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Biomedical subjects

M Harari

Publications and source records attributed to M Harari.

At least 19 recordsLinked to original sources
PubMed2003

Ultraviolet radiation properties as applied to photoclimatherapy at the Dead Sea.

BACKGROUND: The Dead Sea basin, the lowest terrestrial point on earth, is recognized as a natural treatment center for patients with various cutaneous and rheumatic diseases. Psoriasis is the major skin disease treated at the Dead Sea with excellent improvement to complete clearance exceeding 85% after 4 weeks of treatment. These results were postulated to be associated with a unique spectrum of ultraviolet radiation present in the Dead Sea area. METHODS: The UVB and UVA radiation at two sites is measured continuously by identical sets of broad-band Solar Light Co. Inc. meters (Philadelphia, PA). The spectral selectivity within the UVB and UVA spectrum was determined using a narrow-band spectroradiometer, UV-Optronics 742 (Orlando, FL). The optimum exposure time intervals for photoclimatherapy, defined as the minimum ratio of erythema to therapeutic radiation intensities, were also determined using a Solar Light Co. Inc. Microtops II, Ozone Monitor-Sunphotometer. RESULTS: The ultraviolet radiation at the Dead Sea is attenuated relative to Beer Sheva as a result of the increased optical path length and consequent enhanced scattering. The UVB radiation is attenuated to a greater extent than UVA and the shorter erythema UVB spectral range decreased significantly compared with the longer therapeutic UVB wavelengths. CONCLUSIONS: It was demonstrated that the relative attenuation within the UVB spectral range is greatest for the shorter erythema rays and less for the longer therapeutic UVB wavelengths, thus producing a greater proportion of the longer therapeutic UVB wavelengths in the ultraviolet spectrum. These measurements can be utilized to minimize the exposure to solar radiation by correlating the cumulative UVB radiation dose to treatment efficacy and by formulating a patient sun exposure treatment protocol for Dead Sea photoclimatherapy.

Climate↗
PubMed2000

Clinical evaluation of a more rapid and sensitive Psoriasis Assessment Severity Score (PASS), and its comparison with the classic method of Psoriasis Area and Severity Index (PASI), before and after climatotherapy at the Dead-Sea.

BACKGROUND: The Psoriasis Area and Severity Index (PASI) is used to quantify the extent of the disease, and to evaluate its improvement with treatment. It is considered to be a slow, rough, nonsensitive, and complex tool, with high interobserver variability and low reproducibility. OBJECTIVES AND METHODS: To develop a simpler, more sensitive, and more rapid end-point determination for evaluating the psoriatic condition, and to compare its sensitivity with that of the classic PASI score in psoriatic patients undergoing 4-week climatotherapy at the Dead-Sea (Israel). RESULTS: This study describes a new, rapid, and simple Psoriasis Assessment Severity Score (PASS), whose readings are spread over a longer scale, making the test more sensitive than PASI, and allow better differentiation. CONCLUSIONS: The comparison between the classic PASI and our new PASS emphasizes the weight of the "sensitivity to change" (responsivity) in selecting a better evaluation method for psoriatic patients.

Adolescent↗
PubMed2000

Climatotherapy of atopic dermatitis at the Dead Sea: demographic evaluation and cost-effectiveness.

BACKGROUND: About 21% of the patients coming yearly to the DMZ Clinic at the Dead Sea for climatotherapy suffer from atopic dermatitis. This is a common, chronic, and relapsing disease which necessitates drug treatment (topical corticosteroids, antimicrobials, antihistamines, or immunomodulators), phototherapy, or climatotherapy. Objective and methods As the improvement in the condition of patients after 4 weeks of climatotherapy at the Dead Sea is remarkable, we undertook to evaluate the demographic factors that have the strongest impact on this beneficial effect, in adults and children. The major factors studied were: gender, previous medical history, previous stays at the Dead Sea, skin type, skin involvement, age, and duration of treatment. Results A retrospective study of 1718 patients revealed that previous treatments at the Dead Sea and stays longer than 4 weeks caused a clearance greater than 95%, the length of sun exposure was no longer than 5 h daily, and there was no impact of the percentage of skin involvement on the clearance of patients staying more than 4 weeks. CONCLUSION: s Climatotherapy of atopic dermatitis at the Dead Sea is a highly effective modality for treating this disease. It is also a highly cost-effective method, as the patients take no medications and experience no side-effects. Successful climatotherapy of atopic dermatitis requires strict medical supervision throughout the whole length of the patient's stay on shore.

Adolescent↗
PubMed1999

Nocturnal enuresis.

