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Biomedical subjects

R S Carel

Publications and source records attributed to R S Carel.

At least 19 recordsLinked to original sources
PubMed1996

[Annual activities of a regional occupational health service].

The scope and content of the services provided by a regional, occupational health service are described in quantitative terms. Many of its activities are in compliance with state regulations. In this respect this service differs greatly from other, regular, clinical services. About 22,000 examinations are performed annually, and there are about 140,000 employed persons in the region, so that about 1 in 5 workers is examined by the service annually. The 3 main activities of the clinic are pre-employment examinations, periodic surveillance of certain groups of workers and evaluating work capacity. Most of the abnormal findings identified in such examinations relate to musculo-skeletal disorders, noise-induced hearing loss and, to a much lesser degree, lung and skin problems. Some of the ways in which service is provided in remote and small work sites are described, and issues of availability and accessibility presented. Based on the data collected, suggestions are made with respect to future changes, including computerization and quality assurance methods.

Humans↗
PubMed1994

Factors affecting long-term sick leave in an industrial population.

Factors affecting long-term absenteeism for non-accident-related sickness leave in a large, remotely located factory (Dead Sea Industry, Israel) were evaluated. About 10% (89 persons) of the workers were found to be on sick leave for more than 20 days/year. This group was designated as high absence workers (HAW). Most of the sickness absence were for repeated short-term leaves due to intercurrent diseases, rather than for continuous periods related to a major or single illness. Average cumulative duration of sick leave in this group was 54 days/year. The average number of spells was 11 per year (4.9 days/spell). There were significantly more HAW among skilled (relative risk, R.R. = 1.6) workers or shift workers (R.R. = 1.3), compared to white collar workers. There were significantly fewer HAW among workers 35-49 years of age (7.6%) than among younger (12.5%) or older workers (13.8%). Except for possible hearing loss in one worker, no occupationally related illness was identified. Sixty-six percent of the HAW took many sick leaves, over 20 days during the year following the study year, and 52% of this group took over 20 days in the preceding year (usually for minor diseases or complaints). This pattern of long-term sickness absence indicates that various socio-economic factors determine HAW to a greater extent than immediate occupational risks or health problems.

Adult↗
PubMed1994

"Souvenir" casting silicosis.

A case of silicosis in a 47-year-old worker who was employed for many years in a small souvenir casting shop is described. This work site demonstrates many unfavorable characteristics of small industries, such as lack of awareness of the need for safety measures, exposure control, protection of workers, and lack of compliance with environmental and medical-legal standards.

Humans↗
PubMed1993

Repeated multiphasic screening examinations: evaluating the process.

There are sound clinical and epidemiological reasons to promote and emphasize early detection efforts and disease prevention services. A large body of scientific literature supports the notion that detection and intervention early in the course of many diseases is beneficial both to the afflicted individual and to society at large. Several publications deal with the evaluation of multiphasic screening examinations (MSE) as a tool for simultaneous early detection and prevention of multiple risk factors and various diseases. Usually, this technology is evaluated based on data from a single (cross-sectional) comprehensive screening study. However, frequently MSE are performed periodically, resulting in repeated test results of the same individuals. The health impact of such repeated (longitudinal) MSE has not been studied extensively. Similarly, many of the unique theoretical, technical, and epidemiological features characteristic of consecutive (periodical) comprehensive screening examinations are not well-documented. The purpose of this study was to compare the test results of two MSE, performed 3.5 years apart, in order to demonstrate certain characteristics of multiphasic health testing (MHT) technology related to repeated (longitudinal) multiphasic examination of the same individuals.

Humans↗
PubMed1992

Delayed health sequelae of accidental exposure to bromine gas.

The delayed health effects from accidental exposure to bromine vapors in a group of six people were evaluated. During the acute exposure, they had only some respiratory symptoms and skin burns of first to second degree involving small areas. All were treated in one hospital and released within 1-4 d. Six to 8 wk later, some still had health complaints such as cough, shortness of breath, chest tightness, eye irritation, headache, dizziness, fatigue, and memory, sleep, and sexual disturbances, but no objective laboratory or clinical evidence of effects. Mechanisms that might have led to manifestations of such complaints 1-2 mo after the accident are discussed and possible ways to alleviate similar situations are suggested.

Accidents, Traffic↗
PubMed1991

Comparison of two pre-admission testing methods for elective surgery patients.

Patients admitted for elective surgery (inguinal hernia, varicose veins and hemorrhoids) were studied in order to evaluate the impact of performing pre-admission testing (PAT) by utilizing an automated multiphasic health testing (AMHT) technology on the rate of repeating the pre-operative routine laboratory tests during hospitalization. A slightly lower but statistically significant rate of repeated tests was found among patients who performed PAT by AMHTS compared with those who performed the tests via the conventional ambulatory system. This result suggests that performing routine tests before hospitalization in a single authorized AMHTS facility is preferred since it saves the patient time and reduces the need for repeated tests.

