Tuberculosis outbreak in a nursing home involving undocumented migrants and Israeli citizens.

ABSTRACK: OBJECTIVES: Israel has absorbed > 60,000 migrant from the horn of Africa (MHOA) since 2006. No cross-transmission of Mycobacterium tuberculosis from MOHA to Israeli citizens has yet been reported. This study describes the results of contact investigation and laboratory work-out of a unique mixed cluster which included both MOHA and Israeli citizens. METHODS: Description of the results of epidemiological investigation including laboratory confirmation. RESULTS: This unique Mycobacterium tuberculosis strain included 29 patients: 26 were MOHA and three citizens who immigrated to Israel from the former Soviet Union. This is the first mixed cluster described in Israel, which has not been represented in the SITVIT international database of genotyping markers. The transmission from non-citizens to citizens occurred in a nursing institution, when MOHA infected three other contacts- two of whom were retarded residents, one of them died. The index case was screened before employment, and was permitted to return to wok although his chest X-ray demonstrated radiological findings compatible with tuberculosis. Epidemiological links were found in other 12 MOHA members of the cluster. CONCLUSION: This report describes cross-transmission of Mycobacterium tuberculosis from non-citizens MOHA to Israeli citizens who were residents of a nursing home, which may be the first sign for an epidemiological shift. Although cross-ethnical transmission is still rare in Israel, medical settings should employ efficient infection control measures to protect both patients and staff from Mycobacterium tuberculosis.

Ongoing African measles virus genotype outbreak in Tel Aviv district since April, Israel, 2012.

A measles outbreak is affecting the Tel Aviv district, Israel, since April 2012. As of 10 September, 99 cases were confirmed, including 63 (64%) migrants of Eritrean and Sudanese origin. All genotyped cases had the African B3 genotype*. The mean age of migrant and non-migrant cases was 6.0±9.6 and 30.2±24.2 years, respectively (p<0.001). The majority of both migrant and non-migrant cases was unvaccinated. This is the second African measles B3 genotype outbreak within the World Health Organization European region in 2012.

Testicular mass as a presenting symptom of isolated polyarteritis nodosa.

Isolated polyarteritis nodosa (PAN) of the male testes has rarely been reported. The authors describe two young men with testicular mass as a presenting symptom of isolated PAN, which was diagnosed following orchiectomy. The clinical features of the reported cases are reviewed.

Long-term follow-up of patients after pyeloplasty for ureteropelvic junction obstruction.

Between the years 1976 and 1986, 94 patients ranging in age from 2 weeks to 60 years were referred for treatment of ureteropelvic junction obstruction. A dismembered pyeloplasty was performed in 85 patients, ureterocalycostomy in 4 patients and primary nephrectomy in 5 patients. Apart from aberrant vessels found in 14 patients and associated calculi in 12, clinical results were satisfactory in most of the patients (96.2%). The calyceal appearance on the postoperative excretory urogram showed diminution with good drainage in 53.8%, improvement of drainage in 42.3%, and deterioration in 3.8%.

Phenol sclerotherapy for hydrocele: a study in 55 patients.

Sclerotherapy with 2.5% phenol solution was used to treat 63 hydroceles in 55 patients with a mean age of 69 years. In 51.6% of the patients (32 hydroceles) 1 treatment was sufficient, while 2 treatments were necessary in 25.8% (16 hydroceles), 3 in 13% (8 hydroceles) and 4 in 8% (5 hydroceles). One patient required 7 injections. Treatment was unsuccessful in 1 patient in whom a local allergic reaction developed. Only 1 patient complained of pain, and other complications were rare and mild. On the basis of this experience we concluded that sclerotherapy with phenol 2.5% is a painless, highly effective, safe and economical procedure that permits one to avoid an operation, anesthesia and hospitalization. Its use is warranted in adults and particularly in the elderly.

Andrological parameters in human semen of high (greater than or equal to 6 ml) and low (less than or equal to 1 ml) volume.

A study was carried out to evaluate 792 semen of high (greater than or equal to 6 ml) and low (less than or equal to 1 ml) volume and sperm counts ranging from 0.1 to 200 x 10(6) per ml. Particularly emphasized were: motility percentage and grade, percentage viability, morphologically normal sperm and immature cells, and the concentration of fructose in semen (mg/ml). The Duncan multiple range test and the Kruskal-Wallis test with multiple comparison of ranks were used in the statistical analyses. The results show that abnormal semen volume influence neither the basic tendency of andrological parameters to change in accordance with sperm counts of semen nor to correlate with each other. The quality of motility was significantly higher in specimens of high semen volume as compared to those of low semen volume. The concentration of fructose in semen was generally higher in specimens of high volumes than in those of low volumes, including semen devoid of sperm. It was assumed that in general increased semen volume does not affect the quality of other andrological parameters, thus being probably unrelated with fertility potential. The considerably lower values of both motility and viability characterizing the semen of low volume would suggest a lower fertility potential of specimens affected by this type of abnormality.

