PubMed Health⌕ Search

Biomedical subjects

M Modan

Publications and source records attributed to M Modan.

At least 109 records · Page 6Linked to original sources
PubMed1985

Multivariate analysis of prognostic factors in chronic lymphocytic leukemia.

Prognostic factors in a group of 90 patients with chronic lymphocytic leukemia were studied by methods of survival analysis. The relationship between survival and a set of demographic, clinical and laboratory variables, and identification of subsets of variables that are associated with survival, was tested by multivariate analysis, which is based upon Cox proportional hazards regression models in a stepwise procedure. Six variables showed significant correlation with survival: lymph node enlargement, splenomegaly, hepatomegaly, increased percentage (greater than 80%) of lymphocytes, hyperuricemia, and anemia. Stepwise analysis showed that the number of coexistent risk factors was a better predictor of survival than any single risk marker (P less than 0.001). Median survival of patients with 0 or 1 risk marker was 120 months; with 2 or 3, 96 months; with 4, 36 months; and with 5 or 6, only 24 months. Comparison of staging by number of risk markers with staging of the same patients by the Rai system showed a significant trend of decreasing survival with increasing number of risk markers within the same Rai stage. Staging by the number of coexistent risk markers is a simple and readily available method, which may complement existing methods to provide a more accurate assessment of prognosis in patients with chronic lymphocytic leukemia.

Adult↗
PubMed1984

A comparison of postoperative radiotherapy with postoperative chemotherapy in stage II-IV ovarian cancer patients.

A retrospective comparison between 28 stage II-IV ovarian cancer patients who received postoperative abdominopelvic irradiation and 15 such patients who received postoperative cis-platinum, Adriamycin, and Cytoxan chemotherapy was made. In both treatment groups there was a trend for a longer progression-free interval and 3-year survival in patients with residual tumor masses of less than 2 cm in diameter. In these patients there was also a trend favoring radiotherapy. However, all differences were not significant. Criteria for the choice of either modality of postoperative therapy of ovarian cancer patients remain to be determined. Nevertheless, the efficacy of both modes of treatment does not differ greatly.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1984

The epidemiology of childhood acute lymphoblastic leukemia and non-Hodgkin's lymphoma in Israel between 1976 and 1981.

n epidemiologic survey of childhood acute lymphoblastic leukemia (ALL) and non-Hodgkin's lymphoma (NHL) occurring in Israel, Judea, Samaria and the Gaza Strip between the years 1976 and 1981, revealed 205 cases of ALL and 69 of NHL. The mean annual incidence of lymphatic malignancies was 3.1/10(5) in the Israeli Jews, 2.3/10(5) in the Israeli Arabs and 2.5/10(5) in the Gaza Strip. In the Jewish population there was a peak in the incidence of lymphatic malignancies at the 2-5 years age group, while in the Israeli Arabs this was less prominent. There were no significant differences in the incidence or type of lymphatic malignancies in the various Jewish or Arab groups but there was a trend for a high leukemia to lymphoma ratio (LLR) in the patients from the Gaza Strip. A relatively higher LLR was observed in families of a high socioeconomic status, but it did not reach statistical significance. T-cell ALL comprised about a third of the typed ALL cases. A high proportion of the patients with ALL belonged to the high-risk category: 46% of the Jewish children and 76% of the Gaza Strip children. White blood cell count above 100,000/mm3 were found at presentation in 36.7% of the Gaza Strip patients but only in 9.4% of the Jewish patients. In spite of that, the survival at 4 years of the Jewish and Arab patients was similar. However, the patients with T-cell ALL had a significantly worse survival than the standard risk or the non-T high-risk group: 43.3 +/- 9.7, 66.6 +/- 7.1 and 63.6 +/- 10.4%, respectively. Compared to a previous study conducted in this country in the sixties it appears that the epidemiologic differences that were observed at that time between the various Jewish ethnic groups have practically disappeared.

Adolescent↗
PubMed1984

Effectiveness of glycosylated hemoglobin, fasting plasma glucose, and a single post load plasma glucose level in population screening for glucose intolerance.

