PubMed Health⌕ Search

Biomedical subjects

Y Lerman

Publications and source records attributed to Y Lerman.

At least 37 records · Page 2Linked to original sources
PubMed1999

Induced sputum compared to bronchoalveolar lavage for evaluating patients with sarcoidosis and non-granulomatous interstitial lung disease.

Bronchoalveolar lavage (BAL), an important tool for evaluating interstitial lung diseases (ILDs), has limited utility due to its invasiveness and the difficulty of performing it in clinically contraindicated patients. We compared BAL with the induced sputum (IS) technique to analyse cells and T lymphocytes in patients with sarcoidosis (SA) and non-granulomatous ILD (NG-ILD). Pulmonary function tests and BAL were performed by conventional methods. IS induction was done 20 sec after inhalation of 3.5% saline with an ultrasonic nebulizer. Giemsa-stained cytopreps were differentially counted. T lymphocyte subsets were analysed by flow activated cell sorter (FACS). Patients with NG-ILD had impaired total lung capacity (TLC). Transbronchial biopsy demonstrated lung fibrosis in NG-ILD and non-caseating granuloma in SA. The differential cell count in both groups demonstrated a significantly lower percentage of neutrophils and a significantly higher percentage of macrophages in BAL than in IS. The IS samples of patients with SA were significantly richer in metachromatic cells and eosinophils, but had a lower percentage of lymphocytes, compared to the BAL samples. The profiles of T cell subsets showed the same pattern, in both samples, in both groups. A CD4/CD8 ratio of 2.5 or greater had a sensitivity of 100% and a specificity of 81.2%, with a positive predictive value of 81.2% to distinguish SA from NG-ILD. IS is an effective non-invasive technique to identify CD4+ inflammation which distinguishes sarcoidosis from other NG-ILDs.

Adult↗
PubMed1999

Accelerated silicosis with mixed-dust pneumoconiosis in a hard-metal grinder.

We describe a fatal case of accelerated silicosis with a component of mixed-dust pneumoconiosis in a young hard-metal grinder that we believe is the first case of its kind in Israel and one of the rare cases reported worldwide. The patient's diagnosis was based on typical features: restrictive lung function, abnormal chest roentgenogram suggesting lung fibrosis, a history of exposure to silica and hard metals, bronchoalveolar lavage (BAL) fluid findings, and mineralogical studies. BAL cells showed an abundance of giant multinucleated macrophages. The CD4/CD8 ratio of T lymphocytes was 1.1, with a high percentage of CD8 and CD8/38 positive cells (37% suppressor/cytotoxic and 12% cytotoxic T lymphocytes, respectively). mRNA transcripts isolated from BAL cells were positive for interleukin-1 (IL-1) and transforming growth factor (TGF) Il-5, IL-2, and IL-10 but not for IL-6, IL-4, and interferon. Polarizing light microscopic studies of BAL and induced sputum cells showed polarizing particles, which are typical for silica. Mineralogical studies of electron microscopy performed on BAL fluid and on dust collected at the patient's workstation revealed silica particles as well as aluminum-titanium and other particles. The latter might have contributed to the patient's lung disease.

Adult↗
PubMed1999

Increased serum concentrations of growth factor receptors and Neu in workers previously exposed to asbestos.

OBJECTIVES: Epidermal growth factor receptor (EGFR) and oncogene Neu belong to a family of growth factor receptors which may play a part in carcinogenesis. Although increased serum concentrations of Neu and EGFR have been shown in several patients with asbestosis who later developed cancer, serum concentrations have not been studied in workers exposed in the past to asbestos but without asbestos related diseases. METHODS: Serum concentrations of secreted growth factor receptors were studied in 300 workers exposed in the past to asbestos and the results were compared with those of 70 controls. RESULTS: In the controls 4.3% (3/70) had EGFR values > 912 units/ml, compared with 39% (117/299) of the exposed group (p < 0.001). The difference in high values was even more pronounced for Neu with 4.3% of controls having Neu values > 2580 fmol/ml compared with 72% (216/299) of the exposed workers (p < 0.001). Pleural plaques predicted lower serum concentrations of EGFR but not lower Neu concentrations, and this finding remained significant after adjustment for age, exposure time, smoking, and time from initial exposure. CONCLUSIONS: Enhanced secretion of EGFR and Neu was found in a large cohort of retired asbestos workers with a wide range of exposure and latency periods. They did not have asbestosis or cancer and their EGFR values were higher in those without plaques. Further studies are needed to confirm our results, to determine the source of the secreted growth factor receptors, and to study their possible value as risk factors in the development of cancer.

