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Arnquist I, Avalos N, Baxter D, Bertou X, Castelló-Mor N, Chavarria AE, Cuevas-Zepeda J, Gutiérrez JC, Duarte-Campderros J, Dastgheibi-Fard A, Deligny O, De Dominicis C, Estrada E, Gadola N, Gaïor R, Hossbach T, Iddir L, Khalil L, Kilminster B, Lantero-Barreda A, Lawson I, Lee S, Letessier-Selvon A, Loaiza P, Lopez-Virto A, Matalon A, Munagavalasa S, McGuire KJ, Mitra P, Norcini D, Papadopoulos G, Paul S, Piers A, Privitera P, Ramanathan K, Robmann P, Settimo M, Smida R, Thomas R, Traina M, Vila I, Vilar R, Warot G, Yajur R, Zopounidis JP. First Constraints from DAMIC-M on Sub-GeV Dark-Matter Particles Interacting with Electrons. Phys Rev Lett 2023; 130:171003. [PMID: 37172255 DOI: 10.1103/physrevlett.130.171003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 03/21/2023] [Indexed: 05/14/2023]
Abstract
We report constraints on sub-GeV dark matter particles interacting with electrons from the first underground operation of DAMIC-M detectors. The search is performed with an integrated exposure of 85.23 g days, and exploits the subelectron charge resolution and low level of dark current of DAMIC-M charge-coupled devices (CCDs). Dark-matter-induced ionization signals above the detector dark current are searched for in CCD pixels with charge up to 7e^{-}. With this dataset we place limits on dark matter particles of mass between 0.53 and 1000 MeV/c^{2}, excluding unexplored regions of parameter space in the mass ranges [1.6,1000] MeV/c^{2} and [1.5,15.1] MeV/c^{2} for ultralight and heavy mediator interactions, respectively.
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Affiliation(s)
- I Arnquist
- Pacific Northwest National Laboratory (PNNL), Richland, Washington, USA
| | - N Avalos
- Centro Atómico Bariloche and Instituto Balseiro, Comisión Nacional de Energía Atómica (CNEA), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Universidad Nacional de Cuyo (UNCUYO), San Carlos de Bariloche 8400, Argentina
| | - D Baxter
- Kavli Institute for Cosmological Physics and The Enrico Fermi Institute, The University of Chicago, Chicago, Illinois 60637, USA
| | - X Bertou
- Centro Atómico Bariloche and Instituto Balseiro, Comisión Nacional de Energía Atómica (CNEA), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Universidad Nacional de Cuyo (UNCUYO), San Carlos de Bariloche 8400, Argentina
| | - N Castelló-Mor
- Instituto de Física de Cantabria (IFCA), CSIC-Universidad de Cantabria, Santander 39005, Spain
| | - A E Chavarria
- Center for Experimental Nuclear Physics and Astrophysics, University of Washington, Seattle, Washington 98195, USA
| | - J Cuevas-Zepeda
- Kavli Institute for Cosmological Physics and The Enrico Fermi Institute, The University of Chicago, Chicago, Illinois 60637, USA
| | | | - J Duarte-Campderros
- Instituto de Física de Cantabria (IFCA), CSIC-Universidad de Cantabria, Santander 39005, Spain
| | - A Dastgheibi-Fard
- LPSC LSM, CNRS/IN2P3, Université Grenoble-Alpes, Grenoble 38026, France
| | - O Deligny
- CNRS/IN2P3, IJCLab, Université Paris-Saclay, Orsay 91405, France
| | - C De Dominicis
- Laboratoire de physique nucléaire et des hautes énergies (LPNHE), Sorbonne Université, Université Paris Cité, CNRS/IN2P3, Paris 75005, France
- SUBATECH, Nantes Université, IMT Atlantique, CNRS-IN2P3, Nantes 44300, France
| | - E Estrada
- Centro Atómico Bariloche and Instituto Balseiro, Comisión Nacional de Energía Atómica (CNEA), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Universidad Nacional de Cuyo (UNCUYO), San Carlos de Bariloche 8400, Argentina
| | - N Gadola
- Universität Zürich Physik Institut, Zürich 8057, Switzerland
| | - R Gaïor
- Laboratoire de physique nucléaire et des hautes énergies (LPNHE), Sorbonne Université, Université Paris Cité, CNRS/IN2P3, Paris 75005, France
| | - T Hossbach
- Pacific Northwest National Laboratory (PNNL), Richland, Washington, USA
| | - L Iddir
- Laboratoire de physique nucléaire et des hautes énergies (LPNHE), Sorbonne Université, Université Paris Cité, CNRS/IN2P3, Paris 75005, France
| | - L Khalil
- Laboratoire de physique nucléaire et des hautes énergies (LPNHE), Sorbonne Université, Université Paris Cité, CNRS/IN2P3, Paris 75005, France
| | - B Kilminster
- Universität Zürich Physik Institut, Zürich 8057, Switzerland
| | - A Lantero-Barreda
- Instituto de Física de Cantabria (IFCA), CSIC-Universidad de Cantabria, Santander 39005, Spain
| | - I Lawson
- SNOLAB, Lively, Ontario P341N2, Canada
| | - S Lee
- Universität Zürich Physik Institut, Zürich 8057, Switzerland
| | - A Letessier-Selvon
- Laboratoire de physique nucléaire et des hautes énergies (LPNHE), Sorbonne Université, Université Paris Cité, CNRS/IN2P3, Paris 75005, France
| | - P Loaiza
- CNRS/IN2P3, IJCLab, Université Paris-Saclay, Orsay 91405, France
| | - A Lopez-Virto
