Showing papers by "Israel Ministry of Health published in 1998"
TL;DR: High antibody titers against CMV (IgG) may be a strong marker for coronary artery disease, and might predict post-coronary angioplasty restenosis, and also suggest that a chronic immunologic response has a role in atherosclerosis and restenotes.
Abstract: Recent studies have demonstrated that cytomegalovirus (CMV) DNA was found in atherosclerotic coronary arteries in restenotic lesions, and prior infection with CMV could be a strong independent risk factor for restenosis after coronary atherectomy. We studied the correlation between anti-CMV antibody titer and coronary artery disease. Sixty-five patients (50 men and 15 women) with coronary artery disease were enrolled prospectively. All had symptomatic coronary artery disease with an angiographic documentation of a de novo single coronary lesion. All underwent balloon coronary angioplasty and were followed for 12 months with a thallium perfusion scan 3 months after angioplasty. Patients who had recurrent chest pain and/or a positive thallium scan had another coronary angiography. Blood samples were taken before angiography and 1 and 3 months later. Patients with high anti-CMV titer > or = 1:800 had a higher prevalence of coronary artery disease (p or = 1:800) had a higher restenosis rate than seropositive patients with a low antibody titer (< or = 1:400) (p <0.05). High antibody titers against CMV (IgG) may be a strong marker for coronary artery disease, and might predict post-coronary angioplasty restenosis. These findings support the infectious theory of atherosclerosis (especially with prior CMV infection), and also suggest that a chronic immunologic response has a role in atherosclerosis and restenosis.
123 citations
TL;DR: It does not appear that BD during pregnancy caused an increase in the incidence of birth defects, and the increase in spontaneous abortions seems to be a result of the lower gestational age at the time of counseling in the women exposed to BD.
88 citations
TL;DR: Israeli Jews present one of the highest incidences of Kaposi's sarcoma reported from developed countries, and immigrants from other countries in Asia, Africa, the Americas and Europe had similar rates as Jews born in Israel.
Abstract: Background:The incidence of classic Kaposi's sarcoma (CKS) has been reported to be high in Jewish populations, mostly born in Eastern Europe.Objective:To describe the incidence on CKS in Israeli Jews and to determine differences in incidence according to their geography origin.Design:We analysed dat
71 citations
TL;DR: Israel should start to provide a nationwide thalassaemia screening programme as the monetary benefits to society (and even to the health services alone) will exceed the screening programmes costs.
Abstract: Objective In Israel (population 5.7 million) there are around 200 known living subjects with thalassaemia major, of whom around 80% are from the northern district. This study aims at examining the costs and benefits of a national screening programme to prevent thalassaemia in Israel.Measurements and main resultsThe lifetime healthcare costs of caring for a person born with thalassaemia major are d284 154. The costs of the home infusion service (33.1p) actually exceed the costs of the chelating agent itself (22.1p). The remaining 44.8p of costs are due to stay in hospital, operations, outpatient visits, laboratory tests, therapists, etc. Lost earnings and premature mortality costs account for a further d51 843 and d141 944 respectively for each case. A national screening programme would cost d900 197 and prevent around 13.4 homozygotes being born, at a cost of d67 369 for each birth prevented. The benefit-cost ratio of the programme to the health serv...
54 citations
TL;DR: The intervention failed to eradicate carriage of the putative outbreak strain, or to reduce the incidence and fatality rates in the villages, but public health professionals should bear this experience in mind when faced with prolonged, localized, non-explosive outbreaks of meningococcal disease associated with low carriage rates of the outbreak strain.
