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        תוצאת חיפוש

        נובמבר 2000

        אורי פרוינד, עמי מאיו, איבן שוורץ, דוד נויפלד וחיים פארן
        עמ'

        Laparoscopic Cholecystectomy - 1,000 Procedures in a Surgical Department

         

        Uri Freund, Ami Mayo, Ivan Schwartz, David Neufeld, Haim Paran

         

        Dept. of Surgery A, Meir Hospital, Kfar Saba; and Sackler School of Medicine, Tel Aviv University

         

        The first 1,000 laparoscopic cholecystectomies performed in our department were reviewed. There was no operative mortality; conversion to open cholecystectomy was necessary in 2%. In the last 600 cases the rate of conversion had decreased to 0.5%. There was common bile duct injury in 0.3%, with the injuries identified during primary surgery. This clinical experience is consistent with previous studies, which proved that laparoscopic cholecystectomy is safe and should replace open operation as the procedure of choice. 

        אוקטובר 2000

        אורי רובינשטיין, מאיר ויסברוד ובן-ציון גרטי
        עמ'

        Life-Threatening Echovirus 11 Infection During First Month of Life

         

        U. Rubinstein, M. Weisbrod, B. Garty

         

        Neonatal Dept., Laniado Hospital, Kiriat Zans, Natanya; and Pediatrics B, Dept., Schneider Children's Medical Center, Petah Tikva

         

        Infection with Echovirus 11 is mostly asymptomatic, but it may cause a wide variety of clinical diseases, from gastroenteritis to serious diseases such as meningitis and myocarditis. In small infants, especially during the first days of life, echovirus infection may appear as a sepsis-like illness, and cause disseminated intravascular coagulopathy and shock.

        We present 2 infants with severe echovirus 11 infections. A 3.5-month old died within 24 hours of shock and probably myocarditis. The other, 6-days old, presented with meningitis, hepatitis and disseminated intravascular coagulopathy. It recovered after treatment with intravenous immunoglobulin.

        Echovirus 11 may cause life-threatening infections in small infants. Pediatricians should be alert to the special characteristics of this disease.

        גל גולדשטיין, עופר שפילברג, פיה רענני, אנג'לה שטרית ויצחק בן בסט
        עמ'

        Acute Lymphoblastic Leukemia in Adults Treated with German Multicenter Study Group Protocols

         

        G. Goldstein, O. Shpilberg, P. Raanani, A. Chetrit, I. Ben-Bassat

         

        Institutes of Hematology and of Clinical Epidemiology, Sheba Medical Center and Sackler Faculty of Medicine, Tel Aviv University

         

        Acute lymphoblastic leukemia (ALL) is a malignant disease whose incidence is relatively low among adults, unlike in children. Adults with ALL have a lower rate of long-term disease-free survival. During the last 20 years, a German multicenter group has shown that their protocol have achieved good results in adult ALL.

        We reviewed the medical records of 35 ALL patients, aged 19-63 years, whome we treated with these protocol (1988-1997). The remission rate was 94%. At a median follow-up of 46 months the 2-year overall survival was 54% and the disease-free survival was 94%. Although 2 patients died of bone marrow transplant complications, no death was directly associated with drug toxicity. The main grade 3 or 4 side effects (WHO classification) were neutropenia (91%), thrombocytopenia (71%) and anemia (71%).

        With there protocols we achieved high overall and disease-free survival rates, especially in comparison with other reports. Despite the high rate of severe treatment toxicity, there were no fatalities directly related to treatment. These results emphasize the need to concentrate treatment of adult ALL patients in large medical centers with expertise in the use of the complicated treatment protocols required.

        יוני 2000

        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

         

        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.

        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

        אורה שובמן, בוריס גילבורד, פנינה לנגביץ' ויהודה שינפלד. עמ' 1043-1046
        עמ'

        אורה שובמן, בוריס גילבורד, פנינה לנגביץ', יהודה שינפלד

        המח' לרפואה פנימית ב' והיחידה לחקר מחלות אוטואימוניות, המרכז הרפואי שיבא תל השומר והפקולטה לרפואה סאקלר, אוניברסיטת תל אביב

        מילות מפתח:

        נוגדני RA33, RA33, מחלות אוטואימוניות, אורה שובמן, בוריס גילבורד, פנינה לנגביץ', יהודה שינפלד, שובמן, גילבורד, לנגביץ', שינפלד

        רונית חיימוב-קוכמן, ראובן ברומיקר ואריאל מילויצקי. עמ' 1040-1043
        עמ'

        רונית חיימוב-קוכמן1, ראובן ברומיקר2, אריאל מילויצקי1

        1מחלקת נשים ויולדות 2והמחלקה לטיפול נמרץ בילוד, בי"ח הדסה הר הצופים, הפקולטה לרפואה, האוניברסיטה העברית, ירושלים

        דוד פרג, שלמה בכר, אלכסנדר בטלר, ולנטינה בויקו, שמואל גוטליב ויהונתן ליאור
        עמ'

        Thrombolytic Therapy or Primary Coronary Angioplasty in Acute Myocardial Infarction?

         

        David Pereg, Shlomo Behar, Alexander Battler, Valentina Boyko, Shmuel Gottlieb, Jonathan Leor: Israel Thrombolytic Survey Group

         

        Cardiology Division, Soroka Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba; Neufeld Cardiac Research Institute, Tel Hashomer and Tel Aviv University; and Cardiology Dept., Rabin Medical Center, Petah Tikva

         

        There has been continuous debate over the superiority of primary percutaneous, transluminal, coronary angioplasty (PTCA) over thrombolysis for acute myocardial infarction (AMI). It was questioned whether this advantage of primary PTCA reported in selected populations by experienced centers can be replicated in our clinical practice.

