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Biomedical subjects

Nadav Davidovitch

Publications and source records attributed to Nadav Davidovitch.

At least 19 recordsLinked to original sources
PubMed2006

Identification of risk factors for infection in an outbreak of Mycoplasma pneumoniae respiratory tract disease.

BACKGROUND: Mycoplasma pneumoniae is one of the most common pathogens that causes community-acquired respiratory tract infection. Outbreaks are well known, and all age groups are susceptible. An outbreak in an army training unit afforded an opportunity to identify possible risk factors for morbidity. METHODS: An outbreak of respiratory illness that occurred in a unit comprising 91 trainees was investigated and analyzed as a cohort study. M. pneumoniae infection was suspected on clinical grounds and was confirmed by polymerase chain reaction, culture, and serologic testing. Data regarding medical history, symptoms, signs, and laboratory tests were collected. RESULTS: During a period of 12 days, 41 soldiers (45.1%) had respiratory illnesses, of which 10 (11.0%) were pneumonia. Comparison of symptomatic and asymptomatic individuals revealed that smoking was associated with higher rates of disease (risk ratio, 2.1; 95% confidence interval [CI], 1.3-3.2; P<.005) and seroconversion (risk ratio, 2; 95% CI, 1.2-3.4; P=.03). In multivariate analysis, both lower acute immunoglobulin G values (adjusted odds ratio, 7.8; 95% CI, 1.4-42.5; P=.018) and smoking (adjusted odds ratio, 5.6; 95% CI, 1.5-20.4; P=.01) were associated with symptomatic infection; stratification according to smoking status revealed that immunoglobulin G levels among nonsmokers were protective. Patients who had pneumonia had lower lymphocyte counts (1400+/-258 vs. 2000+/-465 cells/microL; P=.001). CONCLUSIONS: Smoking and lower preexisting immunoglobulin G levels were strongly associated with M. pneumoniae respiratory infection. These findings emphasize the importance of immunity and cessation of smoking for the prevention of disease. The high attack rate emphasizes the extent of infection transmission among healthy persons living in close contact.

Cohort Studies↗
PubMed2006

Postexposure treatment with doxycycline for the prevention of tick-borne relapsing fever.

BACKGROUND: Tick-borne relapsing fever (TBRF) is an acute febrile illness. In Israel, TBRF is caused by Borrelia persica and is transmitted by Ornithodoros tholozani ticks. We examined the safety and efficacy of postexposure treatment to prevent TBRF. METHODS: In a double-blind, placebo-controlled trial, 93 healthy subjects with suspected tick exposure (52 with signs of tick bites and 41 close contacts--those without signs but with a similar risk of contact with ticks) were randomly assigned to receive either doxycycline (Dexxon, in a dose of 200 mg the first day and then 100 mg per day for four days) or placebo after presumed exposure to TBRF. Cases of TBRF were defined by fever and a positive blood smear. Serologic analysis for cross-reactivity to Borrelia burgdorferi and polymerase chain reaction (PCR) for the borrelia glpQ gene were also performed. RESULTS: After randomization, 47 subjects (26 with signs of tick bites and 21 close contacts) received doxycycline. Forty-six other subjects (26 with signs of tick bites and 20 close contacts) received placebo. All 10 cases of TBRF identified by a positive blood smear were in the placebo group of subjects with signs of a tick bite (P<0.001). These findings suggested a 100 percent efficacy of preemptive treatment (95 percent confidence interval, 46 to 100 percent). PCR for the borrelia glpQ gene was negative at baseline for all subjects and subsequently positive in all subjects with fever and a positive blood smear. Seroconversion was detected in eight of nine cases of TBRF. PCR and serum samples were negative for all of the other subjects tested. No major treatment-associated adverse effects were identified. CONCLUSIONS: Treatment with doxycycline is safe and efficacious in preventing TBRF after suspected exposure to ticks in a high-risk environment. (ClinicalTrials.gov number, NCT00237016 [ClinicalTrials.gov].).

Adult↗
PubMed2006

Declining population immunity to mumps among Israeli military recruits.

Population-based seroepidemologic data on mumps have not been available in Israel since 1987, and the effects of mass immigration from the Commonwealth of Independent States during the 1990s have not been investigated. We conducted a seroprevalence study of mumps antibodies among 353 Israeli military recruits aged 18-19, based on a representative sample of sera collected in 1999. The overall seroprevalence rate was 83.3%, which was significantly lower than that measured in 1987 (94.1%, P<0.001). Foreign-born subjects had substantially lower seroporevalence rates than their native Israeli counterparts (68.5% versus 86.1%, P<0.001). Recent seroprevalence levels are below those required for herd immunity, and most likely contributed to an outbreak of mumps observed among young adults in Israel in 2005. Immigration appears to be a contributing factor to the decrease in population seroprevalence over time.

