Electrical probe characteristic recovery by measuring only one time-dependent parameter.

Two straightforward methods for recovering the current-voltage characteristic of an electrical probe are proposed. Basically, they consist of replacing the usual power supply from the probe circuit with a capacitor which can be charged or discharged by the probe current drained from the plasma. The experiment requires the registration of only one time-dependent electrical parameter, either the probe current or the probe voltage. The corresponding time-dependence of the second parameter, the probe voltage, or the probe current, respectively, can be calculated using an integral or a differential relation and the current-voltage characteristic of the probe can be obtained.

[Prognosis and treatment of membranous glomerulonephritis-a 5-year prospective study]. / Prognosticul si tratamentul glomerulonefritei membranoase: studiu prospectiv pe 5 ani.

UNLABELLED: The aims of the study were to describe the clinical, pathological and biological features of membranous GN and to prospectively evaluate the relationships between individual negative prognostic factors--type of therapy and outcome. Between 1993-1998, 13/150 (8.7%) consecutive patients with renal biopsy had membranous GN (M = 62%, age = 42.5 +/- 14.5 years). Main (major) findings in these patients were: asymptomatic proteinuria--23.1%, heavy proteinuria (> 10 g/day)--33.3%, microscopic hematuria--53.8%, increased plasma creatinine levels--33.3%, hypertension--23.1% cases. 60% of the patients with nephrotic proteinuria had an underlying cause (infection, malignancy, immune-mediated systemic diseases). 40% of the patients with nephrotic proteinuria had 0 or less than 2 negative prognostic factors (without any of the recognized severe morphological changes). The following differentiated treatment protocols were applied: no treatment for asymptomatic proteinuria (group A), i.v. methyl-prednisolone boluses + prednisone 1 mg/kgc/day 3 months for those patients with few negative prognostic factors (group B), and steroids (as above) + cyclophosphamide (2 mg/kgc/day 3 months) or the Ponticelli regime in patients with important risk factors (group C). Outcome after a median follow-up period of 24 months was: complete remission in all cases from groups A + B (with only one exception were the underlying cause was breast malignancy); in group C in 75% of the subjects a complete or partial remission (proteinuria < 1 g/day) was obtained. Only one case progressed to chronic renal failure. There were no secondary effects from corticoids or immunosuppressive therapy. CONCLUSIONS: In membranous GN treatment should be tailored to the presence and type of negative prognostic factors. Even in high-risk patients combined steroids and immunosuppressive therapy determines a favorable outcome in 75% of the cases, without severe adverse effects.

Malaria Imported by Travelers: The Israeli Experience.

Indigenous malaria has been successfully eradicated in North America, Europe, and a few other previously endemic locations. Extensive antimalarial programs, improvement of health care services, and advances in socioeconomic development have all contributed to one of the most significant achievements in public health of the 20th century.1 Nevertheless, a new malaria transmission pattern is increasingly seen in these areas nowadays. The constantly mounting movement of travelers from developed countries to the tropics and the affluent immigration to the industrialized world from countries where malaria has remained endemic are responsible for the emergence of imported malaria.2 Most physicians who studied medicine in developed countries, although familiar with the classic presentation of the disease, have rarely seen a single case of malaria during training and believe that it is an exotic illness existing elsewhere. It is important therefore to characterize the demographic and clinical features of imported malaria, which is practically the only malaria now seen in the industrialized world, and to make it more familiar to health care providers. This need is further emphasized by the emerging problem of drug-resistant malaria, which may be atypical in patients who had received inappropriate prophylaxis. In Israel malaria is almost exclusively an imported disease. It occurs in Israelis who visit or work in endemic areas and in immigrants, invariably from Ethiopia. The majority of Ethiopian immigrants arrived in two waves in 1985 and 1991 and do not represent an ongoing malaria problem.3 The features of the disease in this population were extensively reported elsewhere.3,4 In the present report we examine the characteristics of malaria imported to Israel by travelers.

Geographic information system in malaria surveillance: mosquito breeding and imported cases in Israel, 1992.

