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        תוצאת חיפוש

        מאי 2001

        עידו וינברג, בן גרוס והרברט פרוינד
        עמ'

        Choice of Infusion Site - Differences in the References of Nurses, Residents and Patients

         

        Ido Weinberg, Ben Gross, Herbert Freund

         

        Department of Surgery, Hadassah University Hospital Mount Scopus and Hebrew University - Hadassah Medical School, Jerusalem

         

        Insertion of an intravenous (IV) line is a common and routine procedure in hospitalized patients. The literature recommends not to insert an IV line in a limb fold, but other than that there are no guidelines regarding optimal locations for the IV line. In this study we attempted to elucidate whether there are other possible preferences and guidelines for choosing the location of an IV line. We studied four groups: patients at the time of hospitalization, hospitalized patients, nurses and surgical interns on a surgical ward. We found that 91.8% of the patients request to take part in choosing the location of their IV line. Moreover, we found that most patients have a hand preference for the IV, whereas, the ward staff has little location preference. Despite these findings, we discovered that, in practice, most patients were not asked to participate in the decision making process regarding their IV line location. Analysis of the results showed that there is a need to include the patient's preference in choosing the location for the IV line, whenever possible. If the patient doesn't have a preference, the IV line should be inserted in the non-dominant hand or the hand in the bed which is more accessible to the medical & nursing staff.

        יולי 2000

        שלומית גזית-ניסים, אייל שיינר, משה מזור ואילנה שהם-ורדי
        עמ'

        Relationship between Occupation and Clinical Characteristics during Pregnancy and Recommendation to Stop Working

         

        S. Gazit-Nissim, E. Sheiner, M. Mazor, I. Shoham-Vardi

         

        Depts. of Epidemiology and Health Services Evaluation, and of Obstetrics and Gynecology, Soroka University Medical Center and Ben-Gurion University of the Negev, Beer Sheba

         

        We examined the relationship between occupation and clinical characteristics during pregnancy and medical recommendations to stop working. Using a case-control design, we compared 58 working women who had preterm births, with 126 who had delivered at term. All women were interviewed postpartum while still in hospital.

        There were no differences between the groups with regard to physical activity outside the home, weekly work hours, nor duration of work. Only a small proportion had been exposed to unusually difficult working conditions, to hazardous agents or to a very uncomfortable working environment. Women who had had preterm births were advised more often to leave their jobs or modify their working patterns. Multivariate analysis revealed that the physician's decision to recommend cessation of work was influenced primarily by complications during the current pregnancy.

        It appears that our patients at risk for preterm birth are probably correctly identified, and receive appropriate guidelines as to working patterns. It is possible that a poor obstetric history or previous abortions may paradoxically have a protective effect, as they influence the physician to recommend cessation of work.

        יוני 2000

        נחום נשר, רונן גלילי, רם שרוני, גדעון אורצקי ומילטון סאוטה
        עמ'

        Videothorascopic Sympathectomy for Palmar Hyperhidriosis

         

        Nahum Nesher, Ronen Galili, Ram Sharony, Gidon Uretzky, Milton Saute

         

        Dept. of Cardiothoracic Surgery, Lady Davis - Carmel Medical Center and Rappaport Faculty of Medicine, Israel Institute of Technology, Haifa

         

        Palmar hyperhidriosis is not a life-threatening disease but leads to loss in the quality of life. Conservative treatment is ineffective and major surgery involves perioperative complications and esthetic impairment.

        From 1992 to 1998 we treated 156 patients with palmar hyperhidriosis using a single port, drainless videothoracoscopic procedure with almost no complications.

        מרץ 2000

        ששון נקר, שלמה וינקר, טל ברו-אלוני ואלי קיטאי
        עמ'

        Family Physicians' Attitudes to Clinical Guidelines for Treatment of Diabetes 


        Sasson Nakar, Shlomo Vinker, Tal Baro-Aloni, Eliezer Kitai

         

        Dept. of Family Medicine, Rabin Medical Center and Sackler Faculty of Medicine, Tel Aviv University

         

        Clinical guidelines are systematically developed statements designed to help practitioners and patients make decisions about appropriate health care for specific clinical states. Attitudes of family physicians to clinical guidelines for treating diabetes and guidelines in general were evaluated from anonymous questionnaires answered by physicians participating in continuous medical education throughout the country (May-June 1998). The questionnaire dealt with attitudes to the recently published specific guidelines for treating the diabetic patient and overall perception of the efficacy of clinical guidelines.

