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Biomedical subjects

G Rahav

Publications and source records attributed to G Rahav.

At least 37 records · Page 2Linked to original sources
PubMed1995

Group A streptococcus bacteremia at the Hadassah Medical Center in Jerusalem.

Streptococcus pyogenes bacteremia occurred in 104 patients over a 6-year period, during which time the annual incidence remained constant. The clinical and epidemiologic characteristics are described for 90 of these patients. Of the 90 patients, 90% had community-acquired infection, and 77% had an underlying illness predisposing them to infection. Skin infection was the cause of bacteremia in 61% of the cases. Septic shock developed in 13 patients. The overall mortality rate was 15%. An increased likelihood of death was associated with septic shock and diabetes mellitus.

Bacteremia↗
PubMed1995

Infections with Chryseomonas luteola (CDC group Ve-1) and flavimonas oryzihabitans (CDC group Ve-2).

We have described 15 cases of infection due to Chryseomonas luteola and Flavimonas oryzihabitans isolated between May 1990 and May 1994. These infections were often associated with the presence of a foreign body, especially central venous access and joint prosthesis. The high frequency of isolating C. luteola and F. oryzihabitans probably expresses the awareness of the clinicians and the laboratory to the importance of these bacteria, especially in patients with the presence of a foreign material.

Abscess↗
PubMed1995

Increased incidence and severity of Streptococcus pyogenes bacteremia in young children.

An increase in the incidence and severity of bacteremia caused by group A streptococci was noted in 1993 and 1994 in the Hadassah University Medical Center, Jerusalem. During the 6-year period 1987 to 1992, 12 children with group A streptococcal bacteremia were hospitalized, whereas in 1993 and 1994 there were 17 patients, 5 of them with 1 each of the following severe clinical manifestations: meningitis and septic shock; streptococcal toxic shock syndrome; septic shock; pleural empyema; and fatal outcome. Our 29 patients with group A streptococcal bacteremia were younger than those reported in the literature: 10 (35%) were < 3 months of age; 17 (59%) were < 1 year old. Most children were previously healthy and only 3 had an underlying immunodeficiency predisposing to infection (1 case each): leukemia; Di George syndrome; and congenital nephrotic syndrome. Two children were recovering from varicella. The skin was the most common site of primary infection (16 of 29). The average white blood cell (WBC) count was 18 150 cells/mm3 (range, 2200 to 34,200). The cases were not related epidemiologically and were caused by a variety of M-protein types. Polymerase chain reaction amplification of the genes encoding exotoxins A (speA) and C (speC) was done on 19 isolates and disclosed 2 strains positive for speA and 5 positive for speC. One of the speA-positive isolates was from the single patient with toxic shock syndrome.

Age Distribution↗
PubMed1994

Molecular epidemiology of catheter-associated bacteriuria in nursing home patients.

Urine samples from 19 nursing home patients with long-term urinary catheters were cultured every 3 months for 18 months. Providencia stuartii, present in 74% of the elderly and in 59% of urine specimens, was the most frequently isolated bacteria. The persistence of P. stuartii was significantly higher among females than among males. In order to study the epidemiology of bacteriuria in this nursing home, bacteria were characterized by biochemical tests, antibiotic susceptibility pattern, and restriction fragment length polymorphism (RFLP) analysis. The antibiotic susceptibility pattern indicated that each patient had two to three different strains of P. stuartii during the 18 months of follow-up. In contrast, the RFLP analysis revealed that a specific strain had persisted in the urinary tract of the patient during the entire follow-up period. According to the biochemical profile, 74% of the patients had the same bacteria in urine cultures, pointing to a common source of transmission. RFLP analysis, however, demonstrated different patterns of RFLP, suggesting concomitant multiple sources of infection.

Aged↗
PubMed1993

Substance use and abuse among deviant and non-deviant adolescents in Israel.

