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Article ; Online: An unusual case of non-resolving lymphadenopathy due to New World leishmaniasis.

Finkelstain, Anna / Schwartz, Eli / Lachish, Tamar

2023 Volume 30, Issue 8

MeSH term(s)	Humans ; Leishmania braziliensis ; Leishmaniasis, Cutaneous ; Leishmaniasis, Mucocutaneous ; Lymphadenopathy/etiology ; Male ; Adult
Language	English
Publishing date	2023-10-07
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	1212504-0
ISSN	1708-8305 ; 1195-1982
ISSN (online)	1708-8305
ISSN	1195-1982
DOI	10.1093/jtm/taad125
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Article ; Online: Morbidity of Returning Travelers Seen in Community Urgent Care Centers throughout Israel.

Itzkowitz, Eyal / Alpert, Evan A / Farojeh, Abdulhadi Z / Zimmerman, Deena R / Schwartz, Eli / Lachish, Tamar

Tropical medicine and infectious disease

2023 Volume 8, Issue 6

Abstract: Information regarding post-travel morbidity is usually reported via dedicated post-travel clinics and mainly relates to travelers returning from low-middle-income countries (LMIC), however, the spectrum of morbidity seen within the community setting is ... ...

Abstract	Information regarding post-travel morbidity is usually reported via dedicated post-travel clinics and mainly relates to travelers returning from low-middle-income countries (LMIC), however, the spectrum of morbidity seen within the community setting is scarcely reported. This prospective observational study among visitors to 17 community Urgent Care Centers (UCC) was designed to evaluate the reasons for post-travel community clinic visits and to compare travelers returning from LMIC to high-income countries (HIC). All visitors within one-month post-travel to all destinations were included. A total of 1580 post-travel visits were analyzed during 25 months. Travelers to LMICs were younger (mean 36.8 years old vs. 41.4 in the HIC group) and stayed longer periods abroad (30.1 ± 41.2 vs. 10.0 ± 10.6 in the HIC group) but more of them had pre-travel vaccines (35.5% vs. 6.6%). Travel-related morbidity was significantly more common in the LMIC group 58.3% (253/434) vs. 34.1% (391/1146) in the HIC group, (
Language	English
Publishing date	2023-06-13
Publishing country	Switzerland
Document type	Journal Article
ISSN	2414-6366
ISSN (online)	2414-6366
DOI	10.3390/tropicalmed8060319
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Article ; Online: Epidemiology, Clinical Characteristics and Risk Factors for Severity of Chronic Disseminated Candidiasis in Jerusalem, Israel.

Cohen, Nerel / Orenbuch-Harroch, Efrat / Olshtain-Pops, Karen / Lachish, Tamar / Korem, Maya

Mycopathologia

2023 Volume 188, Issue 6, Page(s) 873–883

Abstract: Chronic disseminated candidiasis (CDC) occurs mostly in patients with acute hematologic malignancy and its clinical manifestations derive from immune reconstitution following neutrophil recovery. The aim of this study was to describe epidemiological and ... ...

Abstract	Chronic disseminated candidiasis (CDC) occurs mostly in patients with acute hematologic malignancy and its clinical manifestations derive from immune reconstitution following neutrophil recovery. The aim of this study was to describe epidemiological and clinical characteristics of CDC and define risk factors for disease severity. Demographic and clinical data were collected from medical files of patients with CDC hospitalized in two tertiary medical centers in Jerusalem between 2005 and 2020. Associations between different variables and disease severity were evaluated, as well as characterization of Candida species. The study included 35 patients. CDC incidence slightly increased during study years and the average number of involved organs and disease duration was 3 ± 1.26 and 178 ± 123 days, respectively. Candida grew in blood in less than third of cases and the most common isolated pathogen was Candida tropicalis (50%). Histopathological or microbiological workup in patients who underwent an organ biopsy demonstrated Candida in about half of the patients. Nine months after starting antifungals, 43% of the patients still didn't have resolution of organ lesions in imaging modalities. Factors associated with protracted and extensive disease were prolonged fever prior to CDC and absence of candidemia. A C- Reactive Protein (CRP) cutoff level of 7.18 mg/dL was found to predict extensive disease. In conclusion, CDC incidence is increasing and the number of involved organs is higher than previously described. Clinical factors such as fever duration prior to CDC and absence of candidemia can predict severe course of disease and assist in treatment decisions and follow-up planning.
MeSH term(s)	Humans ; Candidemia/microbiology ; Israel/epidemiology ; Retrospective Studies ; Candidiasis/microbiology ; Candida ; Antifungal Agents/therapeutic use ; Risk Factors
Chemical Substances	Antifungal Agents
Language	English
Publishing date	2023-06-16
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	391081-7
ISSN	1573-0832 ; 0369-299X ; 0301-486X ; 0027-5530
ISSN (online)	1573-0832
ISSN	0369-299X ; 0301-486X ; 0027-5530
DOI	10.1007/s11046-023-00755-9
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Article ; Online: Morbidity among Arab-Israeli and Palestinian Hajj Pilgrims: A Prospective Study.