Abstract: In January 1994 mass antibiotic prophylaxis was undertaken in the contiguous villages of Deir el-Asad and B'ine in northern Israel (combined population of 11 600) in response to a prolonged outbreak of serogroup B meningococcal infection with an overall annual rate of 37.4 cases of infection per 100 000 residents. The average case fatality rate in the villages was 23% compared with 11% in Israel during the same period. Neisseria meningitidis group B was identified in 9 of 13 (69%) cases. Seven of these were subtype P1.7,16. The persistence of the outbreak with its accompanying public reaction prompted the establishment of an intervention programme that included antibiotic prophylaxis for the whole community with monitoring for pharyngeal carriage of meningococci in a stratified sample of the population. The objectives were to achieve a reduction of carriage of the outbreak strain and to reduce morbidity and mortality. A total of 1036 pharyngeal swabs were taken 1 day before and 6 weeks after treatment. Antibiotic prophylaxis was administered in one dose: children under 5-years-old received ceftriaxone i.m.; all others received oral ciprofloxacin. Overall, 96% of the population received treatment. The carriage rate was 8.3% prior to treatment (three serogroup B:14 : P1.7,16), and 1.3% afterwards (one serogroup B:14 : P1.7,16). The intervention failed to eradicate carriage of the putative outbreak strain, or to reduce the incidence and fatality rates in the villages. The outbreak finally terminated in late 1996. Public health professionals should bear this experience in mind when faced with prolonged, localized, non-explosive outbreaks of meningococcal disease associated with low carriage rates of the outbreak strain.
24 citations
TL;DR: Elevation of acute phase proteins [C‐reactive protein (CRP) and serum amyloid type A (SAA)] has been demonstrated in unstable angina with an adverse clinical prognosis.
Abstract: Background: Elevation of acute phase proteins [C-reactive protein (CRP) and serum amyloid type A (SAA)] has been demonstrated in unstable angina with an adverse clinical prognosis.
Hypothesis: The study was undertaken to determine the effect of angioplasty on the levels of SAA and the correlation with postangioplasty restenosis.
Methods: In a university-affiliated tertiary medical center, a prospective case study was undertaken in 55 patients who underwent successful percutaneous transluminal coronary angioplasty (PTCA) of a single coronary lesion for angina pectoris. Three groups of patients were clinically characterized according to Braunwald's classification of anginal syndrome: Group A: class III; Group B: class I; Group C: stable angina. Serum amyloid type A was measured by an ELISA method before PICA and after 24 h, 1, and 3 months. Patients were followed clinically for 12 months. A thallium stress perfusion scan was performed 3 months after PTCA and coronary angiography was repeated in patients with an abnormal thallium perfusion scan.
Results: Serum amyloid type A levels >100 m/ml could identify Group A patients with a high sensitivity and specificity (r = 0.85 and 0.86, respectively). Of the patients studied. 75% increased their SAA level 24 h after angioplasty. An increase of SAA by >100% was associated with an increased risk of restenosis, with a relative risk of 6.4 (p < 0.05).
Conclusion: Increased levels of SAA characterize patients with unstable angina pectoris with a high specificity and sensitivity. Levels of SAA that increase > 100% 24 h after angioplasty may serve as a marker of restenosis.
19 citations
TL;DR: The observation of a stable and relatively high incidence of CKS in Israel‐born Arabs, comparable to other populations living in the Mediterranean basin, suggests that risk is related to geographical origin.
Abstract: The incidence of classic Kaposi's sarcoma (CKS) has been reported to be high in Jewish populations living in Israel and in immigrants originating from the Mediterranean basin. No population-based reports are available on the incidence of CKS in Israeli Arabs. We analyzed the incidence of CKS cases occurring between 1970 and 1993 among Arabs living in Israel. Reporting systems were the Israel Cancer Registry, the medical documentation of all-Kaposi's sarcoma cases and the registry of human immunodeficiency virus-seropositive patients. Population figures were derived for census surveys (1972 and 1983) and inter-census data based on annual updating of demographic characteristics. Age-standardized incidence rates (ASR) were 6.87 per million in men and 2.18 per million in women. The ASR did not increase between 1970 and 1993 in either men or women. The age-adjusted male to female ratio was 2.0 below 50 years of age and 3.5 above it. The observation of a stable and relatively high incidence of CKS in Israel-born Arabs, comparable to other populations living in the Mediterranean basin, suggests that risk is related to geographical origin. CKS incidence, however, is lower than that in Israel-born Jews.