Antibodies, Viral↗
PubMed2006

Detection of relapsing fever in human blood samples from Israel using PCR targeting the glycerophosphodiester phosphodiesterase (GlpQ) gene.

Relapsing fever caused by Borrelia persica is an acute tick-borne disease infecting people in the Middle East. A PCR test targeting the glycerophosphodiester phosphodiesterase (GlpQ) gene was used to detect infection in the blood of suspected relapsing fever patients. The assay detected infection in all 19 patients from Israel who were spirochetemic by blood smear examination and in two additional patients with clinical relapsing fever who were negative by smear examination. Patients were positive by PCR of blood only at the febrile stage and not during the incubation period prior to the appearance of clinical symptoms. Of 52 tick-bitten subjects who were tested and followed-up after being bitten by ticks, 10 developed symptoms of relapsing fever and all became positive by PCR following an earlier negative test. Partial sequencing of the 16S rRNA gene supported by phylogenetic analysis indicated that infection was caused by B. persica or a closely related species. A phylogenetic analysis of the GlpQ sequence showed that it was different yet closely related to other relapsing fever Borrelia spp. present in the Old World. The GlpQ PCR was positive also with the relapsing fever spirochetes B. recurrentis and B. crocidure but not with the Lyme disease agent B. burgdorferi DNA. A second modified GlpQ PCR was able to discriminate between probable B. persica and B. recurrentis and B. crocidurae infection. This study describes the first molecular assay for the diagnosis of relapsing fever caused by B. persica.

Borrelia↗
PubMed2006

Measuring adaptability: psychological examinations of Jewish detainees in Cyprus internment camps.

Two medical delegations, one from Palestine and one from the United States, were sent to detainment camps in Cyprus in the summer of 1947. The British Mandatory government had set up these camps in the summer of 1946 to stem the flow of Jewish immigrants into Palestine after World War II. The purpose of the medical delegations was to screen the camps' inhabitants and to propose a mental-health program for their life in Palestine. We examine the activities of these two delegations within the context of their scientific interest in the psycho-pathology of displaced persons after World War II and as part of a broader project of mental hygiene. According to the delegations, the detainees would be a potential source of strength for building a new society if they adapted to life in Palestine. However, they would become a burden if they failed to be absorbed. At the same time, the medical delegations also saw the detainee camps as a potential "living laboratory" for scientific exploration. The case of the two medical delegations in Cyprus is also a story about constructing and transgressing medical borders. Apart from the obvious fact that this case study deals with movement of people, refugees as well as health-care workers, it is also about the transmission of knowledge and professions across the ocean.

Adaptation, Psychological↗
PubMed2006

Last resort? Lobotomy operations in Israel, 1946-60.

In this paper we examine lobotomy operations in mandatory Palestine and Israel between 1946 and 1960. The aim is to reconstruct the circumstances in which these operations were done, and to examine: which patients were lobotomized and why; how lobotomy was perceived by the local psychiatric profession; and the reasons for its decline. Apart from shedding new light on the history of lobotomy, which is usually analysed from the viewpoint of the USA and Europe, this study provides an opportunity to investigate the relation between various concepts of the healthy and ill body in the unique context of Israel, as an immigrant country influenced by its Zionist ideology.

History, 20th Century↗
PubMed2005

Secular trends in age at menarche, smoking, and oral contraceptive use among Israeli girls.

INTRODUCTION: The improved nutrition and socioeconomic status of the population in industrialized countries has resulted in a decrease in the mean age at menarche. This trend raises the question of whether cigarette smoking and the use of oral contraceptives, health behaviors often adopted during adolescence, may also be starting at a younger age. Cigarette smoking and use of oral contraceptives are a public health concern because they pose an increased risk for development of chronic diseases, particularly in combination. This study was designed to identify secular trends in age at menarche, at first cigarette, and at first use of oral contraceptives among a large population-based sample of young Israeli women and to assess whether these trends are associated with sociodemographic factors. METHODS: A systematic, population-based survey used data obtained from female recruits to the Israel Defense Force from 1986 to 2000. During the study period, 11,392 questionnaires were collected from Jewish women aged 18 to 19 years. Participants were interviewed concerning geographic origin and level of education, father's geographic origin and level of education, current smoking status, use of oral contraceptives, and recalled age at first menstruation, first cigarette, and first use of oral contraceptives. RESULTS: Reported mean age (-/+ D) at menarche showed a monotonic trend of decreasing over time, from 13.41 (-/+ .30) years for women born before 1970 to 13.03 (-/+ 1.28) years for those born after 1978 (P < .001). Women born after 1978 were twice as likely to experience menarche by the age of 11 as those born prior to 1970 (odds ratio 2.0; 95% confidence interval, 1.41-2.82). Significant trends toward younger age at first use were observed for cigarettes and oral contraceptives. CONCLUSION: The trends of earlier age at menarche, first cigarette, and first use of oral contraceptives suggest health behaviors among young women that may herald increased chronic disease morbidity in the future. These trends indicate the need for further investigation and preventive measures aimed at this population.