Fteiha, Bashar / Abul Al-Rub, Tawfiq / Schwartz, Eli / Lachish, Tamar

The American journal of tropical medicine and hygiene

2021 Volume 104, Issue 4, Page(s) 1596–1601

Abstract: Thousands of Palestinian and Arab-Israeli pilgrims travel to Mecca each year to complete their pilgrimage. To the best of our knowledge, no previous studies have characterized the infectious and noninfectious morbidity among Arab-Israeli or Palestinian ... ...

Abstract	Thousands of Palestinian and Arab-Israeli pilgrims travel to Mecca each year to complete their pilgrimage. To the best of our knowledge, no previous studies have characterized the infectious and noninfectious morbidity among Arab-Israeli or Palestinian Hajj pilgrims. Thus, we designed and conducted an observational questionnaire-based study to prospectively investigate the occurrence of health problems among these Hajjis who traveled to complete their Pilgrimage during 2019 Hajj season. For the purpose of the study, questionnaires were distributed to Hajj pilgrims at three different time occasions-before travel, inquiring on demographics and medical comorbidities; and 1 and 4 weeks after returning recording any health problems encountered during or after travel. Initial recruitment included 111 Hajjis. The mean age of responders was 49.5 (±9.1) years, with a Male:Female ratio of 1.3:1. The mean travel duration was 18.7 (13-36) days. Altogether, 66.3% of the pilgrims reported at least one health problem during and after the trip, of which 38.6% sought medical attention. Five (4.8%) hajjis were hospitalized, including life-threatening conditions. Cough was the most common complaint (53.8%), and 11.5% also reported fever. Pretravel counseling was associated with reduced outpatient and emergency room visits. We therefore concluded that a high rate of morbidity was reported among this cohort of Hajj pilgrims with a morbidity spectrum similar to pilgrims from other countries. Pretravel consultation with the purpose of educating the pilgrims on the health risks of Hajj may help reduce the morbidity for future Hajj seasons.
MeSH term(s)	Adult ; Aged ; Arabs ; Female ; Health Status ; Humans ; Islam ; Israel/ethnology ; Male ; Mass Gatherings ; Middle Aged ; Morbidity ; Prospective Studies ; Surveys and Questionnaires ; Transients and Migrants/statistics & numerical data ; Travel/statistics & numerical data ; Vaccination/statistics & numerical data
Language	English
Publishing date	2021-01-18
Publishing country	United States
Document type	Journal Article
ZDB-ID	2942-7
ISSN	1476-1645 ; 0002-9637
ISSN (online)	1476-1645
ISSN	0002-9637
DOI	10.4269/ajtmh.20-1460
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Article ; Online: Response letter to Minta et al.

Lachish, Tamar / Schwartz, Eli

Journal of travel medicine

2017 Volume 24, Issue 2

Language	English
Publishing date	2017--01
Publishing country	England
Document type	Journal Article ; Comment
ZDB-ID	1212504-0
ISSN	1708-8305 ; 1195-1982
ISSN (online)	1708-8305
ISSN	1195-1982
DOI	10.1093/jtm/taw081
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Article ; Online: Malaria in travellers in the time of corona.