Although a significant resurgence of malaria in Israel is unlikely at present, the risk for a localized outbreak of malaria cases due to infection of local anopheline mosquitoes by imported cases does exist. A national computerized surveillance system of breeding sites of Anopheles mosquitoes and imported malaria cases was established in 1992 using a geographic information system (GIS). Distances between population centers and breeding sites were calculated, and maps associating epidemiologic and entomologic data were generated. Risk of malaria transmission was assessed with consideration of vectorial capacity and flight range of each Anopheles species. The GIS-based surveillance system ensures that if a localized outbreak does occur, it will be associated rapidly with a likely breeding site, a specific Anopheles vector, and a probable human source, so that prompt control measures can be most efficiently targeted. This cost-effective GIS-based surveillance system can be expanded and adapted for countries with indigenous malaria transmission.

The epidemiology of adult AIDS and HIV infection in Israel.

Between 1980 and 1992, 227 AIDS cases and 1,010 HIV seropositives were diagnosed in Israel, 222 AIDS cases and 965 seropositives occurring in persons aged 13 years and older. Among the AIDS cases, the predominant risk groups were male homo/bisexuals, intravenous drug abusers (IVDAs) and hemophiliacs. Among the seropositives, the predominant risk group comprised men and women originating in countries characterized by pattern II transmission; however, among nonimmigrants, male homo/bisexuals, IVDAs and hemophiliacs predominated. In recent years, there has been a gradual fall in the number of new seropositives among homosexuals and drug abusers, and the appearance of seropositive hemophiliacs has ceased. The spread of HIV infection in the indigenous heterosexual population has been negligible.

[Epidemiology of Hansen's disease in Israel].

There are currently 200 patients with Hansen's disease in Israel who are being followed by the Hansen's Disease Government Hospital and the Ministry of Health (prevalence 4.4/100,000). Most of them immigrated from countries where the disease is endemic. Dermatological findings dominated the initial clinical picture, although 5% of patients are asymptomatic contacts of known cases. Age at onset of disease was less than 20 years in 1/4 of the cases. The incidence in Israel is falling: 0.4/100,000 in 1985-89 compared to 3.6/100,000 in 1950-54. Neurologic and dermatologic findings in an immigrant of any age originating from countries where Hansen's disease is endemic, should prompt appropriate diagnostic evaluation, even years after immigration to Israel. Contacts of known cases of Hansen's disease should be aggressively screened, even if asymptomatic.

Imported malaria from Ethiopia--end of an era?

The immigration of Ethiopian Jews to Israel in the 1980s resulted in the importation of over 2,000 cases of malaria, a major challenge to clinicians and public health officials alike. In contrast, in the massive airlift from Ethiopia in May 1991 and in the sporadic immigration that followed it, malaria prevalence was extremely low, reflecting the routing of the more recent immigrants through nonendemic areas. The dramatic fall in the appearance of new imported malaria cases should not lead to complacency, however, as malaria may still appear in Ethiopians and other immigrants as well as in Israelis returning from regions of the world where the disease is still highly prevalent. A corollary of this caveat is that vigilance in finding and eliminating Anopheles breeding places in Israel must not be allowed to falter.

The 1991 measles epidemic in Israel.

INTRODUCTION AND METHODS. Prior to the institution of universal childhood vaccination against measles in Israel in 1967, large outbreaks occurred in epidemic cycles at intervals of 2-4 years. The mean annual incidence in the pre-vaccination period, 1950-66, was 470/100,000 per year. With the institution of routine measles vaccination, incidence rates fell, and since 1970 measles incidence has averaged less than one-tenth the pre-vaccination incidence rate, although epidemics occurred in 1975, 1982, 1984-85, and 1991. In this report, based upon cases of measles reported to and investigated by the Ministry of Health, we present an analysis of the 1991 measles epidemic, the measures taken to contain it, and an overview of the prospects for measles control in Israel in the future. RESULTS AND CONCLUSIONS. The 1991 measles epidemic, 1036 reported cases (incidence: 20.0/100,000), began in the south of the country among underimmunized Beduin children and spread to the Jewish population in the south and then to the rest of the country. The highest incidence was in children aged 12-23 months, followed by children less than 12 months of age and children aged 2-4 years. In the main, cases occurred in persons never immunized in the past, but in 37% of cases vaccine failure seems to have occurred. Control measures included mass vaccination of children in the south and lowering the age for routine measles vaccination nationwide to 12 months. Despite very substantial gains towards measles control in Israel, elimination of the disease is not a realistic goal, mainly because the transmission potential of the disease is too high and vaccine coverage and efficacy are not high enough. Trends in measles incidence over the last four decades allow a cautious optimism that measles containment can be achieved.

