Biomedical subjects

N Egoz

Publications and source records attributed to N Egoz.

At least 19 recordsLinked to original sources

PubMed2001

The use of technologies to decrease peri-operative allogenic blood transfusion: results of practice variation in Israel.

BACKGROUND: Concern about the side effects of allogeneic blood transfusion has led to increased interest in methods of minimizing peri-operative transfusion. Technologies to minimize allogeneic transfusion include drugs such as aprotinin, desmopressin, tranexamic acid and erythropoietin, and techniques such as acute normovolemic hemodilution, cell salvage and autologous pre-donation. OBJECTIVE: To survey the current use in Israel of these seven technologies to minimize allogeneic blood transfusion. METHODS: Our survey was conducted in 1996-97 in all hospitals in Israel with more than 50 beds and at least one of the following departments: cardiac or vascular surgery, orthopedics, or urology. All departments surveyed were asked: a) whether the technologies were currently being used or not, b) the degree of use, and c) the factors influencing their use and non-use. The survey was targeted at the heads of these departments. RESULTS: Pharmaceuticals to reduce allogeneic blood transfusion were used in a much higher proportion in cardiac surgery departments than in the other three departments. Pre-operative blood donation was used in few of the cardiac, urologic and vascular surgery departments compared to its moderate use in orthopedic departments. The use of acute normovolemic hemodilution was reported in a majority of the cardiac departments only. Moderate use of cell salvage was reported in all departments except urology where it was not used at all. CONCLUSION: There is considerable practice variation in the use of technologies to minimize exposure to peri-operative allogeneic blood transfusion in Israel.

Aprotinin↗

PubMed1992

Ischemic heart disease precipitated by occult cancer.

The hypothesis was tested that cancer, by virtue of it being a thrombotic diathesis, may enhance ischemic heart disease. Because cancer therapy may precipitate thromboembolism, the authors focused on patients with occult neoplasia before therapy. Occult cancer was defined as a time period of 2 years before a cancer diagnosis was established. Data obtained from the files of patients with the diagnosis of malignant tumors and admitted to a general hospital during a 3-year period were reviewed for coronary risk factors, coronary events, and characteristics of cancer. Indices of coronary instability were studied: the incidence of first coronary events, the incidence of all coronary events, and the coronary events burden. These indices were calculated for 366 patients with cancer (from the Department of Medicine files of 166 consecutive patients with cancer of several primary sites and from the surgical ward files of 100 consecutive patients with colorectal cancer and 100 consecutive patients with cancer of the prostate or bladder) and for 100 patients with benign prostatic hypertrophy. The patients with benign prostatic hypertrophy served as controls. A steep and statistically significant increase in coronary instability indices was observed in all groups of patients with cancer in the 2-year period before cancer diagnosis in comparison with the coronary instability indices of control patients (P less than or equal to 0.05 to 0.0001). Patients with colorectal cancer presented the highest indices in the 2-year period before cancer diagnosis, with unstable ischemic heart disease being reported in 18% and first coronary events in 10%. The coronary events burden was 0.92. The lowest indices among patients with cancer were recorded in those with prostatic and bladder cancer. Unstable ischemic heart disease occurred in 6% and first coronary events in 4%. The coronary events burden was 0.36. The indices were several times lower for control patients than for patients with cancer. Unstable ischemic heart disease occurred in 3% of control patients, and first coronary events in 2%. The coronary events burden was 0.15. Other possible etiologic factors, particularly the known coronary risk factors and anemia, were not statistically related with an increased risk of coronary events in the 2-year period before cancer diagnosis. Based on these epidemiologic data, it appears that there may be an association between occult cancer and coronary events.

Adult↗

PubMed1991

An outbreak of Shigella sonnei infection due to contamination of a municipal water supply in northern Israel.

An epidemic of more than 8000 cases of Shigella sonnei infection took place in four adjacent urban communities which share the same water supply. The epidemic was caused by massive faecal contamination of the drinking water due to a leak from a broken main sewage pipe into an adjacent drilled well. The infecting organism in most cases was S. sonnei colicine type 6, biotype A, which showed a high rate of multiple resistance to commonly used antibacterial drugs. Most of those affected were children less than 15 years of age. Among adults the attack rates were higher in women. Most cases were mild, only 91 patients being admitted to hospital. One 5-year-old child died.

Adult↗

PubMed1990

Prevalence of respiratory conditions among schoolchildren exposed to different levels of air pollutants in the Haifa Bay area, Israel.

