Myron S. Cohen

Bio: Myron S. Cohen is an academic researcher from University of North Carolina at Chapel Hill. The author has contributed to research in topics: Population & Acquired immunodeficiency syndrome (AIDS). The author has an hindex of 103, co-authored 549 publications receiving 46021 citations. Previous affiliations of Myron S. Cohen include University of Massachusetts Medical School & Scripps Health.

Bamlanivimab prevents COVID-19 morbidity and mortality in nursing-home setting

Abstract: Background: The COVID-19 pandemic has disproportionately affected residents of skilled nursing and assisted living facilities. Interventions are urgently needed to protect this vulnerable population. Bamlanivimab is a potent neutralizing monoclonal antibody that binds the receptor-binding domain of the spike protein of SARS-CoV-2. This study evaluates the safety and efficacy of bamlanivimab in preventing COVID-19. Methods: BLAZE-2 is a Phase 3, randomized, double-blind, placebo-controlled, single-dose study that enrolled residents and staff at skilled nursing and assisted living facilities reporting at least one confirmed SARS-CoV-2 case. Eligible participants received bamlanivimab (4200 mg) or placebo intravenously. Nasal swabs were collected at baseline and weekly through day 57 to determine SARS-CoV-2 infection status via reverse transcriptase polymerase chain reaction (RT-PCR). COVID-19-releated symptoms and signs were recorded daily. The primary analysis prevention population included participants negative at baseline for SARS-CoV-2 by RT-PCR and serology. The primary endpoint was incidence of mild or worse COVID-19 by day 57. Results: Of the 1175 participants dosed, 966 (82.2%) comprised the prevention population. The prevention population included 299 residents for whom the median age was 76 years (range 31-104), 234 (78.3%) were aged ≥65, and 178 (59.5%) were female. All were considered at high risk for development of severe COVID-19. The proportion of residents in the prevention population with mild or worse COVID-19 by day 57 was significantly lower in the bamlanivimab group compared with the placebo group (odds ratio [OR], 0.20;95% confidence interval [CI], 0.08 to 0.49;p<0.001)(Figure). For this same group, bamlanivimab was associated with significant reductions in the incidence of moderate or worse COVID-19 by day 57 (OR, 0.20;95% CI, 0.08 to 0.49;p<0.001) and incident SARS-CoV-2 infection by day 29 (OR, 0.23;CI, 0.11 to 0.48;p<0.001) compared with placebo. Of the 16 deaths reported during the study, all 5 that were attributed to COVID-19 were in the placebo group. The incidence of both adverse events and serious adverse events were balanced between the bamlanivimab and placebo group. Conclusion: Bamlanivimab was highly effective in reducing the incidence of symptomatic COVID-19 and SARS-CoV-2 infection and was well tolerated. These findings demonstrate the potential beneficial impact of bamlanivimab use on COVID-19 morbidity and mortality among skilled nursing facility residents.

HIV Antiretroviral Postexposure Prophylaxis: A Cautionary Note

Abstract: Antiretroviral therapy can be used in 3 ways to prevent the sexual transmission of HIV infection: (1) to reduce an infected persons viral burden below a critical threshold; (2) as preexposure prophylaxis for people with persistent high-risk behavior(s); and (3) as postexposure prophylaxis (PEP) to be used after occupational needlesticks or sexual or other nonoccupational risks. The first 2 approaches are currently being tested in clinical trials to evaluate their efficacy. However PEP has already found its way into widespread clinical practice. Antiretroviral PEP initiated after occupational needlesticks has been used in an attempt to protect health care workers after exposure to HIV. On the basis of historical data Cardo et al. used a casecontrol design and reported that zidovudine appeared to reduce the risk of HIV infection by 81% from ~1 in 200 to 1 in 10000. But it has been impossible to design case-control or prospective studies to determine the efficacy of the nonoccupational use of PEP against sexual transmission when a partners HIV infection status is unknown and given the poor efficiency of the transmission of HIV infection. Data generated in studies of macaques suggest that therapy for HIV infection initiated within 72 h after genital tract exposure and continued for 28 days can prevent sexual acquisition of HIV infection in the majority of animals. (excerpt)

Prevention of HIV-1 Infection with Early Antiretroviral Therapy

Abstract: Background Antiretroviral therapy that reduces viral replication could limit the transmission of human immunodeficiency virus type 1 (HIV-1) in serodiscordant couples. Methods In nine countries, we...

