faizal, A, Skyes, H, Smythe, A, Hamilton, A., L., Guillevin, E., Hunsche, C. P., Denton, T., Krieg, B., Schwierin, D., Rosenberg, DUO Registry Group: B Raffier, Matucci-Cerinic M., Hirschi, M, Trautinger, F, Schmidt, P, Stetter, M, Hundstorfer, M, Reinhart, V, Monshi, B, Pirkhammer, D, Richter, L, Hamberger, N, Metz, S, Feldmann, R, Semmelweis, K, Lackner, K, Tomi, N, Kolle, H, Hafner, F, Brodmann, M, Kuen-Spiegel, M, Minmair, G, M Heil, P, Broil, H, Holzer, G, Illmer, X, Rintelen, B, Sautner, J, Takacs, M, Thun, M, Zemanova, I, Soukup, T, Smrzova, A, Bohmova, J, Prochazkova, L, Nemec, P, Fojtik, Z, Suchy, D, Becvar, R, B Olsen, A, H Sondergaard, K, Luosu jarvi, R, Vidqvist, K-L, Madaule, S, Beneton, N, Maillard, H, Charlanne, H, Granelbrocard, F, Hachulla, E, Y Hatron, P, Jourdain, N, Lambert, M, Launay, D, Morell, S, Woijtasik, G, Skowron, F, Zenone, T, Dadban, A, Lok, C, Ferrandiz, D, Magybertrand, N, P Moiton, M, Taieb, A, Balquiere, S, Belin, E, Droitcourt, C, Julien, S, Prey, S, Boulon, C, Constans, J, S Doutre, M, Kostrzwewa, E, Richez, C, Greco, M, Misery, L, Sassolas, B, Collet, E, Berthier, S, Leguy-Seguin, V, Imbert, B, Carpentier, P, Blaise, S, Couraud, A, Doeffel-Hantz, V, Spars, A, Bezanahary, H, Boussely, N, Dumonteil, S, L Fauchais, A, Goudran, G, Loustaud-Ratti, V, Manea, P, Vidal, E, Coppere, B, Desmursclavel, H, H Girard-Madoux, M, Hot, A, Ninet, J, Granel, B, D Cohen, J, Keynote, A, Khau van Kien, A, Le Quellec, A, Riviere, S, Rullier, P, Bessis, D, Farcas, C, Bravetti, V, Moline, T, Wahl, D, Zuily, S, Granel-Brocard, F, Agard, C, Durant, C, G Fuzibet, J, Queyrel, V, Berezne, A, Guillevin, L, Mouthon, L, Cabane, J, Tiev, K, Toledano, C, Lazareth, I, Michon-Pasturel, U, Priollet, P, Reguiai, Z, Cazaletslacoste, C, Jego, P, Letremy, A, Perlat, A, B Duval-Modeste, A, Chatelus, E, Chiffot, H, Sibillia, J, Sordet, C, Adoue, D, Couret, B, Moulis, G, Pugnet, G, Sailler, L, Diot, E, Gaches, F, Farge, D, Keshtmand, H, Frances, C, von Elling, A, Bora, D, Ebel, J, Ahmadi-Simab, K, Klein, E, Hahn, K, Schulze, K, Rasche, C, Riemekasten, G, H Lee, H, Deuschle, K, Mattat, K, Becker, M, Worm, M, Mensing, C, Klings, D, Mensing, H, Messall, J, Zuper, R, Eilbacher, P, Saar, P, Kaufmann, P, Hallermann, C, Schmidt, K, Wahn, H, Schildt, K, Schuart, T, Kaczmarczyk, A, Kellner, C, von Oelhafen, J, Baron von Bildering, P, Kunze, S, J Kleiner, H, Alsheimer, B, Schuetz, N, Miirker-Hermann, E, Gottl, K-H, Weiss, E, Reischel, N, Kern, S, H Goettl, K, Goetheuniversitiitsklinikum, J-W, Himsel, A, Henkemeier, U, Schwarting, A, Hazenbiller, A, Nichelmann, V, Rumbaur, C, Boesenberg, I, Schmeiser, T, Mueller-Ladner, U, Unholzer, A, Starz, H, Welzel, J, Plaumann, K, Stoeckl, F, Sperling, S, Podda, M, Wagner, N, Rapprich, H, Niedermeier, A, Messer, G, Sardy, M, Bekou, V, Dill-MUller, D, Wlodarz, M, Belloni, B, Huettig, B, Ziai, M, Hein, R, Kneitz, C, Federow, I, Schneider, K, Semmler, M, Hapke, S, Metzler, C, Stein, T, Enderlein, M, Kayser, M, Werthmann, M, U