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1.
Psychiatry Res ; 338: 115996, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38823164

RESUMO

The terrorist attack of October 7, 2023, and its accompanying war have increased the risk for posttraumatic stress symptoms (PTSS) and suicide ideation (SI). In this national prospective cohort study, we examined the extent to which a sense of loneliness moderates the association between PTSS and SI in the wake of the October 7th attack and the Israel-Hamas war. A representative sample of 710 Israeli adults (362 female, 51.1 %) aged 18-85 (M = 41.01, SD = 13.72) participated in a longitudinal study assessing depression, current SI, and loneliness at two time points: T1, one month before the attack (August 2023) and T2 (November 2023), one month after the attack. We found two significant interactions in which a sense of loneliness at T2 moderated the link between both PTSS at T1 and T2 and current SI at T2. Specifically, the level of PTSS contributed to current SI at T2 more strongly among individuals reporting higher loneliness levels than those reporting low loneliness levels. Clinicians treating individuals coping with high PTSS levels should attend to their patients' sense of loneliness, as it comprises a significant risk factor for current SI and may be considered an important target in treatment.


Assuntos
Solidão , Transtornos de Estresse Pós-Traumáticos , Ideação Suicida , Terrorismo , Humanos , Solidão/psicologia , Feminino , Adulto , Masculino , Pessoa de Meia-Idade , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Idoso , Adolescente , Israel/epidemiologia , Adulto Jovem , Idoso de 80 Anos ou mais , Estudos Prospectivos , Terrorismo/psicologia , Estudos Longitudinais , Fatores de Risco , Guerra , Depressão/psicologia , Depressão/epidemiologia
2.
JMIR Aging ; 7: e53141, 2024 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-38825851

RESUMO

Background: During COVID-19 lockdowns, older adults' engagement in daily activities was severely affected, causing negative physical and mental health implications. Technology flourished as a means of performing daily activities in this complex situation; however, older adults often struggled to effectively use these opportunities. Despite the important role of older adults' social environments-including their families and health professionals-in influencing their technology use, research into their unique perspectives is lacking. Objective: This study aimed to explore the daily activity performance, health, and technology use experiences of healthy independent Israeli adults (aged ≥65 years) during COVID-19 from a 3-dimensional perspective: older adults, older adults' family members, and health professionals. Methods: Nine online focus groups, averaging 6-7 participants per group, were conducted with older adults, family members, and health professionals (N=59). Data were analyzed using thematic analysis and constant comparative methods. Results: The intertwining of daily activity performance and health emerged as a central theme, with differences between the groups. Older adults prioritized their self-fulfilling routines based on motivation and choice, especially in social-familial activities. In contrast, family members and health professionals focused on serious physical and mental health COVID-19-related consequences. A consensus among all three groups revealed the meaningful role of technology use during this period in bridging functional limitations. Participants delved into technology's transformative power, focusing on the need for technology to get engaged in daily activities. Conclusions: This study illustrates the profound interplay between daily activity performances, physical and mental health, and technology use, using a 3-dimensional approach. Its focus on technology's uses and benefits sheds light on what older adults need to increase their technology use. Interventions for improving digital activity performance can be tailored to meet older adults' needs and preferences by focusing on motivational and preference-related activities.


Assuntos
Atividades Cotidianas , COVID-19 , Grupos Focais , Humanos , COVID-19/psicologia , COVID-19/epidemiologia , Idoso , Masculino , Feminino , Atividades Cotidianas/psicologia , Israel/epidemiologia , Idoso de 80 Anos ou mais , Família/psicologia , Pessoal de Saúde/psicologia , Saúde Mental , Nível de Saúde
3.
BMC Public Health ; 24(1): 1498, 2024 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-38835005

RESUMO

BACKGROUND: In the context of persistent wars and conflicts worldwide, the impact of acute, excessive and constant exposure to media coverage of such events on mental health outcomes becomes a serious problem for public health, and requires therefore urgent investigation to inform an effective prevention and management response. The objective of the present study was to test the hypothesis that war-related media exposure is directly and indirectly associated with insomnia through depression and perceived stress among adults from the general population of different Arab countries. METHODS: A cross-sectional study was carried-out two weeks after the beginning of Israel-Gaza war on the 7th of October 2023. An anonymous online survey and a snowball sampling method were adopted to collect data. A sample of 2635 general population adults (mean age of 23.98 ± 7.55 years, 73.1% females) took part of this study. RESULTS: The results of the mediation analysis showed that, after adjusting over potential confounders, depression and perceived stress fully mediated the association between war media exposure and insomnia; higher war media exposure was significantly associated with higher depression (Beta = 0.13; p < .001) and perceived stress (Beta = 0.07; p < .001), whereas higher depression (Beta = 0.43; p < .001) and perceived stress (Beta = 0.31; p < .001) were significantly associated with higher insomnia. It is of note that war media exposure was not significantly and directly associated with insomnia (Beta = - 0.01; p = .178 and Beta = 0.02; p = .098 respectively). CONCLUSION: The present study is the first to provide evidence that more time spent viewing the horrors of war is significantly associated with insomnia. In addition, symptoms of stress and depression were present as early as two weeks following the beginning of the war, and played a significant role in mediating the association between war media coverage and insomnia. These findings suggest that timely screening for, and management of depression and stress symptoms in clinical and preventive programs might be beneficial for community adults who have been heavily and indirectly exposed to war through media, and present with insomnia.


