Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 30.474
Filtrar
1.
Maturitas ; 154: 1-6, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34736574

RESUMO

OBJECTIVE: Gynecologic Sarcomas are rare, aggressive tumors. The aim of this study was to explore the incidence and outcomes of gynecologic sarcomas in a large national data registry and to compare them with reports from other countries. STUDY DESIGN: Records of gynecologic sarcomas diagnosed in Israel (1980-2014) were extracted from the National Cancer Registry and classified according to International Classification of Diseases for Oncology-3 and characterized according to anatomical site, morphology and demographics. Age-standardized incidence rates and 1, 3, 5 and 10-year relative survival rates were calculated for 3 time periods (1980-1994, 1995-2001 and 2005-2014) according to patient age, stage and years of diagnosis. RESULTS: During 1980-2014, 1271 new gynecologic sarcomas were diagnosed in Israel, with incidence slightly increasing in 1980-2004, to an age-standardized incidence rate of 13 per million women. The most common histologic diagnosis was leiomyosarcoma (48%) and the most common anatomical site was the uterus (89%). The age-standardized incidence rate for uterine sarcoma is higher in Israel (10.55 per million) than in England (7.4 per million) and Germany (5.8 per million) respectively. The 5-year overall survival was significantly poorer in patients >70-years, as compared to younger patients (p<0.001) and in those with leiomyosarcoma compared to endometrial stromal sarcoma (p<0.001). The survival rate of patients with leiomyosarcoma in Israel are comparable to survival rates reported by other studies, although substantially lower regarding endometrial stromal sarcoma. CONCLUSIONS: Uterine leiomyosarcoma was the most common gynecologic sarcoma found in the Israeli, European and American registries. Older patients and those with leiomyosarcoma have the worst prognoses. Histological and anatomical variations in Israel are comparable with global statistics, but the incidence in Israel seems higher than in Europe.


Assuntos
Leiomiossarcoma/epidemiologia , Sarcoma/epidemiologia , Neoplasias Uterinas/epidemiologia , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Europa (Continente)/epidemiologia , Feminino , Humanos , Incidência , Lactente , Recém-Nascido , Israel/epidemiologia , Leiomiossarcoma/etnologia , Pessoa de Meia-Idade , Sistema de Registros , Sarcoma/etnologia , Estados Unidos/epidemiologia , Neoplasias Uterinas/etnologia , Adulto Jovem
2.
Artigo em Inglês | MEDLINE | ID: mdl-34769811

RESUMO

In early 2020, the COVID-19 pandemic revealed a faceless, non-adversarial threat that endangered Israelis and Palestinians with the same ferocity. However, the capacities of the health systems to address it were not equal, with Israel more equipped for the outbreak with infrastructure, resources, manpower and later, vaccines. The pandemic demonstrated the life-saving benefits of cooperation and the self-defeating harms brought by non-cooperation. These trends are explored here by an international team of public health and environmental scholars, including those from different sides of the Israeli-Palestinian conflict. This article explores the importance of recognizing the Israeli and Palestinian jurisdictions as a single epidemiological unit, and illustrates how doing so is a pragmatic positioning that can serve self-interest. We demonstrate how despite political shocks precipitating non-cooperation, there has been a recurrent tendency towards limited cooperation. The paper concludes with lessons over the need for reframing public health as a potential bridge, the need for structural changes creating sustainable platforms for accelerated transboundary cooperation to enable the steady management of current and future public and environmental health crises regardless of dynamic political crises, and the importance of civil society and international organizations in forging collaboration in advance of governmental engagement.


Assuntos
COVID-19 , Saúde Pública , Árabes , Vacinas contra COVID-19 , Humanos , Israel , Pandemias , SARS-CoV-2 , Vacinação
3.
Artigo em Inglês | MEDLINE | ID: mdl-34770030

RESUMO

We conducted a prospective study, aimed to study whether the prevalence of mental disorders after birth differs by country of origin. Parturient mothers of Ethiopian origin, Former-USSR (FSU) origin, or nonimmigrant, native-Israeli origin (n = 974, all Jewish) were recruited in hospitals in Israel and were followed 6-8 weeks and one year after birth. General linear models were used to study the associations between origin and mental health, comparing Ethiopian and FSU origin with native-Israeli. Ethiopian and FSU mothers were more likely to report on somatic symptoms, compared with native-Israeli women. Ethiopian origin was negatively and significantly associated with anxiety in all three interviews (ß = -1.281, ß = -0.678 and ß = -1.072, respectively; p < 0.05 in all). FSU origin was negatively associated with depression after birth (ß = -0.709, p = 0.036), and negatively associated with anxiety after birth and one-year postpartum (ß = -0.494, and ß = -0.630, respectively). Stressful life events were significantly associated with all mental disorders in the three time points of interviews. Our findings suggest that immigrants tend to express higher mental distress with somatic symptoms. Additional tools are needed for mental distress screening among immigrants.


