PubMed Health⌕ Search

Biomedical subjects

L Epstein

Publications and source records attributed to L Epstein.

At least 55 records · Page 3Linked to original sources
PubMed1995

Recent changes in the etiology of hearing disorders: perinatal drug exposure.

In recent years, we have observed causes of congenital or early onset hearing disorders that had not been recognized or known to exist before. These include drugs passed to an as-yet unborn child. Principal among them is alcohol, but others, such as cocaine, are now also occupying our attention. This article reviews the effects of such exposure on the communication skills of children who had been exposed. It is not yet clear whether there are specifically auditory effects, nor is it clear whether the communicative effects are long lasting.

Cocaine↗
PubMed1994

The relationship between phospholipid content and Ca2+-ATPase activity in the sarcoplasmic reticulum.

The relationship between the phospholipid composition of sarcoplasmic reticulum and the activity of the Ca2+, Mg2+-stimulated ATPase was analyzed by digestion of membrane phospholipids with phospholipase C and A2 enzymes of diverse specificity and by detergent extraction. Phospholipase C of Clostridium perfringens and Clostridium welchii, that hydrolyze preferentially phosphatidylcholine (PC), inhibited the Ca2+-ATPase activity parallel with the depletion of phosphatidylcholine from the membrane. Phospholipase C of Bacillus cereus hydrolyzed in addition to PC, phosphatidylethanolamine (PE) and phosphatidylserine (PS), causing complete inhibition of Ca2+-stimulated ATPase activity. Digestion of sarcoplasmic reticulum with the phospholipase A2 of snake or bee venom produced similar effects. The phosphatidylinositol (PI)-specific phospholipases of B. cereus and Bacillus thuringiensis caused less than 10% inhibition of the Ca2+-ATPase, accompanied by the hydrolysis of more than 70% of the phosphatidylinositol content of the membrane, without significant change in PC, PE and PS content. The inhibition of ATPase activity by the C type phospholipases was nearly completely reversed by octaethyleneglycol dodecyl ether (C12E8). These experiments suggest that the full phospholipid content of native sarcoplasmic reticulum (congruent to 100 mol phospholipid per mol Ca2+-ATPase), is required for ATPase activity and there is no indication that PE, PS, and PI play a specific role in ATP hydrolysis. Extraction of sarcoplasmic reticulum phospholipids by detergents such as deoxycholate, cholate and C12E8 also caused proportional inhibition of ATPase activity with the decrease in phospholipid content; the parallel extraction of PC, PE and PI left the phospholipid composition largely unchanged during delipidation. These observations do not support the requirement for a 'lipid annulus' of congruent to 30 phospholipid molecules/Ca2+-ATPase as proposed by Hesketh et al. ((1976) Biochemistry 15, 4145-4151) or the specific interaction of phosphatidylethanolamine with the ATPase molecule proposed by Bick et al. ((1991) Arch. Biochem. Biophys. 286, 346-352).

Animals↗
PubMed1994

Unexpected death in infancy. An epidemiologic study in the Haifa district, Israel.

The incidence of unexpected death in infancy (UDI) (2 weeks-12 months) in the Haifa area is 1.17 per 1000 live births. We found a significant interethnic difference between Israeli Jews and Arabs. The incidence among Arabs was 4 per 1000, but was only 0.77 per 1000 among Jews (p < 0.01). When the UDI Jewish group was compared to both the group of infants dying of known causes and the surviving group, the only significant factors related to UDI were found to be: young maternal age and low maternal education. No such association was evident among Arabs. Following logistic regression analysis, low maternal age and low socioeconomic status, but not ethnicity, were significantly associated with UDI as compared to the non-UDI infants. In comparison to non-UDI, UDI was significantly more prevalent during the cold season. UDI incidence has apparently been stable over the past 15 years. Demographic risk factors are similar to those reported from other communities, and ethnicity is possibly mediated through those factors.

Age Distribution↗
PubMed1994

Radiofrequency catheter ablation as a cure for idiopathic tachycardia of both left and right ventricular origin.