Assuntos
Depressão , Distúrbios do Início e da Manutenção do Sono , Estresse Psicológico , Humanos , Feminino , Masculino , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Distúrbios do Início e da Manutenção do Sono/psicologia , Estudos Transversais , Adulto , Israel/epidemiologia , Depressão/epidemiologia , Estresse Psicológico/epidemiologia , Adulto Jovem , Oriente Médio/epidemiologia , Meios de Comunicação de Massa/estatística & dados numéricos , Adolescente , Inquéritos e Questionários , Pessoa de Meia-Idade , Guerra
4.
Isr J Health Policy Res ; 13(1): 28, 2024 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-38835087

RESUMO

BACKGROUND: Age-related macular degeneration (AMD) affects quality of life and independence, and its incidence and prevalence are increasing due to ageing of the population. Access to effective timely treatment can improve vision and reduce incidence of blindness. This study aimed to explore the perspectives of ophthalmologists in the Israeli public healthcare system regarding timely treatment of AMD patients. METHODS: Qualitative semi-structured interviews were conducted in 2020-2021 with 22 senior ophthalmologists, from 10 general hospitals and from two HMOs, representing different geographic regions. All interviewees specialize in retinal diseases and work with AMD patients. Interviews discussed patient pathways involved in the diagnosis and treatment of AMD, access to care, and obstacles to timely care. Thematic analysis was conducted. RESULTS: Based on the interviews, we describe the usual referral and treatment pathways. Themes included regional disparities, long wait times in some areas, a lack of retina specialists, differences in referral pathways, inappropriate use of emergency department to obtain timely treatment, and second-line treatment not fully covered by insurance, most affecting the weakest segments of the population. CONCLUSIONS: Loss of vision incurs high health and societal costs. In the context of insufficient medical manpower in Israel, the healthcare system will need to assess future resources to cope with accumulating burden of AMD cases over time in an ageing population. Precise referral information, and simultaneous referral to imaging and retinal clinics, may minimize delays in treatment. Awareness of AMD symptoms and the importance of early intervention could be highlighted by campaigns, particularly among high-risk groups. HIGHLIGHTS: • Interviews with hospital-based and community ophthalmologists showed regional disparities in AMD treatment, with long wait times and a lack of retina specialists in some areas. • Differences in referral pathways, inappropriate use of emergency department to obtain timely treatment, and second line treatment not fully covered by insurance were highlighted. • The healthcare system will need to assess future resources to cope with accumulating burden of AMD cases over time in an ageing population • Precise referral information, and simultaneous referral to imaging and retinal clinics, may minimize delays in treatment. • Awareness of AMD symptoms and the importance of early intervention should be emphasized in high-risk groups.


Assuntos
Degeneração Macular , Pesquisa Qualitativa , Humanos , Israel/epidemiologia , Degeneração Macular/terapia , Masculino , Feminino , Entrevistas como Assunto , Pessoa de Meia-Idade , Oftalmologistas/estatística & dados numéricos , Encaminhamento e Consulta/estatística & dados numéricos , Qualidade de Vida/psicologia , Acessibilidade aos Serviços de Saúde , Adulto , Idoso
5.
J Med Virol ; 96(6): e29709, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38828947

RESUMO

This study evaluated the epidemiological and clinical characteristics of human metapneumovirus (hMPV) infection among hospitalized patients with acute respiratory infections during 2015-2021 and assessed the impact of the coronavirus disease 2019 pandemic on hMPV infection. A single-center, retrospective cohort study was performed, including pediatric and adult patients with laboratory-confirmed hMPV. Of a total of 990 patients, 253 (25.6%), 105 (10.6%), 121 (12.2%), and 511 (51.6%) belonged to age groups 0-2, 3-17, 18-59, and ≥60 years, respectively. The highest percentage (23.0%) of patients were hospitalized during 2019 and the lowest (4.7%) during 2020. Patients < 18 years experienced high rates of comorbidities (immunodeficiencies: 14.4% and malignancies: 29.9%). Here, 37/39 (94.9%) of all bronchiolitis cases were diagnosed in patients < 2 years, whereas more patients in older age groups were diagnosed with pneumonia. A greater proportion of hMPV patients diagnosed with viral coinfection (mostly respiratory syncytial virus and adenovirus) were <18 years. The highest percentages of intensive care unit admissions were recorded among patients < 18 years. Our findings demonstrate that hMPV is an important cause of morbidity in young children and a possibly underestimated cause of morbidity among older adults.


