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Fetal Head Compression: Its Possible role in Neurologic Injury

Open Journal of Obstetrics and Gynecology 2024年第1期14卷 124-143页

作者： Barry S. Schifrin Brian J. Koos Wayne r. cohen Department of Obstetrics and Gynecology The Western University of Health Sciences Pomona USA The David Geffen School of Medicine at UCLA Los Angeles USA The University of Arizona College of Medicine Tucson USA

It is widely assumed that fetal ischemic brain injury during labor derives almost exclusively from severe, systemic hypoxemia with marked neonatal depression and acidemia. Severe asphyxia, however, is one of several causes of perinatal neurological injury and may not be the most common;most neonates diagnosed with hypoxic-ischemic encephalopathy do not have evidence of severe asphyxia. Sepsis, direct brain trauma, and drug or toxin exposure account for some cases, while mechanical forces of labor and delivery that increase fetal intracranial pressure sufficiently to impair brain perfusion may also contribute. Because of bony compliance and mobile suture lines, the fetal skull changes shape and redistributes cerebrospinal fluid during labor according to constraints imposed by contractions, and bony and soft tissue elements of the birth canal as the head descends. These accommodations, including the increase in intracranial pressure, are adaptive and necessary for efficient descent of the head while safeguarding cerebral blood flow. Autonomic reflexes mediated through central receptors normally provide ample protection of the brain from the considerable pressure exerted on the skull. On occasion, those forces, which are transmitted intracranially, may overcome the various adaptive anatomical, cardiovascular, metabolic, and neurological mechanisms that maintain cerebral perfusion and oxygen availability, resulting in ischemic brain injury. Accepting the notion of a potentially adverse impact of fetal head compression suggests that avoidance of excessive uterine activity and of relentless pushing without steady progress in descent may offer protection for the fetal brain during parturition. Excessive head compression should be considered in the differential diagnosis of ischemic encephalopathy.

关键词： Fetal Brain Injury Fetal Head Compression Ischemic Encephalopathy Neonatal Encephalopathy

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Paclitaxel-associated reticulate hyperpigmentation:report and review of chemotherapy-induced reticulate hyperpigmentation

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World Journal of Clinical Cases 2016年第12期4卷 390-400页

作者： Philip r cohen Department of Dermatology University of California San Diego

Drug-induced reticulate hyperpigmentation is uncommon. Including the patient described in this report, chemotherapy-associated reticulate hyperpigmentation has only been described in ten individuals. This paper describes the features of a woman with recurrent and metastatic breast cancer who developed paclitaxelinduced reticulate hyperpigmentation and reviews the characteristics of other oncology patients who developed reticulate hyperpigmentation from their antineoplastic treatment. A 55-year-old Taiwan residents woman who developed reticulate hyperpigmentation on her abdomen, back and extremities after receiving her initial treatment for metastatic breast cancer with paclitaxel is described. The hyperpigmentation became darker with each subsequent administration of paclitaxel. The drug was discontinued after five courses and the pigment faded within two months. Pub Med was searched with the key words: Breast, cancer, chemotherapy, hyperpigmentation, neoplasm, reticulate, tumor, paclitaxel, taxol. The papers generated by the search, and their references, were reviewed. Chemotherapy-induced reticulate hyperpigmentation has been described in four men and six women. Bleomycin, cytoxan, 5-fluorouracil, idarubacin, and paclitaxel caused the hyperpigmentation. The hyperpigmentation faded in 83% of the patients between two to six months after the associated antineoplastic agent was discontinued. In conclusion, chemotherapy-induced reticulate hyperpigmentation is a rare reaction that may occur during treatment with various antineoplastic agents. The hyperpigmentation fades in most individuals once thetreatment is discontinued. Therefore, cancer treatment with the associated drug can be continued in patients who experience this cutaneous adverse event.

关键词： Breast Cancer Chemotherapy Hyperpigmentation Neoplasm reticulate Tumor Paclitaxel Taxol

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Non-invasive digestion monitoring with an FDA-cleared wearable biosensor:further validation for use in tracking food ingestion

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Gastroenterology report 2021年第5期9卷 475-477,I0003页

作者： Erica r.cohen Mayra Lopez Brennan M.r.Spiegel Christopher V.Almario Karsh Division of Gastroenterology and Hepatology Cedars-Sinai Medical CenterLos AngelesCAUSA Cedars-Sinai Center for Outcomes research and Education(CS-COrE) Los AngelesCAUSA Division of Health Services research Cedars-Sinai Medical CenterLos AngelesCAUSA Department of Health Policy and Management UCLA Fielding School of Public HealthLos AngelesCAUSA Division of Informatics Cedars-Sinai Medical CenterLos AngelesCAUSA

Introduction Obesity affects one-third of the US population and accounts for$200 billion/year in expenditures[1].Diet and exercise form the cornerstone of management,yet are often ineffective[2].Mobile health applications(mHealth apps)can augment traditional strategies;Gill and Panda[3]demonstrated that obese patients can modify their eating behavior and lose weight using an mHealth app to track food *** promising,these apps typically require active data input and currently lack passively collected,physiologic input to support sustained behavior change.