15 citations
TL;DR: The use of clozapine or risperidone reduced hospitalisation costs, but increased community-care costs by $US1627 per patient, giving health-service benefit : cost ratios of 1.87 : 1 and 1.32 : 1, respectively.
Abstract: In this study, the benefits and costs of treating schizophrenia with either risperidone or clozapine were examined. The lifetime drug-treatment cost incurred by a patient with schizophrenia in Israel was $US7561 (1996 values) with an initial 6-month trial with risperidone, compared with $US6326 with clozapine and $US3360 with typical antipsychotics. Total lifetime costs of psychiatric health services (excluding medications) by individuals who were continuously receiving typical antipsychotics were $US181 555 per patient. Assuming a 6.3% decrease in hospital use with typical antipsychotics and an absolute 30% decrease with risperidone or clozapine, the use of clozapine or risperidone reduced hospitalisation costs by $US7159 per patient, but increased community-care costs by $US1627 per patient, giving health-service benefit : cost ratios of 1.87 : 1 and 1.32 : 1, respectively. After adding indirect benefits resulting from increased work productivity (minus indirect costs related to increases in transport costs because of visits for blood monitoring during clozapine therapy), the benefit : cost ratios increased to 2.04 : 1 and 1.48 : 1, respectively. Assuming that clozapine caused a 30% decrease in hospital use by patients with new-onset schizophrenia, risperidone would have to decrease hospital use by 43.2% (i.e. a 13.2% relative advantage) for its societal benefits to justify its increased costs.
15 citations
TL;DR: The authors' objectives were to measure the incidence of BOT in Israel and compare rates among ethnic groups (based on ethnic group and country of birth) for the years 1985‐1993.
Abstract: BACKGROUND
In hospital-based studies, one-eighth of ovarian cancers have been considered borderline ovarian tumors (BOTs). Population-based data regarding the incidence of BOTs are lacking in the international literature. The authors' objectives were to measure the incidence of BOT in Israel and compare rates among ethnic groups (based on ethnic group and country of birth) for the years 1985-1993.
METHODS
The authors analyzed data reported to a nationwide cancer registry. Population estimates by subpopulation were derived from census and intercensus estimates, which were based on an updated population registry.
RESULTS
The age-adjusted standard rate (ASR) for the entire population was 10.6 per million (95% confidence interval [CI], 9.2-12.0) for the period 1985-1993. Significant differences in ASR were observed among ethnic subgroups, with the lowest incidence among non-Jews (ASR, 5.0 per million; 95% CI, 0.7-9.3) and the highest among new immigrants from the former Soviet Union (FSU) who had been arriving since 1989 (ASR, 22.7 per million; 95% CI: 14.2-31.3). Between the periods 1985-1989 and 1990-1993, the ASR for Jews nearly doubled (rate ratio, 1.86; 95% CI, 1.1-2.5). This near-doubling was influenced, but not wholly accounted for, by the immigration from FSU and was observed in all ethnic subgroups.
CONCLUSIONS
The variations in the incidence rates of BOT among ethnic groups may be related to differences in fertility patterns, use of fertility drugs, and genetic predisposition. The pattern of near-doubling in rates may reflect biases caused by increased detection or shifts in the classification of ovarian tumors; if they are real, a biologic explanation is needed. Cancer 1998;82:147-51. © 1998 American Cancer Society.
12 citations
11 citations
TL;DR: There were no significant differences in incidence among Jewish ethnic subgroups, however, the lack of variability in the incidence of these neoplasms among subpopulations is in contrast with findings for cutaneous malignant melanoma.
