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.

Prevalence of hepatitis C infection in Malawi and lack of association with sexually transmitted diseases.

Abstract: To investigate the role of sexual transmission for Hepatitis C virus (HCV) we studied its prevalence in sub-Saharan Africa where sexually transmitted diseases (STDs) are prevalent. Overall, HCV prevalence was 3.9% and similar in 206 STD patients, 127 dermatology patients, and 100 blood donors. No association with HIV or syphilis was observed. Despite high prevalence of STDs, sexual transmission does not appear to significantly contribute to HCV transmission in Malawi.

Mathematical modeling to reveal breakthrough mechanisms in the HIV Antibody Mediated Prevention (AMP) trials.

Abstract: The ongoing Antibody Mediated Prevention (AMP) trials will uncover whether passive infusion of the broadly neutralizing antibody (bNAb) VRC01 can protect against HIV acquisition. Previous statistical simulations indicate these trials may be partially protective. In that case, it will be crucial to identify the mechanism of breakthrough infections. To that end, we developed a mathematical modeling framework to simulate the AMP trials and infer the breakthrough mechanisms using measurable trial outcomes. This framework combines viral dynamics with antibody pharmacokinetics and pharmacodynamics, and will be generally applicable to forthcoming bNAb prevention trials. We fit our model to human viral load data (RV217). Then, we incorporated VRC01 neutralization using serum pharmacokinetics (HVTN 104) and in vitro pharmacodynamics (LANL CATNAP database). We systematically explored trial outcomes by reducing in vivo potency and varying the distribution of sensitivity to VRC01 in circulating strains. We found trial outcomes could be used in a clinical trial regression model (CTRM) to reveal whether partially protective trials were caused by large fractions of VRC01-resistant (IC50>50 μg/mL) circulating strains or rather a global reduction in VRC01 potency against all strains. The former mechanism suggests the need to enhance neutralizing antibody breadth; the latter suggests the need to enhance VRC01 delivery and/or in vivo binding. We will apply the clinical trial regression model to data from the completed trials to help optimize future approaches for passive delivery of anti-HIV neutralizing antibodies.

Specificity of dysuria and discharge complaints and presence of urethritis in male patients attending an STD clinic in Malawi.

Abstract: The World Health Organization (WHO) has recommended a syndromic approach to the case management of sexually transmitted diseases (STDs) in areas with inadequate laboratories and trained personnel. This study evaluated the specificity of discharge and dysuria for laboratory confirmed urethritis among 517 consecutive symptomatic men presenting to an urban STD clinic in Malawi in 1992-93. Patients were randomized to receive one of five antibiotic regimens with an efficacy range of 33-95% and instructed to return for a follow-up visit in 8-10 days. The present analysis was limited to the 330 men with follow-up data. Overall 257 men (70%) had gonococcal urethritis and 13 (4%) had chlamydia urethritis. Laboratory evidence of urethritis was identified in over 90% of symptomatic patients with discharge or dysuria. Men with complaints of dysuria alone were significantly more likely to have sought treatment elsewhere before presenting to the clinic than men with both discharge and dysuria (72% vs. 48%) and were less likely to have had gonorrhea (64% vs. 83%). 92% of those who returned for the follow-up visit had no symptoms of either discharge or dysuria but 22 of these men (9.2%) had gonorrhea and 52 (21.8%) had nongonococcal urethritis. Among men with symptoms at the time of the follow-up visit 26 (28%) had gonorrhea and 12 (13%) had nongonococcal urethritis. These findings suggest that the symptom of dysuria should be added to discharge as an entry criterion for evaluation for urethritis in WHOs treatment recommendations. Moreover given the high prevalence of asymptomatic infection at follow-up in men who received suboptimal antimicrobial therapy it is recommended that the most effective treatment available should be provided at the first clinic visit.

Introduction of partner referral and treatment for control of sexually transmitted diseases in a poor Haitian community.

Abstract: Focus group discussions were held with women attending slum-based antenatal clinics and with male partners of pregnant women separately to evaluate knowledge and attitudes regarding sexually transmitted diseases (STDs) and acceptability of a proposed antenatal STD screening and treatment programme, including partner management Subsequently, antenatal women found to have a STD were asked to refer their partner(s) for STD treatment The institution's routine procedure of internal referral to the curative center was evaluated for loss to follow-up Focus group participants described common STD syndromes, knew that a pregnant woman could transmit a STD to her child, and knew that all sex partners needed to be treated for STDs Discussion participants disagreed on the possibility of asymptomatic STDs and mentioned other ways of contracting STDs beside sexual transmission The response to the proposed programme was positive Of 331 male partners named by antenatal women who were found to have at least one STD, 101 (30%) presented at the clinic through index referral, and an additional 38 (115%) presented because of health worker referral Of the 59 men sent to the curative center for care, only 26 (44%) received treatment The study demonstrated that in Haiti, partners of antenatal STD patients can be treated without apparent adverse effects However, internal referrals to separate treatment centres should be avoided Following this study, education efforts have emphasized the curable nature of STDs, the threat of vertical transmission, and frequent asymptomatic presentation of STDs to promote prevention and treat more partners of STD patients

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.