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Mona Boaz

Publications and source records attributed to Mona Boaz.

46 records · Page 3Linked to original sources
PubMed2003

Severity of acid gastroesophageal reflux assessed by pH metry: is it associated with respiratory disease?

About 50% of children with chronic respiratory diseases (RD) have "silent" gastroesophageal reflux (GER). Our purpose was to evaluate the possibility that RD in patients with GER reflects the presence of more severe acid reflux. We compared the severity of parameters from pH studies in children with chronic RD and "silent" GER, to children with signs of symptomatic gastrointestinal (GI) GER with and without RD. This study included 236 children (aged 1 month to 15 years) with abnormal 24-hr pH monitoring among 718 patients studied for suspected diagnosis of GER. Patients were divided into three groups. Group 1 consisted of children with chronic RD but without any GI symptoms of GER. Group 2 was comprised of children with symptomatic GI presentation of GER such as regurgitation, vomiting, heartburn, and failure to thrive, but without any signs or symptoms of RD. Group 3 included children with prevalent RD and concomitant signs of symptomatic GER. Patients with predominant GI manifestations (group 2) had a significantly higher fraction of time with pH <4 (P < 0.01), total time value of pH <4 (P < 0.05), and longest episode with pH <4 (P < 0.05). Esophageal clearance was significantly longer in group 1 patients than in the other two groups (P < 0.05). Patients with mixed disease (group 3) were similar to patients in group 2. Patients with GI symptoms had significantly worse scores for all parameters evaluated except esophageal clearance score, compared to patients without GI symptoms. Longer esophageal clearance was the only parameter associated with respiratory signs in patients with respiratory symptoms compared to those without. In conclusion, the presence of RD in pediatric patients with silent GER is related to longer esophageal clearance, but is not related to severity of reflux.

Adolescent↗
PubMed2003

Children hospitalized for accidental injuries: Israeli experiences.

Of the total 411 cases of accidents occurring in the State of Israel during 1999, the 314 which were hospitalized at the Edith Wolfson Medical Center, constituting 7.2% of the total pediatric hospitalizations in that regional hospital, were analyzed and summarized. Mean age of the children was 6.6+/-4.4, and ratio of boys to girls was 65:35. Accidents were classified by location of occurrence: home (52.3%); road (19.3%); sports (17.4%); and school (11.6%). Grades of severity were as follows: light (children were discharged without handicaps) (13.2%); moderate (children had undergone surgical intervention with prolonged or permanent disability) (74%); severe (children were treated in intensive care units and had permanent irreversible handicaps) (12.9%). Loss of conscientiousness occurred in 13.3% of cases. Affected body parts included: limbs (52.7%); head and face (32.7%); spine (7%); and multisystem injury (14.6%). Mean duration of hospitalization was 3.1 (+/-2.6 days). Accidental injuries most often occurred in the afternoon and in the absence of parental supervision. These findings generate conclusions for preventive interventions.

Accident Prevention↗
PubMed2003

Extrapancreatic autoimmune manifestations in type 1 diabetes patients and their first-degree relatives: a multicenter study.

OBJECTIVE: To investigate the prevalence of autoimmune diseases in young patients (probands) with type 1 diabetes and their first-degree relatives, and to determine the spectrum of extrapancreatic manifestations in these subjects. RESEARCH DESIGN AND METHODS: The study population included 109 probands age 13 +/- 4.9 years and 412 first-degree relatives age 28.7 +/- 16.2 years. The prevalence rates of autoimmune thyroiditis and celiac disease were determined in all probands and in 100 of the 412 first-degree relatives. Control groups included 78 subjects age 14.9 +/- 10.4 years for the prevalence of autoimmune thyroiditis and 120,000 youth ages 16-17 years for the prevalence of celiac disease. Thyroiditis and celiac disease were diagnosed by abnormally high thyroid peroxidase (TPO), thyroglobulin (TG), antigliadin, and antiendomysial antibody titers. Celiac was confirmed by biopsy. A questionnaire was used to interview probands and relatives to determine the spectrum of autoimmune manifestations. RESULTS: The prevalence of autoimmune thyroiditis determined by high TPO and/or TG titers was 27 and 25% for probands and relatives, respectively. These rates were higher than those for control subjects (P < 000.1). The prevalence of celiac disease among probands and screened relatives was 8.3 and 6%, respectively. These rates were higher than those for control subjects and the 312 family members interviewed only (0.1 and 0.3%, respectively; P < 0.0001). Interviews of participants revealed a wide range of associated autoimmune diseases. The risk of developing an autoimmune disease was higher (P < 0.001) in families with a proband who had an additional autoimmune manifestation. CONCLUSIONS: Screening for autoimmune thyroiditis and celiac disease should be performed in patients with type 1 diabetes and their first-degree relatives, especially when the probands have an additional autoimmune manifestation.

