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Biomedical subjects

L Epstein

Publications and source records attributed to L Epstein.

At least 73 records · Page 4Linked to original sources
PubMed1991

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

Until 1975 in Israel the mortality rates in men greater than or equal to 25 years old were higher in Jews than non-Jews. 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). Death rates from total heart diseases rose in the non-Jewish population during 1970-82, whereas in the Jewish men there were only slight changes. With regard to cancer, death rates were higher in the Jewish group, but from 1970 to 1978 it increased in both groups, the change being relatively higher in non-Jews. Mortality from CVA was higher among Jews at the beginning of the study period, but since 1978 the rates remained higher in the non-Jewish population. Death from heart disease, cancer and CVA can partially explain the reversal in total mortality rates in 1975. A comparison of the data of Israeli men with those of Israeli women shows that the mortality rates of the non-Jewish population of both sexes have changed dramatically over the last decade. These findings have important implications for the planning of further research and for priority determination in health care planning.

Adult↗
PubMed1990

Lung cancer in Israel, 1962-1982. II. Ethnic differences among Jews.

Lung cancer incidence rates among Jews in Israel are significantly lower than in most developed countries in the world. A more detailed analysis of the rates among different Jewish ethnic groups also showed low rates. While Jewish males born in Europe-America (EA) had an 11% increase in rates between 1962-66 and 1977-82, Jewish males from Asian-African (AA) origin had a 45% increase resulting in current higher rates among North African than among East European Jews (the two dominant ethnic groups in Israel). In Jewish females, rates have been relatively stable from 1972 to 1982 and were almost twice as high for females born in EA than females born in AA with less prominent differences between countries. While smoking patterns probably explain the increase in rates among Asian-African Jewish males, other possible risk factors as well as the overall smoking prevalence cannot explain the low incidence in the major ethnic Jewish groups. The possibility of differed susceptibility is raised.

Adult↗
PubMed1990

Blood pressure and hypertension in an elderly population.

In order to study the epidemiology of hypertension in the elderly and its relationship to other disease situations, a study was performed on 815 institutionalized elderly people indicating a statistically significant decrease of both systolic and diastolic blood pressure with age. There is a difference between the population originating in Europe and America and those from Asia and Africa; in the latter group the blood pressure values were significantly higher, specially in females. The prevalence of hypertension as a disease does not differ between younger and older age groups. The lower prevalence in the population studied (28.1%) when compared to data in the literature which indicates prevalence of about 40%, might be due to the fact that the institution population live under sheltered conditions and close medical follow up. In conclusion hypertension in the elderly serves as a major risk factor for several disease situations thus leading to a better survival for those with lower values of blood pressure.

Africa↗
PubMed1990

The care of family physicians and their families: a study of health and help-seeking behaviour.

Physicians in general are at risk for the development of stress, drug and alcohol abuse, as well as for suicide. Furthermore, the treatment of the sick physician is more difficult than that of a 'regular' patient. These difficulties may cause the postponement of diagnosis and treatment to critical stages of the disease. This paper presents a study of self-rated health and health-seeking behaviour of Israeli family physicians and their families. Our major finding is that two-thirds of the physicians do not have a regular family physician, and physicians who suffer from chronic diseases are even less likely to be treated than the 'healthy' ones. Twenty eight per cent of the physicians did not use any kind of medical consultation. However, each physician's family did receive some form of medical consultation, although in some cases this was not the usual form of medical care. The physicians who treated themselves tended to treat their own families and vice versa. Eighty-eight per cent of the physicians reported stress owing to their work (work overload, poor relationships with the medical team or with the patients), and 20% said that their work as physicians negatively affected their marital life. The relationship between the help-seeking behaviour of the family physician and the quality of care they give is as yet unclear. Various alternatives are raised for changing family physicians' behaviour as well as the primary care health system in order to possibly provide better care for the physicians and their families.

Adult↗
PubMed1990

Adhesion of Macroconidia to the Plant Surface and Virulence of Nectria haematococca.

To study spore attachment of the cucurbit pathogen Nectria haematococca (anamorph, Fusarium solani f. sp. cucurbitae), mutants with adhesion-deficient macroconidia were isolated. The adhesion-deficient mutants were selected after treatment with N-methyl-N' -nitro-N-nitrosoguanidine followed by repeated enrichment for macroconidia which did not attach to polystyrene. Two independently derived mutants produced macroconidia with an approximately 50% reduction in attachment to polystyrene and to zucchini fruits. When macroconidia were inoculated into wounded zucchini fruits, the adhesion-deficient mutants were as virulent as the wild-type strain. However, in disease assays in which macroconidia were deposited onto the surface of unwounded zucchini, the mutants were less virulent than the wild type. Thus, adhesion of N. haematococca macroconidia to its host surface appears to be a virulence factor.

Journal Article↗
PubMed1990

Incidence and prevalence of ulcerative colitis in the upper Galilee, Northern Israel, 1967-1986.