OBJECTIVES: The purpose of this study was 1) to investigate the efficacy and safety of radiofrequency energy catheter ablation as curative treatment for idiopathic tachycardia of both left and right ventricular origin, and 2) to compare the usefulness of different methods used to map the site of origin of idiopathic ventricular tachycardia. BACKGROUND: Percutaneous radiofrequency catheter ablation has been used with dramatic success in the treatment of patients with Wolff-Parkinson-White syndrome, atrioventricular node reentrant tachycardia and bundle branch reentrant tachycardia. Limited data are available on the use of radiofrequency energy catheter ablation as curative treatment for idiopathic tachycardia of both left and right ventricular origin. METHODS: Twenty-eight consecutive patients (13 to 71 years old) presenting with idiopathic ventricular tachycardia were enrolled in the study. The site of origin of both left and right ventricular tachycardia was mapped using earliest endocardial activation times during tachycardia and by pace mapping. These mapping techniques were compared. RESULTS: Radiofrequency ablation was successful in all eight patients (100%) with left ventricular tachycardia. Tachycardia recurred in one patient. The ablation procedure was complicated by mild aortic insufficiency in one patient. Right ventricular outflow tract tachycardia was successfully ablated in 17 (85%) of 20 patients. The success rate at follow-up was 85%. In one patient, the ablation procedure was complicated by acute ventricular perforation and death. Pace maps from successful ablation sites were better than pace maps from unsuccessful sites (p < 0.004). Endocardial activation times at successful ablation sites were not different from unsuccessful sites (p < 0.13). CONCLUSIONS: Radiofrequency catheter ablation is an effective treatment for idiopathic ventricular tachycardia. The site of origin of tachycardia is best identified using pace mapping. Significant complications can occur and should be considered in the risk/benefit analysis for each patient.

Adolescent↗
PubMed1994

Pathogenesis of pediatric human immunodeficiency virus type 1 infection.

This discussion of the pathogenesis of infant human immunodeficiency virus (HIV) type 1 infection emphasizes features unique to pediatric disease and provides general insights into HIV illness in all populations. Therapies designed to interrupt transmission of HIV can be most efficiently addressed through studies of maternal-infant transmission. The rapid progression of disease in children constantly emphasizes the urgent need for continued progress in treatment of HIV infection and presents a unique opportunity optimally to assess effects of early intervention.

AIDS Dementia Complex↗
PubMed1994

Genetic and Biochemical Characterization of Nectria haematococca Strains with Adhesive and Adhesion-Reduced Macroconidia.

A previous study reported the isolation of two mutants (LE1 and LE2) of the plant pathogenic fungus Nectria haematococca (anamorph, Fusarium solani f. sp. cucurbitae) with macroconidia with reduced ability to adhere (Att) to zucchini fruits and polystyrene. The adhesion-reduced-phenotype in LE1 and LE2 macroconidia is temperature sensitive and dependent on the concentration of nutrients. Classical genetic analysis of progeny derived from LE1 identified a mutation in a genetic locus, named Att1. The 90-kDa glycoprotein and macroconidial tip mucilage which were previously associated with the development of adhesion competence in Att macroconidia are specifically associated with macroconidia; neither is produced on microconidia, which are relatively nonadherent. However, macroconidia of both Att and Att strains produce the 90-kDa glycoprotein and the macroconidial tip mucilage.

Journal Article↗
PubMed1994

The yield of bone scintigraphy in cancer and non-cancer patients: its association with indication and clarity of the referral question.

The yield of bone scintigraphy was assessed in a general hospital. A random 1:2 sample of the bone studies performed within a year was evaluated. The referral forms were judged to show absent, ambiguous or clear diagnostic questions. The indications for which the study was ordered were matched with the scintigraphic diagnosis, and yield was defined as the proportion of studies with relevant findings on scintigraphy. The overall yield was 23.5%. In cancer patients the yield was 27.2% and in repeat studies 40.2%. In non-cancer patients the yield was 19.8% and when scintigraphy was performed for the evaluation of specific disease entities it was 35.7%. Relatively low-yield indications in non-cancer patients were suspected metastases 11.1%, and evaluation of X-ray abnormalities 11.5%. An association between the clarity of the diagnostic question and the scintigraphic yield was detected in non-cancer patients. When a diagnostic question was absent the yield was 12%, ambiguous 19%, and when it was clear 26%. This correlation is probably attributed to better understanding of this common procedure, and better definition of the diagnostic question in patients with diverse clinical conditions as compared to cancer patients in whom the question always relates to the presence of bone metastases.

Adult↗
PubMed1993

Didanosine (ddI) and zidovudine (ZDV) susceptibilities of human immunodeficiency virus (HIV) isolates from long-term recipients of ddI.