Assuntos
Emigrantes e Imigrantes , Transtornos Mentais , Grupo com Ancestrais do Continente Africano , Feminino , Humanos , Israel/epidemiologia , Transtornos Mentais/epidemiologia , Período Pós-Parto , Estudos Prospectivos
4.
Int J Equity Health ; 20(1): 242, 2021 11 08.
Artigo em Inglês | MEDLINE | ID: mdl-34749718

RESUMO

BACKGROUND: Low socioeconomic status (SES) groups have been disproportionately affected by the COVID-19 pandemic. We aimed to examine COVID-19 vaccination rate by neighborhood SES and ethnicity in Israel, a country which has achieved high vaccination rates. METHODS: Data on vaccinations were obtained from the Israeli Ministry of Health's open COVID-19 database, for December 20, 2020 to August 31, 2021. Correlation between vaccination rate and neighborhood SES was analyzed. Difference in vaccination rate between the first and second vaccine dose was analyzed by neighborhood SES and ethnicity. FINDINGS: A clear socioeconomic gradient was demonstrated, with higher vaccination rates in the higher SES categories (first dose: r = 0.66; second dose: r = 0.74; third dose: r = 0.92). Vaccination uptake was lower in the lower SES groups and in the Arab population, with the largest difference in uptake between Jewish and Arab localities for people younger than 60, and with the gap widening between first and third doses. CONCLUSIONS: Low SES groups and the Arab ethnic minority demonstrated disparities in vaccine uptake, which were greater for the second and third, compared with the first vaccine dose. Strategies to address vaccination inequity will need to identify barriers, provide targeted information, and include trust-building in disadvantaged communities.


Assuntos
Vacinas contra COVID-19 , COVID-19 , Humanos , Israel , Judeus , Grupos Minoritários , Pandemias , SARS-CoV-2 , Fatores Socioeconômicos , Vacinação
5.
Sci Rep ; 11(1): 22120, 2021 11 11.
Artigo em Inglês | MEDLINE | ID: mdl-34764298

RESUMO

The outbreak of the Coronavirus disease 2019 (COVID-19), and the drastic measures taken to mitigate its spread through imposed social distancing, have brought forward the need to better understand the underlying factors controlling spatial distribution of human activities promoting disease transmission. Focusing on results from 17,250 epidemiological investigations performed during early stages of the pandemic outbreak in Israel, we show that the distribution of carriers of the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), which causes COVID-19, is spatially correlated with two satellite-derived surface metrics: night light intensity and landscape patchiness, the latter being a measure to the urban landscape's scale-dependent spatial heterogeneity. We find that exposure to SARS-CoV-2 carriers was significantly more likely to occur in "patchy" parts of the city, where the urban landscape is characterized by high levels of spatial heterogeneity at relatively small, tens of meters scales. We suggest that this spatial association reflects a scale-dependent constraint imposed by the city's morphology on the cumulative behavior of the people inhabiting it. The presented results shed light on the complex interrelationships between humans and the urban landscape in which they live and interact, and open new avenues for implementation of multi-satellite data in large scale modeling of phenomena centered in urban environments.


Assuntos
COVID-19/epidemiologia , Cidades/epidemiologia , Atividades Humanas , Humanos , Israel/epidemiologia , SARS-CoV-2/isolamento & purificação , Imagens de Satélites , População Urbana
6.
Isr J Health Policy Res ; 10(1): 62, 2021 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-34724976

