Biomedical subjects

Itamar Grotto

Publications and source records attributed to Itamar Grotto.

45 records · Page 3Linked to original sources

PubMed2003

Generalized cognitive impairment in male adolescents with schizotypal personality disorder.

Schizotypal Personality Disorder (SPD) shares common genetic and biological substrates with schizophrenia, and patients with SPD have been reported to suffer both from specific cognitive impairments, and from a generalized cognitive dysfunction, similar to those found in schizophrenia. The aim of this cross-sectional, population-based study was to assess general cognitive functioning in adolescents with SPD. The Israeli Draft Board systematically assesses cognitive functioning and administers psychiatric screening in all 16-17-year-old males in the population. Of 341,511 males assessed, the cognitive test scores of adolescents with SPD (N = 326) were retrieved, and compared to the scores of adolescents diagnosed as suffering from schizophrenia (N = 901), and adolescents with no neurological or psychiatric diagnosis (controls, N = 293,820). Male adolescents with SPD or with schizophrenia scored lower on all measures compared to healthy individuals (effect sizes ranging from 0.6-0.88, all P < 0.001). The SPD patients scored significantly higher than the schizophrenia patients on the sub-tests of similarities and Ravens Progressive Matrices, tests that reflect abstract reasoning. On the sub-tests of arithmetic and instruction comprehension, tests that rely on concentration, SPD and schizophrenia patients' scores did not differ significantly from each other. These results might be interpreted to imply that a generalized cognitive impairment, in the presence of schizotypal personality traits and in the absence of psychosis, might be conceptualized as being the core of the schizotaxia syndrome. The greater impairment in abstract reasoning in the schizophrenia patients might be correlated with the psychotic symptoms that differentiate schizophrenia from SPD.

Adolescent↗

PubMed2003

Diastolic blood pressure is the first to rise in association with early subclinical obstructive sleep apnea: lessons from periodic examination screening.

BACKGROUND: Obstructive sleep apnea syndrome (OSAS) is associated with long-term cardiovascular morbidity. Little is known about these relations at early stages. We conducted a case-control study in which we analyzed the clinical characteristics of young adults who underwent a periodic health examination and were screened for, and eventually found to experience, OSAS. METHODS: We identified 121 subjects newly diagnosed in a sleep study as having OSAS, and 229 matched control subjects in which screening for OSAS was negative. All had a medical interview, physical examination, and routine laboratory tests. RESULTS: Subjects who had OSAS had a higher, body mass index (3-kg/m(2) difference) and a higher diastolic blood pressure (4-mm Hg difference) value, without elevation in systolic blood pressure. There was no metabolic difference (lipids profile and fasting glucose levels) between groups. CONCLUSIONS: Diastolic blood pressure is higher early in the course of OSAS. Long term follow-up may determine effects of prevention and early intervention in OSAS and associated hypertension.

Adult↗

PubMed2003

Vitamin A supplementation and childhood morbidity from diarrhea and respiratory infections: a meta-analysis.

OBJECTIVES: To perform an updated meta-analysis of the effect of vitamin A supplementation on childhood morbidity from respiratory tract infections and diarrhea. Study design A comprehensive search of the 1966 to 2000 MEDLINE database and review of the reference lists of relevant articles identified 9 randomized controlled trials dealing with morbidity from respiratory infections and diarrhea in children 6 months to 7 years of age and provided "intention-to-treat" data. RESULTS: The combined results indicated that vitamin A supplementation has no consistent overall protective effect on the incidence of diarrhea (relative risk, 1.00; 95% CI, 0.94-1.07) and that it slightly increases the incidence of respiratory tract infections (relative risk, 1.08; 95% CI, 1.05-1.11). CONCLUSIONS: High-dose vitamin A supplements are not recommended on a routine basis for all preschool children and should be offered only to individuals or populations with vitamin A deficiency.

Child↗

PubMed2003

Clinical and epidemiologic investigation of two Legionella-Rickettsia co-infections.

BACKGROUND: We treated two patients diagnosed with legionellosis and simultaneous Rickettsia conorii co-infection. OBJECTIVES: To report the clinical and laboratory characteristics of this unusual combination, and to describe the execution and results of our environmental and epidemiologic investigations. METHODS: Serial serologic testing was conducted 1, 4 and 7 weeks after initial presentation. Water samples from the patients' residence were cultured for Legionella. Follow-up cultures were taken from identical points at 2 weeks and at 3 months after the initial survey. RESULTS: Both patients initially expressed a non-specific rise in anti-Legionella immunoglobulin M titers to multiple serotypes. By week 4 a definite pattern of specifically elevated IgG titers became apparent, with patient 1 demonstrating a rise in specific anti-L. pneumophila 12 IgG titer and patient 2 an identical response to L. jordanis. At 4 weeks both patients were positive for both IgM and IgG anti-R. conorii antibodies at a titer > or = 1:100. Heavy growth of Legionella was found in water sampled from the shower heads in the rooms of both patients. Indirect immunofluorescence of water cultures was positive for L. pneumophila 12 and for L. jordanis. CONCLUSIONS: Although most cases of community-acquired Legionella pneumonia in our region appear simultaneously with at least one other causative agent, co-infection with R. conorii is unusual and has not been reported to date. This report illustrates the importance of cooperation between clinicians and public health practitioners.

Adult↗

PubMed2003

[Israeli guidelines for investigation and management of SARS cases and their contacts].