During spring 1984, 2334 second and 2000 fifth-grade schoolchildren living in three Haifa Bay areas on the eastern Mediterranean coast with different levels of air pollution were studied. The parents of these children filled out American Thoracic Society and National Heart and Lung Institute health questionnaires, and the children performed the following pulmonary function tests (PFT); FVC, FEV1, FEV1/FEV, PEF, FEF50, and FEF75. A trend of higher prevalence of most reported respiratory symptoms was found for schoolchildren growing up in the medium and high pollution areas as compared with the low pollution area. Part of the reported respiratory diseases were significantly more common among children from the high pollution area. Models fitted for the respiratory conditions that differed significantly among the three areas of residence also included background variables that could be responsible for these differences. Relative risk values, which were calculated from the logistic models, were in the range of 1.38 for sputum with cold and 1.81 for sputum without cold for children from the high pollution area as compared with 1.00 for children from the low pollution area. All the measured values of PFT were within the normal range. There was no consistent trend of reduced pulmonary function that characterized any residential area.

Air Pollutants↗

PubMed1989

[Use of mobile coronary care unit by patients with myocardial infarction].

140 consecutive patients with MI, all those admitted during 1 month to 3 general hospitals in Haifa, were interviewed and their records reviewed. Only 17.3% had been transferred by a mobile coronary care unit (MCCU). The rates of utilization were lower among residents of the Mount Carmel area and among those hospitalized in Carmel Hospital. Those of European origin used MCCU less than those of Asian-African origin. The rate of usage was inversely related to the level of education. Multivariate analysis showed that the continent of origin explained the largest proportion of the variance. Age of patient and day of week were not of significance. Patients who had had a previous coronary event used the MCCU more than those had not. Only 13% referred to hospitals by physicians in the community were transferred by MCCU, in contrast to 33% of those referred by Magen David Adom stations. 67% of the patients had prior knowledge of the MCCU, but this was not associated with rate of usage. We conclude that the use of the MCCU in the Haifa area is not consistent with its original objectives. The reasons are both patient- and service-related.

Africa↗

PubMed1988

An outbreak of typhoid fever due to contamination of the municipal water supply in northern Israel.

An outbreak of typhoid fever followed a large outbreak of dysentery in northern Israel. Both outbreaks resulted from contamination of a drilled well that supplied water to the municipal water system. The well was contaminated with sewage from a broken main-pipe coming from Shefaram (an Arab town). The outbreak of typhoid involved 77 persons, of whom 75 were hospitalized. In 67, phage-type C1 (the phage type dominant in Shefaram since the 1950s) was isolated. The incubation period was relatively long, between 12 and 40 days (median 22) following exposure. Over 50% of the cases were children aged 0 to 14, and only two patients were older than 35 years; the sex ratio among the patients was 1:1. The incidence rate in Shefaram was 2.3 times higher than in the Krayot (outlying suburbs of Haifa). This difference was due mainly to the high incidence in young females in Shefaram. The opposite was observed during the outbreak of dysentery, when the attack rates of the disease were higher in the Krayot. Relapses occurred in 12% (9 cases). This outbreak demonstrates the potential that still exists for serious outbreaks due to contamination of the municipal water supply.

Adolescent↗

PubMed1985

Association of infant mortality with lack of regular prenatal care in the Haifa subdistrict, 1980.

Results from a retrospective, matched case-control study on infant mortality in the Haifa subdistrict in 1980 are presented. Its most significant result was the demonstration of a positive association of lack of prenatal care with subsequent infant mortality among Jews. Of the Jewish mothers whose infants died, 19.2% did not attend a clinic regularly for prenatal care, compared with only 6.8% in the control group (P = 0.06). Among Arab mothers, the percentages were 30.0 and 25.0, respectively, and were not statistically significant. The most probable explanation is that regular prenatal care actually decreases neonatal mortality, but this study cannot confirm it directly. Other results were: none of the Arab mothers whose infants died had been under follow-up in a high-risk clinic during pregnancy, compared with 28.6% of the Jewish mothers whose infants died; and no association was demonstrated between infant mortality and mother's age or birth order.

Birth Order↗

PubMed1984

Campylobacter jejuni infections in Haifa subdistrict, Israel, summer 1981.

A study investigating the clinical and epidemiological characteristics of Campylobacter jejuni infections in an urban community in Israel is presented. Most of the information was obtained by interviewing 76 patients who constituted a systematic sample out of a total of 215 patients suffering from acute Campylobacter jejuni diarrhoea during the summer of 1981. The crude annual incidence rate was 17 per 10 000. Age-specific incidence rate in infants up to one year of age was eight times higher than that in children 1-14 years of age. The median duration of infection until a negative culture was obtained in convalescent patients, was 10 days. No evidence of resistance to erythromycin was found. No statistically significant difference in keeping animals at home was found between the patients and a neighbourhood control group. The frequencies of the various complaints and clinical findings are described.

Adolescent↗

PubMed1983