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        תוצאת חיפוש

        מאי 1999

        נטע נוצר
        עמ'

        Determining Power Factors of Clinical Departments in a Medical Center

         

        Netta Notzer

         

        Medical Education Unit, Sackler Faculty of Medicine, Tel Aviv University

         

        The intradepartmental power factors in a medical center were studied. 3 strategic contingency factors were examined, based on the model of Hickson et al. (1971): centrality, substitutability, and coping-with uncertainty. Only coping-with-uncertainty contributed directly to departmental power, and not the summation of the 3.

         

        Power derives from department resources, connections and influence outside the medical center. Aspects related to in- patient treatment or teaching of residents did not contribute directly to departmental power status. Power is gained in stages: in the first the department contributes to the factor of centrality (mainly patient treatment, teaching and research). In the middle stage, power is gained due to the factor of substitutability- the unique services and research which the department has developed. The third stage contributes directly to power-coping with uncertainty. This implies the ability of a department to solve crucial problems of the medical center. Surprisingly, the clinical field (i.e. surgery) did not contribute significantly to power. The current trend is toward empowering ambulatory units in the medical center.

        מרץ 1999

        פרנקלין גרייף, משה רובין, איתן מור, ישראל נודלמן, ארנולד סיחון, אריה פיגר, אלכס בלינקי ושלמה ללצ'וק
        עמ'

        Liver Surgery - Five Years of Experience

         

        Franklin Greif, Moshe Rubin, Eitan Mor, Israel Nudelman, Arnold Sihon, Arie Figer, Alex Belinki, Shlomo Lelcuk

         

        Hepatobiliary Unit and Depts. of Surgery B, Transplantation, Oncology and Radiology, Rabin Medical Center (Beilinson Campus) and Sackler School of Medicine, Tel Aviv University

         

        Major hepatic resections have been associated with significant morbidity and mortality. In the past decade or so this has changed and such procedures are now done in increasing numbers. In the past 5 years we operated on 129 patients with benign or malignant hepatic lesions (75 females, 54 males; age-range 14-84). the reason for surgery was malignancy in 94 (72.9%) and benign lesions in 35 (27.1%). The most common indication for surgery was liver metastases secondary to colorectal cancer in 45% of all patients or 61.7% of those operated for malignancy. Primary liver cancer was the cause for liver resection in 13.2% of all patients or 18.1% for those with malignancy. Of the 35 patients with benign lesions the leading causes for surgery included: giant cavernous hemangioma, simple liver cysts, echinococcus cysts and focal nodular hyperplasia (11%, 22.8%, 20% and 14.3%, respectively).

         

        76 patients underwent anatomical resection and 63 had either a nonanatomical resection or a different operation. Among the former the most common procedure was right hepatectomy (36) and among the later a nonanatomical resection equal to 1-3 Couinod segments (44). Operating time ranged from 55 min. to 8:41 hours with a mean of 3:31‏1:37. Mean hospital stay was 8.7‏5.8 days and 86.8% received between 0-2 units of blood. Overall mortality was 6.2% and 31.2% of the fatalities had cirrhosis. Overall mortality in noncirrhotic patients was 2.6%. The complication rate was 16.3% and only 7 patients (4.4%) were hospitalized in the intensive care unit. This indicates that major liver resections can be done safely, with morbidity and mortality similar to that of other major abdominal operations. 

        ינואר 1999

        אירינה ציקונובה, יוחנן נשיץ, סימונה קרויטורו, אלישע בר-מאיר ודניאל ישורון
        עמ'

        The Challenge of Space-Occupying Lesions in the Iliopsoas Space

         

        Irena Tsikonova, Jochanan E. Naschitz, Simona Croitoru, Elisha Barmeir, Daniel Yeshurun

         

        Depts. of Medicine and Diagnostic Imaging, Bnai Zion Medical Center, and Bruce Rappaport Faculty of Medicine, The Technion, Haifa

         

        Mass lesions in the iliopsoas compartment (MLIPC) are uncommon in patients in departments of medicine and their incidence and etiologies are unclear. In a prospective study we diagnosed various MLIPCs in 7 patients during a 10-year period, representing 0.03% of admissions. Symptoms included abdominal or flank pain (4 cases), pain along the thigh (5), diminished psoas muscle strength (2), fever (2), and hypotension (1). MLIPC was suspected on clinical grounds in 5 cases. In all cases the diagnosis was established by computed tomography (CT). Tissue was sampled by needle biopsy in 4 and on surgery in 1. MLIPCs were caused by hemorrhage (2), infection (2), neoplasia (2) and inflammatory mass (1). Often MLIPCs are life-threatening so their timely diagnosis by early CT scan is important.

        אפריל 1998

        רפאל יוסף חרותי, רון בן-אברהם, מיכאל שטיין, יניר אברמוביץ, יהושע שמר וברוך מרגנית
        עמ'

        Changes in Structure and Process Components of Trauma Care in Emergedepartments

         

        Rephael Joseph Heruti, Ron Ben-Abraham, Yanir Abramovitch, Michael Stein, Joshua Shemer, Baruch Marganit

         

        Trauma Control, Israeli Center for Disease Control (ICDC), Israel Ministry of Health and Sackler School of Medicine, Tel Aviv University

         

        In recent years there have been tremendous efforts to improve primary trauma care. The Ministry of Health and other authorities have invested in new trauma facilities in various hospitals. A nationwide survey with regard to structure and function of emergency departments was carried out. Compared to a similar survey conducted in 1992, significant progress in quality and quantity of equipment at various emergency departments was demonstrated. However, there are still differences between various hospitals. A drive to standardize trauma care will undoubtedly contribute to improvement in care of the injured.

        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.

        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