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Daniel J. Cohen,Steven Schulan,Charles S. Masarsky,Marion Todres-Masarsky 한국한의학연구원 2018 Integrative Medicine Research Vol.7 No.1
This review article proposes a model of integrative care for cardiovascular patients in institutional settings. We review relevant historic and contemporary examples of medical–chiropractic cooperation and a brief review of the literature illustrating the clinical benefits of chiropractic care for patients with cardiovascular disease. The groundwork proposes a distinct research and clinical practice model incorporating the doctor of chiropractic (D.C.) as a synergistic partner with the medical cardiologist coined the Kaleidoscope Model of Integrative Care (KM). While a traditional kaleidoscope does not alter the nature of light itself, the observer does see the ‘raw data’ of colors and shapes, wavelengths, etc. contained within the “potential” of the light itself; left unrecognized, even subtle re-orientations of the instrument changes the perspective. Similarly, the KM is intended as a conduit for slight reorientations to traditional medical–chiropractic–patient hierarchies, thus creating new treatment options and generating robust changes in inter-professional perception of the patient's condition(s) and treatment options. It is hoped that this model will not only serve future patients within hospitals, but that institutions will serve as incubators for better collaboration and research among the majority of free-standing medical and chiropractic practices ultimately benefitting the patient with cardiovascular disease.
Daniel L Cohen,Amir Mari,Anton Bermont,Dana Zelnik Yovel,Vered Richter,Haim Shirin 대한소화기 기능성질환∙운동학회 2023 Journal of Neurogastroenterology and Motility (JNM Vol.29 No.3
Background/AimsClinical rates of fecal incontinence (FI) are known to vary based on race and ethnicity. It is unclear if anorectal manometry (ARM) findings in patients with FI differ based on ethnicity. MethodsHigh-resolution ARM studies performed between 2014-2021 due to FI at 2 hospitals with multiethnic populations were retrospectively reviewed. ResultsFour hundred and seventy-nine subjects were included––87 (18.2%) Arab Israelis, 76 (15.9%) immigrants from the former Soviet Union, and 316 (66.0%) Jewish Israelis. Median age was 67 years old (76.0% women: 90.4% were parous). The Arab Israeli group had higher rates of smoking, diabetes, and obesity. Over 95% of ARM’s were abnormal per the London classification including 23% with “combined anal hypotension and hypocontractility,” 36% with “anal normotension with anal hypocontractility,” 67% with “dyssynergia,” and 65% with either “rectal hyposensation” or “borderline rectal hyposensation.” On univariate analyses, significant differences between the ethnic groups were noted in the rates of “anal hypotension with normal contractility,” “combined anal hypotension with anal hypocontractility,” and “dyssynergia.” In multivariate logistic regression analyses controlling for age, gender, parity, smoking, diabetes, and obesity, the Arab Israeli group remained several times more likely to have “combined anal hypotension and hypocontractibility” compared to the other groups. ConclusionsEthnicity impacts ARM findings in patients with FI. The reason for this is unclear and future studies on ethnically diverse populations evaluating the clinical relevance of these findings are warranted.