The study examined the hypothesis that the use of psychoactive substances is strongly associated with social deviance. Patterns of alcohol and drug use among two samples of deviant adolescents were investigated and compared to patterns of use among a sample of non-deviant youths. The participants were as follows: ninety-seven juvenile delinquents, inmates in institutions, aged twelve through eighteen; 184 detached youth, aged twelve through eighteen, who are in treatment programs of the Departments of Youth Advancement, Ministry of Education & Ministry of Welfare; and a nationwide representative sample of 8151 high school students, aged twelve through eighteen. Substance use was measured by three self-report indices: frequency of use during the last year, use during the last month, and use during the last week. The results clearly indicate that psychoactive substance use is concentrated among Israeli groups of deviant adolescents. These adolescents use all types of substances, licit as well as illicit, at rates considerably exceeding those found among high school students. However, a great similarity was found between the deviant groups of adolescents and the high school students in several personality correlates (sensation seeking, anxiety, depressive mood and learned resourcefulness) of substance use, and to a much lesser degree in its interpersonal correlates (perceived closeness to parents and to peers). The results' implications for prevention are discussed.

Adolescent↗
PubMed1993

Sexual behavior of homosexual and bisexual men attending an HIV testing clinic in Jerusalem 1986/7-1990.

We investigated whether the sexual practices of homosexual and bisexual men attending the Jerusalem AIDS Clinic had changed between 1986/7 and 1990. The responses of a group of 79 homosexual and bisexual men to a questionnaire in 1986/7 were compared to the responses of a group of 37 homosexuals/bisexuals in 1990. Consistent yet statistically insignificant differences in sexual behavior between the 1990 and 1986/7 groups were observed: More individuals were using condoms (53% vs 36% respectively), and at an earlier age. The practice of anal sex was less common (48% vs 67% respectively) and that of oral sex more common (46% vs 27% respectively). These differences were not confounded by the level of education between the two groups. Analyzed separately for homosexuals and bisexuals, the increase in condom use was more noticeable among homosexuals compared with bisexuals, while the decrease in anal sex was greater in bisexuals compared with homosexuals. These results may indicate a trend towards safer sexual behavior in this at risk population, but further studies are needed to support or refute these observations.

AIDS Serodiagnosis↗
PubMed1993

Invasive fungal sinusitis in patients undergoing bone marrow transplantation.

Invasive fungal sinusitis is becoming increasingly common in patients undergoing BMT. This study was undertaken to evaluate the incidence, presenting symptoms, diagnosis procedures, treatment and outcome of invasive fungal sinusitis. The study population comprised 423 consecutive BMT patients at Hadassah University Hospital from January 1986 to August 1992. Eleven patients (2.6%) developed invasive fungal sinusitis, 8 had underlying hematologic malignancies and 3 severe aplastic anemia (SAA). Median interval between BMT and fungal sinusitis was 22.5 days (range 2-106 days). Eight of 11 patients had protracted neutropenia (median 8 days with median neutrophil count at the time of fungal sinusitis diagnosis of 0.25 x 10(9)/l). Four patients developed GVHD before fungal sinusitis was diagnosed. Presenting symptoms were fever (100%), orbital swelling (63%), facial pain (54%) and nasal congestion (36%). In 8 patients Aspergillus species were isolated (A. flavus in 7, A. quadrilineatus in 1); in 1 patient Candida albicans was isolated and in the other 2 fungal elements were detected histologically (Fusarium and Mucor, respectively). Six of the patients underwent surgical debridement at diagnosis. Three received granulocyte transfusions. All patients received systemic amphotericin B (7 conventional and 4 amphotericin B colloidal dispersion (ABCD)). Only 2 of the 11 patients responded completely to therapy with a follow-up of 15 months. It appears that invasive fungal sinusitis is a potentially fatal complication in immunocompromised patients post-BMT. Current treatment approaches are largely ineffective and new methods of management of this serious problem are needed.

Adolescent↗
PubMed1993

HIV/AIDS among Palestinian Arabs.