关键词：生物传感器消化功能食物摄入

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Impact of Low-Impact Development Technologies from an Ecological Perspective in Different residential Zones of the City of Atlanta, Georgia

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Engineering 2018年第2期4卷 30-35页

作者： Zackery B. Morris Stephen M. Malone Abigail r. cohen Marc J. Weissburg Bert Bras George W. Woodruff School of Mechanical Engineering Georgia Institute of Technology Atlanta GA 30332-0405 USA School of Biological Sciences Georgia Institute of Technology Atlanta GA 30332 USA

Low-impact development （LID） technologies have a great potential to reduce water usage and stormwa- ter runoff and are therefore seen as sustainable improvements that can be made to traditional water infrastructure, These technologies include bioretention areas, rainwater capturing, and xeriscaping, all of which can be used in residential zones, Within the City of Atlanta, residential water usage accounts for 53% of the total water consumption; therefore, residential zones offer significant impact potential for the implementation of LID, This study analyzes the use of LID strategies within the different residen- tial zones of the City of Atlanta from an ecological perspective by drawing analogies to natural ecosys- tems, The analysis shows that these technologies, especially with the addition of a graywater system, work to improve the conventional residential water network based upon these ecological metrics, The higher metric values suggest greater parity with healthy, natural ecosystems.

关键词： Low-impact development Ecological network analysis residential water consumption

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Free tissue reconstruction of the anterior skull base:A review

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2020年第2期6卷 132-136页

作者： Elizabeth Bradford Bell Erin r.cohen Zoukaa Sargi Jason Leibowitz Department of Otolaryngology University of Miami Miller School of MedicineMiamiFLUSA

Objective:There has been a significant shift from open craniofacial resection of the anterior skull base to endoscopic approaches that accomplish the same outcomes in tumor ***,when open resection is required,free flap reconstruction is often necessary to provide sufficient well-vascularized tissue for optimal wound healing as well as providing adequate tissue bulk for *** articleaims to providea focused review of free flaps most commonly used in anterior skull base ***:This is a state-of-the-art review based on expert opinion and previously published reviews and journal articles,queried using PubMed and Google ***&conclusion:Anterior skull base reconstruction via free tissue transfer is imperative in limiting complications and promoting healing,particularly with large defects,post-radiation,and in at-risk *** type of free flap utilized for a particular anterior skull base reconstruction should be tailored to the patient and nature of the *** review offers insight into the numerous reconstructive options for the free flap surgeon.

关键词： Free tissue transfer Anterior skull base Head and neck microvascular reconstruction

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Obstetric Hemorrhage and Hypothermia: Chilling Facts

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Open Journal of Obstetrics and Gynecology 2018年第13期8卷 1260-1270页

作者： Wayne r. cohen Department of Obstetrics and Gynecology University of Arizona College of Medicine Tucson AZ USA

Objective: This clinical perspective reviews the causes, prevention and treatment of accidental hypothermia in severe obstetric hemorrhage. results: Hypothermia commonly accompanies hemorrhagic shock. Hypothermia can inhibit blood coagulation, reduce cardiac contractility, predispose to arrhythmias, contribute to acidosis, and suppress immune function. Several techniques for warming a patient or reducing heat loss are available. Keeping the patient dry, covering her with blankets, and raising the ambient temperature in the room are valuable. Methods to transmit heat actively are more effective. Forced warm air blowers are efficient. Heating intravenous fluids is important, and warm fluid lavage of the open abdomen can be effective. Conclusion: Monitoring core temperature in the operating room and choosing therapy is a shared responsibility of surgeon and anesthesiologist.

关键词： Coagulopathy Hemorrhage Hemorrhagic Shock Hypothermia Postpartum Hemorrhage

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Motion of charged particles in bright squeezed vacuum

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Light(Science & Applications) 2024年第2期13卷 347-353页

作者： Matan Even Tzur Oren cohen Solid State Institute and Physics Department Technion-Israel Institute of TechnologyHaifa3200003Israel

The motion of laser-driven electrons quivers with an average energy termed pondermotive *** explore electron dynamics driven by bright squeezed vacuum(BSV),finding that BSV induces width oscillations,akin to electron quivering in laser light,with an equivalent ponderomotive *** identify closed and open trajectories of the electronic width that are associated with high harmonic generation and above-threshold ionization,respectively,similarly to trajectories of the electron position when its motion is driven by coherent *** the case of bound electrons,the width oscillations may lead to ionization with noisy sub-cycle *** results are foundational for strong-field and free-electron quantum optics,as they shed light on ionization,high harmonic generation,and nonlinear Compton scattering in BSV.

