17,375 results match your criteria Harefuah[Journal]


[PRACTICAL ADVICE FOR THE APPROPRIATE USE OF DIRECT ORAL ANTICOAGULANTS].

Harefuah 2019 Mar;158(3):200-204

Hematology Institute, Meir Medical Center.

Introduction: The direct oral anticoagulants (DOACs) are a class of drugs used for the prevention of stroke and systemic embolism in patients with non-valvular atrial fibrillation and for prevention and treatment of venous thrombo-embolism. They are as effective and are safer than the vitamin K antagonists that were the oral drugs previously used for this purpose. The DOACs are convenient to use because of their fixed dose-response relationship which makes routine monitoring of drug levels unnecessary. Read More

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March 2019
2 Reads

[TREATMENT OF IMMUNE THROMBOCYTOPENIC PURPURA IN ADULTS: UPDATE].

Authors:
Dorit Blickstein

Harefuah 2019 Mar;158(3):196-199

Thrombosis and Hemostasis Unit, Institute of Hematology and Bone Marrow Transplantation, Rambam Health Care Center, Haifa.

Introduction: Primary immune thrombocytopenic purpura (ITP) is an acquired immune-mediated disorder characterized by isolated thrombocytopenia (platelet count less than 100X109/L), caused by IgG autoantibodies which bind to platelets and megakaryocyte, T cell-mediated platelet destruction and impaired megakaryocytic function. Symptoms can manifest as petechiae, purpura, mucosal bleeding and rarely fatal intracranial hemorrhage, as well as reduced quality of life. A wide range of bleeding manifestations exists and it is impossible to tell who will bleed, when and where. Read More

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March 2019
5 Reads

[THROMBOCYTOPENIA, LEG EDEMA AND SHORTNESS OF BREATH FOLLOWING CORONARY ARTERY BYPASS SURGERY].

Harefuah 2019 Mar;158(3):192-195

Thrombosis and Haemostasis Unit, Institute of Hematology, Rabin Medical Center, Beilinson Hospital ,Petah Tikva, Israel.

Introduction: Heparin-induced thrombocytopenia (HIT) is the most important non-hemorrhagic complication of heparin treatment. We report a case of a major thromboembolic event accompanied by thrombocytopenia following heparin exposure during coronary artery bypass graft surgery. Thrombocytopenia was documented one month after the surgery, and a major thromboembolic event which led to the patient's death diagnosed 6 weeks after heparin exposure. Read More

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March 2019
1 Read

[PEDIATRIC VENOUS THROMBOEMBOLISM - A COHORT STUDY IN A TERTIARY CENTER].

Harefuah 2019 Mar;158(3):187-191

The National Hemophilia Center and Thrombosis Unit, and Amalia Biron Research Institute of Thrombosis and Hemostasis, Sheba Medical Center, Tel Hashomer and Sackler Faculty of Medicine, Tel Aviv University, Israel.

Introduction: Deep Venous Thrombosis (DVT) is rare among children, yet may yield high morbidity and mortality. Due to the limited data regarding pediatric DVT, its management has been adopted from adults' protocols. Recent research reported associations of DVT and strokes with genetic thrombophilia, especially in the presence of transient risk factors (e. Read More

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March 2019
1 Read

[PREGNANCY RELATED ACQUIRED HEMOPHILIA A].

Harefuah 2019 Mar;158(3):184-186

Hematology Institute and Blood Bank.

Introduction: Acquired hemophilia A is a rare disease. The incidence has been estimated to be 1.3-1. Read More

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March 2019
1 Read

[THE EFFECT OF INFECTIOUS AND AUTOIMMUNE DISEASES ON PROCOAGULANT ACTIVITY OF FIBRINOGEN-LIKE PROTEIN 2 IN THE PERIPHERAL BLOOD].

Harefuah 2019 Mar;158(3):180-183

Hemato-Oncology Laboratory, Felsenstein Medical Research Center, Petah Tikva, Israel.

Aims: In this article we address the effect of bacterial or viral infections as well as autoimmune diseases on FGL2 activity in the blood.

Background: Fibrinogen-like protein 2 (FGL2) is a novel prothrombinase capable of initiating thrombin generation independent of the classical coagulation pathway. FGL2 is involved in immune-coagulation response. Read More

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March 2019
1 Read

[ELABORATION AND TREATMENT DECISION IN INCIDENTAL SPLANCHNIC VEIN THROMBOSIS].