RESUMO

BACKGROUND: The Covid-19 pandemic began in Israel on February 2020. Between February and October 2020, 2 periods of lockdown were imposed on Israeli population. OBJECTIVE: To assess the effect of the Covid-19 pandemic on visits to the emergency department (ED) and on hospitalizations in medical wards in Israel's Chaim Sheba Medical Center, and to compare the effect during the first and second lockdowns. METHODS: Data regarding the number of visits of non-Covid-19 patients to the ED and the number of admissions to the medical wards, were extracted from the computerized system of the hospital. Data were analyzed for patients' characteristics, length of stay in the medical wards, in hospital mortality and the rate of 7 and 30 days re-hospitalization, and compared to the same period during 2019. RESULTS: Total visits to the Sheba ED during March-October decreased by 18.5%. The most dramatic decrease occurred during the first lockdown. The number of patients admitted to the Sheba medical wards decreased by 28% (P < 0.05). The length of stay decreased from 3.69 days during 2019 to 3.42 days during 2020 (P < 0.01). The most pronounced decrease in the length of stay was observed during the second month of the first lockdown. During the pandemic, hospitalized patients at Sheba were older and were less likely to be males. The in-hospital absolute non-COVID mortality decreased from 913 to 858 respectively. CONCLUSIONS: The Covid-19 crisis emphasizes the role of medical wards in the care of complex patients. Medical wards in Israel were at the frontline of Israel's battle against this pandemic, while continuing to treat very complex non-Covid patients. To avoid burnout of the medical staff who treat very intensively complex patients, we believe these wards should be strengthen with specialists having expertise in treating these patients. Due to our insights, the Sheba medical Center is now redesigning the concept of how intensive care beds should be managed in a big tertiary center.


Assuntos
COVID-19 , Pandemias , Controle de Doenças Transmissíveis , Serviço Hospitalar de Emergência , Hospitalização , Hospitais , Humanos , Israel/epidemiologia , Masculino , SARS-CoV-2
7.
Euro Surveill ; 26(45)2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34763751

RESUMO

The SARS-CoV-2 Lambda (Pango lineage designation C.37) variant of interest, initially identified in Peru, has spread to additional countries. First detected in Israel in April 2021 following importations from Argentina and several European countries, the Lambda variant infected 18 individuals belonging to two main transmission chains without further spread. Micro-neutralisation assays following Comirnaty (BNT162b2 mRNA, BioNTech-Pfizer) vaccination demonstrated a significant 1.6-fold reduction in neutralising titres compared with the wild type virus, suggesting increased susceptibility of vaccinated individuals to infection.


Assuntos
COVID-19 , SARS-CoV-2 , Vacinas contra COVID-19 , Humanos , Israel/epidemiologia , Vacinação
8.
Artigo em Inglês | MEDLINE | ID: mdl-34769731

RESUMO

In the first half of 2021, Israel had been ahead of other countries concerning the speed of its rollout and coverage of COVID-19 vaccinations. During that time, Israel had implemented a vaccine certificate policy, the "Green Pass Policy" (GPP), to reduce virus spread and to allow the safe relaxation of COVID-19 restrictions in a time of great uncertainty. Based on an analysis of GPP regulations and public statements compiled from the Israeli Ministry of Health website, we describe the design and implementation of the GPP. We also look back and discuss lessons learned for countries that are considering a GPP policy, given the current upsurge of the Delta variant as of summer 2021. To reduce equity concerns when introducing a GPP, all population groups should be eligible for the vaccine (contingent on approval from the manufacturer) and have access to it. Alternatively, health authorities can grant temporary certificates based on a negative test. We also highlight the fact that in practice, there will be gaps between the GPP regulations and implementation. While some places might require a GPP without legal need, others will not implement it despite a legal obligation. The GPP regulations should have standardised epidemiological criteria, be implemented gradually, remain flexible, and change according to the epidemiological risks.


Assuntos
COVID-19 , Vacinas , Humanos , Israel , Políticas , SARS-CoV-2
9.
Isr Med Assoc J ; 23(11): 690-692, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34811982

RESUMO

BACKGROUND: Coronavirus disease-19 (COVID-19) impacted medical education and led to the significant modification or suspension of clinical clerkships and rotations. OBJECTIVES: To describe a revised surgery clerkship curriculum, in which we divided in-person clinical teaching into smaller groups of students and adopted online-based learning to foster student and patient safety while upholding program standards. METHODS: The third-year surgery core clerkship of a 4-year international English-language program at the Medical School for International Health at Ben Gurion University of the Negev, Beer Sheva, Israel, was adapted by dividing students into smaller capsules for in-person learning and incorporating online learning tools. Specifically, students were divided evenly throughout three surgical departments, each of which followed a different clinical schedule. RESULTS: National Board of Medical Examiners clerkship scores of third-year medical students who were returning to in-person clinical clerkships after transitioning from 8 weeks of online-based learning showed no significant difference from the previous 2 years. CONCLUSIONS: To manage with the restrictions caused by COVID-19 pandemic, we designed an alternative approach to a traditional surgical clerkship that minimized the risk of exposure and used online learning tools to navigate scheduling challenges. This curriculum enabled students to complete their clinical rotation objectives and outcomes while maintaining program standards. Furthermore, this approach provided a number of benefits, which medical schools should consider adopting the model into practice even in a post-pandemic setting.


