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Jacob T.,Ariel University | Shapira A.,Asaf Harofe Medical Center
Journal of Rehabilitation Medicine | Year: 2010

Objective: To evaluate the perceptions of health and quality of life among a group of polio survivors in Israel and to identify potential activities for improving their quality of life. Design: An observational study. Subjects: The sample consisted of 101 polio survivors who sought treatment at 2 post-polio clinics in Israel. The majority of participants were between the ages of 45 and 65 years, and approximately 25% were wheelchair-bound. Methods: Participants were invited to attend a seminar, where they were invited to complete a questionnaire on demographic variables, mobility, perceptions of and satisfaction with health status and quality of life, and the potential contribution of 16 activities to improve their quality of life. Results: Participants had low physical scores and normative mental scores. Mean scores on the Short-Form-12 questionnaire for physical and mental components were 32.9 and 50.3, respectively. Approximately 70% expressed the belief that exposure to up-to-date information about post-polio, as well as participation in social activities, might improve their quality of life. Conclusion: Information about the physical and mental components of polio survivors, as well as the desire to partake in specific activities for polio survivors, may serve as a basis for the operations and prioritization of service providers © 2010 Foundation of Rehabilitation Information. Source


Yahalom G.,The Chaim Sheba Medical Center | Kivity S.,The unit of Rheumatology | Lidar M.,The Chaim Sheba Medical Center | Lidar M.,Tel Aviv University | And 6 more authors.
European Journal of Neurology | Year: 2011

Background and purpose: To describe and characterize the association between familial Mediterranean fever (FMF) and multiple sclerosis (MS). Methods: The patient registry of The National Center for FMF was screened for the coexistence of FMF and MS. Tel-Hashomer criteria were used for the diagnosis of FMF, and FMF severity was evaluated, using the simplified FMF severity scale. McDonald criteria were used for the diagnosis of MS, and neurologic disability was measured using the expanded disability status scale (EDSS). Results: We identified nine patients, affected with both FMF and MS. The onset of the FMF averaged 15.6 (3-37) years. Most patients suffered from abdominal and joint attacks, and 50% of the patients sustained a moderate to severe FMF. The onset of the MS was at an average age of 31.6 (17-50) years. Neurologic manifestations varied individually, without a dominant deficit, and the course was in a relapsing-remitting pattern in most. The median EDSS was in general of low score (3.0), apart from the patients who were homozygous for the M694V mutation, in whom the MS was more severe. Based on our case series, the frequency of MS in our FMF population is 0.075%, twice higher the expected rate in the general population (P=0.0057). Conclusions: Multiple sclerosis is more common in FMF than in the general Israeli population. Homozygosity for the M694V MEFV mutation may aggravate the phenotype of MS and predispose FMF patients to develop MS. © 2011 The Author(s). European Journal of Neurology © 2011 EFNS. Source


Joshua B.-Z.,Ben - Gurion University of the Negev | Sachs O.,Ben - Gurion University of the Negev | Shelef I.,Soroka University Medical Center | Vardy-Sion N.,Soroka University Medical Center | And 3 more authors.
Otolaryngology - Head and Neck Surgery (United States) | Year: 2013

Objectives. To evaluate bone changes demonstrated by computed tomography (CT) as a predictor of the severity of chronic rhinosinusitis. Study Design. Cross-sectional study. Settings. Tertiary referral university medical center. Subjects and Methods. Thirty-eight patients diagnosed with unilateral chronic maxillary sinusitis underwent endoscopic sinus surgery from 2003 to 2009. Preoperative CTs of all patients were reviewed by a single radiologist blinded to the pathologic diagnosis. Bone density was evaluated and expressed in Hounsfield units (HU). Sinus wall thickness (WT) was also measured and compared with the contralateral side. All the histopathologic specimens were reviewed. A database was constructed containing demographic data, clinical symptoms, CT measurements, and histopathologic findings. Results. Average age was 44.07 years, with 22 women (57.9%) and 16 men (42.1%). The average wall density (WD) was 828.7 HU, and no correlation was found between the density of the diseased maxillary sinus bony walls and the severity of the histopathologic inflammatory process of the soft tissue (P = .474). The average wall thickness of the diseased sinuses was 2.6 mm, and a correlation was found between inflammation severity and wall thickness (P = .018). Wall thickening was found in 97.3% of the cases and an increase in density in 78.9% without correlation between WD and WT. Conclusion. Wall thickness but not WD obtained from CT scans may be a simple index for evaluation of unilateral chronic rhinosinusitis and its severity. Further studies confirming these results and comparing them with clinical correlates are indicated. © American Academy of Otolaryngology-Head and Neck Surgery Foundation 2013. Source


