Clinical Efficacy of Topical Nasal Pomegranate Fruit Extract for Chronic Rhinitis and Chronic Rhinosinusitis

Objective: To evaluate the clinical efficacy of topical nasal Pomegranate Fruit Extract (PFE) for Chronic Rhinitis (CR), Chronic Rhinosinusitis with Nasal Polyposis (CRSwNP), and Chronic Rhinosinusitis without Nasal Polyposis (CRSsNP). Methods: Prospective, double-blinded, randomized study including 111 consecutive patients, between April 2012 and January 2017, afflicted by CRSwNP, CRSsNP, and CR. Patients from each group were randomly assigned to either PFE treatment or placebo twice daily for 30 days. Therapeutic efficacy was assessed by Ear Nose and Throat, blood and tomographic examinations, and the SNOT-20 questionnaire. Results: CR patients treated with PFE suffered significantly less from thick nasal discharge, difficulty falling asleep, reduced productivity, reduced concentration, and sadness (P = .004, P = .02, P = .03, P = .007 and P = .02, respectively). Conclusions: Topical nasal PFE was found to have some benefits for CR patients, however, not for CRS with or without Nasal Polyposis.

Uncovering Resilience Disparities among Religious Groups in Israel's Mass COVID-19 Vaccination Drive: Lessons Learned to the Post-COVID Era

The aim of the current study was to examine the emotional resilience, satisfaction with life, social support, and anxiety during the vaccination process of the Israeli population after the end of the third lockdown, according to religiosity degree. We hypothesized that a higher degree of religiosity (ultra-Orthodox and religious participants) would be associated with higher levels of resilience and with lower levels of anxiety than in secular individuals. In addition, it was hypothesized that satisfaction with life, social support, anxiety, and religiosity will predict resilience and anxiety. Nine hundred and ninety-three native Jewish Hebrew-speaking respondents representing ultra-Orthodox, religious, observant, and secular Jews participated in this study. Ultra-Orthodox participants showed higher resilience and satisfaction with life than other groups, and lower levels of anxiety. Satisfaction with life and social support predicted higher resilience. It is suggested that religious faith as well as satisfaction with life may provide a source of strength and resilience in stressful life events.

The cumulative effect of socioeconomic status and dyslexia on linguistic, cognitive and reading skills among Arabic-speaking children

Research has shown that children with dyslexia and children with a low socioeconomic status (SES) fall behind in terms of literacy acquisition, but a question remains regarding the cumulative effect of dyslexia and SES on linguistic, cognitive and reading skills. To examine the impact of cognition and environment on literacy development, we returned to the data set of 1,441 elementary school children (223 dyslexic readers and 1,241 typical readers) from low and medium-high SES backgrounds within Palestinian society in Israel who had participated in the development study of a comprehensive battery of tests in oral and written Arabic. The findings of this retrospective study reveal that, across grade levels, dyslexic readers from a low SES background showed similar performance to those from a medium-high SES background on most linguistic, cognitive and reading measures. As for typical readers, SES contributed to individual differences in all linguistic, cognitive and reading indices, with the exception of RAN. Finally, a cumulative effect of dyslexia and SES was found in relation to morphology, vocabulary, listening comprehension and text-reading accuracy.

Weight Loss, Dietary Preferences, and Reduction in the Sense of Smell with the Use of a Novel Nasal Device

INTRODUCTION

Exposure to food odors are known to increase food intake. Olfaction declines from age 50 years.

OBJECTIVE

We examined changes in the sense of smell, body weight, food preferences, and parameters of metabolic status, following the use of a specially designed nasal device.

METHODS

This is a randomized, placebo-controlled study. Participants wore a nasal device (soft silicone insert) for 5-12 h daily (device group) or inserted 2 drops of normal saline into each nostril daily (control group). Follow-up visits occurred every 2 weeks. All participants were given a 500 kcal/day reduced diet and instructed not to change their regular physical activity. Weight, food preferences, olfactory sensitivity, and blood tests were performed at baseline and after 12 weeks.

RESULTS

Of 156 participants, 65 (42%) completed the study. Sense of smell decreased in the device group (from 6.4 ± 0.9 to 4.4 ± 1.5, on a scale of 0-7, p < 0.001), and did not change in the control group. Weight loss decreased by 6.6 ± 3.7% (p = 0.001) and by 5.7 ± 3.5% (p = 0.001) in the respective groups (between-group difference, p > 0.05). Among participants aged ≤50 years, weight loss was greater in the device than in the control group (7.7 ± 4.2% vs. 4.1 ± 2.9%, p = 0.02). Insulin level and the homeostatic model assessment of insulin resistance (HOMA-IR) were significantly reduced in the device group (p = 0.02 and p = 0.01, respectively), but not in the control group. Food preferences for sugar (p < 0.02), sweet beverages (p < 0.001), and artificial sweeteners (p < 0.02) were significantly reduced in the device group compared to the control group.