Assuntos
COVID-19 , Estágio Clínico , Educação à Distância/métodos , Educação , Cirurgia Geral/educação , COVID-19/epidemiologia , COVID-19/prevenção & controle , Estágio Clínico/organização & administração , Estágio Clínico/tendências , Currículo/tendências , Transmissão de Doença Infecciosa/prevenção & controle , Educação/métodos , Educação/organização & administração , Educação/tendências , Avaliação Educacional , Humanos , Controle de Infecções/métodos , Israel/epidemiologia , Avaliação de Programas e Projetos de Saúde , SARS-CoV-2 , Estudantes de Medicina , Ensino
10.
Isr J Health Policy Res ; 10(1): 65, 2021 11 24.
Artigo em Inglês | MEDLINE | ID: mdl-34819155

RESUMO

BACKGROUND: Physical distancing contains the corona virus, but compliance with physical distancing across religious minorities in Israel has been shown to be relatively poorer than in the majority population. This study tests the power of messages as drivers of willingness to comply with physical distancing across religious minorities in Israel during the first wave of the COVID-19 from March till June 2020. METHODS: 896 Israeli Muslims, Druze, Bedouins, Jewish Orthodox, Christians, and Jewish Seculars participated in this conjoint-based experimental design. The size of the total sample and of the subgroups is consistent with the suggested size in conjoint analysis studies, particularly when aiming at stability of coefficients rather than stability of means. The dependent variable was 'willingness to comply'. Independent variables were known contributors to compliance: perceived risk, practices of physical distancing, ways to assure compliance, and the agent communicating the policy. RESULTS: A regression analysis indicated minor differences in the power of messages across groups despite dramatic cultural differences amongst them. We identified three distinct mindsets that transcend religious cultures from the responses of the study subjects to various messages and named them "pandemic observers," "obedient followers," and "sensitive interpreters." Compliance of "Pandemic Observers" (n = 306) may be improved by messages such as, "Dangerous virus spreading wildly" and "Health experts suggest what to do but the government is reactive rather than proactive" (ß = 14, p < .005). Compliance of "Obedient Followers" (n = 242) may be driven by the messages "Socialize and work only from home, using the internet, e.g. zoom/Skype" and "Everyone should stay 2 m. (6 ft.) apart" (ß = 16, p < .0050). Compliance of "Sensitive Interpreters" (n = 249) may be improved by messages such as, "Only people who are 60 and over are to be allowed to buy groceries during first 2 h from opening" and by using the media to publicize the official health policy (ß = 8; p < .005). CONCLUSIONS: Mindset-assignment reflects how people think rather than their religious affiliation. A personal viewpoint identifier was developed to predict mindset-assignment and enable health authorities to enhance compliance through mindset-tailored messages for members of each mindset segment. We recommend that health authorities and policy makers consider these different personality types, which range across religious minorities and emphasize the messages that each type responds to in developing and implementing a communication plan to improve physical distancing as an important public health measure.


Assuntos
COVID-19 , Distanciamento Físico , Humanos , Israel , Pandemias , SARS-CoV-2
11.
BMC Med Educ ; 21(1): 581, 2021 Nov 16.
Artigo em Inglês | MEDLINE | ID: mdl-34789223

