Ron Ben-Abraham, MD, Michael Stein, MD, Gideon Paret, MD, Avishy Goldberg, MD, Joshua Shemer, MD and Yoram Kluger, MD.
Background: In the military environment it is the medics who usually provide the initial care of mass casualties in the field.
Objectives: To determine the number of incidents of trauma encountered by medics in the Israel Defense Forces during peacetime, and to ascertain the role of these medics in providing primary trauma care to the victims.
Methods: A retrospective questionnaire, reviewing the activities of medics in treating injured trauma victims, was distributed to medics who were in service for at least 2 years after their professional training.
Results: Of the 128 responding medics, 87 (68%) had actively participated in the treatment of trauma victims under various circumstances. The average number of trauma events was 1.2 events over a period of 2 years per combat medic, and 0.7 for medics stationed in rear units. Their activities included insertion of numerous intravenous fluid lines (57% of medics), assistance in intubations (37%), tube thoracostomies (23%), insertions of central catheters (14%) or orogastric tubes (28%), and manual ventilations (41%).
Conclusion: Since it is difficult to increase the level of practical experience in dealing with trauma within the military framework, new techniques should be applied to improve the trauma training.
Gideon Nesher, MD, Hanan Gur, MD, Michael Ehrenfeld, MD, Alan Rubinow, MD and Moshe Sonnenblick, MD.
Objectives: To evaluate whether the increasing incidence of temporal arteritis in Israel is associated with a changing clinical presentation.
Methods: The demographic data and clinical manifestations of 144 TA1 patients in this large multicenter study were recorded and compared with data obtained in a previous study.
Results: The patient population was older, with 24% ≥80 years compared to 6% in the previous study. There was an increase in the number of nonspecific presenting symptoms, and less patients presented with the “classical” manifestations of headache (81% vs. 71%), fever (83% vs. 40%), jaw claudication (21% vs. 13%), and visual symptoms (47% vs. 24%). The median time from presentation to diagnosis was significantly reduced, from 5 to 1.5 months.
Conclusions: There were substantial changes in the clinical presentation of TA patients in Israel during 1980–95 compared to patients diagnosed prior to 1978. It is suggested that these changes may be attributed not only to the influence of aging of the population, but are due largely to increasing physician awareness to the spectrum of manifestations of TA, which leads to earlier diagnosis.
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1TA = temporal arteritis
Shmuel C. Shapira, MD, MPH
Pnina Langevitz, MD, Avi Livneh, MD, Shai Padeh, MD, Nurit Zaks, MD, Yael Shinar, MD, Deborah Zemer, MD, Elon Pras, MD, and Mordechai Pras, MD.
Sandra Reynoso-Paz, MD, Ross L. Coppel, MD, Aftab A. Ansari MD, and M.Eric Gershwin, MD
Ilan Krause, MD, Miri Blank, PhD, and Yehuda Shoenfeld, MD.
Hertzel Salman, MD, Pearl I. Herskovitz, MD, Simcha Brandis, MD, Michael Bergman, MD, Dror Dicker, MD, and Izhar Zahavi, MD.
Joel Sayfan, MD, and Ada Rosen, MD.
Avishai Ziser, MD, Ludmila Guralnik, MD, Robert Markovits, MD, Yousif Matanis, MD, and Genia Mahamid, MD.
Michael Gdalevich, MD, Daniel Mimouni, MD, Isaac Ashkenazi, MD, and Joshua Shemer ,MD.
Dan Regev, MD, Yoram Wolf, MD, and Daniel Hauben, MD.