We studied 24 HIV-positive Palestinians who presented for medical care in the West Bank, Jerusalem and the Gaza Strip between 1987 and 1992. Three individuals, all males, were detected by blood bank screening. An additional 21 individuals (12 males, 7 females, 2 infants) were diagnosed as having HIV infection. Fifteen of 24 had full-blown AIDS--11/24 (46%) were expatriates; there were 4 heterosexuals, 5 transfusion recipients and 6 homosexuals, together comprising 79% of the individuals whose risk group was known. As compared with Israelis, Palestinians presented for medical treatment at a later stage of HIV infection. We also studied the incidence of HIV infection among Palestinian blood donors between 1987 and 1992. The incidence analysis was based on HIV screening at seven blood banks of major hospitals in the West Bank, at the Makassed Hospital in East Jerusalem, at Hadassah University Hospital (Palestinian blood donors only) and at two blood banks in the Gaza Strip. Demographic features were derived from the health department of the West Bank and from the AIDS clinic at Hadassah Hospital. Approximately 50,000 Palestinians were screened at the blood banks. Only three, all males, were detected as HIV seropositive, giving an HIV overall cumulative incidence of 0.006%. This figure was similar to the incidence among 500,000 Israeli donors (0.008%; NS) during that period. Although the low HIV incidence at the blood banks is encouraging, the negligible number of HIV seropositives and the presentation at a late clinical stage points to a deficiency in AIDS tracing and in access to specialized AIDS care in the West Bank and the Gaza Strip. The small overall number of cases precludes any definite conclusion as to trends in the epidemiology of AIDS in the West Bank and Gaza. However, the receipt of contaminated transfusions and the return of infected expatriates seem to be important features of AIDS in the West Bank and Gaza.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Chronic recurrent multifocal osteomyelitis: report of a case.

We describe a case of a young adult who had chronic recurrent multifocal osteomyelitis that was diagnosed by exclusion and review the distinct clinical course of this disease. It is important to make a correct diagnosis so that unnecessary repeated invasive diagnostic procedures and prolonged use of antibiotics, steroids, or other chemotherapeutic agents can be avoided.

Adult↗
PubMed1992

Alcohol consumption among Israeli youth--1989: epidemiology and demographics.

Epidemiological and sociodemographic findings on alcohol (wine, beer, hard liquor) consumption among the Israeli youth are presented. Three samples of adolescents, aged 12-18, were studied by means of an anonymous self-report questionnaire: a nationwide representative sample of high school students; a sample of detached youth; and a sample of inmates in institutions for juvenile delinquents. Alcohol consumption was assessed by three indices: frequency of use during the last year, use during the last month and use during the last week. Since alcohol is imbibed ceremonially in the Jewish tradition, only non-ritualistic consumption of alcoholic beverages was considered. Prevalence of drinking during the last year was 58%, during the last month 42% and during the last week 25%. Thus, it appears that Israeli youth are approaching the drinking prevalence of European adolescents. The results clearly indicate that alcohol consumption is concentrated among groups of deviant adolescents. These adolescents consume all types of alcoholic beverages at rates considerably exceeding those found among high school students. As for the effect of sociodemographic variables, the results strongly support previous findings showing that the patterns and contexts of alcohol use among Israeli youth are similar to those found among youth in other cultures.

Adolescent↗
PubMed1992

Falciparum malaria-induced hypoglycaemia in a diabetic patient.

We report a patient with diabetes mellitus who suffered severe falciparum malaria complicated by profound and persistent hypoglycaemia. The hypoglycaemia evolved before therapy with quinine was begun and resolved with eradication of the parasitaemia. The patient reverted to her baseline hyperglycaemia despite continuation of quinine. This case illustrates the critical role of falciparum malaria in the pathogenesis of malaria-associated hypoglycaemia, rather than quinine-mediated mechanisms. Anticipation of hypoglycaemia in falciparum malaria and its vigorous treatment may improve the poor prognosis associated with this complication.

Blood Glucose↗
PubMed1992

Nail pigmentation associated with zidovudine: a review and report of a case.

Zidovudine has become the standard therapy for patients with AIDS and for asymptomatic HIV infected patients with low helper-T-cell levels. As experience with the drug has grown, knowledge of the range of side effects has increased. We describe progressive pigmentation of finger and toe nails in a white patient due to zidovudine therapy, a phenomenon not often described. Nail pigmentation occurs primarily in black patients. It appears to be reversible and relatively dose dependent. The mechanism responsible for the discoloration is unknown. It is important to alert patients to this side effect and to prevent unnecessary investigations and treatment for other diagnoses, such as cyanosis.

Adult↗