Lev, Dana / Biber, Asaf / Lachish, Tamar / Leshem, Eyal / Schwartz, Eli

Journal of travel medicine

2020 Volume 27, Issue 6

MeSH term(s)	Adult ; Betacoronavirus ; COVID-19 ; Coronavirus Infections/diagnosis ; Delayed Diagnosis ; Female ; Humans ; Malaria/diagnosis ; Male ; Pandemics ; Pneumonia, Viral/diagnosis ; SARS-CoV-2 ; Time-to-Treatment ; Travel ; Young Adult
Keywords	covid19
Language	English
Publishing date	2020-04-30
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	1212504-0
ISSN	1708-8305 ; 1195-1982
ISSN (online)	1708-8305
ISSN	1195-1982
DOI	10.1093/jtm/taaa067
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Article ; Online: Artemisinin-based combination therapy (ACT) versus atovaquone-proguanil: do not choose between but, rather, combine them.

Schwartz, Eli / Lachish, Tamar

Evidence-based medicine

2016 Volume 21, Issue 2, Page(s) 64

MeSH term(s)	Amodiaquine/therapeutic use ; Antimalarials/therapeutic use ; Artemisinins/therapeutic use ; Atovaquone/therapeutic use ; Female ; Humans ; Malaria, Falciparum/drug therapy ; Male ; Proguanil/therapeutic use
Chemical Substances	Antimalarials ; Artemisinins ; Amodiaquine (220236ED28) ; Proguanil (S61K3P7B2V) ; Atovaquone (Y883P1Z2LT)
Language	English
Publishing date	2016-04
Publishing country	England
Document type	Comment ; Journal Article
ZDB-ID	1324346-9
ISSN	1473-6810 ; 1356-5524
ISSN (online)	1473-6810
ISSN	1356-5524
DOI	10.1136/ebmed-2015-110183
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Zs.A 4793: Show issues

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Article ; Online: The effectiveness of empirical anti-parasitic treatment in returning travellers with persistent abdominal symptoms.

Nissan, Batel / Lachish, Tamar / Schwartz, Eli

Journal of travel medicine

2017 Volume 25, Issue 1

Abstract: Background: Persistent abdominal symptoms (PAS) are common among returning-travellers. In the absence of sensitive tests to identify intestinal parasites, gastrointestinal (GI) symptoms often remain a diagnostic challenge. In this study we examined the ... ...

Abstract	Background: Persistent abdominal symptoms (PAS) are common among returning-travellers. In the absence of sensitive tests to identify intestinal parasites, gastrointestinal (GI) symptoms often remain a diagnostic challenge. In this study we examined the effectiveness of empirical anti-parasitic treatment in returning-travellers with PAS despite no positive stool-test. Methods: A retrospective study among returning travellers who approached the clinic between the years 2014 and 2016 with GI complaints without a positive stool-test. The empirical treatment included broad-spectrum anti-parasitic agents-oral Tinidazole and Albendazole. A follow-up questionnaire was performed at least 6 months post-treatment. Results: A total of 102 patients responded the questionnaire-50% women; average age 31.14 (±12.20) years. The average duration of complaints before treatment was 16.52 (±30.06) months. Common GI symptoms included abdominal pain (83.3%) and diarrhoea (78.4%); 67.6% of the patients complained of extreme fatigue. Overall, 69% of the patients reported an improvement in GI symptoms, 37% of them reported full recovery within a few weeks post-treatment. Furthermore, there was an improvement in the energy level and general well-being in 68% and 70% of the patients, respectively. Only 33% of the patients reported minor side effects related to the treatment. Conclusions: The improvement in GI symptoms, energy level and general well-being shortly after anti-parasitic treatment justifies this empirical approach in returning-travellers with PAS despite negative stool-tests. The association between fatigue and PAS post-travel and the improvement in both as a response to treatment defines fatigue as part of a new syndrome-'Post-travel fatigue and abdominal symptoms'.
MeSH term(s)	Administration, Oral ; Adolescent ; Adult ; Aged ; Albendazole/administration & dosage ; Albendazole/therapeutic use ; Anthelmintics/administration & dosage ; Anthelmintics/therapeutic use ; Diarrhea/drug therapy ; Diarrhea/parasitology ; Drug Administration Schedule ; Female ; Humans ; Intestinal Diseases, Parasitic/drug therapy ; Intestinal Diseases, Parasitic/parasitology ; Israel ; Male ; Middle Aged ; Retrospective Studies ; Surveys and Questionnaires ; Tinidazole/administration & dosage ; Tinidazole/therapeutic use ; Travel Medicine ; Treatment Outcome ; Young Adult
Chemical Substances	Anthelmintics ; Tinidazole (033KF7V46H) ; Albendazole (F4216019LN)
Language	English
Publishing date	2017-11-02
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/tax083
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Article ; Online: The use of a diversion tube to reduce blood culture contamination: A "real-life" quality improvement intervention study.

