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Biomedical subjects

I Priel

Publications and source records attributed to I Priel.

14 recordsLinked to original sources

[Stupor due to sleep apnea syndrome after total knee replacement].

Obstructive sleep apnea syndrome is defined as a condition of repeated episodes of apnea and hypopnea during sleep, accompanied by excessive daytime sleepiness. This syndrome is common among the adult population, and is related to an increased risk for significant complications, during and immediately after surgery. Often, this condition is undiagnosed, and is not considered in the pre-operative evaluation. Therefore, it is highly important to recognize this syndrome in patients who are scheduled for elective surgery, and provide appropriate management, in order to avoid life-threatening exacerbation in the perioperative period. Although this syndrome is common, there is low awareness of its expression in elective surgery in-patients. We present a case report of a patient who suffered from obstructive sleep apnea related respiratory distress following total knee replacement surgery.

Aged↗

Carnosic acid inhibits proliferation and augments differentiation of human leukemic cells induced by 1,25-dihydroxyvitamin D3 and retinoic acid.

Carnosic acid, the polyphenolic diterpene derived from rosemary, is a strong dietary antioxidant that exhibits antimutagenic properties in bacteria and anticarcinogenic activity in various cell and animal models. In the present study, we show that carnosic acid (2.5-10 microM) inhibits proliferation of HL-60 and U937 human myeloid leukemia cells (half-maximal inhibitory concentration = 6-7 microM) without induction of apoptotic or necrotic cell death. Growth arrest occurred concomitantly with a transient cell cycle block in the G1 phase, which was accompanied by an increase in the immunodetectable levels of the universal cyclin-dependent kinase inhibitors p21WAFI and p27Kipl. Carnosic acid caused only a marginal induction of differentiation, as monitored by the capacity to generate superoxide radicals and the expression of cell surface antigens (CD11b and CD14) and receptors for the chemotactic peptide N-formyl-L-methionyl-L-leucyl-L-phenylalanine. However, at low concentrations, this polyphenol substantially augmented (100- to 1,000-fold) the differentiating effects of 1,25-dihydroxyvitamin D3 and all-trans retinoic acid. Furthermore, such combinations of carnosic acid and any of these differentiation inducers synergistically inhibited proliferation and cell cycle progression. These results indicate that carnosic acid is capable of antiproliferative action in leukemic cells and can cooperate with other natural anticancer compounds in growth-inhibitory and differentiating effects.

Abietanes↗

Primary pulmonary hypertension in Israel: a national survey.

OBJECTIVES: To characterize the incidence of patients with primary pulmonary hypertension (PPH) in Israel and their outcomes. METHODS: We have evaluated retrospectively all the patients in Israel in whom PPH was diagnosed between the years 1988 and 1997. We looked at medical history, hemodynamic data, pulmonary function and gas exchange, and demographic variables. Patients were followed up for survival until November 1997. Life table analysis and Kaplan-Meier statistics were used to estimate the overall survival distribution. Regression analysis was used to examine the relations between survival and selected variables. RESULTS: Overall, we found 44 patients with PPH. The estimated incidence of PPH in Israel is 1.4 new cases per year per million population. The mean (+/- SD) age at diagnosis was 43 +/- 13 years. In the Jewish population, PPH was more frequent among immigrants from Europe and the United States. The mean interval from the onset of symptoms to diagnosis was 3 years (median, 2 years). The median survival time was 4 years. The 1-year, 3-year, and 5-year survival rates were 82%, 57%, and 43%, respectively. The major variables influencing the survival rate were the following: interval from symptom onset to diagnosis; and hemodynamic measurements (ie, mean pulmonary artery pressure, mean right atrial pressure, and cardiac index). In comparison to rates discerned from the National Institutes of Health registry data, the survival rate in Israel is somewhat better and prognosis is influenced by similar hemodynamic variables. CONCLUSION: PPH is a rare and fatal disease in Israel. New therapeutic modalities such as prostacyclin therapy and lung transplantation may improve survival among patients with this malignant disease.

Adolescent↗

Knowledge and attitudes of children towards cigarette smoking and its damage.