Guenther, C, Neul, S, Hellmich, B, Loeffler, C, Pflugfelder, J, Karaenke, P, Mueglich, C, P Tony, H, Marina, P, Popp, M, Mittag, M, Baumann, C, G Scheib, E, Brand, H, U Wilhelm, H, Bohm, J, Dyballa, J, Boehm, J, Taggeselle, J, Luthke, K, Wuerzburg, I, Niefanger, K, Mayer, L, Drabek, J, Harmuth, W, Dietl, S, Moritz, D, Gause, A, Gaubitz, M, Hallecker, A, Krupp, E, Rumpel, H, Moosig, F, Frey, P, Kahl, S, Linke, M, Merk, B, H Bloching, H, Ochs, W, Kurthen, R, Eiden, E, Guertler, I, M Aries, P, Kirchberg, S, Jahnke, K, Mettler, S, Toeller, S, Zwenger, S, E Langer, H, Deininger, F, Hartmann, F, Neeck, G, Neek, G, Wernitzsch, H, Meier, L, Herr, U, Meier, U, Aaig, W, Bruckner, L, Sheikh, N, Wollenhaupt, J, Krog, B, Wollersdorfer, E, Hall, R, Diehm, C, Tiggers, C, Peters, J, Kirschke, J, O Schroeder, J, Zeuner, R, Uhlig, S, Barth, S, Huegel, R, Glaeser, R, Schaefer, C, Monshausen, M, Mengden, T, Funkert, A, Blank, N, Lupaschko, S, Voss, B, Megahed, M, Sadeghlar, F, Seidel, M, C Wasmuth, J, Kreuter, A, Vosswinkel, J, Pfoehler, C, Gerber, A, Haust, M, P Hoff, N, Mota, R, Akanay-Diesel, S, Homey, B, Katzemich, A, Erfurt-Berge, C, Sticherling, M, Beyer, C, Distler, J, Mitchell, A, Freundlieb, C, Rushentsova, U, Hermanns, G, Blaschke, S, Fiene, M, Wessel, C, Norgauer, J, Rabe, B, Schuster, J, Scholz, J, Kremer, K, Robakidze-Torbahn, M, Moinzadeh, P, Dohse, A, Muhlack, A, Schultz, L, Schult, S, Frambach, Y, Kruse, S, Kettenbach, A, Fell, I, Schweda, K, Steinbrink, K, Podobinska, M, Fieri beck, G, Schanz, S, Pfeiffer, C, Hassel, R, Herrgott, I, Sunderkoetter, C, Guenzel, J, Athanassiou, P, Dimitroulas, T, Settas, L, Kritikos, I, Tsifetaki, N, Garyfallos, A, Vasilopoulos, D, Boura, P, Kamali, S, Aslanidis, S, Vlachoyannopoulos, P, Galanopoulo, V, Sakkas, L, Koutroubas, A, Elezoglou, T, Galanopoulos, N, Grier, A, Murray, M, O'Rourke, M, Del Papa, N, Maglione, W, Zeni, S, Foti, R, Benenati, A, De Vita, S, Ferraccioli, G, Grassi, W, de Angeli, R, Pomponio, G, Mussi, A, Colonna, L, Airo, P, Zingarelli, S, Scorza, R, Serverino, A, Puppo, F, Negrini, S, Roma, I, Salsano, F, Triolo, G, Mazzuca, S, Carignola, R, Gatti, S, Lunardi, G, Riccieri, V, Salvarani, C, Bajocchi, G, Varcasia, G, Marasini, B, Belloll, L, Matucci-Cerinic, M, de Luca, R, Stisi, S, Bellissimo, S, Fusaro, E, Pellerito, R, Cozzi, F, Rizzo, M, Bartoluzzi, A, Trotta, F, Cantatore, F, Corrado, A, Ferri, C, Colaci, M, Malavolta, N, Mule, R, Galeazzi, M, Lapadula, G, Mathieu, A, Vacca, A, Giacomelli, R, Cipriani, P, M Montecucco, C, Codullo, V, Bucci, R, Battaglia, E, Valentini, G, Cuomo, G, Terlizzi, N, Serafino, L, O Reumatologia, U, Bombardieri, S, Della Rossa, A, Doveri, M, Perricone, R, de Mattia, M, Pallotta, S, M Groenendael, J H L, Seys, P, J Goekoop, R, H Han, K, Wlarvens, M, Bonte-Mineur, F, and W de Bois, M H