Assuntos
COVID-19 , Coinfecção , Hospitalização , Metapneumovirus , Infecções por Paramyxoviridae , Humanos , Estudos Retrospectivos , Metapneumovirus/isolamento & purificação , Infecções por Paramyxoviridae/epidemiologia , Infecções por Paramyxoviridae/virologia , Israel/epidemiologia , Pessoa de Meia-Idade , Criança , Masculino , Adulto , Feminino , Lactente , Adolescente , Pré-Escolar , Hospitalização/estatística & dados numéricos , Adulto Jovem , COVID-19/epidemiologia , COVID-19/virologia , Idoso , Coinfecção/epidemiologia , Coinfecção/virologia , Recém-Nascido , Infecções Respiratórias/epidemiologia , Infecções Respiratórias/virologia , Comorbidade , Idoso de 80 Anos ou mais , SARS-CoV-2
6.
Sci Rep ; 14(1): 13034, 2024 06 06.
Artigo em Inglês | MEDLINE | ID: mdl-38844476

RESUMO

The risk of developing age-related macular degeneration (AMD) is influenced by genetic background. In 2016, the International AMD Genomics Consortium (IAMDGC) identified 52 risk variants in 34 loci, and a polygenic risk score (PRS) from these variants was associated with AMD. The Israeli population has a unique genetic composition: Ashkenazi Jewish (AJ), Jewish non-Ashkenazi, and Arab sub-populations. We aimed to perform a genome-wide association study (GWAS) for AMD in Israel, and to evaluate PRSs for AMD. Our discovery set recruited 403 AMD patients and 256 controls at Hadassah Medical Center. We genotyped individuals via custom exome chip. We imputed non-typed variants using cosmopolitan and AJ reference panels. We recruited additional 155 cases and 69 controls for validation. To evaluate predictive power of PRSs for AMD, we used IAMDGC summary-statistics excluding our study and developed PRSs via clumping/thresholding or LDpred2. In our discovery set, 31/34 loci reported by IAMDGC were AMD-associated (P < 0.05). Of those, all effects were directionally consistent with IAMDGC and 11 loci had a P-value under Bonferroni-corrected threshold (0.05/34 = 0.0015). At a 5 × 10-5 threshold, we discovered four suggestive associations in FAM189A1, IGDCC4, C7orf50, and CNTNAP4. Only the FAM189A1 variant was AMD-associated in the replication cohort after Bonferroni-correction. A prediction model including LDpred2-based PRS + covariates had an AUC of 0.82 (95% CI 0.79-0.85) and performed better than covariates-only model (P = 5.1 × 10-9). Therefore, previously reported AMD-associated loci were nominally associated with AMD in Israel. A PRS developed based on a large international study is predictive in Israeli populations.


Assuntos
Predisposição Genética para Doença , Estudo de Associação Genômica Ampla , Degeneração Macular , Polimorfismo de Nucleotídeo Único , Humanos , Degeneração Macular/genética , Degeneração Macular/epidemiologia , Israel/epidemiologia , Feminino , Masculino , Idoso , Fatores de Risco , Pessoa de Meia-Idade , Estudos de Casos e Controles , Idoso de 80 Anos ou mais , Herança Multifatorial/genética , Judeus/genética , Genótipo
7.
Isr Med Assoc J ; 26(6): 342-345, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38884305

RESUMO

BACKGROUND: Diabetic ketoacidosis (DKA) is an acute metabolic, life-threatening complication of diabetes mellitus with a mortality rate that now stand at less than 1%. Although mortality is coupled with the etiology of DKA, literature on the influence of DKA etiology on patient outcome is scarce. OBJECTIVES: To study different triggers for DKA and their effect on outcomes. METHODS: We conducted a retrospective study that include 385 DKA patients from 2004 to 2017. The study compared demographics, clinical presentation, and mortality rates by different precipitating factors. RESULTS: Patients with DKA due to infections had a higher risk to develop in-hospital mortality after controlling for age and sex (odds ratio 4.40, 95% confidence interval 1.35-14.30), had a higher Charlson Comorbidity Index score, a higher risk of being mechanical ventilated (14% vs. 3%, P < 0.01), and a longer duration of hospitalization (5 days vs. 3 days, P < 0.001). CONCLUSIONS: It is crucial to find the triggers that precipitate DKA and start the treatment as early as possible in addition to the metabolic aspect of the treatment especially when the trigger is an infectious disease.


Assuntos
Cetoacidose Diabética , Mortalidade Hospitalar , Humanos , Cetoacidose Diabética/diagnóstico , Cetoacidose Diabética/complicações , Cetoacidose Diabética/terapia , Masculino , Feminino , Estudos Retrospectivos , Prognóstico , Pessoa de Meia-Idade , Adulto , Fatores de Risco , Tempo de Internação/estatística & dados numéricos , Fatores Desencadeantes , Respiração Artificial , Infecções/complicações , Israel/epidemiologia , Idoso
8.
Isr Med Assoc J ; 26(6): 355-360, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38884308

RESUMO

BACKGROUND: Pseudomonas aeruginosa (PSA) is an infectious pathogen associated with acute appendicitis; however, it is not consistently addressed by empirical antibiotic therapy, despite potential complications. OBJECTIVES: To investigate the incidence, predictors, and outcomes of PSA-associated acute appendicitis in children. METHODS: We conducted a retrospective analysis involving pediatric patients who underwent acute appendicitis surgery and had positive peritoneal cultures. Clinical, microbiological, and intraoperative data were extracted from medical records. RESULTS: Among 2523 children with acute appendicitis, 798 (31.6%) underwent peritoneal cultures, revealing 338 positive cases (42.3%), with PSA detected in 77 cases (22.8%). Children with PSA were three times more likely to exhibit high intraoperative grading ≥ 3 (93.4% vs. 76.8%, 95% confidence interval [95%CI] 1.2-8.3, P = 0.023) and nearly four times more likely to have polymicrobial cultures (88.3% vs. 62.1%, 95%CI 1.8-8.0, P < 0.001) than those without PSA in peritoneal cultures. Duration of symptoms did not predict PSA isolation (P = 0.827). Patients with PSA had longer median hospital stays (8 days, interquartile range [IQR] 7-10) than those with other pathogens (7 days, IQR 5-9) (P = 0.004). Antibiotic treatment duration, intensive care unit admission rates, readmission, and mortality were similar between the two groups (P = 0.893, 0.197, 0.760, and 0.761, respectively). CONCLUSIONS: PSA is a common pathogen in children diagnosed with acute appendicitis and positive peritoneal cultures. The likelihood of isolating PSA increases with high-grade intraoperative assessment and in the presence of multiple pathogens in peritoneal cultures, suggests antipseudomonal treatment.


