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以色列士兵足癣的患病率和危险因素

世界核心医学期刊文摘（皮肤病学分册） 2006年第3期2卷 57-58页

作者： Cohen A.D. Wolak A. AlkanM. 罗素菊 Dermatology Center Clalit Health Services (Southern District) Beer-Sheva Israel Dr

Background: Tinea pedis is a common infection in soldiers. However, prevalence and risk factors for tinea pedis in soldiers were investigated in only a few studies. Objectives: To investigate the prevalence and risk factors for tinea pedis in Israeli soldiers. Methods: A cross-sectional study including interviews, clinical skin examination and mycological tests was performed in Israeli soldiers. The presence of tinea pedis was assessed using the Athlete s Foot Severity Index (AFSI), a scoring system that was developed in order to evaluate the presence and severity of tinea pedis. In soldiers with clinical evidence of tinea pedis (AFSI > 1), scrapings were taken for direct microscopic examination (20% KOH preparation) and fungal culture. Statistical analyses were performed using chi-square or Fisher s exact test for dichotomous variables (as needed), or t-tests for continuous variables. Logistic regression was used for multivariate analyses of dichotomous variables. Results: Two hundred and twenty-three soldiers were included in the study: 205 men (91.9% ) and 18 women (8.1% ). Mean age was 19.6 years (SD 1.0 year). Clinical point prevalence was 60.1% . Mycological point prevalence was 27.3% . Further analyses were performed using the clinical point prevalence. Univariate analyses demonstrated that the prevalence of tinea pedis varied with the setting of military training (basic training: 70.3% , advanced infantry training: 81.5% , armor commander training: 56.4% and armor officer training: 34.8% ) and was associated with male gender, frequency of sock changes and the length of military service. A multivariate analysis demonstrated that tinea pedis was associated with the setting of the military training (OR 1.6, 95% Cl 1.2- 2.1) and male gender (OR 4.3, 95% Cl 1.4- 13.8); however, there was no association with hygiene measures (e.g. frequency of changing socks or sleeping with socks) or the length of military service. Conclusion: Tinea pedis is highly prevalent in Israeli soldiers. Association of tinea pedis wi

关键词：危险因素患病率以色列足癣士兵 Fisher 存在情况检验分析横断面调查显微镜检查

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不同种族人群高血压患者的靶器官损害

世界核心医学期刊文摘（心脏病学分册） 2007年第7期3卷 53-53页

作者： wolak T. Anfanger S. Wolak A. 刘少伟 Hypertension Unit Soroka University Medical Center The Faculty of Health Sciences Beer-Sheba Israel

背景：高血压在不同种族的人群中可伴随不同的靶器官损害。以色列人口的多样性为评估不同种族人群高血压患者的靶器官损害提供了机会。方法和结果：从初级医疗诊所中收集高血压患者的计算机化医疗档案。对576例高血压患者进行分析：138... 详细信息

背景：高血压在不同种族的人群中可伴随不同的靶器官损害。以色列人口的多样性为评估不同种族人群高血压患者的靶器官损害提供了机会。方法和结果：从初级医疗诊所中收集高血压患者的计算机化医疗档案。对576例高血压患者进行分析：138例贝多因人（阿拉伯居民）、141例瑟法底犹太人（北非和中东移民）、152例亚裔-印度犹太人（印度移民）和145例阿肯纳西犹太人（欧洲、北美洲和南美洲移民）。在对已知的危险因素和种族校正后的多元Logistic回归分析中，亚裔-印度犹太人的脑血管疾病患病率最高（OR3．09，P=0．009）。

关键词：高血压患者靶器官损害种族人群多元Logistic回归分析犹太人医疗档案计算机化医疗诊所

与噻氯匹定相比,冠状动脉支架置入术后服用氯吡格雷使患者的远期支架内血栓形成发生率及死亡率升高

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世界核心医学期刊文摘（心脏病学分册） 2006年第1期2卷 58-59页

作者： Wolak A. Amit G. Cafri C. D. Zahger 杜媛 Department of Cardiology Soroka University Medical Center Ben Gurion University of the Negev PO Box 151 Beer Sheva 84101 Israel

