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Biomedical subjects

Y Lerman

Publications and source records attributed to Y Lerman.

At least 91 records · Page 5Linked to original sources
PubMed1985

Acute mercury poisoning with severe chronic pulmonary manifestations.

This report describes a patient who developed acute chemical pneumonitis following overexposure to metal mercury vapor. The exposure occurred in a gold extraction facility where a gold-mercury amalgam was heated in a confined area. Prompt treatment with penicillamine and corticosteroids was instituted; radiologic pulmonary infiltrates disappeared within a week, but there was little change in the pulmonary function abnormalities (restriction and diffusion impairment) over the period of 11 months of follow-up. This raises the possibility of persistent pulmonary function impairment after metal mercury vapor-induced chemical pneumonitis.

Adult↗
PubMed1984

Organophosphate and carbamate pesticide poisoning: the usefulness of a computerized clinical information system.

Organophosphate (OP) and carbamate poisoning are still a worldwide health problem causing numerous fatalities in humans. Physicians who have no clinical toxicological experience with these compounds may have difficulties in promptly identifying the etiologic agent and managing the acute phase of the poisoning. We describe the potential use of a computerized medical information system that includes clinical data on 236 cases of OP and carbamate poisoning, and may improve the management of such poisoning. The methods of constructing the system, the first results of using the system, and the medical institutions that can benefit from such systems are discussed.

Acute Disease↗
PubMed1984

Increased urinary enzyme excretion in workers exposed to nephrotoxic chemicals.

Nephrotoxic chemicals are commonly present in the environment, particularly in the workplace. The level of occupational exposure to these chemicals has been so reduced that exposure to these agents now rarely causes clinically evident acute renal disease. A sensitive indicator of renal injury, urinary excretion of N-acetyl-beta-glucosaminidase, was utilized to evaluate persons exposed in the workplace to lead, mercury, or organic solvents, for evidence of renal effects from this exposure. None of the persons had clinically evident renal disease by history, none had hypertension, and all had normal findings on urinalysis. When compared with appropriate control populations, workers exposed to lead, workers exposed to mercury, and two of three groups of workers exposed to organic solvents had significant increases in urinary acetyl glucosaminidase activity. The third group of laboratory workers with low exposure to organic solvents had no increase in urinary acetyl glucosaminidase activity. It is concluded that exposure to environmental nephrotoxins at levels currently considered safe can produce renal effects as manifested by elevations of urinary acetyl glucosaminidase excretion. It is speculated that these renal effects are not always innocuous.

Acetylglucosaminidase↗
PubMed1984

Clinical problems in organophosphate insecticide poisoning: the use of a computerized information system.

A computerized medical information system has been constructed, which contains clinical data from 236 case records of organophosphate and carbamate insecticides poisoning in Israel. A computer program was used to retrieve, analyze, and cross- tabulate data contained in 162 variables per patient. Clinical criteria were used to distinguish mild (66%) from moderate (19%) and severe (15%) cases. The majority of exposures were occupational (58%), whereas the rest were accidental (31%) or suicidal (11%). Parathion was the toxic compound most frequently involved (153 cases). Grouping signs and symptoms according to the cholinergic synapse systems showed peripheral muscarinic signs to be the most prevalent (92.5% of cases), whereas involvement of all three synapse systems was rare (17%). Listing individual symptoms emphasized the high prevalence of nonspecific symptoms such as vomiting (142 cases) and abdominal pain (115 cases). The mean atropine dose given to adult patients during the first 24 hr after poisoning ranged from 6.0 +/- 0.7 mg in mild cases to 49.8 +/- 4.5 mg in severe cases. Evaluation of clinical decision making was demonstrated through analysis of the guidelines used by physicians to gauge atropine administration. Five of the eighteen fatalities were delayed deaths, one of which was due to a polymorphous ventricular arrhythmia. The same arrhythmia occurred also in four nonfatal cases. Other delayed effects included nonspecific EEG changes and neuropsychiatric symptoms. Matching individual cases with comparable cases in the data bank was demonstrated, using a previously published case report. Computerized consultation may help inexperienced physicians to improve the quality of medical care given to cases of organophosphate insecticide poisoning in small hospitals located in rural areas.

Adolescent↗
PubMed1983

External inspiratory resistance of protective respiratory devices: effects on physical performance and respiratory function.

Twenty subjects wearing protective respirators were studied during submaximal exercise (80% of VO2max) on a treadmill. The protective devices were fitted with canister filters of low expiratory resistance and different inspiratory resistances: (0.3, 1.8, 2.8, 3.4, 3.9, and 4.6 cm H2O X sec/liter). The effect of inspiratory resistance on physical endurance, various physiological parameters, and subjective sensations was examined. With the increase in inspiratory resistance, a significant decrease in physical performance, decrease in tidal volume, increased ratio of inspiratory to expiratory time, increased peak inspiratory pressure, and increased CO2 retention were observed. The difficulty in inspiration correlated significantly to inspiratory resistance and seems to be the main reason for cessation of the effort. No acceptable upper limit for the inspiratory resistance of the canister filters was found. Any decrease in the inspiratory resistance of the mask's filter enhanced endurance and performance.

Adult↗
PubMed1982

Physiological and psychological adaptation to respiratory protective devices.

