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The purpose of this study was to identify differences in the sensitivity of anatomical sites sampling for methicillin-resistant Staphylococcus aureus (MRSA) colonization related to age, gender, clinical situation, and acquisition source as a base for screening protocols. We used a database that included all MRSA-positive cultures (Carmel Medical Center, 2003-2006) taken from nares, throat, perineum, and infection sites. The study population of 597 patients was divided into: “screening sample” (SS), which were cases of routine screening, and “clinical diagnostic sample” (CDS), which were patients with concurrent MRSA infection. MRSA acquisition sources were classified as internal medicine, surgical, referral patients, or intensive care unit (ICU). CDS patients were older than SS patients (median age 78 vs. 74 years, p = 0.0002), more commonly throat colonized (47.5% vs. 31.8%, p = 0.0001), and colonized in more multiple sites (65.7% vs. 43.3% were colonized in three sites in the CDS and SS groups, respectively, p < 0.001) than SS patients. In the SS, group throat colonization was higher in internal medicine wards than in the ICU (odds ratio [OR] = 3.98, p < 0.0001). In the CDS group, perineal colonization was more common in referral patients than in the ICU (OR = 4.52, p < 0.05). Patient age was the most influential factor on nares and multiple sites colonization in the SS and CDS groups, respectively. Our data support multiple sites sampling. Throat cultures are crucial in MRSA-infected patients and internal medicine ward patients. Multiple body sites colonization is more likely in older or MRSA-infected patients, affecting decisions regarding eradication using topical antibiotics.

Physicians often encounter patients who present with a vague clinical syndrome. A wide serological workup is often ordered, which may include tests for Coxiella burnetii in endemic areas. Often, the results of these tests pose new dilemma, with overlapping positive laboratory assays. The objective of this investigation was to characterise the serological overlap between acute Q fever and other infectious and immunological diseases. We retrospectively scanned the files of patients with a positive or equivocal immunoglobulin (Ig) M for C. burnetii phase II over a period of 8 years in a general hospital. Clinical and laboratory data, including antibodies to infectious agents and antibodies related to immunological states, were recorded. Anti-nuclear antibody (ANA), smooth muscle antibody (SMA) and rheumatoid factor were positive in 38%, 33.3% and 22.2% of the cases, respectively. In patients with acute Q fever, elevated IgM levels for Epstein–Barr Virus (EBV), cytomegalovirus (CMV), Mycoplasma pneumoniae , parvovirus, Bordetella pertussis , Rickettsia conorii and R. typhi were noted in 13.8%, 8.3%, 12.12%, 22.2%, 25%, 13% and 21.7% of cases, respectively. Acute Q fever induces a non-specific immunological arousal in a significant number of patients. This may interfere with diagnosis and delay treatment. Caution, clinical judgment and serological follow-up is warranted in such conditions.

We analyze the emission properties of a new sample of 3 596 type 1 AGN, selected from the SDSS DR7 based on the detection of broad Hα emission. The sample extends over a broad Hα luminosity LbHα of 1040–1044 erg s−1 and a broad Hα FWHM of 1 000–25 000 km s−1, which covers the range of black hole mass 106 < MBH/M⊙ < 109.5 and luminosity in Eddington units 10−3 < L/LEdd < 1. We combine ROSAT, GALEX and 2MASS observations to form the SED from 2.2 μm to 2 keV. We find the following: 1. The distribution of the Hα FWHM values is independent of luminosity. 2. The observed mean optical-UV SED is well matched by a fixed shape SED of luminous quasars, which scales linearly with LbHα, and a host galaxy contribution. 3. The host galaxy r-band (fibre) luminosity function follows well the luminosity function of inactive non-emission line galaxies (NEG), consistent with a fixed fraction of ∼ 3% of NEG hosting an AGN, regardless of the host luminosity. 4. The optical-UV SED of the more luminous AGN shows a small dispersion, consistent with dust reddening of a blue SED, as expected for thermal thin accretion disc emission. 5. There is a rather tight relation of νLν(2 keV) and LbHα, which provides a useful probe for unobscured (true) type 2 AGN.