Adolescent↗
PubMed1991

Changes in smoking patterns in young military recruits in relationship to psychosocial characteristics.

We followed 295 young infantry recruits during their first 14 weeks of basic training. The prevalence of smoking increased by 50%. About half of this increase was accounted for by ex-smokers, 57% of whom had resumed the habit. Average education and military psychometric measures of both the baseline smokers and the new smokers were significantly lower than those of the abstaining never-smokers. Asian and North African origin and a lower peer group evaluation score were also risk factors. These relationships were not demonstrated among resuming ex-smokers. The rise in the smoking rate accounts for most of the known rise during full military service. We suggest early preventive measures, especially for the two groups at risk.

Adolescent↗
PubMed1990

[Late health sequelae of accidental bromine exposure].

Health and environmental assessment of the consequences of accidental contamination of an area in the Negev desert is described and the effects of exposure to bromine vapor in 6 persons evaluated. They were only mildly affected during the acute spillage of the bromine, with some respiratory symptoms and first and second degree skin burns of small exposed areas on the legs. All were treated in hospital and were released within 1-4 days. 6-8 weeks later they demonstrated a complex array of complaints, including cough, shortness of breath, chest tightness, eye irritation, headache, dizziness, fatigue, memory disturbances, sleep and sexual disturbances. These complaints could not be substantiated by objective clinical or laboratory examination. There was thus obvious magnification of the complaints 1-2 months after the accident.

Accidents↗
PubMed1990

Occupational stress and well-being: do seafarers harbor more health problems than people on the shore?

The popular image of life at sea is one of stress: often difficult physical conditions, dislocation, isolation and less than ideal personal habits. In order to determine whether this stressful way of life is manifested when seamen's health status is assessed by standard measurements, we studied 144 sea captains and marine chief engineers as compared with a group of ordinarily employed men. The referent men were matched for age, ethnic origin, and level of education with the seamen. Outcome measures included a wide spectrum of physiological, psychological and behavioral indices. The comparisons revealed only mild differences between the two groups. Captains and chief engineers tend to harbor slightly higher levels of certain biochemical or physiological parameters (risk factors), such as serum cholesterol and uric acid, hemoglobin level and leukocyte count. Certain behavioral risk factors were more dominant among the seamen than among the control group (smoking level, alcohol consumption and lack of leisure-time physical activity). The study group did not exhibit a greater prevalence of overt disease or a higher degree of psychological symptoms. It is suggested that the group under study represents a self-selected group of persons well adjusted to their job and their special way of life.

Adult↗
PubMed1988

Smoking, leukocyte count, and ventilatory lung function in working men.

Results of a cross-sectional study of ventilatory lung function (VLF) in a group of 307 working men showed that the leukocyte count in peripheral blood is more closely associated with the relative position (percentile) of a person in the frequency distribution of VLF than is smoking intensity. Leukocyte count is significantly (and inversely) correlated with VLF in nonsmokers as well as in smokers. A multiple regression analysis indicated that, after accounting for the effect of height and age, white blood cell (WBC) count explains more of the VLF variance than many other health determinants. Moreover, WBC count is the only variable, apart from height and age, that contributes significantly to the regression. Current smokers with elevated leukocyte count in peripheral blood may constitute a defined high-risk group because they demonstrate more negative regression age coefficients when compared with smokers without elevated WBC or with nonsmokers. Mechanisms that may explain these findings are discussed.

Adult↗
PubMed1987

Evaluation of the annual activity of a continuing medical and home care unit.

This report presents the annual activity of a home care unit which operates as an extension of a regional hospital into the community. This 'intermediate-care' (between hospitalization and ambulatory care) was developed because of the demographic and health characteristics of the urban population served and in response to their specific health care needs (immediate availability and accessibility of care). During this period, 471 patients were under care, 85% of whom were 65 years old and over. Forty percent were referred with a diagnosis of a malignant disease, about 20% with a diagnosis of a cerebral event and 15% with cardiac and vascular problems. The average period of stay in the program was three months, with less than 10% remaining under supervision for more than a year. In about 50% of the patients involved the care goals were attained and in an additional 25% (terminal cases) the patients were cared for at home until death. The service was found to be an important factor in the interim phase between acute hospitalization and the continuation of care provided by the family physician. The multidisciplinary team care approach was found to be effective in providing services to that group of patients characterized by old age, multiple medical problems and being homebound. The concerned service is continuously developing in compliance with the changing and growing needs of particular groups of patients such as advanced malignant disease, complex cardiovascular problems and multiple (simultaneous) diseases.

Adult↗
PubMed1987

Hypertension in European immigrants to Israel--the possible effect of the holocaust.