RESUMO

BACKGROUND: This study aimed to explore the attitudes of registered physiotherapists (PTs) in Israel toward people identifying as lesbian, gay, or bisexual (LGB) and to identify background characteristics associated with their attitudes toward LGB individuals. METHODS: This nationwide study in Israel employed an observational design. Participants completed an anonymous online questionnaire which included demographic characteristics (e.g., age, sex, gender, sexual orientation, religious affiliation, and religiousness) and questions regarding sources of knowledge about LGB individuals, and type of acquaintance with an LGB individual. In addition to two self-assessment questions regarding levels of homophobia (active engagement against LGB individuals) and heterosexism (holding negative opinions regarding LGB individuals) answered on a five point Likert scale (1 - not at all homophobic/ heterosexist, 5- very homophobic/ heterosexist) and the Hebrew version of the Attitudes Toward Homosexuality Scale (ATHS). Participants were recruited through professional organizations, social media, and word of mouth. RESULTS: The data of 383 registered PTs practicing in Israel were analyzed. The median score regarding level of homophobia and heterosexism was one ("not at all"). ATHS scores ranged between 32 and 110 (out of 110), with a median score of 106 and 41% scoring below the median. Multivariant logistic regression indicated that identifying as men, heterosexual orientation, and religiousness were significantly associated with less positive attitudes toward LGB individuals. Only 2% of the participants reported having been introduced to issues regarding the LGB community during their professional physiotherapy education. CONCLUSIONS: Registered PTs in Israel demonstrated favorable attitudes toward LGB individuals, as reflected both by ATHS scores and levels of self-reported homophobia and heterosexism. Based on the current results regarding sources of knowledge, updating the physiotherapy curriculum to include information regarding sexual orientation and health of the LGB community is suggested.


Assuntos
Fisioterapeutas , Minorias Sexuais e de Gênero , Atitude , Bissexualidade , Estudos Transversais , Feminino , Humanos , Israel , Masculino , Comportamento Sexual
12.
Prehosp Disaster Med ; 36(6): 713-718, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34743777

RESUMO

INTRODUCTION: Securing the airway is a crucial stage of trauma care. Cricothyroidotomy (CRIC) is often addressed as a salvage procedure in complicated cases or following a failed endotracheal intubation (ETI). Nevertheless, it is a very important skill in prehospital settings, such as on the battlefield. HYPOTHESIS/PROBLEM: This study aimed to review the Israel Defense Forces (IDF) experience with CRIC over the past two decades. METHODS: The IDF Trauma Registry (IDF-TR) holds data on all trauma casualties (civilian and military) cared for by military medical teams since 1997. Data of all casualties treated by IDF from 1998 through 2018 were extracted and analyzed to identify all patients who underwent CRIC procedures.Variables describing the incident scenario, patient's characteristics, injury pattern, treatment, and outcome were extracted. The success rate of the procedure was described, and selected variables were further analyzed and compared using the Fisher's-exact test to identify their effect on the success and failure rates. Odds Ratio (OR) was further calculated for the effect of different body part involvement on success and for the mortality after failed ETI. RESULTS: One hundred fifty-three casualties on which a CRIC attempt was made were identified from the IDF-TR records. The overall success rate of CRIC was reported at 88%. In patients who underwent one or two attempts, the success rate was 86%. No difference was found across providers (physician versus paramedic). The CRIC success rates for casualties with and without head trauma were 80% and 92%, respectively (P = .06). Overall mortality was 33%. CONCLUSIONS: This study shows that CRIC is of merit in airway management as it has shown to have consistently high success rates throughout different levels of training, injuries, and previous attempts with ETI. Care providers should be encouraged to retain and develop this skill as part of their tool box.


Assuntos
Serviços Médicos de Emergência , Auxiliares de Emergência , Militares , Humanos , Intubação Intratraqueal , Israel
13.
Harefuah ; 160(11): 724-726, 2021 Nov.
Artigo em Hebraico | MEDLINE | ID: mdl-34817137

RESUMO

INTRODUCTION: Klebsiella pneumoniae is facultative anaerobic bacilli gram-negative bacteria. Klebsiella pneumoniae often causes urinary tract infections and sometimes causes community acquired pneumonia. During the past two decades, a distinct syndrome of Klebsiella pneumoniae with a pyogenic liver abscess was noted. The incidence is higher among patients with diabetes mellitus, and can cause serious complications, including bacteremia, meningitis, endophthalmitis and necrotizing fasciitis. The first cases were reported from Taiwan, but later, more cases emerged in other Asian countries. During recent years the incidence of Klebsiella pneumoniae liver abscess has increased globally, with cases also reported in Australia, New Zealand, West Europe and the United States. To the best of our knowledge, these are the first 2 cases described in Israel.


