Search PubMed⌕ Search

Biomedical subjects

Joshua Shemer

Publications and source records attributed to Joshua Shemer.

25 records · Page 2Linked to original sources
PubMed2003

[Why viral (SARS, Ebola and AIDS) epidemics now?].

In the last three decades we have seen several viral (and bacterial; i.e. TB) epidemics which took place at an era where we would have expected the eradication of many infectious diseases. There are many hypotheses to explain this paradox; 1) Is it the hygiene theory, namely extensive use of wide spread and too potent antibiotics which eliminate protective infecting agent? And hence the beneficial effect of probiotics? Is it the widespread use of vaccine? Is it a mistake or a terror acts of leakage of viral mutant from research or other laboratories? Be it as it may, the globalization and the employment of long distance flights make the spread easy to extreme points in the globe (Shanghai-Toronto). The new epidemiology? Immunology fields will have to deal with these novel aspects to combat and to prevent more events.

AIDS Vaccines↗
PubMed2003

[Utilization patterns of CT and MRI in Israel].

BACKGROUND: One of the major factors contributing to the escalating increase in the costs of the health system is the accelerated utilization of health technologies such as Computed Tomography (CT) and Magnetic Resonance Imaging (MRI). Prior to this study in Israel, there was no available national database to ascertain the scope and utilization patterns of imaging technologies. A number of trends combine in the need to assess the utilization patterns in Israel. Firstly, imaging examinations constitute a larger and ever-growing predominate role in the diagnostic process. Secondly, these technologies can complement or supplement each other. Thirdly, the rising costs to the health system resulting from the numerous examinations conducted and finally, the importance of protecting public health from the damage caused by exposure to radiation during CT examinations. OBJECTIVES: 1. To describe the utilization patterns for CT and MRI examinations in Israel. 2. To compare the consumption of imaging services with that of other Western countries. METHODS: The initial stage was to identify all the institutions operating CT or MRI devices. Data was collected by means of a questionnaire from these organizations on the extent of use, characteristics of the utilization patterns, indications, accessibility, availability, and referents etc. during the period 1995-1999. RESULTS: In the year 2000, 38 CT and 9 MRI devices were operating in Israel. We observed an increase in the number of CT and MRI examinations between the years 1995-1999 and a rise in the level of examinations per 1,000 population. The rate of MRI examinations per person in Israel was found to be lower in comparison to other Western countries. Upon analysis of the distribution of indications it was found that approximately 37% of the CT examinations were cranial examinations and 18% were spinal examinations. In MRI examinations 38% were cranial and 30% spinal tests. CONCLUSION: The rising trends in the rate of CT and MRI examinations during the period 1995-1999 and their characteristics, match the comparable rise witnessed in most Western countries in recent years. Although the level of CT and MRI devices per population in Israel is low in comparison to the Western world, the devices operate intensively. In light of the high level of accessibility and availability of these imaging devices in Israel, the research findings corroborate the claim that the number of devices influences the scope of utilization and supports the supposition that these imaging devices are used efficiently in Israel.

Databases, Factual↗
PubMed2003

Influenza vaccination: reduction in hospitalizations and death rates among members of "Maccabi Healthcare Services" during the 2000-2001 influenza season.

BACKGROUND: Upper respiratory tract illnesses have been associated with an increased risk of morbidity and mortality. OBJECTIVE: To assess the influence of vaccination against influenza on the risk of hospitalization in internal medicine and geriatric wards, and the risk of death from all causes during the 2000-2001 influenza season. METHODS: A historical cohort study was conducted using computerized general practitioner records on patients aged 65 years and above, members of "Maccabi Healthcare Services"--the second largest health maintenance organization in Israel with 1.6 million members. The patients were divided into high and low risk groups corresponding to coexisting conditions, and were studied. Administrative and clinical data were used to evaluate outcomes. RESULTS: Of the 84,613 subjects in the cohort 42.8% were immunized. At baseline, vaccinated subjects were sicker and had higher rates of coexisting conditions than unvaccinated subjects. Vaccination against influenza was associated with a 30% reduction in hospitalization rates and 70% in mortality rates in the high risk group. The NNT (number needed to treat) measured to prevent one hospitalization was 53.2 (28.2 in the high risk group and 100.4 in the low risk group). When referring to length of hospitalization, one vaccine was needed to prevent 1 day of hospitalization among the high risk group. Analyses according to age and the presence or absence of major medical conditions at baseline revealed similar findings across all subgroups. CONCLUSIONS: In the elderly, vaccination against influenza is associated with a reduction in both the total risk of hospitalization and in the risk of death from all causes during the influenza season. These findings compel the rationale to increase compliance with recommendations for annual influenza vaccination among the elderly.

Aged↗
PubMed2002

When is an epidemic an epidemic?

BACKGROUND: The large number of cases of West Nile fever diagnosed in Israel in 2000 once again brought into focus the confusion that frequently accompanies the use of the term "epidemic." OBJECTIVES: To examine the different definitions of the term "epidemic" and to propose ways in which it can be used to both improve communication among professionals and provide the public with a better sense of the associated risks. METHODS: The literature was reviewed for the various definitions of the terms "epidemic" and "outbreak." Sources included popular and medical dictionaries, ancient documents, epidemiology texts, legal texts, and the medical literature. RESULTS: The term epidemic is variously defined. The broad definition given by epidemiologists--namely, more disease than is anticipated by previous experience--is less meaningful to the general public. In some ways it conflicts with the definitions found in the popular literature, which generally imply danger to the public and a very large number of victims. CONCLUSIONS: The interpretation of the term epidemic may vary according to the context in which it is used. For risk communication, we suggest that every effort be made to add descriptive terms that characterize the epidemic.

Communication↗