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        תוצאת חיפוש

        יוני 2000

        בן-עמי סלע. עמ' 1046-1050
        עמ'

        בן-עמי סלע

        המכון לכימיה פתולוגית, המרכז הרפואי שיבא, תל השומר; החוג לביוכימיה קלינית, הפאקולטה לרפואה סאקלר, אוניברסיטת תל-אביב

        ח' טבנקין, ד' שטיינמץ, פ' חמאייסי וע' תמיר. עמ' 1050-1054
        עמ'

        ח' טבנקין1, ד' שטיינמץ2, פ' חמאייסי1, ע' תמיר2

        1המח' לרפואת המשפחה, מרכז רפואי העמק ומחוז הצפון, קופ"ח כללית, שלוחת הצפון של המכון להתמחות החטיבה לבריאות הקהילה, הפקולטה למדעי הבריאות בנגב. 2המח' לאפידמיולוגיה ולבריאות בקהילה, ביה"ח כרמל, הפקולטה לרפואה, הטכניון – חיפה.

        נתן רוז'נסקי ואברהם בן-שושן. עמ' 1055-1060
        עמ'

        נתן רוז'נסקי, אברהם בן-שושן

        מח' לרפואת נשים ויולדות, ביה"ח הדסה, עיןכרם, הפקולטה לרפואה של האוניברסיטה העברית, ירושלים

         

        מאי 2000

        יורם אפשטיין, יובל חלד, דני מורן ויאיר שפירא
        עמ'

        Prediction of Physiological Response from Mathematical Models 


        Yoram Epstein, Yuval Heled, Daniel Moran, Yair Shapiro

         

        Institute of Military Medicine, Medical Corps, Israel Defense Forces and Heller Institute of Medical Research, Sheba Medical Center, Tel Hashomer

         

        The ability to predict the physiological responses of workers exposed to extreme environmental conditions, has been a challenge to environmental physiologists for more than 3 decades. Therefore, mathematical models have been developed to predict metabolic rate under various levels of work intensity and dynamic changes in body temperature and heart rate.

        Based on the effect of exercise on the cardiovascular system, a model was developed to predict mean arterial blood pressure as a function of heart rate. Physiological strain could also be estimated on the basis of thermoregulatory and cardiovascular strains.

        This paper summarizes knowledge accumulated during 25 years of studies in the field of mathematical modeling of physiological parameters. Besides analyzing the logic underlying each model, it explains the scientific approach in developing a model from its early concept to the model's application in the field.

        אהרן פיינסטון, אריה אלדר וצ'ארלס מילגרום
        עמ'

        Pre-Induction Sport Activity in Prevention of Stress Fractures 


        Aharon S. Finestone, Arieh Eldad, Charles Milgrom

         

        Medical Corps, Israel Defense Forces, and Dept. of Orthopedics, Rabin Medical Center, Beilinson Campus, Petah Tikva and Hadassah University Hospital, Ein Kerem, Jerusalem

         

        Pre-induction sports participation of 392 elite infantry recruits was evaluated for correlation with incidence of stress fractures (SF) during 14 weeks of basic training. 23.7% developed lower extremity stress fractures. 72% of the recruits had participated in sports on a regular basis during the 2 years prior to induction. Their fitness as examined by the Bar-Or induction fitness test, was significantly better than that of those who had not trained. 14.9% of the soldiers who had previously participated in ball games (primarily basketball) as an only sport suffered stress fractures, compared to 31.0% of those whose only sport was running (p<0.005).

        Training for only 6 months prior to induction had no effect on the incidence of SF. The reason for the difference between ball games and running is probably related to the higher strains and strain rates developed during ball games and to their multidirectional nature, as compared to running.

        These findings suggest that participation in a pre-induction program that includes activities that create strains, such as basketball, can reduce incidence of SF in infantry recruits. The training period has to last at least 2 years.

        עזרא זהר, יאיר שפירא ויורם אפשטיין
        עמ'

        Man in a Hot Climate - Early Studies of the Institute of Military Physiology 


        Ezra Sohar, Yair Shapiro, Yoram Epstein

         

        Institute of Military Medicine, Medical Corps, Israel Defense Forces and Heller Institute of Medical Research, Sheba Medical Center, Tel Hashomer

         

        In the 1950's many IDF soldiers were hospitalized for heat stroke - about 25% of whom died. Analyzing these cases revealed that commanders misinterpreted human ability to perform in the heat and ignored basic concepts of fluid and electrolyte balance and heat load.

        In the early 1960's a series of studies was conducted with regard to soldiers' performance in the heat. The first study (1959), which later became a classic, was conducted during a 21-day march from Eilat to Metula, crossing all climatic zones of Israel. The study was followed by other investigations which approached the issues of voluntary dehydration, fluid consumption vs sweat loss, salt additives, and the effect of heat load on performance.

        Based on these early studies, proper regulations were issued to field officers. Over the years, the lessons learned from these studies saved many lives. The number of cases of heat stroke and of other climate-related injuries was dramatically reduced, and performance was enhanced.