BACKGROUND: Primary nocturnal enuresis is common, and if left untreated has considerable psychological ramifications on children as they get older. OBJECTIVE: To explain the main treatments for nocturnal enuresis. DISCUSSION: By far the most successful treatment is the bed wetting alarm. In recent years desmopressin nasal spray has also found a clinical niche as a short term solution for children attending school camps or sleeping over at friends' houses. It may also be used as an adjunct to the use of the alarm. Treatment with imipramine is increasingly in disfavour because the relapse rate is unacceptably high and fatal overdose is a possibility.

Adolescent↗
PubMed1998

Compression of the esophagus by the spine and the aorta in untreated scoliosis.

An adult patient with severe scoliosis secondary to familial dysautonomia developed dysphagia and recurrent aspirations. Various imaging studies showed a mechanical obstruction of the esophagus due to compression between the spine and the aorta. The patient underwent a gastrostomy and fundoplication, with a significant decrease in symptoms. The case demonstrates one of the possible long-term consequences of untreated scoliosis.

Adult↗
PubMed1998

Safety of solar phototherapy at the Dead Sea.

BACKGROUND: Climatotherapy at the Dead Sea is effective for patients with psoriasis, atopic dermatitis, vitiligo, and other diseases. Although impressive improvement has been reported for patients with psoriasis, with a clearance rate of more than 80% after a 4-week stay, questions regarding the safety of this treatment have arisen. OBJECTIVE AND METHODS: We compare the mean UVB radiation intensities absorbed by psoriatic patients undergoing a 4-week climatotherapy under supervision at the DMZ Rehabilitation Clinic of Ein-Bokek (The Dead Sea, Israel), with similar climatotherapy studies in Sweden and Switzerland. We also compare the climatotherapy radiation dosages with the UVB intensities absorbed by psoriatic patients in radiation cabins at seven university clinics. RESULTS: According to our individually computerized DMZ protocol, a psoriasis patient with skin type IV is exposed during a 4-week climatotherapy to a mean 3.11 J/cm2 (148 MED) of UVB, similar to that in Sweden and Switzerland. The range of the in-clinic annual phototherapy in the seven medical centers studied varied from 1.17 to 37.80 J/cm2 (56 to 1800 MED). CONCLUSION: When all relevant factors are taken into account, the mean UVB exposure dose at the Dead Sea is one of the lowest reported for clearance of psoriatic plaques.

Humans↗
PubMed1998

Magnesium in the management of asthma: critical review of acute and chronic treatments, and Deutsches Medizinisches Zentrum's (DMZ's) clinical experience at the Dead Sea.

The recognition of asthma as an inflammatory disease has led over the past 20 years to a major shift in its pharmacotherapy. The previous emphasis on using relatively short-acting agents for relieving bronchospasms and for removing bronchial mucus has shifted toward long-term strategies with the use of inhaled corticosteroids, which successfully prevent and abolish airway inflammation. Because some of the biological, chemical, and immunological processes that characterize asthma also underly arthritis and other inflammatory diseases, and because many of these conditions have been successfully treated for the past 40 years at the Dead Sea, we were not surprised to realize and record the significant improvement of asthmatic condition after a 4-week stay at the Dead Sea: lung function was improved, the number and severity of attacks was reduced, and the efficacy of beta2-agonist treatments was improved. After reviewing the acute and chronic treatments of asthma in the clinic (including emergency rooms) with magnesium compounds, and the use of such salts as supplementary agents in respiratory diseases, we suggest that the improvement in the asthmatic condition at the Dead Sea may be due to absorption of this element through the skin and via the lungs, and due to its involvement in anti-inflammatory and vasodilatatory processes.

Ambulatory Care Facilities↗
PubMed1997

Demographic evaluation of successful antipsoriatic climatotherapy at the Dead Sea (Israel) DMZ Clinic.

BACKGROUND: Natural balneologic properties, thermomineral springs and unequivocal success in improving psoriasis, attract an ever-growing number of psoriatics to the DMZ Clinic on the shores of the Dead Sea in Israel. METHODS: This paper analyses the rate of success of this balneotherapy in 740 psoriatics who flew in from Germany specifically for this treatment, during 1995, as a function of sex, family history of the disease, number of previous treatments at the Dead Sea, skin type, skin involvement, joint involvement, duration of treatment, sun-exposure schedule, remission length, and psychologic supervision. RESULTS: After 4 weeks, 70% of the patients were completely cleared, this improvement being about the same across both sexes. Family history of the disease, skin type, and psychologic support did not affect the rate of success. On the other hand, previous treatments at the Dead Sea, moderate to severe skin surface involvement, and participation of arthritis, improved the chance of better clearing of the psoriatic condition. Similar improvement was obtained by a longer sun-exposure schedule and a complete-4-week treatment. CONCLUSION: These results indicate that the medical improvement in the psoriatic condition after a 4-week stay at the Dead Sea can be better enhanced and its remission prolonged if additional demographic and anamnestic factors are carefully taken into account.

Adolescent↗
PubMed1996

Prognostic clues and outcome of early treatment of nonketotic hyperglycinemia.

