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עמוד בית
Sun, 24.11.24

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February 2000
Jacob Bar MD, Raoul Orvieto MD, Yosef Shalev MD, Yoav Peled MD, Yosef Pardo MD, Uzi Gafter MD, Zion Ben-Rafael MD, Ronny Chen MD and Moshe Hod MD

Background: The preconception and intraconception parameters that are relevant to outcome in women with underlying renal disease remain controversial.  

Objectives: To analyze the types and frequencies of short- and long-term (2 years after delivery) maternal and neonatal complications in 38 patients with primary renal disease (46 pregnancies), most of them with mild renal insufficiency.  

Methods: Logistic regression models were formulated to predict successful outcome.  

Results: Successful pregnancy outcome (live, healthy infant without severe handicap 2 years after delivery) was observed in 98% of the patients with primary renal disease. Factors found to be significantly predictive of successful outcome were absence of pre-existing hypertension, in addition to low preconception serum uric acid level.

Conclusions: Most women with primary renal disease who receive proper prenatal care have a successful pregnancy outcome. Worse pregnancy outcome was observed in women with moderate or severe renal failure. Fitted logistic models may provide useful guidelines for counseling women with preexisting renal disease about their prospects for a successful pregnancy in terms of immediate and long-term maternal and neonatal outcome.
 

January 2000
Isabel Zvibel, PhD, Yaron Mintz, MD, Shlomo Brill, MD, Zamir Halpern, MD and Moshe Papa, MD
December 1999
Ehud Lebel, MD, Menachem Itzchaki, MD, Deborah Elstein, PhD, Irit Hadas-Halpern, MD, Ayala Abrahamov, MD, and Ari Zimran MD.
November 1999
Nehama Linder MD, Lea Sirota MD, Amir Snapir MD, Irit Eisen MD, Nadav Davidovitch MD, Giora Kaplan MSc and Asher Barzilai MD

Background: Although the onset of fever in children often prompts parents to seek immediate treatment, the general level of parental knowledge on pediatric fever and administration of antipyretic medications is unknown. Parents without a basic understanding of treatment principles may give their children incorrect doses of medication. Overdosing may cause drug toxicity, while underdosing may lead to unnecessary, repeated clinic and/or emergency room visits.

Objectives: To assess parental decision-making with regard to treating fever in children, and its effectiveness, and to suggest methods for improving the level of treatment.

Methods: In this cross-sectional self-reported survey, questionnaires were completed by 650 parents who sought medical assistance for a child under the age of 10 years. Parents represented various socioeconomic levels, educational backgrounds and religious affiliations.

Results: Ninety-six percent of parents treated fevers that reached 38.5°C, and 77.6% treated fevers of only 38°C. Acetaminophen was the treatment of choice for 96% and dipyrone for 4%. Parental sources of information for managing and administering antipyretic drugs were medical personnel (40.7%), mother's or grandmother's experience (30%), and the enclosed leaflet or instructions on the bottle (29.3%). Forty-three percent of the parents administered the recommended dosage (10–20 mg/kg), whereas 24.3% used less and 32.7% used more; 11% exceeded a daily dosage of 120 mg/kg. 

Conclusions: A total of 57% of parents treated children with incorrect doses of antipyretic drugs. In 11% of the children treated, the daily dose was at a level that could cause severe toxicity. Parental knowledge of the treatment of fever must be improved.

October 1999
Shaul Dollberg MD and Francis B. Mimouni MD
 Background and Objective: Very low birthweight infants (<1,500 g birthweight) often develop significant anemia that requires multiple blood transfusions, which carry a significant risk. Erythropoietin therapy is known to reduce the need for blood transfusions in preterm VLBW(1) infants. Analysis of cost had been reported in prospective studies with conflicting results. No studies comparing the cost-effectiveness of EPO(2) have been reported during routine use in preterm VLBW infants.

Methods: We compared the cost of treating anemia of prematurity in two consecutive 12-month periods: before and after the introduction of EPO therapy in our unit. The cost of blood bank charges as well as disposable items and the cost of EPO were compared.

Results: A significantly smaller number of infants required blood transfusions in the EPO group (2 of 25 vs. 9/21 before EPO was introduced). The cost of therapy for anemia of prematurity was significantly smaller in the EPO group (128±168 US$ per infant vs. 151±189 US$ per infant before the introduction of EPO).

Conclusion: We conclude that EPO is an efficient and cost-effective alternative to blood transfusions in VLBW infants.

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(1) VLBW = very low birthweight

(2) EPO = erythropoietin

September 1999
Avishai Ziser, MD, Ludmila Guralnik, MD, Robert Markovits, MD, Yousif Matanis, MD, and Genia Mahamid, MD.
Dan Regev, MD, Yoram Wolf, MD, and Daniel Hauben, MD.
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