Infectious Diseases Society of America/American Thoracic Society Consensus Guidelines on the Management of Community-Acquired Pneumonia in Adults

Abstract: Lionel A. Mandell, Richard G. Wunderink, Antonio Anzueto, John G. Bartlett, G. Douglas Campbell, Nathan C. Dean, Scott F. Dowell, Thomas M. File, Jr. Daniel M. Musher, Michael S. Niederman, Antonio Torres, and Cynthia G. Whitney McMaster University Medical School, Hamilton, Ontario, Canada; Northwestern University Feinberg School of Medicine, Chicago, Illinois; University of Texas Health Science Center and South Texas Veterans Health Care System, San Antonio, and Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, Houston, Texas; Johns Hopkins University School of Medicine, Baltimore, Maryland; Division of Pulmonary, Critical Care, and Sleep Medicine, University of Mississippi School of Medicine, Jackson; Division of Pulmonary and Critical Care Medicine, LDS Hospital, and University of Utah, Salt Lake City, Utah; Centers for Disease Control and Prevention, Atlanta, Georgia; Northeastern Ohio Universities College of Medicine, Rootstown, and Summa Health System, Akron, Ohio; State University of New York at Stony Brook, Stony Brook, and Department of Medicine, Winthrop University Hospital, Mineola, New York; and Cap de Servei de Pneumologia i Allergia Respiratoria, Institut Clinic del Torax, Hospital Clinic de Barcelona, Facultat de Medicina, Universitat de Barcelona, Institut d’Investigacions Biomediques August Pi i Sunyer, CIBER CB06/06/0028, Barcelona, Spain.

Role of free radicals and catalytic metal ions in human disease: an overview.

Abstract: Publisher Summary This chapter discusses the role of free radicals and catalytic metal ions in human disease. The importance of transition metal ions in mediating oxidant damage naturally leads to the question as to what forms of such ions might be available to catalyze radical reactions in vivo . The chapter discusses the metabolism of transition metals, such as iron and copper. It also discusses the chelation therapy that is an approach to site-specific antioxidant protection. The detection and measurement of lipid peroxidation is the evidence most frequently cited to support the involvement of free radical reactions in toxicology and in human disease. A wide range of techniques is available to measure the rate of this process, but none is applicable to all circumstances. The two most popular are the measurement of diene conjugation and the thiobarbituric acid (TBA) test, but they are both subject to pitfalls, especially when applied to human samples. The chapter also discusses the essential principles of the peroxidation process. When discussing lipid peroxidation, it is essential to use clear terminology for the sequence of events involved; an imprecise use of terms such as initiation has caused considerable confusion in the literature. In a completely peroxide-free lipid system, first chain initiation of a peroxidation sequence in a membrane or polyunsaturated fatty acid refers to the attack of any species that has sufficient reactivity to abstract a hydrogen atom from a methylene group.

Regression Diagnostics: Identifying Influential Data and Sources of Collinearity

Abstract: 1. Introduction and Overview. 2. Detecting Influential Observations and Outliers. 3. Detecting and Assessing Collinearity. 4. Applications and Remedies. 5. Research Issues and Directions for Extensions. Bibliography. Author Index. Subject Index.

Sexually transmitted diseases treatment guidelines.

Abstract: The MMWR series of publications is published by the Office of Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention (CDC), U.S. Department of Health and Human Services, Atlanta, GA 30333.