תוצאת חיפוש

Clinical Characteristics of Crohn's Disease in Children and Adults

Yoram Menachem, Zvi Weizman, Chaim Locker, Shmuel Odes

Gastroenterological Institute and Pediatric Gastroenterology and Nutrition Unit, Soroka Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba

There are few reports contrasting the clinical characteristics of Crohn's disease in different age groups. We therefore compared retrospectively children and adults with Crohn's disease. 23 children (mean age: 12.8±2.5 years) and 66 adults (mean age: 27.0±4.0 years) were studied. Presenting symptoms of abdominal pain and diarrhea were significantly more common in adults, while in children anorexia and weight loss were more frequent. Children tended to present with extra-gastrointestinal tract symptoms as well, mainly anemia and joint involvement. Common symptoms during active disease did not differ between groups, except that weight loss, evident in all children, was found in only 70% of adults. Anemia was present during active disease in all pediatric cases but in only 62% of adults. There were no significant differences between groups regarding disease location, gastrointestinal complications and extra-intestinal manifestations. We conclude that in children Crohn's disease may differ significantly, mainly presenting with nonclassical symptoms, such as anemia and joint involvement. The primary care physician should be aware of these differences.

Penetrating Ocular Injuries: a Retrospective Study

M. Schneck, S. Weitzman, T. Lifshitz, B. Biedner

Dept. of Ophthalmology, and Epidemiology and Health Services Evaluation Unit, Soroka Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba

Penetrating injuries of the eye are an important cause of unilateral visual loss. We studied a series of 82 cases of penetrating injuries treated here from 1987 through 1993. The injuries were caused by sharp objects in 66% and blunt trauma in 6%. The prognosis after a penetrating injury is greatly influenced by the nature of the injury and the extent of the initial drainage. Among factors associated with an unfavorable visual outcome were diminished preoperative visual acuity and scleral wounds with dense vitreous hemorrhage.

Epidemiologic Characteristics of Pediatric Emergency Room Referral and Hospitalization for Diarrhea in the Negev

Moni Benifla, Drora Fraser, Zvi Weizman, Amalia Levy, Ron Dagan

Dept. of Epidemiology and Health Services Evaluation and S. Daniel International Center for Health and Nutrition, Ben-Gurion University of the Negev, and Pediatric Dept. and Pediatric Infectious Disease Unit, Soroka Medical Center and Ben-Gurion University of the Negev

Diarrheal diseases weigh heavily on the health of children, especially in developing countries, but also impose burdens on health care services worldwide. This study was performed to determine whether patterns of referrals in the Negev to the pediatric emergency room (PER) for diarrhea differ between the Jewish and Bedouin populations of the Negev, and the extent of the burden imposed on the PER and in-hospital services in the Negev. Characteristics of referrals and hospitalizations were examined from March 1994 to February 1995. Of the 27,834 referrals to the PER for children under 16, 2518 (9%) had diarrhea and there were 5,169 hospital admissions, 701 (13.6%). The annual rates of referral were 146 per 10,000 in Jews and 225 in Bedouin, giving an odds ratio (OR) of 1.5 (p<0.001). for Bedouin. The rates of hospitalization were 23 per 10,000 in Jews and 99 in Bedouin (OR 4.4, p<0.001). 1380 (54.8%) of the PER referrals were of infants under a year of age. For hospitalization, the annual rates were 164 per 10,000 in Jews and 756 in Bedouins (OR 4.9, p<0.001). During June to August referrals and hospitalizations for diarrhea were significantly higher, and from December to February significantly lower than during the remaining months. These differences arise from the marked seasonal pattern in the Bedouin population, whereas in the Jewish population there was no seasonal variation. Even in the 90's the burden on health services in the Negev as a result of diarrheal illness is considerable and the Bedouin population still contributes to that burden disproportionately. There is need both to reduce the gap in referrals and hospitalization between the populations, as well as to reduce the rates, using currently available means such as education, while developing new technologies, such as vaccines.