PubMed Health⌕ Search

Biomedical subjects

J R Goldsmith

Publications and source records attributed to J R Goldsmith.

At least 55 records · Page 3Linked to original sources
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↗
PubMed1986

Comparative epidemiology of men exposed to asbestos and man-made mineral fibers.

Comparative analyses are presented of selected studies of long-term reactions to occupational exposures to asbestos and man-made mineral fibers (MMMF), with emphasis on studies with dose-response information and long enough period of follow-up to observe lung cancer excess, if it occurred. Uniform dose estimates based on average number of fibers per milliliter were derived and tabulated with the corresponding standard mortality (or morbidity) ratio (SMR), crude probability for each unfavorable outcome, and the likelihood that at least as many deaths would have occurred as a result of the expected numbers under Poisson assumptions. A dose-response relationship was said to have been indicated when the crude probability increased monotonically with dose and/or the Poisson probability decreased and reached a value of less than 0.05. Some arbitrary assumptions had to be made in estimation of the dose, and they may need to be corrected. Gravimetric dose estimates may have given different results. Studies selected for analysis included Quebec asbestos miners and asbestos cement workers exposed to asbestos, and pooled U.S. and European studies of MMMF workers, as well as a sample of cigarette-smoking fiberglass workers whose X-ray films were evaluated for fine nodular or irregular opacities. The lowest dose capable of showing either a statistically significant excess (single point criterion--SP) or the median dose in an apparent dose-response relationship with cause of death or radiological results is tabulated. Radiological changes show a dose-response relationship for all types, with a median dose for asbestos of 2.8 fibers/ml. For fiberglass workers, the median dose of electron-microscopically detected fibers was two orders of magnitude less. For asbestos SP, exposures of 1.4 to 22 fibers/ml were associated with increased lung cancer, while for mineral wool, the minimal level with significant SP increase in lung cancer was an order of magnitude less. Based on fiber or particle counts, man-made mineral fibers appear to be more potent than asbestos with regard to chronic pulmonary disease.

Asbestos↗
PubMed1986

Epidemiology of childhood respiratory disease in Israel.

Second and fifth grade schoolchildren living within 19 km from a 1400 megawatt coal fired power plant are followed up. Their parents filled out an ATS-NHLI health questionnaire and they performed pulmonary function tests (PFT), which included: FVC, FEV1, FEV1/FVC, and PEF. The effects of socioeconomic background, smoking habits and pulmonary diseases in the families on the distribution of respiratory symptoms, respiratory diseases and PFT of the children were analysed. Higher FEV1/FVC, lower prevalence of respiratory diseases and excess respiratory symptoms were present among children from crowded homes. Mothers' smoking was found to be connected with significantly higher prevalence of bronchitis, non significant higher prevalence of asthma, significant lower FEV1/FVC and a trend of lower FEV1 and PEF among their children. House heating did not effect the prevalence of respiratory symptoms and diseases of the children. Significantly higher prevalence of respiratory symptoms and diseases was found among children, whose families reported about a history of pulmonary diseases, but no reduction of PFT parameters could be found among them. Mothers' contribution to respiratory symptoms and diseases of their children seems to be more significant than that of the children's fathers. Most respiratory symptoms were more common among children with a history of pneumonia in childhood, especially those who had pneumonia recently.

Child↗
PubMed1986

Young adult mortality as an index: associations with income and social indicators.

In an effort to find an indicator for use in studies of the epidemiological impact of drug abuse in California in the late 1960s, we recognized that, for comparative analyses, cause specific mortality was less attractive than total mortality of the population group principally affected, young adults. This paper examines the all cause mortality; and its major components for young adults, age 15-24, (Young Adult Mortality, YAM) for the U.S. as it varied over time and for various countries in relation with income and social indicators. Between 1961 and 1969 in the United States a striking overall increase occurred (40.6%) with motor vehicle accidents a dominant cause which neither accounted for, all the increase, nor for the racial gradients. Male rates are higher than female rates. In the U.K. a steep and persistent social class gradient has been shown. Comparative studies done among countries whose vital statistics are reported to the World Health Organization, were analyzed in relation to international social and economic indicators. Countries with a Per Capita Income (GNP/person) below $3,000 show a striking increase in mortality from diseases with decreasing income, but above $3000 GNP/person "environmental" (non-disease) causes of death begin to increase, so that total mortality increases with increasing income. Two distinct groups of "industrialized countries" can be identified, seven with low mortality, and ten with high mortality. Per capita expenditure on education and ethnic homogeneity appear to be the social indicators which best discriminate between these two groups of countries.

Accidents, Traffic↗