Antibodies elicited by HIV-1 strains, and which neutralize such strains in vitro, bind to synthetic peptides of 5-8 amino acids in length. These amino acids, although variable, have a fixed location between two cysteines in the carboxyl terminus of the HIV-1 external envelope. Nine peptides of 9 amino acids corresponding to the gp120 domains of European and American (LAV-1, NY5, CDC4, SF2), Haitian (RF) and African (ELI, MAL, Z3, Z6) HIV-1 strains, were synthesized using LAV-1 and RF neutralization epitopes as models. Serum of chimpanzees infected with LAV-1, HTLV-IIIB or HTLV-IIIRF reacted predominantly with the homologous peptide, although cross-reactivity with heterologous peptides occurred: 8 out of 11 human sera with HTLV-IIIB-neutralizing activity bound the LAV-1/HTLV-IIIB peptide, and 6 out of 7 sera with HTLV-IIIRF-neutralizing activity bound the RF peptide. African sera reacted most frequently with the Z3 peptide (78%) while only 35% (p = 0.0001) of European and 20% (p less than 0.0001) of American sera recognized it. Recognition patterns of children from the USA and Europe were different. Although multiple reactivities were observed, blocking experiments favoured cross-reactivity as the explanation. Based on the antibody profiles of nonapeptide recognition, peptides LAV-1, RF and SF2 were clustered, as were NY5 and CDC4, and so were Z6, MAL and ELI. This antigenic relatedness of HIV-1 strains could not entirely be explained by the physico-chemical characteristics of the nonamers per se. Resemblance was observed with the clustering of HIV-1 strains based on the divergence of the nucleotide sequence of entire HIV-1 envelopes. This implies a role of peripheral envelope residues, in the context of infectious particles or infected cells, in determining the specificity of antibodies reactive to the V3 domain. Therefore, the neutralization domain in this variable region may be considered part of a conformational structure involving several envelope regions which appear distinct from each other in the primary sequence.

Amino Acids↗

PubMedDate not supplied

The role of the hospital administrator in the control of nosocomial infections.

The hospital administrator is responsible for the allocation of resources at the disposal of the institution and therefore plays an important role in the control of nosocomial infections. The problem of determining what proportion of these resources can be allocated to the control of nosocomial infections is complicated by the fact that there remain many unanswered questions concerning this problem, such as whether is is possible to prevent many of the infections acquired in hospital, what the most efficient method of infection surveillance is, and whether the use of antibiotics should be controlled. In such a climate of uncertainty, particularly in a milieu that demands severe budgetary reductions, the hospital administrator will need the assistance of clinicians and epidemiologists to provide data on nosocomial infections so that the limited resources available may be used most effectively.

Anti-Bacterial Agents↗

PubMedDate not supplied

Mortality from ischemic heart disease and cerebrovascular disease in Israel 1969-1978.

Age standardized mortality data from Ischemic heart disease (IHD) and Cerebrovascular disease (CVD) for the population of Israel were analyzed for the years 1969 to 1978. There has been a clear fall in mortality from both diseases over this period that has been more pronounced in relation to CVD. The mortality from IHD is considerably higher in the total population and in each of the ethnic groups except for those born in North Africa, in whom the difference is small. The mortality in males from IHD is higher than that for females but the reverse is the situation in relation to CVD.

Actuarial Analysis↗

PubMedDate not supplied

Cholesteatoma: an epidemiologic study among members of kibbutzim in northern Israel.

In this study 3,056 members (10 years of age and older) of the kibbutzim in the northern part of Israel were examined in order to determine the prevalence of chronic otitis media and cholesteatoma. In addition to demographic factors, the influence of altitude was investigated, but the differences were not found to be significant. The prevalence of chronic otitis media was found to be 0.95% and of cholesteatoma, 0.4%. Of the patients who had chronic otitis media, 41% suffered from cholesteatoma as well. Chronic otitis media was more prevalent in males than females (0.02 greater than p greater than 0.01) in the Ashkenazic than Sephardic populations (0.05 greater than p greater than 0.02), and in industrial and agricultural workers (0.05 greater than p greater than 0.02), as compared to others. Among cholesteatoma patients a family history was found in 64%. In 71% of patients, illness began in infancy. Fifteen percent of the patients did not know of their disease until they were examined in this study. These results suggest a high rate of cholesteatoma among chronic otitis media patients and emphasize the need for performing more extensive studies to determine the rate of cholesteatoma in the general population. The necessity for preventive ear examinations, earlier diagnosis, and treatment of cholesteatoma is emphasized.

Adolescent↗

PubMedDate not supplied

Pesticide applications of copper on perennial crops in California, 1993 to 1998.