Infectious disease and mortality surveillance in Israel in peace and war.

The goals of infectious disease surveillance in war and in peace are the same: the detection of infectious diseases, outbreak identification and control, the assessment of vaccination programs, and the determination of the need for specific preventive measures. In the 1991 Gulf War, Israel's infectious disease surveillance system was utilized to follow the progress of a measles epidemic and to look for evidence of a concealed biological warfare attack. Stepped up mortality and morbidity surveillance, based on a prepared and smoothly functioning notification system, failed to uncover any suggestion that biological agents had been deployed.

Correlation of serum ibuprofen concentration with clinical signs of toxicity in three canine exposures.

The clinical signs and serum concentrations of ibuprofen are reported for 3 canine exposures. No adverse clinical signs or abnormal laboratory parameters were observed when serum ibuprofen concentrations were less than 31 micrograms/mL. Melena and 38 mg blood urea nitrogen/dL (normal 7-26 mg/dL) were present in an animal with a serum ibuprofen of 138 micrograms/mL.

The epidemiology of echinococcosis in Israel.

Shifts in population and employment patterns in Israel since 1948 have been accompanied by profound changes in the distribution of echinococcal disease. Formerly, it was most commonly imported with the mass immigration of Jews after 1948 from the Arab countries of North Africa and Asia Minor, and appeared to be relatively uncommon in Israel-born Jews and Arabs. In 1980 the disease was made notifiable, and this paper presents a review of the years 1981-1989. The prevalence pattern that prevailed after the end of mass immigration has reversed so that cases are now twice as common in Arabs as in Jews. Among the Arabs the disease appears most commonly in the north of the country, especially among the Druze, less commonly among Christians and least in Muslims. We suggest that this prevalence pattern is related largely to home slaughter of sheep, to differing attitudes to dogs, and possibly also to the hunting of wild pig. Targetted education and better enforcement of existing regulations can lead to a reduction in disease.

Malaria in Israel: the Ethiopian connection.

Over 2,000 cases of imported malaria were diagnosed in Israel in the last decade, the vast majority in immigrants from Ethiopia, making malaria a continuing public health problem of significance. In 1988, more than one- fifth of imported cases were caused by chloroquine-resistant Plasmodium falciparum. Since the Anopheles vector is still present in many areas of the country, it is necessary to detect and treat all cases quickly and effectively and to strengthen anti-malaria vector activities if local transmission is to be prevented. Despite massive and continuous importation of the disease, the Ministry of Health has had substantial success in the area of malaria control, through administration of presumptive treatment to Ethiopian immigrants, rapid diagnosis of imported cases and strict vector control.

Poliomyelitis outbreak in Israel in 1988: a report with two commentaries.

An outbreak of 15 cases of paralytic poliomyelitis caused by type 1 poliovirus between July and October, 1988, prompted mass vaccination of the whole Israeli population under the age of 40 years. The focus of the outbreak (12 cases) was the Hadera subdistrict, one of two subdistricts where enhanced inactivated poliovaccine (eIPV) had been the only poliovaccine used for infants since 1982. 9 of the 15 victims were 15 years or older, and 9 had previously been immunised with at least three doses of oral poliovaccine (OPV). The authors are divided in their interpretation of the findings. One group considered that the likely causative factors were the greater susceptibility of young adults previously vaccinated with OPV as well as transmission of wild poliovirus to susceptible people by children with low gut immunity against poliovirus after vaccination with eIPV; they concluded that a vaccination programme combining eIPV with OPV is the best option for Israel in future. The other group believed the causative factors were exposure to contaminated sewage or close social contact within the epidemic foci, the presence of an epidemic strain differing from the wild Mahoney and Sabin type 1 vaccine strains, and the lower seropositivity rates and geometric mean titres of neutralising antibodies to the epidemic than to vaccine strains; they believe that eIPV is the means to achieve effective control of poliomyelitis in Israel.

