Assigning Israeli medical graduates to internships.

BACKGROUND: Physicians in Israel are required to do an internship in an accredited hospital upon completion of the medical studies, and prior to receiving the medical license. For most students, the assignment is determined by a lottery, which takes into consideration the preferences of these students. OBJECTIVES: We propose a novel way to perform this lottery, in which (on average) a larger number of students gets one of their top choices. We report about implementing this method in the 2014 Internship Lottery in Israel. METHODS: The new method is based on calculating a tentative lottery, in which each student has some probability of getting to each hospital. Then a computer program "trades" between the students, where trade is performed only if it is beneficial to both sides. This trade creates surplus, which translates to more students getting one of their top choices. RESULTS: The average student improved his place by 0.91 seats. CONCLUSIONS: The new method can improve the welfare of medical graduates, by giving them more probability to get to one of their top choices. It can be applied in internship markets in other countries as well.

[Borderline personality disorder and bipolar II disorder--similarities and differences].

Since both borderline personality disorder (BPD) and bipolar II disorder (BP-II) are common psychiatric diagnoses due to their co-morbidity and similar characteristics, some researchers suggested they coexist along a spectrum of cyclical affective disorders. As part of the ongoing debate regarding these central diagnoses, a few studies were recently conducted. The results showed that patients with BPD reported higher Levels of impulsiveness and hostility across Axis I diagnostic groups. Furthermore, refining the impulsivity scale revealed different types of impulsivity in the two disorders. This should be carefully considered as impulsivity is known to predict suicidal behavior in both disorders. Subjective reported depression differed across groups, with BPD patients reporting higher Levels of cognitive and anxiety-related symptoms, supporting the notion that BPD patients show increased sensitivity to negative emotional states. Thus, providing further evidence that BP-II and BPD are distinct diagnostic entities. On the other hand, recent studies didn't attain statistically significant differences between bipolar disorder and BPD, although BPD patients displayed higher scores than unipolar patients in mood and cognition depressive subdomains. Further research is still needed to clarify this diagnostic and clinical question.

Infant lungs are preferentially infected by adenovirus and herpes simplex virus type 1 vectors: role of the tissue mesenchymal cells.

BACKGROUND: Adenovirus (AD) and herpes-simplex-virus-1 (HSV-1) have been extensively applied as vectors for gene and cancer therapy in clinical trials. AD5, from which the vector was constructed, is a common respiratory virus that infects mainly infants, yet the reasons for infant sensitivity to infection, other than immunity, are not clear. HSV-1, usually a neurotropic virus, may also cause severe pneumonia or disseminated diseases in infants and immunocompromised patients. METHODS: The tropism of these viruses to different human and mouse lung tissues of newborn and adult was studied in an ex vivo organ culture and it was also applied in vivo using a murine model. RESULTS: The data obtained indicated preferential viral infection of young lung tissues versus adult tissues in organ culture. Further studies indicated that the preferential infection of young tissues was not related to differences in receptor expression or exposure but rather to the different distribution of cell types in these tissues. Murine and human young lungs consist of a relative abundance of mesenchymal cells and these cells were much more susceptible to viral infection compared to adjacent epithelial-pneumocyte cells. These observations were further confirmed using an in vivo model of mouse infection. CONCLUSIONS: The similarity of the human and mouse tissues, with respect to viral vector tropism, validates the mouse model in studies of gene transfer to the lung. Furthermore, the results should facilitate the improved design of gene therapy trials for lung-related diseases in young and adults patients. Copyright © 2011 John Wiley & Sons, Ltd.

Evaluation and management of sleep disturbance during the menopause transition.

Sleep disturbances in midlife women are common and have been associated with the menopause transition itself, symptoms of hot flashes, anxiety and depressive disorders, aging, primary sleep disorders (i.e., obstructive sleep apnea, periodic limb movement disorder), comorbid medical conditions and medications, as well as with psychosocial and behavioral factors. Because there are several common sources of sleep problems in midlife women, the cause of an individual woman's sleep disturbance may be multifactorial. Effective behavioral and pharmacological therapies are available to treat sleep disturbances of different etiologies. This review provides an overview of different types of sleep disturbance occurring in midlife women and presents data supporting the use of hormone therapy, hypnotic agents, and behavioral strategies to treat sleep problems in this population. The review aims to equip clinicians evaluating menopause-age women with the knowledge and evaluation tools to diagnose, engage sleep experts where appropriate, and treat sleep disturbance in this population. Sleep disorders in midlife women should be treated because substantial improvements in quality of life and health outcomes are achievable.

Environmental risk factors for psychopathology.

In the past all psychopathologies were viewed as caused by the environment. Later on case-control and family-based studies of major psychiatric disorders found genetic associations, but in many cases these findings did not survive replications. A gene-environment approach gave new hope for possible associations. Gene environment correlations emphasized that the relationship are bidirectional. However, recent meta-analyses raised doubts about the consistency of these findings as well. The review summarizes the current view on the environmental factors in the major psychopathologies.