Abstract: The incidence rate of cutaneous lymphomas (CL) [including mycosis fungoides (MF) and non-mycosis fungoides (non-MF)] for the period 1985-93 in Israel was determined using data from the population-based Cancer Registry supplemented by a field survey that covered approximately 80% of lymphoma cases. After the field survey, corrected rates were 49% and 24% higher for MF and non-MF respectively (37% for CL overall). The age-adjusted incidence rates per 100,000 were 1.18 and 0.63 for Jewish men and women respectively. MF rates (0.77 in men and 0.35 in women) were higher than non-MF (0.41 and 0.28 respectively). Rates of CL were significantly lower in non-Jews. There were no significant differences in incidence among Jewish ethnic subgroups. However, the lack of variability in the incidence of these neoplasms among subpopulations is in contrast with findings for cutaneous malignant melanoma; the observed high rates of CL could, nonetheless, be consistent with the sunlight exposure hypothesis, operating perhaps through a different mechanism.
TL;DR: An open label trial was conducted to study the efficacy of zuclopenthixol decanoate, a D1/D2 antagonist, in the treatment of chronic (> 10 years) neuroleptic-resistant aggressive schizophrenia and psychotic oligophrenic patients.
01 Jan 1998
TL;DR: In this article, the authors summarized the reactions of ClO2 with the major inorganic compounds or organic groups which are, or may be, present in water, and described their products.
Abstract: Chlorine dioxide is frequently used for the disinfection of drinking water and wastewater effluents. Its use is desired in particular in case of taste and odor problems caused by chlorine, or when the concentration of undesirable chlorinated by-products exceeds their maximum allowable concentrations. The chemical reactions of chlorine dioxide are much more specific and selective than those of chlorine and, as a consequence, it has a lower demand by water and does not produce as many by-products. However, chlorine dioxide is not an ideal oxidant either, because it reacts with various inorganic and organic aquatic compounds to produce a variety of products. The present chapter summarizes the reactions of ClO2 with the major inorganic compounds or organic groups which are, or may be, present in water, and describes their products. Special attention has been paid to the mechanisms of reactions in order to enable the prediction of reactions and products not specified in the current chapter. Some toxicological assessments of chlorine dioxide disinfection in general, and of some of its by-products in particular, are also included.
TL;DR: The results of this study indicate that several processes are involved in bacterial resistance/adaptation to chlorine stress and together they form a barrier against external damages caused by chemical disinfection.
TL;DR: Government legislation enforcing the use of rare earth screens is essential, because of the lack of prestige associated with acquiring rare earth technology, as well as institutional reluctance to accept the external benefits of reduced morbidity and mortality and/or to extend budgetary time horizons.
Abstract: In Israel the diffusion of rare earth screen technology has been limited. These screens could halve the radiation dose to the patient from diagnostic X-ray radiography, with little managerial effort and without being detrimental to the quality of the diagnostic image. We estimated the total effective dose from diagnostic film radiography capable of reduction by the use of rare earth screens, based on the number of hospital and ambulatory diagnostic X-ray procedures. This number was multiplied by the computed radiation dose per body site for a series of diagnostic procedures. The annual dose was approximately 0.53 mSv per head, approximately half of which could be averted by the introduction of rare earth screen technology. Based on a fatality risk of 3% Sv-1, it is estimated that the adoption of rare earth screen technology might reduce the annual incidence of cancer by some 93 cases, half of which would be fatal after an average latency period of 18.4 years. The cost of purchasing rare earth screens on a...
TL;DR: Immigrants from the former USSR appear to be more susceptible to diphtheria, thus increasing the possibility of clinical disease, and it is recommended that they receive booster doses of diphTheria toxoid.
