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Biomedical subjects

D Cohen

Publications and source records attributed to D Cohen.

At least 19 recordsLinked to original sources

Climate change and the emergence of Vibrio vulnificus disease in Israel.

In 1996, a major unexplained outbreak of systemic Vibrio vulnificus infection erupted among Israeli fish market workers. The origins of this emergent infectious disease have not been fully understood. A possible link between climate change and disease emergence is being investigated. Meteorological service data from 1981, the earliest detection and reporting of V. vulnificus for the time in Israel, to 1998 for two stations located within the main inland fish farm industry were analyzed. The 1996-1998 summers were identified as the hottest ever recorded in Israel in the previous 40 years. Time series of monthly minimum, maximum, and mean temperatures showed significant increase in the summer temperatures along the 18 years. The highest minimum temperature value was recorded in summer 1996. Lag correlation analysis revealed significant correlations between temperature values and hospital admission dates. The eruption appeared 25-30 days after the extreme heat conditions in summer 1996, at a lag of 3 weeks in summer 1997 while the results for 1998 were at a lag of less than a week. Higher significant results were detected for the daily minimum temperatures in summer 1996 compatible with the disease eruption. These findings suggest that high water temperature might have impacted the ecology of our study area and caused the emergence of the disease, as an effect of global climate change.

Climate↗

Socioeconomic correlates of antibody levels to enteric pathogens among Israeli adolescents.

We examined the association between socioeconomic status and the level of serum antibodies to selected faeco-orally transmitted pathogens among Israeli adolescents. Random samples of eighty volunteers aged 12-15 years from high (HSL), medium (MSL) and low (LSL) standard of living towns were included in the study. Serum samples were examined by radioimmunoassay for HAV and by in-house-developed ELISA systems for IgA and IgG antibody levels against Shigella sonnei, S. flexneri, E. coli O157:H7 lipopolysacchride and Cryptosporidium parvum antigens. Seropositivity to HAV was highest (98.8%) in the LSL towns and lowest (25%) in the HSL towns, showing a statistically significant linear trend. Antibody levels to the other enteropathogens had gender variation, with higher titres in females. Significantly lower titres in the HSL towns were found for: IgA anti-S. sonnei in females (P<0.001); IgG anti-S. sonnei in females (P=0.024) and males (P=0.033); IgG anti-S. flexneri in females (P=0.016). Inverse linear association with socioeconomic status was found for IgA anti-C. parvum in females (P<0.001); IgA anti-E. coli O157:H7 in females (P<0.001) and males (P=0.024). A statistically significant association between HAV seropositivity and higher titres of IgA anti-S. sonnei and E. coli O157:H7 was shown. In conclusion, exposure to enteropathogens transmitted via the faecal-oral route in communities of lower socioeconomic status is reflected in a higher prevalence of lifelong lasting antibodies to HAV, and higher levels of antibodies to bacterial and protozoan enteropathogens. Among females, the levels of specific serum antibodies are higher and more strongly associated with low socioeconomic status.

Adolescent↗

PP2A-Bgamma subunit and KCNQ2 K+ channels in bipolar disorder.

Many bipolar affective disorder (BD) susceptibility loci have been identified but the molecular mechanisms responsible for the disease remain to be elucidated. In the locus 4p16, several candidate genes were identified but none of them was definitively shown to be associated with BD. In this region, the PPP2R2C gene encodes the Bgamma-regulatory subunit of the protein phosphatase 2A (PP2A-Bgamma). First, we identified, in two different populations, single nucleotide polymorphisms and risk haplotypes for this gene that are associated to BD. Then, we used the Bgamma subunit as bait to screen a human brain cDNA library with the yeast two-hybrid technique. This led us to two new splice variants of KCNQ2 channels and to the KCNQ2 channel itself. This unusual K+ channel has particularly interesting functional properties and belongs to a channel family that is already known to be implicated in several other monogenic diseases. In one of the BD populations, we also found a genetic association between the KCNQ2 gene and BD. We show that KCNQ2 splice variants differ from native channels by their shortened C-terminal sequences and are unique as they are active and exert a dominant-negative effect on KCNQ2 wild-type (wt) channel activity. We also show that the PP2A-Bgamma subunit significantly increases the current generated by KCNQ2wt, a channel normally inhibited by phosphorylation. The kinase glycogen synthase kinase 3 beta (GSK3beta) is considered as an interesting target of lithium, the classical drug used in BD. GSK3beta phosphorylates the KCNQ2 channel and this phosphorylation is decreased by Li+.

Animals↗

Use of rubella seroepidemiological data for assessment of previous vaccination policy and for decision making in response to epidemics in Israel.