Achalasia During Pregnancy: Proposed Management Algorithm Based on a Thorough Literature Review
( Sergei Vosko ),( Daniel L Cohen ),( Ortal Neeman ),( Shai Matalon ),( Efrat Broide ),( Haim Shirin ) 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 2021 Journal of Neurogastroenterology and Motility (JNM Vol.27 No.1
Fewer than 40 cases of achalasia occurring in pregnant woman have been reported in the literature. Given the rarity of achalasia during pregnancy, and the numerous treatment options that are available for achalasia in general, no guidelines exist for the management of achalasia during pregnancy. Diagnosis of new cases may be difficult as symptoms and physiological changes that occur during pregnancy may obscure the clinical presentation of achalasia. The management of achalasia in pregnancy is also challenging. Treatment decisions should be individualized for each case, considering both the welfare of the mother and the fetus. Since pregnant women suffering from achalasia represent a diagnostic and therapeutic challenge with complex maternal-fetal aspects to consider, we have reviewed the available literature on the subject and summarized current diagnostic and therapeutic options. Additionally, we present a management algorithm as a means to guide treatment of future cases. We recommend that a conservative approach should be adopted with bridging therapies performed until after delivery when definitive treatment of achalasia can be more safely performed. (J Neurogastroenterol Motil 2021;27:8-18)
OROMANDIBULAR DYSTONIA: DEMOGRAPHICS AND CLINICAL DATA FROM 240 PATIENTS
Linda SLAIM,Myriam COHEN,Patrick KLAP,Marie VIDAILHET,Alain PERRIN,Daniel BRASNU,Denis AYACHE,Marie MAILLY 대한파킨슨병및이상운동질환학회 2018 Journal Of Movement Disorders Vol.11 No.2
Objective: to report demographic data from a large cohort of patients with oromandibular dystonia (OMD). Methods: This is a retrospective review of patients with OMD referred to our institution, between 1989 and 2015. Demographic (age of onset, sex, familial history of dystonia) and clinical (type of OMD, associated dystonia, etiology of dystonia) data were collected from a cohort of 240 individuals. Results: The mean age of onset was 51.6 year-old, with a female predominance (2:1). A family history of dystonia was found in 6 patients (2.5%). One hundred and forty nine patients (62.1%) had the jaw-opening OMD; 48 patients (20.0%) had the jaw-closing type, and 43 patients (17.9%) had mixed OMD; 64 patients (26.7%) had associated lingual dystonia. Eighty-two patients (34.2%) had a focal dystonia, 131 patients (54.6%) had segmental dystonia, and 27 patients (11.3%) had generalized dystonia. One hundred and seventy one patients (71.3%) had idiopathic OMD. Conclusions: OMD is a chronic, disabling focal dystonia. Our study finds a female prevalence, onset in middle age and mostly idiopathic etiology. Unlike in other studies, jaw-opening was the most frequent clinical type of OMD.
Nasari, Masoud M.,Szyszkowicz, Mieczysław,Chen, Hong,Crouse, Daniel,Turner, Michelle C.,Jerrett, Michael,Pope III, C. Arden,Hubbell, Bryan,Fann, Neal,Cohen, Aaron,Gapstur, Susan M.,Diver, W. Ryan,Stie Springer Netherlands 2016 AIR QUALITY ATMOSPHERE AND HEALTH Vol.9 No.8
<P>The effectiveness of regulatory actions designed to improve air quality is often assessed by predicting changes in public health resulting from their implementation. Risk of premature mortality from long-term exposure to ambient air pollution is the single most important contributor to such assessments and is estimated from observational studies generally assuming a log-linear, no-threshold association between ambient concentrations and death. There has been only limited assessment of this assumption in part because of a lack of methods to estimate the shape of the exposure-response function in very large study populations. In this paper, we propose a new class of variable coefficient risk functions capable of capturing a variety of potentially non-linear associations which are suitable for health impact assessment. We construct the class by defining transformations of concentration as the product of either a linear or log-linear function of concentration multiplied by a logistic weighting function. These risk functions can be estimated using hazard regression survival models with currently available computer software and can accommodate large population-based cohorts which are increasingly being used for this purpose. We illustrate our modeling approach with two large cohort studies of long-term concentrations of ambient air pollution and mortality: the American Cancer Society Cancer Prevention Study II (CPS II) cohort and the Canadian Census Health and Environment Cohort (CanCHEC). We then estimate the number of deaths attributable to changes in fine particulate matter concentrations over the 2000 to 2010 time period in both Canada and the USA using both linear and non-linear hazard function models.</P><P><B>Electronic supplementary material</B></P><P>The online version of this article (doi:10.1007/s11869-016-0398-z) contains supplementary material, which is available to authorized users.</P>
