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Biomedical subjects

B Modan

Publications and source records attributed to B Modan.

At least 91 records · Page 5Linked to original sources
PubMed1995

The need for liver transplantation: a nationwide estimate based on consensus review.

Orthotopic liver transplantation (OLT) is widely practised in developed countries. The procedure is costly, the supply of donor organs limited, and it is not known how many patients need transplantation. A community-wide estimate of the needs for OLT was performed over two years in all general hospitals in Israel. Records of 1851 patients with liver disease were screened to identify those who might eventually need OLT. The annual estimate of transplantation needs in the country was 10-15.5 per million population, with equal numbers of males and females. The addition of patients with nonreformed alcoholism and end-stage liver disease, originally set as an exclusion criteria, would have added 20% to this estimate. 37% of potential candidates were under 40 years of age at diagnosis, and about 50% were 55-64 years old. Almost 80% of patients had cirrhosis of the liver and 13.6% had fulminant hepatitis. These findings provide a basis for a national plan of OLT in Israel, and similar studies might be useful in other countries.

Adolescent↗
PubMed1995

[Potential effect of the Russian immigration on cancer incidence in Israel].

Cancer incidence patterns of Jews from the former USSR differ from those among Israeli Jews originating from Europe who arrived with previous waves of immigration. Projected estimates of cancer incidence in Israel following the current Russian immigration indicate that the total cancer rate in the country will grow in proportion to this immigration. In addition, changes are anticipated in the distribution of cancer sites. These include increases in the incidence of esophageal cancer of 50%, stomach and cervical 33%, pulmonary 21%, and laryngeal 18%. In contrast, malignant melanoma, breast and rectal cancer, and leukemia and lymphomas, will decrease slightly. These changes mandate appropriate adjustments with regard to both curative and preventive measures.

Emigration and Immigration↗
PubMed1995

[Long-term follow-up in polycythemia vera].

67 patients with polycythemia vera, diagnosed and treated between 1963-1990, were analyzed retrospectively. The mean follow-up was 7.4 +/- 5.1 years and median actuarial overall survival 23.6 years. 50% were treated with a single chemotherapeutic agent, and 46% with combinations of agents. In only 4% was phlebotomy the sole treatment. There were hematological complications in 18%, thromboses in 18%, and bleeding in 21%.

Combined Modality Therapy↗
PubMed1995

Twenty-five-year mortality rate decrease in patients in Israel with a first episode of acute myocardial infarction. Secondary Prevention Reinfarction Israeli Nifedipine Trial Study Group. Israeli Thrombolytic Survey Group.

The aim of our study was to compare the outcome of patients with a first acute myocardial infarction (AMI) among three large cohorts of patients hospitalized between 1966 and 1992 in Israel, in view of changes in treatment facilities and investigation methods. Patients with a first AMI constituted 71% of all myocardial infarctions in 1966, 74% in 1981-1983, and 71% in 1992. The male-female ratio and the distribution of the site of infarction also remained stable from 1966 to 1992. The mean age of patients increased over time. Thrombolytic therapy was not available in 1966 and 1981-1983, whereas 53% of patients were treated with a thrombolytic agent and 22% examined with coronary angiography in 1992. The 21-day mortality rate decreased markedly, from 22% in 1966 to 14% in 1981-1983 and to 8% in 1992. The decrease was similar in both genders and among 10-year age groups. The 1-year postdischarge mortality rate (not evaluated in 1966) decreased from 7% in 1981-1983 to 6% in 1992. We conclude that a significant reduction in mortality rate after a first AMI took place over the 25-year period. Changes in treatment modality and management of the acute phase may explain this decrease in mortality rate over time.

Adult↗
PubMed1995

The effect of diagnosis and treatment delay on prognostic factors and survival in endometrial carcinoma.

OBJECTIVE: The aim of this study was to assess the association of diagnosis and treatment delay with established prognostic factors and survival. STUDY DESIGN: The study group comprised 181 consecutive patients with endometrial carcinoma diagnosed between 1970 and 1986, whose records contained details with regard to diagnosis delay; 174 of them also contained details with regard to treatment delay. RESULTS: The significant prognostic factors that we found, namely, age, clinical stage, grade, depth of myometrial invasion, and histologic type, are in line with those of other studies. However, no significant correlation was found between the duration of delay and these prognostic factors or with survival. CONCLUSION: We conclude that delay of diagnosis (< 1 year) and of treatment of < 4 months do not compromise survival of patients with endometrial cancer.

Adenocarcinoma↗
PubMed1995

Eating disorders among Jewish female adolescents in Israel: a 5-year study.