Harefuah 2019 Mar;158(3):176-179

Liver Unit of Clalit Medical Services - Haifa and Western, Galilee region.

Introduction: In the present article, a patient with incidental findings in computerized tomography (CT) of cavernous transformation of the splanchnic veins, thrombosis of the splenic and portal veins, esophagus and gastric varicose veins and splenomegaly is presented. The CT was performed due to mild chronic normocytic anemia known for two years and the elevated level of LDH (Lactic dehydrogenase). Although usually such incidental findings without cirrhosis do not necessitate anticoagulation therapy according to the literature, in cases of myeloproliferative diseases, anticoagulation is required in order to prevent thrombus propagation. Read More

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March 2019
1 Read

[HEMOPHILIA - A ROYAL DISEASE IN THE HOLY LAND].

Harefuah 2019 Mar;158(3):173-175

National Hemophilia Center and Thrombosis Institute, Sheba Medical Center, Tel Hashomer, Israel.

Introduction: Hemophilia is a hereditary congenital hemorrhagic diathesis caused by mutations in blood coagulation factor VIII (FVIII) or IX (FIX) genes, causing hemophilia A and B, respectively. Most cases are familial but a significant minority is sporadic.

Objectives: To examine the presenting symptoms of patients with hemophilia in Israel and identify causes for delay in diagnosis. Read More

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March 2019
1 Read

[PLATELETS FUNCTION IN A DROP OF BLOOD: FLOW CYTOMETRY ANALYSIS COMPARED TO PLATELET AGGREGATION].

Harefuah 2019 Mar;158(3):168-172

Hemophilia National Center and the Institute of Thrombosis and Hemostasis, Sheba Medical Center, Tel Hashomer, Israel.

Introduction: Light transmission aggregometry (LTA) is the most commonly used test for the diagnosis of platelet function disorders, but requires large amounts of blood samples and normal platelet count.

Objectives: To compare flow cytometric (FC) platelet function testing to standard LTA in the general population, in patients treated with anti-platelets drugs and in term and preterm neonates.

Methods: Platelet function was assessed with LTA and FC using PAC1 binding and p-selectin expression, as platelet activation markers, in response to agonist activation. Read More

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March 2019
1 Read

[ACQUIRED HEMOPHILIA A AND THE TIMING OF IMMUNOMODULATORY THERAPY].

Harefuah 2019 Mar;158(3):165-167

Thrombosis and Hemostasis Unit, Rambam Health Care Campus, Haifa, Israel.

Introduction: Acquired hemophilia A is an autoimmune disease affecting men and women equally and is idiopathic in 50% of the cases. As the mortality rate reaches 50%, prompt diagnosis and treatment are needed. Diagnosis is made in a patient with a bleeding manifestation and prolonged PTT (partial thromboplastin time) that is not corrected in a mixing study with normal plasma. Read More

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March 2019
4 Reads

[EXPERIENCE IN DIAGNOSTIC ASSAYS FOR HEPARIN-INDUCED THROMBOCYTOPENIA - EXPERIENCE OF A TERTIARY HOSPITAL IN ISRAEL].

Harefuah 2019 Mar;158(3):160-164

Hematology Laboratory, Rambam Health Care Campus, Haifa, Israel.

Aims: To analyze the experience of a tertiary medical center in clinical and laboratory diagnosis of suspected HIT.

Background: The diagnosis of heparin-induced thrombocytopenia (HIT) requires clinical data and laboratory detection of platelet activating factor 4/heparin (PF4/H) antibodies by immunological or functional assays. Although antigen screening assays are widely used, the functional assays are performed only by several expert labs. Read More

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March 2019
3 Reads

[FETAL/NEONATAL ALLOIMMUNE THROMBOCYTOPENIA (F/NAIT) - THE PREVALENCE VERSUS AWARENESS OF A LIFE-THREATENING CLINICAL CONDITION].

Harefuah 2019 Mar;158(3):155-159

Hematology and BMT Department, Rambam Health Care campus.

Aims: To determine the prevalence and incidence of HPA antigens and antibodies in the Israeli population and to evaluate the degree of awareness to F/NAIT in Israel.

Background: In fetal/neonatal alloimmune thrombocytopenia (F/NAIT) the fetus suffers from thrombocytopenia mediated by maternal IgG antibodies directed against fetal platelets leading to intracranial hemorrhage (ICH) in about 20% of cases. The antibodies are directed against Human Platelet Antigens (HPA). Read More

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March 2019
1 Read

[RISK FACTORS ASSOCIATED WITH THE DEVELOPMENT OF UPPER EXTREMITY DEEP VEIN THROMBOSIS FOLLOWING PERIPHERALLY INSERTED CENTRAL CATHETER INSERTION].