Wiener-Well, Yonit / Levin, Phillip D / Assous, Marc V / Algur, Nurit / Barchad, Orit Wolfovitz / Lachish, Tamar / Zalut, Todd / Yinnon, Amos M / Ben-Chetrit, Eli

American journal of infection control

2023 Volume 51, Issue 9, Page(s) 999–1003

Abstract: Background: Blood culture contamination is associated with health care costs and potential patient harm. Diversion of the initial blood specimen reduces blood culture contamination. We report results of the "real-life" clinical implementation of this ... ...

Abstract	Background: Blood culture contamination is associated with health care costs and potential patient harm. Diversion of the initial blood specimen reduces blood culture contamination. We report results of the "real-life" clinical implementation of this technique. Methods: Following an educational campaign, use of a dedicated diversion tube was recommended prior to all blood cultures. Blood culture sets taken from adults using a diversion tube were defined as "diversion sets," those without, "non-diversion" sets. Blood culture contamination and true positive rates were compared for diversion and nondiversion sets and to nondiversion historical controls. A secondary analysis investigated efficacy of diversion by patient age. Results: Out of 20,107 blood culture sets drawn, the diversion group included 12,774 (60.5%) and the nondiversion group 8,333 (39.5%) sets. The historical control group included 32,472 sets. Comparing nondiversion to diversion, contamination decreased by 31% (5.5% [461/8333] to 3.8% [489/12744], P < .0001]. Contamination was also 12% lower in diversion than historical controls [3.8% (489/12744) vs 4.3% (1,396/33,174) P = .02)]. The rate of true bacteremia was similar. In older patients, contamination rate was higher, and the relative reduction associated with diversion decreased (54.3% amongst 20-40-year-olds vs 14.5% amongst >80-year-olds). Conclusions: Use of a diversion tube in the ED reduced blood culture contamination in this large real life observational study. Efficacy decreased with increasing age, which requires further investigation.
MeSH term(s)	Adult ; Humans ; Aged ; Blood Specimen Collection ; Blood Culture/methods ; Quality Improvement ; Bacteremia/prevention & control ; Health Care Costs ; Equipment Contamination
Language	English
Publishing date	2023-03-10
Publishing country	United States
Document type	Observational Study ; Journal Article
ZDB-ID	392362-9
ISSN	1527-3296 ; 0196-6553
ISSN (online)	1527-3296
ISSN	0196-6553
DOI	10.1016/j.ajic.2023.02.015
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Article ; Online: 35 Humanitarian Aid Workers

Lachish, Tamar / Tenenboim, Shiri / Schwartz, Eli

Travel Medicine

Abstract: Abstract Traveling to extreme environments for humanitarian aid mission is now common. Humanitarian aid workers (HAWs) typically travel for extended periods, work in close proximity to local populations, and work in high-risk environments in low-resource ...

Abstract	Abstract Traveling to extreme environments for humanitarian aid mission is now common. Humanitarian aid workers (HAWs) typically travel for extended periods, work in close proximity to local populations, and work in high-risk environments in low-resource regions. Owing to the nature of their work, HAWs are often unable to avoid high-risk behaviors and frequently encounter stressful conditions, leading to psychologic repercussions. Although morbidity might be high, death during volunteer missions is not common and it is usually not attributable to infectious diseases. Medical evacuations are also not common. One unique aspect of ill-returning HAWs might be their threat to public health in their home countries, as was demonstrated in the 2014–2015 Ebola outbreak in West Africa. Thus pretravel and posttravel physical and psychologic screening evaluations, in addition to routine health care, are essential for this population.
Keywords	covid19
Publisher	Elsevier; PMC
Document type	Article ; Online
DOI	10.1016/b978-0-323-54696-6.00035-5
Database	COVID19

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