Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 15 de 15
Filter
1.
Isr Med Assoc J ; 25(8): 568-572, 2023 Aug.
Article in English | MEDLINE | ID: mdl-37574897

ABSTRACT

BACKGROUND: While several studies have noted smell impairment in schizophrenia, it is unclear whether this impairment extends to acute psychosis and whether it is associated with more severe illness as expressed in extended hospitalization. OBJECTIVES: To evaluate the olfactory function of patients in an acute psychotic state and correlate it with clinical symptomatology and length of hospitalization. METHODS: Olfactory function was assessed in 20 patients with schizophrenia in their first week of hospital admission for acute psychosis compared with matched controls. Olfaction was evaluated via three stages: threshold, discrimination, and identification of different odors utilizing the Sniffin' Sticks test battery. RESULTS: Schizophrenia patients scored significantly lower on total smell score, discrimination, and identification abilities. A significant association was observed between hospitalization duration and total smell score and smell discrimination. No significant associations between smell and clinical symptomatology were observed. CONCLUSIONS: Study observations confirm impaired sense of smell in schizophrenia patients and suggest that smell impairment may be a potential marker of more serious illness as expressed in longer hospital stay.


Subject(s)
Olfaction Disorders , Psychotic Disorders , Schizophrenia , Humans , Smell , Schizophrenia/complications , Olfaction Disorders/diagnosis , Olfaction Disorders/epidemiology , Olfaction Disorders/etiology , Psychotic Disorders/diagnosis , Hospitalization
2.
J Biomed Opt ; 25(4): 1-15, 2020 04.
Article in English | MEDLINE | ID: mdl-32329265

ABSTRACT

SIGNIFICANCE: Accurate and objective identification of Alzheimer's disease (AD) and dementia with Lewy bodies (DLB) is of major clinical importance due to the current lack of low-cost and noninvasive diagnostic tools to differentiate between the two. Developing an approach for such identification can have a great impact in the field of dementia diseases as it would offer physicians a routine objective test to support their diagnoses. The problem is especially acute because these two dementias have some common symptoms and characteristics, which can lead to misdiagnosis of DLB as AD and vice versa, mainly at their early stages. AIM: The aim is to evaluate the potential of mid-infrared (IR) spectroscopy in tandem with machine learning algorithms as a sensitive method to detect minor changes in the biochemical structures that accompany the development of AD and DLB based on a simple peripheral blood test, thus improving the diagnostic accuracy of differentiation between DLB and AD. APPROACH: IR microspectroscopy was used to examine white blood cells and plasma isolated from 56 individuals: 26 controls, 20 AD patients, and 10 DLB patients. The measured spectra were analyzed via machine learning. RESULTS: Our encouraging results show that it is possible to differentiate between dementia (AD and DLB) and controls with an ∼86 % success rate and between DLB and AD patients with a success rate of better than 93%. CONCLUSIONS: The success of this method makes it possible to suggest a new, simple, and powerful tool for the mental health professional, with the potential to improve the reliability and objectivity of diagnoses of both AD and DLB.


Subject(s)
Alzheimer Disease , Lewy Body Disease , Alzheimer Disease/diagnostic imaging , Diagnosis, Differential , Humans , Lewy Body Disease/diagnostic imaging , Machine Learning , Microscopy , Reproducibility of Results
4.
Isr Med Assoc J ; 20(11): 670-673, 2018 Nov.
Article in English | MEDLINE | ID: mdl-30430794