Harefuah 2019 Mar;158(3):150-154

Hematology Department, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.

Background: The occurrence of upper extremity deep vein thrombosis (UEDVT) is not uncommon following peripherally inserted central catheter (PICC) insertion. However, the risk factors associated with this condition are unknown. Moreover, the role of prophylactic anticoagulation in the prevention of PICC-related UEDVT is not well established. Read More

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[COAGULATION - A PHYSIOLOGICAL SYSTEM INTERFACING ALL OTHER BODY SYSTEMS].

Authors:
Yona Nadir

Harefuah 2019 Mar;158(3):148-149

Thrombosis and Hemostasis Unit, Department of Hematology, Rambam Health Care Campus, Haifa, Israel.

Introduction: The coagulation system is a rapidly advancing area of clinical and basic research. Among the critical clinical issues to be urgently addressed are those related to the application of new direct oral anticoagulants in real life. Extensive research in the challenging field of thrombosis and bleeding is ongoing and has already resulted in new pharmacological modalities such as siRNA. Read More

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March 2019
1 Read

[TOPICAL ANTI-INFLAMMATORY AGENTS FOR DRY EYE DISEASE].

Harefuah 2019 Feb;158(2):130-135

Department of Ophthalmology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.

Introduction: Dry eye disease (dry eye) is a multifactorial disorder of the ocular surface. Dry eye is one of the most frequent ocular disorders, affecting 5% to 50% of the entire population at all ages. Evidence suggests that inflammation and hyperosmolarity are considered core mechanisms in the development of dry eye. Read More

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February 2019
7 Reads

[NEW LENSES IN MODERN CATARACT SURGERY].

Harefuah 2019 Feb;158(2):126-129

Department of Ophthalmology, Meir Medical Center, Kfar Saba, Affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Introduction: During cataract surgery the natural opaque crystalline lens is replaced by an artificial intraocular lens that compensates for the optical loss following lens removal. The conventional intraocular lens is mono-focal and necessarily requires spectacle correction for the clear vision at various foci in the same eye. In recent years a variety of intraocular lenses were developed including multifocal (bifocal and trifocal), "toric" lenses to correct corneal astigmatism, lenses with extended depth of focus and their combinations. Read More

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February 2019
22 Reads

[INTRAVITREAL INJECTION - A SMALL PROCEDURE FOR THE EYE, A GIANT LEAP FOR OPHTHALMOLOGY].

Harefuah 2019 Feb;158(2):121-125

Department of Ophthalmology, Tel Aviv Medical Center.

Introduction: Intravitreal injections are the most common therapeutic procedures in ophthalmology. These injections allow intraocular delivery of drugs that are highly effective for the treatment of a variety of retinal diseases. The procedure is short and simple, has an excellent local and systemic safety profile, and enables restoration and preservation of visual acuity in a large number of patients. Read More

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February 2019
1 Read

[CHILDHOOD GLAUCOMA].

Harefuah 2019 Feb;158(2):115-120

Department of Ophthalmology, Lady Davis Carmel Medical Center, Haifa.

Introduction: "Childhood glaucoma" is a heterogenic group of diseases, characterized by elevated intraocular pressure (IOP) associated with optic-disc damage and other ocular comorbidities. Diagnosis requires two or more of the following: elevated IOP, optic nerve damage, enlarged cornea or Descemet's membrane ruptures, enlarged eye, high myopia and visual field defects. Childhood glaucoma is classified as primary if it occurs as an isolated ocular disease, and secondary, when the disease occurs along with other ocular anomalies or systemic diseases such as Neurofibromatosis and Sturge-Weber, or with acquired conditions such as uveitis complications, ocular trauma, cataract surgery, as well as from systemic and ocular steroid use. Read More

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February 2019
5 Reads

[DEMODEX PARASITES AND CHRONIC BLEPHARITIS].

Authors:
Itay Lavy

Harefuah 2019 Feb;158(2):112-114

Department of Ophthalmology, Hadassah Medical Center, Jerusalem, Israel.