        293 family physicians, aged 40.2‏7.0 responded (83%). 93.5% appreciated the guidelines and thought them applicable. Most (83.7%) reported the guidelines to be of help in their daily work; 31.4% said they were oversimplified; a quarter said they aimed main at containing costs. Most respondents preferred written guidelines of up to 5 pages.

        In view of our results, attention can now be turned to developing ways to implement the guidelines. To improve adherence, they need to be short and the rate of publication of new clinical guidelines should be slowed.

        נובמבר 1999

        לוטפי ג'אבר, שמואל דהאן ואילנה הררי
        עמ'

        Control of Brucellosis in Taibe: Intersectoral Collaboration

         

        Lutfi Jaber, Shmuel Dahan, Ilana Harari

         

        Bridge-to-Peace Community Pediatric Center, Taibe; Community Pediatrics Unit, Schneider Children's Medical Center, Petah Tikva; Sackler Faculty of M, Tel Aviv University; and Israel Ministry of Health, Sharon District

         

        Brucellosis is contracted from domestic animals. Poor hygiene, primitive animal breeding methods and traditional food preparation are the main contributory factors. We describe an intersectoral program for controlling brucellosis in Taibe, an Arab town in Israel, which had a particularly high incidence of the disease in 1992 and 1993.

        At the beginning of 1994 the Israel Ministry of Health and the Community Pediatric Center of Taibe established a community-based program for controlling brucellosis in Taibe. It included an intensive public health education campaign and periodic examination and vaccination of animals. Physicians, veterinarians, nurses, school officials and health inspectors were recruited for this purpose. Residents' awareness of brucellosis was determined before and after the study.

        After intervention, the incidence of the disease sharply declined from 176.6 and 175.0/100,000 in 1992 and 1993 respectively, to 5.7, 10.4 and 2.5/100,000 in 1994, 1995 and 1996, respectively, (odds-ratio 24.44; p<00000). Residents' awareness of brucellosis and preventive measures were significantly increased by the end of the study. We conclude that intersectoral collaboration is an important tool for controlling brucellosis.

        ספטמבר 1999

        ר שטיינמן, גילה אבלס סוטון ודני אלעד
        עמ'

        Equine Rhodococcus Equi Pneumonia: First Report in Israel and its Significance for Man

         

        A. Steinman, G.A. Sutton, D. Elad

         

        Koret School of Veterinary Medicine, Hebrew University of Jerusalem; and Kimron Veterinary Institute, Beit Dagan

         

        Rhodococcus equi is an important pathogen in young horses. In recent years it has been increasingly recognized as an opportunistic infectious agent in patients with immune deficiency. The increase in recognized cases may be related to the increased prevalence of AIDS. However, more cases may have been recognized lately due to increased awareness of the pathogenicity of this bacterium. Based on medical reports, there appears to be an association between Rhodococcus equi infections and exposure to animals, horses in particular.

        During the past year, 2 cases of rhodococcus pneumonia were diagnosed in foals in Israel. This information deserves the attention of the local medical community because of the zoonotic potential of Rhodococcus equi and the danger of its becoming more common. The climate in Israel is conducive to its growth and viability and since it flourishes in an environment with horses, the significant growth in our equine industry in recent years may contribute to an increase in Rhodococcus infections.

        מאי 1998

        יעקב פלדמן, אברהם ירצקי וקרולה ויגדר
        עמ'

        Community-Acquired Pneumonia in the Elderly: Guidelines for Hospitalization

         

        Jacob Feldman, Abraham Yarezky, Carola Vigder

         

        Geriatric. Dept., Meir Hospital, Kfar Saba and Sakler Faculty of Medicine, Tel Aviv University

         

        A prospective study was carried out among elderly patients with community-acquired pneumonia to determine if there are any specific features that could help in deciding whether to hospitalize, or to treat in the community. We concluded that there is no correlation between clinical presentation of pneumonia and outcome, except for impairment of consciousness. Laboratory data showed a correlation between oxygen saturation in arterial blood, levels of hemoglobin and albumin, and outcome. Sputum culture was not helpful in deciding about diagnosis and treatment, which remain empiric. These patients should be treated at home if conditions permit. Recommendations are made for improving such conditions.

