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Biomedical subjects

M S Green

Publications and source records attributed to M S Green.

At least 19 recordsLinked to original sources
PubMed2006

Use of rubella seroepidemiological data for assessment of previous vaccination policy and for decision making in response to epidemics in Israel.

We examined the prevalence of rubella antibodies in a representative sample of the Israeli population. Three thousand three hundred and twenty-six sera collected during 1997 and 1998, from an age-stratified general population sample were tested for specific IgG antibodies against rubella. The sero-positivity rates to rubella were higher among females as compared with males (89.1% versus 82.3%, respectively (p < 0.001). This difference was the result of much lower sero-positivity rates among males in the age group 13-17, with the lowest value (56.3%) among subjects aged 16. Male subjects of this age group were in 2000 the target of an outbreak of rubella among 18-19-year old male recruits of the Israel Defense Force. The data of this study served to assess previous exposure to the wild virus or vaccine strains, to identify pockets of low level of immunity and contributed to decision making in response to the onset of a rubella outbreak.

Adolescent↗
PubMed2006

Seroepidemiology of Varicella zoster in Israel prior to large-scale use of varicella vaccines.

OBJECTIVES: This large-scale study provides up-to-date estimates of Varicella zoster virus (VZV) age-specific seroprevalence and characteristics of VZV transmission in a representative sample of the Israeli population. METHODS: In 2000-2001, 1,642 sera collected from an agestratified general population sample were tested for VZV antibodies using an indirect IgG ELISA system. RESULTS: The age-weighted VZV overall estimate was 90.2%. Seropositivity increased rapidly with age, from 68.9% at age 4 to 94.4% at age 7 and 96.6% at age 12 years. The highest force of infection was in the 4-5 years age group (0.548 per susceptible year) followed by the 6-9 years age group. Multivariate analysis revealed that VZV seroprevalence estimates were significantly associated with age and place of origin. The highest seroprevalence estimate was found among subjects of Eastern origin. CONCLUSIONS: The seroepidemiology of VZV in Israel shows a pattern corresponding to that described for developed European countries. This study indicates that the highest force of infection is in pre-school children. Knowledge of pre-vaccination seroepidemiology is important to evaluate the effect of vaccination programs on the epidemiology of the disease.

Adolescent↗
PubMed2006

Prevalence and correlates of diphtheria toxoid antibodies in children and adults in Israel.

A seroepidemiological study was performed to evaluate immunity to diphtheria and to determine the correlates of diphtheria toxoid antibody levels among children and adults in Israel. In total, 3,185 sera from an age-stratified sample of children and adults, obtained in 2000-2001, were tested for diphtheria toxoid antibodies by an in-house double-antigen ELISA. A level of or=0.1 IU/mL (full protection or seropositivity). Seronegativity increased significantly in subjects aged >50 years, reaching levels of 9.7%, 12.6% and 18.9% in the groups aged 50-54, 55-59 and >60 years, respectively (p 0.001), with rates of basic immunity following a similar pattern. Subjects born abroad had higher seronegativity rates than those born in Israel (7.7% vs. 4.9%; p 0.019). No difference in diphtheria toxoid antibody levels was found according to other demographical variables, such as gender, Jewish or Arab ethnicity, urban or rural settlements, and the subjects' place of residence. The level of immunity to diphtheria among children and adults in Israel was satisfactory, with the exception of individuals aged >50 years. The risk of diphtheria outbreaks is low, but sporadic cases may occur among individuals lacking basic immunity against the disease.

Adolescent↗
PubMed2004

Triggering risk factors for ischemic stroke: a case-crossover study.