PURPOSE: The current study examines the nationwide incidence of eating disorders (ED) among Jewish adolescents over a 5-year period (1989-93). METHODS: Data were obtained from 80% of all community and hospital adolescent and mental health institutions in Israel. Case identification was based on screening records according to DSM-III-R criteria for ED. RESULTS: Six hundred and thirty two new cases were identified with the following diagnostic distribution: anorexia 60%, bulimia 17%, anorexia and bulimia 4%, and ED not otherwise specified 20%. The present analysis is limited to females only (N = 602 or 95%). Median age for anorexia is 15 years and for bulimia 16 years. CONCLUSION: On the basis of this initial survey, the mean annual incidence of all eating disorders in Jewish Israeli females 12-18 years of age is 48.8 per 100,000. For anorexia the mean incidence is 29.0 and for bulimia 8.6. These figures represent an underestimation of the actual incidence due to incomplete data accrual.

Adolescent↗
PubMed1995

Thyroid cancer after exposure to external radiation: a pooled analysis of seven studies.

The thyroid gland of children is especially vulnerable to the carcinogenic action of ionizing radiation. To provide insights into various modifying influences on risk, seven major studies with organ doses to individual subjects were evaluated. Five cohort studies (atomic bomb survivors, children treated for tinea capitis, two studies of children irradiated for enlarged tonsils, and infants irradiated for an enlarged thymus gland) and two case-control studies (patients with cervical cancer and childhood cancer) were studied. The combined studies include almost 120,000 people (approximately 58,000 exposed to a wide range of doses and 61,000 nonexposed subjects), nearly 700 thyroid cancers and 3,000,000 person years of follow-up. For persons exposed to radiation before age 15 years, linearity best described the dose response, even down to 0.10 Gy. At the highest doses (> 10 Gy), associated with cancer therapy, there appeared to be a decrease or leveling of risk. For childhood exposures, the pooled excess relative risk per Gy (ERR/Gy) was 7.7 (95% CI = 2.1, 28.7) and the excess absolute risk per 10(4) PY Gy (EAR/10(4) PY Gy) was 4.4 (95% CI = 1.9, 10.1). The attributable risk percent (AR%) at 1 Gy was 88%. However, these summary estimates were affected strongly by age at exposure even within this limited age range. The ERR was greater (P = 0.07) for females than males, but the findings from the individual studies were not consistent. The EAR was higher among women, reflecting their higher rate of naturally occurring thyroid cancer. The distribution of ERR over time followed neither a simple multiplicative nor an additive pattern in relation to background occurrence. Only two cases were seen within 5 years of exposure. The ERR began to decline about 30 years after exposure but was still elevated at 40 years. Risk also decreased significantly with increasing age at exposure, with little risk apparent after age 20 years. Based on limited data, there was a suggestion that spreading dose over time (from a few days to > 1 year) may lower risk, possibly due to the opportunity for cellular repair mechanisms to operate. The thyroid gland in children has one of the highest risk coefficients of any organ and is the only tissue with convincing evidence for risk about 1.10 Gy.

Adolescent↗
PubMed1995

Surgical vs. clinical staging of endometrial carcinoma. The impact on treatment modification, morbidity and survival.

OBJECTIVE: To assess the impact of surgical staging on treatment modification and outcome in endometrial carcinoma (EC) patients. METHODS: Two groups of histologically confirmed clinical Stage I and II EC patients, diagnosed during two time periods (1976-1984 and 1985-1991), were retrospectively compared. Sixty-five patients diagnosed during the first period were staged only clinically and treated according to a protocol based on this staging system. Fifty-six patients diagnosed during the second period were staged surgically and treatment was modified according to surgical pathological findings. RESULTS: The findings based on the surgical staging spared radiotherapy in some patients and prompted additional treatment in others. The morbidity and survival were similar in the two groups. CONCLUSIONS: Surgical pathological findings in EC patients may modify management and contribute to prognostic significance. No effect on postoperative morbidity or on actuarial survival was demonstrated.

Adult↗
PubMed1994

The quandary of cancer prevention.

The incidence and mortality due to the major cancers such as lung, breast, colon-rectum, prostate, and ovary have changed very little over the past 20-30 years, in spite of the introduction of important new treatments and apparent prolongation of survival of patients with these cancers. The new strategies focus on earlier detection and primary prevention of cancer. Three approaches for prevention are receiving increasing prominence as an approach to reducing the incidence of cancer: (1) control of common source environmental carcinogens, (2) modification of personal health behavior believed to increase or decrease the risk of cancer, and (3) identification of specific genotypes that increase the risk of cancer. All of these approaches offer some hope of reducing cancer incidence and morbidity. All will be costly and, therefore, require careful evaluation. It is likely that the changes in personal health behaviors will have the greatest overall impact on cancer incidence. Identification of specific genotypes will be of importance for high risk families. At present, it is unlikely that control of environmental common sources will substantially reduce cancer incidence without better measures of exposure and risk of disease.