- Instituto de Física de Cantabria (IFCA), CSIC-Universidad de Cantabria, Santander 39005, Spain
| | - A Matalon
- Kavli Institute for Cosmological Physics and The Enrico Fermi Institute, The University of Chicago, Chicago, Illinois 60637, USA
- Laboratoire de physique nucléaire et des hautes énergies (LPNHE), Sorbonne Université, Université Paris Cité, CNRS/IN2P3, Paris 75005, France
| | - S Munagavalasa
- Kavli Institute for Cosmological Physics and The Enrico Fermi Institute, The University of Chicago, Chicago, Illinois 60637, USA
| | - K J McGuire
- Center for Experimental Nuclear Physics and Astrophysics, University of Washington, Seattle, Washington 98195, USA
| | - P Mitra
- Center for Experimental Nuclear Physics and Astrophysics, University of Washington, Seattle, Washington 98195, USA
| | - D Norcini
- Kavli Institute for Cosmological Physics and The Enrico Fermi Institute, The University of Chicago, Chicago, Illinois 60637, USA
| | - G Papadopoulos
- Laboratoire de physique nucléaire et des hautes énergies (LPNHE), Sorbonne Université, Université Paris Cité, CNRS/IN2P3, Paris 75005, France
| | - S Paul
- Kavli Institute for Cosmological Physics and The Enrico Fermi Institute, The University of Chicago, Chicago, Illinois 60637, USA
| | - A Piers
- Center for Experimental Nuclear Physics and Astrophysics, University of Washington, Seattle, Washington 98195, USA
| | - P Privitera
- Kavli Institute for Cosmological Physics and The Enrico Fermi Institute, The University of Chicago, Chicago, Illinois 60637, USA
- Laboratoire de physique nucléaire et des hautes énergies (LPNHE), Sorbonne Université, Université Paris Cité, CNRS/IN2P3, Paris 75005, France
| | - K Ramanathan
- Kavli Institute for Cosmological Physics and The Enrico Fermi Institute, The University of Chicago, Chicago, Illinois 60637, USA
| | - P Robmann
- Universität Zürich Physik Institut, Zürich 8057, Switzerland
| | - M Settimo
- SUBATECH, Nantes Université, IMT Atlantique, CNRS-IN2P3, Nantes 44300, France
| | - R Smida
- Kavli Institute for Cosmological Physics and The Enrico Fermi Institute, The University of Chicago, Chicago, Illinois 60637, USA
| | - R Thomas
- Kavli Institute for Cosmological Physics and The Enrico Fermi Institute, The University of Chicago, Chicago, Illinois 60637, USA
| | - M Traina
- Center for Experimental Nuclear Physics and Astrophysics, University of Washington, Seattle, Washington 98195, USA
- Laboratoire de physique nucléaire et des hautes énergies (LPNHE), Sorbonne Université, Université Paris Cité, CNRS/IN2P3, Paris 75005, France
| | - I Vila
- Instituto de Física de Cantabria (IFCA), CSIC-Universidad de Cantabria, Santander 39005, Spain
| | - R Vilar
- Instituto de Física de Cantabria (IFCA), CSIC-Universidad de Cantabria, Santander 39005, Spain
| | - G Warot
- LPSC LSM, CNRS/IN2P3, Université Grenoble-Alpes, Grenoble 38026, France
| | - R Yajur
- Kavli Institute for Cosmological Physics and The Enrico Fermi Institute, The University of Chicago, Chicago, Illinois 60637, USA
| | - J-P Zopounidis
- Laboratoire de physique nucléaire et des hautes énergies (LPNHE), Sorbonne Université, Université Paris Cité, CNRS/IN2P3, Paris 75005, France
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Aguilar-Arevalo A, Amidei D, Baxter D, Cancelo G, Vergara BAC, Chavarria AE, D'Olivo JC, Estrada J, Favela-Perez F, Gaïor R, Guardincerri Y, Hoppe EW, Hossbach TW, Kilminster B, Lawson I, Lee SJ, Letessier-Selvon A, Matalon A, Mitra P, Overman CT, Piers A, Privitera P, Ramanathan K, Da Rocha J, Sarkis Y, Settimo M, Smida R, Thomas R, Tiffenberg J, Traina M, Vilar R, Virto AL. Results on Low-Mass Weakly Interacting Massive Particles from an 11 kg d Target Exposure of DAMIC at SNOLAB. Phys Rev Lett 2020; 125:241803. [PMID: 33412014 DOI: 10.1103/physrevlett.125.241803] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Accepted: 11/04/2020] [Indexed: 06/12/2023]
Abstract
We present constraints on the existence of weakly interacting massive particles (WIMPs) from an 11 kg d target exposure of the DAMIC experiment at the SNOLAB underground laboratory. The observed energy spectrum and spatial distribution of ionization events with electron-equivalent energies >200 eV_{ee} in the DAMIC CCDs are consistent with backgrounds from natural radioactivity. An excess of ionization events is observed above the analysis threshold of 50 eV_{ee}. While the origin of this low-energy excess requires further investigation, our data exclude spin-independent WIMP-nucleon scattering cross sections σ_{χ-n} as low as 3×10^{-41} cm^{2} for WIMPs with masses m_{χ} from 7 to 10 GeV c^{-2}. These results are the strongest constraints from a silicon target on the existence of WIMPs with m_{χ}<9 GeV c^{-2} and are directly relevant to any dark matter interpretation of the excess of nuclear-recoil events observed by the CDMS silicon experiment in 2013.