We examined the prevalence of rubella antibodies in a representative sample of the Israeli population. Three thousand three hundred and twenty-six sera collected during 1997 and 1998, from an age-stratified general population sample were tested for specific IgG antibodies against rubella. The sero-positivity rates to rubella were higher among females as compared with males (89.1% versus 82.3%, respectively (p < 0.001). This difference was the result of much lower sero-positivity rates among males in the age group 13-17, with the lowest value (56.3%) among subjects aged 16. Male subjects of this age group were in 2000 the target of an outbreak of rubella among 18-19-year old male recruits of the Israel Defense Force. The data of this study served to assess previous exposure to the wild virus or vaccine strains, to identify pockets of low level of immunity and contributed to decision making in response to the onset of a rubella outbreak.

Adolescent↗

Prevalence and risk factors of Helicobacter pylori infection among healthy 3- to 5-year-old Israeli Arab children.

We determined the prevalence and risk factors of H. pylori infection among 197 healthy 3- to 5-year-old Israeli Arab children, in a population under socioeconomic and environmental transition. Data on the socioeconomic and environmental characteristics were obtained by personal interviews. The presence of H. pylori infection was identified using an ELISA kit for detection of H. pylori antigens in stool specimens. The prevalence rate of H. pylori infection was 49.7% (95% CI 42.8-56.67). It varied significantly among the different villages. In the univariate analysis stratified by village, the risk of infection increased according to household crowding, number of siblings younger than 5 years and siblings' H. pylori positivity. In the multivariate analysis the village of residence and siblings' H. pylori positivity were the only variables that remained strongly associated with H. pylori infection. In a population such as that described in this study the socioeconomic and living conditions are major risk factors of H. pylori infection and the intra-familial transmission of H. pylori in early childhood has an important role.

Arabs↗

[Pregnancies occurring during oral contraception: lessons from the GRECO study].

OBJECTIVES: The GRECO study has collected data on pregnancies, regardless of their outcome, that occurred in women taking an oral contraceptive. PATIENTS AND METHODS: The analysis concerned 551 women prospectively recruited in services of gynaecology or obstetrics, termination of pregnancy centres, family planning centres or consultations of gynaecology in France throughout 2002 and who were 12 weeks pregnant or less. RESULTS: Contraception used during the cycle of conception was an estroprogestative combination in 88% of cases, a microprogestative in 8.7%, a macroprogestative in 0.9% or another type of pill in 2.4%. Progestatives were levonorgestrel 59.0%, gestoden 17.2%, desogestrel 4.7%, norethisterone acetate 2.9%, norgestimate 1.8%, cyproterone acetate 2.0%, norgestrel 1.6%. When asked about the potential cause of the oral contraceptive failure, 76.9% of women reported events such as missed pills which were the most frequent cause of failure (60.8% of failures and 80.1% of events, 2.7+/-2.7 missed pills), followed by vomiting and diarrhoea. 81.5% of women chose to terminate their pregnancy. DISCUSSION AND CONCLUSION: The GRECO study, despite its limitations (retrospective collection of missed pills data, declaratory data) showed that missed pills, even once, were the most common reason for oral contraceptive failure. The most frequent decision was the termination of pregnancy.

Abortion, Induced↗

Vanilla mosaic virus isolates from French Polynesia and the Cook Islands are Dasheen mosaic virus strains that exclusively infect vanilla.

Sequence was determined for the coat protein (CP) gene and 3' non-translated region (3'NTR) of two vanilla mosaic virus (VanMV) isolates from Vanilla tahitensis, respectively from the Cook Islands (VanMV-CI) and French Polynesia (VanMV-FP). Both viruses displayed distinctive features in the N-terminal region of their CPs; for VanMV-CI, a 16-amino-acid deletion including the aphid transmission-related DAG motif, and for VanMV-FP, a stretch of GTN repeats that putatively belongs to the class of natively unfolded proteins. VanMV-FP CP also has a novel DVG motif in place of the DAG motif, and an uncommon Q//V protease cleavage site. The sequences were compared to a range of Dasheen mosaic virus (DsMV) strains and to potyviruses infecting orchids. Identity was low to DsMV strains across the entire CP coding region and across the 3'NTR, but high across the CP core and the CI-6K2-NIa region. In accordance with current ICTV criteria for species demarcation within the family Potyviridae, VanMV-CI and VanMV-FP are strains of DsMV that exclusively infect vanilla.

3' Untranslated Regions↗

[Irreducible traumatic dislocation of the hip caused by labral and capsular entrapment with a buttonhole effect].

