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Biomedical subjects

M Wiener

Publications and source records attributed to M Wiener.

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

Meningococcal disease in the Israel Defense Force: epidemiologic trends and new challenges.

To determine recent trends in its epidemiology and the need to reconsider prophylactic interventions, meningococcal disease in the Israel Defense Force (IDF) from 1975 through 1993 was studied. All cases of meningitis or meningococcemia were included. A considerable increase in the number of cases has been observed since 1991, with serogroup C becoming predominant (76% of cases) since then. Serogroup Y was the second most frequent serogroup during this period, while serogroup B, predominant in the civilian population of Israel, was rare. Most cases occurred during the first 6 months of military service. Seasonality was important, with most of the cases occurring between December and March, although a small summer peak was also noted. Since 1992, three small clusters of meningococcal disease were encountered in the IDF, for the first time, with all cases caused by group C meningococci. In one cluster, the emergence of rifampicin resistance resulted in failure of chemoprophylaxis. The rise in group C and Y cases since 1991, and the occurrence of rifampicin resistance, necessitate considering meningococcal vaccines and new antimicrobial agents for prophylaxis.

Bacterial Vaccines↗
PubMed1994

[Medical kits in Army physicians' vehicles].

Physicians' medical kits (PMK) were distributed to 50 physicians, graduates of an advanced trauma life support course. The kits were always to be present in the physicians' designated vehicles, enabling them to provide advanced life support at the earliest possible stage (the "golden hour"). The kits have equipment for advanced airway intervention and management, chest trauma management (chest tube insertion, etc.) and fluid administration. To help assess the impact of the PMK and its cost effectiveness, questionnaires were sent to the physicians involved, of whom 35/50 responded. The questions included 2 subjects: the presence of the kit in the car and details of its use for injuries. The kit was present at all times in the cars of all except 1 of 31 physicians. 7 (22.5%) of them used the kit in 50 incidents which involved 74 injured persons. The injuries were caused by road accidents in 54 cases, in 17 by terrorist activity, and 3 cases involved heart attacks and cardiac resuscitation. Distribution of the PMK among army physicians appears to be valuable in the field, and before hospitalization.

Automobiles↗
PubMed1994

Long-term persistence of anti-diphtheria toxin antibodies among adults in Israel. Implications for vaccine policy.

Vaccination against diphtheria has essentially led to the disappearance of the disease in Israel. However, in other countries with high immunization coverage, isolated cases and small outbreaks have occurred in adults. Immunity following vaccination or natural exposure to toxigenic strains of C. diphtheriae is conferred by serum antibodies to diphtheria toxin. Since booster doses of diphtheria toxoid are recommended every ten years in adults, this raises the question of persistence of protective levels of anti-diphtheria toxin antibodies. In this study we assessed a possible age-related decline in anti-diphtheria toxin antibodies among adults in Israel. The study population comprised random samples in three age groups: 263 male recruits aged 18-19 years, 116 male reserve soldiers aged 25-35 years and 153 aged 41-51 years. Anti-diphtheria toxin antibody levels were measured by means of ELISA. Results indicate that 64.3% (95% CI = 58.5-70.1%) of those aged 18-19 had anti-diphtheria toxin levels in excess of 0.1 IU ml-1, whereas the corresponding figures for ages 25-35 and 41-51 were 32.8% (95% CI = 24.2-41.3%) and 15% (95% CI = 9.4-20.7%). However, even in the oldest age group, 95.4% (95% CI = 90.8-98.1%) had antibodies above the presumed protective level of 0.01 IU ml-1. Although these results indicate a significant age-related decline in anti-diphtheria toxin antibodies in vaccinated subjects, most had apparently protective levels. The absence of cases suggests that vaccine-induced immunity is long-lasting. However the immune status of the population should be carefully monitored.

Adolescent↗
PubMed1994

Epidemic spread of Shigella sonnei shigellosis and evidence for development of immunity among children attending day-care centers in a communal settlement (Kibbutz).

An investigation of two Shigella sonnei shigellosis outbreaks that occurred in a communal settlement indicated that the transmission of the pathogen was restricted to day-care classes and secondary infection of family members was minimal. Development of serotype-specific immunity following S. sonnei infection was observed among infected children.

