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Biomedical subjects

J R Goldsmith

Publications and source records attributed to J R Goldsmith.

At least 19 recordsLinked to original sources
PubMed1992

Nuclear installations and childhood cancer in the UK: mortality and incidence for 0-9-year-old children, 1971-1980.

Data on cancer incidence and mortality in the vicinity of nuclear installations in England and Wales have been published, covering the period 1959-1980. Several age classes and a number of cancer sites have been included. Systematic analysis has so far been limited to cancer mortality. This suggests that childhood leukemia is unusually frequent near some types of installations and the excess is greater for years 0-9 than for later ages. In the earlier decade, 1959-1969, there was questionable consistency of incidence reporting. This report uses the incidence and mortality data only for the period 1971-1980; leukemia and non-leukemia cancer data for those 0-9 years are analyzed, and consistency of incidence reporting is evaluated by comparing incidence and mortality. For comparison with reported data for grouped local authority areas (LAAs) near to 21 different installations, two sources of expected incidence are used. The first is based on regional data, and the second is based on a group of LAAs similar in location, urban/rural character and population size. Effectiveness of treatment of acute lymphocytic leukemia (ALL, the principal type among 0-9-year-old children) has improved in recent decades and this has decreased the case fatality rate, and increased the relevance of incidence data. No significant differences in the mortality/incidence ratio were found when comparing areas near installations with their matched reference areas. Although some standardized incidence ratios (SIRs) are low in comparison areas, these are a reflection of the small numbers in the denominator. Low and high SIRs are observed in both installation and comparison areas. Excluding the populations near Sellafield and Dounreay, the installations of which include nuclear reprocessing and which are reported elsewhere, children living near one of a group of six installations have significantly increased leukemia incidence. One hundred sixty-five cases were observed for the combined population group, whereas 133.6 were expected on the basis of regional data and 141.9 on the basis of comparison areas. The operations of these installations include nuclear research, nuclear fuel production, nuclear weapons manufacture, and radio-isotopic reagent manufacture and marketing. No evidence of any increase of leukemia incidence is found for populations surrounding nuclear power installations, nor in coastal communities possibly affected by Sellafield discharges.(ABSTRACT TRUNCATED AT 400 WORDS)

Child↗
PubMed1992

Involvement of protein kinase C in serotonin-induced spike broadening and synaptic facilitation in sensorimotor connections of Aplysia.

1. Plasticity at the connections between sensory neurons and their follower cells in Aplysia has been used extensively as a model system to examine mechanisms of simple forms of learning. Earlier studies have concluded that serotonin (5-HT) is a key modulatory transmitter and that it exerts its short-term actions via cAMP-dependent activation of protein kinase A. Subsequently, it has become clear that other kinase systems such as protein kinase C (PKC) also may be involved in the actions of 5-HT. 2. Application of phorbol esters, which activate PKC, produced a slowly developing spike broadening but had little effect on excitability (a process known to be primarily cAMP dependent). Moreover, the effects of phorbol esters and 5-HT on spike duration were not additive, suggesting that they may share some common mechanisms. 3. The protein kinase inhibitor staurosporine suppressed both 5-HT-induced slowly developing spike broadening and, under certain conditions, facilitation of transmitter release. Staurosporine did not inhibit 5-HT-induced enhancement of excitability. The effectiveness of staurosporine on spike broadening was dependent on the time at which spike broadening was examined after application of 5-HT. Staurosporine appeared to have little effect on spike broadening 3 min after application of 5-HT, whereas it inhibited significantly 5-HT-induced spike broadening at later times. The staurosporine-insensitive component of 5-HT-induced spike broadening may be mediated by cAMP. 4. The results suggest that the activation of PKC plays a key role in components of both 5-HT-induced spike broadening and facilitation of synaptic transmission.(ABSTRACT TRUNCATED AT 250 WORDS)

Alkaloids↗
PubMed1991

Perspectives on what we formerly called threshold limit values.

From the point of view of an epidemiologist with experience in community air quality standards, occupational health standards, radiation standards, and water quality standards, reasons are given for discarding the assumption that occupational health protection should be based on threshold concepts. The weakness of worker health protection based on prescription of maximal exposure levels is noted, regardless of whose judgement is used for such levels.

Air Pollutants, Occupational↗
PubMed1991

Neural and molecular bases of nonassociative and associative learning in Aplysia.