Introduction: In the current issue of 'Harefuah', Livny et al present an article on the prevalence of Demodex parasites in patients with chronic blepharitis and healthy controls in Israel. This prospective case controlled study describes the quantitative connection between the number of parasites found on 6-8 sample eyelashes and chronic blepharitis, one of the most prevalent conditions in the general population and especially prevalent in the ophthalmologist office visits. Blepharitis symptoms may vary from being asymptomatic, chronic condition, dry eye, and sometimes even a severe compromise of ocular surface with a morbid impact on patient quality of life. Read More

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February 2019
1 Read

[UNUSUAL VITREOUS DETACHMENT].

Harefuah 2019 Feb;158(2):109-111

Ocular Oncology Service - The Goldschleger Eye Institute, Sheba Medical Center, Tel-Aviv University, Israel.

Introduction: A 49 years old patient with a history of brachytherapy for choroidal melanoma was referred to the ocular emergency room for suspected recurrence due to pigment in the vitreous cavity. On examination, pigmented vitreous secondary to posterior vitreous detachment with traction from the atrophic tumor was observed with no evidence of recurrence. Read More

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February 2019
2 Reads

[IDIOPATHIC RETINAL VASCULITIS - THE INTERPLAY BETWEEN A CHRONIC IDIOPATHIC OCULAR DISEASE, ITS THERAPY AND THE PATIENT].

Harefuah 2019 Feb;158(2):105-108

Uveitis and Ophthalmic Pathology Service Department of Ophthalmology, Rambam Medical Center.

Introduction: This is an article on a six year follow-up of a patient diagnosed with idiopathic retinal vasculitis. Her medical history, symptoms and findings are presented in detail, related to the diagnostic investigations and the resulting diagnosis. Patient follow-up was marked with repeated attempts to utilize steroid sparing strategies including antimetabolites such as Methotrexate and mycophenolate Mofetyl with only limited success. Read More

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February 2019
1 Read

[OPHTHALMIC MANIFESTATIONS OF SILENT SINUS SYNDROME].

Harefuah 2019 Feb;158(2):101-104

Meir Medical Center, Kfar Saba, Israel.

Aims: To describe 7 case reports of "silent sinus syndrome" (SSS) cases and review the literature on this topic.

Methods: A retrospective review of 7 consecutive cases of SSS seen by the authors from 2005 to 2017. Data collected included patient demographics, clinical presentation, imaging findings, surgery performed, outcome and follow up. Read More

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February 2019

[TREATMENT DILEMMAS IN FULMINANT INTRACRANIAL HYPERTENSION].

Harefuah 2019 Feb;158(2):96-100

Department of Ophthalmology, Barzilai University Medical Center, Israel.

Introduction: Fulminant intracranial hypertension is a rare, acute presentation of idiopathic intracranial hypertension with rapid and devastating visual loss that can lead to blindness. As vision deteriorates quickly and often irreversibly, prevention of further visual loss requires emergent treatment to decrease intracranial pressure. The case presented is that of an 18 years old male with new symptoms of headaches and visual obscurations that had rapid progressive visual loss with findings of severe bilateral swollen discs. Read More

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February 2019
7 Reads

[THE ISRAELI INHERITED RETINAL DISEASES CONSORTIUM (IIRDC)- CLINICAL-GENETIC MAPPING AND FUTURE PERSPECTIVES].

Harefuah 2019 Feb;158(2):91-95

Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa.

Introduction: The sense of vision is highly important for humans and its loss markedly affects function and quality of life. Many inherited retinal diseases (IRDs) cause visual loss due to dysfunction or progressive degeneration of photoreceptor cells. These diseases show clinical and genetic heterogeneity. Read More

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February 2019
4 Reads

[PREVALENCE OF DEMODEX PARASITES IN PATIENTS WITH CHRONIC BLEPHARITIS AND HEALTHY CONTROLS IN ISRAEL].

Harefuah 2019 Feb;158(2):87-90

Department of Ophthalmology, Rabin Medical Center, Petah-Tikva, Israel.

Introduction: Previous studies demonstrated the potential pathogenic relationship between infestation of the eyelashes by the parasite Demodex and chronic blepharitis, whereas other studies did not demonstrate such relations and concluded that Demodex is a normal eyelid flora.

Aims: This study examines the prevalence of Demodex in patients with blepharitis compared to a healthy control group in Israel, in order to further explore and establish its pathogenic role in cases of chronic blepharitis.

Methods: A case-control study was conducted including 110 participants: 60 patients with chronic blepharitis attending a tertiary medical center and 50 subjects with no signs of blepharitis. Read More

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February 2019

[PREVALENCE OF ASTIGMATISM BEFORE ROUTINE CATARACT SURGERY: COMPARISON BETWEEN BEDOUIN AND JEWISH POPULATION IN SOUTHERN ISRAEL].