ABSTRACT

BACKGROUND: Previously described as a subcategory of obsessive compulsive disorder (OCD), hoarding disorder was added to the fifth Diagnostic and Statistical Manual of Mental Disorders (DSM-V) as a stand-alone diagnosis for the first time. The first formal research in the 1990s surprisingly found no connection between material deprivation early in life and hoarding; however, later studies linked early traumatic life experiences with hoarding. Subsequent familial studies demonstrated a genetic predisposition for hoarding. Emerging evidence suggests a link between a post-traumatic stress disorder (PTSD) and hoarding in Jewish Holocaust survivors. OBJECTIVES: To evaluate the literature on PTSD among Jewish Holocaust survivors for associations between PTSD and hoarding. METHODS: A systematic search of selected databases, including PubMed, Google Scholar, NCBI, Psych Info, and EBSCO Host was conducted from 1 March 2017 to 15 July 2018 using the following search terms: hoarding, hoarding disorder, obsessive compulsive disorder, OCD, compulsive hoarding, Jewish Holocaust survivors, Shoa, post-traumatic stress disorder, and PTSD. Inclusion criteria included peer reviewed research published on adults in English since 1990. Because no publications linking hoarding and PTSD in Jewish Holocaust survivors were found, references in retained papers were also searched for any relevant published work. RESULTS: Seven articles linking PTSD and hoarding were identified for this review. However, no articles were found linking PTSD and hoarding in Jewish Holocaust survivors. CONCLUSIONS: A relationship between PTSD and hoarding in Jewish Holocaust survivors is conceivable and should be explored to effectively diagnose and care for affected individuals.


Subject(s)
Hoarding/epidemiology , Holocaust/psychology , Stress Disorders, Post-Traumatic/epidemiology , Survivors/psychology , Databases, Factual , Hoarding/psychology , Humans , Jews/psychology , Models, Theoretical , Obsessive-Compulsive Disorder/epidemiology , Obsessive-Compulsive Disorder/psychology , Research Design , Stress Disorders, Post-Traumatic/psychology
5.
Nat Rev Rheumatol ; 14(8): 488-498, 2018 08.
Article in English | MEDLINE | ID: mdl-29884803

ABSTRACT

As medical use of cannabis is increasingly legalized worldwide, a better understanding of the medical and hazardous effects of this drug is imperative. The pain associated with rheumatic diseases is considered a prevalent indication for medicinal cannabis in various countries. Thus far, preliminary clinical trials have explored the effects of cannabis on rheumatoid arthritis, osteoarthritis and fibromyalgia; preliminary evidence has also found an association between the cannabinoid system and other rheumatic conditions, including systemic sclerosis and juvenile idiopathic arthritis. The potential medicinal effects of cannabis could be attributable to its influence on the immune system, as it exerts an immunomodulatory effect on various immune cells, including T cells, B cells and macrophages. However, the available evidence is not yet sufficient to support the recommendation of cannabinoid treatment for rheumatic diseases.


Subject(s)
Cannabinoids/therapeutic use , Pain/drug therapy , Rheumatic Diseases/drug therapy , Animals , B-Lymphocytes/drug effects , Cannabinoids/adverse effects , Cannabinoids/pharmacology , Humans , Immunomodulation , Macrophages/drug effects , Pain/etiology , Receptors, Cannabinoid/metabolism , Rheumatic Diseases/complications , Rheumatic Diseases/metabolism , Signal Transduction/drug effects , T-Lymphocytes/drug effects
6.
Nutr Diet ; 74(4): 365-371, 2017 Sep.
Article in English | MEDLINE | ID: mdl-28901698