Background: Clopidogrel has largely replaced ticlopidine following coronary stent implantation. Recently, concern has been raised regarding the possibility of excess long term mortality in patients given clopidogrel rather than ticlopidine following coronary stenting. Methods: We studied 1519 consecutive patients who underwent 2020 stent implantations and were discharged on dual antiplatelet regimens of either aspirin and ticlopidine or aspirin and clopidogrel given for up to 4 weeks. Thrombotic stent occlusion(TSO) was defined as ST elevation myocardial infarction in the stented artery territory associated with angiographic demonstration of complete stent occlusion. Mortality follow up was obtained for all patients by linkage to the Population Register. Follow up duration was 12 months. Results: TSO occurred in 37 stents at a median of 29 days post procedure. Of these cases, six occurred in the ticlopidine group(0.7%) and 31 in the clopidogrel group(2.8%)(p< 0.01). The median time to TSO was 34 days and 28 days in ticlopidine and clopidogrel treated patients, respectively(p< 0.01). After controlling for multiple demographic, clinical and angiographic variables clopidogrel(vs. ticlopidine) treatment remained the sole predictor of TSO(OR: 5.4,95%CI=1.2-24.1, p=0.028). Of even more concern, clopidogrel treatment was associated with an increased risk of 1 year mortality(OR: 1.8, 95%CI=1.2-2.8). Conclusions: Long term follow up after stent implantation in patients receiving the traditional 2-4 weeks course of dual antiplatelet therapy reveals increased rates of TSO and mortality in patients given clopidogrel as opposed to ticlopidine. Whether longer treatment with clopidogrel will change these observations deserves further study.

关键词：支架内血栓形成冠状动脉支架噻氯匹定氯吡格雷置入术后死亡率患者升高发生率服用

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美中应在制定气候变化政策上加强合作

博鳌观察 2014年第3期 74-76页

作者：弗兰克·沃勒克(Frank A.wolak) 永年美国斯坦福大学不详

过去20年来,国际社会一直在举行《联合国气候变化框架公约》缔约方会议,但结果却越来越令人失望。这充分表明,需要世界各国先签约同意温室气体排放目标,再出台协作政策的＂自上而下＂的方式不太可能成功。最初,许多工业化国家同意出台... 详细信息

过去20年来,国际社会一直在举行《联合国气候变化框架公约》缔约方会议,但结果却越来越令人失望。这充分表明,需要世界各国先签约同意温室气体排放目标,再出台协作政策的＂自上而下＂的方式不太可能成功。最初,许多工业化国家同意出台实质性的温室气体减排举措,尤其是欧盟（EU）各国建立了欧盟碳排放交易体系（EU-ETS）。

关键词：气体排放碳排放交易美中气候变化缔约方会议法律约束加拿大魁北克国际社会司法管辖实体分配

急性冠脉综合征冠脉介入治疗期间依诺肝素能够安全替代普通肝素吗?

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世界核心医学期刊文摘（心脏病学分册） 2005年第1期1卷 34-35页

作者： Wolak A. Ayzenberg Y. Cafri C. D. Zahger 王亭忠 Department of Cardiology So roka Medical Center Fac. Hlth. Sci. Ben Gurion Univ. N. Beer Sheva Israel

Background: Enoxaparin has gained wide acceptance in patients with acut e coron ary syndromes. However, there is uncertainty regarding management of patients wh o require coronary intervention while on enoxaparin. Some physicians withhold th e morning dose of enoxaparin prior to coronary intervention while others switch patients to unfractionated heparin. Both methods do not provide optimal anticoag ulation in the hours preceding intervention. There are no published controlled data to assess the safety of coronary intervention using enoxaparin alone in patients with acute coronary syndromes. Methods: We p rospectively compared enoxaparin to unfractionated heparin during coronary angio graphy and intervention. Sixty four patients admitted to the coronary care unit( CCU)were given enoxaparin twice daily, including on the morning of procedure. Co ronary angiography and intervention were performed without additional unfraction ated heparin. The control group comprised of 52 patients admitted to Internal Me dicine for an acute coronary syndrome. These were also given enoxaparin but the morning dose was withheld and unfractionated heparin was used during procedure. Results: Patients in both groups had similar baseline characteristics. No signif icant differences were observed between the two groups in procedural success rat e, complications or bleeding. One year follow up showed similar rates of hospita lization and mortality. Conclusion: Enoxaparin seems to offer safe and effective procedural anticoagulation in patients undergoing percutaneous intervention for acute coronary syndromes. Patients given enoxaparin can probably have coronary intervention without interruption of enoxaparin treatment and without additional procedural anticoagulation. These findings require confirmation in larger, rand omized trials.

关键词：依诺肝素急性冠脉综合征普通肝素冠脉介入治疗冠脉造影抗凝作用住院率随机试验