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Affiliation(s)
| | - D Amidei
- Department of Physics, University of Michigan, Ann Arbor, Michigan 48109-1040, USA
| | - D Baxter
- Kavli Institute for Cosmological Physics and The Enrico Fermi Institute, The University of Chicago, Chicago, Illinois 60637, USA
| | - G Cancelo
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | | | - A E Chavarria
- Center for Experimental Nuclear Physics and Astrophysics, University of Washington, Seattle, Washington 98195, USA
| | - J C D'Olivo
- Universidad Nacional Autónoma de México, Mexico City, 04510, Mexico
| | - J Estrada
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - F Favela-Perez
- Universidad Nacional Autónoma de México, Mexico City, 04510, Mexico
| | - R Gaïor
- Laboratoire de Physique Nucléaire et des Hautes Énergies (LPNHE), Sorbonne Université, Université de Paris, CNRS-IN2P3, 75005 Paris, France
| | - Y Guardincerri
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - E W Hoppe
- Pacific Northwest National Laboratory (PNNL), Richland, Washington 99354, USA
| | - T W Hossbach
- Pacific Northwest National Laboratory (PNNL), Richland, Washington 99354, USA
| | - B Kilminster
- Universität Zürich Physik Institut, Zurich 8057, Switzerland
| | - I Lawson
- SNOLAB, Lively, Ontario P3Y 1N2, Canada
| | - S J Lee
- Universität Zürich Physik Institut, Zurich 8057, Switzerland
| | - A Letessier-Selvon
- Laboratoire de Physique Nucléaire et des Hautes Énergies (LPNHE), Sorbonne Université, Université de Paris, CNRS-IN2P3, 75005 Paris, France
| | - A Matalon
- Kavli Institute for Cosmological Physics and The Enrico Fermi Institute, The University of Chicago, Chicago, Illinois 60637, USA
- Laboratoire de Physique Nucléaire et des Hautes Énergies (LPNHE), Sorbonne Université, Université de Paris, CNRS-IN2P3, 75005 Paris, France
| | - P Mitra
- Center for Experimental Nuclear Physics and Astrophysics, University of Washington, Seattle, Washington 98195, USA
| | - C T Overman
- Pacific Northwest National Laboratory (PNNL), Richland, Washington 99354, USA
| | - A Piers
- Center for Experimental Nuclear Physics and Astrophysics, University of Washington, Seattle, Washington 98195, USA
| | - P Privitera
- Kavli Institute for Cosmological Physics and The Enrico Fermi Institute, The University of Chicago, Chicago, Illinois 60637, USA
- Laboratoire de Physique Nucléaire et des Hautes Énergies (LPNHE), Sorbonne Université, Université de Paris, CNRS-IN2P3, 75005 Paris, France
| | - K Ramanathan
- Kavli Institute for Cosmological Physics and The Enrico Fermi Institute, The University of Chicago, Chicago, Illinois 60637, USA
| | - J Da Rocha
- Laboratoire de Physique Nucléaire et des Hautes Énergies (LPNHE), Sorbonne Université, Université de Paris, CNRS-IN2P3, 75005 Paris, France
| | - Y Sarkis
- Universidad Nacional Autónoma de México, Mexico City, 04510, Mexico
| | - M Settimo
- SUBATECH, CNRS-IN2P3, IMT Atlantique, Université de Nantes, Nantes 44300, France
| | - R Smida
- Kavli Institute for Cosmological Physics and The Enrico Fermi Institute, The University of Chicago, Chicago, Illinois 60637, USA
| | - R Thomas
- Kavli Institute for Cosmological Physics and The Enrico Fermi Institute, The University of Chicago, Chicago, Illinois 60637, USA
| | - J Tiffenberg
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - M Traina
- Laboratoire de Physique Nucléaire et des Hautes Énergies (LPNHE), Sorbonne Université, Université de Paris, CNRS-IN2P3, 75005 Paris, France
| | - R Vilar
- Instituto de Física de Cantabria (IFCA), CSIC-Universidad de Cantabria, Santander 39005, Spain
| | - A L Virto
- Instituto de Física de Cantabria (IFCA), CSIC-Universidad de Cantabria, Santander 39005, Spain
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3
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Aguilar-Arevalo A, Amidei D, Baxter D, Cancelo G, Cervantes Vergara BA, Chavarria AE, Darragh-Ford E, de Mello Neto JRT, D'Olivo JC, Estrada J, Gaïor R, Guardincerri Y, Hossbach TW, Kilminster B, Lawson I, Lee SJ, Letessier-Selvon A, Matalon A, Mello VBB, Mitra P, Molina J, Paul S, Piers A, Privitera P, Ramanathan K, Da Rocha J, Sarkis Y, Settimo M, Smida R, Thomas R, Tiffenberg J, Torres Machado D, Vilar R, Virto AL. Constraints on Light Dark Matter Particles Interacting with Electrons from DAMIC at SNOLAB. Phys Rev Lett 2019; 123:181802. [PMID: 31763884 DOI: 10.1103/physrevlett.123.181802] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 10/03/2019] [Indexed: 06/10/2023]
Abstract
We report direct-detection constraints on light dark matter particles interacting with electrons. The results are based on a method that exploits the extremely low levels of leakage current of the DAMIC detector at SNOLAB of 2-6×10^{-22} A cm^{-2}. We evaluate the charge distribution of pixels that collect <10e^{-} for contributions beyond the leakage current that may be attributed to dark matter interactions. Constraints are placed on so-far unexplored parameter space for dark matter masses between 0.6 and 100 MeV c^{-2}. We also present new constraints on hidden-photon dark matter with masses in the range 1.2-30 eV c^{-2}.
