Israel Medical Association Journal

Background: Breast reconstruction following oncological resection offers psychosocial benefits. Various factors influence patient reconstruction decisions, including ethnicity, socioeconomic status, and education. We investigated disparities in breast reconstruction among Bedouin and non-Bedouin women in the Negev region.

Objectives: To investigate the influence of ethnicity in breast reconstruction decisions between Bedouin and non-Bedouin women in Israel and to identify factors influencing the choice of reconstruction following oncological breast surgery.

Methods: In this retrospective cohort study, we examined women undergoing breast cancer surgery, with or without reconstruction, between 2015 and 2021 in a breast cancer referral center. Demographics and detailed medical data were collected from electronic health records. We analyzed the factors that influenced decisions regarding breast reconstruction.

Results: The study included 1415 patients who underwent breast resection. Age was a significant factor in breast reconstruction choices, with younger patients being more likely to choose reconstruction. Marital status and education level influenced the decision, whereas socioeconomic status and number of children did not. Ethnicity analysis highlighted distinct demographic and socioeconomic differences between Bedouin and non-Bedouin women. Despite these disparities, surgical choices did not differ significantly between ethnicities.

Conclusions: Significant disparities exist between Bedouin and non-Bedouin women in terms of sociodemographic factors. However, these disparities did not affect their breast reconstruction decisions. Age, marital status, and education level influenced the decision to reconstruct the breast.

Background: Food-borne pharyngitis outbreaks causing substantial morbidity have been documented.

Objectives: To investigate an outbreak of food-borne Streptococcus beta hemolyticus group A pharyngitis among employees of a high-tech company.

Methods: We received a report on an unusually high rate of morbidity among employees of a company in September 2003. The Tel Aviv District Health Office conducted an epidemiological investigation of the outbreak.

Results: Among the 278 people who attended a company party, 83 people became ill. The overall attack rate was 29.8%. Information was available on 174 of 193 employees and family members who attended the party and worked in the Tel Aviv district. Forty-six of them became ill (attack rate 26.4%). The secondary attack rate was 3.8%. Most cases developed symptoms 24–48 hours following the event. Seven cases had throat cultures positive for Streptococcus beta hemolyticus group A. Three items were significantly associated with becoming sick: spring chicken (odds ratio 2.26, 95% confidence interval 1.11–4.63, P = 0.02), vegetable salad (OR[1] 2.88 95%CI[2] 1.40–5.94, P = 0.003) and corn (OR 7.73, 95%CI 3.18–18.80, P < 0.001). Eating corn remained significantly associated with pharyngitis after controlling for other food items consumed.

Conclusions: We describe the epidemiological investigation of a large food-borne outbreak of Streptococcus beta hemolyticus group A pharyngitis most probably transmitted by corn. No previous publication has implicated corn. Food handlers and the public should be aware that they can transmit diseases to others.. Physicians should be aware that streptococcal pharyngitis could be a food-borne disease and that outbreaks in a non-confined setting may be easily missed.