Increase in pulse transit time to the foot after epidural anaesthesia treatment

Epidurally induced anaesthetic treatment is a routine treatment for pain relief during surgical procedure, based on blocking the sensory and sympathetic fibres that mediate pain. The epidural sympathetic block results in relaxation of the muscle walls in the lower limbs, which can be assessed by the resultant haemodynamic changes. In the current study, the difference t_t,f in the transit time of the blood pressure pulses between the toe and the finger is measured by photoplethysmography (PPG). Fifteen patients are administered 10 ml 0.25% of bupivacaine, ten patients are administered 10 ml 0.5%, and 17 patients are administered 40 ml 0.0625%. t_t,f decreases as a function of the patient's age and blood pressure, both before and after the sympathetic block, owing to the decrease in arterial compliance with age and blood pressure. The time delay t_t,f increases after the epidural treatment by 10.1±7.0 and by 16.8±10.8 ms for the 0.25% and the 0.5% concentrations, respectively. The time delay increase for the lowest concentration is not statistically significant. The toe-finger time delay change is found to reflect the haemodynamic changes induced by the sympathetic block with higher reliability than the routine methods of skin temperature or arterial blood pressure.     

Intra-articular pressure measurements in patients with suddenly developing, severely limited mouth opening.

A condition of sudden, severe, and persistent limited mouth opening, which readily responds to arthrocentesis, is postulated to be the effect of a vacuum between disc and fossa in the upper compartment of the temporomandibular joint. In 16 patients with this condition, the negative intra-articular pressure was found to be significantly lower (mean, -82.6 +/- 25.4 mm Hg) than in the control group (mean, -7.7 +/- 2.5 mm Hg) (P less than .0001). It is suggested that the process underlying the vacuum effect starts with persistent pressure (eg, clenching) resulting in the viscoelastic disc being pressed flat against the fossa. Immediately on cessation of the pressure, the disc resumes its natural biconcave shape, but its rims remain fastened to the fossa. The consequent increased negative pressure in the closed space created firmly anchors the disc to the fossa and any attempt to elicit condyle and disc sliding will only stretch the joint capsule and cause pain. This, in turn, will reflexly prevent the pterygoid muscle from exerting sufficient force to pull the disc and thus release the vacuum. This chain of events may account for the severe and persistent limitation in jaw movement and for the easy reversal of the condition by simple nonsurgical treatment.     

Streptococcus group B isolates in a regional hospital area

A survey of the frequency of group B streptococcal infections in the Sharon area (Isreal) was done in this laboratory. In the female genital tract streptococcus group B was found in 11.8%. This microorganism was recovered in lower frequencies (1.6%–7.4%) in other infection sites (CSF, wounds, throat, blood, and urine). The streptococci were identified as belonging to group B by biochemical properties such as resistance to bacitracin and capability to hydrolyze hippurate. Later the isolates were classified serologically. Serotypes Ib, Ic, and II were predominant in the vaginal smears (25%–28% each serotype). In the other infection sites serotype Ib was the most frequent (36%). The isolates were sensitive to penicillin, cloxacillin, cephalothin, and erythromycin — M.I.C. 0.1–0.2gmg/ml. Most of the isolates were resistant to tetracycline (69%) and some to chloramphenicol (17.5%). Synergism has been obtained in vitro using a combination of gentamicin and penicillin simultaneously. Group B streptococci orStreptococcus agalactiae first became known because of association with bovine mastitis. This microorganism is now widely appreciated as a potent human pathogen. In several geographic regions it is the leading cause of meningitis during the first two months of life (Eickhoff et al. 1965; Franciosi et al. 1973; Baker et al. 1973; Patterson and Hafeez 1976; Anthony and Okada 1977; Baker 1977). Two clinical syndromes have been defined among infants. The first syndrome, called early onset, is observed in neonates aged five days or less (Baker et al. 1973). In older infants (between 10 days and three months of age) the second syndrome or the late-onset may appear (Franciosi et al. 1973; Baker et al. 1973). In the last few years infections in adults have also been reviewed (Bayer et al. 1976; Lerner et al. 1977). Group B streptococci are divided into five serological types: Ia, Ib, Ic, II, and III (Wilkinson and Eagon 1971); some strains appear to be devoid of type-specific antigens and are called nontypable (NT). The serotypes of group B streptococci isolated from infants with early onset disease are identical with those isolated from the genital tracts of their mothers. Infants probably acquire the microorganism during passage through the birth canal (Baker and Barrett 1973). Furthermore, the genitourinary tract is known to be a major reservoir of infection and a source for subsequent dissemination in both men and women (Wilkinson 1978). The appearance of sepsis and meningitis in neonates caused by group B streptococci and which was reported previously by this laboratory (Maayan et al. 1978; Nitzan et al. 1978) has prompted us to study the current situation of the infections caused by this microorganism. This study presents a survey on the frequency of infections, serotype distribution, and susceptibility to antimicrobial agents of group B streptococcal isolates in the Sharon district (Israel). It seems that the transformation of the group B streptococci to human pathogens has also affected this area.     

Aging of tissues of the roots of nonfunctional human teeth (impacted canines).

In order to examine the aging of dentin and cementum, seventy-two impacted human canines, nonfunctional and not affected by external factors, such as attrition, abrasion, caries, etc., were surgically extracted. Ground sections were prepared and the areas of sclerotic dentin and cementum were measured with the aid of a planimeter and expressed as a percentage of the total root area. It was found that there is a significant increase in sclerotic dentin and apposition of cementum with an increase in age.     

Prevalence of obesity in Israel

Israel is a multiethnic society and offers an ongoing 'experiment' concerning the cultural determinants of obesity. The First Israeli National Health and Nutrition Survey 1999-2001 (MABAT) measured a representative population of 2782 adults (49% men) aged 25-64 years (mean 43 years); it showed a prevalence of overweight in 39.3% and obesity in 22.9%. Overweight is more common in men and obesity is more prevalent in women; the Israeli Arab population is more obese than the Jewish one.     

Rebelliousness in patients suffering from schizophrenia-spectrum disorders—A possible predictor of attitudes towards medication

The inclusive trait of rebelliousness has a proven role both in development and in the understanding of non-psychotic psychopathologies. The present study focused on evaluating rebelliousness levels and their possible correlation with the attitude towards medication among patients suffering from schizophrenia-spectrum disorders.