Subjects
Adult, Employment, Male, Registrie, Scleroderma, Systemic, Systemic, Middle Aged, Scleroderma, Fingers, Disability Evaluation, Cost of Illness, Skin Ulcer, Activities of Daily Living, Finger, Humans, Female, Registries, Self Report, Human
Abstract

Digital ulcers (DUs) are frequent manifestations of systemic scleroderma (SSc). This study assessed functional limitations due to DUs among patients enrolled in the Digital Ulcer Outcome (DUO) Registry, an international, multicentre, observational registry of SSc patients with DU disease.Patients completed at enrolment a DU-specific functional assessment questionnaire with a 1-month recall period, measuring impairment in work and daily activities, and hours of help needed from others. Physician-reported clinical parameters were used to describe the population. For patients who completed at least part of the questionnaire, descriptive analyses were performed for overall results, and stratified by number of DUs at enrolment.This study included 2327 patients who completed at least part of the questionnaire. For patients with 0, 1-2, and ≥3 DUs at enrolment, mean overall work impairment during the prior month among employed/self-employed patients was 28%, 42%, and 48%, respectively. Across all included patients, ability to perform daily activities was impaired on average by 35%, 54%, and 63%, respectively. Patients required a mean of 2.0, 8.7, and 8.8 hours of paid help and 17.0, 35.9, and 63.7 hours of unpaid help, respectively, due to DUs in the prior month. Patients with DUs had more complications and medication use than patients with no DUs.With increasing number of DUs, SSc patients reported more impairment in work and daily activities and required more support from others.