Adult↗
PubMed1999

Assessment of hazardous dust exposure by BAL and induced sputum.

OBJECTIVES: BAL, an important tool in assessing occupational lung diseases, is unsuitable for screening programs, exposure evaluation, or monitoring hazardous dust because it is an invasive technique. The results of induced sputum (IS) analysis were compared with BAL and evaluated as a possible alternative. METHODS: We compared BAL with IS analysis of 5 workers exposed to asbestos and 14 exposed to silica and hard metals. Pulmonary function tests and BAL were performed by conventional methods. IS induction was performed after a 20-min inhalation of 3.5% saline solution with an ultrasonic nebulizer. Giemsa-stained cytopreparations were differentially counted. T-lymphocyte subsets were analyzed by flow-activated cell sorter, and messenger RNA (mRNA) was transcribed by reverse transcriptase-polymerase chain reaction. Mineralogic particles were analyzed by scanning electron microscopy and polarizing light microscopy and quantified by an analyzer. RESULTS: The percentage of neutrophils was significantly lower in BAL fluid than in IS specimens, whereas no differences were found in the percentage of lymphocytes and subsets profile. Asbestos fibers were found in BAL but not in IS samples from workers exposed to asbestos. Polarizing particles were found in both samples. Similar mineral elements were found in qualitative analysis by scanning electron microscopy. Quantitative studies showed similar size distribution with a small shift toward larger particles in sputum; mRNA showed the same cytokine profile. CONCLUSIONS: A comparison of BAL and IS specimens in the evaluation of the study population yielded similar quantitative and qualitative results. Further research is needed to evaluate the hypothesis that IS, being a noninvasive technique, may be useful in monitoring exposed workers.

Adult↗
PubMed1998

Evaluation of an occupational health education program among 11th grade students.

BACKGROUND: There is a paucity of publications on occupational health as part of the educational curricula in high schools. We investigated the extent to which a new occupational health education program for 11th graders succeeded in achieving changes in their knowledge and attitudes. METHODS: Six classrooms were randomly assigned to either 96 participating students or to a control group (n = 100) that did not participate. Data on knowledge, attitudes, and beliefs were collected before and 4 months after completion of the course by means of an anonymous self-reported questionnaire. One point was assigned to each answer that was either correct or in the desired direction. Scoring was measured by adding up the points and then converting the total into a scale of 100. RESULTS: The experimental group had a statistically higher mean score (from 24.56 to 80.74) after completing the course. The control group had low scores at both time 1 (20.15) and time 2 (17.00). At least 50% more students of the experimental group gave correct answers after the course, while there was no such change in the control group. CONCLUSIONS: Our findings indicate that occupational health learning can occur in the secondary school setting and confirm the program's effectiveness in achieving desired changes in the immediate outcome of knowledge, attitudes, and beliefs in different areas of occupational health. The subject of occupational health is a topic with relevance to larger educational objectives and policies. In many countries all over the world as well as in Israel, this curriculum can potentially be integrated into the body of the current instruction of "Life Abilities," which are courses that cover topics that prepare the youngsters for adult lifestyles.

Adolescent↗
PubMed1998

The in vivo effect of isocyanate-induced asthma on basophil histamine release.