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Affiliation(s)
| | - D Amidei
- Department of Physics, University of Michigan, Ann Arbor, Michigan 48109-1040, USA
| | - D Baxter
- Kavli Institute for Cosmological Physics and The Enrico Fermi Institute, The University of Chicago, Chicago, Illinois 60637, USA
| | - G Cancelo
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | | | - A E Chavarria
- Center for Experimental Nuclear Physics and Astrophysics, University of Washington, Seattle, Washington 98195, USA
| | - E Darragh-Ford
- Kavli Institute for Cosmological Physics and The Enrico Fermi Institute, The University of Chicago, Chicago, Illinois 60637, USA
| | - J R T de Mello Neto
- Universidade Federal do Rio de Janeiro, Instituto de Física, Rio de Janeiro 21.941-611, Brazil
| | - J C D'Olivo
- Universidad Nacional Autónoma de México, Mexico City 04510, Mexico
| | - J Estrada
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - R Gaïor
- Laboratoire de Physique Nucléaire et des Hautes Énergies (LPNHE), Sorbonne Université, Université de Paris, CNRS-IN2P3 75005, Paris France
| | - Y Guardincerri
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - T W Hossbach
- Pacific Northwest National Laboratory (PNNL), Richland, Washington 99354, USA
| | - B Kilminster
- Universität Zürich Physik Institut, Zurich 8057, Switzerland
| | - I Lawson
- SNOLAB, Lively, Ontario P3Y 1N2, Canada
| | - S J Lee
- Universität Zürich Physik Institut, Zurich 8057, Switzerland
| | - A Letessier-Selvon
- Laboratoire de Physique Nucléaire et des Hautes Énergies (LPNHE), Sorbonne Université, Université de Paris, CNRS-IN2P3 75005, Paris France
| | - A Matalon
- Kavli Institute for Cosmological Physics and The Enrico Fermi Institute, The University of Chicago, Chicago, Illinois 60637, USA
- Laboratoire de Physique Nucléaire et des Hautes Énergies (LPNHE), Sorbonne Université, Université de Paris, CNRS-IN2P3 75005, Paris France
| | - V B B Mello
- Universidade Federal do Rio de Janeiro, Instituto de Física, Rio de Janeiro 21.941-611, Brazil
| | - P Mitra
- Center for Experimental Nuclear Physics and Astrophysics, University of Washington, Seattle, Washington 98195, USA
| | - J Molina
- Facultad de Ingeniería, Universidad Nacional de Asunción, Asuncion 2169, Paraguay
| | - S Paul
- Kavli Institute for Cosmological Physics and The Enrico Fermi Institute, The University of Chicago, Chicago, Illinois 60637, USA
| | - A Piers
- Center for Experimental Nuclear Physics and Astrophysics, University of Washington, Seattle, Washington 98195, USA
| | - P Privitera
- Kavli Institute for Cosmological Physics and The Enrico Fermi Institute, The University of Chicago, Chicago, Illinois 60637, USA
- Laboratoire de Physique Nucléaire et des Hautes Énergies (LPNHE), Sorbonne Université, Université de Paris, CNRS-IN2P3 75005, Paris France
| | - K Ramanathan
- Kavli Institute for Cosmological Physics and The Enrico Fermi Institute, The University of Chicago, Chicago, Illinois 60637, USA
| | - J Da Rocha
- Laboratoire de Physique Nucléaire et des Hautes Énergies (LPNHE), Sorbonne Université, Université de Paris, CNRS-IN2P3 75005, Paris France
| | - Y Sarkis
- Universidad Nacional Autónoma de México, Mexico City 04510, Mexico
| | - M Settimo
- SUBATECH, CNRS-IN2P3, IMT Atlantique, Université de Nantes, Nantes 44300, France
| | - R Smida
- Kavli Institute for Cosmological Physics and The Enrico Fermi Institute, The University of Chicago, Chicago, Illinois 60637, USA
| | - R Thomas
- Kavli Institute for Cosmological Physics and The Enrico Fermi Institute, The University of Chicago, Chicago, Illinois 60637, USA
| | - J Tiffenberg
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - D Torres Machado
- Universidade Federal do Rio de Janeiro, Instituto de Física, Rio de Janeiro 21.941-611, Brazil
| | - R Vilar
- Instituto de Física de Cantabria (IFCA), CSIC-Universidad de Cantabria, Santander 39005, Spain
| | - A L Virto
- Instituto de Física de Cantabria (IFCA), CSIC-Universidad de Cantabria, Santander 39005, Spain
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4
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Aguilar-Arevalo A, Amidei D, Bertou X, Butner M, Cancelo G, Castañeda Vázquez A, Cervantes Vergara BA, Chavarria AE, Chavez CR, de Mello Neto JRT, D'Olivo JC, Estrada J, Fernandez Moroni G, Gaïor R, Guardincerri Y, Hernández Torres KP, Izraelevitch F, Kavner A, Kilminster B, Lawson I, Letessier-Selvon A, Liao J, Matalon A, Mello VBB, Molina J, Privitera P, Ramanathan K, Sarkis Y, Schwarz T, Settimo M, Sofo Haro M, Thomas R, Tiffenberg J, Tiouchichine E, Torres Machado D, Trillaud F, You X, Zhou J. First Direct-Detection Constraints on eV-Scale Hidden-Photon Dark Matter with DAMIC at SNOLAB. Phys Rev Lett 2017; 118:141803. [PMID: 28430473 DOI: 10.1103/physrevlett.118.141803] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Indexed: 06/07/2023]
Abstract
We present direct detection constraints on the absorption of hidden-photon dark matter with particle masses in the range 1.2-30 eV c^{-2} with the DAMIC experiment at SNOLAB. Under the assumption that the local dark matter is entirely constituted of hidden photons, the sensitivity to the kinetic mixing parameter κ is competitive with constraints from solar emission, reaching a minimum value of 2.2×10^{-14} at 17 eV c^{-2}. These results are the most stringent direct detection constraints on hidden-photon dark matter in the galactic halo with masses 3-12 eV c^{-2} and the first demonstration of direct experimental sensitivity to ionization signals <12 eV from dark matter interactions.