47. EFFECT OF THE ANTIARRHYTHMIC AGENT MORICIZINE ON SURVIVAL AFTER MYOCARDIAL-INFARCTION

Author

ROGERS, WJ, EPSTEIN, AE, ARCINIEGAS, JG, CROSSLEY, GH, DAILEY, SM, KAY, GN, LITTLE, RE, MACLEAN, WAH, PAPAPIETRO, SE, PLUMB, VJ, SILBER, S, BAKER, AR, CARLISLE, K, COHEN, N, COX, M, THOMAS, C, LEVSON, L, VONHAGEL, D, WALTON, AE, PRATT, CM, MAHMARIAN, J, MORRIS, G, CAPONE, RJ, BERGER, EE, CHMIELEWSKI, C, GORKIN, L, KHAN, AH, KORR, K, HANDSHAW, K, CONNOLLY, E, FITZPATRICK, D, CAMERON, T, WYSE, DG, DUFF, HJ, MITCHELL, LB, GILLIS, AM, WARNICA, JW, SHELDON, RS, LESOWAY, NR, KELLEN, J, HALE, C, INKSTER, M, BRODSKY, M, WOLFF, L, ALLEN, B, ZELMAN, R, THOMAS, G, CAUDILLO, G, TAKEDA, D, SHERWOOD, C, RANAZZI, R, RAPAPORT, E, DOHRMANN, ML, RASKIN, S, DREW, DW, SOMELOFSKI, CA, DANFORTH, JW, HUI, PY, JOHNSON, MR, LABARCA, JR, WALDO, AL, CARLSON, MD, ADLER, DS, HOLLAND, JB, BUCHTER, CM, BAHLER, RC, PAMELIA, FX, JOSEPHSON, RA, HENTHORN, RW, ZUELGARAY, JG, WOOD, K, REDMON, P, VARGAS, MA, VARGO, L, SCHALLER, SE, KOBUS, CE, CHOBAN, NL, BIGGER, JT, GREENBERG, HM, GREGORY, JJ, HOCHMAN, JS, RADOSLOVICH, G, STEINBERG, JS, ROTHBART, ST, CASE, R, DWYER, EM, SQUATRITO, A, KELLY, M, CAMPION, JM, TORMEY, D, ANTHONY, R, CALLAGHAN, E, CHAPNICK, M, RIPLEY, B, FONTANA, C, SCHLANT, RC, ARENSBERG, D, CORSO, JA, HURST, JW, MORRIS, DC, SHERMAN, SW, SILVERMAN, BD, SILVERMAN, ME, ROBERTS, JS, BALLOU, SK, JEFFRIES, VD, BRACKNEY, BA, SEALS, AA, HARTLEY, J, BAKER, RM, GILMOUR, KE, BAKER, SB, HOWARD, J, KATZ, RJ, BESCH, GA, BRILL, D, DIBIANCO, R, DONOHUE, D, FISHER, G, FRANCIS, C, FRIEDMAN, D, GOLDBERG, D, GOLDBERG, S, KOSS, G, LARCA, L, LEONARD, R, LINDGREN, K, RONAN, J, ROSENBLATT, A, ROSING, D, ROSS, A, ROTSZTAIN, A, SHAWL, F, SINDERSON, T, STEVENSON, R, TINKER, B, VARGHESE, J, YACKEE, J, BIGHAM, H, FRANKLIN, W, GOLD, R, GRAHAM, G, GROSSBERG, D, HOARE, R, LEVY, W, MAHMOOD, T, TANNENBAUM, E, TULLNER, W, EISENHOWER, E, GERACI, T, WILHELMSEN, L, BERGSTRAND, R, FREDLUND, BO, SIGURDSSON, A, SIVERTSSON, R, SWEDBERG, K, HOULTZ, B, WIKLUND, I, SCHLYTER, G, HEDELIN, G, LEIJON, M, MORGANROTH, J, CARVER, J, HOROWITZ, L, KUTALEK, S, PAPA, L, SANDBERG, J, VICTOR, M, CESARE, S, VRABEL, C, TALARICO, K, LUHMANN, S, PALAZZO, D, GOLDSTEIN, S, GOLDBERG, AD, FRUMIN, H, WESTVEER, D, DEBUTLIER, M, SCHAIRER, J, STOMEL, R, FRANK, DM, JARANDILLA, R, DAVEY, D, HASSE, C, SHINNEY, S, MORLEDGE, JH, FARNHAM, DJ, HINDERACKER, PH, MUSSER, WE, DEVRIES, K, KUSHNER, JA, RAO, R, PETERSON, DT, MCCAULEY, CS, BERGEN, TS, BOWMAN, KO, GILLMAN, A, FULLER, L, OBRIEN, J, MORLEDGE, J, DEMARIA, AN, KUO, CS, KAMMERLING, JM, CORUM, J, THIEMANN, M, SCHRODT, R, PETERS, R, SUTTON, F, GOTTLIEB, S, PAPUCHIS, G, MATTIONI, T, TODD, L, CUSACK, C, SCHECK, J, HUANG, SKS, ALPERT, JS, GORE, JM, RYAN, M, COLLETTWILLEY, P, CHAHINE, RA, SEQUEIRA, RF, LOWERY, MH, DELGADO, LM, CORREA, JL, LASO, LJ, HODGES, M, SALERNO, D, ANDERSON, B, COLLINS, R, DENES, P, DUNBAR, D, GRANRUD, G, HAUGLAND, J, HESSION, W, MCBRIDE, J, GORNICK, C, SIMONSON, J, TOLINS, M, ETTINGER, A, PETERSON, S, SLIVKEN, R, GRIMALDI, L, ROY, D, THEROUX, P, LEMERY, R, MORISSETTE, 