Adolescent↗
PubMed2003

Lipid oxidation kinetics in hemodialysis patients with and without history of myocardial infarction.

BACKGROUND: In lipid oxidation kinetics studies, prevalent cardiovascular disease has been associated with shortened lag phase, the length of time preceding the onset of oxidation. OBJECTIVES: To examine, in vitro, copper-induced lipid oxidation kinetics in unfractionated serum from hemodialysis patients and to determine differences in kinetic parameters between patients with and without a history of CVD. METHODS: Of the 76 patients enrolled in a study of oxidative stress in hemodialysis (44/76 with prevalent CVD, 53/76 males), 9 males with a history of myocardial infarction were selected and matched for age, diabetes and smoking status with 9 males from the non-CVD group. The kinetics of lipid oxidation was studied. Blood chemistry determinations including serum lipids, lipoproteins, hemostatic factors and serum malondialdehyde were obtained. Variables were compared using the t-test for independent samples with history of MI entered as the categorical variable. RESULTS: Tmax, the oxidation kinetic parameter defined as the time at which the rate of absorbing product accumulation was maximal, was significantly shorter in dialysis patients with a history of MI than in those without (115.2 +/- 38.5 vs. 162.7 +/- 48.9 minutes, P = 0.04). Further, Tmax and MDA were negatively correlated to one another (r = -0.47, P = 0.04). Odds ratios indicate that each 1 minute increase in Tmax was associated with a 3% decrease in odds that a subject had a history of MI. CONCLUSIONS: These findings indicate the presence of increased oxidative stress in hemodialysis patients with a history of MI.

Case-Control Studies↗
PubMed2002

Diagnosing brain death using the transcranial Doppler with a transorbital approach.

BACKGROUND: Transcranial Doppler is a sensitive instrument for the diagnosis of brain death. The guidelines for the determination of brain death include the demonstration of specific blood flow patterns in the anterior and posterior circulation systems. A limitation of this method is the frequent false finding of no flow, especially when using the transtemporal approach in older women. OBJECTIVE: To evaluate the efficacy of the transorbital approach in the diagnosis of brain death using transcranial Doppler. METHODS: A prospective controlled, diagnostic test study was performed. Transorbital, transtemporal, and transforaminal approaches were used. Fifty-seven patients (29 men and 28 women; mean +/- SD age, 68.2 +/- 12.1 years) with clinically determined brain death were examined. RESULTS: In 45 patients, oscillatory flow or systolic spikes were found in all approaches. In 4 patients, no flow was detected. In 6 patients, oscillatory flow or systolic spikes were found in 2 approaches, including the transorbital one. In 2 patients, a positive finding was demonstrated only using the transorbital approach. Using the transorbital approach, the percentage of positive findings with definitive diagnoses of brain death rose from 79% to 88%. CONCLUSION: The transorbital approach is a useful addition for the diagnosis of brain death, using the transcranial Doppler technique.

Adult↗
PubMed2002

Low compliance of iron supplementation in infancy and relation to socioeconomic status in Israel.

OBJECTIVE: To evaluate the compliance of parents in purchasing iron-containing drugs for their infants. In addition, we looked for possible socioeconomic characteristics of the parents who prevent their infants from accessing these medications. DESIGN: All infants (4-12 months) whose parents bought (from January to August 1999 and from January to August 2000) the iron-containing drugs as recommended by the Israeli Ministry of Health were retrieved from a database. The socioeconomic status of the citizens was determined according to the "mean real income" (INCMV) and "relative income" (INCMS). The percentage of parents who purchased the medication from each district was compared with the socioeconomic status of this population. RESULTS: Forty-four pediatricians' offices in the Tel Aviv metropolitan area were included. The data of 4929 infants was summarized. Only 27% of the parents bought the drugs. Only 11.5% to 20% of parents from the 5 highest socioeconomic classes purchased the medication compared with 43.6% to 57.1% of the parents from the 5 lowest socioeconomic classes. CONCLUSION: There was low compliance by parents in obtaining iron-containing medications for their infants, mainly among parents from high socioeconomic classes.