Five shortcut methods of population screening for glucose intolerance (impaired glucose tolerance and non-insulin-dependent diabetes mellitus) were assessed for effectiveness: 1) glycosylated hemoglobin concentration (HbA1), 2) fasting plasma glucose level, 3) combinations of fasting plasma glucose and HbA1, 4) plasma glucose one hour post oral glucose load, and 5) plasma glucose two hour post oral glucose load. In a sample of the Israeli Jewish population aged 40-70 years, 2040 participants in the Israel Study of Glucose Intolerance, Obesity and Hypertension, who were not known to be diabetic, underwent an oral glucose tolerance test based on three blood samples (fasting, one hour, and two hour post oral glucose load). In 1058 of the subjects, HbA1 was also measured, and was found to increase significantly (P less than 0.001) with increasing glucose intolerance, but with extensive overlap of ranges, even between normals and newly found diabetics. Fasting plasma glucose was more effective than HbA1 in screening for both impaired glucose tolerance and diabetes by its higher specificity and predictive value of a positive test at comparable sensitivity levels. Combinations of HbA1 and fasting plasma glucose did not improve prediction over fasting plasma glucose alone. As observed in other studies, the screening effectiveness of fasting plasma glucose was also unsatisfactory, either post load glucose level being more effective. Plasma glucose level two hour post load was better for detection of diabetes alone. Plasma glucose level one hour post load was more effective at detecting the total group of glucose intolerance, but did not discriminate well between impaired tolerance and diabetes. A cost-risk-benefit evaluation suggests that a full three-sample oral glucose tolerance test is the best method in screening for both intolerance categories.

Adult↗
PubMed1984

Hereditary factor XIII deficiency: report of four families and definition of the carrier state.

Definition of the carrier state of hereditary factor XIII deficiency was attempted by a study of four unrelated families with patients affected by the disease. Ten homozygotes, 14 obligatory carriers and 20 suspected carriers were available for determination of plasma factor XIII subunits A and B levels (by electroimmunoassay) and for assay of factor XIII enzymatic activity (by 14C-putrescine incorporation into casein). Evaluation of the ability of seven variables related to these tests to discriminate between healthy controls and obligatory carriers disclosed that two variables related to the enzymatic assay classified correctly 92.9% of the carriers and 73.3% of the controls, whereas the variables related to subunit A had a lower discriminative ability. Entering both enzymatic and immunologic variables into the discriminant function did not improve the result of the former. A classification function was established from which the posterior probability of suspected carriers can be determined by measuring the incorporation of 14C-putrescine into casein at 90 min after adding the labelled amine.

Caseins↗
PubMed1984

The diagnostic value of sperm in post-ejaculatory urine.

Post-ejaculatory urine samples ( PEUS ) were obtained from patients undergoing semen analysis. The samples were examined for the presence, number and morphology of sperm. Spermatozoa were found in PEUS of 84.8% of 171 patients whose semen contained sperm. The presence of sperm after, but not before, ejaculation and their concentration in the first part of the void indicated the spermaturia to be the result of urethral washing after ejaculation. The number of sperm in PEUS was a small and variable fraction of the ejaculated sperm. A significant positive correlation was found between the PEUS and the semen sperm count, but there was a considerable overlap of PEUS counts between oligospermic and normospermic individuals. The percentage of sperm with normal morphology in PEUS reflected that in semen. It is concluded that although PEUS reflects some of the semen characteristics, a single PEUS cannot serve as a precise substitute for a direct semen analysis in the individual patient. It can, however, be used for establishing whether populations exposed to dangerous ecological conditions or to drugs which are known to adversely affect spermatogenesis, have reduced sperm count by comparison to appropriate control groups.

Ejaculation↗
PubMed1984

Evaluation of the morphology of sperm in urine of adolescent boys.

The morphology of spermatozoa in the first morning void of boys aged 12-16 years was evaluated. The results suggest that the number of cells having normal morphology increases with advancing age. Thus, the percentage of boys with greater than 45% normal sperm was 26% at the age of 12-13, increasing to 51% at the age of 15-16.

Adolescent↗
PubMed1984

Increased rate of glucose intolerance in endometrial cancer--a community-based study.