ABSTRACT

AIM: Nutrition professionals in Israel are developing a system to document the Dietetic Care Process (DCP) tailored for specific patient sectors and compliant with national health guidelines. The ultimate goal is to achieve uniform documentation and improve nutrition care. Israeli dietetic practitioners work in specific patient sectors; therefore, a patient population-specific reporting system is proposed instead of the typical singular format applied across all patient populations. The purpose of this project was to evaluate learning outcomes and attitudes among registered dietitians (RDs) after online training of a novel DCP documentation system. METHODS: A total of 80 Israeli RDs working in geriatric practice completed an eight-week online educational program learning documentation that is compatible for use with electronic health records and compliant with Israeli standards of practice. A paired sample t-test and McNemar test were used to analyse pre- to post-test performance, while Pearson's r, point-biserial, Spearman's and ANOVA were used to assess relationships among variables. RESULTS: Post-test knowledge scores increased significantly, t (67) = -9.007, P = 0.000; 95% CI (-26.713, -17.019). Age, education, geographic location and previous experience with online courses were not correlated with academic performance, suggesting that demographic characteristics did not impact training. Overall, RDs (>80%) responded positively to the training model and were highly interested in future proficiency online learning opportunities (98%). CONCLUSIONS: A sectoral DCP online training program significantly improved knowledge and was rated favourably by Israeli RDs. DCP training for clinical practitioners may be optimised when standardised nutrition care and reporting systems are adapted to specific patient populations.

7.
Isr Med Assoc J ; 19(6): 360-364, 2017 Jun.
Article in English | MEDLINE | ID: mdl-28647933

ABSTRACT

BACKGROUND: Standardization of the dietetic care process allows for early identification of malnutrition and metabolic disorders, interdisciplinary collaboration among the medical team, and improved quality of patient care. Globally, dietitians are adopting a nutrition care model that integrates national regulations with professional scope of practice. Currently, Israel lacks a standardized dietetic care process and documentation terminology. OBJECTIVES: To assess the utilization of a novel sectoral documentation system for nutrition care in Israel. METHODS: Seventy dietitians working in 63 geriatric facilities completed an online training program presenting the proposed patient-sectoral-model. Training was followed by submission of sample case studies from clinical practice or completion of a case simulation. Application of the proposed model was assessed by measuring the frequency participants implemented different sections of the model and responses to an approval questionnaire. RESULTS: Fifty-four participants (77%) provided completed cases. Over 80% of participants reported each step of the proposed dietary care process with 100% reporting the "nutrition diagnosis". Fifty-one dietitians (72.8%) completed the approval survey with the section on nutrition diagnosis receiving a highly favorable response (95%), indicating that the new documentation system was beneficial. Over 80% of participants rated the model useful in clinical practice. CONCLUSIONS: A sectoral approach for documenting dietetic care may be the ideal model for dietitians working in specific patient populations with the potential for improving interdisciplinary collaboration in patient care.


Subject(s)
Documentation , Interdisciplinary Communication , Nutritionists , Physicians , Dietetics/standards , Humans , Israel , Nutritionists/education , Terminology as Topic
9.
Article in English | MEDLINE | ID: mdl-26985361

ABSTRACT

BACKGROUND: Antipsychotic medications (APMs) are commonly prescribed in nursing homes (NHs) and their excessive use raises concerns about the quality of care. They are often seen as "chemical restraints", and were shown to increase morbidity and mortality risks in NH residents. The objective of this study was to investigate the variability in prevalence in APM use in a sample of Israeli NHs and to examine the effect of facility characteristics on the use of APMs. METHODS: A retrospective cross-sectional study was conducted in 2011 using data which were collected in a sample of NHs in the Tel Aviv district during the annual certification process. Prevalence of APMs was determined on the basis of all residents using antipsychotics on a regular basis. The association between facility characteristics and APM use was assessed by multivariate analysis. RESULTS: Forty-four NHs providing care for 2372 residents were investigated. The prevalence of APM use varied between facilities from 14.8 to 70.6 %, with an overall prevalence of 37.3 %. Multiple linear regression analysis revealed that greater use of APMs was associated with for-profit facilities, facilities in which most of the residents were self-pay, the presence of a "mentally frail" unit, a medical director non-specialized in geriatrics, shortage of social workers and occupational therapists, presence of unsafe/non-fitting equipment or self-aids (e.g., unsafe bath/toilet seats, unsuitable height of tables) and shortage of recreational activities. CONCLUSIONS: A wide variation in APM use was recorded in NHs in the Tel Aviv district. This variation was associated with facility characteristics that undermine quality of care. Application of APM use as a measure of quality in NHs and publicizing their utilization may decrease their overall use.