Bacteriophages↗
PubMed1994

Asthma ski day: cold air sports safe with peak flow monitoring.

The Colorado Asthma Ski Day, an annual cross-country and alpine skiing event, encourages children with asthma to participate fully in outdoor winter sports. Since cold air and exercise can trigger bronchospasm, we examined the peak expiratory flow rates of 80 children who attended Asthma Ski Day 1992 or Asthma Ski Day 1993 to establish a safety profile for this event. Peak expiratory flow rates were measured prior to skiing, at lunchtime, and at the end of the day's activities. We asked the children to pretreat with their regular medications, as prescribed by their physicians, to use their bronchodilator inhalers p.r.n., and to report to our medical station if an episode of acute asthma occurred. The average age of the participants was 9.5 years, and the average baseline daytime peak flow rate was 100.03% of predicted. The average percent change in peak flow rates during the day was an increase of 5.00%. Our results demonstrate that with medical supervision, peak expiratory flow rate monitoring, and properly administered medications, peak flow rates can be stabilized and even improve during cold-weather exercise to an extent that safety concerns need not restrict children with asthma from engaging in exercise or cold-weather sports. The Colorado Asthma Ski Day can serve as a model event for other organizations that want to promote outdoor activities for children with asthma.

Adolescent↗
PubMed1994

Low back pain and body mass index.

We have examined the association between body mass index and the prevalence of low back pain in about a quarter of a million male recruits aged 17-18 years at the time of their medical draft examination. Low back pain prevalence is shown to rise with increasing body mass index. This statistically significant association may suggest a role of body weight and height in the pathogenesis of low back pain and supports the previously reported need for education regarding weight reduction as a useful implement in low back pain prevention.

Adolescent↗
PubMed1994

Glucose polymer ingestion--effect on fluid balance and glycemic state during a 4-d march.

The effect of glucose-polymer solution on physical performance has been extensively studied under controlled laboratory conditions. The present study was conducted to investigate the influence of such beverages on fluid balance and on glycemic state during a moderate, prolonged field exercise. Forty-eight endurance trained, male subjects participated in the study. The maneuver consisted of a 4-d march; 29, 39, 36, 30 km.d-1, at a speed of 5-6 km.h-1. The subjects covered a total distance of 134 km at an estimated exercise intensity of approximately 40% VO2max, under hot climate conditions (ambient temperature, 32-41 degrees C; relative humidity, 60-14%). Subjects were randomly assigned to one of two groups: glucose polymer-electrolyte beverage (GP; N = 24) and tap water (TW; N = 24). Each group was then divided into two subgroups consuming fluid ad libitum (TWa, GPa) or instructed to consume 900 ml.h-1 (TWb, GPb). The mean daily fluid consumption of all subgroups was similar (5252 +/- 229 and 4640 +/- 67 ml in TWa and TWb; 5257 +/- 317 and 5253 +/- 216 ml in GPa and GPb, respectively). Weight loss, reflecting the degree of dehydration, was 1.2 +/- 0.1% and 1.9 +/- 0.3% of initial body weight in TW and GP, respectively. On day 1, plasma volume changed by +0.4% and -1.8% in the TW and GP groups, respectively. On the days 2-4 changes in both groups were similar.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Secondary structure analysis of purified functional CHIP28 water channels by CD and FTIR spectroscopy.

