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Biomedical subjects

A Morag

Publications and source records attributed to A Morag.

At least 19 recordsLinked to original sources
PubMed2005

Use of complementary and alternative medicine among cancer patients in Israel.

Complementary and alternative medicine (CAM) has gained in popularity among cancer patients in recent years. The present study assessed the patterns of CAM use among cancer patients in Israel. The design of the study was descriptive cross-sectional, and data were collected using a 27-item questionnaire. The sample consisted of 111 Israeli cancer patients who were part of a larger European study. Among the participants, past or current CAM use was reported by 32.4% (n=36). The most common therapies used included herbal medicine (22.2%), spiritual therapies (19.4%), visualization and relaxation techniques (16.7% for each), and vitamins/minerals (13.9%). Younger patients with higher education, higher annual income, and previous standard treatment were more likely to use CAM. The mean satisfaction and perceived effectiveness scores were 5.36+/-1.37 and 5.48+/-1.39, respectively, out of a maximum score of 7. The main benefits from CAM reported by patients included improvement in emotional and physical well-being (40% and 34.3%, respectively) and increased ability to fight the disease (31.4%), although 17.1% of patients reported no benefits at all from CAM. The main sources of information about CAM were friends/family and the media. Findings suggest that due to the relatively high use of CAM among cancer patients, this topic should be taken into account in a holistic approach to this patient population.

Adult↗
PubMed2001

Cytokine-associated emotional and cognitive disturbances in humans.

BACKGROUND: Infectious, autoimmune, and neurodegenerative diseases are associated with profound psychological disturbances. Studies in animals clearly demonstrate that cytokines mediate illness-associated behavioral changes. However, the mechanisms underlying the respective psychological alterations in humans have not been established yet. Therefore, we investigated the effects of low-dose endotoxemia, a well-established and safe model of host-defense activation, on emotional, cognitive, immunological, and endocrine parameters. METHODS: In a double-blind, crossover study, 20 healthy male volunteers completed psychological questionnaires and neuropsychological tests 1, 3, and 9 hours after intravenous injection of Salmonella abortus equi endotoxin (0.8 ng/kg) or saline in 2 experimental sessions. Blood samples were collected hourly, and rectal temperature and heart rate were monitored continuously. RESULTS: Endotoxin had no effects on physical sickness symptoms, blood pressure, or heart rate. Endotoxin caused a mild increase in rectal temperature (0.5 degrees C), and increased the circulating levels of tumor necrosis factor alpha (TNF-alpha), soluble TNF receptors, interleukin (IL)-6, IL-1 receptor antagonist, and cortisol. After endotoxin administration, the subjects showed a transient significant increase in the levels of anxiety (effect size [ES] = 0.55) and depressed mood (ES = 0.66). Verbal and nonverbal memory functions were significantly decreased (ES = 0.55 to 0.64). Significant positive correlations were found between cytokine secretion and endotoxin-induced anxiety (r = 0.49 to r = 0.60), depressed mood (r = 0.40 to r = 0.75), and decreases in memory performance (r = 0.46 to r = 0.68). CONCLUSIONS: In humans, a mild stimulation of the primary host defense has negative effects on emotional and memory functions, which are probably caused by cytokine release. Hence, cytokines represent a novel target for neuropsychopharmacological research.

Adult↗
PubMed2001

A double-blind trial of a new inactivated, trivalent, intra-nasal anti-influenza vaccine in general practice: relationship between immunogenicity and respiratory morbidity over the winter of 1997-98.