Adult↗
PubMed2002

Role of steroid receptors in the pathogenesis of tubal pregnancy.

OBJECTIVE: To determine the role of steroid receptors in the pathogenesis of tubal pregnancy. STUDY DESIGN: Twenty-two women in the reproductive-age group who had undergone salpingectomy because of ectopic pregnancy or sterilization were enrolled. The study group consisted of 12 women who underwent salpingectomy for ectopic pregnancy. The control group included 10 patients in whom the tubes had been removed for elective sterilization. RESULTS: Estrogen receptors were detected in 1 (8.3%) tube with ectopic pregnancy and in 10 (100%) normal tubes (P = .0001). Progesterone receptors were present in 4 (33.3%) tubes in the study group and in all the tubes in the control group (P = .002). CONCLUSION: Our findings indicate that a basic cellular component, the steroid receptor, is damaged in tubes harboring pregnancy.

Adult↗
PubMedDate not supplied

The significance of prestroke aspirin dosage in fatal outcome of acute stroke.

BACKGROUND: Aspirin is an effective and generally accepted treatment drug during the acute stage of ischemic brain infarction. The association between the pretreatment aspirin dosage and fatal outcome among these treated patient groups has not been analyzed previously. OBJECTIVE: The aim of the study was to evaluate 14- and 30-day poststroke survival in patients treated with 325 mg immediately on admission to the hospital for prestroke antiaggregation/anticoagulation treatment. METHODS: This prospective study was conducted in a government tertiary care facility. The medical records of all 1245 patients admitted to the hospital for stroke from 1997 to 2002 were reviewed. The association between demographic parameters, stroke risk factors, stroke subtype, prestroke antiaggregation/anticoagulation treatment, and risk of fatal poststroke outcome, 14 days and 30 days after the event, was analyzed using Cox survival analyses. RESULTS: During the 14-day poststroke period, 320 patients (25%) died. By day 30 poststroke, 386 patients (31%) had died. Older age, female gender, chronic heart disease, and cardiac arrhythmias were associated with increased risk of increased fatal outcome. Mortality was higher in patients with stroke caused by cardioembolism (P < 0.0001) and was significantly lower in patients with small-vessel occlusion (P < 0.0001). Prestroke medium-dose aspirin treatment was associated with a relative reduction in 30-day poststroke period mortality (P < 0.0001). Conversely, prestroke low-dose aspirin treatment was associated with increased mortality (P < 0.0001). CONCLUSION: Prestroke medium-dose aspirin treatment was associated with reduced 30-day poststroke mortality, whereas low-dose prestroke aspirin therapy was associated with increased 30-day poststroke mortality.

Aged↗
PubMedDate not supplied

The effects of an external nasal dilator on labor.

BACKGROUND: The aim of this study was to assess the effect of an external nasal dilator on several variables characterizing labor in both mother and fetus. METHODS: One hundred and fifty primigravida women in active labor were randomized to wear, throughout labor, either a dilator spring-loaded nasal strip or a placebo device. Data were obtained during labor and compared between the groups. After delivery, the satisfaction rate was assessed. RESULTS: No differences were found between the study and the control group regarding rate of induction or augmentation of labor as well as Montevideo units reached, frequency of rupture of membranes, duration of the active phase and second stage of labor, usage of epidural analgesia, normal fetal heart pattern, meconium-stained amniotic fluid, and neonatal well being. Length of maternal and neonatal hospitalization also did not differ between the groups. Satisfaction rate was significantly higher in parturient women wearing nasal strips with a dilator spring than in parturient women wearing a placebo spring (P < 0.0001). CONCLUSION: Nasal strips do not change the course but ameliorate the quality of labor by improving the ease of breathing. Nasal dilators sustain the respiratory effort associated with the long process of labor and may control the switch from nasal to oronasal breathing during delivery.

Adult↗