Mumps incidence in Israel--impact of MMR vaccine.

BACKGROUND: Measles-mumps-rubella (MMR) vaccine replaced measles vaccine in the routine childhood vaccination schedule in Israel in December 1988, primarily to eliminate congenital rubella syndrome. In this observational study, we report on changes in mumps incidence in Israel from the time of the introduction of MMR vaccine until the end of 1991. METHODS: The report is based upon passive surveillance of mumps incidence, which has been notifiable in Israel since 1977. RESULTS: In the three years since the introduction of MMR vaccine, reported mumps incidence has fallen to less than 10% of the pre-vaccine period. CONCLUSIONS: Although this report is based on a relatively short period of observation, it can be tentatively concluded that MMR has led to a reduction in mumps incidence in Israel. It would be imprudent, however, to predict that mumps outbreaks will not occur in the future, and further observation of morbidity data will be needed to determine the magnitude and durability of the observed trend.

Q fever in Israel.

BACKGROUND: Q fever was first described over fifty years ago. While in a proportion of cases there is a clear etiologic link to farm animals, their products, and fomites, in the majority of cases no such association is apparent, and the mode of infection is a mystery. METHODS: In this paper, we examine the reported incidence of Q fever in Israel since it was made notifiable in 1951, and in particular for the period 1981-1985, when special surveillance at national reference laboratories was carried out. RESULTS: Age and sex as well as urban-rural distributions suggest the influence of occupation, but in the large majority of cases mode of transmission was unknown. CONCLUSIONS: If our knowledge concerning the etiology of Q fever in Israel, and the means of preventing it, is to be advanced, each case should be investigated assiduously to uncover risk factors for exposure, and sero-epidemiologic studies carried out to identify geographic or occupational groups differentially infected.

Epidemiology of Haemophilus influenzae type b meningitis in Israel, 1981-90.

BACKGROUND AND METHODS: In the Western world, Haemophilus influenzae type b is an important cause of morbidity and long-term disability in children. The availability of vaccines capable of preventing H. influenzae type b disease in very young infants stimulated this longitudinal observational review of the epidemiology of H. influenzae type b meningitis in Israel, based on cases reported to the Ministry of Health in the decade 1981-90. RESULTS: In the last decade, H. influenzae type b accounted for 884 cases of meningitis, making it the main cause of bacterial meningitis in children. Almost all cases were in children under the age of 5 years, the great majority under 18 months. Age-standardized incidence rates were the same in Jews and in non-Jews, and in both sectors incidence was slightly higher in males than in females. The case fatality rate was 3.3%. CONCLUSIONS: The new Haemophilus b conjugate vaccines are reported to be safe, effective at an early age, and compatible with current vaccination schedules. Their availability means that control of invasive disease caused by this organism is within reach. Use of the vaccines in infants should be encouraged and their effect on morbidity patterns should be closely monitored.

Foodborne botulism: an international outbreak.

We report an outbreak of fishborne botulism caused by type E Clostridium botulinum. The eight cases, six in Israel and two in New York City, resulted from the consumption of ribbetz or kapchunka, a freshwater whitefish soaked in brine and air-dried, that was processed commercially in New York. Half the cases were males; the age range was 9 to 77 years. Five of the victims were hospitalized; the oldest died, and two others required ventilatory assistance. Laboratory confirmation of botulism was obtained in three cases. Prolonged lack of refrigeration during transatlantic flight and packaging contributing to an anaerobic environment were felt to be contributing environmental factors in the Israeli cases. Rapid communication and full cooperation between Israeli and US health authorities limited the extent of the outbreak. Despite adequate understanding of how foodborne botulism may be avoided, outbreaks still occur, particularly among people consuming certain high-risk or ethnic foods.