10.
Immunol Res ; 56(2-3): 287-92, 2013 Jul.
Article in English | MEDLINE | ID: mdl-23553228

ABSTRACT

Parasitic infections may induce variable immunomodulatory effects and control of autoimmune disease. Toxoplasma gondii (T. gondii) is a ubiquitous intracellular protozoan that was recently associated with autoimmunity. This study was undertaken to investigate the seroprevalence and clinical correlation of anti-T. gondii antibodies in patients with rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). We evaluated sera from European patients with RA (n = 125) and SLE (n = 164) for the prevalence of anti-T. gondii IgG antibodies (ATXAb), as well as other common infections such as Cytomegalovirus, Epstein-Barr, and Rubella virus. The rates of seropositivity were determined utilizing the LIAISON chemiluminescent immunoassays (DiaSorin, Italy). Our results showed a higher seroprevalence of ATXAb in RA patients, as compared with SLE patients [63 vs. 36 %, respectively (p = 0.01)]. The rates of seropositivity of IgG against other infectious agents were comparable between RA and SLE patients. ATXAb-seropositivity was associated with older age of RA patients, although it did not correlate with RA disease activity and other manifestations of the disease. In conclusion, our data suggest a possible link between exposure to T. gondii infection and RA.


Subject(s)
Arthritis, Rheumatoid/epidemiology , Lupus Erythematosus, Systemic/epidemiology , Toxoplasma/immunology , Toxoplasmosis/epidemiology , Virus Diseases/epidemiology , Adult , Age Factors , Aged , Antibodies, Protozoan/blood , Arthritis, Rheumatoid/diagnosis , Arthritis, Rheumatoid/immunology , Environmental Exposure/adverse effects , Europe , Humans , Immunoglobulin G/blood , Lupus Erythematosus, Systemic/diagnosis , Lupus Erythematosus, Systemic/immunology , Middle Aged , Seroepidemiologic Studies , Toxoplasmosis/diagnosis , Toxoplasmosis/immunology , Virus Diseases/diagnosis , Virus Diseases/immunology
11.
Exp Mol Pathol ; 93(3): 386-90, 2012 Dec.
Article in English | MEDLINE | ID: mdl-23022373

ABSTRACT

BACKGROUND: Currently not much is known regarding the environmental factors involved in primary biliary cirrhosis (PBC). It is even more unclear which factors may determine the subgroup (i.e., AMA status) of patients with PBC. We thus tested AMA+and AMA- PBC patients' sera for antibodies (Abs) against multiple infectious agents. METHODS: Sera from 69 patients with PBC (49 AMA+and 20 AMA-) and 100 matched controls were screened for IgG-Abs against Toxoplasma gondii, Helicobacter pylori, Epstein-Barr virus (EBV), cytomegalovirus (CMV), hepatitis B, and hepatitis C utilizing the BioPlex 2200 and ELISA kits (Bio-Rad Laboratories, USA). RESULTS: The prevalence of four anti-infectious agents Abs was significantly elevated among PBC patients when compared with controls, namely anti-T. gondii (ATxA; 71% vs. 40%, p<0.0001), EBV early antigen (EA; 44% vs. 12%, p<0.0001), H. pylori (54% vs. 31%, p<0.01), and CMV (90% vs. 75%, p<0.05) Abs, respectively. The co-occurrence of these four anti-infectious agents Abs was highly common in PBC, whereas this infection burden was rare in healthy subjects (20% vs. 3% respectively, p<0.0001). Furthermore, specific infections interactions possibly increasing PBC risk were noted as well. Seropositivity of ATxA was inversely associated with cirrhosis among PBC patients (p<0.05). Finally, no differences were observed between AMA- sera and their AMA+counterparts with regard to seroprevalence of any of the investigated infectious agents. CONCLUSIONS: We note the association of ATxA and PBC, with the possibility of a milder disease manifestation. We also suggest that multiple exposures to infectious agents may contribute to PBC risk.