To examine the effect of stressful life events and chronic emotional distress in the development of hypertension, we compared the blood pressure of 1,150 Israelis (aged 50 to 80) who immigrated from Europe before 1939 with that of 2,159 European-born Israelis who immigrated to Israel after World War II. Most of the subjects were examined as part of a periodical health examination offered by their employers. There were only minor differences in age, height, country of origin and level of education between the two groups. There was no difference in the prevalence of hypertension between the two immigration groups, and a similar percentage of both groups were receiving treatment. Hypertension was defined as any one or more of the following: supine systolic greater than or equal to 160 mm Hg, diastolic greater than or equal to 95 mm Hg, or treatment with antihypertensive medications. Analysis of variance showed that age, sex and degree of obesity were the main factors contributing to the blood pressure. Although the degree of emotional stress was greater in the Holocaust survivors, there was no correlation between level of emotional distress, satisfaction with life or number of psychosomatic complaints and level of blood pressure or prevalence of hypertension.

Aged↗
PubMed1987

Routine urinalysis (dipstick) findings in mass screening of healthy adults.

We present results of simple urinalysis examinations (dipstick) in a large (approximately 21,000 people) working population. In about 10% of the screened individuals at least one abnormality was found. In men the most common finding was proteinuria (4.9%). Hematuria was found in 2.6% and glycosuria in 0.6%. The most prevalent finding in women was hematuria (8.1%), followed by proteinuria (3.9%) and glycosuria (0.6%). Only about 1% of the examinees had two or more abnormalities in their urine examinations. These findings attest to the utility and practicability of incorporating urine testing into various screening and clinical examinations.

Adult↗
PubMed1986

Emotional distress and satisfaction in life among Holocaust survivors--a community study of survivors and controls.

Results are reported from a large population study (of working people) comparing Holocaust survivors and a control group in regard to emotional distress, satisfaction in life and psychosomatic symptoms. It was found that, even 40 years after the traumatic experience, this group of survivors exhibited a slightly higher degree of emotional disorders than controls who were not under Nazi occupation during WWII. These long-term effects were usually more prominent in women than in men, and the relationship to age was minimal.

Adaptation, Psychological↗
PubMed1985

Computerized ECG interpretation in ambulatory health care services--optimal configuration of the "heart station".

The paper presents a method for optimization of the configuration of a computerized "heart station" (for interpretation of electrocardiograms from large ambulatory populations). The optimization model takes into account several factors that affect efficiency and acceptance of the newly introduced technology. Efficient operation may be determined by minimizing cost/ECG or maximizing number of ECGs/technician/hr. If the acceptance of new computerized medical technologies is expected to be gained smoothly and rapidly, great attention should be paid to the acutal "interfacing" of the new devices with patients and operators. The concerned model is general enough to assist in decisions concerning various technologies and is not limited to computerized ECG interpretation systems only.

Ambulatory Care↗
PubMed1985

Factors affecting leukocyte count in healthy adults.

The relationships between white blood cell (WBC) count, smoking, and other health variables were determined among 35,000 apparently healthy men and women. The effect of smoking on the WBC count was greater than that of all other variables. The leukocyte level and the variance in WBC count values increased with increased smoking intensity. The relationship between smoking intensity and leukocyte level is expressed quantitatively by the following regression equation: WBC (10(3)/mm3) = 7.1 + 0.05(SM), where SM has seven values according to the smoking level. Multiple regression analysis with additional variables other than smoking did not much improve the predictive value of the equation. The effect of smoking on WBC count could be only partially explained by an inflammatory process, e.g., chronic bronchitis. Relationships of statistical significance (but mostly with r values of less than 0.10) were found between WBC count and the following variables: hemoglobin, heart rate, weight (or Quetelet index), cholesterol, uric acid, creatinine, sex, ethnic origin, systolic blood pressure, height, blood sugar, and diastolic blood pressure. The normal WBC count range for smokers differs from that of nonsmokers and is shifted to the right according to the smoking level. This may have both a diagnostic and prognostic significance in different clinical settings.

Adult↗
PubMed1985

Effect of pilocarpine in ocular hypotension.

In patients with normal intraocular pressure (IOP), local ocular application of pilocarpine causes IOP elevation, reaching a maximum at 10-20 min, and a subsequent prolonged fall of IOP below the baseline. We have studied the effect of pilocarpine in normal subjects with low baseline IOP (less than 10 mm Hg). The initial rise was larger than in normotensive controls (21 vs. 12%) and the subsequent fall was of similar relative magnitude (20%) as that of normotensives. Lower baseline IOP values were associated with greater initial rises and smaller subsequent falls. The mechanisms that may explain the two phases of IOP response to the administration of pilocarpine are discussed.

Adult↗