Assuntos
Antibacterianos , Apendicite , Infecções por Pseudomonas , Pseudomonas aeruginosa , Humanos , Apendicite/microbiologia , Apendicite/cirurgia , Apendicite/epidemiologia , Feminino , Pseudomonas aeruginosa/isolamento & purificação , Criança , Estudos Retrospectivos , Masculino , Infecções por Pseudomonas/epidemiologia , Infecções por Pseudomonas/diagnóstico , Incidência , Antibacterianos/uso terapêutico , Tempo de Internação/estatística & dados numéricos , Apendicectomia/métodos , Doença Aguda , Israel/epidemiologia , Adolescente , Pré-Escolar
9.
Isr Med Assoc J ; 26(6): 388-394, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38884313

RESUMO

BACKGROUND: Hidradenitis suppurativa (HS) is a chronic relapsing inflammatory skin disease associated with a heavy burden of morbidity and cost. OBJECTIVES: To provide standardized estimates of trends in HS incidence and prevalence among patients in Israel between 2016 and 2019. METHODS: We conducted a population-based analysis of routinely collected electronic health records data from Clalit Health Services, the largest nationwide public health service provider in Israel. Age- and sex-adjusted rates were reported by using the standard European population as a reference. RESULTS: The study included 3488 HS incident cases. The mean ± SD age of onset was 30.3 years and was similar in males and females. HS was more common among Jews with low and medium socioeconomic status. The annual HS incidence rate increased throughout the study period. HS prevalence increased from 0.12% in 2016 to 0.17% in 2019. CONCLUSIONS: HS prevalence and incidence rates steadily rose among the Israeli population between 2016 and 2019. Awareness of these findings can help provide an optimal allocation of healthcare resources by policymakers and health service providers and prevent delays in diagnosis.


Assuntos
Hidradenite Supurativa , Humanos , Israel/epidemiologia , Hidradenite Supurativa/epidemiologia , Hidradenite Supurativa/diagnóstico , Masculino , Incidência , Feminino , Prevalência , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Adolescente , Judeus/estatística & dados numéricos , Criança , Idoso
10.
JAMA Netw Open ; 7(6): e2415392, 2024 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-38848064

RESUMO

Importance: Evidence regarding the relative effectiveness of bariatric metabolic surgery (BMS) and glucagon-like peptide-1 receptor agonists (GLP-1RAs) in reducing mortality and major adverse cardiovascular events (MACEs) is limited. Objective: To compare all-cause mortality and nonfatal MACEs associated with BMS vs GLP-1RAs for adults with obesity and diabetes and without known cardiovascular disease. Design, Setting, and Participants: This observational, retrospective cohort study was based on data obtained from the electronic medical records of Clalit Health Services (Clalit), the largest health care organization in Israel. The study included 6070 members aged 24 years or older, who had diabetes and obesity and no prior history of ischemic heart disease, ischemic stroke, or congestive heart failure. Patients who underwent BMS and patients who received GLP-1RAs from January 1, 2008, through December 31, 2021, were matched 1:1 by age, sex, and clinical characteristics. Follow-up ended December 31, 2022. Exposures: Initiation of BMS or GLP-1RAs. Main Outcomes and Measures: The primary outcome was all-cause mortality, assessed by multivariate Cox proportional hazards regression models. The secondary outcome was nonfatal MACEs, assessed by multivariate competing risk models. Results: The study included 3035 matched pairs of patients (total, 6070; mean [SD] age, 51.0 [9.5] years; 3938 women [64.9%]), who were followed up for a median of 6.8 years (IQR, 4.1-9.4 years). Among those with a diabetes duration of 10 years or less (2371 pairs), mortality was lower for those who underwent BMS than for those treated with GLP-1RAs (hazard ratio [HR], 0.38; 95% CI, 0.25-0.58). This association became nonsignificant when weight loss during the follow-up period was also included in the model (HR, 0.79; 95% CI, 0.43-1.48). Among patients with a duration of diabetes longer than 10 years (664 pairs), no survival advantage was demonstrated for BMS over GLP-1RA (HR, 0.65; 95% CI, 0.39-1.08). The risk for nonfatal MACEs did not differ between the treatment groups (HR, 0.74; 95% CI, 0.49-1.10 among patients with a diabetes duration of ≤10 years; HR, 1.21; 95% CI, 0.80-1.85 among patients with a diabetes duration of >10 years). Conclusions and Relevance: In this cohort study, BMS was associated with greater reduced mortality compared with first-generation GLP-1RAs among individuals with a diabetes duration of 10 years or less, mediated via greater weight loss. No differences in the risk for mortality were observed between the treatment modalities among individuals with a longer duration of diabetes, nor in the occurrence of nonfatal MACEs among all patients.