Glycosylated hemoglobin was compared in 22 unselected endometrial carcinoma cases 1-10 years (mean +/- SD = 3.3 +/- 2.8) after diagnosis and in 939 controls, a representative population sample in the same age range tested for oral glucose tolerance. Relative weight was similar in patients and controls. Glycosylated hemoglobin was significantly increased (p less than 0.01) in the cases. The distribution of glycosylated hemoglobin indicated that most if not all of the cases had at least impaired glucose tolerance. These results support a true association of glucose intolerance and endometrial carcinoma.

Blood Glucose↗
PubMed1984

Clinical features of Jewish Israeli patients with squamous cell carcinoma of the vulva.

The clinical features of all 150 Jewish patients with squamous cell carcinoma of the vulva diagnosed in Israel during a 13-year period (1961-73) are presented. As in other studies, the frequencies of diabetes, hypertension, atherosclerosis and early onset of menopause were relatively high, and there was a long time lag from onset of symptoms to diagnosis. The most common complaint was pruritus vulvae, and the labia were the most common site of the primary lesion. The predictive value of clinical lymph node examination was reasonably good; lymph node involvement adversely affected survival. In contrast to other studies, the frequency of nulliparity and venereal diseases was low and the most common second primary malignancy was carcinoma of the breast. During the period reviewed, the surgical approach was mainly conservative and the postoperative mortality high, yielding a low 5-year survival rate. We attribute this to the lack of trained gynecologic oncologists during the period reviewed. Preliminary data indicate that in recent years a more aggressive surgical approach is being used and an improved 5-year survival rate achieved.

Adult↗
PubMed1983

Errors in computing drug doses.

The 85 members of the pediatric and neonatal divisions of a medical centre were tested for their ability to calculate the appropriate volumes of drugs commonly administered to pediatric patients. Of a total of 680 computations 43 (6.3%) were wrong. Half the errors would have led to either a 10-fold overdose or a dose a 10th of that prescribed. Significantly more of the errors (p less than 0.01) were made by the nurses in the neonatal division (11.5%) than by those in the pediatric division (3.4%). A deficiency in the in-service training of the nurses in the neonatal division appeared to contribute to the higher proportion of errors in this group. There was also a trend towards a greater chance of error as the length of professional experience increased. All medical personnel involved in the ordering and administration of drugs should be taught computing skills and be evaluated routinely.

Humans↗
PubMed1983

Viral antibodies in maternal and cord sera.

Viral antibodies were determined in paired maternal and cord blood sera of 258 consecutive deliveries. Antibodies to Epstein-Barr virus (EBV), cytomegalovirus (CMV), herpes simplex type 1 (HSV-1), adenovirus (ADV), and varicella zoster (VZV) were tested by indirect immunofluorescence and to rubella (RUB) by hemagglutination inhibition. Analysis of the overall pattern of differences between maternal and cord blood showed a highly significant difference for all six viruses. Analysis regarding individual viruses showed significantly higher titers to CMV and RUB in cord blood, a higher titer to VZV in maternal blood, and similar levels of antibodies to EBV, HSV-1, and ADV in maternal and cord blood. Infants with one or more risk indicators (weight less than 3 kg, Apgar score less than or equal to 7, clinical jaundice, meconium-stained amniotic fluid, respiratory distress syndrome) were defined as "at risk." Infants free of such indicators were defined as "normal." Significantly lower antibody levels to all six viruses were found in both maternal and cord blood of the "at risk" as compared to the "normal" group, while the ratios between the maternal and cord blood levels remained similar. Birth defects were found to have no effect on antibody titers. These results indicate an efficient and selective transfer through the placenta of certain viral antibodies and the possible association of lower antibody production with the presence of risk indicators in the infants.

Antibodies, Viral↗
PubMed1983

Idiopathic hypercalciuria: a familial generalized renal hyperexcretory state.