Harefuah 2019 Feb;158(2):82-86

Department of Ophthalmology, Soroka University Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel.

Objectives: To assess the prevalence of corneal astigmatism among patients before routine cataract surgery and overall ocular difference between Jewish and Bedouin population in the south of Israel.

Methods: Retrospective research collecting biometric information from IOLMaster (Carl Zeiss Meditec AG, Germany) in patients attending cataract surgery at Soroka University Medical Center, Beer-Sheva, Israel between the years 2015 -2016.

Results: Mean corneal astigmatism among all cohorts was 1. Read More

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February 2019

[OPHTHALMOLOGY - FACING THE FUTURE].

Authors:
Dan D Gaton

Harefuah 2019 Feb;158(2):80-81

Rabin Medical Center - Beilinson Hospital.

Introduction: This special issue of HaRefuah is dedicated to Ophthalmology facing the future. This dynamic and forever innovative field of medicine is in a constant state of development in all its sub-specialties. In ophthalmology we often witness immediate rewarding results of treatment and surgery, having a huge impact on one of the most important senses, namely improving sight, stopping deterioration and preventing blindness. Read More

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February 2019

[HIGH VOLTAGE ELECTRIC INJURY: MECHANISM OF INJURY, CLINICAL FEATURES AND INITIAL EVALUATION.]

Harefuah 2019 Jan;158(1):65-69

Trauma Unit, Hillel Yaffe Medical Center, Hadera, Israel.

Introduction: Electrical injury is an infrequent but potentially devastating form of multisystem injury associated with high morbidity and mortality. Despite significant improvement in injury prevention and implementation of safety protocols at work places, electrical injury accounts for more than 500 deaths per year in the United States with a mortality rate of 10-30%. Electrical injuries are traditionally divided into low-voltage electric power injuries (less than 1,000V) and high-voltage )more than 1,000V). Read More

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January 2019
1 Read

[MINIMALLY INVASIVE GLAUCOMA SURGERIES].

Harefuah 2019 Jan;158(1):60-64

Ophthalmology Department, Hillel Yaffe Medical Center.

Introduction: The goal of all glaucoma surgery is to lower eye pressure to prevent or reduce damage to the optic nerve. Standard glaucoma surgeries - trabeculectomy, ExPRESS shunts and external tube-shunts like the Ahmed and Baerveldt valves - are major surgeries. While they are very often effective at lowering eye pressure and preventing progression of glaucoma, they have a long list of potential complications. Read More

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January 2019
1 Read

[VENOUS THROMBOEMBOLISM DURING PREGNANCY AND THE PUERPERIUM - WHO? WHEN? AND HOW TO TREAT?]

Harefuah 2019 Jan;158(1):53-59

Maternal Fetal Medicine Unit, the Department of Obstetrics and Gynecology, Hillel Yaffe Medical Center, Hadera, Israel.

Introduction: Venous thromboembolism (VTE) is a potentially life-threatening medical condition during pregnancy and the puerperium. During pregnancy, the risk of VTE is increased four to tenfold compared to non-pregnant women of comparable age. The risk is even higher in the puerperium. Read More

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January 2019
3 Reads

[THE ROLE OF COMPREHENSIVE CONSERVATIVE MANAGEMENT IN ELDERLY PATIENTS WITH END STAGE RENAL DISEASE].

Harefuah 2019 Jan;158(1):48-52

Management Department, Hillel Yaffe Medical Center.

Introduction: The number of dialysis patients is consistently growing and the dialysis population is aging. Of all age groups of dialysis patients, the higher prevalence rate is in the elderly group (aged 75 years and older). The elderly patients have a high rate of comorbidities. Read More

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January 2019
1 Read

[WHEN IT SNOWS ALL YEAR ROUND - VISUAL SNOW].

Harefuah 2019 Jan;158(1):44-47

Ophthalmology Department, Hillel Yaffe Medical Center.

Introduction: Visual snow is a neurological condition manifested as a prolonged visual experience of small flickering dots encompassing the entire visual field with additional visual and sensory-neural symptoms. The pathogenesis of this disturbance is unknown, although much progress has been made in recent years. The disturbance has been better defined and characterized. Read More

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January 2019
5 Reads

[PREFERENCES OF PARENTS FOR PEDIATRIC INPATIENT WARD PHYSICIAN'S ATTIRE].