Peer A.,Rambam Medical Center | Gottfried M.,Meir Medical Center | Sinibaldi V.,Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins | Carducci M.A.,Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins | And 5 more authors.
Prostate | Year: 2014

BACKGROUND: Abiraterone, a potent CYP 17 inhibitor, is standard treatment in docetaxel refractory, metastatic castrate resistant prostate cancer (mCRPC). However, in countries where abiraterone has not been approved yet, or for patients who cannot afford it, ketoconazole is used as an alternative CYP 17 inhibitor. Although preclinical data suggests that ketoconazole is a less potent inhibitor of CYP 17, there are limited clinical data comparing both agents. We aimed to compare the clinical effectiveness of abiraterone versus ketoconazole in docetaxel refractory mCRPC. METHODS: Records from mCRPC patients treated with ketoconazole (international multicenter database, n = 162) were reviewed retrospectively. Twenty-six patients treated post docetaxel were individually matched by clinicopathologic factors to patients treated with abiraterone (national multicenter database, n=140). We compared the PSA response, biochemical and radiological progression free survival (PFS), and overall survival (OS) between the groups. PFS and OS were determined by Cox regression. RESULTS: The groups were matched by Gleason score, pre-treatment disease extent, ECOG PS, pre-treatment risk category (Keizman, Oncologist 2012). Furthermore, they were balanced regarding other known confounding risk factors. In the groups of abiraterone versus ketoconazole, PSA response was 46% versus 19% (OR 4.3, P=0.04), median biochemical PFS 7 versus 2 months (HR 1.54, P=0.02), median radiological PFS 8 versus 2.5 months (HR 1.8, P=0.043), median OS 19 versus 11 months (HR 0.53, P=0.79), and treatment interruption d/t severe adverse events 8% (n=2) versus 31% (n=8) (0R 0.6, P=0.023). CONCLUSIONS: In docetaxel refractory mCRPC, the outcome of abiraterone treatment may be superior to ketoconazole. Prostate 74:433-440, 2014. © 2013 Wiley Periodicals, Inc. Source


Gerss J.,University of Munster | Gerss J.,The Interdisciplinary Center | Roth J.,University of Munster | Holzinger D.,The Interdisciplinary Center | And 33 more authors.
Annals of the Rheumatic Diseases | Year: 2012

Objectives: Juvenile idiopathic arthritis (JIA) is a chronic inflammatory joint disease affecting children. Even if remission is successfully induced, about half of the patients experience a relapse after stopping antiinflammatory therapy. The present study investigated whether patients with JIA at risk of relapse can be identified by biomarkers even if clinical signs of disease activity are absent. Methods: Patients fulfilling the criteria of inactive disease on medication were included at the time when all medication was withdrawn. The phagocyte activation markers S100A12 and myeloid-related proteins 8/14 (MRP8/14) were compared as well as the acute phase reactant high-sensitivity C reactive protein (hsCRP) as predictive biomarkers for the risk of a flare within a time frame of 6 months. Results: 35 of 188 enrolled patients experienced a flare within 6 months. Clinical or standard laboratory parameters could not differentiate between patients at risk of relapse and those not at risk. S100A12 and MRP8/14 levels were significantly higher in patients who subsequently developed flares than in patients with stable remission. The best single biomarker for the prediction of flare was S100A12 (HR 2.81). The predictive performance may be improved if a combination with hsCRP is used. Conclusions: Subclinical disease activity may result in unstable remission (ie, a status of clinical but not immunological remission). Biomarkers such as S100A12 and MRP8/14 inform about the activation status of innate immunity at the molecular level and thereby identify patients with unstable remission and an increased risk of relapse. Source

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