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Biomedical subjects

J B Friedman

Publications and source records attributed to J B Friedman.

11 recordsLinked to original sources

Osteoarthritis, the hazard of living longer: arthroscopy vs. conservative treatment.

The lengthening of the average life span has led to an increase in degenerative diseases, among them osteoarthritis. Arthroscopy, which has been used extensively to decrease pain and inflammation and increase the range of motion, has recently been challenged as the treatment of choice. Several studies have found that joint lavage, which is a less costly procedure, provides better solutions to joint disorders. In Israel, where resources for health care are limited, physicians must also be guided by cost-benefit and cost-effectiveness. Since there is limited benefit to be gained from arthroscopy in cases where there is no mechanical damage to the knee, we suggest that nonsurgical, conservative methods be employed in treating the majority of cases of osteoarthritis.

Aged↗

Tetanus in Israel, Judea/Samaria and Gaza, 1968-89: progress and challenge.

During the 1950s tetanus was a major public health concern in Israel, with incidence rates of up to 2/100,000 occurring predominantly among farmers and infants (tetanus neonatorum). These rates have declined considerably since then, with an average of 2 cases per year in recent years, and 5 cases in 1988. There has been a major decline in tetanus incidence in Judea/Samaria and Gaza, due to a successful vaccination program reaching over 90% of infants and schoolchildren and to educational programs. In Judea/Samaria and Gaza, prevention of tetanus neonatorum has improved as a result of the increasing number of hospital deliveries (now 62% in the West Bank and 80% in Gaza), and the widespread immunization of pregnant women and adolescent girls of childbearing age. Special efforts were given to the education of traditional birth attendants (dayas). Prevention of adult tetanus was achieved through immunization of high school students and laborers. Recent cases in all three areas are equally distributed between newborns and elderly persons. Because of the persistence of the incidence of tetanus, a review of Israel's immunization policy is indicated, focusing on high risk groups such as Bedouin women of childbearing age and the elderly.

Adult↗

Measles in Israel, the West Bank, and Gaza: continuing incidence and the case for a new eradication strategy.

Measles continues to occur in epidemic waves in Israel, Gaza, and the West Bank, causing morbidity and mortality. In Israel, immunization of infants against measles began in 1967, and 90% had been immunized by the mid-1980s. In Gaza and the West Bank, where immunization of infants against measles began in 1973 and 1976, respectively, the immunization rate reached 75% in the late 1970s and increased to greater than 90% in the 1980s. Measles epidemics, which previously had occurred in 5- to 7-year cycles, occurred every 2-4 years in the 1980s and affected individuals who were older than those affected in previous years. Israel's commitment to eradicating measles by 1992 will require a substantially expanded immunization program in comparison with the traditional program that requires immunization of infants alone. The benefits of several alternative immunization strategies considerably exceed their costs. A new, two-dose immunization will be needed as a minimal strategy, and a campaign for administering booster doses to school-aged children may be required as well to achieve control and eradication of measles. Measles is a serious but preventable public health problem; appropriate strategies must be devised by national and international public health officials to control the disease in developing and developed countries.

Adolescent↗