BACKGROUND: Influenza is responsible for considerable morbidity not only among older people but in younger age groups as well. However, most large-scale anti-influenza vaccination campaigns are still aimed principally at the elderly using injectable vaccines. Until now there has been much less emphasis on targeting younger populations or using intra-nasal vaccines in mass anti-influenza immunisation programmes. OBJECTIVES: To assess the immunogenicity of a new inactivated intra-nasal anti-influenza vaccine and to measure its effect on respiratory morbidity in a volunteer general practice population. STUDY DESIGN: A prospective, double-blind, placebo-controlled trial using the new vaccine was carried out over the winter of 1997-98 on 274 healthy patients aged 12-60 from three Israeli general practices, 182 in the vaccine group and 92 in the placebo group. Following vaccination the changes in the antigen levels and episodes of respiratory illness in the vaccine and placebo groups were measured. RESULTS: Protective antibody levels occurred after a single dose of vaccine [influenza H1N1, 41% immune pre-vaccination to 73% post-vaccination; influenza H3N2, 35-66%; influenza B, 27-64%]. Between January and March 1998, when influenza activity was at a peak in Israel, the average number of respiratory illness events in the vaccine group [14 events/100 subjects per month] was significantly less than in the placebo group [22 events/100 subjects per month]; similarly, the average number of respiratory illness days in the vaccine group over the same period [69 days/100 subjects per month] was significantly less than in the placebo group [117 days/100 subjects per month]. CONCLUSIONS: The new vaccine possessed significant immunogenicity and was associated with a significant reduction in respiratory morbidity among a group of healthy older children and adults. Since intra-nasal vaccines are simpler to administer and more acceptable to the public than injections the vaccine's potential for use in routine anti-influenza vaccination campaigns seems promising, especially if its beneficial effects are also reproducible in more medically vulnerable populations.

Administration, Intranasal↗
PubMed2001

Is herpes simplex virus associated with pulp/periapical inflammation?

OBJECTIVES: This study focuses on the detection of herpes simplex virus (HSV) DNA in dental pulp and inflamed periapical tissue. STUDY DESIGN: Dental pulp tissue (vital and necrotic) and periapical tissue samples were collected under strictly sterile conditions and examined for the presence of HSV DNA. Saliva samples were also examined for the presence of the viral DNA. The polymerase chain reaction assay was used to detect viral DNA. Blood samples were collected, and the enzyme-linked immunosorbent assay (ELISA) for immunoglobulin G (IgG) and immunoglobulin M (IgM) antibodies against HSV was carried out. RESULTS: According to the ELISA test, 19 of the 23 blood samples were IgG-positive and IgM-negative to HSV, whereas 4 were IgG-negative and IgM-negative. HSV DNA was not detected in the tissue and the saliva samples tested. CONCLUSION: HSV is not present and therefore is probably not involved in the pathology of tooth neural tissue.

Adolescent↗
PubMed2001

Serum and mucosal immunologic responses in children following the administration of a new inactivated intranasal anti-influenza vaccine.

Children are at considerable risk for influenza infection and may constitute the main vector for transmitting the virus to adults in the community. At present, the use of available vaccines in children is limited mainly because of a fear of side effects from the injection. Intranasal immunization was assessed as a painless, side effect-free method of facilitating the enrollment of children in vaccination programs. One intranasal dose of a trivalent inactive whole virus vaccine containing 20 microg of the three recommended seasonal viral strains was administered to 28 children recruited over two separate winter periods (1997/1998 and 1998/1999). No adverse effects were recorded. Serum IgG responses were determined by the hemagglutination inhibition (HI) method and nasal IgA responses by enzyme-linked immunosorbent assay (ELISA). In both study period seasons, 77.7%-94.4% of children were found to be immune. There was a 3.7 x and 4.7 x increase in geometric mean titer (GMT) for A/H3N2 strains, 1.9 x and 3.9 x for A/H1N1 strains, and a 3.2 x and 1.7 x for B strains in 1997/1998 and 1998/1999, respectively. The increase in GMT, as well as fourfold increases in titer level, was higher when calculated among the nonimmune children prior to vaccination. Of these, 50%-87.5% became immune following immunization. Local antibody response to the three viral strains was detected in 50%-55% of the immunized children. Also, 83.3%, 73.3%, and 61.1% of the vaccinees exhibited a mucosal and/or serum antibody response to the A/Beijing, A/Sydney, and B/Harbin strains, respectively. This mucosal response may forestall influenza development in its early stages, thereby contributing significantly to the reduction of influenza spread in the community.

Administration, Intranasal↗
PubMed2001

[Vaccinations in sports and recommendations for immunization against flu, hepatitis A and hepatitis B].