Environmental Health↗
PubMed1994

Familial aggregation of haematological neoplasms: a controlled study.

Advances in molecular biology techniques suggest that many haematological neoplasms originate from a transformation process at the level of the haemopoietic pluripotential stem cell. While familial aggregation has been reported for many haematological neoplasms, most studies were uncontrolled and examined the presence of the same haematological neoplasm as the index case. We assessed the familial aggregation of all haematological neoplasms in 4061 family members of 189 patients with various haematological neoplasms and two control groups: 955 relatives of 36 patients with non-malignant haematological disorders and 508 relatives of 33 patients with type II diabetes mellitus. Data collection included self-administered questionnaires. The odds ratio for haematological neoplasms among relatives of the index cases adjusted for age, sex, ethnicity, number of relatives in the family, and degree of familial linkage in the study group versus the two control groups was 3.62 (95% confidence interval, 1.44-9.07; P < 0.01). The vast majority of the haematological neoplasms among family members did not belong to the same histopathological category as the index cases. The data support the hypothesis of a genetic predisposition to haematological neoplasms. The fact that the aggregation is not disease specific is consistent with a defect in the pluripotent haemopoietic stem cell.

Adolescent↗
PubMed1993

Orthodox Jews have a lower incidence of malignant melanoma. A note on the potentially protective role of traditional clothing.

The incidence of malignant melanoma (MM) in orthodox and non-orthodox Jews in Israel during the years 1970-1982 was compared through an assessment of incidence rates in the orthodox and non-orthodox neighborhoods in the city of Jerusalem and by a comparison of the rates in 2 cities on the outskirts of Tel Aviv, one of which has a strongly orthodox population. Within the city of Jerusalem the incidence of MM for the European-American born in the orthodox neighborhoods was significantly lower than in the rest of the city in males, and of borderline significance in females. A similar pattern was seen upon comparison of the orthodox city of Bnei Brak to its neighbor city, Givatayim. The findings are consistent with the role of sun exposure in the etiology of malignant melanoma.

Clothing↗
PubMed1993

Quantitative and qualitative assessment of plasma von Willebrand factor in classic Kaposi's sarcoma.

BACKGROUND: von Willebrand factor (vWF) is synthesized almost exclusively by endothelial cells and is stored there as ultra-high-molecular-weight multimers. The vWF multimers that are detected in the plasma are smaller than those stored within the endothelium. In two previous studies, comprising small series of cases with classic Kaposi's sarcoma (KS), an endothelium-derived tumor, increased levels of plasma von Willebrand factor antigen (VWF:Ag, the antigenic structure) were reported, suggesting that vWF:Ag may be a marker of endothelium proliferation. OBJECTIVE: Our purpose was to investigate the quantitative as well as qualitative alterations of plasma vWF in a large series of patients with classic KS at various stages of the disease. METHODS: Levels of plasma vWF:Ag were studied in 38 patients with classic KS confined to the skin at various stages of the disease and compared with a control group. Thirty-three patients had active KS (i.e., with skin lesions) and five were in remission. In five patients with active KS multimeric analysis of plasma vWF was also performed. RESULTS: The levels of vWF:Ag were significantly higher among KS patients than in the control group (n = 29, p < 0.01). Levels of vWF:Ag were also significantly higher in patients with active disease as compared with those in remission (p < 0.05). No correlation was found between vWF:Ag levels and the extent of KS. Analysis of the multimeric pattern of plasma vWF showed enhanced staining of all bands, particularly the intermediate and high molecular weight forms, which resemble the endothelial forms as opposed to normal circulating vWF multimers. CONCLUSION: Quantitative as well as qualitative alterations in plasma vWF were found in patients with KS, which may reflect the destruction or activation of endothelial cells within the lesions. vWF:Ag may serve as a marker of disease activity in classic KS; however, it is not a good marker for the extent of the disease.

Aged↗
PubMed1993

Screening for cervical cancer--should the routine be challenged?

Despite the extensiveness of cervical cancer screening programs, certain major issues are still at stake: (a) substantial false negative rates are common, mostly due to impaired test quality, (b) the optimal length of interval between screenings is uncertain, being a function of available resources and the physicians' attitude, (c) the postmenopausal population, in which incidence is highest, is inadequately tapped. Efforts must be made to optimise the process through more stringent control measures, and a more comprehensive cover of the target population.

Adult↗