CONCLUSIONS

The use of a novel self-administrated nasal device led to reduced olfactory sensitivity, improved insulin sensitivity, weight loss, and lesser preference for sweets in adults aged ≤50 years.

Efficacy of an Early Intervention Program for At-Risk Preschool Boys: A Two-Group Control Study

OBJECTIVE. We report the results of a preschool-based multidisciplinary intervention program.

METHOD. This study took place in two educational settings and included 81 preschool boys from unique cultural backgrounds and of low social economic status (SES). The settings were randomly assigned to an intervention or control group. In the intervention group, boys identified as at risk for or with developmental delays received 8 mo. of intervention through a monitoring model. Additionally, a collaborative consultation model was used with all participants. Performance skills (visual–motor integration, motor, and cognitive) and performance and participation in preschool activities were evaluated at pretest and posttest.

RESULTS. At termination of intervention, all children in the intervention group scored significantly better than control children on most performance skills and more fully participated in preschool activities.

CONCLUSION. A multidisciplinary preschool early intervention program appears to assist children of low SES with improving their performance skills, and participation in preschool activities.

The influence of environmental factors on the development of ultra-orthodox preschool boys in Israel

The study objectives were: (a) to compare the prevalence of children at risk and/or with developmental delay (at risk/delayed) among the Ultra-Orthodox community with the prevalence reported in the literature and (b) to compare the performance of Ultra-Orthodox children in kindergarten versus that of children in preschool. To this end, motor, visual-motor integration and cognitive performance of 203 Ultra-Orthodox boys from low socio-economic status were assessed. We found a higher percentage of children who were at risk/delayed in gross motor and motor-cognitive skills as compared with the percentage reported in the literature. However, as opposed to expected, the results did not show that there was a higher percent of at-risk/delayed children among the kindergarten group as compared with those among the preschool group. Our findings are consistent with the research literature suggesting that children's cultural background and economic constraints can affect their motor and cognitive development. Thus, occupational therapists and other health professionals should be more culturally competent and more aware of the specific values and practices of families of children with whom they work, which can impact their development. However, in this study, it is difficult to distinguish between the influence of the cultural factors and the influence of socio-economic factors. Therefore, it is recommended to repeat this study among children from either low socio-economic status or other cultural backgrounds.

Evaluating the impact of age and disease on survival of chronic lymphocytic leukaemia patients by a new method

BACKGROUND

The impact of chronic lymphocytic leukaemia (CLL) on survival may be different in younger patients, but this remains controversial.

OBJECTIVES

The aim of the study was to examine the effect of age on survival in CLL using an original method.

METHODS

Clinical, laboratory and survival data of 87 CLL patients treated in our institute were analysed. The survival of patients in different age groups was determined and compared, as related to the expected survival of age- and gender-matched general population obtained from national statistical data.

RESULTS

The mean age in the younger (< or = 65 years, n = 37) and older (> 65 years) age groups was 56 and 74 years (p < 0.001). The younger group had more unfavourable presentation, with advanced stage (Rai 2-4) in 46% vs. 16% (p = 0.002), and diffuse involvement of bone marrow in 60% vs. 18% (p = 0.03), compared with the older group, and were more likely to require treatment (p = 0.02). The Kaplan-Meyer curve showed a more favourable survival for the younger group. However, the loss of expected survival exposed a reversed pattern: while the older patients lost only 13%, the survival loss in the younger patients was 44% (p < 0.001).

CONCLUSIONS

Chronic lymphocytic leukaemia had a more unfavourable presentation and a more severe clinical course in the younger patients. Our method of evaluating the negative impact of disease on expected survival reveals that their survival also is significantly more affected than that of older patients. We suggest calculating the loss of expected survival as a new criterion for assessing disease impact.

Blood pressure variability in acute ischemic stroke depends on hemispheric stroke location

The relationship between blood pressure (BP) variability and stroke location was examined in 85 patients admitted with acute ischemic stroke. The patients were divided into three groups according to stroke location: right hemisphere (32 patients), left hemisphere (30 patients) and non-localized (23 patients). BP upon admission was 147.94/76.53 +/- 20.72/13.70 mmHg in the right hemisphere group, 151.81/76.10 +/- 25.69/16.23 mmHg in the left hemisphere and 155.23/83.41 +/- 30.45/15.74 in the non-localized group. The left hemisphere group had significantly (p < 0.01) greater variations in systolic and diastolic BP between days 2 and 3 and in systolic BP between days 3 and 4 after stroke compared with the other groups. BP in the left hemisphere group was less stable than in the other two groups. Non-localized patients without pre-existing hypertension had a significantly lower and more stable BP during the week following stroke than non-localized patients with pre-existing hypertension. Non-localized patients with pre-existing hypertension had the highest BP and showed no improvement during the week. Systolic BP tended to be higher and less stable in left hemisphere patients than in right hemisphere, whereas among non-localized ischemic stroke patients BP was higher in those who had a prior diagnosis of hypertension.