An epidemiological study of ulcerative colitis was performed in the Upper Galilee, Israel, over a 20-yr period (1967-1986). The average annual incidence of ulcerative colitis was 2.23 per 100,000 population, and the prevalence on December 31, 1986, was 44.58 per 100,000. Considering the fact that strict steps were taken to include only definite cases, these figures are probably an underestimation. An increase of the average annual incidence from 0.88 in the period 1967-1976 to 3.79 in 1977-1986 was found. When the data were stratified according to ethnic groups, the highest average annual incidence and the highest point prevalence was found in Israeli-born Jews (6.9 and 138.2 per 100,000 population, respectively). When Jewish residence patterns were compared, the highest average annual incidence and point prevalence were found among Kibbutz members (5.52 and 110.39, respectively), and the lowest (1.94 and 38.76) among Moshav inhabitants. There were 10 Arab patients with an average annual incidence of 0.96 and a point prevalence of 19.27. There were 25 women and 28 men (female:male ratio of 0.89). Among the Jews, the female:male ratio was 1.04. Peak incidence was found in the 25- to 34-yr-old range. No second peak was noticed. Anemia was demonstrated in 66.6% of the women and 27.5% of the men in our study. We suggest that the increase in UC incidence and prevalence in Israeli and Asia/africa-born Jew and in Arabs in the Upper Galilee points toward environmental factors in the etiology of this disease.

Adolescent↗
PubMed1989

Incidence, mortality, and case-fatality rate of stroke in northern Israel.

We studied the incidence and mortality of stroke in northern Israel to determine possible reasons for the differences previously found in mortality from this condition between the sex and ethnic groups in Israel as a whole. We identified 1,149 cases of stroke during 1984. While the age-standardized incidence was higher in men, the case-fatality rate was twice as high in women. After controlling for ethnic origin, we found that incidence was higher only in men of Western origin, while the female rates were higher in women of Asian and North African extraction. The case-fatality rate was substantially higher in women in all ethnic groups. These differences, especially in relation to the case-fatality rate, have important implications for health services in relation to both possible preventive action and to management of the acute disease phase.

Age Factors↗
PubMed1989

End-stage renal disease replacement therapy in Israel: demographic and regional differences.

Incidence (by sex and ethnic group), prevalence and mortality rates (by age) of end-stage renal disease (ESRD) replacement therapy in Israel were calculated for the periods 1975-78 and 1979-82. Rates were higher for males (relative risk male/female 1.70 for the first period and 1.83 for the second). Incidence and prevalence rates increased with age among men; among women the maximal rates were attained by the 45-64 age-group. Incidence and prevalence rates were higher during the second period. Among the Jewish population, rates of treatment were higher in the Asian and African-born groups, and European-American and Israeli-born Jews showed the lowest rates. Mortality rates during treatment were lower among Arabs. Rates of therapy rose with age, were higher for males and had a well-defined ethnic pattern. In order to assess differences in ESRD replacement therapy between districts, rates of incidence, prevalence and mortality during treatment (for the Jewish population) were computed by district and adjusted by age and continent of birth for both periods. Significant differences in ESRD therapy coverage were detected only during the second period. Prevalence rates were considerably higher in the central, Tel Aviv and southern districts, and incidence rates were considerably elevated in the central and Tel Aviv districts and low in Jerusalem. Mortality during treatment was lowest in Haifa. It seems improbable that these findings are due to differences in accessibility to ESRD replacement therapy; however, early diagnosis and prevention of disabling kidney conditions at the primary care level may play an important role.

Adolescent↗
PubMed1988

An introduction to clinical epidemiology.

Clinical epidemiology is defined and its influence on methods of diagnosing and treating patients assessed. A plea is made for the wider application of such methods.

Clinical Competence↗
PubMed1988

Community-orientated primary health care. The responsibility of the team for the health of the total population.

Community-orientated primary health care (COPHC) is presented as a framework for the delivery of primary health care based on the epidemiologically assessed needs of the population. It requires that the health team and the responsible agencies or institutions take upon themselves responsibility for the provision of care in relation to these measured needs of all those persons entitled to the service. This epidemiological diagnosis of community health conditions will include both the measurement of the distribution of health and disease states in the community as well as the possible causes for this distribution--this is in order to plan possible intervention adequately. It is concluded that COPHC is to the advantage of the community, the health team and the health care system.

Community Health Services↗
PubMed1988

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

The magnitude and dynamics of lung cancer incidence in Jews and Arabs in Israel between the years 1962 and 1982 were studied. In general, age-standardized incidence rates increased consistently between the years 1962 and 1976 among Jewish (24% increase) and Arab (39%) males, and to a lesser degree among Jewish females (15%). Arab females had the highest (77%) increase. From 1977 to 1982 a general decrease in incidence rates, which was largest among Arab males (19%) and females (15%), was noted. Rates among Jewish males are currently 26% higher than among Arab males, and are 162% higher among Jewish females than in Arab females. Lung cancer rates in both males and females in Israel (Jews and Arabs) are lower than in most developed countries in the world. Among the possible reasons are differences in the population risk factors profile, availability of health care and the level of diagnosis and ascertainment of cases.

