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Biomedical subjects

L Neumann

Publications and source records attributed to L Neumann.

At least 91 records · Page 5Linked to original sources
PubMed1996

Assessing functional disability and health status of women with fibromyalgia: validation of a Hebrew version of the Fibromyalgia Impact Questionnaire.

OBJECTIVE: To validate a translated version of the Fibromyalgia Impact Questionnaire (FIQ) to be used by Hebrew speaking populations. METHODS: We administered the FIQ to 100 women with fibromyalgia (FM). The FIQ measures physical functioning, work status, depression, anxiety, sleep, pain, stiffness, fatigue, and well being. All patients were asked about the presence and severity (assessed by visual analog scale) of relevant FM symptoms (pain, fatigue, anxiety, etc.); a count of 18 tender points was conducted by thumb palpation, and tenderness thresholds were assessed by dolorimetry. Test-retest reliability was assessed using Spearman correlations. Internal consistency was evaluated with Cronbach's alpha coefficient of reliability. To assess content validity a cutoff criterion of > or = 25% impairment responses was set to indicate a valid item. Construct validity of the FIQ was evaluated by correlating the physical functioning score as well as the separate items with measures of symptom severity, count of tender points, and tenderness thresholds. RESULTS: Test-retest reliability was r = 0.96 for physical functioning, and 0.80-0.96 for other items of FIQ. Internal consistency was alpha = 0.93 at Time 1 and 0.86 at Time 2. Seventeen of 19 items of the FIQ met the > or = 25% criterion. Significant moderate to high correlations were obtained between the FIQ items and severity symptoms, point count, and tenderness threshold. CONCLUSION: The FIQ is a reliable and valid instrument for measuring functional disability and health status in Israeli women with FM.

Disability Evaluation↗
PubMed1996

No correlation between prolactin levels and clinical activity in patients with systemic lupus erythematosus.

OBJECTIVE: To assess the frequency of hyperprolactinemia and its possible clinical significance in patients with systemic lupus erythematosus (SLE). METHODS: Concentrations of prolactin (PRL) were determined in 63 consecutive patients with SLE by an immunoradiometric assay. Antinuclear antibodies, anti-DNA, ribonucleoprotein, Sm, Ro, La, and anticardiolipin antibodies were determined by standard techniques. PRL concentrations were correlated with SLE clinical and serological activity. RESULTS: Elevated serum concentration of PRL (> 20 ng/ml) were found in 10 of 63 (15.9%) patients [21 to 57 ng/ml, mean (SD) 35.6 (13.4)]. No direct correlation between PRL levels and clinical disease activity of SLE was found (Pearson correlation r = -0.186, NS). In addition, hyperprolactinemia was not associated with serological activity. CONCLUSION: Mild hyperprolactinemia is present in a subset of patients with SLE but its clinical significance is still uncertain.

Adolescent↗
PubMed1996

The effects of diuretics on quality of life of hypertensive patients.

OBJECTIVES: To study the effect of diuretics and diuretics discontinuation on the quality of life (QOL) of hypertensive patients. METHODS: 149 beta blocker treated mild to moderate hypertensive patients were included in the study. Seventy-three were treated by beta blockers (BB's) only and 60 by BB's and diuretics, for 40 patients diuretics was discontinued. Physical symptoms and QOL were assessed before and 9-15 months after the change in treatment. RESULTS: At baseline, subjects on diuretics experienced more gastrointestinal symptoms, weakness, and sex related problems; and their QOL was poorer. At the end of the follow-up, patients on diuretics scored poorest on physical strength items and on health perceptions; those who were never treated by diuretics scored best; and those who stopped were in between. CONCLUSIONS: Diuretics treatment adversely affect patients' QOL. Cessation of diuretics treatment for at least 9 months improved some aspects of patients' QOL, though those who never received diuretics were better of than others.

Adrenergic beta-Antagonists↗
PubMed1995

Relationship among self-esteem, internal-external locus of control, and weight change after participation in a weight reduction program.

This report covers 15 to 47 months of follow-up study of 66 obese women who participated in a 10-week weight reduction program. Subjects were divided into three self-esteem groups and into two groups of "internal" and "external" subjects. The average weight regain during the follow-up period was 3.1 kg, although all subjects remained below their pretreatment weight. The higher the self-esteem score, the lower the average weight regain during follow-up (1.7 kg, 2.6 kg, and 3.5 kg, respectively). For internals the average weight regain was 1.8 kg and for externals 3.4 kg. Implications are discussed, and suggestions for improved weight reduction programs are presented.

Adult↗
PubMed1995

Hyperemesis gravidarum: epidemiologic features, complications and outcome.