The present study reports the results of knowledge and attitudes of 280 children (mean age = 6.9 +/- 0.75 years) towards cigarettes and smoking. Subjects were divided into two groups: (I) children of parents who smoked (n = 178) and (II) children whose parents did not smoke (n = 102). The scoring for knowledge in the topics of cigarettes, smoking and the consequences was similar in the two groups (6.2 +/- 2.2 vs 6.1 +/- 2) (N.S.). The differences between the two groups were obvious and significant (p = 0.001) in their attitude towards smoking and its damage; children in group I displayed tolerant attitudes towards smoking even though they knew its consequences in comparison with the children of group II (6.1 +/- 2.4 vs 7.0 +/- 2.2). Without any exceptions among the children of the two groups, 7.4% believe that even at this young age they will begin to smoke one day. In addition, 2.1% pointed out that it is possible they will belong one day to the smokers' group. Of the population study, 90.2% believe that instruction about smoking damage should be included starting from the first grade of elementary school, and certainly, it should be at the level which will be understandable for them. As the pupils' knowledge about the consequences of smoking was lacking, we could add that the important topic of smoking and the damage it can inflict should be taught in all schools from the level of the first grade and during all subsequent years of study. Pupils should be familiar with all aspects of negative consequences caused by cigarette smoking. This knowledge may have influence upon their attitude towards smoking and smokers. More studies should be done to find what may change the positive attitudes of these pupils towards cigarettes and smoking.

Attitude to Health↗

Rectal colonization with vancomycin-resistant enterococci among high-risk patients in an Israeli hospital.

The prevalence of rectal carriage of vancomycin-resistant enterococci (VRE) in two high-risk populations--61 patients admitted to ICU and 92 patients on renal dialysis--was studied longitudinally over a period of six months in a 650-bed general hospital. ICU patients were swabbed weekly and dialysis patients monthly. Enterococcal isolates were fully identified using the ATB identification system, and MICs were determined according to the NCCLS recommendations. Enterococci were isolated in 52 (83.6%) ICU patients and 86 (93.4%) dialysis patients. VRE were recovered at least once in 14 (27%) ICU patients and four (4.8%) dialysis patients. All VRE isolates (MIC of vancomycin > or = 256 micrograms/mL) were resistant to teicoplanin (MIC > or = 32 micrograms/mL; vanA phenotype), 87.5% were ampicillin-resistant, and 92% showed high-level resistance to gentamicin; 88% were E. faecium. The main risk factors for acquisition of VRE included duration of hospitalization in the six months preceding entry into the study and during the survey (P = 0.009 and 0.007 respectively, for ICU patients), and duration of antibiotic administration (P = 0.005, for ICU patients). The impact of vancomycin was most prominent (P = 0.005 for receipt and 0.06 for duration of administration, in ICU patients). Six of the 18 VRE carriers developed bacteraemia, six isolates being vancomycin-susceptible and one vancomycin-resistant (one patient had both). In this study, the first in Israel, a low rectal carriage rate occurred in renal dialysis patients and antibiotic use was the most important risk factor for VRE colonization.

Aged↗

Successful management of an infected implantable cardioverter defibrillator with oral antibiotics and without removal of the device.

Infection of an implantable cardioverter defibrillator developed 2 weeks after implantation, presenting with fever, swelling, redness, and tenderness of the skin above the generator site. A cloxacillin resistant coagulase-negative staphylococcus was repeatedly cultured from the abdominal wall pocket fluid. The infection was successfully treated with a combination of two antibiotics, fusidic acid and rifampin, given orally for 3 months. Although the device was not removed, infection did not recur during a 24-month follow-up.

Administration, Oral↗

Another complication of thoracostomy--perforation of the right atrium.

Tube thoracostomy is an invasive procedure that is frequently life-saving but carries a risk of complications. We describe herein a complication not documented before-laceration of the right atrium. This occurred in a severely kyphoscoliotic patient with a markedly narrowed chest and led to his demise. This case attests to the extreme caution warranted when using trocar-type thoracostomy in patients with thoracic deformities.

Aged↗

Malignant fibrous histiocytoma complicating mitral valve replacement.

A 67 year old woman developed a fatal febrile illness 8 years after mitral valve replacement for rheumatic valvular heart disease. The final disease persisted for 1 year and was characterized clinically by weakness, weight loss, congestive heart failure and multiple embolic events to the central nervous system and abdominal organs. The source of the emboli was a tumor, malignant fibrous histiocytoma of the left atrium, originating from the anulus fibrosus around the covered base of the prosthetic valve. This unique case suggests the possibility that chronic exposure to materials, such as Dacron, covering prosthetic valves may induce local malignant tumors.

Aged↗