RESUMEN
In Israel, the reported prevalence of hepatitis-C virus (HCV) infection among blood donors is 0.44%. As we found a high prevalence of chronic hepatitis-B virus (HBV) and HCV infection in Jewish immigrants from Uzbekistan and Tajikistan (Bukharian Jews) among our general patient population, we determined the prevalence of HBV and HCV infection among "healthy" Bukharian Jewish immigrants by screening for HBV and HCV markers and risk factors in a population of Bukharian Jews in north Jerusalem. A total of 27 (26.5%) of 102 patients were anti-HCV positive (by ELISA and confirmation tests). The HCV positive patients were older and had a higher rate of liver enzyme abnormalities than were the HCV-negative patients (56.5 +/- 2.3 versus 47.6 +/- 1.8, p = 0.003; and 14 of 27 versus 7 of 75, p < 0.01, respectively). HCV-positive patients with liver enzyme abnormalities were younger than HCV-positive patients without liver enzyme abnormalities (52.5 +/- 3.0 versus 62.8 +/- 2.8, p = 0.02). Sixteen patients (15.7%) were hepatitis-B surface antigen (HBsAg) carriers, and only two of these HBsAg carriers had liver enzyme abnormalities. None of the HCV-positive patients were HBsAg carriers (0 of 27 among HCV-positive patients versus 16 of 75 among HCV-negative patients, p = 0.0055). Past infection with HBV was found in 67 examinees (66%) (45 of 75 HCV-negative patients and 22 of 27 HCV-positive patients, p = 0.058). However, similar proportions of patients from both groups had past and present exposure to HBV [61 (81.3%) of 75 among HCV-negative patients versus 22 (81.5%) of 27 among HCV-positive patients]. Only 14 patients (13.7%) had no exposure to either HCV or HBV. Possible risk factors were use of nondisposable needles during mass vaccination in the U.S.S.R. or possible intrafamilial spread. The study concluded that immigrant Jews from former Asiatic U.S.S.R. republics have the highest rate of HCV positivity ever reported, and many of them have past and present HBV infection. Measures to prevent intrafamilial transmission of both viruses should be instituted.
Asunto(s)
Hepatitis B/etnología , Hepatitis C/etnología , Judíos , Adolescente , Adulto , Anciano , Emigración e Inmigración , Femenino , Hepatitis B/prevención & control , Hepatitis C/prevención & control , Humanos , Israel/epidemiología , Masculino , Persona de Mediana Edad , Prevalencia , Factores de Riesgo , Estudios Seroepidemiológicos , Tayikistán/etnología , Uzbekistán/etnologíaRESUMEN
A 38-year-old woman presented with iron-deficiency anemia in 1983. Eight years later, she developed classic symptoms of celiac disease, ie, diarrhea, weight loss, and diminished appetite. New noninvasive blood tests and the ease with which small bowel biopsies can be achieved are having an impact on the clinical pattern of the disease. This report includes a discussion of anemia as the presenting sign of celiac disease and a review of the literature.
Asunto(s)
Anemia Ferropénica/etiología , Enfermedad Celíaca/diagnóstico , Adulto , Enfermedad Celíaca/complicaciones , Femenino , HumanosRESUMEN
4,612 urine samples were sent to this laboratory in 1990, and the results of those sent during a single week in each of the 4 seasons were studied. Of 4501 urinary cultures sent from the general population, 811 (80%) were positive for E. coli, Klebsiella and Proteus mirabilis. 60% were resistant to ampicillin, 35% to cotrimoxazole and 20% to cephalexin. Of 111 urine samples sent from senior citizen homes, 57 (80%) were positive for E. coli, Proteus mirabilis, Klebsiella and Pseudomonas. 74% were resistant to ampicillin, 72% to cotrimoxazole and 46% to cephalexin. Ofloxacin and norfloxacin were very effective in urinary tract infections in the general population, with 94% and 97% sensitive to them, respectively. 68% of the urinary cultures sent from the senior citizen centers were sensitive to each of them.
Asunto(s)
Infecciones Urinarias/epidemiología , Anciano , Antibacterianos/toxicidad , Infecciones por Escherichia coli/epidemiología , Humanos , Incidencia , Israel/epidemiología , Infecciones por Klebsiella/epidemiología , Pruebas de Sensibilidad Microbiana , Infecciones por Proteus/epidemiología , Proteus mirabilis , Infecciones por Pseudomonas/epidemiología , Infecciones Urinarias/diagnóstico , Infecciones Urinarias/tratamiento farmacológicoRESUMEN
Skin blood flow and microvascular resistance were measured in the feet of hypertensive and normotensive subjects by the non-invasive transient thermal clearance method. Skin blood flow decreased and microvascular resistance increased as a function of systolic brachial blood pressure for the non-diabetic subjects who were not treated by vasoactive medication. The relationship between blood flow and systolic blood pressure for diabetic patients and for patients who were treated by enalapril was poor. The average resistance for non-diabetic patients treated by enalapril was lower than that of untreated non-diabetic subjects. For diabetic patients no significant difference in resistance between enalapril treated and untreated patients was found. The results demonstrate that for non-diabetic patients the role of microvascular resistance in hypertension is significant while it is less important in diabetic patients.