Background:Acne vulgaris,a common skin disease,affects up to 80% of the population.Moderate to severe acne requires treatment with a combination of topical and oral drugs such as antibiotics,hormones and retinoids.Ret...Background:Acne vulgaris,a common skin disease,affects up to 80% of the population.Moderate to severe acne requires treatment with a combination of topical and oral drugs such as antibiotics,hormones and retinoids.Retinoids have many contraindications and adverse effects requiring close monitoring.The study's objectives were to describe prescribing trends in acne medication over time in a military setting,and assess physician adherence to guidelines for acne treatment,including drug precautions,clinical monitoring,and treatment progression.Methods:We conducted a descriptive,serial cross-sectional study of acne drugs prescribed in the Israel Defense Forces(IDF) in the years 2002–2007,analyzing the classes of drugs prescribed and patient characteristics.In addition,the clinical quality of the medical encounter was assessed by examining physician adherence to IDF guidelines.Results:Between 2002 and 2007,64,281 patients were treated for acne.Treatment courses generally persisted for 1–2 months.Over 70% of female patients receiving oral retinoids were not concomitantly receiving oral contraceptives.Conclusions:This study provides a unique perspective of acne treatment in a military setting,overall displaying good adherence to general guidelines.The common prescription of oral retinoids to young females without concomitant contraception is alarming.展开更多
Background: Occupation is a significant factor in life, health and well-being. Long-term military service is a unique career path that may influence life expectancy, even after excluding obvious risks such as battlefi...Background: Occupation is a significant factor in life, health and well-being. Long-term military service is a unique career path that may influence life expectancy, even after excluding obvious risks such as battlefield mortality. However, it remains unclear what the effects of a military career are on the life trajectory of personnel who retire from service. We aimed to compare life expectancy among retired military personnel(RMP) to their sex- and birth cohortspecific reference populations.Methods: For this historical-cohort study we collected data on sex, year of birth, year of death, time in service, and rank at end of service for 4,862 Israeli RMPs. Data on reference populations were provided by the Israel Central Bureau of Statistics, by birth decade from 1900 to 1989. We calculated the difference between each individual RMP's age at death and the "expected" age at death, based on sex- and birth cohort-specific means in the reference populations. Results: Overall, 67.9% of RMPs lived longer than average relative to their sex specific birth cohort. This difference in life expectancy was more pronounced among women than among men. There was a significant trend of increasing difference between RMP males and reference males over time(P<0.002), whereas no significant trend was identified among females. Length of service and rank were not associated with relative longevity for RMPs.Conclusions: The mechanism of the protective effect of military service on life expectancy remains unknown, but our findings indicate that it affects men and women differently, with women being more likely to benefit from the protective effect of military service. The healthy worker effect is known to vary from one occupation to another. To the best of our knowledge, this is the first attempt to quantify the magnitude of the healthy worker effect among career military servicemen and women.展开更多
文摘Background:Acne vulgaris,a common skin disease,affects up to 80% of the population.Moderate to severe acne requires treatment with a combination of topical and oral drugs such as antibiotics,hormones and retinoids.Retinoids have many contraindications and adverse effects requiring close monitoring.The study's objectives were to describe prescribing trends in acne medication over time in a military setting,and assess physician adherence to guidelines for acne treatment,including drug precautions,clinical monitoring,and treatment progression.Methods:We conducted a descriptive,serial cross-sectional study of acne drugs prescribed in the Israel Defense Forces(IDF) in the years 2002–2007,analyzing the classes of drugs prescribed and patient characteristics.In addition,the clinical quality of the medical encounter was assessed by examining physician adherence to IDF guidelines.Results:Between 2002 and 2007,64,281 patients were treated for acne.Treatment courses generally persisted for 1–2 months.Over 70% of female patients receiving oral retinoids were not concomitantly receiving oral contraceptives.Conclusions:This study provides a unique perspective of acne treatment in a military setting,overall displaying good adherence to general guidelines.The common prescription of oral retinoids to young females without concomitant contraception is alarming.
文摘Background: Occupation is a significant factor in life, health and well-being. Long-term military service is a unique career path that may influence life expectancy, even after excluding obvious risks such as battlefield mortality. However, it remains unclear what the effects of a military career are on the life trajectory of personnel who retire from service. We aimed to compare life expectancy among retired military personnel(RMP) to their sex- and birth cohortspecific reference populations.Methods: For this historical-cohort study we collected data on sex, year of birth, year of death, time in service, and rank at end of service for 4,862 Israeli RMPs. Data on reference populations were provided by the Israel Central Bureau of Statistics, by birth decade from 1900 to 1989. We calculated the difference between each individual RMP's age at death and the "expected" age at death, based on sex- and birth cohort-specific means in the reference populations. Results: Overall, 67.9% of RMPs lived longer than average relative to their sex specific birth cohort. This difference in life expectancy was more pronounced among women than among men. There was a significant trend of increasing difference between RMP males and reference males over time(P<0.002), whereas no significant trend was identified among females. Length of service and rank were not associated with relative longevity for RMPs.Conclusions: The mechanism of the protective effect of military service on life expectancy remains unknown, but our findings indicate that it affects men and women differently, with women being more likely to benefit from the protective effect of military service. The healthy worker effect is known to vary from one occupation to another. To the best of our knowledge, this is the first attempt to quantify the magnitude of the healthy worker effect among career military servicemen and women.