Assuntos
Cirurgia Bariátrica , Receptor do Peptídeo Semelhante ao Glucagon 1 , Humanos , Feminino , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Receptor do Peptídeo Semelhante ao Glucagon 1/agonistas , Cirurgia Bariátrica/mortalidade , Cirurgia Bariátrica/métodos , Adulto , Israel/epidemiologia , Diabetes Mellitus Tipo 2/tratamento farmacológico , Diabetes Mellitus Tipo 2/mortalidade , Obesidade , Hipoglicemiantes/uso terapêutico , Doenças Cardiovasculares/mortalidade , Modelos de Riscos Proporcionais , Agonistas do Receptor do Peptídeo 1 Semelhante ao Glucagon
11.
J Safety Res ; 89: 224-233, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38858046

RESUMO

INTRODUCTION: In this study, we use the media-based database of Beterem-Safe Kids Israel, to provide a 15-year review of unintentional fatal childhood drowning in Israel, between 2008 and 2022. METHOD: It total, we identified 257 cases of child mortality due to drowning during this period. RESULTS: Our results demonstrate a gradual rise in childhood mortality due to drowning, from 72 cases in 2008-2012, to 85 cases in 2013-2017, and to 100 cases in 2018-2022. Especially worth noting is the increase in childhood drowning in domestic swimming pools. We point to a link between low socioeconomic status and cases of drowning, showing that the risk of drowning extends beyond a mere matter of caregiver inattention. We recommend a series of regulatory and legislative steps to reduce fatal childhood drowning, including fencing built around domestic swimming pools, extending lifeguard activity hours, adding declared beaches, forming programs of safe behavior in water environments for adolescents, and establishing swimming lessons during the 2nd grade, for all populations. We further recommend that a special focus will be put in municipalities situated at the bottom of the socioeconomic index.


Assuntos
Afogamento , Humanos , Afogamento/prevenção & controle , Afogamento/mortalidade , Israel/epidemiologia , Criança , Pré-Escolar , Feminino , Masculino , Lactente , Adolescente , Piscinas , Mortalidade da Criança/tendências
12.
Vet Parasitol Reg Stud Reports ; 52: 101042, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38880565

RESUMO

Giardiasis is a small intestinal disease caused by the zoonotic parasite, Giardia duodenalis. This study presents the molecular findings of G. duodenalis infection in companion dogs, domestic livestock and wildlife in the Northern Jordan Basin, Israel. Identification of G. duodenalis was accomplished by nested PCR (nPCR) targeting the 18S rRNA gene. Samples were collected from water (five samples from four sources of which one was recycled water), as well as feces from wolves (Canis lupus) (n = 34), jackals (Canis aureus) (n = 24), wild boars (Sus scrofa) (n = 40), cattle (Bos taurus) (n = 40), dogs (Canis lupus familiaris) (n = 37) and nutria (Mayocastor coypus) (n = 100). All positive samples were sequenced and a phylogenetic tree was drawn using the Bayesian Inference (BI) algorithm. Differences in G. duodenalis prevalence between the different hosts were analyzed by Pearson's chi-square (p < 0.05). Of the total 275 fecal samples, 36 were positive for G. duodenalis (13%). Frequency rates among different animal species was highest in wolves (32.3%), whilst rates in wild boars (22.5%), dogs (16.2%), cattle (12.5%) and jackals (4.2%), were observed to be significantly lower (p < 0.001). Three out of 5 recycled water (RW) samples were G. duodenalis positive. Three clusters with high posterior probabilities (PP) were found in the BI: Cluster 1: samples from wolves, wild boars, water and cattle together with database sequences of assemblages A, B and F, Cluster 2: samples from dogs, nutria and a jackal with sequences from assemblage D and Cluster 3: samples from cattle, wild boars, wolves and dogs with sequences from assemblage C and D. We suggest that wolves serve as reservoirs of G. duodenalis in this region. The finding of Giardia in RW suggests that this vehicle may further contaminate crops intended for human consumption as this water source is used for agricultural irrigation.


Assuntos
Animais Selvagens , Doenças do Cão , Fezes , Giardia lamblia , Giardíase , Filogenia , Animais , Cães , Giardíase/veterinária , Giardíase/epidemiologia , Giardíase/parasitologia , Giardia lamblia/genética , Giardia lamblia/isolamento & purificação , Giardia lamblia/classificação , Prevalência , Fezes/parasitologia , Doenças do Cão/parasitologia , Doenças do Cão/epidemiologia , Israel/epidemiologia , Animais Selvagens/parasitologia , Gado/parasitologia , RNA Ribossômico 18S/análise , RNA Ribossômico 18S/genética , Bovinos , Reação em Cadeia da Polimerase/veterinária , Animais de Estimação/parasitologia
13.
Viruses ; 16(5)2024 05 20.
Artigo em Inglês | MEDLINE | ID: mdl-38793689