Assuntos
Infecções por Klebsiella , Abscesso Hepático , Pneumonia , Humanos , Israel/epidemiologia , Klebsiella , Infecções por Klebsiella/diagnóstico , Infecções por Klebsiella/epidemiologia , Klebsiella pneumoniae , Abscesso Hepático/diagnóstico , Abscesso Hepático/epidemiologia
14.
Harefuah ; 160(11): 732-739, 2021 Nov.
Artigo em Hebraico | MEDLINE | ID: mdl-34817140

RESUMO

INTRODUCTION: Childhood and adolescent obesity are significant global public health concerns. In recent decades, the Israel Medical Corps, in collaboration with other health organizations, initiated studies regarding the obesity epidemic in Israel, characterized specific groups that are at-risk for obesity and analyzed the short- and the long- term risks for associated medical conditions among those with obesity. According to these data, adolescent obesity and severe obesity prevalence have increased by 4- and 20-fold in the last decades in Israel, respectively. Low socioeconomic status, low level of education and low cognitive function were associated with a higher risk for obesity. Adolescents with obesity are at greater risk than those with normal weight for hyperhidrosis, asthma, different orthopedic abnormalities, hypertension and type 2 diabetes. A longitudinal study that followed the adolescents for 11 years has demonstrated a significant risk for adolescents with obesity for type 2 diabetes with hazard ratios (HRs) of 13 to 45, depending on sex and obesity degree. Longitudinal studies reported hazard ratios of 7 for end-stage chronic kidney disease, 1.3 for cancer, 3 for ischemic stroke and 7 for coronary heart disease in adulthood for adolescents with obesity compared to those with normal weight. Adolescents with overweight and obesity had greater risk for all-cause mortality in adulthood. Given the alarming increase in the prevalence of obesity and the significant short- and long- term consequences of adolescent obesity, the burden of the economic and clinical services on the healthcare system is expected to rise.


Assuntos
Diabetes Mellitus Tipo 2 , Obesidade Pediátrica , Adolescente , Adulto , Índice de Massa Corporal , Criança , Humanos , Israel/epidemiologia , Estudos Longitudinais , Sobrepeso , Obesidade Pediátrica/epidemiologia
15.
Sci Rep ; 11(1): 21002, 2021 10 25.
Artigo em Inglês | MEDLINE | ID: mdl-34697335

RESUMO

COVID19 infection was associated with possible psychiatric manifestations, including psychosis and mania. In addition, psychiatric disorders might be triggered by severe psychological reactions to the pandemic or the measures taken to contain it. This study aimed to assess the trends of new-onset psychosis/mania during the pandemic timeline. Psychiatric emergency department records during January-July 2019 and 2020 of two regional mental health centers were manually examined. Cases of new-onset psychosis or mania were found in 326 out of 5161 records examined. The ratio of these cases increased by 45.5% in 2020 compared to 2019 (189 out of 2367, 137 out of 2479, respectively, p = 0.001). The peak increase was in April 2020 (9.4% vs. 4.7%, p = 0.015). There was no association between the rise of new-onset psychotic or manic episodes and national incidence of COVID19 cases, as observed during Israel 2nd wave. PCR tests were negative, except a single case. In this study, an increase in new-onset psychosis/mania was identified during the initial phase of the pandemic. Though causality could not be directly inferred, lack of infection symptoms, negative PCR testing and temporal distribution incongruent with COVID19 caseload did not support a direct effect of SARS-CoV-2. Alternative explanations are discussed, such as psychological reaction to stress and preventive measures, as well as case-shifting between different mental health settings.


Assuntos
Transtorno Bipolar/epidemiologia , COVID-19/epidemiologia , Serviço Hospitalar de Emergência/estatística & dados numéricos , Hospitais Psiquiátricos/estatística & dados numéricos , Transtornos Psicóticos/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Transtorno Bipolar/psicologia , Teste de Ácido Nucleico para COVID-19 , Registros Eletrônicos de Saúde , Serviço Hospitalar de Emergência/tendências , Feminino , Hospitais Psiquiátricos/tendências , Humanos , Israel/epidemiologia , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Pandemias , Transtornos Psicóticos/psicologia , Estresse Psicológico , Adulto Jovem
16.
Isr J Health Policy Res ; 10(1): 61, 2021 10 29.
Artigo em Inglês | MEDLINE | ID: mdl-34715931

RESUMO

As of the beginning of March 2021, Israeli law requires the presentation of a Green Pass as a precondition for entering certain businesses and public spheres. Entitlement for a Green Pass is granted to Israelis who have been vaccinated with two doses of COVID-19 vaccine, who have recovered from COVID-19, or who are participating in a clinical trial for vaccine development in Israel. The Green Pass is essential for retaining immune individuals' freedom of movement and for promoting the public interest in reopening the economic, educational, and cultural spheres of activity. Nonetheless, and as the Green Pass imposes restrictions on the movement of individuals who had not been vaccinated or who had not recovered, it is not consonant with solidarity and trust building. Implementing the Green Pass provision while advancing its effectiveness on the one hand, and safeguarding equality, proportionality, and fairness on the other hand may imbue this measure with ethical legitimacy despite involving a potential breach of trust and solidarity.