Renal and bladder function recovery after prostatectomy in patients with a chronic residual urine of above 1,000 ml.

Among 750 patients who underwent surgery because of benign prostatic hyperplasia, 26 (3.5%) were found, before surgery, to have a huge residual urine of over 1,000 ml without classic prostatic symptoms. Dilatation of the upper urinary tract was found in 22 (84.6%) of these 26 patients. After surgery, almost two thirds of the patients remained with the anatomical damage (dilatation) of the upper tract. Before surgery all the patients had elevated serum creatinine. After release of the obstruction 50% of the patients were left with irreversible renal damage (as determined by serum creatinine). Although anatomical changes of the urinary bladder remained in all the patients, a satisfactory clinical recovery with a fairly good detrusor contraction and almost no residual urine was found after surgical removal of the obstruction. Awareness of the entity described here followed by early treatment can prevent progressive renal failure and detrusor decompensation.

Percutaneous drainage of a giant pyelocaliceal diverticular abscess in pregnancy.

A large renal pyelocaliceal diverticular abscess during pregnancy has been successfully managed by a percutaneous approach. After a normal vaginal delivery, an excision of the diverticulum was done with an uneventful postoperative course.

Combined hormone-chemotherapy for metastatic prostatic carcinoma. Eleven-year follow-up.

Thirty-six patients with histology-proved Stage D2 carcinoma of the prostate were treated with a combination of bilateral orchiectomy, diethylstilbestrol 3 mg/day, and chemotherapy (5-fluorouracil and cyclophosphamide) soon after diagnosis was established. The combined therapy was well tolerated by the patients, and complications were not severe and of a transient nature. The majority of patients showed a subjective and objective improvement: 75 per cent of patients had relief of bone pain, and 80 per cent reported relief in urinary symptoms. There was regression or stabilization of the primary tumor in 82.2 per cent. Disappearance or stabilization of osteoclastic lesions on bone scans was noted in 55.5 per cent of patients. The cumulative survival rate at eleven years is 55.5 per cent.

Pharmacologic, nonhormonal treatment of impotence. Evaluation of associated factors.

A group of impotent patients previously treated with Strychiomel was evaluated. Strychiomel is a compound of three drugs, yohimbine, thioridazine (Mellaril), and strychnine sulfate, each of which has a specific effect. The results suggest that the compound drug may be beneficial in the majority of patients (66.7%) when impotence occurs without hormonal or severe vascular or psychologic problems. Other factors such as age or presence of other simultaneous diseases do not appear to be significant when treatment with this multiaction drug (Strychiomel) is utilized.

Mixed carcinoma of the prostate with penile metastases and priapism.

A case report of mixed prostatic carcinoma metastasizing to the penis is presented. A review of the literature revealed only 55 cases of prostatic carcinoma metastasizing to the penis report to date. To the best of our knowledge, no such unusual case has been reported before.

Hyaluronidase activity in split human semen.

Hyaluronidase is an acrosomal enzyme which participates in the dissolution of the cumulus oophorus matrix, containing hyaluronic acid, and is essential for the fertilization process. In this study hyaluronidase activity was determined in two fractions of split normozoospermic and oligozoospermic human semen. The method consisted of measurements of areas of digestion of hyaluronic acid in agar (Petri dishes) as compared to activity obtained by commercial testicular hyaluronidase. It was found that the first splits of semen, which are generally characterized by higher sperm density and better quality of sperm, exhibit higher enzyme activity (136.0 +/- 11.6-207.0 +/- 15.1 micrograms/mL) as compared to the second splits (117.8 +/- 10-134.0 +/- 12.9 micrograms/mL).

Early stages of the pathogenesis of rat ventral prostate hyperplasia induced by citral.

Typical lesions of benign prostatic hyperplasia (BPH) were induced experimentally in the ventral prostate of adolescent (6 week old) male rats by citral, a nonsteroidal compound. Incipient BPH changes were already observed in the acinar glands 10 days after citral administration. A longer period of treatment (1 month) significantly enhanced epithelial hyperplasia, whereas the stromal elements were less reactive. Characteristic BPH lesions involving both prostatic compartments were found after 3 months of treatment. Castration prior to citral administration prevented such BPH changes; however, citral did not prevent the involutive lesions of castration. The mechanism of action of citral is yet unknown, various possibilities concerning the induction of BPH in rats are presented and discussed. The potential advantage of this model, especially as BPH is not necessarily linked to age or exogenous hormones, may offer new alternative pathways for understanding the complexity of BPH pathogenesis in animals and perhaps even in man.

Familial occurrence of undescended testes.

We had the opportunity of treating a family with 6 siblings, 2 of them twins, all sons of the same father and mother, 5 of whom had undescended testes. We hereby report on this rare occurrence of familial undescended testes. Only 1 similar case was previously reported in the English literature. The literature is reviewed, and possible etiologic factors are mentioned.