Thirty HIV isolates, obtained from 15 patients before and after receiving single drug therapy with didanosine (ddI), were examined for sensitivity to ddI and zidovudine (ZDV) using a peripheral blood mononuclear leukocyte (PBML)-based assay. Fourteen of the patients had ARC, one had AIDS and 12 had received previous therapy with ZDV. After a median of 1 year of ddI therapy, isolates were significantly less sensitive to ddI than were isolates obtained prior to therapy (P = 0.03). A decrease in ddI sensitivity was observed in ten of the 15 isolate pairs. In contrast to ddI susceptibilities, sensitivity to ZDV increased over the same period of time (P = 0.03). Additional isolates were obtained from four patients who received ddI monotherapy for 2 years. Three of these isolates demonstrated no change in ddI sensitivity compared to baseline. No correlation could be made in this study between development of decreased ddI sensitivity and serum p24 levels, CD4 counts, or clinical outcome. Decreased ddI sensitivity occurs frequently among HIV isolates obtained from long-term recipients of ddI. This decreased sensitivity is modest in degree and is of unknown clinical significance.

AIDS-Related Complex↗
PubMed1993

Bowel habits in Israel. A cohort study.

We interviewed 1,900 healthy subjects who belonged to one of the three following ethnic groups: (a) Ashkenazi Jews, (b) Sephardi and Oriental Jews, and (c) Arabs (including Druses)--about their bowel habits, laxative use, and beliefs about bowel action. Using stepwise logistic regression, we found that the following variables were significantly and independently related to bowel frequency: (a) sex--male > female (p = 0.0001); (b) age--young > old (p = 0.0001); (c) physical activity--high > little (p = 0.001); (d) body habitus--lean > obese (p = 0.02); (e) marital status--married > single (0 = 0.009); and (f) ethnic group--Arab > Jewish (p = 0.004). Regular use of laxatives was found in 18.4% of women and 10.8% of men (p < 0.0001). This habit was more common among Ashkenazi Jews (17%) than among Sephardi and Oriental Jews (10.7%) and Arabs (4.8%). Laxative intake was higher among the elderly (p = 0.0001) and the obese (p = 0.0004). Concerning the "ideal" bowel frequency, 12.4% of the Ashkenazis, 22.7% of the Sephardis and Oriental Jews, and 26.1% of the Arabs preferred to have at least 9 movements per week. Strikingly, 51.8% of all interviewed believed that constipation was "harmful to health;" women were more concerned than men (56.3% versus 47.5%). Subjects with a high level of education were significantly more concerned about constipation.

Adolescent↗
PubMed1992

[Characteristics and perceptions of physician managers in Israel].

In a survey of 120 physician managers (PM) of the Israel Ministry of Health and the General Sick Fund (Kupat Holim), demographic and managerial characteristics and perceptions of what is important for effective performance were studied. Medical directors of hospitals, districts and Kupat Holim clinics were included. The majority of the respondents had some training in medical management. 33% are family physicians, 15% are internists, 33% have degrees in public health, 17% are board certified in medical management, and 8% are pediatricians. None of the district and hospital medical directors of the General Sick Fund is a woman, but 40% of medical directors in Ministry of Health districts are women. More than 50% of PMs are not satisfied with the dualistic management that exists mainly in the General Sick Fund. 42% of the respondents stated that 8 or more years after residency is the most appropriate time to assume managerial roles. The average score of those who chose medical management from the point of view of job satisfaction was 7.4 +/- 2.3, but the rated satisfaction from performance as a PM in the health care system today is 4.2 +/- 2.6 (on a 1-10 scale). The most important managerial characteristics perceived by the respondents were credibility, ability to communicate and delegate, and leadership.

Female↗
PubMed1991

[Air pollution and morbidity in the Haifa region].

The effects of exposure to air pollution (defined by levels of SO2) were studied in a representative sample of over 3,500 households in the greater Haifa area. The sample was drawn from 16 high and low pollution neighborhoods which also represented different socioeconomic strata. A very significant relationship was found between levels of pollution in residential and work areas and self-reported respiratory symptoms and diseases. This finding was strongly supported by a statistically significant relationship between actual measured levels of pollution in the 2 weeks prior to the interview and the use of medical services by both adults and children, as well as by the number of days their activity was restricted during that period.

Adult↗
PubMed1991

Lung cancer histology in major ethnic groups among the Jews. Israel, 1962-1982.

Lung cancer rates in Israel are lower than in other Western countries, not explainable by smoking habits. Due to the different relation of Squamous cell carcinoma (SqCC) and Adenocarcinoma (AC) with smoking it was of interest to study the histologic distribution in Israel. A total of 7508 histologically confirmed lung cancer cases among Jews were studied in the period 1962-82. SqCC was the leading tumor-type in Jewish men and AC in Jewish women. European-American born males in the last study period showed a decrease in SqCC rate while Asian-African born males showed a steep increase in SqCC rate, most prominent among the younger age-groups. Rates of AC increased in both, European-American and Asian-African males, but more steeply in the latter in most age-groups. Only for Large cell carcinoma were the overall rates higher in Asian-African than in European-American born males. SqCC increased in European-American born females and also steeply increased in the over 55 years old Asian-African born females. AC increased in European-American born females (both young and old), but only in the young Asian-African born females (decreasing in the older). European-American born Jews still have higher rates of both, more and less smoking related lung cancer histological types, than Asian-African born Jews. The steep increase in rates of some of the histological types in the latter with the pronounced increased in the younger age-groups is expected to cause a change in the ethnic rate-ratio which has already been demonstrated for the overall lung cancer rates.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗
PubMed1991

Assessment of primary care nursing in relation to adolescent health behaviour by means of trigger films.

