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11.
Harefuah ; 145(8): 581-2, 2006 Aug.
Article in Hebrew | MEDLINE | ID: mdl-16983841
13.
J R Army Med Corps ; 149(4): 260-4, 2003 Dec.
Article in English | MEDLINE | ID: mdl-15015796

ABSTRACT

Parachuting, be it static line or skydiving, places enormous stresses on the human spine. It is, therefore, important to determine the prevalence and severity of degenerative changes in the lumbar spine of subjects who practice this sport activity. Seventy four parachuting instructors, mean age 33 years and with an average of 410 static line and skydiving jumps, were included in the study. Past radiographs were examined and compared to current anterolateral and lateral views of the lumbar spine, in order to determine the prevalence of degenerative changes and document possible progression. Doubtful radiographic changes in the lumbar spine were identified in 47.4 percent of the parachuting instructors, mild degeneration in 9.6 percent, moderate degenerative disease in 10.9 percent and severe radiographic changes in 5.5 percent. Schmorll nodes were found in 8.1 percent of the subjects. Traction spurs--osteophytes were identified in 6.8 percent. The degenerative changes correlated with age and the number of jumps. Spondylolysis of L5-S1 and L3-L4 segments were observed in 12.2 and 1.4 percent respectively. Progressive spondylolisthesis was found in 2 subjects. No correlation was found between the severity of radiographic changes and either the prevalence and the severity of low back pain. The present findings provide a rational for considering repeated sheer stress as an etiology of degenerative changes in the spinal cord, and as a possible contributing factor to the pathogenesis of spondylolysis. Further study has to be done comparing parachuting instructors to a non-parachuting group, or equivalent physically active individuals, in order to assess the effect of sport-background on the development of degenerative changes.


Subject(s)
Aviation , Lumbar Vertebrae/pathology , Military Personnel , Spinal Osteophytosis/epidemiology , Adult , Disease Progression , Humans , Lumbar Vertebrae/diagnostic imaging , Male , Middle Aged , Occupational Health , Prevalence , Radiography , Risk Factors , Spinal Osteophytosis/etiology , Spinal Osteophytosis/physiopathology , Stress, Mechanical
14.
Isr Med Assoc J ; 3(11): 799-802, 2001 Nov.
Article in English | MEDLINE | ID: mdl-11729571
15.
Epidemiol Infect ; 127(2): 179-84, 2001 Oct.
Article in English | MEDLINE | ID: mdl-11693494

ABSTRACT

The purpose of this article is to define the distinguishing characteristics of food-borne streptococcal pharyngitis by reviewing the literature. The main cause of this infection lies in poor handling and preservation of cold salads, usually those which contain eggs and are prepared some hours before serving. A shorter incubation period and a higher attack rate (51-90%) than in transmission by droplets was noted. The epidemics tend to occur in warm climates and in the hottest months of the year. Streptococcus pyogenes seems to originate from the pharynx or hand lesions of a food handler. In comparison to airborne transmission symptoms such as sore throat, pharyngeal erythema, and enlarged tonsils, submandibular lymphadenopathy are more frequent than coughing and coryza. Seven out of 17 reports revealed an M-untypeable serotype, which may possess virulent characteristics. Penicillin prophylaxis was shown to limit additional spread of the infection. There were no non-suppurative sequels, and suppurative sequels were very rare. We assume that the guidelines for the prevention of food poisoning would apply to food-borne streptococcal pharyngitis. Food handlers should be supervised to ensure they comply with strict rules of preparation and storage of food. Cold salads, especially those containing eggs, should not be left overnight before serving.


Subject(s)
Disease Outbreaks , Food Handling , Food Microbiology , Foodborne Diseases/prevention & control , Pharyngitis , Streptococcus pyogenes/isolation & purification , Climate , Foodborne Diseases/drug therapy , Humans , Penicillins/therapeutic use , Pharyngitis/drug therapy , Pharyngitis/epidemiology , Pharyngitis/microbiology
16.
J Trauma ; 51(4): 767-72, 2001 Oct.
Article in English | MEDLINE | ID: mdl-11586173

ABSTRACT

BACKGROUND: The pain of major trauma patients remains often unrelieved while in the emergency department. Our objective was to examine pain management in several trauma units, and to evaluate the impact of implementation of a trauma pain management protocol. METHODS: Current status was evaluated from questionnaires filled by trauma unit personnel of nine medical centers. In one, a pain management protocol was introduced. Staff and patients evaluated pain management before and after the protocol was instituted. RESULTS: About 80% of staff respondents from various centers were not aware of guidelines for pain management in trauma. The belief that pain assists diagnosis was the main reason (78.6%) for withholding analgesia. Large variability existed on what contraindicates analgesia, with the majority withholding analgesia in abdominal and multiple injuries. When administered, analgesia was delayed, and most commonly intramuscular meperidine was given. After the protocol's implementation, the personnel's awareness of analgesia increased, and consequently it was administered earlier and to more patients, mostly as intravenous morphine. Patients appreciated the timely analgesia (38% after vs. 14% before, p = 0.01), with fewer receiving none. Analgesia was considered beneficial by more patients (70% after vs. 23% before, p < 0.001), and enhanced cooperativity with personnel (p < 0.001). This was reflected in increased overall satisfaction with pain relief during the entire hospitalization. CONCLUSION: The importance of pain management protocols in major trauma was demonstrated by the response of personnel and patients.