Abstract Objective: To assess the effect of size at birth, maternal nutrition, and body mass index on blood pressure in late adolescence. Design: Population based analysis of birth weight corrected for gestational age, mother's weight before pregnancy and weight gain in pregnancy, obtained from the Jerusalem perinatal study, and blood pressure and body mass index at age 17, available from military draft records. Setting: Jerusalem, Israel. Subjects: 10 883 subjects (6684 men and 4199 women) born in Jerusalem during 1974-6 and subsequently drafted to the army. Main outcome measures: Systolic and diastolic blood pressures measured at age 17 and their correlation with birth weight, size at birth, mother's body mass index and weight gain during pregnancy, and height and weight at age 17. Results: Systolic and diastolic blood pressures were significantly and positively correlated with body weight, height, body mass index at age 17, and with mother's body weight and body mass index before pregnancy, but not with birth weight or mother's weight gain in pregnancy. Conclusion: Variables reflecting poor intrauterine nutrition, including low maternal body mass index before pregnancy, poor maternal weight gain in pregnancy, and being born small for gestational age, were not associated with a higher blood pressure in late adolescence. Key messages Several studies have shown a significant inverse relation between blood pressure and birth weight, though the finding is not consistent In 10 883 Israelis blood pressure measured at age 17 was related to their birth weight adjusted for gestational age, their current body mass index, and their mother's weight before pregnancy and weight gain during pregnancy Blood pressure was significantly and positively correlated with body mass index at age 17 and with mother's weight before pregnancy but not with birth weight or mother's weight gain during pregnancy Variables reflecting poor intrauterine nutrition were therefore not associated with higher blood pressures in late adolescence

Objective--To study the effect of birth weight and body weight on blood pressure in late adolescence. Design--Analysis of data on weight, height, and blood pressure at age 17 of subjects from the Jerusalem perinatal study, according to their birth weight. Data for men and women were analysed separately. Setting--Jerusalem, Israel. Subjects--32,580 subjects (19,734 men and 12,846 women) born in the three major hospitals in Jerusalem during 1964-71 and subsequently drafted in to the army. MAIN OUTCOME MEASURES--Correlations between birth weight and blood pressure at age 17 and weight and height at age 17 and blood pressure. Results--Diastolic and systolic blood pressures were associated with birth weight in both young men and young women, but the correlation coefficients were low. A high body weight at age 17 (greater than 66 kg for women, greater than 75 kg for men) rather than a low birth weight (less than 2500 g) was linked with higher systolic and diastolic blood pressures in both men and women (p less than 0.01). Conclusions--Intrauterine environment, as reflected by birth weight, has little effect on blood pressure in young men and women. Modification of factors which lead to excess weight during adolescence may have a major role in preventing hypertension in adults.

OBJECTIVES--To study effects of time, sex, ethnic origin, and area of residence on prevalence of asthma in Israeli adolescents. DESIGN--Retrospective survey of asthma from computerised medical draft records of conscripts examined up to the end of 1989. SETTING--Five regional centres in Israel. SUBJECTS--443 186 conscripts (262 836 males and 180 350 females) aged 17-18 who were born over a nine year period. MAIN OUTCOME MEASURES--Asthma determined by medical history, physical examination, and lung function tests at rest and after exercise. RESULTS--Asthma was more prevalent in males than females (26.5/1000 v 21.4/1000, relative risk 1.25 (95% confidence interval 1.19 to 1.32)). Subjects were split into three groups according to year of birth, and prevalence of asthma increased over time from 18/1000 to 24/1000 to 36/1000 (risk of asthma 0.56 (0.54 to 0.59) for first birth group relative to last birth group and 0.69 (0.66 to 0.72) for second group relative to last group). Risk of asthma was also affected by ethnic origin (highest for Western origin and lowest for north African origin, relative risk 1.63 (1.56 to 1.71)) and area of residence (highest in the central coastal region--risk of 1.24 (1.19 to 1.30) relative to the north coastal region--and lowest in inland areas--risk of 0.67 (0.64 to 0.70) relative to north coastal region). CONCLUSIONS--Prevalence of asthma in Israel is increasing and is higher in males, in people of Western origin, and in those living in the most industrialised coastal region.