Subject(s)
Antibodies, Bacterial/blood , Antibodies, Viral/blood , Bacterial Infections/blood , Biomarkers/blood , Liver Cirrhosis, Biliary/blood , Virus Diseases/blood , Bacterial Infections/diagnosis , Bacterial Infections/microbiology , Female , Host-Pathogen Interactions , Humans , Liver Cirrhosis, Biliary/diagnosis , Liver Cirrhosis, Biliary/microbiology , Male , Middle Aged , Seroepidemiologic Studies , Virus Diseases/diagnosis , Virus Diseases/virology
12.
Ann N Y Acad Sci ; 1173: 343-9, 2009 Sep.
Article in English | MEDLINE | ID: mdl-19758171

ABSTRACT

Patients with neurological disease of unknown etiology sometimes present with antigliadin and antitissue transglutaminase antibodies. The association between these antibodies and multiple sclerosis has been previously suggested. The purpose of this study was to determine the prevalence of these antibodies in multiple sclerosis patients. We determined the level of serum immunoglobulin A and immunoglobulin G antigliadin and antitissue transglutaminase antibodies in 98 patients with multiple sclerosis. We found a highly significant increase in titers of immunoglobulin G antibodies against gliadin and tissue transglutaminase in the multiple sclerosis patients. Seven patients had a positive IgG AGA, whereas only 2 controls presented positive titers (P = 0.03). Four patients had positive IgG anti-tTG while all the controls tested negative (P = 0.02). However, immunoglobulin A antibodies against gliadin and tissue transglutaminase were not statistically higher in the multiple sclerosis group in comparison to the control group. Our findings support the associations between antibodies against gliadin and tissue transglutaminase to multiple sclerosis. The specific role of these antibodies in the pathogenesis of multiple sclerosis remains uncertain and requires additional research. A gluten free diet should be considered in specific cases of patients who present with gluten antibodies.


Subject(s)
Autoantibodies/blood , Glutens/immunology , Multiple Sclerosis/blood , Adult , Cross-Sectional Studies , Female , Gliadin/immunology , Humans , Immunoassay/methods , Immunoglobulin A/blood , Immunoglobulin G/blood , Male , Middle Aged , Multiple Sclerosis/immunology , Transglutaminases/immunology
13.
Harefuah ; 148(5): 320-1, 349, 2009 May.
Article in Hebrew | MEDLINE | ID: mdl-19630363

ABSTRACT

A relatively large number of neurodegenerative diseases are associated with sleep disorders. In some diseases it was shown that the sleep disorder occurred long before the diagnosis. Therefore, it is hereby suggested that performing overnight polysomnography should be a routine check for any patient complaining about memory loss, cognitive decline or Parkinsonism. Identifying sleep disorders and trying to treat them could prevent or even improve cognition and/or behavior in some of the neurodegenerative diseases. In addition, it is suggested to perform neurocognitive evaluation for patients suffering from obstructive sleep apnea.


Subject(s)
Cognition Disorders/etiology , Sleep Apnea, Obstructive/complications , Sleep Apnea, Obstructive/psychology , Sleep Wake Disorders/complications , Sleep Wake Disorders/psychology , Humans , Memory Disorders/complications , Parkinson Disease/complications , Polysomnography , Sleep Wake Disorders/etiology
14.
J Autoimmun ; 32(3-4): 261-6, 2009.
Article in English | MEDLINE | ID: mdl-19356903