Inorganic copper is used as a broad-spectrum fungicide and bacteriocide on a variety of agricultural crops. After application, the copper residue typically accumulates in the upper 15 cm of soil. Data from the California Pesticide Use Reports were used to estimate the augmentation of copper in the soil that resulted from pesticide applications for the six years from 1993 to 1998 on 12 crops that are grown without rotation. The estimated mean mg Cu kg(-1) soil added to the upper 15 cm during the six years was the following: walnut (Juglans regia L.), 28; peach [Prunus persica (L.) Batsch var. persica], 22; nectarine [Prunuspersica (L.) Batsch var. nucipersica (Suckow) C.K. Schneid], 19; cherry (Pseudolmedia oxyphyllaria Donn. Sm.), 18; rice (Orvza sativa L.), 16; apricot (Prunus armeniaca L.), 11; orange [Citrus sinensis (L.) Osbeck) and plum (Prunus domestica L. subsp. domestica ), 9; lemon [Citrus limon (L.) Burm.f.] and almond [Prunus dulcis (Mill.) D.A. Webb], 6; pear (Pyrus communis L.), 4; and grape (Vitis vinifera L.), 3. In addition, for the first five of these crops, we estimated the area that was treated with each level of kg Cu ha(-1). For example, for walnut orchards, we estimated that 12 500 ha, or 17% of the planted area, was treated with a quantity of Cu that would increase the total concentration of Cu in the upper 15 cm of soil by at least 50 mg Cu kg(-1) soil. A comparison of the amount of Cu per unit planted area that was applied in the first and second half of the study indicated that the intensity of copper use is either relatively constant or increasing, depending on the crop. The findings are discussed in relation to the potential effect of continued long-term use of Cu pesticides on soil sustainability.

Agriculture↗

PubMedDate not supplied

Risk factors and causes of stroke in young women in Israel.

OBJECTIVE: to identify risk factors and likely causes for stroke in young women, as a basis for designing a strategy for stroke incidence reduction. DESIGN: retrospective chart review for comparisons between the sexes. SETTING: general and rehabilitation hospitals. PATIENTS: all 263 patients aged 17-45 years with stroke over a 15-year period. EXCLUSIONS: patients seen at 14 general hospitals who were not referred to the Loewenstein. ASSESSMENTS: data on sociodemographic, anamnestic, and clinical aspects. RESULTS: stroke under the age of 30 years was more frequent in women, and in them the risk factors differed from those in an older population. The most frequent cause of stroke in the younger women was embolism, in the majority on the basis of a rheumatic valvular defect, whereas in young men the usual cause was atherosclerosis. CONCLUSIONS: opportunities for preventive initiatives have not always been grasped, and more attention should be directed to such possibilities.

Adolescent↗

PubMedDate not supplied

Possible influence of changes in risk factors on cardiovascular morbidity and mortality in Israel: need for an information system.

Mortality from ischemic heart disease (IHD) and cerebrovascular disease (CVD) has continued to fall in Israel during the period 1978-82. Proportionally, the fall has been 27.5% in males and 34.4% in females for IHD and 37.0 and 40.4% for CVD. There are few data available in Israel that can explain this decline, and it is doubtful whether it is due to any major attempt to change risk factor status. A top priority at this stage would seem to be the development of an information system (including data collection and processing) on a national level that will provide the opportunity for future assessment of the significance of change in such mortality. The need for future major intervention programs should be determined on the basis of such morbidity and mortality data.

Cardiovascular Diseases↗

PubMedDate not supplied

Israel's prevention programs and screening policies for cardiovascular disease.

For all four broad ethnic groups in Israel, mortality rates declined over the last decade for both ischemic heart disease (IHD) and cerebrovascular disease (CVD), the first and third most important causes of death in the country. The four broad ethnic groups consist of persons born in Israel, Asia, North Africa, and Europe. Mortality data also indicate a low male to female ratio in mortality from IHD, a definite female predominance in mortality from CVD, and high mortality rates for IHD and CVD in males and females born in North Africa. Morbidity data, especially incidence, are scarce for CVD in both sexes and IHD in females. The feasibility of preventive intervention needs to be tested under the specific conditions of Israel. Although a multiple risk factor trial in Jerusalem showed that such a program can be conducted in a primary care framework, it clearly still needs to be tested in clinics rather than in a model teaching institution. The best place for intervention would seem to be the primary health care system, which has almost complete access to the country's population. Kupat Holim (the Health Insurance Institute of the General Federation of Labour) is attempting systematically to identify and manage hypertension patients. To date, management of acute coronary disease has been emphasized in Israel. Although additional resources are needed for primary prevention services, other options are suggested for obtaining those services.

Coronary Disease↗