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Affiliation(s)
| | - D Amidei
- Department of Physics, University of Michigan, Ann Arbor, Michigan 48109-1040, USA
| | - X Bertou
- Centro Atómico Bariloche, CNEA/CONICET/IB, Bariloche 8400, Argentina
| | - M Butner
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
- Northern Illinois University, DeKalb, Illinois 60115, USA
| | - G Cancelo
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | | | | | - A E Chavarria
- Kavli Institute for Cosmological Physics and The Enrico Fermi Institute, The University of Chicago, Chicago, Illinois 60637, USA
| | - C R Chavez
- Facultad de Ingeniería, Universidad Nacional de Asunción, Asuncion 2169, Paraguay
| | - J R T de Mello Neto
- Universidade Federal do Rio de Janeiro, Instituto de Física, Rio de Janeiro 21.941-611, Brazil
| | - J C D'Olivo
- Universidad Nacional Autónoma de México, Mexico City 04510, Mexico
| | - J Estrada
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - G Fernandez Moroni
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
- Universidad Nacional del Sur, Bahia Blanca 8000, Argentina
| | - R Gaïor
- Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), Universités Paris 6 et Paris 7, CNRS-IN2P3, F-75005 Paris, France
| | - Y Guardincerri
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | | | - F Izraelevitch
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - A Kavner
- Department of Physics, University of Michigan, Ann Arbor, Michigan 48109-1040, USA
| | - B Kilminster
- Universität Zürich Physik Institut, Zurich 8057, Switzerland
| | - I Lawson
- SNOLAB, Lively, Ontario P3Y 1N2, Canada
| | - A Letessier-Selvon
- Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), Universités Paris 6 et Paris 7, CNRS-IN2P3, F-75005 Paris, France
| | - J Liao
- Universität Zürich Physik Institut, Zurich 8057, Switzerland
| | - A Matalon
- Kavli Institute for Cosmological Physics and The Enrico Fermi Institute, The University of Chicago, Chicago, Illinois 60637, USA
| | - V B B Mello
- Universidade Federal do Rio de Janeiro, Instituto de Física, Rio de Janeiro 21.941-611, Brazil
| | - J Molina
- Facultad de Ingeniería, Universidad Nacional de Asunción, Asuncion 2169, Paraguay
| | - P Privitera
- Kavli Institute for Cosmological Physics and The Enrico Fermi Institute, The University of Chicago, Chicago, Illinois 60637, USA
| | - K Ramanathan
- Kavli Institute for Cosmological Physics and The Enrico Fermi Institute, The University of Chicago, Chicago, Illinois 60637, USA
| | - Y Sarkis
- Universidad Nacional Autónoma de México, Mexico City 04510, Mexico
| | - T Schwarz
- Department of Physics, University of Michigan, Ann Arbor, Michigan 48109-1040, USA
| | - M Settimo
- Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), Universités Paris 6 et Paris 7, CNRS-IN2P3, F-75005 Paris, France
| | - M Sofo Haro
- Centro Atómico Bariloche, CNEA/CONICET/IB, Bariloche 8400, Argentina
| | - R Thomas
- Kavli Institute for Cosmological Physics and The Enrico Fermi Institute, The University of Chicago, Chicago, Illinois 60637, USA
| | - J Tiffenberg
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - E Tiouchichine
- Centro Atómico Bariloche, CNEA/CONICET/IB, Bariloche 8400, Argentina
| | - D Torres Machado
- Universidade Federal do Rio de Janeiro, Instituto de Física, Rio de Janeiro 21.941-611, Brazil
| | - F Trillaud
- Universidad Nacional Autónoma de México, Mexico City 04510, Mexico
| | - X You
- Universidade Federal do Rio de Janeiro, Instituto de Física, Rio de Janeiro 21.941-611, Brazil
| | - J Zhou
- Kavli Institute for Cosmological Physics and The Enrico Fermi Institute, The University of Chicago, Chicago, Illinois 60637, USA
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5
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Grossman A, Ben-Assuli O, Zelber-Sagi S, Golbert R, Matalon A, Yeshua H. The management of pre-hypertension in primary care: Is it adequate? Blood Press 2015; 24:237-41. [PMID: 25875919 DOI: 10.3109/08037051.2015.1032515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Pre-hypertension (pHT) is frequently diagnosed in the primary care setting, but its management by primary care physicians (PCPs) is not well characterized. METHODS All individuals aged 30-45 years who were insured by Clalit Health services in the Tel Aviv district and had their blood pressure (BP) measured from January 2006 to December 2010 were evaluated. Individuals were divided into three groups based on their initial BP value: optimal (< 120/80 mmHg), normal (systolic BP 120-129 or diastolic 80-84 mmHg) and borderline (130-139/85-89 mmHg). Groups were compared regarding clinical and laboratory follow-up performed by their PCP. RESULTS Of the 20,214 individuals included in the study, 6576 (32.5%) had values in the pHT range. Of these, 2126 (32.3% of those with pHT) had BP values defined as "borderline" and 4450 (67.6% of those with pHT) had BP values defined as "normal". The number of follow-up visits by the PCP and repeat BP measurement were similar in those with "optimal" BP and pHT. A third and fourth BP measurement were recorded more frequently in those with pHT. In those with pHT, there were more recorded BP measurements than in those with borderline BP (3.35 ± 3 vs. 3.23 ± 2.6), but the time from the initial to the second measurement and a record of a third and fourth measurement were the same in the two groups. CONCLUSION Identification of pHT does not lead to a significant change in follow-up by PCPs, irrespective of BP values in the pHT range.
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Affiliation(s)
- A Grossman
- Institute of Endocrinology and Metabolism , Petah Tikva , Israel
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Abstract
AIMS Primary focal segmental glomerulosclerosis (FSGS) is a common cause of end-stage renal disease in both children and adults. Our current treatments are suboptimal, and a significant percentage of cases are resistant to current therapy. PATIENTS AND METHODS We performed an open-label, 6-month trial of the new immunosuppressive agent mycophenolate mofetil (MMF) in 18 biopsy-proven patients resistant to a course of corticosteroids therapy. Seventy-five percent had also failed to respond to a cytotoxic agent and/or a calcineurin inhibitor. RESULTS A substantial improvement in proteinuria was seen in 44% (8/18) of the patients by 6 months. This was sustained for up to 1 year post treatment in 50% (4/8) of this group. No patient had a complete remission. No deterioration in renal function was observed in any patient over the treatment period, but 3 progressed to chronic kidney failure during follow-up. Adverse effects were mild. Only 1 patient required a dose reduction due to an intercurrent infection. CONCLUSIONS MMF appears safe to use in this group of patients and did lower proteinuria in 44% of this cohort resistant to other forms of treatment. Relapses were common, suggesting more prolonged or combination therapy may be required. More rigorous trials utilizing this medication should be considered to further assess the risk-benefit ratio of treatment with MMF in patients with FSGS.
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Affiliation(s)
- D C Cattran
- Department of Medicine, University Health Network, University of Toronto, Ontario, Canada.