Nonketotic hyperglycinemia presenting in the neonatal period is considered a devastating neurological condition. Most patients die soon after birth, and those who survive manifest severe neurological deficits, psychomotor retardation, and convulsions that are difficult to control. These abnormalities probably result from overstimulation of the N-methyl-D-aspartate receptor in the brain. In the present study, we wished to delineate prognostic clues for patients with neonatal (classic) nonketotic hyperglycinemia and to evaluate the results of early treatment with glycine-receptor modulators. The charts of six children treated in our department since 1991 were reviewed for details that might contribute to the prediction of prognosis. Postnatal clinical presentation and initial cerebrospinal fluid and plasma glycine levels were not predictive of outcome, but early treatment with N-methyl-D-aspartate modulators appeared to reduce late neurological complications and probably is as important as treatment with sodium benzoate. Attainment of developmental milestones, however, varies from one patient to another, presumably because of a factor or factors still unknown.

Amino Acid Metabolism, Inborn Errors↗
PubMed1995

Sustained decrease of blood pressure in psoriatic patients during treatment at the Dead Sea.

The diastolic and systolic blood pressure of 1366 psoriatic patients, treated at the Dead Sea for a period of 4 weeks, was monitored from the day following their arrival. The patients were divided into three categories: (a) psoriatics on antihypertensive medication; (b) psoriatics not receiving antihypertensive medication, but whose initial diastolic blood pressure equaled or exceeded 90 mmHg, and (c) psoriatics with normal blood pressure (diastolic pressure lower than 90 mmHg). A paired t-test revealed that the systolic blood pressure of the two hypertensive groups (a and b) dropped by an average of 22 mmHg, and the diastolic blood pressure dropped by 11 and 16 mmHg, respectively. The drop was evident 2 days after their arrival, and leveled off only after 2 weeks. A similar drop in systolic blood pressure was observed in normotensive psoriatics. On the basis of this study it may be concluded that high blood pressure is not a contraindication for the treatment of psoriasis at the Dead Sea.

Adult↗
PubMed1995

Increased incidence and severity of Streptococcus pyogenes bacteremia in young children.

An increase in the incidence and severity of bacteremia caused by group A streptococci was noted in 1993 and 1994 in the Hadassah University Medical Center, Jerusalem. During the 6-year period 1987 to 1992, 12 children with group A streptococcal bacteremia were hospitalized, whereas in 1993 and 1994 there were 17 patients, 5 of them with 1 each of the following severe clinical manifestations: meningitis and septic shock; streptococcal toxic shock syndrome; septic shock; pleural empyema; and fatal outcome. Our 29 patients with group A streptococcal bacteremia were younger than those reported in the literature: 10 (35%) were < 3 months of age; 17 (59%) were < 1 year old. Most children were previously healthy and only 3 had an underlying immunodeficiency predisposing to infection (1 case each): leukemia; Di George syndrome; and congenital nephrotic syndrome. Two children were recovering from varicella. The skin was the most common site of primary infection (16 of 29). The average white blood cell (WBC) count was 18 150 cells/mm3 (range, 2200 to 34,200). The cases were not related epidemiologically and were caused by a variety of M-protein types. Polymerase chain reaction amplification of the genes encoding exotoxins A (speA) and C (speC) was done on 19 isolates and disclosed 2 strains positive for speA and 5 positive for speC. One of the speA-positive isolates was from the single patient with toxic shock syndrome.

Age Distribution↗
PubMed1991

Clinical signs of pneumonia in children.

Clinical and chest radiographic findings were recorded prospectively in 185 children with cough who attended an outpatient clinic in Papua New Guinea. Children were studied if they were between 8 weeks and 6 years of age; patients with wheeze, stridor, measles, or pertussis were excluded. 56 children (30%) had radiological evidence of pneumonia. The presence of either a respiratory rate greater than or equal to 50/min or chest indrawing, or of both signs, was a good indication of pneumonia, with a predictive power of 46% for a positive test and 83% for a negative test. A more complex definition of tachypnoea, as a respiratory rate greater than or equal to 40/min in children over 12 months old and greater than or equal to 50/min in infants, showed little additional diagnostic benefit.

Child, Preschool↗
PubMed1989

Possible effects of Strongyloides fuelleborni-like infections on children in the Karimui area of Simbu Province.

A parasitological survey of 75 children less than 5 years of age from the village of Yuro, 5km south-east of Karimui, revealed that 47 (63%) were infected with the Strongyloides species resembling S. fuelleborni; 42 (56%) were infected with hookworm. Poor compliance with an intervention study of thiabendazole therapy resulted in the abandonment of the proposed follow-up survey. However, with the small number of children who did comply, we found evidence to suggest a link between high Strongyloides egg count and poor nutritional status.

Anthropometry↗