Intensive physical training in elite athletes can have an adverse effect on the immune system, and can increase the susceptibility to infectious diseases. The insult to the immune system includes the cellular, humoral and phagocitic pathways. The increased incidence of viral infections (in particularly of the upper respiratory tract) occurs mainly during periods of intense exercise training and competitions due to the combination of physiological and psychological stress. Other factors that may contribute to the decreased immunity and increased susceptibility to infections include eating disorders and nutritional deficiencies, jet lag, sleep deprivation, and lack of proper hygiene in shared food and sleeping quarters. For elite athletes, even a mild viral infection can be devastating due to loss of important training hours and/or compromise of competitive performance. Therefore, in addition to the goal of improving the athletes performance, another important responsibility/obligation of the staff working with athletes (physicians, nutritionists, physiotherapists, and psychologists), is to emphasize preventive medicine and maintenance of good health. In this article we define athletes, and especially elite athletes, as a population at risk of various infections, and recommend immunization against hepatitis A and B and a yearly immunization against influenza.

Hepatitis A↗
PubMed2000

Illness, cytokines, and depression.

Various medical conditions that involve activation of the immune system are associated with psychological and neuroendocrine changes that resemble the characteristics of depression. In this review we present our recent studies, designed to investigate the relationship between the behavioral effects of immune activation and depressive symptomatology. In the first set of experiments, we used a double-blind prospective design to investigate the psychological consequences of illness in two models: (1) vaccination of teenage girls with live attenuated rubella virus, and (2) lipopolysaccharide (LPS) administration in healthy male volunteers. In the rubella study, we demonstrated that, compared to control group subjects and to their own baseline, a subgroup of vulnerable individuals (girls from low socioeconomic status) showed a significant virus-induced increase in depressed mood up to 10 weeks after vaccination. In an ongoing study on the effects of LPS, we demonstrated significant LPS-induced elevation in the levels of depression and anxiety as well as memory deficits. These psychological effects were highly correlated with the levels of LPS-induced cytokine secretion. In parallel experiments, we demonstrated in rodents that immune activation with various acute and chronic immune challenges induces a depressive-like syndrome, characterized by anhedonia, anorexia, body weight loss, and reduced locomotor, exploratory, and social behavior. Chronic treatment with antidepressants (imipramine or fluoxetine) attenuated many of the behavioral effects of LPS, as well as LPS-induced changes in body temperature, adrenocortical activation, hypothalamic serotonin release, and the expression of splenic TNF-alpha mRNA. Taken together, these findings suggest that cytokines are involved in the etiology and symptomatology of illness-associated depression.

Adolescent↗
PubMed2000

Novel approach for specific detection of herpes simplex virus type 1 and 2 antibodies and immunoglobulin G and M antibodies.

Recently a few new herpes simplex virus (HSV) type-specific serological diagnostic tests have been introduced to the commercial market, but these tests have some limitations. Moreover, it is not yet clear which commercial test can be regarded as a "gold standard" for the serodiagnosis of HSV infections. In order to improve the clinical diagnostic value of serological tests for the detection of HSV infections, we developed novel, competition-based enzyme-linked immunosorbent assays for the specific determination of HSV type 2 antibodies (SeroHSV2) and HSV type 1 antibodies (SeroHSV1) and two complementary tests for the detection of HSV immunoglobulin M (IgM) and IgG antibodies (SeroHSV IgM and SeroHSV IgG). These four new kits were evaluated in comparison with some commercial kits for the detection of HSV antibodies that are commonly used at present in Israeli clinical laboratories. The results indicate that SeroHSV2 is highly sensitive (>92%) and highly specific (>94%). SeroHSV2 does not cross-react with other alphaherpesvirus antibodies. SeroHSV1 is highly sensitive (>94%) and specific (>91%) compared to four commercial available kits. SeroHSV IgM is highly specific (>92%) in comparison with other commercial HSV IgM tests. The sensitivity of SeroHSV IgM ranges between 50 and 70% compared to these tests. Further investigation of the discrepant results obtained by using in-house competition tests indicated that SeroHSV IgM is more sensitive. SeroHSV IgG was also found to be highly sensitive (>94%) and highly specific (>92%) compared to the other commercial HSV IgG tests.

Antibodies, Viral↗
PubMed1998

Influence of socioeconomic status on behavioral, emotional and cognitive effects of rubella vaccination: a prospective, double blind study.