RESUMO

BACKGROUND AND AIMS: An increase in the number of cases of acute hepatitis of unknown origin (HUO) in children was observed in 2021. Adenovirus and adeno-associated virus 2 (AAV2) infections have been suggested as possible triggers. However, the potential etiology is still unclear. We aimed to characterize a cohort of children with HUO in Israel in view of the COVID-19 pandemic. METHOD: Demographics, clinical data, and laboratory results on the children compatible with the CDC criteria for HUO were collected by the established registry of the Ministry of Health. Available specimens were sent to the Central Virology Laboratory. RESULTS: A total of 39 children were included in the registry. A total of 20 were enrolled prospectively, in which human herpes virus 6 (HHV6) infection or reactivation was identified in 11/19, adenovirus was found in 4/19 of the cases, and AAV2 was detected in 2/16. Past COVID-19 exposure was recorded for 24/39 of the children. A total of 10 children underwent liver biopsy, and 8 were successfully treated with steroids and 2 underwent liver transplantation. CONCLUSIONS: The COVID-19 pandemic and the related containment measures combined with reactivation or active infection with other viruses could have been a trigger for the HUO outbreak. In our cohort, HHV6 was the most abundant finding.


Assuntos
COVID-19 , SARS-CoV-2 , Humanos , COVID-19/epidemiologia , COVID-19/virologia , Criança , Feminino , Masculino , Pré-Escolar , Lactente , Israel/epidemiologia , Adolescente , Herpesvirus Humano 6/fisiologia , Surtos de Doenças , Estudos Prospectivos , Doença Aguda/epidemiologia , Pandemias
14.
BMC Public Health ; 24(1): 1440, 2024 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-38811887

RESUMO

BACKGROUND: Molar pregnancies, encompassing complete and partial moles, represent a rare and enigmatic gestational disorder with potential ethnic variations in incidence. This study aimed to investigate relations of ethnicity with risks of complete and partial molar pregnancies within an Israeli population while accounting for age differences. METHODS: A retrospective study was conducted of data recorded during 2007-2021 in an academic medical center in Israel. The study population comprised 167 women diagnosed with complete or partial moles, for whom data were obtained through histological examination and P57 immunostaining. Maternal age and ethnicity were extracted from electronic medical records. Incidence rates were calculated per 10,000 live births, and a nested case-control study compared demographic characteristics and molar pregnancy incidences between Arab and Jewish women. Statistical analyses included age-adjusted comparisons, relative risk calculations and multivariate logistic regression. RESULTS: The overall risk of molar pregnancy was 22 per 10,000 live births (95% confidence interval [CI] 18-25). Among Arab women, the overall risk was 21 (95% CI 17-25), and for PM and CM: 14 (95% CI 11-17) and 7 (95% CI 5-10), respectively. Among Jewish women, the overall risk was 23 (95% CI 18-29), and for PM and CM: 12 (95% CI 8-17) and 11 (95% CI 7-16), respectively. Among Arab women compared to Jewish women, the proportion of all the partial moles was higher: (65.3% vs. 51.6%, p = 0.05). The incidence of partial mole was higher among Arab than Jewish women, aged 35-39 years (26 vs. 8 per 10,000, p = 0.041), and did not differ in other age groups. After adjusting for age, the relative risk of partial moles was lower among Jews than Arabs (0.7, 95% CI 0.4-1.0, p = 0.053). For Arab compared to Jewish women, the mean age at molar pregnancies was younger: 31.0 vs. 35.1 years. However, other factors did not differ significantly between Arab and Jewish women with molar pregnancies. In multivariate analysis, Jewish ethnicity was significantly associated with a higher risk of complete molar pregnancies (OR = 2.19, 95% CI 1.09-4.41, p = 0.028). CONCLUSION: This study highlights ethnic differences in molar pregnancy risk within the Israeli population. Jewish ethnicity was associated with a higher risk of complete molar pregnancies, while Arab women had a significantly higher risk of partial moles. These findings underscore the need to consider ethnicity when studying gestational disorders. Further research should seek to elucidate the underlying factors contributing to these differences.


Assuntos
Árabes , Mola Hidatiforme , Judeus , Humanos , Feminino , Gravidez , Estudos Retrospectivos , Judeus/estatística & dados numéricos , Israel/epidemiologia , Adulto , Árabes/estatística & dados numéricos , Mola Hidatiforme/etnologia , Mola Hidatiforme/epidemiologia , Incidência , Estudos de Casos e Controles , Adulto Jovem , Idade Materna , Fatores de Risco
15.
Isr J Health Policy Res ; 13(1): 27, 2024 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-38811996

RESUMO

BACKGROUND: During the past two decades, there have been many changes in automotive and medical technologies, road infrastructure, trauma systems, and demographic changes which may have influenced injury outcomes. The aim of this study was to examine injury trends among traffic casualties, specifically private car occupants, hospitalized in Level I Trauma Centers (TC). METHODS: A retrospective cohort study was performed based on data from the Israel National Trauma Registry. The data included occupants of private cars hospitalized in all six Level I TC due to a traffic collision related injury between January 1, 1998 and December 31, 2019. Demographic, injury and hospitalization characteristics and in-hospital mortality were analyzed. Chi-squared (X2) test, multivariable logistic regression models and Spearman's rank correlation were used to analyze injury data and trends. RESULTS: During the study period, 21,173 private car occupants (14,078 drivers, 4,527 front passengers, and 2,568 rear passengers) were hospitalized due to a traffic crash. The percentage of females hospitalized due to a car crash increased from 37.7% in 1998 to 53.7% in 2019. Over a twofold increase in hospitalizations among older adult drivers (ages 65+) was observed, from 6.5% in 1998 to 15.7% in 2018 and 12.6% in 2019. While no increase was observed for severe traumatic brain injury, a statistically significant increase in severe abdominal and thoracic injuries was observed among the non-Jewish population along with a constant decrease in in-hospital mortality. CONCLUSIONS: This study provides interesting findings regarding injury and demographic trends among car occupants during the past two decades. Mortality among private car occupant casualties decreased during the study period, however an increase in serious abdominal and thoracic injuries was identified. The results should be used to design and implement policies and interventions for reducing injury and disability among car occupants.