In vitro studies have suggested that basophils are involved in the asthmatic response to isocyanate. Classified by the type of airway response, three groups of patients exposed to isocyanate were studied: 1) nonreactive (n=3), 2) immediate responders (n=4), and 3) late responders (n=4). Basophil histamine release to concanavalin A (conA), FMLP, and anti-IgE was evaluated before and during the airway response. Histamine release significantly (P=0.009 for conA and 0.03 for anti-IgE) increased after exposure to isocyanate only in the group which had late bronchial response. Additionally, good correlation was found between baseline FEV1/FVC% and degree of histamine release of basophils stimulated with conA. These findings support a role for basophils in the late asthmatic response to isocyanate.

Adult↗
PubMed1998

Workers' health in Israel.

BACKGROUND: Occupational hazards are important causes of morbidity, mortality, and disability in the community. This article presents a review of workers' health in Israel. METHODS: Data were collated from the Occupational Health Institute of the University of Tel Aviv, the National Insurance Institute, the Occupational Health Departments of the General Sick Fund, and the Institute of Safety and Hygiene of the Ministry of Labor and Welfare. International comparisons are based on data derived from the WHO Health for All database for the European region. RESULTS: Levels of most biological and chemical exposures in 1996 were found to be in accordance with the standards, except for dust, gases, pesticides, and noise exposure. In 1996, 4.3% of the working population received injury compensation from the National Insurance Institute. 78% of workers' claims approved in 1992-1994 were for injuries to the back and spine. 93% of new cases of occupational diseases and injuries reported in 1996 by the occupational health service of the largest Health Fund were due to noise-induced hearing impairments. In 1996, there were 87 reported deaths following work accidents; about 50% of them were falls that occurred in the construction industry, and 26% of fatalities were among foreign workers. Rates of work accidents, average days of incapacity per accident, and fatalities have been increasing since 1991. Rates of occupational accidents and of occupational fatalities are higher than the European Community average. CONCLUSIONS: Rates of occupational diseases and of injury compensation among workers are increasing, despite the efforts and resources invested in the prevention of work accidents and the promotion of workers' health. These findings indicate the necessity for further research and efforts toward the prevention of injuries and the promotion of occupational health in Israel.

Humans↗
PubMed1997

The Need for Consistent Criteria for Impairment and Disability.

Medical committees that are responsible for pension funds (FMCs) rarely agree with decisions taken by occupational physicians to displace workers from their workplaces and to certify their eligibility for retirement on medical grounds. The major reason for this substantial disagreement, as demonstrated in this article, is a difference between the definition of disability used by the FMCs and that used by the employers or the occupational physicians. The dispute is usually about the evaluation of the worker's ability to function well in an alternative suitable job or with some modification in the customary job. It is also obvious that work options that existed in the past and were offered to disabled workers are diminishing nowadays due to technological and economic advances. The meaning of this disagreement to employers is that they can find their enterprises stuck with disabled workers who are unable to continue their jobs but are not entitled to pensions from the fund because they are considered suitable to cope with another theoretical job. The authors conclude with several approaches to avoiding certain dilemmas concerning the medical aspects associated with the displacement of disabled workers.

Journal Article↗
PubMed1996

Measles immunity and response to revaccination of a young adult population in Israel.

In order to evaluate the true immune status and the effect of revaccination on a young adult population, we collected serum samples from 289 military recruits who were vaccinated during an outbreak in 1991. Most vaccinees, age 18-25 years, had apparently been immunized once before as infants. Sera collected just prior to the vaccination and 14 and 28 days afterwards were tested for measles antibodies by hemagglutination inhibition (HI) and enzyme-linked immunosorbent assay (ELISA)-IgM. Before vaccination, 46 (15.9%) of the subjects had no HI antibodies, (< 1:4) and 48 (16.6%) had borderline (1:4) HI titer. Following vaccination, only ten (3.5%) remained negative and 19 (6.6%) had borderline titer. The increase in HI antibody titer was inversely proportional to the prevaccination titer, and 159 subjects (55.0%) showed no increase at all. The geometric mean titer (GMT) rose from 9.14 to 21.47. Among the prevaccination-negative subjects (HI < 1:4) 28 (60.9%) reached a postvaccination titer of > or = 1:8, and eight (17.4%) reached a titer of 1:4. Twelve (26.1%) of the negative subjects seroconverted and developed IgM, 16 (35%) seroconverted without IgM, and 18 (39%) remained negative and did not develop IgM. A group of eight vaccinees with prevaccination titer of > or = 1:4 developed IgM. Some were probably infected by the circulating wild-type virus prior to the vaccination. Thus, a total number of 20 of the 289 subjects studied (6.9%) had true negative preimmune status as judged by the IgM test. However, the vaccination campaign prevented further measles cases, apparently by increasing the population's immunity, particularly in individuals with very low titers or without measles antibodies.