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RODEN, DM, CAMPBELL, WB, ECHT, DS, LEE, JT, MURRAY, KT, SPELL, JD, BONHOTAL, ST, JARED, LL, THOMAS, TI, GOLDNER, F, RICHARDSON, DW, ROMHILT, DW, ELLENBOGEN, KA, BANE, BB, FIELDS, J, SHRADER, S, POWELL, E, CHAFFIN, CF, WELLS, A, CONWAY, KT, PLATIA, EV, ODONOGHUE, S, TRACY, CM, ALI, N, BOWEN, P, BROOKS, KM, OETGEN, W, WESTON, LT, CARSON, P, OBIASMANNO, D, HARRISON, J, SAYLOR, A, POWELL, S, HAAKENSON, CM, SATHER, MR, MALONE, LA, HALLSTROM, AP, MCBRIDE, R, GREENE, HL, BROOKS, MM, LEDINGHAM, R, REYNOLDSHAERTLE, RA, HUTHER, M, SCHOLZ, M, MORRIS, M, FRIEDMAN, LM, SCHRON, E, VERTER, J, JENNINGS, C, PROSCHAN, M, BRISTOW, JD, DEMETS, DL, FISCH, C, NIES, AS, RUSKIN, J, STRAUSS, H, WALTERS, L, ROGERS, WJ, EPSTEIN, AE, ARCINIEGAS, JG, CROSSLEY, GH, DAILEY, SM, KAY, GN, LITTLE, RE, MACLEAN, WAH, PAPAPIETRO, SE, PLUMB, VJ, SILBER, S, BAKER, AR, CARLISLE, K, COHEN, N, COX, M, THOMAS, C, LEVSON, L, VONHAGEL, D, WALTON, AE, PRATT, CM, MAHMARIAN, J, MORRIS, G, CAPONE, RJ, BERGER, EE, CHMIELEWSKI, C, 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50. Conventional terrorism and critical care.

Author

Singer P, Cohen JD, Stein M, Singer, Pierre, Cohen, Jonathan D, and Stein, Michael

Abstract

Incidents of conventional weapons terror are increasingly part of the reality of the modern world, and in Israel, 19,948 incidents have been reported from September 2000 to December 2003. Most victims are injured in explosions resulting from suicide bombings. Exposure to the blast (primary mechanism of injury) may produce unique injuries affecting gas-containing organs, including perforation of the eardrums (most common injury); pulmonary blast injury, characterized by alveolar capillary disruption and bronchopleural fistulas; and bowel perforation, which is uncommon and may be delayed from 1 to 14 days after the injury. However, most injuries are the result of penetrating trauma (secondary mechanism) resulting from bomb fragments and nails, bolts, and steel pellets embedded in the bomb striking the victim, and blunt trauma (tertiary mechanism) sustained when the victim is propelled against an object by the blast wind. The severity of the injuries is increased when the blast occurs in a confined space. Victims of terror-inflicted injuries have a high Injury Severity Score (30% >16), a high requirement for intensive care unit admission (22.8% in Israel), and have a more prolonged hospital course and higher mortality than victims of any other form of trauma. [ABSTRACT FROM AUTHOR]

Published
2005
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