Influence of intense multidisciplinary follow-up and orlistat on weight reduction in a primary care setting

Background

Obesity is the most common health problem in developed countries. Recently, several physicians' organizations have issued recommendations for treating obesity to family physicians, including instructions in nutrition, physical activity and medications. The aim of this study was to examine if effective weight-reducing treatment can be given by a family physician. It compares regular treatment with intensive treatment that include close follow-up and orlistat treatment.

Methods

The study was conducted in three primary care clinics. 225 patients were divided into three groups according to their choice. Group A received a personal diet with fortnightly meetings with the family physician and dietitian and orlistat treatment. Group B received a general diet, monthly meetings with the family physician only and orlistat treatment. Group C received a personal diet, monthly meetings with the dietitian only and no drug treatment. The primary endpoint was reduction of at least 5% of the initial weight during the study period.

Results

A greater percentage of patients in group A achieved their weight reduction goals than in other groups (51%, 13% and 9% in groups A, B and C, respectively, p < 0.001). There was a significant reduction in triglycerides in all groups, a significant reduction of low density lipids (LDL) in groups A and B and no significant difference in high density lipids (HDL) in any group.

Conclusions

Significant weight reduction was obtained in a family physician setting. Further research is needed to evaluate if, by providing the family physician with the proper tools, similar success can be achieved in more clinics.

Calcium and vitamin D enriched diets increase and preserve vertebral mineral content in aging laboratory rats

To assess the long-term effect of vitamin D or calcium supplementation on the skeletal metabolism of aging laboratory rodents, 1.5-month-old female Wistar rats were fed with diets containing twice the concentration of vitamin D (group 2) and of calcium (group 3) as in the usual rat chow. Follow-up to 24 months of age did not show significant differences between the enriched-diet groups and the controls (group 1) in terms of the vertebral body weight and protein content. Significantly higher bone mineral contents were found in groups 2 and 3 than were found in controls, as revealed by an increased bone mineral density (BMD: +62%, group 2; +48%, group 3) and vertebral calcium content (+73%, group 2; +84%, group 3). The vertebral alkaline phosphatase enzymatic activity was significantly lower in the enriched diet groups than in controls (-47%, group 2; -45%, group 3). The ratio alkaline phosphatase/acid phosphatase activity was markedly reduced in groups 2 and 3 (-57% and -59%, respectively), which might indicate a diminished rate of bone turnover. The trabecular bone volume (BV/TV) decreased in all groups during senescence, being significantly elevated in group 3 as compared to controls. Vitamin D and calcium dietary supplementations increase the axial mineral bone content in laboratory rats and might reduce the bone turnover. Their influence on the trabecular bone volume has yet to be examined.

Injury severity scoring and length of stay in hospital of war casualties--demonstration of an association and possible selection bias

The Injury Severity Score (ISS) is a widely used measure of anatomical injury. It is the sum of squares of the highest scores on the Abbreviated Injury Scale (AIS) in each of the three most severely injured body regions. This study was designed to describe the relationship between ISS and length of stay (LOS) in hospital. The ISS was independently determined by four physicians who studied 491 war casualties, excluding dead on arrival and non-trauma patients. The study demonstrates non-linear and non-homogeneous relationships between ISS and LOS. Exclusion of fatalities resulted in biased (higher) estimates of LOS among those with ISS scores of 25-66. The patients could be grouped into five categories according to their maximal AIS (MAIS): (1) Slight injury--i.e. those with injuries appropriate for AIS scores 1 or 2 that lead to an LOS of median 5 days; (2) Moderate injury--i.e. those with injuries appropriate to AIS scores of 3, with an expected median LOS of 10 days; (3) Severe injuries--i.e. those with injuries appropriate to AIS scores of 4, with expected median LOS of about 17 days; (4) Very severe injuries--i.e. those with one injury appropriate to an AIS score of 5; and (5) Multiple severe injuries--those who are severely wounded in two or more body regions, i.e. those with two or more injuries appropriate to AIS scores of 5 and 4, with a median LOS of 39 days.(ABSTRACT TRUNCATED AT 250 WORDS)

Growth and development of children conceived by in vitro fertilization

To assess the physical and mental development of infants born after in vitro fertilization (IVF), we performed a general physical and developmental examination (Bayley and Stanford-Binet scales) on a cohort of 116 IVF children, conceived and born at our institution between February 1985 and March 1989, and on 116 non-IVF matched controls. Study and control groups were each composed of 66 singletons, 19 pairs of twins and 4 sets of triplets, whose age at examination ranged from 12 to 45 months. The developmental indices of IVF infants were within the normal range and did not differ from those of their matched controls. The indices were positively correlated to gestational age, birth weight, head circumference at birth and at examination, and mother's education. Mean birth weight, gestational age, and birth weight percentile of IVF infants were lower than the mean of the healthy population. Mean percentiles of weight and length at examination (mean age 22.4 months) were equally low but did not differ from those of the matched controls. However, mean percentiles of head circumference at birth and at examination compare well with the normal mean, both in IVF and control groups. Twins and triplets (IVF and controls) had significantly lower physical and mental indices as compared to singletons.