Adolescent↗
PubMed1996

Determination of immunity to measles virus in young adults: comparative evaluation of a commercial enzyme immunoassay and the hemagglutination inhibition techniques.

BACKGROUND: Determination of the immune status against measles in young adults requires careful evaluation of the laboratory methods because of waning immunity. The hemagglutination inhibition (HI) test and enzyme-linked immunosorbent assay (ELISA) may lack the sensitivity required to detect very low levels of antibodies. In addition, the correlation between ELISA-IgG assays and the degree of protection from measles is not well defined. OBJECTIVES: (a) Evaluation of a commonly used measles ELISA-IgG test kit in comparison with the hemagglutination inhibition (HI) test which corresponds strongly to virus neutralization; (b) determination of false negative rates of the ELISA-IgG and the HI tests; (c) evaluation of the ELISA-IgG test kit as a quantitative assay. STUDY DESIGN: One hundred and eighty serum samples collected from 60 vaccinated young adults immediately before vaccination and 14 and 28 days postvaccination, were tested comparatively by HI and by a commercial ELISA-IgG kit. For evaluation of false negative rates, postvaccination sera of a cohort of 48 vaccinees with negative HI or ELISA-IgG prevaccination sera were tested for IgM. Sixty-three of the samples were also titrated by the ELISA-IgG kit using serial dilutions, for comparison with HI titers. RESULTS: Using the HI test as a reference method, the ELISA-IgG kit was found to have overall accuracy of 81%, sensitivity of 80% and specificity of 84%. The false negative and the false positive rates were 20% and 16%, respectively. In contrast, when we used postvaccination IgM test to distinguish between true and false prevaccination negatives in both the HI and ELISA-IgG tests, we found that the false negative rates were 75.6% by ELISA and 72.5% by HI, and false positive rates were 2.4% and 0%, respectively. Serum titers determined by the ELISA-IgG test were generally 5-10-fold higher than the corresponding HI titers, but without a consistent correlation. CONCLUSIONS: Both the ELISA-IgG and the HI tests frequently failed to detect residual immunity. The two tests also did not correlate well with each other suggesting that different antigenic determinants of the virus are involved in each assay and therefore the HI test should not be used as a reference method for evaluation of the sensitivity of ELISA IgG kits.

Adolescent↗
PubMed1996

Epidemiologic characteristics of participants and nonparticipants in health-promotion programs.

There is potential for nonparticipation in health-promotion programs to impact on all overall success of these programs. The evidence on the relationship of participation of demographic and health characteristic is conflicting. The study presented here prospectively examined the relationship of personnel data and self-reported smoking, exercise, and dietary behavior to participation in the initial phase of a new health-promotion program. Compared with the total population, participants tended to be older and more educated, to be foreign-born and of Eastern ethnic origin, and to have more children. The participant population also tended to include more women, married individuals, and noncommissioned officers. A low smoking prevalence (17% of the participants), a high mean exercise rate (four times per week), and low weekly mean egg consumption (2.7) were observed among the program participants. These results indicate that this program preferentially enrolled people who already were committed to healthy lifestyles, and did not reach all segments of the work force equally.

Adult↗
PubMed1996

Safety and immunogenicity of investigational Shigella conjugate vaccines in Israeli volunteers.