A double-blind prospective design was used to investigate the immediate and prolonged psychological effects of a specific viral infection, and the role of immune activation in mediating these effects. Subjects were 240 female teenager girls who were vaccinated with rubella vaccine. Based on analysis of levels of antibodies to rubella, subjects were divided into two groups. An experimental group (n = 60), which included subjects who were initially seronegative and were infected following vaccination, and a control group (n = 180), which included subjects who were already immune to rubella before vaccination. Compared with the control group and to their own baseline, low socioeconomic status (SES) subjects within the experimental group showed a significant increase in the severity of depressed mood, social and attention problems, and delinquent behavior. Ten weeks post-vaccination there were no differences between the experimental and control groups in serum levels of interleukin-1 beta, interferon-gamma, soluble interleukin-2 receptors (sIL-2r), and cortisol. However, a significant negative correlation was found between fatigue-related symptoms and sIL-2r levels in the experimental (r = -0.325), but not the control group (r = -0.046). These findings suggest that viral infection can produce prolonged behavioral, emotional and cognitive problems mainly in subjects belonging to the low SES.

Adolescent↗
PubMed1998

Isolation of influenza C virus during an outbreak of influenza A and B viruses.

During the winter of 1996 to 1997 two cases of influenza C were confirmed, one by isolation and the second by serology (fourfold increase in hemagglutination inhibition antibodies). The cases of influenza C occurred during an outbreak of influenza A (H3N2) and B viruses. The positive isolation was from one of three throat washings sent to the laboratory, and the other case was from a group of 51 students participating in a study of influenza virus vaccination. It seems, therefore, that influenza C virus should also be considered when examining patients with respiratory infections during the influenza season.

Adult↗
PubMed1998

Herpes simplex virus-1 and varicella virus infections in familial dysautonomia patients.

Familial dystautonomia (FD) patients are deficient in type C fibers, suggesting that there may be a different pattern of infection and clinical presentation when infected by Herpes simplex virus type 1 (HSV-1) or Varicella-Zoster virus (VZV). These viruses infect and are reactivated in the periphery of the body through type C sensory nerve fibers. HSV-1 infects epithelial cells, penetrates into type C fibers, and migrates to the ganglia to generate latent infection. In reactivation, the viral DNA migrates through type C fibers, infecting the epidermis at the entry site. VZV infects through the respiratory tract, causing systemic viral infection and latency in the ganglia, from which it is reactivated and reaches the skin. The study was carried by clinical questionnaire and by HSV and VZV IgG antibodies on fifty-one FD patients and eighty matched controls. The questionnaire revealed that no FD patient had a history of clinical HSV-1 infection, compared to 15% in the control group (P < 0.05), while 50% FD patients had been infected by varicella, compared to 66% in the VZV control group. However in FD, VZV clinical manifestations were mild in comparison to controls. There was no difference in infection rates for some other viral diseases. HSV-1 antibodies were detected in 24% of the FD patients, compared to 38% in the control group (P < 0.1). VZV antibodies were similar in FD and controls (66%, 63%). We concluded that the rate of HSV infection in FD is low and clinical reactivation is rare. The rate of varicella infection appears to be the same for patients and controls, but in FD the clinical presentation is mild. We suggest that these differences are due to the lack of type C fibers in FD patients.

Adolescent↗
PubMed1998

Antibodies to cytomegalo and Epstein-Barr viruses in human saliva and gingival fluid.

The prevalence of antibodies to EBV and CMV was studied in 34 samples of whole saliva and gingival crevicular fluids (GCF) obtained from clinically healthy volunteers and compared to the corresponding antibodies present in the serum of each individual. Higher prevalence of serum antibodies was found to EBV (85.2%) than to CMV (64.7%) (P < 0.04). The percentage of saliva samples containing IgG and/or IgA antibodies was not significantly different for the two viruses (79.4% for EBV and 58.8% for CMV). However, in the GCF the percentage to EBV was lower-32.3% as compared to 70.5% for CMV (P < 0.002). The prevalence of CMV in serum saliva and GCF was similar. However, while in the saliva similar levels of IgG and IgA were found, in the GCF IgA prevails. The picture for EBV is different: a similar percentage of antibodies was noticed in serum and saliva, but it was significantly lower in the GCF. However, antibodies to EBV were mostly IgA both in the saliva and the GCF. Although a similar number of samples were positive to both viruses in the saliva, the IgA response to EBV was higher than to CMV (P < 0.05), while in GCF IgA response was higher to CMV (P < 0.05). Passive transudation rather than active transport of plasma-derived Ig is probably responsible for the presence of IgG, while the IgA found in saliva and GCF is derived from local synthesis by plasma cells rather than from selective transport from blood.