Harefuah 2019 Jan;158(1):41-43

Departments of Pediatrics, Hillel Yaffe Medical Center, Hadera, Israel.

Background: The preferred attire for physicians has not been defined to date. In Israel, where casual attire is acceptable in most circumstances, patients' preferences have not yet been systematically evaluated.

Methods: This is a cross-sectional study that was designed to evaluate parents' preferences for physicians' attire in a pediatric inpatient ward. Read More

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January 2019
2 Reads

[DIRECT ADMISSION OF STEMI PATIENTS TO THE CARDIAC CARE UNIT VERSUS ADMISSION VIA THE EMERGENCY DEPARTMENT FOR PRIMARY CORONARY INTERVENTION IMPROVES SHORT AND LONG-TERM SURVIVAL].

Harefuah 2019 Jan;158(1):35-40

Heart Institute, Hillel Yaffe Medical Center, Hadera, Israel, affiliated to the Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa - Israel.

Introduction: Shortening door-to-balloon time intervals in ST-elevation myocardial infarction (STEMI) patients treated by primary percutaneous coronary intervention (PPCI) is necessary in order to limit myocardial damage. Direct admission to the cardiac care unit (CCU) facilitates this goal. We compared characteristics and short- and long-term mortality of PPCI-treated STEMI patients admitted directly to the CCU with those admitted via the emergency department (ED). Read More

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January 2019
6 Reads

[THE PROLIFERATIVE EFFECT OF DENDRITIC CELLS IN OVARIAN CANCER AND THE RELATIONSHIP WITH THE IGF SIGNALING PATHWAY].

Harefuah 2019 Jan;158(1):30-34

Gynecologic Oncology Division, Department of Obstetrics and Gynecology, Hillel Yaffe Medical Center, Hadera, Israel.

Introduction: Epithelial ovarian cancer (EOC) is the principal cause of death from gynecologic cancer in developed countries. While surgery and chemotherapy can improve survival, the mortality and morbidity rates remain significantly high. The insulin-like growth factor (IGF) axis has been shown to play an important part in carcinogenesis of several human malignancies. Read More

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January 2019
3 Reads

[INFECTIOUS DISEASE ASSESSMENT OF TERM INFANTS WITH RISK FACTORS - EVALUATION OF NECESSITY AND METHODS OF PREVENTION].

Harefuah 2019 Jan;158(1):25-29

The Neonatal Department, The Hillel Yaffe Medical Center, affiliated with the Rappaport Faculty of Medicine, The Technion, Haifa.

Aims: To characterize the demography of infants for whom blood tests were indicated due to perinatal risk factors for infection and to elaborate on ways to minimize these invasive tests.

Methods: A retrospective study based on an analysis of the medical records of term and late-preterm infants born between January 1st, 2013 and December 31st, 2015, for whom blood cultures were indicated due to maternal risk factors.

Results: The study included 583 infants. Read More

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January 2019
10 Reads

[CONTRIBUTION OF CONVENTIONAL CHEST/ABDOMINAL PLAIN FILMS FOR THE DECISION-MAKING PROCESS IN PATIENTS WITH PREVIOUS ABDOMINAL SURGERIES, WHO HAVE SUSPECTED GASTROINTESTINAL PERFORATION].

Harefuah 2019 Jan;158(1):21-24

The Surgical Division, Hillel Yaffe Medical Center, Hadera, Israel.

Introduction: Gastrointestinal perforation is a well-known phenomenon among patients presented to emergency rooms. Common causes for perforation are gastric and duodenal ulcers, colon tumors and trauma. Some patients are operated on immediately due to the clear clinical picture of acute abdomen. Read More

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January 2019
14 Reads

[WAITING TIME FOR SURGICAL FIXATION OF FEMORAL NECK FRACTURES: DOES A DIAGNOSIS-RELATED GROUP PAYMENT METHOD MATTER?]

Harefuah 2019 Jan;158(1):16-20

Division of Orthopedics, Hillel Yaffe Medical Center, Hadera, Israel.

Background: Early surgical fixation of femoral neck factures in elderly patients has been suggested to decrease morbidity and mortality and to improve treatment outcome. This study evaluates the effect of the implementation of a diagnosis-related group payment method in our hospital on waiting time for surgery and the short-term outcomes of elderly patients following surgical fixation of hip fractures.