The safety and immunogenicity of investigational conjugates, composed of the O-specific polysaccharides of Shigella sonnei and Shigella flexneri type 2a covalently bound to Pseudomonas aeruginosa recombinant exoprotein A (rEPA), were evaluated in 192 Israeli soldiers. None had significant local reactions or fever. Fourteen days after injection, 90% of S. sonnei-rEPA recipients and 73 to 77% of S. flexneri-rEPA recipients had a fourfold or greater increase in serum immunoglobulin G (IgG) and IgA anti-lipopolysaccharide (anti-LPS) levels; at 2 years, these remained higher than at prevaccination (P < 0.01). There was a fourfold or greater increase in IgM anti-LPS in 20% of vaccinees at 2 weeks, but levels returned to prevaccination values at 6 to 12 months. IgG was the highest and most sustained class of LPS antibodies. Reinjection at day 42 did not boost antibody levels. Eighteen of 23 (78%) who received S. sonnei-rEPA and 13 of 19 (68%) who received S. flexneri-rEPA. had significant IgA-secreting cell responses. Significant IgG antibody-secreting cell responses were detected in 19 of 23 (83%) and 11 of 19 (58%) volunteers following vaccination with S. sonnei-rEPA and S. flexneri 2a-rEPA, respectively. On the basis of these data, further evaluation of the Shigella conjugates for protective efficacy in field trials in Israel was started.

Adolescent↗
PubMed1995

The effect of using short versus detailed self-administered questionnaires on the estimate of illicit drug use among young adults.

We compared two study instruments in use in the Israel Defence Forces to ascertain the prevalence of illicit drug use: a short versus a detailed self-administered anonymous questionnaire. A relatively lower estimate of illicit drug use was found among subjects that answered the short questionnaire. The difference was noted for lifetime prevalence of illicit drug use for women but not for men (6.5% of women reported ever use of illicit drugs using the detailed questionnaire versus 2.1% of women using the short questionnaire, p = 0.002); for prevalence of infrequent illicit drug use (3.3% of men and 3.4% of women reported less than monthly use of illicit drugs using the detailed questionnaire versus 0.2% of men and none of the women with the short questionnaire; p = 0.004 and p < 0.001, respectively), but not for frequent use (i e monthly or more). There was no difference in the percent of subjects that admitted that they knew where to get drugs. We conclude that the short questionnaire in routine use for more than a decade is a useful instrument when compared with the detailed questionnaire, in that the yield of important information such as frequent illicit drug use is similar. This is achieved with the benefit of greater convenience and ease of application to large samples at a lower cost.

Journal Article↗
PubMed1995

Effect of valvular heart diseases, migraine headaches, and perianal diseases on the risk of involvement in motor vehicle crashes.

Impaired health can interfere with driving performance. We have launched this investigation to identify in professional military drivers health parameters that might be associated with involvement in motor vehicle crashes (MVCs). All Israel Defense Forces professional male drivers (N = 5,605) conscripted into compulsory military service between April 1, 1988 and April 1, 1990 were divided into two groups according to whether (N = 1,300) or not (N = 4,305) the driver was involved in MVCs during the same time frame. Using the multivariate Cox model, a significant association was shown between involvement in MVCs and the following health parameters: mild-to-moderate valvular heart disease (p = 0.0002, chi 2 = 13.89), migraine headaches (p = 0.009, chi 2 = 6.91), and perianal diseases (p = 0.006, chi 2 = 7.44). We hypothesize that interference with the driver's performance level may be a result of the discomfort associated with those clinical conditions. It is possible that interference with the personal performance level decreased the ability of the driver to cope with the specific driving task demands and resulted in the involvement of the driver in MVCs. We suggest that because of the high social and economic costs associated with road accidents, it is important to investigate further the association of involvement in MVCs and health problems. If our findings are confirmed in the future studies, intervention programs to reduce MVC rates would be suggested and conducted among professional drivers.

Accidents, Traffic↗