Irreducible hip dislocation following capsular and labral entrapment is a rare condition. We report a case of irreducible posterior traumatic pure hip dislocation where reduction was successfully achieved only with open surgery. An analysis of this case in the light of the published literature recalls the different etiologies of irreducible traumatic dislocation of the hip and the requirement for open surgery.

Acetabulum↗

Salmonella enterica serotype Virchow: epidemiology, resistance patterns and molecular characterisation of an invasive Salmonella serotype in Israel.

This study outlines the unique epidemiology of Salmonella enterica serotype Virchow in Israel. Between 1997 and 2002, the overall incidence of non-typhoid Salmonella enterica (NTS) decreased from 69.3 to 53.3 infections/100,000 population, but the incidence of S. Virchow increased (from 7.2 to 9.1 infections/100,000). Since 2000, S. Virchow has become the second-ranking NTS isolate, accounting for 17% and 27% of all stool and blood NTS isolates, respectively. Infants aged < 1 year had the highest incidence of isolation from stools (92.8/100,000). The incidence of isolation from blood was highest for infants aged <1 year (4.4/100,000). Only 6% of isolates were susceptible to all ten antibiotic agents tested; 34% were resistant to one agent, 54% to one to three agents, and 40% to four to six agents. A high proportion of the tested isolates were resistant to nalidixic acid (89%), streptomycin (56%), tetracycline (43%), trimethoprim-sulphamethoxazole (38%) and chloramphenicol (28%), but none to ciprofloxacin or ceftriaxone. Pulsed-field gel electrophoresis revealed two closely related clusters, each containing a predominant pulsotype. Coupled with its invasive propensity, the increasing incidence of highly resistant S. Virchow in Israel is of real concern. Future research should focus on the sources of S. Virchow in the food chain in order to institute effective control measures.

Adolescent↗

Prevalence and correlates of diphtheria toxoid antibodies in children and adults in Israel.

A seroepidemiological study was performed to evaluate immunity to diphtheria and to determine the correlates of diphtheria toxoid antibody levels among children and adults in Israel. In total, 3,185 sera from an age-stratified sample of children and adults, obtained in 2000-2001, were tested for diphtheria toxoid antibodies by an in-house double-antigen ELISA. A level of or=0.1 IU/mL (full protection or seropositivity). Seronegativity increased significantly in subjects aged >50 years, reaching levels of 9.7%, 12.6% and 18.9% in the groups aged 50-54, 55-59 and >60 years, respectively (p 0.001), with rates of basic immunity following a similar pattern. Subjects born abroad had higher seronegativity rates than those born in Israel (7.7% vs. 4.9%; p 0.019). No difference in diphtheria toxoid antibody levels was found according to other demographical variables, such as gender, Jewish or Arab ethnicity, urban or rural settlements, and the subjects' place of residence. The level of immunity to diphtheria among children and adults in Israel was satisfactory, with the exception of individuals aged >50 years. The risk of diphtheria outbreaks is low, but sporadic cases may occur among individuals lacking basic immunity against the disease.

Adolescent↗

Prevalence of diabetes mellitus in chronic schizophrenic inpatients in relation to long-term antipsychotic treatment.

BACKGROUND: Many reports indicate that the incidence and prevalence of diabetes mellitus is increased in schizophrenic patients and related to antipsychotic treatment. In an exploratory cross-sectional study we assessed the prevalence of type 2 diabetes mellitus in 266 chronic schizophrenic and schizoaffective inpatients and investigated whether the duration of antipsychotic treatment was related to the development of diabetes mellitus. METHOD: We measured the non-fasting plasma glucose level in 266 inpatients with DSM IV diagnosis of schizophrenia or schizoaffective disorder in 5 different long-stay wards in the Netherlands. Measured variables were: age, sex, ethnicity, BMI, current antipsychotic treatment, duration of illness and duration of antipsychotic treatment. RESULTS: The overall prevalence of type 2 diabetes mellitus was 9%, which is significantly higher than the prevalence of 4.9% in the general population (OR 1.89, CI 1.14-3.13; p<0.014). The prevalence was increased in two age cohorts: 30-39 years (3.8% vs. 0.3%, OR=13.29, CI=2.17-81.36, p=<0.005) and 40-49 years (9.3% vs. 1.5%, OR=6.74, CI=2.77-16.38, p=0.000). No new cases of diabetes mellitus were detected during the course of the study. The increased prevalence was found to be related to overweight and obesity. The time of exposure to antipsychotic treatment was not significantly correlated with the prevalence of diabetes mellitus when adjusted for age (F=0.804, df=1, p=0.371, respectively, F=0.194, df=1, p=0.660). Both typical and atypical antipsychotics contributed equally to the prevalence of diabetes mellitus. CONCLUSION: No significant relation between long-term antipsychotic treatment and prevalence of diabetes mellitus was found. The high prevalence of diabetes mellitus in schizophrenic patients warrants screening of these patients already at young age for glucose disturbance.