Methods: Demographic and clinical characteristics of 75 consecutive patients, who underwent surgery for hip fracture in our hospital, before the implementation of a diagnosis-related group payment method, were compared with those of 75 consecutive patients, who were operated on after the implementation of the payment system. Read More

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January 2019
4 Reads

[CHRONIC Q FEVER IN PATIENTS AT THE HILLEL YAFFE MEDICAL CENTER - THREE YEARS OF FOLLOW UP].

Harefuah 2019 Jan;158(1):12-15

Infectious Diseases Unit, Hillel Yaffe Medical Center, Hadera.

Introduction: Q fever is an acute zoonotic infection, which in some cases is complicated by a chronic disease. Diagnosis is based on serology, and in patients with a chronic disease, the source of infection must be investigated.

Aims: To describe patients with chronic Q fever, who were treated at the Hillel Yaffe Medical Center: risk factors, course of the disease, and serological findings. Read More

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January 2019
11 Reads

[CORRELATION BETWEEN MRI AND ARTHROSCOPIC FINDINGS IN THE DIAGNOSIS OF KNEE PATHOLOGY IN YOUNG AND ADULT PATIENTS].

Harefuah 2019 Jan;158(1):7-11

Orthopedic Surgery Department, Hillel Yaffe Medical Center.

Background: MRI is increasingly used as a diagnostic tool for sports injuries involving the knees before referral to arthroscopy.

Objectives: Since degenerative changes increase with age, we aimed to evaluate whether age affects the accuracy of MRI.

Methods: This is a retrospective study of patients with knee injury whose evaluation included both MRI and arthroscopy. Read More

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January 2019
6 Reads

[HILLEL YAFFE MEDICAL CENTER - SIXTY YEARS OF ADVANCEMENT].

Authors:
Alon Nevet

Harefuah 2019 Jan;158(1):4-6

Hillel Yaffe Medical Center, Hadera.

Introduction: The Hillel Yaffe Medical Center began its journey sixty years ago. Since its early days, the hospital's dedicated teams have struggled to bridge the gaps between limited resources and their uncompromising desire to meet patients' needs. Today, Hillel Yaffe Medical Center possesses more than five hundred beds in approximately eighty departments and units and dozens of ambulatory clinics. Read More

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January 2019
1 Read

[ELDERLY HOSPITALIZED FEBRILE PATIENTS WITH A SUSPECTED URINARY TRACT INFECTION: DIAGNOSTIC AND THERAPEUTIC APPROACH].

Harefuah 2018 Dec;157(12):802-806

Unit of Clinical Utility, Laniado Hospital, Netanya.

Introduction: Since the urinary tract is thought to be one of the common sources of fever in hospitalized geriatric patients, urine analysis and urine cultures are routinely ordered in patients with and without urinary tract symptoms. The widespread lack of understanding of the uncertainties in the diagnosis and treatment of a symptomatic urinary tract infection (UTI) leads to unnecessary laboratory testing, and inappropriate antibiotic therapy. We present evidence for the following proposal that on the one hand will limit urine cultures and unnecessary antibiotic therapy without compromising patient safety and on the other hand will ensure proper antibiotic therapy. Read More

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December 2018
15 Reads

[THE PARADIGM SHIFT IN MEDICINE FOLLOWING THE 4TH INDUSTRIAL REVOLUTION].

Harefuah 2018 Dec;157(12):797-801

Medical Research Infrastructure Development, Sheba Medical Center Fund.

Introduction: A tremendous paradigm shift is occurring in the field of medicine. This is because the forward momentum in the evolving sphere of digital medicine has opened up new worlds of discovery that all fuse together to form a tsunami of innovation, along with sociological and social changes. The exponential rate of technological change creates profound sociological changes and these dynamics affect the medical field. Read More

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December 2018
13 Reads

[PRIMARY BILIARY CHOLANGITIS: THERAPEUTIC APPROACH IN THE MODERN ERA].

Harefuah 2018 Dec;157(12):791-796

Gastroenterology Institute, Hillel Yaffe Medical Center, affiliated to the Ruth and Rappaport Faculty of Medicine, Haifa, Israel.

Introduction: Primary biliary cholangitis (PBC) is a progressive, autoimmune cholestatic liver disease, predominantly affecting middle-aged women. Hallmark features include a persistent elevation of cholestatic liver enzymes, presence of anti-mitochondrial antibodies and characteristic histologic findings. PBC has a varied course of progression, ranging from mild uncomplicated disease to aggressive disease leading to cirrhosis and resulting in the need for liver transplantation. Read More

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December 2018
11 Reads

[STRIAE GRAVIDARUM - ETIOLOGY, PREVALENCE AND TREATMENT].