Neck circumference (NC), as an upper body obesity index, is a simple screening measure for identifying overweight and obese patients. This study examines a relationship between changes in systolic blood pressure (BP), and diastolic BP and changes in NC, and other components of the metabolic syndrome. In a longitudinal cohort study the study group was comprised of 364 subjects (155 men and 209 women) with no known major medical conditions who were not receiving any medication therapy. Main indicators studied included systolic BP, diastolic BP, NC, waist circumference (WC), waist-to-hip ratio (WHR), lipoprotein, glucose, and uric acid levels. Pearson's correlation coefficients indicated a significant association between changes in systolic BP and changes in NC (men, r = 0.54; women, r = 0.56; each, P < .0001), WC men, r = 0.51; women, r = 0.56; each, P < .0001), triglycerides (men, r = 0.41; women, r = 0.44; each, P < .0001), and glucose (men, r = 0.43, P < .001; women, r = 0.48, P < .0001); between changes in diastolic BP and changes in NC (men, r = 0.56; women, r = 0.68; each, P < .0001), WC (men, r = 0.62; women, r = 0.50; each, P < .0001), triglycerides (men, women; each, r = 0.39, P < .0001), and glucose (men, r = 0.45; women, r = 0.49; each, P < .0001). Changes in systolic BP and diastolic BP correlated positively with changes in NC and other components of the metabolic syndrome.

The effect of low birth weight on the incidence of asthma by 17 years of age was investigated by studying medical draft examination records of 20,312 male subjects born in Jerusalem between January 1967 and December 1971. Additional information on birth weight and other demographic factors was abstracted from the Jerusalem Perinatal Study computerised database. A stepwise multiple logistic regression was used to estimate the odds ratios for developing asthma by 17 years of age in 500 g birthweight categories from less than 2000 g to 4500 g. The odds ratios were adjusted for the confounding effects of ethnic origin, social class (determined by area of residence), paternal education, maternal age, and birth order. The group with low birth weights (less than 2500 g, n = 1004) had a significantly increased risk of developing asthma by 17 years of age, with an adjusted odds ratio of 1.44 (95% confidence interval (CI) 0.79 to 2.66) for birthweight group less than 2000 g and 1.49 (95% CI 1.05 to 2.12) for birthweight group 2000-2499 g compared with the reference group of 3000-3499 g. We conclude that infants with birth weights of less than 2500 g may have a higher risk of asthma during childhood and adolescence than infants who were heavier at birth.

Normal spirometry is required for medical clearance of professional divers in many countries. Divers frequently have unusually large lung volumes associated with a low ratio of FEV(1) to FVC (FEV(1)%), suggestive of obstructive airways disease. We retrospectively analyzed the records of divers in the Israeli Navy with a low FEV(1)% who fulfilled the criteria for large lungs, to determine whether this might be the effect of training or natural selection. We also investigated changes in pulmonary function in relation to diving experience. A total of 171 divers with FEV(1)% < 80% on simple spirometry were evaluated. We conducted a retrospective analysis of lung function data for those subjects who met the criteria for large lungs. One hundred nine of 171 divers with low FEV(1)% met the criteria for large lungs and were included in the study. Their average age was 25 years (range, 18 to 44 years), and their mean diving experience was 7 years (range, 0 to 26 years). No difference was found in FVC values between experienced and inexperienced divers. The mean forced expiratory flow at 50% of vital capacity was significantly reduced in the most experienced group compared with the novice or less experienced divers. No difference was found in the diffusing capacity of the lung for carbon monoxide between experienced and inexperienced divers. We suggest that large lungs may represent part of the natural selection for diving, rather than a training effect. Prolonged diving experience may result in the development of small airways disease.

OBJECTIVE: To determine the efficacy of blue versus blue-green phototherapy using new light sources with narrow luminous spectra. The devices made of high-intensity gallium nitride light-emitting diodes (LEDs) were also compared to conventional halogen-quartz bulbs phototherapy. DESIGN: Prospective open randomized study. PARTICIPANTS: A total of 114 jaundiced, but otherwise healthy term infants who met the entry criteria for phototherapy set by the American Academy of Pediatrics' Practice Parameter. MAIN OUTCOME MEASURES: The duration of phototherapy and the rate of decrease in total serum bilirubin (TSB). RESULTS: The mean TSB concentrations at initiation and termination of treatment, as well as the duration of phototherapy and the rate of decrease in TSB, were not statistically different in newborns receiving blue LED, blue-green LED or conventional phototherapy. The average rate of decrease in TSB (slope), after adjustment by a linear regression analysis for confounding factors, was −3.61  μ mol/hour (95% confidence limits −5.47, −1.75) in the 25 newborns receiving blue LED phototherapy compared with −2.57  μ mol/hour (−4.32, −0.82) in the 22 newborns treated with blue-green LED phototherapy and −3.42  μ mol/hour (−5.02, −1.81) in the 57 newborns who received conventional phototherapy. CONCLUSIONS: When using low light irradiance, there was no statistically significant difference in the effectiveness of phototherapy using blue-green LEDs, blue LEDs or conventional halogen-quartz bulbs.