Twenty-two children with idiopathic hypercalciuria (IH) as well as their parents and siblings were compared to 29 control children and their parents and siblings. Urinary calcium excretion following calcium deprivation or calcium loading was significantly higher in parents and siblings of the IH children than in the corresponding controls. Significantly higher rates of glomerular filtration and increased urinary excretion of sodium potassium and phosphate were found in all family members in the IH group as compared to controls. Significant positive correlations of the five variables studied (glomerular filtration and urinary excretion of calcium, phosphate, sodium, and potassium) were noted within individuals and also within families, both in the IH and the control groups, notwithstanding the lower mean levels in the latter. Serum concentrations of calcium, phosphate, potassium, and sodium were similar in the IH and controls. The distributions of all urinary variables in both the IH and control groups were unimodal with considerable overlap of the two groups, suggesting that IH may be a single entity, possibly representing the upper end of normality. Our data seem to indicate that IH is more likely to be due to nutritional than to genetic factors, since maintenance of sodium potassium homeostatis in the face of increased excretion necessitates increased ingestion of these electrolytes, while increased sodium ingestion is known to be associated with increased urinary excretion of calcium, potassium, and phosphate.

Adult↗
PubMed1983

Transfer of viral antibodies from mother to infant.

Antibody titers to Epstein-Barr virus (EBV), cytomegalovirus (CMV), herpes simplex virus (HSV) Type 1, varicella-zoster virus (VZV) and rubella virus (RV) were determined in maternal and in newborn cord sera in 258 consecutive deliveries. Infants born with one or more of the following risk factors--weight less than 2.5 kg, Apgar score less than 7, clinical jaundice, meconium-stained amniotic fluid, birth defects and respiratory distress syndrome--were considered to be at risk. Similar geometric mean titers (GMT) of antibodies to EBV and HSV were seen in cord blood. Anti-VZV maternal antibody levels were significantly higher than those of cord blood (P less than 0.01). Levels of antibody to CMV and RV, the two viruses most implicated in fetal damage were significantly higher in cord blood than in maternal blood (P = 0.02, and P less than 0.001, respectively). Lower GMTs of antibodies to all five viruses were found in both maternal and cord sera of the group of infants at risk, as compared with infants without risk factors, while the ratio of maternal to cord blood antibody levels remained similar. It appears that inefficient production of antibodies correlates with the presence of risk factors in the newborn.

Antibodies, Viral↗
PubMed1983

Amniotic fluid fluorescence polarization value at physiological temperature: a marked improvement in assessing fetal lung maturity.

Determination of fetal lung maturity by measurement of the fluorescence polarization (P) value of the amniotic fluid at room temperature has become the method of choice in an increasing number of perinatal units because of its simplicity and relatively high predictive value. Nevertheless, its power to discriminate between cases with and without hyaline membrane disease (HMD) needs improvement. To this end, we assessed the discriminative power of the P value at the physiological temperature of 37 degrees C (P37) as compared with the power at 25 degrees C (P25). The study group consisted of 288 consecutive cases at risk for preterm delivery. Samples from all 288 cases were measured at 25 degrees C and samples from 112 of these were measured concurrently at 37 degrees C as well. HMD occurred in 27 infants of the total group, nine of whom belonged to the subgroup tested at both temperatures. When sensitivity was fixed at 100% the specificity of P37 was 97% as compared to 79% for P25 (p less than 0.001). The percentage of cases with infants free of HMD who had borderline P values was also significantly smaller: 1% vs 21%, respectively (p less than 0.001). Although data on more HMD cases are needed to establish the precise threshold of lung maturity for P37, we conclude that P37 is a considerably better discriminator for fetal lung maturity determination than P25.

Amniotic Fluid↗
PubMed1982

Some epidemiologic aspects of carcinoma of the vulva in Israel.

A nationwide study of squamous cell carcinoma of the vulva in Israeli Jewish women has been conducted for a comparison of the incidence, the age pattern and the ethnic distribution of squamous cell carcinoma of the vulva to those of squamous cell carcinoma of the cervix. The mean annual incidence rates by age in squamous cell carcinoma of the vulva rise continuously to age 70 + while in squamous cell carcinoma of the cervix a plateau is reached at age 40 to age 69. In contrast to the relatively low incidence of squamous cell carcinoma of the cervix in Israeli Jewish women, the age-specific incidence rates of squamous cell carcinoma of the vulva are similar to those of white women in the United States. On the other hand, there is a trend to a higher incidence of both squamous cell carcinoma of the cervix and squamous cell carcinoma of the vulva in the North African ethnic group of Israeli Jewish women.

Adult↗