Assuntos
COVID-19 , Vacinas contra COVID-19 , Humanos , Israel , SARS-CoV-2
17.
Plant Sci ; 312: 111048, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34620445

RESUMO

Commercial avocado orchards typically consist of composite trees. Avocado is salt-sensitive, suffering from substantial growth and production depreciation when exposed to high sodium and chloride levels. Salt ions penetrate the roots and are subsequently transferred to the foliage. Hence, understanding distinct physiological responses of grafted avocado plant organs to salinity is of great interest. We compared the ion, metabolite and lipid profiles of leaves, roots and trunk drillings of mature 'Hass' scion grafted onto two different rootstocks during gradual exposure to salinity. We found that one rootstock, VC840, did not restrict the transport of irrigation solution components to the scion, leading to salt accumulation in the trunk and leaves. The other rootstock, VC152, functioned selectively, moderating the movement of toxic ions to the scion organs by accumulating them in the roots. The leaves of the scion grafted on the selective rootstock acquired the standard level of essential minerals without being exposed to excessive salt concentrations. However, this came with an energetic cost as the leaves transferred carbohydrates and storage lipids downward to the rootstock organs, which became a strong sink. We conclude that mutual scion-rootstock relationships enable marked tolerance to salt stress through selective ion transport and metabolic modifications.


Assuntos
Persea/crescimento & desenvolvimento , Persea/genética , Folhas de Planta/crescimento & desenvolvimento , Raízes de Plantas/crescimento & desenvolvimento , Caules de Planta/crescimento & desenvolvimento , Salinidade , Tolerância ao Sal/genética , Tolerância ao Sal/fisiologia , Produtos Agrícolas/crescimento & desenvolvimento , Variação Genética , Genótipo , Israel , Lipidômica , Metaboloma , Raízes de Plantas/genética , Caules de Planta/genética
18.
Eur J Gen Pract ; 27(1): 294-302, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34633891

RESUMO

BACKGROUND: Frequent Attenders with Medically Unexplained Symptoms (FA/MUS) are common in primary care, though challenging to identify and treat. OBJECTIVES: This study sought to compare FA/MUS to FA with organic illnesses (FA/OI) and the general clinic population (Non-FA) to understand their demographic characteristics and healthcare utilisation patterns. METHODS: For this retrospective, observational study, Electronic Medical Records (EMR) were obtained from Clalit Health Services, regarding the population of a sizeable primary care clinic in Be'er-Sheva, Israel. Electronic medical records were screened to identify the top 5% of FA. FA were stratified based on whether they had OI. FA without OI were then corroborated as having MUS by their physicians. Demographics, healthcare utilisation and costs were analysed for FA/OI, FA/MUS and Non-FA. RESULTS: Out of 594 FA, 305 (53.6%) were FA/OI and 264 (46.4%) were FA/MUS. FA/OI were older (69.1 vs. 56.4 years, p<.001) and costlier (ILS27693 vs. ILS9075, p<.001) than FA/MUS. Average costs for FA/MUS were over four times higher than Non-FA (ILS9075 vs. ILS2035, p<.001). The largest disparities between FA/OI and FA/MUS were in hospitalisations (ILS6998 vs. ILS2033) and surgical procedures (ILS8143 vs. ILS3175). Regarding laboratory tests, differences were smaller between groups of FA but significantly different between FA and Non-FA. CONCLUSION: FA/MUS are more costly than Non-FA and exhibit unique healthcare utilisation and costs patterns. FA/OI had more severe illnesses necessitating hospitalisations and surgical interventions, while FA/MUS had more investigations and tests, attempting to find an explanation for their symptoms.