As the first emerging epidemic of the 21st century, SARS has raised much interest and fear among statesmen, economists, and the general public, as well as within the medical community. This new disease is characterized by several daunting challenges, including person-to-person transmission, an environmentally resistant agent, a non-specific clinical presentation, and a high fatality rate among high risk individuals. In Israel, as elsewhere, public health authorities were forced to quickly design appropriate measures to confront this new threat. The Israeli guidelines for surveillance, epidemiologic investigation and intervention in the event of a SARS outbreak were drafted in the absence of complete data on some of the most basic epidemiologic characteristics of the disease. Discrepancies between published guidelines from several countries made the decision-making process even more complicated. We describe the epidemiologic guidelines for SARS drafted by the Israeli working group, as well as the considerations on which they are based. The recent experience with this new outbreak has already provided several valuable lessons on policy making which may help future planning for emerging and re-emerging infectious diseases.

Disease Outbreaks↗

PubMed2002

Anticapsular polysaccharide meningococcal antibodies in Israeli military recruits: immune status and the effect of simultaneous administration of immune globulin on the response to polysaccharide vaccine.

The effect of the administration of immune globulin (Ig), given during summer months to prevent hepatitis A, on the immune response to a simultaneously administered quadrivalent meningococcal polysaccharide vaccine (QMPV) was studied in Israeli military recruits. Data were obtained for the first time regarding the immune status of an Israeli population. Anticapsular polysaccharide antibodies were determined using a standardized ELISA assay before, 2 weeks and 3 months after QMPV immunization with or without Ig in two groups of recruits chosen to span the date determining seasonal administration or non-administration of Ig. Pre-vaccination antibody concentrations were > or = 2 microg/ml in 98.4 and 38.9% of subjects against serogroups A and C meningococci, respectively. These levels are consistent with the extremely low incidence of disease due to serogroup A in Israel, and with the previously documented occurrence of serogroup C disease in servicemen and women. Co-administration of Ig was associated with some reduction in antibody concentrations 3 months after vaccination, especially against serogroup A meningococci (P<0.05), but not to an extent likely to be of clinical significance.

Adolescent↗

PubMed2002

Adult infection with hepatitis A despite declining endemicity; in favor of adult vaccination.

Seropositivity against hepatitis A was examined among 4806 standing army personnel (4497 males and 309 females) during 1998-1999. Each bi-annual birth cohort examined showed a decline in seropositivity compared to the previous one. When compared with a study performed in 1989, however, for each of the 1961-1962, 1963-1964, 1965-1966, 1967-1968 and 1969-1970 birth cohorts examined, the 1998-1999 study showed 5-15% higher seropositivity. This trend remained after controlling for differences between the two studies in ethnic origin, sibship size and level of education. The overall seroconversion rate is estimated as 1.15% per year and the clinical to subclinical ratio as 1:14. Thus, hepatitis A infection continues to occur in the young adult age group and vaccination of this group should be considered.

Adult↗

PubMed2002

Measles antibody prevalence rates among young adults in Israel.

BACKGROUND: In Israel, vaccination coverage against measles is high, yet seroepidemiologic studies have shown that more than 15% of the 18-year-old population were unprotected against the disease. A 2-dose program of vaccination against measles, mumps, and rubella at the ages of 1 and 6 years was begun in 1990, supplemented by a measles catch-up plan for all 13-year-olds. The aim of this study was to assess the prevalence of antimeasles antibodies at induction to the Israel Defense Forces in the first doubly vaccinated birth-cohort. METHODS: In 1996, serum samples of 540 recruits, 339 men and 201 women, were tested for measles virus antibody. Findings were compared with surveys conducted in 1987 and 1990. RESULTS: Measles antibodies were present in 95.6% (95% CI, 93.5-97.1) of the recruits. Antibody prevalence was higher in women than in men (99% vs 93.5%; P =.0096). A slightly lower seroprevalence was found in recruits born in the former Soviet Union. The results were substantially higher than the seroprevalence rates found in 1987 (73.3%) and 1990 (84.6%). CONCLUSIONS: The high prevalence of antimeasles antibodies in the young adult population in Israel points to the success of the double-vaccination policy in promoting immunity against the disease.

Adolescent↗

PubMedDate not supplied

Validity of self-assessment of skin reaction after smallpox vaccination.

OBJECTIVE: Smallpox vaccinees should be evaluated for the presence of a major skin reaction ("take") one week after vaccination, but this could prove to be logistically infeasible in the context of an emergency mass-vaccination campaign. We validated a tool for self-evaluation of the vaccination site for presence of take. METHODS: We conducted a prospective, double-blinded, paired-measurement validation study of 174 non-naive adult vaccinees and their physician evaluators. Subjects provided paired, blinded, independent assessments of take 7-9 days after vaccination. RESULTS: Overall, vaccinees and evaluators agreed on 157 of 174 (90.2%) take assessments. Sensitivity of the tool was 99.1%, and specificity was 75%. The positive predictive value of self-assessment was 87.2% and the negative predictive value was 98%. Specificity of the tool and measures of agreement were significantly modified by age, education, and occupation. When adjusted for the expected take rate among a population including naive vaccinees, positive predictive value and overall agreement increased significantly. CONCLUSIONS: Self-assessment may be a feasible option for evaluation of take in the event of mass smallpox vaccination. The predictive values and overall agreement of the tool are satisfactory, and can be expected to increase when used in a largely naive population.

Adult↗