        א' בלייך
        עמ'

        Military Psychiatry in Israel: a 50-Year Perspective 


        Avi Bleich

         

        Tel Aviv-Souraski Medical Center and Sackler Faculty of Medicine, Tel Aviv University

         

        The history of military psychiatry in Israel may be divided into 2 main periods. The first extended from the War of Independence in 1948, through the Sinai, Six Day and Yom Kippur Wars. Its outstanding feature was avoidance of the issue of combat stress reaction (CSR). The Yom Kippur War made the recognition of CSR inescapable, assisted in breaking up denial, and served as a stimulus for development of the next phase of the system.

        This second phase was characterized by impressive progress in all areas of military psychiatry. The rich experience accumulated during the wars, together with the assimilation of a research culture which began blooming, especially in the wake of the Lebanon War, aided the development and crystallization of concepts related to combat and non-combat military psychiatry alike. The build-up of the mental health organization overlapped field deployment of the Medical Corps.

        משה אברמוביץ, מוטי שמושקביץ, אבי וייצמן ומרדכי מרק
        עמ'

        New Psychopharmacological Approaches in Mental Health as Applied by the Israel Defense Forces

         

        Moshe Zvi Abramowitz, M. Shmushkevich, Avraham Weizman, Mordechai Mark

         

        Mental Health Department, Medical Corps, Israel Defense Forces; Sackler Faculty of Medicine, Tel Aviv University; Jerusalem Mental Health Center; and Geha Psychiatric Hospital

         

        In the past decade there have been far-reaching developments in psychopharmacology. Previously, only a few classes of medication were at the disposal of psychiatrists, as many had serious side effects that limited their use. Now our psychopharmacological armamentarium has grown considerably, allowing for greater choice of treatment in the military.

        We review these developments, and discuss the special considerations to be taken into account when treating soldiers with psychiatric medication. We discuss suitable medication for ongoing outpatient treatment, as well as the standard list of medication currently used by units deployed in the field.

        Advances in psychopharmacologic treatment should enable more soldiers to serve safely in the military with fewer restrictions on their duties.

        אוריאל י' דרייפוס
        עמ'

        Burn Injuries During the Six Day War 


        Uriel Y. Dreyfuss

         

        Dept. of Orthopedics, Bnai Zion Medical Center, Haifa

         

        About 2500 soldiers were injured during the Six Day War (June 1967) of whom 115 suffered from burns. In 34 of them 15% or more of their body surface was involved and 11 died. Typical features of these burn cases were supplementary injuries, a high rate of infection, and long periods of hospitalization. Prophylactic antibiotics were not useful. The general condition of many deteriorated during the first week after injury, indicating the importance of treating severe burns in specialized facilities.

        צ' גימון וי' אדלר
        עמ'

        Medical Support During The Sinai War Of Attrition (1968-1970): A 30-Year Perspective 


        Z. Gimmon, J. Adler

         

        Dept. of General Surgery, Hadassah-Hebrew University Medical Center, Ein Kerem, Jerusalem and Medical Section, Israteam, Lod

         

        The War of Attrition between Israel and Egypt along the Suez Canal line lasted 23 months (9/1968-8/1970), during which the Israel Defense Forces (IDF) were mostly in fixed fortifications. A few of the important principles of field medical support, which became cornerstones of IDF procedure, were established during that war. These included use of armored vehicles for evacuation under artillery fire, as well as emergency treatment, physiological stabilization, and maintenance of the wounded until evacuation.

        The latter objectives were achieved by stationing medical officers and paramedics within the fortifications, where they remained with the troops. A field surgical hospital was established in Refidim which had a trained surgical staff and a well-equipped emergency department. It included an operating theater and post-op recovery facilities for proper surgical care until evacuation to hospitals in the rear.

        Tables showing the number of casualties throughout 1 year of the War of Attrition are presented. Better personal shielding by helmets and body shields decreased the number and severity of head and thoraco-abdominal injuries. The relative large number of those who died-of-wounds was due to the proximity of medical facilities, so that treatment could be administered within the fortifications. Otherwise, many more would have been included among the killed-in-action.

        רן אריאלי ואבי שצ'ופק
        עמ'

        Israel Naval Medical Institute: 20 Years of Applied Research, and Future Goals 


        Ran Arieli, Avi Shupak

         

        Israel Naval Medical Institute, Medical Corps, Israel Defense Forces

         

        The Israel Naval Medical Institute (INMI) is unique as a research center located in a naval base and having close inter-relations with naval underwater units. It is ideal for applied research, and for mutual exchange of needs and of ideas and instructions.

        Factors making this institute so suitable for applied research include: direct personal communication with combat divers, professional naval divers, submariners, civilian recreational divers and professional civilian divers, as well as naval vessel crews prone to seasickness; hyperbaric oxygen therapy is administered in cooperation with a large neighboring hospital.

        Close spatial and personal relations with an academic institution (the Technion, with its Faculties of Medicine, Biology and Biophysics) provide a basis for cooperative research which expands research capabilities, and allows access to extensive expertise, instrumentation and equipment. Close ties with physicians who served at the INMI in the past also bring them into this research community.