ABSTRACT

OBJECTIVE: To evaluate the prevalence of serum antibodies against hepatitis C virus and other infectious agents in a large cohort of well-characterized patients with autoimmune diseases (AID). METHODS: We utilized 1322 sera from patients with 18 different AID and 236 sera from healthy controls from the same countries and with similar age and sex distribution. All sera were tested for the presence of serum anti-hepatitis C virus (HCV) antibodies as well as antibodies directed at other infectious agents and autoantibodies. RESULTS: Anti-HCV antibody was detected in 115/1322 (8.7%) of patients with AID and 0.4% of matched healthy controls (P < 0.0001). The prevalence of anti-HCV antibody was significantly higher in 7/18 different AID (i.e. cryoglobulinemia, mixed cryoglobulinemia pemphigus vulgaris, vasculitis, secondary anti-phospholipid syndrome, Hashimoto's thyroiditis, and inflammatory bowel disease) compared to controls. Patients with AID and serum anti-HCV positivity had an increased prevalence of antibodies against hepatitis B virus, Toxoplasma gondii and Cytomegalovirus as opposed to a lower frequency of serum autoantibodies. CONCLUSIONS: The enhanced prevalence of anti-HCV serum antibodies in AID may suggest a role for HCV in tolerance to breakdown, similarly to its established role in mixed cryoglobulinemia. This immune mediated effect does not rule out the role of other infectious agents.


Subject(s)
Autoantibodies/blood , Autoimmune Diseases/blood , Autoimmune Diseases/immunology , Hepatitis C Antibodies/blood , Hepatitis C/immunology , Aged , Autoimmune Diseases/epidemiology , Female , Hepatitis C/blood , Hepatitis C/epidemiology , Humans , Male , Middle Aged , Prevalence
15.
Autoimmun Rev ; 7(8): 621-5, 2008 Sep.
Article in English | MEDLINE | ID: mdl-18603025

ABSTRACT

BACKGROUND: The etiology of autoimmune diseases is not fully clarified and the mechanisms underlying their initiation and progression are still obscure. It is becoming clear that in a genetic susceptible individual an environmental trigger such as infectious agent in general and viruses in particular could initiate the development of an autoimmune disease. Hepatitis B virus (HBV) is notorious in its association with diverse autoimmune diseases. Therefore, we aimed to determine the presence of hepatitis B core antibody (HBcAb), a seromarker for past or present infection with HBV, in a large number of sera collected from patients with different autoimmune diseases. METHODS: A cohort of 675 sera samples of 5 different autoimmune diseases and healthy donors were screened for evidence of a prior infection with HBV. All samples were tested for hepatitis B core antibody (IgG) using the Monolisa anti-HBc PLUS commercial kit (Bio-Rad, Hercules, San Francisco, USA). RESULTS: Lower percentage of HBcAb was found in sera of the autoimmune diseases when compared to normal controls. Fifteen (10.7%) from 140 normal controls were found positive for the presence of HBcAb. Two (2%) out of 98 multiple sclerosis (MS) sera were positive for the presence of HBcAb (OR: 0.17, 95%CI: 0.03-0.77, p=0.01), 3 (2.5%) out of 117 systemic lupus erythematosus (SLE) sera (OR: 0.2, 95%CI: 0.06-0.77, p=0.01), 4 (4.5%) out of 89 type 1 diabetes (T1D), 5 (6.1%) from 82 Sjogren's syndrome (SS) sera and 12 (8%) from 149 rheumatoid arthritis (RA) sera were positive for the presence of HBcAb. CONCLUSIONS: Our data divulge an unexpected low percentage of antibodies to HBcAg in patients with SLE, MS and T1D in comparison to healthy matched donors. This finding may raise a protective role to HBV in some autoimmune diseases i.e. hygiene theory.


Subject(s)
Autoimmune Diseases/prevention & control , Autoimmune Diseases/virology , Hepatitis B virus/immunology , Hepatitis B/immunology , Autoimmune Diseases/blood , Autoimmune Diseases/immunology , Hepatitis B/blood , Hepatitis B Antibodies/blood , Humans
SELECTION OF CITATIONS
SEARCH DETAIL
...