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  1. Article ; Online: Safety of measles, rubella and mumps vaccines in adults: a prospective cohort study.

    Ami, Neuberger / Eyal, Nadir / Asaf, Biber / Chen, Avni / Adi, Brom / Drorit, Attias / Neta, Petersiel / Hajar, Dallashi / Stav, Rakedzon / Eli, Schwartz

    Journal of travel medicine

    2021  Volume 28, Issue 8

    Abstract: Background: In recent years, multiple outbreaks of measles associated with vaccine hesitancy occurred in high-income countries, where measles incidence had previously been low. Most safety data about the measles, mumps and rubella (MMR) vaccine are ... ...

    Abstract Background: In recent years, multiple outbreaks of measles associated with vaccine hesitancy occurred in high-income countries, where measles incidence had previously been low. Most safety data about the measles, mumps and rubella (MMR) vaccine are derived from studies conducted among children, whereas evidence regarding the safety profile of the vaccine in adults is scarce.
    Methods: In 2017, during an outbreak of measles in Europe, Israeli travellers to high-risk locations who were incompletely vaccinated, were urged to complete the two MMR vaccination schedule before their travel. In this prospective cohort study, we analysed adverse events (AEs) of MMR and MMRV (measles, mumps, rubella and varicella) vaccines among these travellers. All participants were followed up using structured questionnaires 2-4 weeks after vaccination.
    Results: Seven hundred and eighty-five adult travellers whose median age was 49.2 years were vaccinated and followed up. Any AEs were reported by 25.2% of all participants; 11.6% reported local AEs, and 18.6% reported systemic AEs, none of which were severe. In general, AEs were much more common among female travellers (19.4% of males vs 30.1% of females (P < 0.001)). Local AEs, overall systemic AEs, headache and arthralgia were much more common among females, whereas rates of general malaise and fever were not statistically different between genders. We did not observe any significant differences in the rates of total, local or systemic AEs between the MMR and MMRV vaccines. Higher rates of systemic AEs were observed among participants who were younger and probably immunized once with MMR compared to older vaccines immunized once to measles only and to those who were never immunized.
    Conclusions: The current study demonstrated low rates of systemic AEs and no serious AEs following either MMR or MMRV administration. More AEs were reported among females, and rates of AEs were similar after either MMR or MMRV.
    MeSH term(s) Antibodies, Viral ; Chickenpox/prevention & control ; Chickenpox Vaccine/adverse effects ; Child ; Female ; Humans ; Infant ; Male ; Measles/prevention & control ; Measles-Mumps-Rubella Vaccine/adverse effects ; Middle Aged ; Mumps/chemically induced ; Mumps/epidemiology ; Mumps/prevention & control ; Prospective Studies ; Rubella ; Vaccines, Combined/adverse effects
    Chemical Substances Antibodies, Viral ; Chickenpox Vaccine ; Measles-Mumps-Rubella Vaccine ; Vaccines, Combined
    Language English
    Publishing date 2021-06-07
    Publishing country England
    Document type Journal Article
    ZDB-ID 1212504-0
    ISSN 1708-8305 ; 1195-1982
    ISSN (online) 1708-8305
    ISSN 1195-1982
    DOI 10.1093/jtm/taab071
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: The “Great Masquerader" Strikes Again

    Adi Brom / Idan Goren / Gad Segal

    European Journal of Case Reports in Internal Medicine, Vol 1, Iss

    Secondary Syphilis Presentation with Erythema Multiforme (EM)-Like Lesions

    2014  Volume 1

    Abstract: Syphilis is a sexually transmitted disease known to present with highly variable manifestations, especially when left untreated. Patients who present to Internal Medicine Departments with fever and a rash are always a diagnostic challenge since mild ... ...

    Abstract Syphilis is a sexually transmitted disease known to present with highly variable manifestations, especially when left untreated. Patients who present to Internal Medicine Departments with fever and a rash are always a diagnostic challenge since mild viral diseases and life-threatening bacterial infections may manifest themselves similarly. In the following case presentation, we describe a patient with 1 month’s duration of fever and rash on the palms of the hand and soles of the feet, in the form of erythema multiforme (EM)-like lesions. His disease was diagnosed as secondary syphilis, once again justifying its name: the “great masquerader".
    Keywords Syphilis ; erythema multiforme ; fever and rash ; fever of unknown origin ; Medicine ; R
    Language English
    Publishing date 2014-12-01T00:00:00Z
    Publisher SMC MEDIA SRL
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: THE âNEW SETTLERSâ

    Gad Segal / Adi Brom / Erez Ramati

    American Journal of Infectious Diseases, Vol 9, Iss 4, Pp 136-

    RESULTS OF A BACTERIOLOGICAL SURVEY DURING THE FIRST 6-MONTHS OPERATION PERIOD OF AN INTERNAL MEDICINE WARD IN A TERTIARY HOSPITAL

    2013  Volume 141

    Abstract: During the first six months of operating a new Internal-medicine ward in a tertiary hospital, a prospective survey, tracking both patient and environment bacteriological samples taken, was conducted. The motive behind the study was to establish the ... ...