        During their specialization, physicians may spend up to 6 months working with us on a research project. Undergraduate, graduate and post-graduate students may complete their research at our institute with the agreement of their parent academic institutions.

        Much of the research can be released to the international community. However, some is classified, serves only internal needs or is not of public interest. The number of published papers has stabilized since 1991 at about 16 a year.

        Studies of gas exchange and oxygen toxicity originate mainly in the Hyperbaric Research Unit, research on motion sickness in the Motion Sickness and Human Performance Laboratory, and work on hyperbaric and diving medicine in the Clinical Section of the INMI.
         

        אמנון גיל, אבי שצ'ופק, חיים לבון ויוחאי אדיר
        עמ'

        Decompression Sickness in Divers Treated at the Israel Naval Medical Institute 


        A. Gil, A. Shupak, H. Lavon, Y. Adir

         

        Israel Naval Medical Institute, Israel Defense Forces, Haifa

         

        Clinical characteristics of 125 divers treated for decompression sickness (DCS) in the hyperbaric multiplace chambers of this Institute during 1992-1997 were analyzed retrospectively. In 62 (51%) the diagnosis was DCS Type I (joint pain or skin involvement) and in 60 (49%) DCS Type II (neurological, inner ear or pulmonary disease). Risk factors for the evolution of DCS were depth and duration of the dives involving accidents, violation of recommendations of the decompression tables, and repeated dives.

        Results were available for 112 of the 125 patients. 54 of them (48%) recovered completely, and another 54 recovered partially; 4 did not respond to treatment. Inner ear DCS was less responsive to hyperbaric oxygen treatment (p=0.0001). There was significant improvement of neurological function in those with severe neurological injury (p=0.0001). Rapid diagnosis and transportation of divers with DCS to a hyperbaric chamber is of crucial importance.

        מ' גדלביץ, ד' גיליס, ד' מימוני, א' גרוטו וע' שפילברג
        עמ'

        Trends in Epidemiology of Hepatitis in the Israel Defense Forces 


        Michael Gdalevich, David Gillis, Daniel Mimouni, Itamar Grotto, Ofer Shpilberg

         

        Institute of Military Medicine, Medical Corps, Israel Defense Forces

         

        During the 50's and 60's there were large scale epidemics of hepatitis A every 3-4 years in the Israel Defense Forces. During these epidemics the annual incidence exceeded 10/1000 soldiers at risk. There has been a highly significant decrease in rates during the past 30 years. The average annual incidence of clinically identified viral hepatitis A decreased from an average of 6/1000 during the 60's to 2.5/1000 during the 70's. The decrease coincided with the introduction in the 1970's of wide-scale post-exposure prophylaxis with immune serum globulin (ISG). The incidence was further significantly reduced to 0.5-1.0/1000 with the introduction of pre-exposure prophylaxis with ISG, starting in 1978 (p<0.001).

        Other factors probably played a role in accelerating the decline in morbidity, such as improvement in personal hygiene and sanitation facilities, and in waste disposal and other aspects of military environmental health.

        These improvements were probably more pronounced in the civilian sector, leading to decreased exposure of children to the virus and consequently a higher proportion of seronegatives at induction. Increase in the proportion of recruits without natural immunity to the virus poses greater risk, both in terms of personal morbidity as well as military operational ability. This risk, combined with problems of ISG use and availability, has propelled hepatitis A prevention policy towards the use of the new inactivated vaccines.

        מירי יבזורי, ניר אוריאל, נורית פורת, רון דגן, רוחמה אמבר, עופר שפילברג ודני כהן
        עמ'

        Development of Molecular Tests for Rapid Detection of Enteropathogens 


        Miri Yavzori, Nir Uriel, Nurith Porat, Ron Dagan, Ruhama Ambar, Ofer Shpilberg, Dani Cohen

         

        Army Health Branch Research Unit, Medical Corps, Israel Defense Forces; Pediatric Infectious Disease Unit, Soroka University Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba; and Sackler Faculty of Medicine, Tel Aviv University

         

        Amplification of specific DNA sequences by polymerase chain reaction (PCR), enables rapid, sensitive and direct, specific identification of pathogens at very low concentrations in clinical samples. Studies in recent years have reported identification of several enteropathogens directly from stool samples by PCR. The amplification process includes the use of primers complementary to the DNA sequences specific to the pathogen, thus relying on the pathogen's genotype, rather than its phenotype on which identification by the methods of classical microbiology were based.

        We have developed PCR protocols for the differential identification of enteropathogens resembling the normal flora (enterotoxigenic E. coli (ETEC), E. coli O-157), Shigella spp, and the detection of enteropathogens that can not be grown on classic growth media (Norwalk virus). The amplification process is inhibited by several substrates present in fecal material (phenol, hemoglobin), limiting DNA extraction by phenol. The protocols we have developed for direct detection of Shigella spp and ETEC in stools circumvent inhibition of PCR by the use of a 4-hour pre-enrichment step in brain-heart infusion broth.

        Rapid and accurate identification of enteropathogens is important for prompt and focused intervention to stop the chain of transmission in outbreaks of gastroenteritis in military and civilian populations.

        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