Sima Halevy, MD, Hani Giryes, MD, Michael Friger, PhD, Nili Grossman, PhD, Zeev Karpas, PhD, Batia Sarov, PhD and Shaul Sukenik, MD
Background: A beneficial effect was observed in patients with psoriasis vulgaris following balneotherapy with Dead Sea bath salt.
Objectives: To evaluate the possible role of trace elements in the effectiveness of balneotherapy.
Methods: Serum levels of 11 trace elements were analyzed in 23 patients with psoriasis vulgaris who participated in a double-blind controlled study of balneotherapy, with either Dead Sea bath salt (12 patients) or common salt (11 patients). Thirteen healthy volunteers served as controls.
Results: The mean pre-treatment serum levels of boron, cadmium, lithium and rubidium were significantly lower in patients compared to controls, whereas the mean pre-treatment serum level of manganese was significantly higher in patients compared to controls. Balneotherapy with Dead Sea bath salt resulted in a significant decrease (P = 0.0051) in the mean serum level of manganese from 0.10 ± 0.05 mmol/L to 0.05 ± 0.02 mmol/L. The mean reduction in the serum level of manganese differed significantly (P = 0.002) between responders (% Psoriasis Area and Severity Index score reduction ³ 25) and non-responders (% PASI score reduction < 25). Following balneotherapy with Dead Sea bath salt the mean serum level of lithium decreased in responders by 0.01 ± 0.02 mmol/L whereas its level in non-responders increased by 0.03 ± 0.03 mmol/L. (P = 0.015).
Conclusions: Manganese and lithium may play a role in the effectiveness of balneotherapy with Dead Sea bath salt for psoriasis.
Baruch Klin, MD, Lev Zlotkevich, MD, Tifha Horne, MD, Yigal Efrati, MD, Francis Serour, MD and Gad Lotan, MD
Background: Acute scrotal pain in children presents a major diagnostic and therapeutic challenge. Epididymitis has been considered uncommon in childhood. The clinical spectrum and therapeutic policy of the acute scrotum in children is continually being reassessed.
Objectives: To determine whether there has been an increase in the incidence of epididymitis in children and to advocate a more selective surgical approach to the acute scrotum.
Methods: We conducted a retrospective review of 65 children admitted to our department of pediatric surgery with the diagnosis of acute scrotum during a 5 year period.
Results: Of the 65 children admitted with the diagnosis of acute scrotum, epididymitis was diagnosed in 42 (64.6%). The remaining cases included torsion of the testis in 12 patients (18.5%), torsion of the appendix testis in 5 (7.7%), scrotal pain and minimal physical findings in 4 (6.1%), and scrotal hematoma and idiopathic scrotal edema in one patient each. Doppler ultrasound of the groin, color Doppler ultrasound of the testis and testicular nuclide scintigraphy (Tc-99m scan) examinations were performed on 49, 30 and 57 occasions, respectively; the Tc-99m scan was the most effective tool. All the patients with epididymitis were diagnosed before surgical intervention and were treated conservatively.
Conclusions: We observed an increasing frequency of epididymitis in children admitted with the diagnosis of acute scrotum.
Rahamim Avisar, MD, Aharon Arnon, MD, Erez Avisar, BSc and Dov Weinberger, MD
Background: The time to recurrence after surgical removal of primary pterygium (pterygium) and the association between the rate of recurrence and the postoperative interval remain unclear.
Objective: To determine the amount of follow-up time needed to identify recurrence in patients after surgical removal of pterygium.
Methods: We rviewed the files of 143 patients (143 eyes) with recurrent pterygium to determine the interval from surgery to recurrence.
Results: Almost all (91.6%) of the recurrences appeared by 360 days after surgery.
Conclusions: One year is the optimal follow-up time to identify recurrence of pterygium.
Dror Mevorach, MD and Yaakov Naparstek, MD
David S. Pisetsky, MD, PhD
Anna Ghirardello, PhD, Andrea Doria, MD, Sandra Zampieri SciBiol, Pier Franca Gambari, MD and Silvano Todesco, MD
Rabin Gerrah, MD, Yehuda Abramovitch, MD and Amir Elami, MD
Mariana Munichor, MD, Daniel Gold, PhD, Jacob Lengy, PhD, Ran Linn, MD and David Merzbach, PhD
Kostas Konstantopoulos, MD, Alexandra Kanta, MD, Michael Tzoulianos, MD, Sophia Dimou, MD, Flora Sotsiou, MD, Marianna Politou, MD and Dimitris Loukopoulos, MD