A model that summarizes some of the neural and molecular mechanisms contributing to short- and long-term sensitization is shown in Figure 14. Sensitizing stimuli lead to the release of a modulatory transmitter such as 5-HT. Both serotonin and sensitizing stimuli lead to an increase in the synthesis of cAMP and the modulation of a number of K+ currents through protein phosphorylation. Closure of these K+ channels leads to membrane depolarization and the enhancement of excitability. An additional consequence of the modulation of the K+ currents is a reduction of current during the repolarization of the action potential, which leads to an increase in its duration. As a result, Ca2+ flows into the cell for a correspondingly longer period of time, and additional transmitter is released from the cell. Modulation of the pool of transmitter available for release (mobilization) also appears to occur as a result of sensitizing stimuli. Recent evidence indicates that the mobilization process can be activated by both cAMP-dependent protein kinase and protein kinase C. Thus, release of transmitter is enhanced not only because of the greater influx of Ca2+ but also because more transmitter is made available for release by mobilization. The enhanced release of transmitter leads to enhanced activation of motor neurons and an enhanced behavioral response. Just as the regulation of membrane currents is used as a read out of the memory for short-term sensitization, it also is used as a read out of the memory for long-term sensitization. But long-term sensitization differs from short-term sensitization in that morphological changes are associated with it, and long-term sensitization requires new protein synthesis. The mechanisms that induce and maintain the long-term changes are not yet fully understood (see the dashed lines in Fig. 14) although they are likely to be due to direct interactions with the translation apparatus and perhaps also to events occurring in the cell nucleus. Nevertheless, it appears that the same intracellular messenger, cAMP, that contributes to the expression of the short-term changes, also triggers cellular processes that lead to the long-term changes. One possible mechanism for the action of cAMP is through its regulation of the synthesis of membrane modulatory proteins or key effector proteins (for example, membrane channels). It is also possible that long-term changes in membrane currents could be due in part to enhanced activity of the cAMP-dependent protein kinase so that there is a persistent phosphorylation of target proteins.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗
PubMed1991

Follow-up of schoolchildren in the vicinity of a coal-fired power plant in Israel.

This study was carried out in the framework of a health monitoring system set up in the vicinity of a 1400 megawatt coal-fired power plant in Israel. Second- and fifth-grade school children were followed up every 3 years; they performed pulmonary function tests (PFT), and their parents filled out American Thoracic Society-National Heart and Lung Institute health questionnaires. Among the cohort of second graders (in 1983) living in the area expected to be most polluted, a significant increase in the prevalence of part of the respiratory symptoms (such as cough and sputum, wheezing with and without cold and wheezing accompanied by shortness of breath) was evident in 1986. The prevalence of asthma among fifth graders in this area doubled (p = 0.0273) compared with prevalence when they were second graders. Among the children from the older cohort (fifth graders in 1983) living in this community, a similar although milder trend could be observed, especially in regard to an increased prevalence of asthma in 1986 compared with 1983 (13.9% versus 8.1%). Annual increases in PFT in the four groups of children (boys and girls from both cohorts) were found to be higher in the community expected to be polluted (especially in the younger cohort) compared with the two other communities. The discrepancy between the increased prevalence of respiratory symptoms and diseases and the higher annual increase in PFT among children from the expected more polluted community may be partly attributable to differential annual increase in height and to different distribution of background variables (such as socioeconomic status, passive smoking, heating, and respiratory diseases among parents) in the three communities.

Air Pollution↗
PubMed1991

Preventability of neonatal cold injury and its contribution to neonatal mortality.

When the body temperature of a small neonate falls below 35 degrees C, lassitude can be noted; severe derangements of cardiovascular, renal, hepatic, immunological, and hematological systems may also occur depending in part on the duration and severity of hypothermia. Diagnosis requires a low-reading thermometer, lacking which the diagnosis can be suspected, but most often is missed. Fatal cases of diagnosed cold injury commonly have terminal pneumonia or sepsis. Prevention involves identification and home visits to high-risk infants; intensive care of those with the diagnosis at Soroka Hospital Medical Center has reduced the case-fatality rate from 30% in 1971 to 3% in 1988-1989. During the same period in our region, the proportion of neonatal deaths occurring in winter months of December, January, and February has dropped from 55 to 27%. The expected proportion is 25%. We hypothesize that excess neonatal mortality during winter months, especially due to pneumonia and sepsis or sudden infant death syndrome (SIDS) is an indicator of missed cold injury syndrome. A preliminary evaluation was made form U.S. data by state, provided by the National Center for Health Statistics, which records no fatalities from cold injury during 1986. Contrasted with this are 26 cold injury deaths in Israel for 1977-1980. In the U.S., though, excess winter neonatal deaths in 1986 from SIDS, pneumonia, and sepsis are reported.(ABSTRACT TRUNCATED AT 250 WORDS)

Cold Temperature↗
PubMed1989

Clustering of Parkinson's disease in southern Israel.