Adolescent↗
PubMed2005

Reliability of self-reported smoking history and age at initial tobacco use.

BACKGROUND: Many studies use questionnaires to determine smoking status and age of smoking onset. This study aimed to determine the reliability of self-reported smoking history and age of smoking initiation. METHOD: The proportion of inconsistent answers and correlation coefficients of reported age of initial smoking were measured by an answer-reanswer analysis of questionnaires in an ongoing, two-step, population-based survey of health behavior. Interviews were conducted on the day of recruitment to and the day of discharge from mandatory military service in Israel among a sample of 25,437 young men and women recruited between 1986 and 2000. RESULTS: Of 7276 participants reporting current or past smoking upon recruitment, 559 (7.7%) reported never having smoked upon discharge, thus demonstrating prima facie inconsistency. Variables significantly associated with reliable reporting in a multivariate logistic regression model were female gender (P = 0.04) and more than 4 years of military service (P < 0.01). 6010 subjects who reported a positive smoking history at both recruitment and discharge were available for analysis of reliability of reported age at smoking onset. Intraclass correlation coefficients for recruitment/discharge consistency in reported age at first cigarette were 0.73 (95% CI: 0.71-0.74) and 0.76 (95% CI: 0.74-0.78) for men and women, respectively. Eastern origin, lower subject education level, and lower paternal education level were also associated with lower reliability. CONCLUSIONS: Our results showed a relatively high level of answer-reanswer reliability, with some variance attributable to personal characteristics. These results suggest that self-reported age at onset of tobacco use is practical and reliable in normative, young adult populations. However, time elapsed between questionnaires and demographic and lifestyle characteristics may affect reliability rates, and thus should be carefully regarded in future studies.

Adolescent↗
PubMed2005

Medical selection and the debate over mass immigration in the new state of Israel (1948-1951).

This paper examines the discourse regarding medical selection of immigrants to Israel during the years 1948-51, which was a period of mass immigration in which approximately 700,000 people immigrated to the State, thereby doubling the Jewish population in only three years. The paper focuses on the debate the preceded the Israeli Government's eventual acceptance of a selection policy. We assert that the debate was shaped to a large extent by a combination of Zionist ideology and eugenic influences - two intellectual forces that had interacted well before the creation of the Israeli State in the first half of the 20th century.

Emigration and Immigration↗
PubMed2005

Influenza outbreak control in confined settings.

Influenza may rapidly disseminate within populations living in confined settings, causing considerable morbidity and disrupting daily activities. We describe an influenza A outbreak on a military base where 3,000 young adults, most of whom were unvaccinated, lived in close daily contact. Visits to the base clinic by 48 persons with acute respiratory illness within 2 days allowed early identification of this outbreak and prompted immediate epidemiologic investigation. Overall, 85 personnel (2.83% of base population) met the case definition for influenzalike illness. On-site laboratory confirmation with field detection kits, rapid implementation of respiratory illness control protocols, and a mass vaccination campaign were applied to limit disease dissemination. The outbreak was halted 14 days after the mass vaccination campaign was completed. We review the control measures available for controlling influenza outbreaks in confined settings and discuss the role of rapid mass vaccination within this context.

Disease Outbreaks↗
PubMed2005

Cost-benefit of stockpiling drugs for influenza pandemic.

We analyzed strategies for the use of stockpiled antiviral drugs in the context of a future influenza pandemic and estimated cost-benefit ratios. Current stockpiling of oseltamivir appears to be cost-saving to the economy under several treatment strategies, including therapeutic treatment of patients and postexposure prophylactic treatment of patients' close contacts.

Acetamides↗
PubMed2005

Tickborne relapsing fever in Israel.

We evaluated the epidemiology of relapsing fever from 1971 to 2003 in Israel. In civilians, incidence declined from 0.35 to 0.11 cases per 100,000 persons annually; in military personnel it averaged 6.4 cases per 100,000 persons annually. These data imply that the pathogen and vector continue to exist in Israel.

Animals↗
PubMed2005

Infectious diarrheal outbreaks in the Israeli military, 1988-2002.