Subject(s)
Analgesics/therapeutic use , Clinical Protocols , Pain Measurement , Pain/drug therapy , Trauma Centers/standards , Clinical Competence , Humans , Israel , Nursing Staff, Hospital , Pain/etiology , Patient Satisfaction , Practice Patterns, Physicians' , Time Factors , Wounds and Injuries/complications , Wounds and Injuries/therapy
17.
Harefuah ; 140(7): 624-7, 2001 Jul.
Article in Hebrew | MEDLINE | ID: mdl-11481967
18.
Isr Med Assoc J ; 3(1): 9-12, 2001 Jan.
Article in English | MEDLINE | ID: mdl-11344818

ABSTRACT

BACKGROUND: Familial Mediterranean fever is a genetic disorder manifested by recurrent attacks of peritonitis, pleuritis and arthritis, and characterized by clinical, histological and laboratory evidence for localized and systemic inflammation. Colchicine treatment usually prevents the attacks and the associated inflammation. Inflammation may play an important role in the initiation and progression of atherosclerosis and ischemic heart disease. OBJECTIVE: To study the effect of inflammation and its prevention on the occurrence of IHD, using FMF as a model. METHODS AND PATIENTS: We studied the presence of IHD and its risk factors in 290 FMF patients aged 40 years or more, and in two control groups--233 spouses of the FMF patients, and 126 patients with inflammatory diseases obtained from other outpatient clinics, FMF patients were also compared with age and gender-matched individuals from the population reference data of the Israel Ministry of Health. RESULTS: The prevalence of IHD in FMF patients was significantly lower than in the group of controls from other outpatient clinics (15.5% vs. 30.2%, P < 0.05) and comparable with their spouses (11.2%) and with the matched general population in Israel (16%). CONCLUSIONS: These findings suggest that despite the evidence of recurrent inflammation, colchicine-treated FMF patients are not more predisposed to IHD than the normal population.


Subject(s)
Familial Mediterranean Fever/complications , Myocardial Ischemia/complications , Myocardial Ischemia/epidemiology , Adult , Case-Control Studies , Colchicine/therapeutic use , Familial Mediterranean Fever/prevention & control , Female , Gout Suppressants/therapeutic use , Humans , Inflammation/complications , Inflammation/prevention & control , Israel/epidemiology , Male , Middle Aged , Prevalence , Registries , Risk Factors , Smoking/adverse effects , Surveys and Questionnaires
19.
Mol Cell Endocrinol ; 176(1-2): 1-12, 2001 May 15.
Article in English | MEDLINE | ID: mdl-11369437

ABSTRACT

The insulin-like growth factor-I receptor (IGF-l-R) plays a critical role in normal and pathological growth processes. The expression of the IGF-l-R gene is regulated by various stimuli, including hormones and growth factors. We have investigated the molecular mechanisms by which two inhibitory cytokines, tumor necrosis factor-alpha (TNF-alpha) and interferon-gamma (IFN-gamma), regulate IGF-l-R gene expression. TNF-alpha and IFN-gamma reduced the proliferation rates of the osteogenic sarcoma cell line, Saos-2, and the human salivary gland cell line, HSG, in a dose- and time-dependent fashion. This effect was associated with significant reductions in the levels of IGF-l-R mRNA and protein, and with inhibition of IGF-l-R promoter activity, suggesting that TNF-alpha and IFN-gamma affect IGF-l-R gene expression at the transcriptional level. In addition, TNF-alpha significantly decreased IGF-l-R mRNA stability. Combined cytokine treatment inhibited cellular proliferation and promoter activity in an additive manner. Taken together, these results suggest that a novel potential mechanism by which TNF-alpha and IFN-gamma affect cellular proliferation involves suppression of IGF-l-R promoter activity, as well as destabilization of IGF-l-R transcripts.


Subject(s)
Interferon-gamma/pharmacology , Receptor, IGF Type 1/genetics , Receptor, IGF Type 1/metabolism , Tumor Necrosis Factor-alpha/pharmacology , Blotting, Western , Cell Division/drug effects , Gene Expression Regulation/drug effects , Humans , Promoter Regions, Genetic/genetics , RNA Stability/drug effects , RNA, Messenger/genetics , RNA, Messenger/metabolism , Reverse Transcriptase Polymerase Chain Reaction , Sequence Deletion/genetics , Transcription, Genetic/drug effects , Tumor Cells, Cultured
20.
Public Health ; 114(6): 484-7, 2000 Nov.
Article in English | MEDLINE | ID: mdl-11114763

ABSTRACT

Animal rabies is endemic in Israel, with 50-80 laboratory-confirmed cases being diagnosed annually. Despite the high incidence among animals, human rabies has not occurred in Israel for almost four decades. This is likely due to the highly effective prevention policy implemented by the Ministry of Health, based on pre-exposure vaccination of populations at risk, post-exposure treatment, and updated rules. Notwithstanding the previous success, a human case occurred in 1996 when a soldier was bitten, while asleep, by an unidentified small animal, which according to his description was a rat or a mouse. Since injuries by these rodents do not require antirabies treatment, no antirabies post-exposure prophylaxis was administered. Five weeks later the soldier complained of fever and nausea with interchanging periods of rage and calm, confusion, and water aversion. His condition deteriorated gradually, leading to deep coma and death. Immunofluorescence examination of a skin biopsy was positive for rabies, and PCR of saliva revealed Lyssavirus genotype 1. We review the changes in the epizootiology of rabies in Israel, the trends of human exposure to animals, and the pre- and post-exposure prophylaxis guidelines, and discuss possible measures that could have been undertaken to prevent the eventuality of this case. This case of rabies, the first after a long period without human disease, accentuates the importance of strict adherence to prevention guidelines. Considerations of geography, epidemiology, and the circumstances of exposure are crucial in the treatment decision-making process.


Subject(s)
Bites and Stings , Military Personnel , Rabies/physiopathology , Rodentia/virology , Adult , Animals , Fatal Outcome , Humans , Israel , Male , Rabies/diagnosis , Rabies/therapy , Rabies virus/isolation & purification
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