Adult↗

Molecular analysis of noroviruses involved in acute gastroenteritis outbreaks in military units in Israel, 1999-2004.

The study presented here was conducted to determine the genetic properties of noroviruses (NoVs) identified between 1999 and 2004 in army recruits with acute gastroenteritis. Partial sequence analysis of the RNA-dependent RNA polymerase gene revealed the presence of two major sub-genogroups, all of which were related to genogroup II of NoV. Serological analysis using recombinant antigens confirmed this observation. Local strains associated with a 1999 outbreak were closely related to GII-6 strains, while those identified later were very closely related to GII-4 strains. GII-4 strains were also associated with an outbreak in civilian nursing homes in Israel in 2002 and samples from this outbreak were included in this study for comparison. This is the first report describing the molecular properties of NoV strains associated with diarrhea-related morbidity in Israel.

Acute Disease↗

A randomised study of whole-breast vs tumour-bed irradiation after local excision and axillary dissection for early breast cancer.

AIMS: Whole-breast radiotherapy (WBRT) after conservative surgery for early breast cancer is a routine standard of care. Despite this, a number of uncertainties in management still exist. Over recent years, a number of new technologies have allowed the development of partial-breast irradiation, with the intention of improving the risk-benefit relationship of routine breast radiotherapy. We report the results of a trial comparing partial- with WBRT, with prolonged follow-up. MATERIALS AND METHODS: Between 1986 and 1990, 174 women were randomised to receive conventional whole-breast radiotherapy (WBRT) (40 Gy in 15 fractions), with a tumour-bed boost or partial-breast irradiation by a variety of techniques. Recruitment was problematic, and the trial closed prematurely well before meeting its recruitment target. RESULTS: A trend was observed towards higher local recurrence and a higher locoregional recurrence rate after irradiation of the tumour bed alone. Distant recurrence and survival were the same. CONCLUSIONS: Conclusions are limited in view of the failure to complete accrual of the target of 400 participants, and in the context of the techniques of partial-breast radiotherapy used during this study, which would not compare with those in current use. Tumour-bed irradiation alone cannot currently be recommended as routine treatment outside the context of clinical trial.

Adult↗

A large-scale gastroenteritis outbreak associated with Norovirus in nursing homes.

An increase in gastroenteritis outbreaks due to Norovirus has been reported worldwide. We investigated a large-scale outbreak affecting 246 residents and 33 staff members in six nursing homes in the Tel-Aviv district, Israel, during 3 weeks in 2002. Person-to-person spread was noticed in all nursing homes. The spread of disease could not be attributed to social interactions. Among the elderly residents, the hospitalization rate was 10.2% and the case-fatality rate was 2.0%. Bacteriological cultures were negative. Overall, 7 out of 15 stool specimens were positive for Norovirus by RT-PCR. All were sequenced and found to be 90% identical. The characteristics of this outbreak and the RT-PCR results suggest that illness was caused by Norovirus. Due to the high case-fatality rate of Norovirus gastroenteritis, there should be a high index of suspicion when encountering a gastroenteritis outbreak among the elderly. This will enable prompt action to stop the spread of illness.

Adult↗

Correlation of IgA, IgM and IgG antibody-detecting assays based on filamentous haemagglutinin, pertussis toxin and Bordetella pertussis sonicate in a strictly adult population.

Pertussis diagnosis among adults is primarily based on serology. In this study, receiver operation characteristics (ROC) analysis was utilized to evaluate three IgA, IgM and IgG ELISAs based on B. pertussis whole-cell sonicate (WC), pertussis toxin (PT), or combined PT-filamentous haemagglutinin (FHA) antigens in a healthy adult population and in adults suffering from symptoms consistent with pertussis. The assays were compared to a PT and FHA reference ELISA. The reference assay showed high correlation with PT- and PT-FHA-based ELISAs but low correlation was found with the WC-based ELISA. However, ROC analysis indicated that all the assays enabled fine differentiation between healthy subjects and subjects suffering from symptoms suggestive of pertussis. The WC IgA ELISA showed the best diagnostic performance [highest specificity (98.8%) with highest sensitivity (53.8%)]. We conclude that despite a low correlation between the various assays they all carry good diagnostic capability for an adult population.

Adolescent↗