Adult↗
PubMed1996

HIV infection and AIDS in Jerusalem: a microcosm of illness in Israel.

During the decade 1985-94, 158 individuals (124 males, 34 females) with HIV/AIDS were seen at the AIDS clinic of Hadassah University Hospital. They comprised 10% of the total reported number of HIV-infected Israelis and included 6% of all reported HIV-infected Ethiopians and all HIV-infected West Bank Palestinians. Most individuals (82%) were self-referred; 12% were detected through the local HIV screening clinic. Risk groups for AIDS were homo/bisexuality (39%), heterosexual relations (30%), intravenous drug abuse (15%), contaminated blood transfusions (9%), born to HIV+ mothers (1%), and hemophilia (< 1%). In 5% (all males) no risk factor was given. Of the 158 individuals 29 were Ethiopian immigrants, 25 West Bank Palestinians, and the rest were local Israelis and tourists. Of the 34 females seen, 21 acquired HIV heterosexually, 6 were intravenous drug abusers, 5 were recipients of contaminated transfusions, and 2 were infants. An initial clinical presentation with full-blown AIDS was observed in 30% of the individuals. The range of clinical presentations was similar to that seen in western countries, with Pneumocystis carinii pneumonia, cytomegalovirus retinitis, mycobacterial infections and Kaposi's sarcoma seen most frequently. One case of disseminated cutaneous leishmaniasis was observed. The mortality rate during the follow-up was 55%. In 35% of individuals the immediate cause of death was severe bacterial infections. The Palestinian subpopulation presented at an advanced stage of the disease with a high incidence of transfusion recipients, while most HIV-infected Ethiopians presented with asymptomatic disease transmitted heterosexually. HIV/AIDS as seen at Hadassah University Hospital during 1985-94 exhibited the mixed form of Euro-American AIDS with additional facets of recently introduced African infection.

Adult↗
PubMed1995

Enteric viral infections in Gaza children--incidence and associated factors and phenomena.

Regular administration of live attenuated polio vaccine (TOPV) to babies in Gaza failed to give adequate protection against infection and disease with wild polio viruses. The possible interference of the "take" of the vaccine was investigated by obtaining demographic, socioeconomic and virological data. More than 100 babies during their first year of life, and their families, were followed. Enteroviruses were isolated in 25.3% and 7.9% of stool samples obtained from healthy babies and babies with diarrhea, respectively. In the same cases, rotaviruses were detected in only 1.9% and 1.4% respectively. It appears that the most common candidates for viral interference in this population are enteroviruses and not rotaviruses, either in healthy babies or in babies suffering from diarrhea.

Adult↗
PubMed1995

Underutilization of influenza vaccine in Jerusalem.

BACKGROUND: Influenza is an annual winter disease which causes considerable morbidity in the general population and may be lethal in defined high-risk groups. A killed vaccine, recommended for the high-risk groups as well as for several occupational categories, is moderately protective against the disease, but vaccine sales suggest that use is low. METHODS AND RESULTS: In a hospital-based convenience survey of 295 persons belonging to groups for whom influenza vaccine is recommended, 78 (26.4%) reported having received the vaccine in 1989, and 74 (25.1%) in 1990. All vaccine recipients belonged to the 244 subjects eligible because of advanced age and/or chronic illness, giving vaccination rates in this group of 32.0% in 1989 and 30.3% in 1990. None of the 51 hospital doctors and nurses interviewed had received vaccine. Among the 244 eligible because of age or illness, vaccine receipt in 1990 was related to older age and number of risk factors, but even in subjects with three separate indications for receipt of vaccine, the vaccination rate was only 48%. Among persons advised by anyone to have influenza vaccine, 62.7% received vaccine in at least one of the two years, compared to a rate of 16.4% among subjects never advised to be vaccinated. Vaccine recommendation by a medical professional increased the vaccination rate to 69.3%. CONCLUSIONS: Influenza vaccine uptake in vaccine eligibles in Jerusalem is low, about 30% in the sick and elderly and considerably lower in medical personnel. Since influenza vaccination can save lives, it would be worthwhile to convince the medical profession to enthusiastically recommend this vaccine to high risk individuals and to explore novel ways of increasing uptake in the high-high risk groups such as persons in hospital or those residing in institutions.

Adolescent↗