Adolescent↗
PubMed1988

Simian immunodeficiency virus/delta-induced immunodeficiency disease in rhesus monkeys: relation of antibody response and antigenemia.

Infection of the rhesus macaque (Macaca mulatta) with simian immunodeficiency virus (SIV) induces a disease similar to AIDS. We compared SIV-specific antibody and antigenemia with the progression of disease in monkeys experimentally infected with SIV/Delta isolates that varied in pathogenicity. Western blot, immunoprecipitation, and sandwich enzyme-linked immunosorbent assay of serial sera from macaques infected with attenuated virus revealed a persistent antibody response and no evidence of SIV antigenemia. Immunosuppressed macaques without central nervous system (CNS) infections responded similarly to initial infection, but antibody specific for gag or, less frequently, to gag and env determinants declined predictably before clinical disease. Monkeys with CNS infections, however, had little, if any, detectable antibody to either envelope or gag proteins, regardless of the duration of survival. SIV/Delta-specific antigenemia, evident only in immunodeficient monkeys, fluctuated reciprocally with antibody. Our data suggest that SIV/Delta-induced disease is dependent upon antigenemic episodes that, particularly in animals with CNS infection, appear coincident with diminished antibody.

Animals↗
PubMed1988

Tracking of blood pressure in children: results of 7 years' follow-up. The Nahariya Study.

Four hundred and seventy-five school children initially aged 7, 8 and 9 years were examined for blood pressure and risk factors at intervals over a period of 7 years (1978, 1980 and 1985). A significant correlation between successive blood pressure measurements was found after 2 years of follow-up for systolic blood pressure, with tracking coefficients of 0.16 for boys and 0.22 for girls. A similar correlation was found after 7 years, with correlations of 0.16 and 0.26, respectively. For diastolic blood pressure the correlations were 0.15 and 0.18 after 7 years. Children greater than 7 years old were more likely to be above the 90th percentile, with increasing percentiles found in the initial examination. A significant correlation was found between the initial weight, as recorded in the first examination, and the blood pressure percentiles in all three measurements. The correlation coefficient values increased progressively in the successive examinations--0.11, 0.23 and 0.25, respectively, for systolic pressure, and 0.10, 0.14 and 0.19, respectively, for diastolic pressure. There was significant correlation between the initial body mass index and the blood pressure levels in the last examination. Thus, both initial blood pressure levels and body mass appear to be valid predictors of future blood pressure levels.

Adolescent↗
PubMed1988

An outbreak of Mycoplasma pneumoniae pneumonia in two kibbutzim: a clinical and epidemiologic study.

During a period a 9 months, 125 individuals with pneumonia due to infection with Mycoplasma pneumoniae were identified among 1,242 individuals in two Israeli kibbutzim. The monthly incidence of M. pneumoniae pneumonia (MPP) was 13.3/1,000 population. Of those infected, 93 (74.4%) were under the age of 18 years. The clinical course of MPP was mostly benign. The prominent signs and symptoms of disease were cough (100%), fine respiratory crepitations (77%), fever (37%), and diminished breathing sounds (25%) above affected lung areas. Leukocytosis was rare (9.6%); however, eosinophilia was observed in 23% of 53 tests performed. Exacerbations of bronchial asthma was observed among 36% of 11 patients with a previous history of asthma. The average duration of disease was 13.5 days, under treatment. A recurrence rate of 11.2% was noted among all MPP patients, with a very high (42.3%) rate among patients treated with cotrimoxazole. All patients with recurrent pneumonia were children under the age of 10 years.

Adolescent↗
PubMed1987

Variations in mortality of the coloured, white and Asian population groups in the RSA, 1978-1982. Part V. Hypertensive diseases.

An analysis was undertaken of mortality from hypertensive disease in the RSA between 1978 and 1982 among whites, coloureds and Asians. The age-specific mortality rates for each group are presented and comparisons are also made between these groups based on age-standardised mortality rates. As with a similar study undertaken for the period 1969-1971, marked variations are seen between the various population groups. The rates for Asians exceeded those for coloureds substantially, and both these groups had far higher rates than whites. These results demonstrate an interesting variation when compared with mortality from ischaemic heart disease and recent prevalence studies of hypertension. The possibility that this variation is due to better control of hypertension in whites or is a result of a different ratio of risk factors in each group studied is considered.

Adult↗
PubMed1987

Variations in mortality of the coloured, white and Asian population groups in the RSA, 1978-1982. Part VI. Ischaemic heart disease.

An analysis of ischaemic heart disease (IHD) mortality for the period 1978-1982 showed markedly different rates for the Asian, white and coloured population groups in the RSA. Age-specific and age-standardised rates for Asians were in general considerably higher than those for whites, and did not show the marked decline with time observed in rates for whites. Although coloureds were seen to have considerably lower age-standardized rates than Asians or whites of the same sex, an increase in the age-standardised rates for coloured males over a 10-year period and a slight decrease among females suggested that rates for coloureds may be in the process of approaching those for the other groups. The observed decline in IHD rates among whites of both sexes suggests that preventable major risk factors may be coming under control, apparently to a greater extent in this group than among Asians or coloureds.

Age Factors↗