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Biomedical subjects

M Giladi

Publications and source records attributed to M Giladi.

At least 55 records · Page 3Linked to original sources

DNA probes specific for Entamoeba histolytica possessing pathogenic and nonpathogenic zymodemes.

A number of DNA probes which hybridize to highly abundant DNA sequences of Entamoeba histolytica were developed. Variations in the hybridization patterns of different E. histolytica strains were detected with selected probes. Four types of restriction fragment length patterns were obtained. Of these, the first class belonged to E. invadens and E. histolytica-like var. Laredo. The next two classes consisted of various strains of E. histolytica which were originally isolated from symptomatic patients and possessed pathogenic patterns of isoenzymes (zymodemes), whereas the fourth group contained E. histolytica strains with nonpathogenic zymodemes obtained from asymptomatic carriers. DNA probes, based on DNA sequences specific to E. histolytica isolates with pathogenic and nonpathogenic zymodemes were isolated, and their nucleotide sequences were determined. These probes (P145 and B133) hybridized selectively to DNA of isolates possessing either pathogenic or nonpathogenic isoenzyme patterns. The newly developed probes could be useful for diagnostic purposes and could serve as tools to investigate the molecular basis of pathogenicity and the genetic mechanisms which regulate the variable aggressive behavior of the parasite.

Animals↗

Combined effect of foot arch structure and an orthotic device on stress fractures.

In a prospective study, quantitative measures of the structure of the longitudinal arch of the foot were established and related to the incidence of stress fractures in the bones of the lower limbs of military recruits. In addition, the role of a semirigid orthotic device (Langer military stress orthotic) in preventing stress fractures was evaluated as a function of the structure of the longitudinal arch. Femoral and tibial stress fractures were found to be more prevalent in the presence of feet with high arches, whereas the incidence of metatarsal fractures was higher in feet with low arches. The use of an orthotic device reduced the incidence of femoral stress fractures only in the presence of feet with high arches and the incidence of metatarsal fractures only among feet with low arches. The findings suggest that the normal foot with a low arch acts as a better shock absorber than the normal foot with a high arch, and that an orthotic device may improve the shock absorbing capacity of the arch.

Adult↗

Shigellosis in adults: epidemiologic, clinical, and laboratory features.

One hundred and sixteen cases of adult patients hospitalized for shigellosis have been reviewed. The most common presentation included diarrhea (most frequently watery), fever, and abdominal pain, while dysentery has been less frequent. S. flexneri infection, as compared to S. sonnei, was more common in elderly patients and in males, and was characterized by a more prolonged clinical course. Abnormalities of serum electrolytes and hepatic enzymes were the most common laboratory complications, most often seen in elderly patients. Most isolates exhibited susceptibility to the common antimicrobial agents used in shigellosis therapy.

Anti-Bacterial Agents↗

The effect of pretraining sports activity on the incidence of stress fractures among military recruits. A prospective study.

In a prospective study of stress fractures among Israeli infantry recruits, no correlation was found between the recruits' prior participation in sports activities or their aerobic physical fitness and the incidence of stress fractures during basic training. This finding discredits the concept that improving physical fitness prior to basic training can be a prophylactic means of limiting the incidence of stress fractures during subsequent training.

Adult↗

An analysis of the biomechanical mechanism of tibial stress fractures among Israeli infantry recruits. A prospective study.

The biomechanical mechanism of tibial diaphyseal stress fractures was studied prospectively in a group of 286 Israeli recruits. Before training each recruit had roentgenograms taken of his tibiae. Measurements of total tibial and cortical widths in the anteroposterior (AP) and mediolateral planes were made on these roentgenograms at two levels: at the point of the narrowest tibial width on AP roentgenograms (Level 1) and at the point of the narrowest width on lateral roentgenograms (Level 2). The tibial cross section was idealized as an eccentric ellipse within an ellipse, and on the basis of measurements taken from the roentgenograms, the cross-sectional area (compression strength), area moments of inertia about AP and mediolateral axes of bending (bending strength), and the area polar moment of inertia (torsional strength) were calculated for each cross section. During the course of 14 weeks of training, 20% of the recruits sustained tibial diaphyseal stress fractures, all of which were along the medial cortex. Using stepwise logistic regression analysis the tibia's bending strength along an AP axis of bedding at Level 2 was found to be the most significant factor determining whether or not a recruit would develop a tibial stress fracture.

Adult↗

Stress fractures and tibial bone width. A risk factor.

A prospective study of 295 infantry recruits has shown that the mediolateral width of the tibia measured radiographically at each of three different levels in the bone had a statistically significant correlation with the total incidence of stress fractures as well as with those in the tibia alone or the femur alone. A narrow tibial width was shown to be a risk factor, but cortical thickness was not found to be significant.

Femoral Fractures↗

Clinical significance of nonfocal scintigraphic findings in suspected tibial stress fractures.

