Herman Cohen - Academia.edu (original) (raw)

Papers by Herman Cohen

Infection, 1997

Herpetic gingivostomatitis is common in young children, but primary oral infection has also been ... more Herpetic gingivostomatitis is common in young children, but primary oral infection has also been described in adults. Herpetic whitlow as an occupational hazard of medical personnel has been well documented. Four cases of primary herpetic gingivostomatitis are reported in two pediatricians and two pediatric nurses who contracted the infection in their fourth decade of life. All suffered from sore throat and fever as presenting symptoms. Correct diagnosis was delayed for 4-5 days. In conclusion, pediatric personnel with pharyngitis and a negative history of herpetic gingivostomatitis or herpes labialis should bear the possibility of oral HSV infection in mind. Early diagnosis is essential to prevent the spread of the infection to their patients.

Patient Education and Counseling, Apr 1, 2005

Many symptoms are attributed to teething. Little evidence exists to support these beliefs, despit... more Many symptoms are attributed to teething. Little evidence exists to support these beliefs, despite their implications on clinical management. This study attempted to investigate parental and medical personnel's beliefs about teething. The study was conducted by means of a questionnaire, submitted to 55 pediatricians and 130 nurses. A parent survey was conducted simultaneously. We evaluated 462 questionnaires. An association of teeth eruption with infant morbidity was believed to exist by 76% of the responders, mostly by parents and nurses, and less so by physicians. Irritability, fever, and loose stools/diarrhea were believed to be the most common symptoms associated to teeth eruption. We conclude that almost all parents, the majority of nurses, and many physicians believe that teething is associated with the appearance of symptoms, most of which are minor and relate to discomfort rather than physical illness, but a substantial minority still ascribes potentially serious symptoms to teething.

Chest, 2002

To determine the utility of inhaled hypertonic saline solution to treat ambulatory infants with v... more To determine the utility of inhaled hypertonic saline solution to treat ambulatory infants with viral bronchiolitis. Design: Randomized, double-blind, controlled trial. Sixty-five ambulatory infants (mean ؎ SD age, 12.5 ؎ 6 months) with viral bronchiolitis received either of the following: inhalation of 0.5 mL (5 mg) terbutaline added to 2 mL of 0.9% saline solution as a wet nebulized aerosol (control; group 1; n ‫؍‬ 32) or 0.5 mL (5 mg) terbutaline added to 2 mL of 3% saline solution administered in the same manner as above (treatment; group 2; n ‫؍‬ 33). This therapy was repeated three times every day for 5 days. Results: The clinical severity (CS) scores at baseline on the first day of treatment were 6.4 ؎ 1.8 in group 1 and 6.6 ؎ 1.5 in group 2 (not significant). After the first day, the CS score was significantly lower (better) in group 2 as compared to group 1 on each of the treatment days (p < 0.005; Fig 1). On the first day, the percentage decrease in the CS score after inhalation therapy was significantly better for group 2 (33%) than for group 1 (13%) [p < 0.005; Fig 1]. On the second day, the percentage improvement was better in the hypertonic saline solution-treated patients (group 2) as compared to the 0.9% saline solution-treated patients (group 1) [p ‫؍‬ 0.01; Fig 1]. Conclusions: We conclude that in nonasthmatic, nonseverely ill ambulatory infants with viral bronchiolitis, aerosolized 3% saline solution plus 5 mg terbutaline is effective in decreasing symptoms as compared to 0.9% saline solution plus 5 mg terbutaline.

PubMed, 1994

Background: Traditionally, children with tympanostomy ventilating tubes, or grommets, were advise... more Background: Traditionally, children with tympanostomy ventilating tubes, or grommets, were advised that water should not enter their ears in order to prevent ear infections. This group of children has been considered somewhat handicapped regarding swimming. We conducted a prospective study to determine if there is a relation between suppurative otitis media and surface swimming in children with grommets. Methods: Forty-two children with tympanostomy ventilating tubes were included in this study. Of the 42 children, 22 were swimmers and 20 were nonswimmers, who served as the control group. The age range was 3 to 12 years, and there was no difference in the age distribution between the groups. Surface swimming was allowed without earplugs or a bathing cap, although it was mandatory to use polymyxin B-neomycin-hydrocortisone eardrops at bedtime on the day of swimming. No diving was allowed. Results: Three of 22 swimmers and 2 of 20 nonswimmers developed otorrhea. In 4 of the 5 children, the otorrhea was followed by an upper respiratory tract infection. In all cases, a bacterial culture revealed Pseudomonas. The ear drainage was easily controlled with local otic treatment in all the patients. Conclusions: Taking into consideration the possible risks of infection and bearing in mind the value and joy of swimming to children and parents, families should be reassured that surface swimming does not increase the risk of infection in children with tympanostomy tubes.