Assuntos
Sintomas Inexplicáveis , Efeitos Psicossociais da Doença , Humanos , Israel , Atenção Primária à Saúde , Estudos Retrospectivos
19.
Isr Med Assoc J ; 23(10): 611-614, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34672439

RESUMO

BACKGROUND: Israel has experienced three waves of coronavirus disease-2019 (COVID-19) infection since late February 2020, with lockdown and other measures employed to contain infection rates. In cooperation with the Israel Ministry of Health, serological testing was conducted by all four health maintenance organizations (HMO) in order to estimate national infection rates and the proportion of previously undetected disease. OBJECTIVES: To estimate the proportion of the population that was seropositive, identify factors associated with seropositive outcome, and approximate the proportion of residents that were asymptomatic. METHODS: Seroconversion rates (IgG) were measured in a representative sample of over 17,000 members of Maccabi Healthcare Services. Direct standardization was used to estimate the seropositive rates for COVID-19 infection for members of the HMO. Rates were adjusted for sensitivity and specificity of the testing products used. In addition to blood sampling, respondents were asked to complete a digital survey regarding potential exposures and symptoms experienced. RESULTS: It was estimated that 1.9% of the adult HMO population was seropositive 4 months after the first infected person was identified in the country. Seroconversion was associated with travel abroad and exposure to infected individuals. Loss of smell and taste, fever, cough, and fatigue are associated with infection. Of those found to be seropositive for COVID-19, 160 (59%) had a prior negative polymerase chain reaction (PCR) or no PCR test at all. CONCLUSIONS: Adult seropositive rates of infection were low relative to other countries. The findings suggest that early initiatives to limit infection entry and spread were effective.


Assuntos
Teste Sorológico para COVID-19 , COVID-19 , Controle de Doenças Transmissíveis , Avaliação de Sintomas , Adulto , Infecções Assintomáticas/epidemiologia , COVID-19/diagnóstico , COVID-19/epidemiologia , COVID-19/imunologia , COVID-19/prevenção & controle , Teste Sorológico para COVID-19/métodos , Teste Sorológico para COVID-19/normas , Teste Sorológico para COVID-19/estatística & dados numéricos , Controle de Doenças Transmissíveis/métodos , Controle de Doenças Transmissíveis/estatística & dados numéricos , Doenças Transmissíveis Importadas/epidemiologia , Transmissão de Doença Infecciosa/prevenção & controle , Transmissão de Doença Infecciosa/estatística & dados numéricos , Feminino , Humanos , Israel/epidemiologia , Masculino , Pessoa de Meia-Idade , Sensibilidade e Especificidade , Soroconversão , Estudos Soroepidemiológicos , Avaliação de Sintomas/métodos , Avaliação de Sintomas/estatística & dados numéricos
20.
Medicine (Baltimore) ; 100(37): e26966, 2021 Sep 17.
Artigo em Inglês | MEDLINE | ID: mdl-34664827

RESUMO

ABSTRACT: The association between stopping statins and 1-year mortality in the general population of the oldest-old - with or without ischemic heart disease (IHD) - has been studied herein for the first time.This was a retrospective study. Included were all consecutive patients (n = 369) aged 80 years or more (mean age 87.8 years) hospitalized in a single Geriatrics department during 1 year. The study group included 140 patients in whom statins were stopped upon admission (statin stoppers). The control group included 229 patients who did not use statins in the first place (statin non-users). All-cause 1-year mortality rates were studied in both groups following propensity score matching and in IHD patients separately.Overall, 110 (29.8%) patients died during the year following admission: 38 (27.1%) statin stoppers and 72 (31.4%) statin non-users (P = .498). Cox regression analysis showed no association between stopping statins and 1-year mortality in the crude analysis (hazard ratio [HR] 0.976, 95% confidence interval [CI] 0.651-1.463, P = .907) and following propensity score matching (HR 1.067, 95%CI 0.674-1.689, P = .782). Among 108 IHD patients, 38 (35.2%) patients died during the year following admission: 18 (27.7%) statin stoppers and 20 (46.5%) statin non-users (P = .059). Cox regression analysis showed a nearly significant association between stopping statins (rather than not using statins) in IHD patients and lower 1-year mortality (HR 0.524, 95%CI 0.259-1.060, P = .072).Hence, stopping statins in the general population of the oldest-old - with or without IHD - is possibly safe. Future studies including the oldest-old statin continuers are warranted to confirm this observation.


Assuntos
Inibidores de Hidroximetilglutaril-CoA Redutases/efeitos adversos , Inibidores de Hidroximetilglutaril-CoA Redutases/farmacologia , Mortalidade/tendências , Isquemia Miocárdica/tratamento farmacológico , Idoso de 80 Anos ou mais , Distribuição de Qui-Quadrado , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Israel , Masculino , Modelos de Riscos Proporcionais , Estudos Retrospectivos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...