BACKGROUND: While vascular risk factors for stroke are well established, little is known about factors that may precipitate the acute event. In this study the authors investigated the association between exposure to seven potential triggers during waking hours and acute onset of ischemic stroke. METHODS: In a case-crossover study, 200 consecutive stroke patients were interviewed 1 to 4 days after the event using a validated questionnaire. Reported exposure to potential triggers including negative and positive emotions, anger, sudden posture changes as response to a startling event, heavy physical exertion, heavy eating, and sudden temperature changes during a 2-hour hazard period prior to stroke onset were compared to the same period during the preceding day and to average exposures in the last year. RESULTS: Seventy-six patients (38%) reported exposure to at least one of the study triggers during the 2-hour hazard period. For all factors combined, the OR was 8.4 (95% CI 4.5 to 18.1). The OR for negative emotions was 14.0 (95% CI 4.4 to 89.7), for anger 14.0 (95% CI 2.8 to 253.6), and for sudden changes in body posture in response to a startling event 24.0 (95% CI 5.1 to 428.9). It is important to interpret the reported ORs as estimates of a short-term 2-hour period relative risk and not as cumulative risks. CONCLUSIONS: Negative emotions, anger, and sudden changes in body posture in response to a startling event appear to be independent triggers for ischemic stroke.

Adrenergic beta-Antagonists↗
PubMed2004

Reverse atrial electrical remodelling following atrial defibrillation as determined by signal-averaged ECG.

BACKGROUND: Following successful cardioversion for atrial fibrillation (AF), the rate of early recurrence remains high. Analysis of the signal-averaged electrocardiogram of the P wave has been proposed as a noninvasive method of predicting those at risk of recurrence. PURPOSE: To determine the change in signal-averaged P wave duration (SAPWD) following cardioversion from AF, and to determine whether SAPWD is associated with the risk of recurrence. METHODS: SAPWD was determined in 76 patients immediately following successful electrical cardioversion and three days later. Patients were then followed clinically for one year. RESULTS: Recurrent AF was observed in 32 of 76 patients at 90 days following cardioversion. There was no difference in SAPWD immediately following cardioversion (158+/-28 ms versus 164+/-31 ms, P=NS) or three days following cardioversion (152+/-24 ms versus 158+/-36 ms, P=0.4) in patients with and without recurrent AF. There was, however, a significant decrease in the SAPWD during the first three days following cardioversion in the patients who remained in sinus rhythm (158+/-28 ms initially versus 152+/-24 ms on day three, P=0.009). Among the patients with recurrent AF, the decrease was smaller and not statistically significant (161+/-30 ms versus 158+/-36 ms, P=0.3). CONCLUSION: Shortening of the SAPWD occurs following atrial defibrillation in patients who maintain sinus rhythm at 90 days. This provides evidence for reverse atrial electrical remodelling and its association with the maintenance of sinus rhythm.

Atrial Fibrillation↗
PubMed2004

Utilization of prenatal genetic testing by Israeli Moslem women: a national survey.

The number of prenatal genetic tests that are being offered to women is constantly increasing. However, there is little national data as to who is performing the tests and the reasons for doing or not doing so. The aim of the study was to evaluate the proportion of Israeli Moslem women who perform the various prenatal genetic tests and the factors affecting the performance of these tests. A 2-day survey was conducted in all the maternity departments in Israel based on a structured interview. Of the 242 women interviewed, 74.2% underwent the triple test (TT), 15.8% of the women older than 35 years who were eligible to take the test free of charge underwent amniocentesis and only 1.5% underwent fragile-X (FX) carrier testing which costs 100 dollars privately. In the stepwise regression analysis, having fewer children and having had a higher education affected the performance of the TT. None of the sociodemographic factors were associated with the performance of amniocentesis or FX carrier testing, but the sample sizes were small. The main reason reported by the women for not performing the TT and FX carrier testing was not being referred for testing. The main reason for not performing amniocentesis was that they chose not to perform the test (the majority of these women were religious or ultrareligious). Consideration should be given to providing first-trimester prenatal diagnosis when termination of pregnancy in the Moslem population is more acceptable. In addition, consideration should be given to including state-subsidized FX testing as there is a low rate of FX testing partly due to the cost. Primary care givers should be educated about the importance of prenatal genetic testing.

Adult↗
PubMed2003

Clinical and laboratory presentation of EBV positive infectious mononucleosis in young adults.