Abstract: Large outbreaks of diphtheria occurred recently in the former USSR. Between 1989 and 1994, a total of about 600,000 Soviet immigrants arrived in Israel. The immune status against diphtheria in a sample of 992 men aged 17-49 and 195 women aged 17-19, who arrived in Israel during 1990-91, was studied in order to evaluate the need for vaccination. Participants completed a self-administered questionnaire and diphtheria antitoxin antibody levels were measured by means of ELISA. At age 17-19, the prevalence of antitoxin antibody levels below the protective level of 0.01 IU/ml was 4.8% in the men and 2.1% in the women. Among the men, the percentage lacking protection declined from 4.8% at age 17-19 years to 1.6% at age 20-24, and increased to 18.2% at age 35-49. In the oldest group, the prevalence of those lacking protection was considerably higher than for the general Israeli population. In the multivariate analysis, age, mother's education and republic of origin were significantly associated with the absence of protection. Immigrants from the former USSR appear to be more susceptible to diphtheria, thus increasing the possibility of clinical disease, and it is recommended that they receive booster doses of diphtheria toxoid.
Journal Article•
TL;DR: Sensitivity to the problematic issues involved in assessing malingering behavior is an important step toward malingered detection in the clinical setting and to the establishment of assessment methods that are less confounded by these issues.
Abstract: Neurobehavioral assessment is frequently made in a forensic context. The cognitive assessment may be biased due to an international manipulation of data by the patient motivated by attainment of compensation, that is, malingering. Although malingering is highly relevant in behavioral toxicology, the issue and its assessment are underrepresented in the literature. A routine assessment of malingering is important to reduce false-positive and false-negative errors in assessment, thereby establishing the credibility and validity of behavioral assessment. In the long run, the routine inclusion of malingering measurements might reduce claims and encourage employers to be more cooperative in behavioral toxicology studies. Guidelines for malingering assessment and research, inferred from the clinical and research literature, are discussed. Sensitivity to the problematic issues involved in assessing malingering behavior is an important step toward malingering detection in the clinical setting and to the establishment of assessment methods that are less confounded by these issues.
Journal Article•
TL;DR: This is a summary of the second effort to characterize medical research activities in Israel (1994-97), based on responses to a questionnaire sent to all participants in the first survey (1991-94) and to additional, including younger, investigators.
Abstract: This is a summary of the second effort to characterize medical research activities in Israel (1994-97). The study relies on responses to a questionnaire sent to all participants in the first survey (1991-94) and to additional, including younger, investigators. There were 1450 direct responses this time versus 1088 the first time. The distribution of investigators is 60% hospital-based versus 40% in basic sciences. The average number of funding sources per investigator has decreased from 2.6 to 2.2; however the percentage of funded investigators has increased from 60% to 70%. The greatest concentration of funded investigators remains at the Hebrew University and Hadassah Medical Center, followed by Tel Aviv University and associated hospitals. The Chief Scientist's Office of the Ministry of Health funds more than 40% of funded investigators (more than double the next highest funding source, the US-Israel Binational Fund), followed in decreasing order by the National Academy of Sciences, Ministry of Science, German-Israeli Foundation for Scientific Research and Development (GIF), Israel Cancer Society, and NIH. The percentage of funded hospital-based investigators has increased from 59% to 62%; however, funding remains higher for basic science investigators. There has been an increase in the percentage of Ph.D.'s working in a hospital environment and an interesting anomaly is that the nonacademic-affiliated Ph.D. investigators in hospitals have been successful in receiving funding, so now a greater percentage of nonacademic hospital staff are funded than academic staff (69% versus 61%).
Journal Article•
TL;DR: Limiting legal liability for those who opt to perform new medical procedures as part of clinical trials will encourage a more prudent and better regulated introduction of new technologies into medical practice.
Abstract: Before it is permitted for general use, a newly developed drug or medical device must undergo a series of pre-clinical testing and clinical trials to prove safety and efficacy. However, new medical procedures--even highly sophisticated and ethically controversial ones, such as organ transplants and I.V.F. do not require any clearance from regulatory authorities. This is an undesirable situation, which can be corrected by limiting legal liability for those who opt to perform new medical procedures as part of clinical trials. By this means we shall encourage a more prudent and better regulated introduction of new technologies into medical practice.