During the period of 4 years between 1985 and 1988, 190 patients suffering from hyperemesis gravidarum (HG) were hospitalized at the Soroka Medical Center. From the 190 patients, 164 were followed up throughout their pregnancies and delivered at our Medical Center. The epidemiology of HG as well as the incidence of maternal complications and pregnancy outcome were analyzed and compared with 209 controls. The incidence of HG in our patient population was 6.3/1000 live births. The patients in the study group had fewer pregnancies and deliveries and more spontaneous abortions in the past than in the control population. Premature contractions and vaginal bleeding during the first trimester were more common among women with HG. Other complications of pregnancy were no more common than among controls. Women with HG in their current pregnancy had a lower incidence of spontaneous abortions (3.1%) as compared with previously reported rates in the general population (15%). Perinatal outcome was no different in women with HG than in the controls. Women with severe HG did not have statistically significant differences in the incidence of pregnancy complications and their pregnancy outcome was the same as in those without severe HG.

Female↗
PubMed1995

Musculoskeletal manifestations of brucellosis: a study of 90 cases in Israel.

Rheumatological manifestations are frequently reported in patients with brucellosis. In a retrospective study of 90 patients diagnosed with brucellosis over a period of 18 years, 83 (92%) patients were Bedouins, 55 of whom (61%) reported ingestion of unpasteurized goat milk and goat milk products. The male/female ratio was 1:1, and the adult to child ratio was 3:2. The mean age of the patients was 25 years (range, 1-72 years). Rheumatological manifestations (myalgia, arthralgia, and arthritis) were reported in more than half of the patients. These manifestations started on days 3 and 4 of the disease and were mild to moderate in severity. Myalagia was evident in 49 (54%) patients and was more common in adults than in children (67% versus 37%; P < .01) and in men (67%) than in women (42%; P < .01). Arthralgia was the most common musculoskeletal manifestation, found in 55 (61%) patients, and occurred more often in children than in adults (74% versus 52%; P < .05). Arthritis was detected in 37 (41%) patients. The hip and knee joints were the most common sites of arthritis (31% each) followed by sacroiliac involvement (17%) and shoulder or spine involvement (5% each). Arthritis was also more common in children (63% versus 29%; P < .01). The prevalence of arthritis was similar in men and women. Cure was achieved in all patients after antibiotic therapy.

Adolescent↗
PubMed1995

Plasma lipids and the progression of nephropathy in diabetes mellitus type II: effect of ACE inhibitors.

Ninety-four normotensive type II diabetics with normal renal function and microalbuminuria were randomized to receive enalapril 10 mg/day or placebo and were followed for five years. In the patients treated by enalapril plasma creatinine values and albuminuria remained stable throughout the observation period. Their plasma total cholesterol decreased from an initial value of 245 +/- 27 mg/dl to mean study value of 236 +/- 29 mg/dl, and to a fifth year value of 232 +/- 27 mg/dl (P < 0.001). The changes in HDL cholesterol and triglyceride values were nonsignificant. In the placebo group there was a significant increase in albuminuria and a mean decline of 13% in reciprocal creatinine values during the five years. Plasma total cholesterol increased from an initial mean value of 246 +/- 24 to a mean study value of 252 +/- 25 mg/dl, and to a fifth year mean value of 259 +/- 32 mg/dl (P < 0.001). There was a significant correlation between both initial and mean plasma total cholesterol values, and the decline in renal function and the rise in albuminuria in the placebo treated patients. This correlation persisted after stratification for blood pressure. Treatment with enalapril did not eliminate these correlations. Cholesterol may be an additional risk factor for diabetic nephropathy. ACE inhibitors may have a modest cholesterol lowering effect in diabetic patients mediated, in part, through the decline in albuminuria.

Adult↗
PubMed1995

Case report: lipoma arborescens of the sub-deltoid bursa.

Lipoma arborescens is a rare synovial disorder which principally affects the knee joint. We describe an unusual case of lipoma arborescens arising within the sub-deltoid bursa in association with a rotator cuff tear. Pre-operative diagnosis was made by magnetic resonance imaging.

Aged↗
PubMed1995

Bone buttress operation for recurrent anterior shoulder dislocation in epilepsy.

Patients suffering from generalised convulsions may dislocate their shoulders either anteriorly or posteriorly. Those with anterior dislocation are likely to have recurrent episodes because of secondary bony damage to the anterior rim of the glenoid and head of the humerus. In such patients there is high rate of failure of the standard soft-tissue stabilisation procedures. We have therefore devised a bone buttress operation in which autograft or allograft is secured to the deficient anterior glenoid and shaped to form an extension of its articular surface. We report our experience in 14 patients with grandmal epilepsy and recurrent anterior dislocation of the shoulder. After the bone buttress operation there were no further dislocations and all patients were satisfied despite a small restriction in their range of movement. We believe this to be the operation of choice for patients with this difficult problem.