Clinical descriptions of Epstein-Barr virus (EBV) positive infectious mononucleosis (IM) are rare and their results are inconsistent. Over a 4-year period, we prospectively studied 590 young adults with clinically suspected IM, all of whom were tested for the presence of EBV IgM antibodies. We investigated the demographical, clinical and laboratory features of subjects with positive EBV IgM serology and heterophile antibodies. Contrary to previous studies, we found a seasonal disease pattern with a peak incidence during summer months, and a lower-than-expected prevalence of lymphadenopathy (88.9%), leucocytosis (46.2%), atypical lymphocytosis (89.2%) and elevated liver enzymes (57.9%). The prevalence of hyperbilirubinemia was relatively high (14.9%). The classic triad of fever, sore throat and lymph-adenopathy had relatively low sensitivity (68.2%) and specificity (41.9%) for EBV infection. Our study provides a complete and updated description of the clinical and laboratory presentation of laboratory confirmed IM, which is important for both clinicians and epidemiologists.

Adolescent↗
PubMed2003

The fall and rise of gonorrhoea incidence in Israel: an international phenomenon?

BACKGROUND: There is evidence of a recent resurgence of the incidence of gonorrhoea in some countries. AIM: To examine trends in gonorrhoea incidence in Israel and compare them with the United States and countries in Europe METHOD: The 1967-2001 annual incidence of gonorrhoea in Israel was obtained from the Israel Ministry of Health's department of epidemiology and for the United States from summary reports of the Centers for Disease Control. The incidence of gonorrhoea in European countries was extracted from the World Health Organization, Health for All database. RESULTS: In Israel, following a long period of decline from 40 per 100 000 in 1970 to 0.74 per 100 000 in 1997, incidence rates began to increase in 1998 to 13.8 per 100 000 in 2001. This pattern parallels those observed in a number of European countries and to some extent, in the United States. Most reported morbidity in Israel occurs among males aged 20-44 years. CONCLUSIONS: The resurgence of gonorrhoea does not appear to be explained solely by behavioural changes. Transmission of the disease should be further studied among different subpopulations in order to develop new prevention strategies.

Adult↗
PubMed2002

Familial risk factors for breast cancer among Arab women in Israel.

The incidence of breast cancer in Arab women is low compared with western populations in other countries. Very few studies on risk factors for breast cancer in Arab women have been reported. The aim of the present study was to evaluate familial risk factors for breast cancer among Arab women in Israel. A case-control study was carried out on 72 Arab women diagnosed with breast cancer and 140 healthy controls. Cases were identified through oncology wards and controls were sampled from community and hospital out-patient clinics. All participants were interviewed and information obtained on family history of breast cancer and other cancers, and other potential risk factors. Eight women with breast cancer and five women without breast cancer had a first-degree relative with breast cancer. The odds ratio for breast cancer for a woman with a first-degree relative with breast cancer was 3.4 (95% confidence interval (CI) 1.06-10.7, P = 0.04). The odds ratio for Muslim women with a first-degree relative with breast cancer was higher than that for Christian women (6.07 and 1.53, respectively). Family history of breast cancer was a risk factor for breast cancer in Arab women. The estimated relative risk associated with an affected first-degree relative was generally higher than that reported from other populations.

Adult↗
PubMed2002

[West Nile fever: the virus, the mosquito, the disease and our coping].

West Nile fever is a viral disease, transmitted to humans by a mosquito bite. An outbreak of West Nile fever occurred last year in Israel, causing substantial morbidity and mortality. This article reviews the literature regarding this disease, focusing on several recent outbreaks around the world, and with special emphasis on the situation here, in Israel. Recommendations for better coping with future outbreaks to the general public, health authorities and state leaders, are presented at the end of the article.

Animals↗
PubMed2001

Decline in immunity to polio among young adults.

A serologic survey was conducted on a population-based representative sample of 521 18-year-old soldiers recruited to the Israel Defence Forces in 1997. The prevalence of neutralizing antibodies and geometric mean titers (GMTs) against the three types of poliovirus (Mahoney, MEF and Saukett strains) were found to be 98.7% (GMT--169.95), 99.6% (GMT--297.14) and 96.4% (GMT - 59.48), respectively. These GMTs are markedly lower than those recorded 4 years after booster vaccination carried out during a 1988 polio outbreak, and suggest a decline in immunity against polio among young adults. These findings support the policy of routine revaccination of children and adolescents in countries at risk of imported polioviruses and of revaccination of adults traveling to areas to which polio is endemic.