This study was conducted to investigate the adaptation process to respiratory protective devices (RPD). Twenty healthy subjects were tested at 80% of their Vo2 max for 6 consecutive days with a fitted RPD with an airway resistance of 2.80 +/- 0.07 cm H2O s/1. It was concluded that working with RPD at a work capacity close to maximum for several minutes per day induces a rapid adaptation process. This is demonstrated by an improvement in physiological parameters rather than in subjective sensations.

Adaptation, Physiological↗
PubMedDate not supplied

Immunity to measles in young adults in Israel.

The likelihood of an epidemic of measles in 1990-92 in Israel prompted us to study the immune status against measles in a random sample of 454 recruits aged 18-19 years in order to obtain data that might be used in determining vaccination policy. This cohort had received one dose of measles vaccine at 12 months of age. The measles immunity status was studied by determination of antibody values that were measured by means of an enzyme-linked immunosorbent (ELISA) IgG antibody test. Of the recruits, 84.6% were found to have positive sera for anti-measles IgG antibodies, while 13.7% had negative sera. Eight (1.7%) subjects had borderline results. The results of this study indicate the need to administer a second dose of measles vaccine at an older age in addition to the MMR (measles, mumps, rubella) vaccine that is now given in Israel at 12 months of age. This step will help achieve the World Health Organization's target of complete eradication of measles.

Adult↗
PubMedDate not supplied

Risk of hepatitis A virus infection among sewage workers in Israel.

Sewage workers are exposed to a wide range of chemicals and biological agents, including the hepatitis A virus. Inasmuch as Israel is an endemic area for hepatitis A, it is unclear if sewage workers are at increased risk for hepatitis A or which factors contribute to such risk. The authors compared seropositivity of hepatitis A in 100 sewage workers with that in 100 blue-collar worker controls. Hepatitis A seropositivity was highly prevalent, but nonsignificant, in both sewage workers and controls (82% and 91%, respectively). In sewage workers, the major risk for serological positivity was age (odds ratio = 4.5, 95% confidence interval = 1.6, 12.4 for every 10 y). The factors associated negatively with seropositivity were years of education and years of seniority. The authors concluded that exposure to sewage is not a risk factor for hepatitis A infection in Israel, and, therefore, sewage workers do not require special attention in this regard.

Adult↗
PubMedDate not supplied

Association between burnout at work and leukocyte adhesiveness/aggregation.

OBJECTIVE: This study examined whether burnout at work is associated with leukocyte adhesiveness/aggregation (LAA), a phenomenon known to be affected by stress. METHODS: The LAA levels of 179 employees (68 men and 111 women) of Tel Aviv University were determined when the employees underwent their annual routine medical checkup. Blood pressure and toxic chemical exposure were also measured, and background data were retrieved from medical records. Information on burnout and somatic complaints (known to be a general marker of stress) was collected through a self-report questionnaire. RESULTS: Total burnout and each of its subcomponents, emotional exhaustion, chronic fatigue, and cognitive weariness, was significantly associated with LAA levels, even after controlling for age, sex, and educational level. Burnout and somatic complaints intercorrelated positively, but somatic complaints were not significantly associated with LAA levels before or after controlling for the above possible confounders. CONCLUSIONS: Burnout was positively associated with LAA levels. This finding is consistent with the growing evidence of the negative impact of burnout on physical health. The lack of an association between somatic complaints and LAA levels reinforces the claim that burnout and stress are two different concepts.

Adult↗
PubMedDate not supplied

Rapid method for mapping morbidity and mortality during epidemics.

A rapid method for mapping health information during epidemics is described. We divided maps of cities into coded squares and assigned a code to each street which corresponded to its location on the map. Thus, health data information could be easily transferred from the field by indicating the number of cases in each square and readily transferring this information onto a map. By applying density data of the civilian population in each neighborhood it was possible to calculate incidence and prevalence rates at any given time.

Communicable Disease Control↗
PubMedDate not supplied

Motion sickness-like syndrome among tank simulator drivers.

A military tank driving simulator has recently been introduced as a training aid for tank drivers in the Israel Defense Forces. Reports of nausea and vomiting among the first users of the simulator launched our investigation of the possible existence of a motion sickness-like syndrome among simulator drivers. Although the 59 subjects drove the simulator without any report of vomiting, other motion sickness-like symptoms were frequently reported. A comparison of symptoms reported after simulator and real tank driving show that dizziness, nausea, disorientation and hypersalivation were more frequently reported by simulator drivers and were of greater intensity. However, sweating and drowsiness were more prevalent among real tank drivers. The objective effect of driving the simulator was evaluated by instability and performance tests that were conducted before, during and after driving the simulator. A greater decrement in test results was observed among subjects reporting higher frequency of motion sickness-like symptoms.

Adult↗
PubMedDate not supplied

Mortality in Israel during the Persian Gulf war--initial observations.

During the 6-week-long 1991 Persian Gulf war, in which the civilian population was subjected to 18 separate missile attacks and the constant threat of nonconventional warfare, crude mortality rates in Israel were no higher than in the previous decade. Although the results are preliminary and need to undergo more sophisticated epidemiologic analysis, it appears that our population was able to tolerate the subacute period of psychological stress without excess mortality.

Cause of Death↗