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Peled T, Weingarten M, Varsano N, Matalon A, Fuchs A, Hoffman RD, Zeltcer C, Kahan E, Mendelson E, Swartz TA. Influenza surveillance during winter 1997-1998 in Israel. Isr Med Assoc J 2001; 3:911-4. [PMID: 11794913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
BACKGROUND Each winter influenza activity is a major cause of morbidity and mortality both in Israel and worldwide. OBJECTIVES To identify the influenza viruses active in Israel during the winter season and to assess the extent of influenza morbidity. METHODS Information was collected on a population of 18,684 individuals enrolled in two community clinics in central Israel. It included the total number of visits for acute respiratory infection--including influenza and influenza-like illness (ARI/flu-like)--during a 20 week surveillance period (23 November 1997 to 27 March 1998) and the percent of influenza virus isolates in nasopharyngeal specimens from a sample of patients with ARI/flu-like collected on a weekly basis during the same period. RESULTS A total of 5,947 visits for ARI/flu-like were recorded among 18,684 enrolled patients in two community clinics (18.1%). The progressive increase in the number of visits for ARI/flu-like reached a peak on week 2/98 with 597 visits and a rate of 31.95 visits per 1,000 population. After this, a decrease to the initial values was evident by week 12/98. Most affected patients were in the age groups 5-14 and 65 years and over, with a rate of 733.5 and 605.3 visits per 1,000 population, respectively. Influenza virus was isolated from 92 of the 426 nasopharyngeal specimens (21.6%). The most commonly detected strain was A/Sydney/5/97 (H3N2) like (77.2%). The peak rate of isolates was recorded at the beginning of January (01/98). CONCLUSIONS A/Sydney/5/97 (H3N2) like-strain was the dominant influenza virus. Its presence did not prevent the simultaneous activity of influenza A/H1N1 virus. The dynamic of the clinical disease as expressed by the weekly visit rate for ARI/flu-like was similar to the temporal pattern of the virological findings. The extent of morbidity suggests moderate epidemic activity.
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Affiliation(s)
- T Peled
- Israel Center for Disease Control, Gertner Institute for Health Policy Research, Tel Hashomer, Israel.
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Matalon A, Markowitz GS, Joseph RE, Cohen DJ, Saal SD, Kaplan B, D'Agati VD, Appel GB. Plasmapheresis treatment of recurrent FSGS in adult renal transplant recipients. Clin Nephrol 2001; 56:271-8. [PMID: 11680656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023] Open
Abstract
Plasmapheresis (PP) is often employed in the treatment of recurrent focal segmental glomerulosclerosis (FSGS) in the renal allograft, where it appears to be effective in the pediatric population. The efficacy of PP in adults and predictors of response are not well documented. We analyzed the records of 13 adult patients from three transplant centers who underwent PP for recurrent FSGS between 1993 and 1999. One patient (8%) had a complete response, one (8%) had a partial response, and 3 (23%) partially responded but remain PP-dependent. All 5 responders were started on PP within 30 days of recurrence, while 7 of the 8 non-responders initiated PP after a delay of at least 42 days (p = 0.0047). FSGS recurred within 30 days of transplantation in all 5 responders, while 4 of 8 non-responders had no evidence of recurrence until 42-150 days after transplantation (p = 0.098). Post-transplant biopsies were examined in 10 patients and revealed either cellular (6) or collapsing (4) variants of FSGS. We conclude PP is less effective in adults than in children as a treatment for recurrent FSGS in the renal allograft. Predictors of response to PP include early initiation of treatment after recurrence and possibly an early recurrence of disease.
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Affiliation(s)
- A Matalon
- Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, 10032, USA
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Matalon A, Nahmani T, Rabin S, Maoz B, Hart J. Ergebnisse einer integrierten biopsychosozialen Intervention bei Patienten mit hoher Inanspruchnahme ärztlicher Behandlung. Balint 2001. [DOI: 10.1055/s-2001-14681] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Matalon A. A memorable patient: Just being there. West J Med 2001. [DOI: 10.1136/bmj.322.7282.342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Matalon A, Valeri A, Appel GB. Treatment of focal segmental glomerulosclerosis. Semin Nephrol 2000; 20:309-17. [PMID: 10855941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Focal segmental glomerulosclerosis (FSGS) has been increasing in incidence over the past 2 decades and may currently be the most common form of primary nephrotic syndrome in the United States. Nephrotic patients with FSGS who do not achieve a remission in proteinuria usually advance to end-stage renal disease within 5 to 10 years. Although initially felt to be a steroid-resistant disease, especially in adults, studies show significant responsiveness to more prolonged courses of steroids. For patients with steroid-resistant or steroid-dependent FSGS, cyclosporine A and cytotoxic agents have shown efficacy in clinical trials. Other agents used include pulse methylprednisolone, azathioprine, tacrolimus, mycophenolate mofetil, and combination therapy. For recurrent FSGS after renal transplantation, plasmapheresis is often used but appears not to be as efficacious in adults as in the pediatric population.
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Affiliation(s)
- A Matalon
- Department of Medicine, Columbia University, College of Physicians and Surgeons, New York, NY 10032, USA
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Matalon A, Yinnon A. [Malaria in travelers returning to Israel from endemic areas: diagnosis of two patients in a family practice]. Harefuah 1999; 137:617-8, 679. [PMID: 10959388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/15/2023]
Abstract
2 cases of malaria in family practice are described in a 26- and a 50-year-old woman. Both probably could have been prevented had common chemoprophylactic drugs been taken. The risk of malaria is greater than the risk of possible side-effects of the drugs commonly used by travelers for prevention. Family physicians must be aware of the possibility of malaria in young people with fever, especially those who have travelled to equatorial areas and special attention should be given to encourage chemoprophylaxis.