Assuntos
Acidentes de Trânsito , Hospitalização , Sistema de Registros , Centros de Traumatologia , Ferimentos e Lesões , Humanos , Acidentes de Trânsito/estatística & dados numéricos , Acidentes de Trânsito/tendências , Acidentes de Trânsito/mortalidade , Feminino , Masculino , Israel/epidemiologia , Sistema de Registros/estatística & dados numéricos , Centros de Traumatologia/estatística & dados numéricos , Centros de Traumatologia/tendências , Adulto , Pessoa de Meia-Idade , Estudos Retrospectivos , Hospitalização/estatística & dados numéricos , Hospitalização/tendências , Idoso , Ferimentos e Lesões/epidemiologia , Ferimentos e Lesões/mortalidade , Adolescente , Mortalidade Hospitalar/tendências , Adulto Jovem , Demografia , Criança
16.
Psychiatry Res ; 337: 115973, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38776726

RESUMO

INTRODUCTION: On October 7, 2023, Israeli citizens came under an unprecedented terrorist attack that impacted the entire country. Recent research has begun to document the mental health impact of the attack but has yet to address the question of whether the attack had a differential impact across ethnic communities. In this nationwide prospective cohort study, we aimed to determine possible differences in psychopathology between Jews and Arabs in the post-October 7th attack. Specifically, we aimed to understand the role ethnicity may play in changes in probable PTSD, depression, and anxiety diagnoses from pre- to post-attack. METHODS: The sample comprised 656 participants (332 female, 50.7%) aged 18-85 (M = 41.01, SD = 13.72). Of this cohort, 557 participants (84.9%) were Jews, and 99 (15.1%) were Arabs, reflecting their national proportionality. Validated self-report questionnaires were completed to assess PTSD, depression, and anxiety at two time points: August 20 to 30th, 2023 (T1; 6-7 weeks before the attack) and November 9-19, 2023 (T2; 5-6 weeks after the attack). RESULTS: At T2, Arab Israeli participants reported significantly higher prevalences of probable PTSD, depression, and anxiety diagnoses than Jewish Israeli participants. A series of hierarchical logistic regressions revealed that, compared with Jews, Arab participants presented with higher prevalence of probable PTSD (OR = 2.53 95% CI = 1.46-4.37, p < 0.0001), depression (OR = 1.68 95% CI = 1.35-3.01, p < 0.0001) and anxiety (OR = 6.42 95% CI = 3.95-10.52, p < 0.0001), controlling for prevalences of probable diagnoses at T1 as well as for trauma-related variables. DISCUSSION: Citizens belonging to the Arab ethnic minority in Israel were found to be at higher risk for psychopathology in the aftermath of the October 7, 2023, terrorist attack compared with their Jewish majority counterparts. Thus, it becomes critical to employ culturally sensitive assessments and interventions following the attack to prevent the development of chronic symptoms and disorders.


Assuntos
Ansiedade , Árabes , Depressão , Judeus , Transtornos de Estresse Pós-Traumáticos , Terrorismo , Humanos , Feminino , Árabes/estatística & dados numéricos , Árabes/psicologia , Masculino , Israel/epidemiologia , Israel/etnologia , Judeus/estatística & dados numéricos , Judeus/psicologia , Adulto , Pessoa de Meia-Idade , Terrorismo/psicologia , Terrorismo/estatística & dados numéricos , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/etnologia , Idoso , Adolescente , Estudos Prospectivos , Adulto Jovem , Idoso de 80 Anos ou mais , Depressão/epidemiologia , Depressão/etnologia , Ansiedade/epidemiologia , Ansiedade/etnologia , Saúde Mental/etnologia , Saúde Mental/estatística & dados numéricos
17.
J Psychosom Res ; 182: 111809, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38795400

RESUMO

BACKGROUND: This study investigates the increased prevalence of endometriosis in Israel and its association with psychiatric comorbidities, focusing on the timing of psychiatric diagnoses in relation to endometriosis diagnosis. METHODS: Employing a retrospective cohort analysis, we reviewed data from 1,291,963 patients in a large scale medical database, identifying 24,259 cases (1.88%) of endometriosis. The analysis included demographic details, ICD-10 diagnoses of endometriosis and mental health conditions, and medication use patterns. RESULTS: A marked rise in endometriosis diagnosis was observed, particularly among women born between 1973 and 1978. Those with endometriosis were more likely to have psychiatric disorders-such as mood disorders, anxiety, PTSD, and eating disorders-than the control group, with the majority of psychiatric diagnoses occurring prior to endometriosis detection, except for PTSD. The study also highlighted significant sociocultural and socioeconomic disparities in endometriosis diagnosis, suggesting barriers to healthcare access and the influence of cultural factors. Limitations include potential biases from the retrospective design and the specific context of Israel's healthcare system, which may limit generalizability. CONCLUSIONS: The significant rise in endometriosis and its strong association with psychiatric comorbidities, predominantly preceding the diagnosis of endometriosis, underscores the necessity for integrated care approaches. The disparities in diagnosis rates call for culturally sensitive healthcare practices and early psychiatric interventions.