Archives of pediatrics & adolescent medicine, Jul 1, 2001

To determine the efficacy and tolerance of Otikon Otic Solution (Healthy-On Ltd, Petach-Tikva, Is... more To determine the efficacy and tolerance of Otikon Otic Solution (Healthy-On Ltd, Petach-Tikva, Israel), a naturopathic herbal extract (containing Allium sativum, Verbascum thapsus, Calendula flores, and Hypericum perforatum in olive oil), compared with Anaesthetic (Vitamed Pharmaceutical Ltd, Benyamina, Israel) ear drops (containing ametocaine and phenazone in glycerin) in the management of ear pain associated with acute otitis media (AOM). Design: Children between the ages of 6 and 18 years who experienced ear pain (otalgia) and who were diagnosed with eardrum problems associated with AOM were randomly assigned to be treated with Otikon or Anaesthetic ear drops, which were instilled into the external canal(s) of the affected ear(s). Ear pain was assessed using 2 visual analog scales: a linear scale and a color scale. Pain assessment took place throughout the course of 3 days. The mean score of pain reduction was used to measure outcome.

Clinical Pediatrics, Mar 1, 1993

The American journal of occupational therapy : official publication of the American Occupational Therapy Association

We evaluated the driving skills of teenagers with attention deficit hyperactivity disorder (ADHD)... more We evaluated the driving skills of teenagers with attention deficit hyperactivity disorder (ADHD) during simulated driving before starting driving lessons and observed whether methylphenidate (MPH) affected their performance. Sixty teenagers ages 15-18 yr were included; 29 teenagers with ADHD were tested with and without MPH, and 31 teenagers (control group) were tested once. All participants were tested on the STISIM Drive™ simulator. The number of center-line crossings was higher in the group without MPH treatment than in the control group and the MPH-treated group. The group without MPH treatment had more road-edge excursions compared with the control group and drove faster than the MPH-treated group. Adolescents with ADHD without MPH treatment demonstrated impaired performance more often while driving the simulator, resembling characteristics found during on-road driving among teenagers with ADHD. Trainer awareness is a primary intervention before taking driving lessons to help ...

Pediatrics, 2012

BACKGROUND:Infections with viruses causing upper respiratory tract infection (URI) are associated... more BACKGROUND:Infections with viruses causing upper respiratory tract infection (URI) are associated with increased leukotriene levels in the upper airways. Montelukast, a selective leukotriene-receptor antagonist, is an effective treatment of asthma and allergic rhinitis.OBJECTIVE:To determine whether prophylactic treatment with montelukast reduces the incidence and severity of URI in children.METHODS:A randomized, double-blind, placebo-controlled study was performed in 3 primary care pediatric ambulatory clinics in Israel. Healthy children aged 1 to 5 years were randomly assigned in a 1:1 ratio to receive 12-week treatment with 4 mg oral montelukast or look-alike placebo. Patients were excluded if they had a previous history of reactive airway disease. A study coordinator contacted the parents by phone once a week to obtain information regarding the occurrence of acute respiratory episodes. The parents received a diary card to record any acute symptoms of URI. The primary outcome mea...