Activities of Daily Living↗
PubMed1995

Balneotherapy for rheumatoid arthritis at the Dead Sea.

Thirty-six patients with active rheumatoid arthritis were treated for 12 days at the Ein Gedi Spa. The patients were allocated randomly to four study groups. Group 1 (n = 9) was treated with daily baths in the Dead Sea, group 2 (n = 9) was treated with daily sulphur baths, group 3 (n = 10) was treated with a combination of daily Dead Sea bathing and sulphur baths, and group 4 (n = 8) served as a control group. All patients were assessed by a rheumatologist who was blinded to the treatment modalities and group allocation. Clinical parameters assessed included: duration of morning stiffness, 15 m walk time, grip strength, activities of daily living, patient's assessment of disease severity, number of active joints, and the Ritchie articular index. Statistically significant improvement lasting up to 3 months was observed only in the three treatment groups.

Activities of Daily Living↗
PubMed1995

Demographic data from a hospital case series of endoscopically-diagnosed benign peptic ulcer in southern Israel, 1989-1990.

BACKGROUND: A knowledge of the clinical and epidemiological features of duodenal and gastric ulcer is of importance to clinicians and other health care providers. These aspects of ulcer disease have not been studied previously in the Negev region of southern Israel, which is home to 300,000 Jews and 60,000 Bedouin Arabs. METHODS: Clinical, demographic and risk factors were analyzed in a case series of benign duodenal and gastric ulcers (first or recurrent attack) diagnosed at endoscopy at the Soroka Medical Center in the years 1989-1990. RESULTS: There were 336 cases of duodenal ulcer (321 cases in Jews, 15 in Bedouins) and 79 cases of gastric ulcer (all in Jews). The annual rate of endoscopically-detected duodenal ulcer was 54/10(5) in Jews and 13/10(5) in Bedouins. The annual ratio of endoscopically-detected gastric ulcer in Jews was 13/10(5). The ratio of male to female patients was 2.7 for duodenal ulcer in Jews and Bedouins, and 1.9 for gastric ulcer in Jews. The mean age +/- standard deviation at diagnosis was 48 +/- 17 years for duodenal ulcer and 63 +/- 15 years for gastric ulcer (p < 0.001). Duodenal ulcer was significantly commoner than gastric ulcer at all ages, but the ratio DU:GU decreased with increasing age, so that by age 48 years, 20% of all endoscopically-diagnosed ulcers were GU. Of several risk factors examined, smoking was associated with duodenal ulcer (p < 0.05) but not gastric ulcer. Occupation was not a risk factor. Duodenal ulcer was 1.3 times more frequent in winter than summer. CONCLUSIONS: Endoscopically-diagnosed duodenal and gastric ulcer is commoner in Jews than Bedouins and in men than women. Duodenal ulcer is commoner than gastric ulcer and presents at a younger age. Smoking is a risk factor for duodenal ulcer, and European and American ethnic origin is a risk factor for duodenal and gastric ulcers. Bleeding is associated with one-third of endoscopically-diagnosed ulcers in this institution.

Adolescent↗
PubMed1995

Fibromyalgia syndrome in children--an outcome study.

OBJECTIVE: To assess the outcome of fibromyalgia syndrome (FM) in a 30-month followup study of children with FM. METHODS: In the original study to assess the prevalence of FM in healthy schoolchildren, we found 21 children with FM and an additional 7 fulfilling the point count criterion only (11 of 18). Fifteen of the 21 and all 7 were recruited for a 2nd assessment in our present study. In all children, a count of 18 tender points (TP) was conducted by thumb palpation. Tenderness of 9 of the TP sites as well as 4 control point sites was further assessed using a Chatillon dolorimeter. All children were questioned concerning the presence of widespread pain or aching. Children were considered to have FM if they met the American College of Rheumatology criteria for diagnosis. RESULTS: After 30 months, 11 of the 15 children with FM (73%) were no longer fibromyalgic. The mean point count of the 15 children significantly decreased from 12.5 to 4.6 (p < 0.001). The mean tenderness threshold of the 9 tender sites increased from 2.4 to 3.4 kg (p < 0.01), and the mean tenderness threshold of the 4 control sites increased from 4.1 to 5.6 kg (p < 0.05). Of the 7 children initially fulfilling the point count criterion only, none had developed FM. Their mean point count decreased from 11.4 to 3.4 (p = 0.001), and their mean tenderness thresholds increased from 2.7 kg to 3.9 kg (p = 0.001) at tender sites and from 4.3 kg to 6.8 kg (p < 0.001) at control sites. CONCLUSION: We suggest that the outcome of FM in children is more favorable than in adults. More followup studies are needed to clarify the longterm outcomes of FM in children and adults.