Assuntos
Comorbidade , Endometriose , Transtornos Mentais , Humanos , Endometriose/epidemiologia , Feminino , Israel/epidemiologia , Adulto , Estudos Retrospectivos , Transtornos Mentais/epidemiologia , Prevalência , Pessoa de Meia-Idade , Saúde Mental , Adulto Jovem
18.
PLoS One ; 19(5): e0299574, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38809902

RESUMO

We propose a new approach to estimate the vaccination rates required to achieve herd immunity against SARS-COV2 virus at a city level. Based on information obtained from the Israeli Ministry of Health, we estimate two separate quadratic models, one for each dose of the BNT162b2 mRNA Pfizer vaccine. The dependent variable is the scope of morbidity, expressed as the number of cases per 10,000 persons. The independent variables are the first and second vaccination rates and their squares. The outcomes corroborate that herd immunity is achieved in the case that 71 percent of the urban population is vaccinated, and the minimum anticipated scope of morbidity is approximately 5 active COVID-19 cases per 10,000 persons, compared to 53-67 cases per 10,000 persons for zero vaccination rate. Findings emphasize the importance of vaccinations and demonstrate that urban herd immunity may be defined as a situation in which people continue to interact, yet the COVID-19 spread is contained. This, in turn, might prevent the need for lockdowns or other limitations at the city level.


Assuntos
COVID-19 , Imunidade Coletiva , SARS-CoV-2 , COVID-19/imunologia , COVID-19/prevenção & controle , COVID-19/epidemiologia , Humanos , SARS-CoV-2/imunologia , Israel/epidemiologia , Vacinação , Cidades , Vacinas contra COVID-19/imunologia , População Urbana , Vacina BNT162/imunologia
19.
Front Public Health ; 12: 1364868, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38813420

RESUMO

Introduction: The present study examined the relationships of Lifetime Cumulative Adversity (LCA) and country inequalities, as well as the interactions between them, with the self-rated health (SRH) in old age. Methods: Using data from the Survey of Health, Aging and Retirement in Europe (SHARE), the study regressed self-rated health on Lifetime Cumulative Adversity and country-level inequality indices across European countries in two points in time. The analysis also considered adversity-inequality interactions, controlling for confounders. The sample was comprised of 28,789 adults, aged 50 to 80, from 25 European countries and Israel. Results: The findings pointed out that LCA is negatively associated with SRH, but democracy and welfare regimes modify the ill effects of LCA on health. These effects are reduced as the LCA level increases. The effects remained significant over two measurement time-points over three years, showing that life-course trajectories may be shaped by individual accumulated risk exposure to stress, along with inequalities at the society level. Discussion: The study provides constructive and important guidance for decreasing the harmful effect of lifetime adversity in old age, by the modification of the country's welfare policies.


Assuntos
Fatores Socioeconômicos , Humanos , Idoso , Pessoa de Meia-Idade , Feminino , Masculino , Europa (Continente) , Idoso de 80 Anos ou mais , Israel/epidemiologia , Inquéritos Epidemiológicos , Disparidades nos Níveis de Saúde , Nível de Saúde , Envelhecimento
20.
Arthritis Res Ther ; 26(1): 108, 2024 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-38802958

RESUMO

BACKGROUND: Psoriatic arthritis (PsA) is a chronic, potentially debilitating inflammatory arthritis often associated with psoriasis. Understanding the epidemiology of PsA across diverse populations can provide valuable insights into its global burden and the role of genetic and environmental factors. This study aimed to estimate PsA's temporal trends, prevalence, and incidence, while assessing variations in age, gender, and ethnicity in Israel from 2016 to 2022. METHODS: Data were sourced from the Clalit Health Services (CHS) database, covering over half of the Israeli population. Algorithm-based definitions for PsA and psoriasis cases were used. Demographic factors, including age, gender, socioeconomic status (SES), ethnicity, urban/rural residence, BMI, and smoking status, were analyzed. Standardized prevalence and incidence rates were calculated. Logistic regression analyses examined associations of sociodemographic variables with PsA. RESULTS: In 2022, the prevalence of PsA was 0.221%, with an incidence rate of 13.54 per 100,000 population. This prevalence has tripled since 2006, reflecting a rising trend in PsA over time. Females exhibited a higher prevalence (1.15; 95%CI 1.09-1.21), and PsA was more common in Jewish individuals (1.58; 95%CI 1.45-1.71) those with higher SES (1.4; 95% CI 1.31, 1.5), and those with obesity (2.17; 95%CI 2.04-2.31). CONCLUSIONS: This comprehensive population-based study pointed to an increase prevalence of PsA, emphasizing the rising healthcare demands and economic burden faced by this patient population. Further research is essential to delve into the factors driving these trends.


Assuntos
Artrite Psoriásica , Humanos , Artrite Psoriásica/epidemiologia , Feminino , Masculino , Israel/epidemiologia , Pessoa de Meia-Idade , Adulto , Prevalência , Idoso , Incidência , Adulto Jovem , Adolescente , Idoso de 80 Anos ou mais
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