        אפריל 1998

        א' ירצקי, ק' ויגדר וי' פלדמן
        עמ'

        Nursing Home-Acquired Pneumonia: Guidelines for Hospitalization

         

        A. Yaretzky, C. Vigder, I. Feldman

         

        Geriatric Dept., Meir Hospital, Kfar Saba, and Sackler Faculty of Medicine, Tel Aviv University

         

        To determine if there are any specific features of nursing-home acquired pneumonia we carried out a retrospective study in a nursing home between 1995-1996, based on clinical and laboratory data. We found no correlation between these findings and the severity of pneumonia, so it would be hazardous to determine rigid guidelines. These patients should be treated in the nursing home as long as conditions allow, in order to avoid hospitalization.

        ינואר 1998

        בעז מושקוביץ, עופר נתיב, אדמונד סבו, יוסף ברבארה, דניאל מורדכוביץ, יוסף כפתורי, אריה שלהב ובנעד גולווסר
        עמ'

        Percutaneous Ablation of Malignant Kidney Tumors in Rabbits by Low Frequency Radio Energy

         

        Boaz Moskovitz, Ofer Nativ, Edmond Sabo, Yousef Barbara, Daniel Mordohovich, Yoseph Kaftori, Arie Shalhav, Benad Goldwasser

         

        Bnai-Zion Medical Center and Bruce Rappaport Faculty of Medicine, The Technion, Haifa

         

        Radio-frequency (RF) current has been used successfully to ablate normal human tissue. To investigate further the clinical application of this modality in tumors, we studied the potential of using RF percutaneously to destroy experimental kidney tumors. 35 outbred albino rabbits underwent direct-implantation of renal VX2 tumor during open surgery. After 21 days, ultrasonography was performed to show tumor presence and size. A shielded RF needle was designed to be inserted percutaneously through an introduction needle. An electrical insulation shield covering the RF needle was retractable, controlling the length of exposure of the RF needle inside the tissue. 22 days after tumor implantation, RF was applied via this special needle using a ZoMed International RF generator. In one group of rabbits the procedure was performed under direct vision during open surgery, while in another group treatment was percutaneous, the needle guided by palpation of the tumor. Rabbits were killed 3 days later and revealed 4-25 mm intra-tumoral RF-induced lesions. A direct relation was found between lesion size and the power and duration of RF applied (at 7.5 W, R=0.48, and P=0.32). Based on our preliminary results we can conclude that RF may have clinical applications in the near future for percutaneous local tumor control in parenchymal organs.

        יולי 1997

        אלי אשכנזי, סטיבן ת' אונסטי ויוסט ו' מיקולסון
        עמ'

        Surgical Approach to Benign Extradural Lesions of the Thoracic Spine

         

        Ely Ashkenazi, Stephen T. Onesti, W.J. Michelsen

         

        Depts. of Neurosurgery, Hadassah University Hospital, Jerusalem and Montefiore Medical Center, Albert Einstein College of Medicine of Yeshiva University, The Bronx, New York

         

        A benign epidural lesion in the thoracic spine is rare, and usually the result of intervertebral disc herniation or infection. Not long ago patients were diagnosed late in the course of their disease and the surgical results of the standard laminectomy usually performed were grave. The development of newer imaging techniques (CT and MRI) has made diagnosis much easier, so diagnosis is often earlier, when neurological deficit is minimal. Newer neurosurgical techniques and approaches to the thoracic spoine have been developed to treat these lesions, which we describe. Clinical data on 16 patients operated from January 1996 to January 1997 are presented.

        הבהרה משפטית: כל נושא המופיע באתר זה נועד להשכלה בלבד ואין לראות בו ייעוץ רפואי או משפטי. אין הר"י אחראית לתוכן המתפרסם באתר זה ולכל נזק שעלול להיגרם. כל הזכויות על המידע באתר שייכות להסתדרות הרפואית בישראל. מדיניות פרטיות
        כתובתנו: ז'בוטינסקי 35 רמת גן, בניין התאומים 2 קומות 10-11, ת.ד. 3566, מיקוד 5213604. טלפון: 03-6100444, פקס: 03-5753303