Adolescent↗
PubMed1995

[Dead Sea bath salts for osteoarthritis of the knee].

26 patients with osteoarthritis of the knees were randomly divided into 2 groups of 13 each with patients of similar ages, sex distribution and duration and severity of disease. All were treated with daily baths at 34-35 degrees C for 20 min. containing Dead Sea bath salts (Group I) or sodium chloride (Group II). The study was double-blind and of 2 weeks duration. Patients were evaluated by a rheumatologist before, at the end of treatment and 1 month later. Clinical parameters evaluated included index of severity of osteoarthritis, patient's assessment of disease severity, range of movement of knees, soft tissue swelling, effusion and crepitus. There was significant improvement in the index of severity of osteoarthritis at the end of the treatment in both groups (p < 0.01). 1 month later, in Group I the significance of the index was still p < 0.01, but p < 0.05 in Group II. Patient's assessment of improvement was significant only in Group I at the end of the treatment period (p < 0.01). There was no statistical improvement in either group in the other parameters assessed.

Balneology↗
PubMed1994

Compression neuropathy of the common peroneal nerve caused by a ganglion.

A case of compression of the common peroneal nerve caused by a ganglion herniating from the superior tibio-fibular joint is reported. MR imaging was partially helpful in making the diagnosis. The patient has made an almost complete recovery 3 months after excision of the lesion. Early diagnosis and treatment is required to ensure recovery.

Ganglia↗
PubMed1994

Increasing serum creatinine and age reduce the response to hepatitis B vaccine in renal failure patients.

The relationship between diminished response to hepatitis B vaccine in renal failure patients and serum creatinine level, age and other factors is unknown. The immune response of patients with renal failure of varying severity to hepatitis B vaccine was determined in this study. Sixty-eight patients with renal failure of varying severity who were negative for hepatitis B markers received four doses of hepatitis B vaccine, and anti-HBs titers were determined at 0, 1, 2, 3, 6, 8 and 12 months. Maximum anti-HBs titers were seen at 8 months. At this time 86% of patients with creatinine < or = 4 mg/dl but only 37% with creatinine > 4.0 mg/dl had a protective titer of > or = 10 mIU/ml (p < 0.002). Age was inversely related to anti-HBs titer (p = 0.045) and was independent of serum creatinine in predicting antibody response. We conclude that all patients with chronic renal failure should be immunized against hepatitis B as early as possible in the development of their disease, to ensure maximum response, and to minimize the effects of elevated serum creatinine and increasing age.

Adult↗
PubMed1994

Prognostic value of the immediate response to surfactant.

AIM: To evaluate the association between the immediate response to surfactant treatment and morbidity and mortality in infants with severe respiratory distress syndrome. METHODS: The response to surfactant was defined as the difference in the arterial:alveolar (delta a:A) ratio before and one hour after the first surfactant dose. Measurements were obtained from 253 Israeli infants participating in the multi-centre Curosurf 4 trial of surfactant replacement therapy. RESULTS: Delta a:A ratios ranged from -0.115 to 0.8 and were significantly related to both birth weight and gestational age. Among infants weighing 1001-1500 g mortality decreased from 40% among very bad responders to zero among good responders. The incidence of pneumothorax decreased with better response. Logistic regression analysis showed a hierarchy of predictive power for mortality: birth weight or gestational age; immediate response to surfactant; severity of initial disease. CONCLUSION: The immediate response to surfactant treatment is a significant prognostic indicator for mortality and morbidity.

Biological Products↗
PubMed1994

Epidemiology of Crohn's disease in southern Israel.

OBJECTIVES: Crohn's disease in Israel was described in the past as being of low incidence, more common in Europe-America-born Jews than other Jews, and of uncharacteristically low morbidity. However, recent experience has suggested that these premises are no longer correct. METHODS: The records of all hospital and outpatient cases of Crohn's disease in southern Israel for the period 1968-1992 were reviewed. Private family practitioners and specialists were contacted to assure complete case ascertainment. RESULTS: The prevalence rate of Crohn's disease among Jews on December 31, 1992, was 50.6/10(5) (Asia-Africa-born Jews 55.0/10(5), Europe-America-born Jews 58.7/10(5), and the rate was 8.2/10(5) among Bedouin Arabs. The annual incidence rate (1987-1992) was calculated as 4.2/10(5)/yr in Jews (Asia-Africa-born 4.6/10(5)/yr, Europe-America-born 3.9/10(5)/yr). The age of presentation declined progressively over the study period, was lower in Israel-born patients than immigrants, and was lower in ileocolonic versus other sites of disease. CONCLUSIONS: The data show that Crohn's disease has become more common in Jews in Israel, losing ethnic differences of frequency, and that it occurs at a younger age than before. In Arabs, the disease is more rare.

Crohn Disease↗