The clinical significance of nonfocal increased uptake on skeletal scintigraphy in suspected tibial stress fractures is controversial, because it may represent either bone reaction to stress or a stress fracture in evolution. The scintigraphic evolution of areas of abnormal tibial activity, graded according to a 1 to 4 rating system and their corresponding clinical courses, were analyzed in 27 military recruits, as part of a prospective study. Disappearance of pain correlated with scintigraphic healing and increased pain with progression to stress fracture. Decreased or persistent pain had equivocal scintigraphic correlation. Eight of 14 nondiscrete scintigraphic lesions disappeared in spite of continuous training by the recruits; four such lesions, however, progressed to stress fractures. This uncertainty of progression suggests that military recruits and people training for sports who have such scintigraphic activity should have a brief rest period and proper monitoring before resuming training.

Adolescent↗

External rotation of the hip. A predictor of risk for stress fractures.

External rotation of the hip was found to have a statistically significant correlation with the incidence of stress fractures, in a prospective study among Israeli infantry recruits of possible anthropomorphic predictors of risk for stress fractures. Soldiers in whom hip external rotation was greater than 65 degrees were at a higher risk for tibial and total stress fractures than those with external rotations of less than 65 degrees. The mean hip external rotation in this study of 57 degrees +/- 9.3 degrees was higher than in statistics reported in the American literature. The existence of a larger subpopulation with hip external rotation greater than 65 degrees may partially explain why the reported incidence of stress fractures in the Israeli army is higher than that of the American army.

Adolescent↗

Stress fractures of the medial femoral condyle.

Three military recruits who presented with medial joint line pain and positive Appley grinding tests were found on the basis of scintigrams plus arthroscopy and/or arthrogram to have no intra-articular pathology, but rather medial femoral condyle stress fractures. The importance of the differential diagnosis is emphasized.

Adolescent↗

Recurrent stress fractures in military recruits. One-year follow-up of 66 recruits.

Of 66 recruits who sustained stress fractures during basic training and returned to training after a period of rest, seven (10.6%) suffered recurrent fractures within one year. None of the recurrences was at the original anatomical site. All of the recruits with recurrent stress fractures had had at least one of their initial stress fractures in the femur. This suggests that a femoral stress fracture carries a high risk of recurrence at other sites.

Adult↗

Effect of intense physical activity on the bone-mineral content in the lower limbs of young adults.

The effect of intense physical training on the bone-mineral content of young adults who are unaccustomed to physical activity has not yet been established. In this study, 268 male recruits, eighteen to twenty-one years old, were evaluated before and after fourteen weeks of strenuous physical training. The bone-mineral content of both legs at the level of the distal third of the tibia in each individual was measured using single-beam photon absorptiometry. The subjects started their training with equal values for bone-mineral content in both legs. During the training period, the average bone-mineral content of the left leg increased by 11.1 per cent and that of the right leg, by 5.2 per cent. In the group of subjects who did not complete the training course, mainly because they incurred stress fractures, the increase in bone-mineral content was significantly less than the increase in those who completed the program. This study indicated that in young adults a high level of loading of bone results in either a stress fracture or a rapid increase in bone-mineral content.

Adolescent↗

Medial tibial pain. A prospective study of its cause among military recruits.

In a prospective study of 295 infantry recruits during 14 weeks of basic training, 41% had medial tibial pain. Routine scintigraphic evaluation in cases of medial tibial bone pain showed that 63% had abnormalities. A stress fracture was found in 46%. Only two patients had periostitis. None had ischemic medial compartment syndrome. Physical examination could not differentiate between cases with medial tibial bone pain secondary to stress fractures and those with scintigraphically normal tibias. When both pain and swelling were localized in the middle one-third of the tibia, the lesion most likely proved to be a stress fracture.

Fractures, Bone↗

A prospective study of the effect of a shock-absorbing orthotic device on the incidence of stress fractures in military recruits.

In a prospective study of stress fractures the hypothesis that a shock-absorbing orthotic device worn within military boots could lessen the incidence of stress fractures was tested. The incidence of metatarsal, tibial, and femoral stress fractures was lower in the orthotic group, but only the latter difference was statistically significant. The time of onset and the location of stress fractures between orthotic and nonorthotic users did not differ. These findings suggest that the incidence of femoral stress fractures, which are the most dangerous type of stress fracture because of their high risk of developing into displaced fractures, can be reduced by an orthotic device.

Fractures, Bone↗

The normal range of subtalar inversion and eversion in young males as measured by three different techniques.

In a prospective study, 272 males aged 18 to 20 had goniometric measurement of their subtalar inversion and eversion by three different methods. Placing the ankle in dorsiflexion while performing the measurements decreased the mean inversion from 32 to 22 degrees but had little effect on eversion. The neutral position of the subtalar joint was found to have a mean value of 3 degrees of varus from the midpoint of the tibia. The technique for measuring subtalar motion as described by the Committee for the Study of Joint Motion of the American Academy of Orthopaedic Surgeons has less subjective variables than the other two methods used in this study. Its use is therefore recommended if comparisons are to be made between series.

Adolescent↗

Stress fractures in military recruits. A prospective study showing an unusually high incidence.

In a prospective study of 295 male Israeli military recruits a 31% incidence of stress fractures was found. Eighty per cent of the fractures were in the tibial or femoral shaft, while only 8% occurred in the tarsus and metatarsus. Sixty-nine per cent of the femoral stress fractures were asymptomatic, but only 8% of those in the tibia. Even asymptomatic stress fractures do, however, need to be treated. Possible explanations for the unusually high incidence of stress fractures in this study are discussed.

Adolescent↗