( Christoph Sarrazin ),( Mark S. Sulkowski ),( Preethi Krishnan ),( Rakesh Tripathi ),( Gretja Schnell ),( Yan Xie ),( Daniel E. Cohen ),( Roger Trinh ),( Lino Rodrigues-jr. ),( Yan Luo3,Nancy S. Shul 대한간학회 2016 춘·추계 학술대회 (KASL) Vol.2016 No.1
Aims: The 3 direct-acting antiviral (3-DAA) regimen of ombitasvir, ritonavir-boosted paritaprevir and dasabuvir ± RBV is approved in the US and EU for treatment of hepatitis C virus (HCV) genotype (GT) 1 infection. Baseline resistance associated variants (RAVs) in HCV NS3 or NS5A can impact response to other DAA regimens; we assessed the prevalence and impact of RAVs on response to the 3-DAA regimen. Methods: Next-generation sequencing (Illumina MiSeq) assessed baseline samples from treatment-naive (PEARL-IV), -experienced (SAPPHIRE- II), or cirrhotic (TURQUOISE-II) GT1a patients who received 3-DAA + RBV, and treatment-experienced (PEARL-II) or cirrhotic (TURQUOISE-III) GT1b patients who received 3-DAA alone. Thresholds of 1 and 15%, respectively, detected the prevalence and impact of baseline RAVs; impact of RAVs conferring ≥ 5-fold resistance to components of the 3-DAA regimen on response was determined by com- paring SVR rates in patients with or without RAVs. Results: SVR rates were 96% and 100% in patients with GT1a and GT1b, respectively. One or more NS5A RAVs were present in 11% of treatment-experienced or cirrhotic GT1a patients, whereas NS5A RAVs were found in 19% of GT1b patients (15% threshold). Similar SVR rates were seen in GT1a patients with or without NS5A RAVs. All GT1b patients with NS5A RAVs, including at position Y93, achieved SVR. NS3 RAVs were uncommon (≤2%). NS3 RAVs were not seen in any of the 14 virologic failures and an NS5B RAV was seen in 1 virologic failure. The presence of the GT1a NS3 Q80K polymorphism had no impact on SVR. Conclusions: Understanding impact of baseline NS5A RAVs on treatment outcomes is important for relevant HCV therapies. Patients with HCV GT1a-infection treated with the 3-DAA regimen + RBV achieved high SVR rates, regardless of the presence of baseline RAVs. All GT1b patients treated with the 3-DAA regimen alone achieved SVR.
Risk Factors for Cervical Cancer and CIN3 in Jewish Women in Israel - Two Case Control Studies
Bassal, Ravit,Schejter, Eduardo,Bachar, Rachel,Perri, Tamar,Korach, Jacob,Jakobson-Setton, Ariella,Ben-David, Liat Hogen,Cohen, Daniel,Keinan-Boker, Lital Asian Pacific Journal of Cancer Prevention 2016 Asian Pacific journal of cancer prevention Vol.17 No.4
Purpose: The aim of the study was to identify risk and protective factors/markers for cervical cancer and cervical intraepithelial neoplasia 3 (CIN3) in Israeli Jewish women in order to settle the discrepancy of low incidence rate of cervical cancer and relatively high incidence rate of CIN3. Materials and Methods: We conducted two case control studies, which examined the association between potential risk and protective factors/markers for cervical cancer or CIN3 using self administered detailed questionnaires. Results: For studying cervical cancer, 40 cases and 40 matched controls were interviewed. In the univariable and multivariable analyses older age, depression or anxiety and ever smoking seemed to act as independent risk factors/markers, while older age at first intercourse was protective. For studying CIN3, 99 cases and 79 controls were interviewed. Multivariable analysis has demonstrated that being born in Israel, depression or anxiety and ever smoking were independent risk factors/markers for CIN3. Conclusions: The risk factors/markers studied, that were associated with cervical cancer or CIN3 among Jewish women in Israel, are similar to those reported in other parts of the world, and do not explain the observed discrepancy of high in-situ cervical cancer rates and low invasive cervical cancer incidence in Israel.