The patterns of adolescents' behaviour place them at a risk from developing health and social pathology. In order to assess whether primary care nursing meets adolescents' health needs, the reported performance of 306 registered nurses working in different primary health care settings was studied. The research tool developed especially for the study was a video-taped trigger film. Demographic, education and work-related variables were studied by means of a questionnaire. The behaviour patterns studied were smoking, sexual activity, alcohol and drug consumption, and eating habits. The clinical issues were hypertension, obesity and anorexia nervosa. Reported performance was low--35% of the total possible score--with the lowest scores in the areas of preventive care, data gathering and recording, and somewhat higher in the areas of curative care and follow-up. The video-taped trigger films were considered to have face validity; they were found to be reliable, with an ability to assess the nurses' reported performance and to differentiate between the nurses in the three different work settings. This is the first study of its kind in Israel. The results show that primary health nursing of adolescents is insufficient, and that teenagers should get higher priority as a target population from the nursing profession in order to achieve WHO's aims of 'health for all by the year 2000'.

Adult↗
PubMed1991

Lung cancer histology in Jews and Arabs in Israel, 1962-1982.

Lung cancer rates in Israel are lower than in Western countries, not explainable by smoking habits. Because of the different relations of squamous cell carcinoma and adenocarcinoma to smoking it was of interest to study the histologic distribution in Israel. A total of 7,871 histologically confirmed lung cancer cases were studied in the period 1962-1982. Squamous cell carcinoma was the leading tumor type in Jewish men and adenocarcinoma in Jewish women. Rates of both adenocarcinoma and squamous cell carcinoma increased throughout the period in both Jewish men and women, but the increase in adenocarcinoma was more pronounced in the last study period than that in squamous cell carcinoma. In 1977-1982 the rate ratio of squamous cell carcinoma to adenocarcinoma among Jewish men was 1.7. In Arab men it was 2.9, and in Jewish women 0.57. The Kreyberg I/II ratio among Jewish men was about 2.7 with no clear trend throughout the study period, and among Arab men this gradually decreased from 8.1 to 3.5. Jewish women had a constant Kreyberg I/II ratio of about 1 through the whole study period, but the ratio in Arab women was significantly higher than 1, with a mean overall ratio of 3.2. Jews and Arabs in Israel are different from each other in their patterns of lung cancer histology and are different to some extent from other populations in the Western world.

Adenocarcinoma↗
PubMed1991

Lung cancer histology and smoking--relationship and time trends among Jewish males in Israel.

Due to the recent reported increase in incidence rates of adenocarcinoma and the weaker relationship of this histological type to smoking, a study was undertaken to investigate changes over time in smoking and lung cancer histology. Medical records of 428 Jewish male lung cancer patients from 1957 to 1985 were studied for smoking history and histological diagnosis. No time trend was found in the smoking-histology relationship, although in this study adenocarcinoma was found to be strongly related to smoking in all periods. Thus, the increase in adenocarcinoma reported in Israel is not the reflection of less smoking or a change in the smoking-adenocarcinoma relationship. It is postulated that changes in the type of cigarettes smoked might be responsible for the change in the incidence of histological types.

Adenocarcinoma↗
PubMed1991

Mortality trends among Jewish and non-Jewish women in Israel, 1960-82.

Until 1975 in Israel mortality rates in women aged greater than or equal to 25 years old were higher among Jewish women than non-Jewish women. Since then the relationship has been reversed with higher rates in the non-Jewish group. The three main causes of death in the two groups were heart disease, cancer and cerebrovascular disease (CVA). The proportional mortality and death rates from total heart diseases rose in the non-Jewish population during 1970-82, whereas in Jewish women there were only slight changes. With regard to cancer, the proportional mortality and death rates were higher in the Jewish group. However, from 1970 to 1982 cancer mortality in the Jewish population declined continuously, while in the non-Jewish group it rose. Mortality from CVA rose in both Jewish and non-Jewish women until 1974, but then declined. Since then, the rates remained considerably higher in the non-Jewish population. Death from heart disease, cancer and CVA can partially explain the reversal in total mortality rates in 1975.

Adult↗