Adolescent↗
PubMed2001

Relationship between pacemaker dependency and the effect of pacing mode on cardiovascular outcomes.

BACKGROUND: A recently completed trial, the Canadian Trial of Physiological Pacing (CTOPP), showed that physiological pacing did not significantly reduce mortality, stroke, or heart failure hospitalization, but it did show that atrial fibrillation occurred less frequently in patients with physiological pacing. Many pacemaker patients experience only transient bradyarrhythmias with an adequate unpaced heart rate (UHR) and are not pacemaker-dependent. The purpose of the present analysis was to determine if pacemaker-dependent patients have an increased benefit from physiological pacing compared with non-pacemaker-dependent patients. METHODS AND RESULTS: Of 2568 patients included in the CTOPP trial, 2244 patients had a pacemaker dependency test performed at the first follow-up visit. The yearly event rate of cardiovascular death or stroke steadily increased with decreasing UHR in the ventricular pacing group, but it remained constant in the physiological pacing group. When the patients were subdivided to UHR </=60 bpm or >60 bpm, there was an interaction between pacing mode treatment and UHR subgroup. The Kaplan-Meier plot confirmed a physiological pacing advantage only in the UHR </=60 bpm subgroup. This differential effect was also present for the outcomes of cardiovascular death and total mortality. CONCLUSIONS: This study demonstrated that UHR at first follow-up has an important influence on how pacing mode selection affects cardiovascular death and total mortality. Pacemaker-dependent patients with low UHR will probably be paced frequently and will likely benefit from physiological pacing. In contrast, non-pacemaker-dependent patients will likely be paced infrequently and may not benefit from physiological pacing.

Aged↗
PubMed2001

Identification of a gene responsible for familial Wolff-Parkinson-White syndrome.

BACKGROUND: The Wolff-Parkinson-White syndrome, with a prevalence in Western countries of 1.5 to 3.1 per 1000 persons, causes considerable morbidity and may cause sudden death. We identified two families in which the Wolff-Parkinson-White syndrome segregated as an autosomal dominant disorder. METHODS: We studied 70 members of the two families (57 in Family 1 and 13 in Family 2). The subjects underwent 12-lead electrocardiography and two-dimensional echocardiography. Genotyping mapped the gene responsible to 7q34-q36, a locus previously identified to be responsible for an inherited form of Wolff-Parkinson-White syndrome. Candidate genes were identified, sequenced, and analyzed in normal and affected family members to identify the disease-causing gene. RESULTS: A total of 31 members (23 from Family 1 and 8 from Family 2) had the Wolff-Parkinson-White syndrome. Affected members of both families had ventricular preexcitation with conduction abnormalities and cardiac hypertrophy. The maximal combined two-point lod score was 9.82 at a distance of 5 cM from marker D7S636, which confirmed the linkage of the gene in both families to 7q34-q36. Haplotype analysis indicated that there were no alleles in common in the two families at this locus, suggesting that the two families do not have a common founder. We identified a missense mutation in the gene that encodes the gamma2 regulatory subunit of AMP-activated protein kinase (PRKAG2). The mutation results in the substitution of glutamine for arginine at residue 302 in the protein. CONCLUSIONS: The identification of this genetic defect has important implications for elucidating the pathogenesis of ventricular preexcitation. Further understanding of how this molecular defect leads to supraventricular arrhythmias could influence the development of specific therapies for other forms of supraventricular arrhythmia.

AMP-Activated Protein Kinases↗
PubMed2001

Pregnancy outcome following exposure to shortwaves among female physiotherapists in Israel.