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Affiliation(s)
- A Matalon
- Dept. of Family Medicine, Tel Aviv University, Jerusalem
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Abstract
Handwashing is acknowledged as a critical factor in the prevention of nosocomial infection. Nonetheless, health care personnel often wash their hands inadequately. The purpose of this study was to examine the flora of hands and the frequency of handwashing of physicians working in primary care pediatric community clinics. The fingers of the dominant hand of 55 physicians working in 12 clinics were sampled for bacterial cultures. Only 354/720 (49%) of the expected handwashings by 17 board-certified pediatricians were recorded as having been performed. None of them washed their hands after each contact with an examined child. All physicians' hands were found to be contaminated with microorganisms. Staphylococcus species were isolated from 47 (85.4%) of the physicians' hands. Methicillin-resistant Staphylococcus aureus was found on the hands of 9.1% of the physicians. Such contaminated hands may serve as a potential vector of community-acquired infection with highly resistant organisms. Compliance with handwashing recommendations among these physicians was low. An active educational infection control program must be introduced in ambulatory pediatric community clinics.
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Affiliation(s)
- H A Cohen
- Dept. of Family Medicine, Sackler School of Medicine, Tel Aviv University, Petach Tikvah, Israel
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15
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Abstract
OBJECTIVES We aimed to determine whether stethoscopes and otoscopes used in community paediatric clinics harboured pathogenic micro-organisms, and, if so, which measures could prevent this. METHODS Fifty-five stethoscopes belonging to paediatric physicians working in 12 community clinics were sampled for bacterial cultures by two methods: (i) direct impression of the diaphragm and bell section of each stethoscope for 5 seconds onto blood agar plates and a mannitol-salt-agar plate; (ii) swabbing the entire surface of the diaphragm of the stethoscope with a sterile cotton-tipped applicator. Forty-two otoscopes from the same physicians were sampled by rubbing the handles of the otoscopes with cotton-tipped swabs. The plates were incubated at 37 degrees C for 48 hours and examined for colony growth at 24 and 48 hours of incubation. Culture results were recorded as mean numbers of colony-forming units (CFUs). Eight additional stethoscope diaphragms were chosen at random at the participating clinics and cultured as described above. They were then wiped with alcohol swabs (isopropyl alcohol 70%), allowed to air dry for approximately 10 minutes and cultured a second time. RESULTS All the stethoscopes and 90% of the otoscope handles were colonized by microorganisms. Staphylococci were isolated from 85.4% of the stethoscopes and 83.3% of the otoscopes, with 54.5% and 45.2% respectively being S. Aureus. Methicillin-resistant S. aureus were found in four each of the stethoscopes (7.3%) and otoscopes (9.5%). Cleaning with alcohol reduced the colony count by an average of 96.3%. CONCLUSIONS Fomites can harbour potentially pathogenic bacteria, and with the increasing trend for children with more complex medical problems to be managed in an ambulatory setting, often by physicians who also work in hospitals, there is a real risk of spreading potentially serious infections to such patients. Simple cleansing with alcohol effectively eliminates the bacterial contamination of the fomites, and should be encouraged.
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Affiliation(s)
- H A Cohen
- Department of Family Medicine, Sackler School of Medicine, Tel Aviv University, Petach Tikvah, Israel
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Cohen HA, Matalon A, Mezger A, Ben Amitai D, Barzilai A. Striae in adolescents mistaken for physical abuse. J Fam Pract 1997; 45:84-85. [PMID: 9228918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Physiological striae are common in adolescence, occurring in the lumbar and gluteal regions, the upper thighs, breast, lower abdomen, and back. The lesions may be mistaken for nonaccidental injury, that is, physical abuse. We present four cases of adolescents with lesions thought to be due to physical abuse. Three of these cases were revealed during a school screening program for scoliosis; of the 2600 adolescents screened, aged 12 to 16 years, 168 were found to have striae. One case was found by a family physician when a young boy presented with low back pain. Since striae may be mistakenly ascribed to physical abuse, it is important for family physicians, nurses, and pediatricians to be familiar with this benign condition.
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Affiliation(s)
- H A Cohen
- Pediatric Ambulatory Center, Sackler School of Medicine, Tel Aviv University, Petach Tikvah, Israel
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Abstract
OBJECTIVE To study the impact of the cost of pharmaceuticals on physicians' decisions about drug prescription. DESIGN A simulation protocol for the treatment of two patients, one with mild and the other with a severe form of urinary tract infection (UTI), was designed. Thirty family physicians in outpatient clinics and 30 physicians in the internal medicine wards of a Community Hospital participated in the project. They had to prescribe treatment for the patients twice: at phase I, when the drug cost was unknown, and at phase II, after 2 months, when the price of the drugs was brought to their attention. The physicians selected the medication from a list of drugs commonly used for the treatment of UTIs. RESULTS Analysis of the findings indicates that an awareness of drug costs affects prescription decisions among physicians in hospital wards, whereas family physicians showed a preference for less expensive drugs even before they were informed about drug costs. An extrapolation of the results shows that knowledge about the cost of the drugs usually administered for treatment of UTI, could save at least IS 112,883 ($34,207) a month to Kupat Holim Klalit (KHK) the health insurance institution to which the outpatient clinics and the hospital belong. CONCLUSIONS When economic aspects of healthcare are considered, information on drug costs may be an important factor in physicians' decision-making processes and for saving pharmaceutical expenses.
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Affiliation(s)
- J Hart
- Medical Technology Division-Health Insurance Institution (Kupat Holim Klalit, Tel Aviv, Israel
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Abstract
OBJECTIVE To report four cases of fixed drug eruption induced by hydroxyzine hydrochloride (Otarex, Teva, Israel). CASE SUMMARY Four children with restlessness who were treated with hydroxyzine hydrochloride developed fixed drug eruption of the penis. Drug discontinuation was followed by complete resolution of the skin eruption. Rechallenge resulted in the same drug rash. Macrophage migration inhibiting factor (MIF) assay with hydroxyzine hydrochloride was positive. DISCUSSION The pathogenesis of fixed drug eruption and the role of macrophage MIF assay in diagnosis is discussed. CONCLUSIONS A fixed drug eruption induced by hydroxyzine hydrochloride is possible, but is a rare phenomenon.