The integral membrane protein CHIP28 is an important water channel in erythrocytes and kidney tubule epithelia and is a member of a family of channel/pore proteins including the lens protein MIP26. The purposes of this study were to purify functional, delipidated CHIP28 to homogeneity and to determine secondary structure by circular dichroism (CD) and Fourier transform infrared spectroscopy (FTIR). CHIP28 was initially purified and delipidated by anion-exchange chromatography following solubilization of N-lauroylsarcosine-stripped erythrocyte membranes with beta-octylglucoside (OG); MIP26 was initially purified and delipidated by anion-exchange chromatography following solubilization of urea-stripped bovine lens membranes by monomyristoylphosphatidylcholine. CHIP28 (glycosylated and nonglycosylated) and MIP26 were purified further by high-performance size-exclusion chromatography, eluting in OG as apparent dimers and tetramers, respectively. Proteoliposomes reconstituted with purified CHIP28 were highly water-permeable, with an osmotic water permeability Pf of 0.04 cm/s at 10 degrees C that was inhibited by 0.1 mM HgCl2. Proteoliposomes reconstituted with MIP26 had a low Pf of 0.005 cm/s. CD spectra of CHIP28 in OG or in reconstituted proteoliposomes gave a maximum at 193 nm and minima at 208 and 222 nm. Spectral decomposition using protein basis spectra gave 40 +/- 5% alpha-helix and 43 +/- 3% beta-sheet and -turn. HgCl2 did not affect the CD spectrum of CHIP28. Attenuated total reflectance FTIR of air-dried, membrane-associated CHIP28 gave 38 +/- 5% alpha-helix and 40 +/- 4% beta-sheet and -turn by spectral decomposition of the amide I resonance. For comparison, CD of MIP26 in OG gave 49 +/- 7% alpha-helix and 32 +/- 12% beta-sheet and -turn; FTIR gave 32 +/- 8% alpha-helix and 45 +/- 6% beta-sheet and -turn. Analysis of CHIP28 and MIP26 sequence data by the generalized hydropathy method of Jähnig [Jähnig, F. (1990) Trends Biochem. Sci. 15, 93-95] predicted 39-47% alpha-helix and 15-20% beta-structures. These results establish procedures to obtain large quantities of pure CHIP28 and MIP26 in functional forms and provide evidence for multiple membrane-spanning alpha-helices or mixed alpha/beta-domains.

Animals↗
PubMed1993

Ethnic and gender differences in the prevalence of anti-cytomegalovirus antibodies among young adults in Israel.

The population of Israel comprises offspring of immigrants from countries of high and low incidence of cytomegalovirus infection. To evaluate possible ethnic differences in the prevalence of antibodies against cytomegalovirus in young adults, blood samples were taken from a random sample of 422 Israel military recruits aged 18-19 years, during 1987. Antibodies against cytomegalovirus were determined by means of ELISA. Subjects originating from North Africa or Asia had higher prevalences than those originating from Western countries (84.0% and 74.0% versus 60.0%, P < 0.001) and the differences persisted after adjustment for gender, education and socioeconomic status. The prevalence of antibodies was significantly lower in men than in women (63.1% versus 76.5%). These findings identify subpopulations who are at increased risk of primary cytomegalovirus infection during adulthood and may be candidates for future anti-cytomegalovirus vaccines.

Adolescent↗
PubMed1993

Injury severity scoring and length of stay in hospital of war casualties--demonstration of an association and possible selection bias.

The Injury Severity Score (ISS) is a widely used measure of anatomical injury. It is the sum of squares of the highest scores on the Abbreviated Injury Scale (AIS) in each of the three most severely injured body regions. This study was designed to describe the relationship between ISS and length of stay (LOS) in hospital. The ISS was independently determined by four physicians who studied 491 war casualties, excluding dead on arrival and non-trauma patients. The study demonstrates non-linear and non-homogeneous relationships between ISS and LOS. Exclusion of fatalities resulted in biased (higher) estimates of LOS among those with ISS scores of 25-66. The patients could be grouped into five categories according to their maximal AIS (MAIS): (1) Slight injury--i.e. those with injuries appropriate for AIS scores 1 or 2 that lead to an LOS of median 5 days; (2) Moderate injury--i.e. those with injuries appropriate to AIS scores of 3, with an expected median LOS of 10 days; (3) Severe injuries--i.e. those with injuries appropriate to AIS scores of 4, with expected median LOS of about 17 days; (4) Very severe injuries--i.e. those with one injury appropriate to an AIS score of 5; and (5) Multiple severe injuries--those who are severely wounded in two or more body regions, i.e. those with two or more injuries appropriate to AIS scores of 5 and 4, with a median LOS of 39 days.(ABSTRACT TRUNCATED AT 250 WORDS)

Humans↗
PubMed1993

Overexertional lumbar and thoracic back pain among recruits: a prospective study of risk factors and treatment regimens.