BACKGROUND: The findings of the few epidemiological studies on the possible association between shortwave diathermy use by pregnant physiotherapists and adverse pregnancy outcome are inconsistent. We investigated such an association among physiotherapists in Israel. METHODS: Individualized data on exposure to shortwaves, ultrasound, and heavy lifting were collected by questionnaires and telephone interviews. RESULTS: The 434 studied women included 930 pregnancies: 175 ended in spontaneous abortions, 45 had fetal malformations, 47 were delivered prematurely, and 33 infants had low birth weight. The remaining 630 normal pregnancies comprised the control group. Univariate analysis showed that exposure to shortwaves was associated with a significantly increased odds ratio (O.R.) for congenital malformations (O.R. 2.24, CI 1.27-4.83, P =.006) and low birth weight (O.R. 2.99, CI 1.32-6,79, P =.006). This effect increased in a dose-related manner. After controlling for potential confounding variables, only low birth weight reached statistical significance (O.R. 2.75, CI 1.07-7.04, P =.03). From the potentially confounding variables tested, febrile disease during pregnancy was found to be significantly associated with low birth weight (O.R. 3.37, CI 1.38-8.25, P =.01). CONCLUSIONS: The findings of our study suggest that shortwaves have potentially harmful effects on pregnancy outcome, specifically low birth weight.

Case-Control Studies↗
PubMed2001

Differences in trends of lung carcinoma by histology type in Israeli Jews and Arabs, 1981-1995.

Between 1981 and 1995 the national cancer register in Israel received reports on 13,600 new cases of lung cancer. We evaluated the trends in total lung cancer and the histologic subtypes, in Jewish and Arab Israelis. During this period, the age-adjusted incidence of lung cancer increased in the male Arab population, while for male Jews there was a non-significant decrease, for women in both population groups the rates were stable. When analyzed by age group, there was a significant decrease in incidence rates in Jewish males aged 75 years and older. An analysis by histologic subtypes showed two different trends. In the Jewish population, the age adjusted incidence rates of squamous cell carcinoma (SQCC) decreased and the incidence rates of adenocarcinoma (AC) increased, whereas in the Arab population the incidence rates of both subtypes increased, although statistically significantly only for SQCC. The changes found in the Jewish population are similar to those found in other western countries, where the rates of AC are increasing and the rates of SQCC are decreasing. The trends in the Arab population in Israel are different. This may be due to different trends in the prevalence of smoking in the two populations.

Adenocarcinoma↗
PubMed2001

Risk factor profile for atherosclerosis among young adults in Israel--results of a large-scale survey from the young adult periodic examinations in Israel (YAPEIS) database.

Assessing the prevalence of relevant risk factors among young adults is a critical step in the process of preventing atherosclerotic cardiovascular diseases (ASCVD) later in life. The Israel Defense Force Periodic Health Examination Center performs a routine check-up for subjects aged 25-45 years. Medical history, physical examination notes, laboratory results and ECG tracings are recorded, computerized and processed to form the Young Adults Periodic Examinations in Israel (YAPEIS) database. Data representing 31,640 subjects (27,769 males and 3871 females) examined between the years 1991-1999 were analyzed. The prevalence of documented risk factors for ASCVD were evaluated. The results of all parameters were graded categorically as low, moderate or high and the Framingham risk score was calculated. Fifty-one percent of the study participants were found to be overweight (body mass index > or = 25 kg/m2), 8.5% had high systolic blood pressure and 14.6% had high diastolic blood pressure. The prevalence of hypercholesterolemia and hyperglycemia was found to be 44.7 and 9.7%, respectively. Thirty-two percent of the subjects smoked cigarettes, and 76.7% reported not performing any routine physical activity. Furthermore, 31.8% had a Framingham score indicating a greater than 5% risk for developing a coronary event within the next 10 years. As expected, the prevalence of these risk factors increased with age and were found to be less frequent among females. Thus we conclude that many young Israeli adults hold significant risk factors for future ASCVD. Many of these risk factors are modifiable, and risk behavior is often amenable to alteration. Awareness to the high prevalence of risk factors among young adults should spark vigorous health-promotion programs as well as screening, education, and interventional measures aimed at altering the expected outcome of future ASCVD.

Adult↗