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Affiliation(s)
- H A Cohen
- Department of Family Medicine, Sackler School of Medicine, Tel Aviv University, Petach Tikvah, Israel
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Sedlis SP, Lorin J, Matalon A, Chandrasekaran S, Gold J, Santini C, Negron M, Kumar K, Steinberg EH. Dobutamine stress testing in the cardiac catheterization laboratory. Am J Cardiol 1996; 78:340-3. [PMID: 8759816 DOI: 10.1016/s0002-9149(96)00289-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Dobutamine stress ventriculography is a safe test that appears to separate groups of patients with and without significant coronary artery stenoses. In this study, all 7 patients with significant coronary artery stenoses who reached a heart rate > or = 110 beats/min had a positive stress test, whereas 9 of 10 control patients had a negative stress test.
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Affiliation(s)
- S P Sedlis
- New York Veterans Affairs Medical Center, New York University School of Medicine 10010, USA
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Monnickendam SM, Borkan JM, Matalon A, Zalewski S. Trials and tribulations of country doctors: a qualitative study of doctor-patient relationships in rural Israel. Isr J Med Sci 1996; 32:239-45; discussion 245-7. [PMID: 8606141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Rural areas of Israel are organized into small villages that attract physicians by offering inexpensive accommodation and the promise of a high quality of life. However, conflicts often arise in the relationship between the village residents and the doctor, leading to dissatisfaction and physician turnover. In order to examine the issues, we conducted a qualitative study of rural physicians using a group interviewing technique, called focus groups. The sample consisted of 46 physicians, aged between 35 and 45, of whom 60% were male. In the focus groups, the physicians mainly discussed issues of unclear boundaries between private life and physician roles, exaggerated expectations on the part of community members, difficulties with teamwork, the impact of the physician's family, work satisfaction, and burnout. Recommendations for physicians considering rural practice include making a careful and studied choice of a village before making a final decision, setting both clear professional limits and an overall time limit for service, allowing for mistakes, and organizing Balint-type physician support groups.
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Affiliation(s)
- S M Monnickendam
- Department of Family Medicine, Sackler Faculty of Medicine Tel Aviv University, Israel
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21
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Matalon A. [Disease at any price: psychological challenge and the financial costs of somatization]. Harefuah 1996; 130:19-22, 71. [PMID: 8682374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
In clinical medicine we sometimes deal with patients with unexplained somatic complaints. In a 45-year-old woman with multiple somatic complaints, 2 years of medical examinations in search of a disease diagnosis cost almost 250,000 shekels (about +84,000). The differential diagnosis between somatization, hypochondriasis and psychosomatic pain, and the reasons why physicians are tempted to participate in the "investigation dance" are presented.
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Affiliation(s)
- A Matalon
- Kupat Cholim Clalit, Machoz Dan -- Petah Tikva
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Matalon A, Yinon A, Goldman S, Antonovsky A. [The Kibbutz physician: family medicine theory in practice]. Harefuah 1994; 127:70-4. [PMID: 7927039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
124 of 251 physicians living and working in 109 of the 194 kibbutzim in Israel answered a 125-item postal questionnaire on their professional and personal characteristics and the special issues affecting a kibbutz physician. Most were specialists in family practice, had had the best of modern medical training, were deeply involved in their communities, and were familiar with all aspects of their patients' lives. They were given the opportunity to express the bio-psycho-social model of family medicine. This study relates to the special encounter of family medicine theory and its practice in the kibbutz system of health care delivery, including the problems of the kibbutz physician and the degree of personal satisfaction derived.
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Affiliation(s)
- A Matalon
- Dept. of Family Medicine, Tel Aviv University
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Abstract
Insomnia is a common symptom in family practice, and hypnotics are frequently prescribed for its treatment. A survey was performed in an urban clinic serving 1900 persons in order to detect the prevalence of this disorder and to reassess the need for hypnotics. Sixty-one patients were identified who were taking prescribed hypnotic drugs, mainly benzodiazepines. All were over the age of 40, and they comprised 8.1% of this age group. Forty-five were chronic users, taking hypnotics for more than 4 months during a 6-month study period. Eighty-nine percent of these chronic users were above 60 years of age. Seventy-seven percent had difficulty initiating sleep and 23% had problems maintaining sleep. Information was given to these patients on the side effects and possible addictive nature of chronic hypnotic use. Different kinds of psychological support were offered as alternatives to drug treatment, but these were refused by all. We conclude that in view of the addiction associated with chronic use and the difficulty of weaning patients off the sleeping pill, there is a place for more careful evaluation and management before hypnotics are prescribed.
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Affiliation(s)
- A Matalon
- Kfar Ganim Kupat Holim Clinic, Petach-Tikva, Israel
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Abstract
Two hundred twenty-four children were examined for koilonychia of the toenails. Koilonychia was encountered in 55 out of 171 (32%) kibbutz children compared with 9 out of 53 (17%) of urban children (p less than 0.046). The most likely explanation for the increased prevalence of koilonychia in kibbutz children is habitual minor trauma associated with barefoot walking and frequent water immersion.
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Affiliation(s)
- A M Yinnon
- Department of Internal Medicine, Shaare Zedek Medical Center, Jerusalem, Israel
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Abstract
Two hundred fifty-six children were born in 195 births from 176 women that conceived after human menopausal gonadotropin/human chorionic gonadotropin (hMG/hCG)-induced ovulation. The secondary sex ratio was 50% male to 50% female births, which is not statistically different from the Israeli or Occidental population. The same trend was observed for single births and for twins. Thus, the data presented do not support the reports of increased numbers of female infants in those conceived after induction of ovulation. Factors that are expected to have been shown to affect sex ratio: maternal age at delivery, total number of ampules of hMG/hCG administered in the conceptional cycle, urinary estrogen levels on the day of hCG injection, degree of ovarian hyperstimulation syndrome, and time of insemination in relation to the basal body temperature rise were found to be insignificant. Thus, the hypothesis that a local hormonal environment (gonadotropin or estrogen levels) during hMG/hCG treatment possibly affects sex selection was not confirmed.
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