Clinical Pediatrics, 1993

A 3.5-year-old girl was admitted because of a sudden change in her mental state. Two days before,... more A 3.5-year-old girl was admitted because of a sudden change in her mental state. Two days before, she had complained of headaches and anorexia and had a temperature of 38.3°C. Progressive somnolence was apparent until admission, when she became stuporous. Massive vomiting also occurred immediately after she arrived. Physical examination disclosed a stuporous child with a score of 9 out of 13 on the modified Glasgow coma scale. Her temperature measured 39.4°C; pulse, 160/min; and blood pressure, 91/52 torr. Respirations were regular at 24/min. The patient exhibited marked nuchal rigidity, with positive Kernig’s and Brudzinski’s signs. The optic discs were normal. Diffuse rales and rhonchi over both

Acta Paediatrica, 2008

I read with great interest the paper on “Benign paroxysmal Torticollis in Infancy” by Sanner &amp... more I read with great interest the paper on “Benign paroxysmal Torticollis in Infancy” by Sanner & Bergstrom (4). I completely agree that most of the differential diagnoses mentioned by the authors (posterior fossa tumor, cervical dislocation, epilepsy, Sandifer’s syndrome, etc.) lack-among other symptoms-the regular periodicity of paroxysmal torticollis but I wish to comment on their differential diagnosis as to drug-induced dystonic reactions:

Helicobacter, 2012

ABSTRACT Helicobacter pylori-associated disease has led to aggressive diagnostic and eradication ... more ABSTRACT Helicobacter pylori-associated disease has led to aggressive diagnostic and eradication protocols that are partially responsible for the decrease in prevalence of H. pylori carriage. Recent evidence indicates that in low-prevalence populations, H. pylori may have protective effects on allergic diseases. The aim of this study was to explore the relationship between pediatric asthma and H. pylori infection in a population with high prevalence of H. pylori infection. A national referral laboratory was screened for all (13) C urea breath tests performed in children aged 5-18 years between 2007 and 2008, for patient demographics and physician-diagnosed asthma. Data concerning asthma-associated medication usage were extracted from electronic medical records and databases. Data were analyzed using a stepwise logistic regression model. During the study period, 6959 patients underwent urea breath testing (average age 12.4±3.5years). Of these, 3175/6959 (45.6%) were positive for H. pylori, and 578/6959 (8.3%) had asthma. Rates of asthma in H. pylori-positive and H. pylori-negative children were 7.3 and 9.1%, respectively (odds ratio 0.82; 95% confidence interval (CI) 0.69-0.98; p=.032). We also confirmed that male gender, urban residence, and age are associated with childhood asthma. We demonstrate an inverse association between H. pylori and pediatric asthma in a population with a high prevalence of H. pylori.

Israel Journal of Health Policy Research, 2015

Background: Energy drink consumption among youth is increasing despite recommendations by the Ame... more Background: Energy drink consumption among youth is increasing despite recommendations by the American Academy of Pediatrics to eliminate consumption by youth. This study provides information on consumption of energy drinks and alcohol mixed with energy drinks (AmED) in a sample of Israeli youth and how consumer knowledge about the risks affects consumption rates. Methods: The study was conducted in three Tel Aviv public schools, with a total enrollment of 1,253 students in grades 8 through 12. Among them, 802 students completed a 49-item questionnaire about energy drink and AmED consumption, for a 64 % response rate Non-responders included 451 students who were absent or refused to participate. All students in the same school were administered the questionnaire on the same day. Results: Energy drinks are popular among youth (84.2 % have ever drunk). More tenth through twelfth grade students consumed energy drinks than eighth and ninth grade students. Students who began drinking in elementary school (36.8 %) are at elevated risk for current energy drink (P < .001) and AmED (P = .002) use. Knowledge about amounts consumed and recommended allowances is associated with less consumption (OR 1.925; 95 %CI 1.18-3.14). Discussion: The association between current AmED consumption and drinking ED at a young age is important. Boys and those who start drinking early have a greater risk of both ED and AmED consumption. The characteristics of early drinkers can help increase awareness of potential at-risk youth, such as junior and senior high school students with less educated or single parents. Conclusions: Risks posed by early use on later energy drink and AmED consumption are concerning. We suggest that parents should limit accessibility. Increased knowledge about acceptable and actual amounts of caffeine in a single product might decrease consumption.

Vaccines

We aimed to examine rates of COVID-19 vaccination to elucidate the need for targeted public healt... more We aimed to examine rates of COVID-19 vaccination to elucidate the need for targeted public health interventions. We retrospectively reviewed the electronic medical files of all adults registered in a central district in Israel from 1 January 2021 to 31 March 2022. The population was characterized by vaccination status against COVID-19 and the number of doses received. Univariate and multivariable analyses were used to identify predictors of low vaccination rates that required targeted interventions. Of the 246,543 subjects included in the study, 207,911 (84.3%) were vaccinated. The minority groups of ultra-Orthodox Jews and Arabs had lower vaccination rates than the non-ultra-Orthodox Jews (68.7%, 80.5% and 87.7%, respectively, p < 0.001). Adults of low socioeconomic status (SES) had lower vaccination rates compared to those of high SES (74.4% vs. 90.8%, p < 0.001). Adults aged 20–59 years had a lower vaccination rate than those ≥60 years (80.0% vs. 92.1%, p < 0.0001). Mul...