A total of 395 male infantry recruits were evaluated in a prospective study of possible risk factors for overexertional back pain and the efficacy of drug treatment regimens for this syndrome. Recruits were classified into subgroups of lumbar or thoracic, and paraspinal or spinous process pain. Recruits were divided into three treatment groups: Ibuprofen, Paracetamol, and no drug treatment. Of the recruits, 18% were diagnosed as having overexertional back pain during the course of 14 weeks of training. By multivariate analysis low body mass index was found to be a risk factor for overexertional lumbar pain (p = 0.005) and increased lumbar lordosis a risk factor for overexertional thoracic pain (p = 0.005). Of recruits with overexertional back pain, 65% were asymptomatic by the end of basic training. There was no statistically significant difference between cure rates according to treatment groups.

Acetaminophen↗
PubMed1993

Treatment of overuse patellofemoral pain. Prospective randomized controlled clinical trial in a military setting.

The efficacy of treatment of overuse patellofemoral pain with an elastic knee sleeve with a silicone patellar ring was compared with a simple elastic sleeve and with no treatment in a prospective study of 395 army recruits. During 14 weeks of basic training, 84 knees were diagnosed as having overuse patellofemoral pain. Recruits treated with a simple elastic knee sleeve had a statistically significant better comfort score and more had their pain resolved by the end of training than those treated with elastic knee sleeves with a silicone patellar ring. The mean pain score at the end of training decreased more among recruits who were treated with a simple elastic knee sleeve than among recruits who received no treatment, but this difference was not significant. Among the treatment options tried, the simple elastic knee sleeve was no more effective than no treatment at all, but it was more effective than the more elaborate patellar brace.

Braces↗
PubMed1993

Promotion of a lifestyle conducive to cardiovascular health in the Israel Defence Force.

This article reviews the characteristics and components of intervention programs that are conducted by the Israel Defence Forces (IDF) in an attempt to reduce future cardiovascular (CV) morbidity and mortality among Israeli military personnel. Various populations have been targeted for intervention, ranging from selected high-risk individuals to the entire military population. The four basic elements of the activity are educational programs, environmental changes, legislation, and enforcement of the rules. Important characteristics of the program, which probably will contribute to its success, are (1) the establishment of a standing joint committee for developing and implementing health promotion programs in the IDF; and (2) the adoption and the follow-up of the suggested intervention programs by the head of the Manpower Branch, together with commanders of the other relevant branches. The effectiveness of the intervention programs will be measured in the future mainly by a follow-up on the prevalence of CV risk factors among Israeli military personnel.

Cardiovascular Diseases↗
PubMed1992

Psychiatric implications of missile attacks on a civilian population. Israeli lessons from the Persian Gulf War.

OBJECTIVE: To determine the proportion of hospitalized patients who had stress reactions as a result of missile attacks during the Persian Gulf War and evaluate the factors that influenced their evacuation. DESIGN: Review of medical records of patients hospitalized as a result of missile attacks. SETTING: During the Persian Gulf War in the winter of 1991, Israel received 18 missile attacks involving 39 surface-to-surface Scud missiles. The uncertainty in time, place, and type of warhead, conventional or chemical, was a source of chronic stress and the immediate cause for many traumatic stress reactions at or near the missile attack sites. PARTICIPANTS: Data from victims who were injured after each missile attack were available through a central hookup between 12 local hospitals and the Medical Corps of the Israeli Defence Force. MAIN OUTCOME MEASURE: The number of persons diagnosed in the hospital as psychological casualties after each missile attack. RESULTS: Approximately 43% of the 773 casualties evacuated to hospitals were diagnosed as psychological casualties, and an additional 27% had mistakenly injected themselves with atropine. Data also indicated that triage of psychological casualties to hospitals was more a function of the rescue team's training and preparation than the severity or extent of injury or damage. CONCLUSIONS: Optimal treatment during events that cause mass casualties requires proper preparation of rescue teams as well as reorganization of the hospital's psychiatric services. The threat of chemical warfare affected the number and nature of stress reactions.

Atropine↗