On three adjacent kibbutzim (collective rural communities) in the Negev (Southern Israel) 13 parkinsonian patients were found among a population of 592 persons 40 years or older. The clinical picture was not different from that of patients from other areas with idiopathic parkinsonism. Long term residence in the kibbutzim is characteristic of this population. In the past most of the drinking water has been supplied by wells from a common aquifer. From other patients with Parkinson's disease in the Negev, we estimated the age-specific incidence for the region. The incidence is about five times greater in each of these kibbutzim than in the remainder of the Negev. Although associations with rural residence and well water use have been reported elsewhere, clusters of this sort have not been reported. They strongly suggest that a common environmental factor exists.

Adult↗
PubMed1989

Cardiovascular disease hospitalization rates in Negev communities: are differences due to differential prevalence or differential use of health care?

Goldsmith and Pilpel found the rate of hospitalization for cardiovascular disease (CVD) in Beer Sheva in 1981 to be approximately twice that of five development towns in the Negev. In order to determine whether this difference was due to differences in the prevalence of heart disease, data on heart disease mortality hospitalization for 1981, 1983 and 1985 was studied, and hypertension prevalence in these communities were examined. From 1981 death records, age-adjusted CVD rates for the male population greater than 30 years were 397.7/100,000 in Beer Sheva and 344.4 in development towns; for women the rates were 351.5 and 411.2, respectively. Myocardial infarction rates for men were the only subset of CVD to be significantly different (Beer Sheva 174.3 vs. development towns 115.7). Beer Sheva residents with CVD were significantly more likely to die in the hospital or another health care facility than residents of development towns. The rates of emergency room use were higher in Beer Sheva than in development towns, but the proportion of those patients who came to the emergency room because of chest pain who were hospitalized was the same for both communities. Data from a sample study of hypertension recorded for patients in primary care clinics in 1983 showed no differences in prevalence or treatment status between Beer Sheva and development town residents. Overall CVD hospitalization rates were 27.7% greater for BS men and 33.3% for BS women. We conclude that: a) the higher rate for myocardial infarction in Beer Sheva merits further investigation, but cannot account for the differential rates of hospital use; and b) distance from the hospital and c) culturally associated attitudes toward hospitalization on the part of both patients and physicians are likely explanations that should be further investigated.

Adult↗
PubMed1988

Comprehensive pediatric primary care vs traditional care in an Israeli population: their influence on pediatric emergency room use and hospitalization.

Emergency room (ER) utilization and hospitalization were studied as indicators of the impact of improvements in pediatric primary care services in an Israeli development town, Ofakim, population 12,000. One of the two pediatric services was upgraded in 1976 through the introduction of pediatric faculty, integration of preventive and curative services and conversion of the medical records to a problem-oriented format ("experimental" clinic "B"). The primary care system remained unchanged in the second clinic ("traditional" clinic "A"). During 1980, ER utilization by the "B" clinic population was 9.3/100 compared with 17.6/100 for the "A" clinic population. Fifty two percent of the "B" clinic population patients reaching the ER were hospitalized compared with 25% of "A" clinic patients. The lower ER utilization rate represents a significant saving for the health services, and educational interventions are suggested from the study. Analysis of ER utilization data seems to offer useful information for overall planning and monitoring of ambulatory services for a community.

Adolescent↗
PubMed1988

Racial or ethnic variation in spirometric lung function norms. Recommendations based on study of Ethiopian Jews.

It is widely known that different ethnic (or racial) groups do not appear to have lung function test results which fit the same prediction formulae. Israel, with ethnic minorities from many countries, is faced with a dilemma as to what to use as a basis for normative estimates. We studied 146 Ethiopian Jewish immigrants (68 males and 78 females), all nonsmokers with no evidence of any chronic disease. The FEV1 and FVC were analyzed separately by sex and age (those less than 25 and those 25 years or more of age). Standard prediction formulae based on height overpredicted the values found by from 15 to 29 percent. Logarithmic formulae based on sitting height provided a good fit for values for children (less than 25 years). Compared to other populations the sitting height-standing height ratio was low for this population, (0.48 vs 0.52) reflecting their relatively long limbs and shorter thoracic height. Our findings suggest that as a guideline, ethnic groups with deviant standing height-sitting height ratios either use ethnic-group specific prediction formulae or derive prediction formulae using sitting height.

Body Height↗