World Journal of Pediatrics, 2016

Background: Available pediatric treatments for acute cough are limited by lack of demonstrated ef... more Background: Available pediatric treatments for acute cough are limited by lack of demonstrated effi cacy. The objective of this trial is to compare the effects of a polysaccharide-resin-honey based cough syrup, and carbocysteine syrups on nocturnal and daytime cough associated with childhood upper respiratory tract infections (URIs). Methods: Using a single-blind randomization design, the study recruited children from 4 general pediatric community clinics. Participants included 150 children aged 2 to 5 years with an URI, nocturnal and daytime cough and illness duration of ≤7 days. To be eligible, children had to be free of medication on the day before presentation. A survey was administered to parents on 4 consecutive days beginning from the day of presentation in clinic. Children received the study preparation on the fi rst evening and then 3 times per day for 3 further days. Main outcome measures were cough frequency, cough severity, bothersome nature of cough, and quality of sleep for both child and parent. Results: Both preparations were well tolerated and cough improved over the study period. After one night and on all survey days, there was a significantly better result for polysaccharide-resin-honey (P<0.05) for all the main outcome measures. The trend of improvement over the 4 days was steeper for polysaccharide-resin-honey (P<0.05) with regards to all cough parameters. Conclusions: Both polysaccharide-resin-honey and carbocysteine cough syrups were well tolerated in children over 2 years of age. The polysaccharide-resinhoney syrup was associated with a more rapid and greater improvement in all clinical cough symptoms measured, beginning from the fi rst night of therapy. Both nocturnal and daytime cough improved, as did sleep quality for both children and parents.

The Journal of pediatrics, 2015

ITT is an important methodological validity issue of a clinical therapeutic study. ITT can be sum... more ITT is an important methodological validity issue of a clinical therapeutic study. ITT can be summarized as "analyze what you randomize"-even if patients do not take their assigned therapy or drop out of the study. The purpose of ITT methodology is to mirror typical, real-life clinical conditions. For example, consider a two-group, parallel-design, randomized controlled trial comparing amoxicillin and placebo for the treatment of otitis media. A number of the patients randomized to the amoxicillin group never take the amoxicillin. Simple logic may suggest that either those patients should be removed from analysis or switched to the placebo group. ITT requires these patients to be analyzed in the amoxicillin group because patients do not always take their medicine, and they do not always follow-up. Outcome measures (eg, number needed to treat) are derived from these real-life groups, and are therefore reflective of what is likely to occur in the real-life clinical venue. SEARCHING PEARL: ADVANCED USE OF PUBMED-ANNE O'TATE: PubMed is a free, US-governmentsupported search and retrieval system of the MEDLINE biomedical database. Since PubMed's debut, a number of programs have been developed to organize PubMed results in a user-friendly manner. Anne O'Tate is one of those programs, designed to identify and summarize key features of the most relevant articles. Anne O'Tate (http://arrowsmith.psych.uic.edu/cgi-bin/arrowsmith_uic/AnneOTate.cgi) is a free service that offers a number of ways to organize one's PubMed search to facilitate specific topic retrieval or specific field browsing. Examples include: (1) "important words"-organizes the retrieved articles by words that occur more frequently in the literature retrieved, than in PubMed generally, thus identifying a lexicon specific to the literature retrieved; (2) "topics" organizes by medical subject headings (MeSH terms); and (3) "cluster by function"-organizes by larger topics (from the MeSH terms), generating themes and allowing the user to gain a quick overview of the retrieved literature.-Jordan Hupert, MD