    Abstract During the first six months of operating a new Internal-medicine ward in a tertiary hospital, a prospective survey, tracking both patient and environment bacteriological samples taken, was conducted. The motive behind the study was to establish the pattern in which environmental colonization is transmitted to the hospitalized patients, and vice versa, thus defining the nosocomial pathogens that are typical to the ward. That information can be used to guide empirical antibiotic treatment. Patient sampling was done on clinical grounds whereas environmental cultures were systematically acquired from different surfaces around the ward. 6-monthsâ results analysis suggest that clinically guided culture rates were tightly associated with volume of patients admitted, with no such association demonstrated between volume of cultures taken and rate of positive results, except for urine cultures. Regarding environmental sampling, we demonstrated no benefit in taking empirical, surface samples for common nosocomial pathogens. Our findings could further improve future resources allocation with regard to infection control and clinical bacteriology routines in newly established internal medicine wards.
    Keywords Bacteriological Survey ; Colonization ; Cultures ; Environmental Cultures ; Internal Medicine ; Infectious and parasitic diseases ; RC109-216 ; Internal medicine ; RC31-1245 ; Medicine ; R
    Subject code 616
    Language English
    Publishing date 2013-01-01T00:00:00Z
    Publisher Science Publications
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article: Low Blood ALT Activity and High FRAIL Questionnaire Scores Correlate with Increased Mortality and with Each Other. A Prospective Study in the Internal Medicine Department.

    Irina, Gringauz / Refaela, Cohen / Adi, Brom / Avia, Davidi / Liron, Hofstetter / Chen, Avaki / Gad, Segal

    Journal of clinical medicine

    2018  Volume 7, Issue 11

    Abstract: Background: Low blood ALT, Alanine aminotransferase activity and high FRAIL (Fatigue, Resistance, Ambulation, Illnesses and Loss of Weight) questionnaire scores were previously shown to be associated with frailty and increased risk of mortality. We ... ...

    Abstract Background: Low blood ALT, Alanine aminotransferase activity and high FRAIL (Fatigue, Resistance, Ambulation, Illnesses and Loss of Weight) questionnaire scores were previously shown to be associated with frailty and increased risk of mortality. We aimed to correlate these tools with mortality and each other in patients hospitalized in an internal medicine department.
    Methods: This is a prospective study in a large tertiary hospital. We assessed the predictive value for clinical outcomes of both low ALT blood activity and the pre-frail and frail categories of the "FRAIL" questionnaire.
    Results: During a 15 months study, 179 consecutive patients were recruited, of whom 20 died. When all study participants were divided to three groups according to admission ALT levels (below 10 IU/L, 11 to 19 IU/L and above 20 IU/L) we found a statistically significant difference in the rate of mortality: 4 patients died within the group of ALT < 10 IU/L, 14 patients died in the group of 10 IU/L < ALT < 19 IU/L and in the group of patients with ALT > 20 IU/L, only 2 patients died (
    Conclusions: Both the FRAIL questionnaire and blood ALT activity are simple and practical tools for frailty assessment and risk stratification of patients hospitalized in the internal medicine department. Both tool's results also correlate with each other.
    Language English
    Publishing date 2018-10-25
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2662592-1
    ISSN 2077-0383
    ISSN 2077-0383
    DOI 10.3390/jcm7110386
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Frailty and Sarcopenia Assessment upon Hospital Admission to Internal Medicine Predicts Length of Hospital Stay and Re-Admission

    Sapir Anani / Gal Goldhaber / Adi Brom / Nir Lasman / Natia Turpashvili / Gilat Shenhav-saltzman / Chen Avaky / Liat Negru / Muhamad Agbaria / Sigalit Ariam / Doron Portal / Yishay Wasserstrum / Gad Segal

    Journal of Clinical Medicine, Vol 9, Iss 2659, p

    A Prospective Study of 980 Patients

    2020  Volume 2659

    Abstract: Background: Frailty and sarcopenia are associated with frequent hospitalizations and poor clinical outcomes in geriatric patients. Ascertaining this association for younger patients hospitalized in internal medicine departments could help better ... ...

    Abstract Background: Frailty and sarcopenia are associated with frequent hospitalizations and poor clinical outcomes in geriatric patients. Ascertaining this association for younger patients hospitalized in internal medicine departments could help better prognosticate patients in the realm of internal medicine. Methods: During a 1-year prospective study in an internal medicine department, we evaluated patients upon admission for sarcopenia and frailty. We used the FRAIL questionnaire, blood alanine-amino transferase (ALT) activity, and mid-arm muscle circumference (MAMC) measurements. Results: We recruited 980 consecutive patients upon hospital admission (median age 72 years (IQR 65–79); 56.8% males). According to the FRAIL questionnaire, 106 (10.8%) patients were robust, 368 (37.5%) pre-frail, and 506 (51.7%) were frail. The median ALT value was 19IU/L (IQR 14–28). The median MAMC value was 27.8 (IQR 25.7–30.2). Patients with low ALT activity level (<17IU/L) were frailer according to their FRAIL score (3 (IQR 2–4) vs. 2 (IQR 1–3); p < 0.001). Higher MAMC values were associated with higher ALT activity, both representing robustness. The rate of 30 days readmission in the whole cohort was 17.4%. Frail patients, according to the FRAIL score (FS), had a higher risk for 30 days readmission (for FS > 2, HR = 1.99; 95CI = 1.29–3.08; p = 0.002). Frail patients, according to low ALT activity, also had a significantly higher risk for 30 days readmission (HR = 2.22; 95CI = 1.26–3.91; p = 0.006). After excluding patients whose length of stay (LOS) was ≥10 days, 252 (27.5%) stayed in-hospital for 4 days or longer. Frail patients according to FS had a higher risk for LOS ≥4 days (for FS > 2, HR = 1.87; 95CI = 1.39–2.52; p < 0.001). Frail patients, according to low ALT activity, were also at higher risk for LOS ≥4 days (HR = 1.87; 95CI = 1.39–2.52; p < 0.001). MAMC values were not correlated with patients’ LOS or risk for re-admission. Conclusion: Frailty and sarcopenia upon admission to internal medicine departments ...
    Keywords sarcopenia ; frailty ; ALT ; MAMC ; frail questionnaire ; internal medicine ; Medicine ; R
    Subject code 610 ; 616
    Language English
    Publishing date 2020-08-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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