We analyzed 865 diarrheal outbreaks with an identified bacterial pathogen or unknown cause that occurred in the Israeli military between 1988 and 2002. The number of outbreaks per year declined over the study period, as did the proportion of outbreaks with an identified pathogen. Shigella, Salmonella, and Staphylococcus species were the bacteria most commonly isolated. Seventy percent of the outbreaks involved < 35 cases and only 5% involved > 100 cases. More than one-half of the outbreaks occurred in field units, but these outbreaks were smaller than those in other units. The most commonly identified cause of the outbreaks was a lapse in maintaining standards of food preparation. Improvements in infrastructure and enhanced attention to surveillance, education, and infection control have resulted in a marked decline in the number of outbreaks in recent years.

Disease Outbreaks↗
PubMed2005

[Smallpox vaccination techniques: considerations and unresolved issues].

The smallpox vaccine is the oldest--and was, for 90 years, the only--vaccine known to man. Many vaccination techniques have been used over time, with no fewer than ten employed during the 20th century alone. In Israel, two main techniques were used prior to smallpox eradication in 1978--multiple punctures using a standard needle, and jet injection--while most other countries adopted the bifurcated needle as the method of choice. Despite the vaccination experience gained over time, doubt remains today as to the preferred vaccination technique. During 2002, when Israel became the first country to conduct large-scale smallpox vaccination in the 21st century, multiple standard needle puncture was adopted as the method of choice, while at the same time the bifurcated needle was readopted in the United States. The article reviews the various smallpox vaccination techniques, the supporting scientific data, and the current lacunae in knowledge related to the subject. Together, these factors will most likely influence the adoption of a preferred vaccination technique during a smallpox emergency.

Humans↗
PubMed2005

[Antiviral prophylaxis following possible sexual exposure to HIV].

In Israel, as in certain European countries, national health guidelines exist for preventive treatment after possible post-coital exposure to the HIV virus. Scientifically, this treatment is still regarded as experimental, though over the past years there is a mounting level of evidence of its efficacy. The administration of prophylaxis for HIV after unprotected coitus may be justified by the similar risk of HIV transmission for certain sexual and occupational exposures. Other considerations include: biological plausibility, the effectiveness of post-exposure prophylaxis in animal studies and occupational exposures in humans, efficacy in the prevention of vertical HIV transmission, and cost effectiveness studies. The preventive post-exposure treatment bears many side effects and possible complications, and therefore, each case should be cautiously analyzed before starting such treatment. This article reviews the scientific evidence on this topic, the considerations taken by the physician in initiating post coital HIV exposure treatment, and the guidelines available in Israel and throughout the world.

Acquired Immunodeficiency Syndrome↗
PubMed2005

[Sexually transmitted diseases--an update].

Sexually transmitted infections represent an worldwide challenge for the public health. According to WHO estimates, approximately 330 million people are infected annually by curable sexually transmitted infections (AIDS excluded). and their incidence has been increasing, particularly in high-risk populations. Like in other developed countries, the occurrence of venereal diseases in Israel has been increasing recently. In addition, a sharp rise has been observed in the resistance rate of gonococci to fluoroquinolones. The purpose of the present review is to update the information on the epidemiology, diagnosis, therapy and prevention of sexually transmitted diseases (STDs) in Israel. In response to the reemergence of these diseases in Israel, it was decided in the Ministry of Health to open for the first time ever STD clinics in the two cities with the highest disease burden, namely Tel Aviv and Haifa. These clinics are staffed with a multidisciplinary group of specialists, including gynecologists, dermatologists, epidemiologists, nurses and social workers.

Female↗
PubMed2004

Declining seroprevalence of rubella antibodies among young Israeli adults: a 12-year comparison.

BACKGROUND: In March 2000, the Israel Defense Force (IDF) experienced an outbreak of rubella. No population-based rubella seroepidemiologic data were available for the 13-year period preceding the epidemic. METHODS: We conducted a population-based seroprevalence study of rubella antibodies among 289 IDF recruits drafted in 1999. RESULTS: We found that 69.2% of males and 90.8% of females in service were seropositive at recruitment in 1999, immediately before the outbreak. These rates were significantly lower than those last measured in 1987 (88% among males and 98.1% among females). CONCLUSIONS: Our findings indicate that this rubella outbreak among young adults was facilitated by a decrease in immunity to levels below those required for herd immunity, at which epidemic virus transmission was no longer blocked. This is most likely due to widespread pediatric vaccination coverage with incomplete catch-up immunization among adolescents and young adults. These findings serve as a reminder that changes to childhood vaccination programs may affect the epidemiology of disease among older segments of the population several years after the change is implemented.

Adult↗