Harefuah 2018 Dec;157(12):787-790

Helen Schneider's Hospital for Women, Rabin Medical Center, Petah Tikva.

Introduction: Striae gravidarum is the second most prevalent skin manifestation after skin pigmentation during pregnancy. Its etiology is uncertain, but it is assumed that changes in the structure of collagen, mediated by hormonal changes during pregnancy, are the causative factor. These marks normally appear during the third trimester of pregnancy and disappear several months after delivery. Read More

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December 2018
22 Reads

[INTERVENTIONS FOR SUPPORTING WOMEN TO STOP SMOKING IN PREGNANCY].

Harefuah 2018 Dec;157(12):783-786

Department of Gynecology and Obstetrics, Rambam Health Care Campus, affiliated with Technion-Israel Institute of Technology, Haifa, Israel.

Introduction: Smoking during pregnancy is a public health problem because of the many adverse effects associated with it. These include intrauterine growth restriction, placenta previa, abruptio placentae, decreased maternal thyroid function, preterm premature rupture of membranes, low birth weight, perinatal mortality, and ectopic pregnancy. An estimated 5-8% of pre-term deliveries, 13-19% of term deliveries of infants with low birth weight, 23-34% cases of sudden infant death syndrome (SIDS), and 5-7% of preterm-related infant deaths can be attributed to prenatal maternal smoking. Read More

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December 2018
17 Reads

[FUTURE CHALLENGES OF MEDICAL EDUCATION].

Harefuah 2018 Dec;157(12):779-782

Department of Health Policy Research, Myers-JDC-Brookdale Institute, Jerusalem, Israel.

Introduction: Medical education faces three challenges: those related to admission policies to medical schools (can "non-academic" qualifications such as compassion and social orientation be identified?), the clinical learning environment (is "bedside" teaching the optimal way to impart clinical skills?) and the duration of medical training (can it be shortened?). I believe that over the next decades, the assessment of "non-academic" qualifications in screening medical school candidates will be the subject of critical review, and may even be canceled; the limitations of the hospital learning environment will lead to the transfer of clinical training to community clinics; and that an effort will be made to reduce the duration of medical training by splitting the curriculum into distinct career tracks, such as primary medicine, biomedical research and diagnosis by ancillary testing, secondary and tertiary clinical medicine, and epidemiology and public health. Read More

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December 2018
2 Reads

[TREATMENT WITH DUAL ANTIPLATELET THERAPY FOR SECONDARY PREVENTION OF STROKE - PROS AND CONS].

Harefuah 2018 Dec;157(12):773-778

Internal Medicine Department - Gimel.

Introduction: The role of dual antiplatelet therapy combining aspirin and clopidogrel, is controversial. There are two settings in which such treatment might be considered: (a) patients presenting with a first ischemic event at high risk for a recurrence; and (b) patients who experience a second ischemic event while being treated with aspirin or clopidogrel monotherapy. In this paper we review the literature dealing with secondary prevention of ischemic stroke, with an emphasis on dual antiplatelet therapy. Read More

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December 2018
11 Reads

[THE ASSOCIATION BETWEEN URINE RESIDUAL VOLUME AT ADMISSION AND THE OUTCOMES OF HOSPITALIZED ELDERLY MEN WITH URINARY TRACT INFECTION].

Harefuah 2018 Dec;157(12):769-772

Department of Internal Medicine "C", Rabin Medical Center, Beilinson Hospital, Petah-Tikva, Israel.

Background: Early assessment of urine residual volume (URV) at admission is essential in elderly men with urinary tract infection (UTI). Large URV might predispose these patients to subsequent complications; nevertheless, only scarce data are available concerning the impact of URV on the outcomes of elderly men with UTI.

Objectives: To determine the impact of URV on the outcomes of elderly men hospitalized with UTI, including:  bacteremia rates, length of hospital stay, short and long-term mortality. Read More

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December 2018
2 Reads

[PULMONARY EMBOLISM IN A PATIENT WITH KLINEFELTER SYNDROME].

Harefuah 2018 Dec;157(12):767-768

Department of Medicine 'B', Sheba Medical Center, Tel-Hashomer.

Introduction: Klinefelter syndrome (47, XXY) is the most common chromosomal aberration in males. It occurs in 0.15% of newborn males. Read More

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December 2018
10 Reads