Patient Education and Counseling, 2006

Background: The exclusion of ill children from childcare centers may be associated with high soci... more Background: The exclusion of ill children from childcare centers may be associated with high social, economic and medical costs. Objective: To assess the opinions of pediatricians working in an outpatient setting in Israel on the exclusion/return of children in childcare centers. Methods: A questionnaire on practices of exclusion/return of children in childcare centers, in general and according to specific signs and symptoms, was administered to a random computer-selected cross-sectional sample of 192 primary care community pediatricians in Israel. Results: One hundred and seventy-three pediatricians completed the questionnaires, for a response rate of 90%; 147 were board-certified and 26 were not. About half the pediatricians felt pressured by parents requesting antibiotic therapy to accelerate the return of their sick child to the childcare center. The majority also believed their practice was overloaded by often unnecessary demands for medical notes by the childcare centers before children could return. More than half based their decision to exclude children on ''common sense'' and the remainder, on accepted guidelines. Except for scabies and lice, there were no significant correlations between the physicians' stipulation for a note on return of the child and the specific illness guidelines. Conclusions: This study shows that a high proportion of pediatricians based their exclusion practices on ''common sense'' and personal understanding instead of established guidelines, and that the guidelines did not affect their opinion on the duration of illness that warrant a note. Furthermore, half were subjected to parental pressure to employ inappropriate practices. These findings, combined with our earlier survey of childcare centers staff, indicate that better education of parents and day-care staff about ill childcare center exclusion policy in Israel would increase their common understanding with pediatricians.

The Journal of family practice, 1994

BACKGROUND Traditionally, children with tympanostomy ventilating tubes, or grommets, were advised... more BACKGROUND Traditionally, children with tympanostomy ventilating tubes, or grommets, were advised that water should not enter their ears in order to prevent ear infections. This group of children has been considered somewhat handicapped regarding swimming. We conducted a prospective study to determine if there is a relation between suppurative otitis media and surface swimming in children with grommets. METHODS Forty-two children with tympanostomy ventilating tubes were included in this study. Of the 42 children, 22 were swimmers and 20 were nonswimmers, who served as the control group. The age range was 3 to 12 years, and there was no difference in the age distribution between the groups. Surface swimming was allowed without earplugs or a bathing cap, although it was mandatory to use polymyxin B-neomycin-hydrocortisone eardrops at bedtime on the day of swimming. No diving was allowed. RESULTS Three of 22 swimmers and 2 of 20 nonswimmers developed otorrhea. In 4 of the 5 children, t...

Clinical Pediatrics, 1993

Among the foreign bodies most often found in children's nostrils are hair, beads, toy parts, ... more Among the foreign bodies most often found in children's nostrils are hair, beads, toy parts, paper wads, and food.1 Sometimes extraction of nasal foreign bodies can be difficult, especially if they are spherical. The classical presentation is a unilateral, persistent, foul-smelling; purulent, or bloody nasal discharge. Ulceration, dislodgement of the foreign body into the nasopharynx, and aspiration of the foreign body can complicate the problem.

BACKGROUND Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorde... more BACKGROUND Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder characterized by inattention, impulsivity and hyperactivity. Recently, increases in ADHD prevalence and methylphenidate use have been reported. There is evidence that children and adolescents use ADHD medication only during the school year. OBJECTIVES To investigate trends in methylphenidate dispensing over a period of 3 years (2010-2012) at the monthly level and to investigate whether there is any monthly variation, especially during the summer season. METHODS The database of Clalit Health Services (the largest of the four health funds in Israel) was used to identify (i) patients aged 6-17 years with a diagnosis of ADHD, and (ii) methylpenidate dispensation during the period 2010-2012. RESULTS Among children aged 6-17 years diagnosed with ADHD, 43% were treated with methylphenidate. For the period 2010 to 2012 there was an annual drop in methylphenidate dispensing, beginning in June a...

Infection, 1997

Patient Education and Counseling, Apr 1, 2005

Chest, 2002

PubMed, 1994

Archives of pediatrics & adolescent medicine, Jul 1, 2001

Clinical Pediatrics, Mar 1, 1993

The American journal of occupational therapy : official publication of the American Occupational Therapy Association

Pediatrics, 2012

Clinical Pediatrics, 1993

Acta Paediatrica, 2008

Helicobacter, 2012

Israel Journal of Health Policy Research, 2015

Vaccines

World Journal of Pediatrics, 2016

The Journal of pediatrics, 2015

Patient Education and Counseling, 2006

The Journal of family practice, 1994

Clinical Pediatrics, 1993