关键词： structure vacuum ionization

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Scabies Surrepticius (Presenting as Crusted-Norwegian-Scabies, Scalp Scabies, and Scabies Incognito) in an Immunocompromised Patient: A Challenging Condition to Diagnose and Treat

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International Journal of Dermatology and Venereology 2020年第3期3卷 184-185页

作者： Philip r.cohen San Diego Family Dermatology National CityCAUSA Touro University California College of Osteopathic Medicine VallejoCAUSA

Dear Editor:I read with interest the excellent report by Zhang et al.1 of a 55-year-old woman with Norwegian scabies(which is also referred to as crusted scabies)that masqueraded as scalp seborrheic dermatitis for 5 months until the correct diagnosis was *** authors attributed her immunosuppressed state-which accounted not only for the crusted scabies but also its location on her scalp in addition to other body areas-to a chronic hepatitis C *** mite infestation also had a component of scabies incognito from the application of high-potency topical corticosteroids(0.05%fluticasone propionate cream and 0.1%halcinonide solution)for 5 months.

关键词： abies attributed diagnosis

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Follicular contact dermatitis revisited: A review emphasizing neomycin-associated follicular contact dermatitis

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World Journal of Clinical Cases 2014年第12期2卷 815-821页

作者： Philip r cohen Division of Dermatology University of California San Diego San Diego CA 92131-3643 United States

Follicular contact dermatitis clinically presents as individual papules that include a central hair follicle. Pathologic features involve the follicle and the surrounding dermis: spongiosis and vesicle formation of the follicular epithelium associated with perifollicular and perivascular lymphocytic inflammation. Using the Pub Med database, an extensive literature search was performed on follicular contact dermatitis and neomycin. relevant papers were reviewed and the clinical and pathologic features, the associated chemicals(including a more detailed description of neomycin), the hypothesized pathogenesis, and the management of follicular contact dermatitis were described. Several agentseither as allergens or irritants-have been reported to elicit follicular contact dermatitis. Several hypotheses have been suggested for the selective involvement of the follicles in follicular contact dermatitis: patient allergenicity, characteristics of the agent, vehicle containing the agent, application of the agent, and external factors. The differential diagnosis of follicular contact dermatitis includes not only recurrent infundibulofolliculitis, but also drug eruption, mite infestation, viral infection, and dermatoses that affect hair follicles. The primary therapeutic intervention for follicular contact dermatitis is withdrawal of the causative agent; treatment with a topical corticosteroid preparation may also promote resolution of the dermatitis. In conclusion, follicular contact dermatitis may be secondary to allergens or irritants; topical antibiotics, including neomycin, may cause this condition. Several factors may account for the selective involvement of the hair follicle in this condition. Treatment of the dermatitis requires withdrawal of the associated topical agent; in addition, topical corticosteroids may be helpful to promote resolution of lesions.

关键词： Allergic Contact Dermatitis Follicular Irritant Neomycin Papular

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Sarcoma-associated sarcoid reaction: report of cutaneous sarcoid reaction in a patient with liposarcoma

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World Journal of Clinical Cases 2015年第12期3卷 988-992页

作者： Bryce D Beutler Philip r cohen School of Allied Health Sciences University of Nevada Department of Dermatology University of California

Sarcoidosis is a systemic inflammatory condition in which noncaseating epithelioid cell granulomas appear within one or several body sites. Sarcoid reaction(also referred to as sarcoidal or sarcoid-like reaction) occurs in patients who do not fulfill the diagnostic criteria for systemic sarcoidosis but present with similar clinical and histological features. As sarcoma-associated sarcoid reactions are rare, we describe the features of sarcoid reaction that developed in a man with liposarcoma and summarize reports of other oncology patients with sarcoma-associated sarcoid reactions. A 68-yearold man with retroperitoneal liposarcoma presented for evaluation of erythematous dermal plaques on his left leg. Microscopic examination of a tissue specimen revealed multiple epithelioid granulomas in the superficial and mid-reticular dermis. Correlation of the clinical presentation and histopathologic findings established a diagnosis of liposarcoma-associated cutaneous sarcoid reaction. Sarcoid reactions have been described in only seven individuals with sarcoma, including two patients with leiomyosarcoma and one patient with either carcinosarcoma, Kaposi sarcoma, liposarcoma, malignant peripheral nerve sheath tumor, rhabdosarcoma, or synovial sarcoma. Sarcoidal granulomas most commonly develop within the locoregional draining lymph nodes. Sarcoid reactions may also affect other organs, such as the lungs, skin, and spleen.

关键词： Liposarcoma Malignancy Sarcoid Sarcoid reaction Sarcoidosis Sarcoma

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