Mordechai Shani

CHOLELITHIASIS IN THE ÆTIOLOGY OF GALLBLADDER NEOPLASMS

Abstract A study of all newly diagnosed patients with gallbladder and biliary tract cancer in Israel during a five-year period indicates that cholelithiasis plays a major part in the aetiology of gallbladder cancer. This conclusion is based on the following findings: ( a ) high frequency of gallstones in gallbladder cancer cases compared with biliary tract cancer and the general population; ( b ) similar frequency of gallstones in gallbladder cancer in both sexes and in all ethnic groups; ( c ) similar sex and ethnic population trends in the incidence of cholelithiasis and of gallbladder cancer.

Reduction of Hospital Mortality from Acute Myocardial Infarction by Anticoagulant Therapy

A nationwide study of all 2330 patients hospitalized for a first definite acute myocardial infarction in Israel during a one-year period revealed a significantly lower 21-day mortality rate of patients treated by anticoagulants: 8.3 versus 27.3 per cent in those not receiving such therapy (p less than 0.0001). Out of the 22 hospitals studied, the effect was present in 18, absent in two, and not assessable in two. There was a highly significant inverse correlation between the proportion of patients receiving anticoagulant therapy in each hospital and the total 21-day mortality from infarction in that institution (r equals 0.57; less than 0.01). The superior survival of patients on anticoagulant therapy did not seem related to differences in age, sex, disease severity, site of infarction, diagnostic criteria or type of hospital. Despite the obvious limitations of retrospective studies the data justify a re-evaluation of the approach to the problem by further investigative effort.

Nodal and Extranodal Malignant Lymphoma in Israel: An Epidemiological Study

Records of all patients with malignant lymphoma diagnosed in Israel between 1960 and 1964 were reviewed. Evidence for different patterns of the disease in various age and population groups has been noted. Thus, in the younger age groups and in the Asian‐African segment of the population, as well as the Arabs, the disease presented more often at extranodal sites, while in older age groups and among the Europeans it was predominantly in lymph nodes or generalized at presentation.

Aplastic anemia in Isreal: evaluation of the etiological role of chloramphenicol on a community-wide basis.

A nationwide study of aplastic anemia in Israel revealed a mean yearly incidence of 7.1sol;1,000,000 in males and 8.7/1,000,000 in females. Twenty-five per cent of the cases reported had an apparent chloramphenicol etiology. Ten patients, five treated with chloramphenicol and five without it, developed acute leukemia. The median survival was 11 months in males and 28 in females. Survival was particularly inferior in chloramphenicol-related cases, suggesting that this group constitutes a specific entity

Active and inactive factor VII in Dubin-Johnson syndrome with factor-VII deficiency, hereditary factor-VII deficiency and on coumadin administration.

Summary. Factor VII was purified from a lyophilized powder of PTC complex (Hemoplex, Cutter Laboratories) and an antiserum was prepared in rabbits to the partially‐purified fraction. The antiserum was found to inhibit specifically factor VII of normal plasma and the activity of the purified factor‐VII preparation.

Characteristics of patients seeking health information online via social health networks versus general Internet sites: a comparative study.

Background: Camoni.co.il, a Hebrew-language social health network offers advice, consultation, and connection to others with chronic illness. This study compared characteristics and objectives of Camoni.co.il users and individuals seeking medical information through general Internet sites. Methods: Similar questionnaires were sent to 1009 Internet and 900 Camoni users. Cluster analysis defined four modes of online social health network use: “acquiring information and support”, “communicating”, “networking” and “browsing”. Results: Six hundred and five Internet and 125 Camoni users responded. Diabetes, hypertension, obesity and lung diseases were found more often among general Internet users than Camoni users. Among Camoni users, “acquiring information and support” was the main motivation for individuals over age 55 years, women, those with lower income, chronic pain, obesity and depression. “Communicating” was the main incentive of men, those 20–34 years old, those with less education, or an eating disorder. “Networking” was the most significant motivation for those with multiple sclerosis or depression. Browsing was most frequent among individuals with multiple sclerosis. Conclusions: Identifying needs of social health network surfers will allow planning unique contents and enhancing social health sites. Physicians might advise patients to use them to obtain support and information regarding their conditions, possibly leading to improved compliance and self-management.

Development and validation of tele-health system for stroke rehabilitation

Abstract Tele-rehabilitation refers to the use of information and communication technologies to provide rehabilitation services to people in their homes or other environments. The objective of this paper was to present the development, validation, and usability testing of a low-cost, markerless, full-body tracking virtual reality system designed to provide remote rehabilitation of the upper extremity in patients with stroke. The Methods and Results sections present the progress of our work on system development, system validations, and a feasibility/usability study. We conclude with a brief summary of the initial stages of an intervention study and a discussion of our findings in the context of the next steps. The validation study demonstrated considerable accuracy for some outcomes (i.e., shoulder “pitch” angle, elbow flexion, trunk forward, and side-to-side deviation). In addition, positive responses were received from the clients who participated in the feasibility study. We are currently in the process of improving the accuracy of the system and analyzing results from a randomized clinical trial, which assessed the effectiveness of the system to improve upper extremity function post-stroke.

The impact of information on medical thinking and health care policy

The information revolution has, till now, concentrated on the collection, storage, transfer, and analysis of data, with emphasis on the technology and not on the information itself. Information in health care is conductive to two major changes. One aspect is the conversion of clinical medicine from an art, based on clinical intuition to a more scientific profession based on clinical guidelines and evidence based medicine. The second aspect relates to health care policy based on better information.

Tele-rehabilitation service delivery journey from prototype to robust in-home use.

Tele-rehabilitation refers to the use of information and communication technologies to provide rehabilitation services to people remotely in their homes or other environments. The goal is to improve patient access to care by receiving therapy beyond the physical walls of a traditional healthcare facility, thus expanding continuity of rehabilitation care. The objectives of this paper are (1) to provide data that document the service delivery implemented by ReAbility Online for the past 18 months and (2) to report on the results of a focus group of clients who took part in the service during its initial implementation. We conclude with a short discussion based on the lessons learned during the development, evaluation and service implementation process.

Esophageal cancer in Israel: Selected clinical and epidemiological aspects

Records of all patients diagnosed as having carcinoma of the esophagus in Israel between 1960 and 1966 were reviewed. The mean annual incidence was 2.3/100,000, with a male/female ratio of 1.6:1. Incidence was higher among the Asian-born segment of the population below 60 years of age. The most frequent localization was in the middle third of the esophagus, followed by the lower third. More than two thirds of the patients were considered unsuitable or surgery. Overall 5-year survival was 5.8%.