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Biomedical subjects

D S Silverberg

Publications and source records attributed to D S Silverberg.

At least 55 records · Page 3Linked to original sources
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

Use of management-by-objective for the case finding and treatment of hypertension.

A management-by-objective approach was used by the health care administration of the Kupat Holim Sick Fund to improve the detection and quality of treatment of hypertension in 20 family practices in Ashdod, Israel. The number of hypertensive patients in each practice was estimated from the age-sex register and this was compared with the actual number. The combined prevalence in the 20 practices was only 20.8% of the expected prevalence, and of those treated the blood pressure of 29.6% was not under control (diastolic pressure 95 mmHg or over). The practice teams committed themselves to improving the detection of hypertension by active case finding. Once every six months for three years the health care consultant reviewed the results of detection and treatment with each team. After three years the number of hypertensive patients had increased from 977 patients (20.8% of expected prevalence) to 2914 patients (62.1%) - a three-fold increase. The percentage of treated patients whose blood pressure was not under control (diastolic pressure 95 mmHg or over) did not change substantially (from 29.6% to 27.9%). A management-by-objective approach, when accompanied by regular feedback, appears to motivate primary care teams to improve the detection of hypertension in their patients.

Adult↗
PubMed1985

Observations on the chemical and physiological properties of urodiolenone, an urinary compound found in hypertension.

Urodiolenone is a substance that appears as the glucuronide in the urine of 1 in 3 hypertensive subjects. It is a potent inhibitor of Na+, K+-ATPase in kidney tissue of the guinea pig, as measured by cytochemical assay. Chemical and mass spectrometric evidence is presented, from which it is concluded that urodiolenone is a sesquiterpenoid substance, is a bicyclic enone with a vicinal diol side chain, and has molecular formula C15H24O3.

Female↗
PubMed1985

Hypertension in European immigrants to Israel: those who experienced the Holocaust and those who did not.

To examine the effect of stressful life events and chronic emotional distress in the development of hypertension (HT), we have compared the blood pressure (BP) of 1150 Israelis (aged 50-80 years) who immigrated from Europe before the Second World War with 2159 Israelis who survived the Holocaust and came to Israel after the Second World War. 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 HT (lying systolic > or = 160 mmHg and/or diastolic > or = 95 mmHg and/or on antihypertensive medications) between the two immigration groups and a similar percentage of both groups were receiving treatment. Analyses of variance showed that age, sex and degree of obesity were the main factors contributing to the BP. 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 BP or prevalence of HT.

Age Factors↗
PubMed1985

A national programme of hypertension control using a doctor-nurse team approach: the Israel experience.

Studies in Israel in the early 1970s showed that only about one-quarter of the men and half of the women with hypertension were on treatment and only about one-quarter of the treated males and half of the treated females were under control (diastolic blood pressure < 95 mmHg). Drop-out rate averaged about 30%. To improve detection and treatment of hypertension the nurses in the family clinics of Kupat Holim were taught to work with the family physicians in a team approach. This included a more efficient appointment system, case-finding, an active follow-up system for drop-outs, better documentation of findings and active health education. Reports are sent annually to a central registry in Tel Aviv. Results are tabulated and returned to the teams. Up to December 1983, 729 family practices (35.7% of the total number) were participating, and 46,909 patients are currently under treatment. This represents about half of the expected number of hypertensives in these practices. About three-quarters of the treated men and women are under control (diastolic blood pressure < 95 mmHg). Drop-out rate has fallen to 2.1% and waiting time from 105 to 7 min.

Adult↗
PubMed1984

A controlled study of group therapy in essential hypertension.

Seventy-eight patients with essential hypertension participated in a controlled study of group therapy (GT). They were alternately assigned alphabetically to receive GT (48 patients) and to a control group (30 patients). The therapy was aimed at changing some of the patients' coping mechanisms. In both groups, patients continued to take the same dose of antihypertensive medications that they had been taking previously. At the end of 6 months, eight patients had dropped out of the GT group. In the GT group there was a fall in systolic blood pressure of 20.9 +/- 13.1 and in diastolic pressure of 12.8 +/- 6.3 mm Hg (mean +/- SD, P less than 0.01), while in the control group there was no significant change in blood pressure. In neither group was there a significant change in weight. Follow-up 3 months and 1 year after group therapy showed that the effect of the therapy persisted in most patients.

Adult↗
PubMed1983

Follow-up of normotensive men with exaggerated blood pressure response to exercise.

The early detection of hypertension is of foremost concern. It may be that individuals who are normotensive at rest but who show an exaggerated blood pressure (BP) response to exercise are at greater risk of developing hypertension in the future. From exercise tests, a group (ER) of healthy young males who were normotensive at rest (BP less than or equal to 140/90) but showed an exaggerated BP response to exercise (systolic BP greater than or equal to 200 mm Hg and/or diastolic BP 10 mm Hg to greater than 90 mm Hg) were selected. A control group (NR) with exercise BP values less than these were matched for age, weight/height, skinfold thickness, resting BP less than or equal to 140/90, resting heart rate, aerobic fitness level, physical activity, smoking history, and family history of hypertension. After a follow-up period of 5.8 years (range 3 to 14 years) eight of the subjects from the ER group were found to be hypertensive, whereas none of the NR group were hypertensive. Stepwise multivariate regression showed the exercise blood pressure to be the best predictor of future blood pressure of the parameters reviewed in this study. Exaggerated BP response to exercise may serve as an additional risk marker for hypertension.

Adolescent↗
PubMed1983

The role of the doctor-nurse team in control of hypertension in family practice in Israel.

In the 1960s and early 1970s, only 9.4% of all hypertensives in Israel were under control, due to a low rate of detection, a high dropout rate and a low rate of patient compliance. In the past seven years, a program of screening and careful follow-up of hypertensives in over 400 community clinics has been introduced, based on the active participation of clinic nurses in addition to that of family doctors. This program has been associated with a large increase in the number of detected hypertensives, a fall in the dropout rate, and a decrease in patient waiting time. In one study of 5,541 hypertensives treated initially by a doctor alone, and then by the doctor-nurse team, the number of treated hypertensives who were under control increased from 42.1 to 84.6%. The improvement in hypertension control has paralleled the reduction in cardiovascular disease in Israel.

Family Practice↗