        We compared demographic and clinical variables, therapies and outcome in AMI treated with primary PTCA vs thrombolytic therapy. Clinical and demographic variables of 1,678 unselected AMI patients (admitted January/February and May/July 1996) were analyzed in 16 cardiac care units with on-site catheterization facilities and ability to perform PTCA. Of these 803 (48%) were treated by thrombolysis and 99 (6%) by primary PTCA.

        The prevalence of adverse prognostic variables, such as anterior wall MI, heart failure on admission or during hospital stay, pulmonary edema, and ventricular tachycardia or fibrillation, was higher in the PTCA group. The 7-day, 30-day and 1-year mortality rates were similar in the 2 groups: 4%, 7.2% and 12.8%, respectively, in the PTCA group and 5%, 7.2% and 11.1% in the thrombolysis group. There was a trend toward lower mortality in subgroups of high-risk patients: those with heart failure on admission (Killip class >1), the elderly (>65 years), and those with previous MI treated with PTCA. After adjusting for confounders, treatment with primary PTCA was not found to be associated with lower mortality.

        Only a small proportion of AMI patients in Israel were treated with primary PTCA in 1996. The frequency of adverse prognostic factors among them was higher but their short and long term outcomes were similar to those of high risk patients treated with thrombolysis.

        מאי 2000

        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.

        אפריל 2000

        ד' ב' גפן, ס' מן וי' כהן
        עמ'

        Etoposide and Cisplatin for Non-Small Cell Lung Cancer 


        David B. Geffen, Sofia Man, Yoram Cohen*

         

        Dept. of Oncology, Soroka-University Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba

         

        Etoposide and cisplatin (EP) has been the standard therapy for non-small cell lung cancer (NSCLC) at many cancer centers for over a decade. We analyzed our experience with EP in NSCLC to provide a baseline for comparison with new drugs. From 1986 through 1994, 46 of our patients with NSCLC received EP as first-line chemotherapy. Radiation therapy was administered to 25 of them, including 20 who received it immediately before or concomitantly with chemotherapy. Toxicity was mild and included only 1 episode of neutropenic fever and 1 case of reversible renal failure.

        Overall response was 22%. In 3, response was complete (pathologically documented in 2 of them) and in 7 partial. Median survival in locally advanced (stage III) and metastatic disease (stage IV and recurrent) were 12 months and 7 months, respectively. 2 patients are alive and free of disease more than 6 years after diagnosis.

        Our results are consistent with other published studies of EP in NSCLC. EP provides modest benefit in locally advanced NSCLC, with minimal toxicity.

        Jules E. Harris Chair in Oncology.

        נובמבר 1999

        אברהם אמיר, רם סילפן ודניאל האובן
        עמ'

        Treatment of Velopharyngeal Insufficiency

         

        Abraham Amir, Ram Silfen, Daniel J. Hauben

         

        Dept. of Plastic and Reconstructive Surgery, Rabin Medical Center, Beilinson Campus, Petah Tikvah

         

        Weak and hypernasal speech, along with nasal escape of air, are the main characteristics of velo-pharyngeal incompetence (VPI). We describe 10 years of experience (1989-1998) with surgical treatment of VPI.

         

        51 patients underwent pharyngeal flap elevation. 37 had cleft palate (8 of them submucous), 7 had neuromuscular disorders and another 7 were idiopathic. All underwent evaluation by a speech therapist before and after operation. 25 had further nasal endoscopy and/or videofluroscopy.

         

        There was significant speech improvement in volume and clarity in 35 (73%), mild improvement in 13 (27%) and none in 3. The complication rate was 15% and included sleep apnea, wound infection and dehiscence, stridor and bleeding. Complications were correlated with advanced age.

         

        VPI should be diagnosed as early as possible to achieve good results and to prevent social problems.

        חן מימון, אלי דרייזין, צבי וינראוב, יאן בוקובסקי ואריה הרמן
        עמ'

        Screening for Down's Syndrome by Measuring Fetal Nuchal Translucency Thickness

         

        Ron Maymon, Eli Dreazen, Zwi Weinraub, Ian Bukovsky, Arie Herman

         

        Ultrasound Unit, Dept. of Obstetrics and Gynecology, Assaf Harofeh Medical Center, Zerifin, and Sackler Faculty of Medicine, Tel Aviv University

         

        Increased fetal muchal translucency (NT) thickness at 10-14 weeks of gestation may indicate underlying fetal chromosomal abnormalities, anatomical anomalies and genetic syndromes. Between January 1997 and May 1998, 1400 women 10-14 weeks pregnant underwent sonographic screening for detection of Down's syndrome (DS). Follow-up was complete in 1208 (86%).

        Maternal age ranged from 17-44 years (mean 18.0). 87% were found by screening to have a higher risk (1:380) for DS diagnosed at birth. All these fetuses were karyotyped and 8 had chromosomal abnormalities. 2 fetuses with normal NT were diagnosed later as having DS, 1 by the mid-gestation triple test and 1 by amniocentesis because of advanced maternal age.

        Thus sonographic screening identified 8 out of 10 fetuses found to have chromosomal abnormalities at birth. Neonates not karyotyped before birth had no traits at birth that justified chromosomal analysis. Results of this study suggest that NT measurement, combined with maternal age, is an effective 1st trimester screening method for DS in an unselected obstetric population.

        אוגוסט 1999

        אברהם דומב. עמ' 127-131
        עמ'

        אברהם דומב

        המח' לכימיה תרופתית, ביה"ס לרוקחות, הפקולטה לרפואה, האוניברסיטה העברית, ירושלים

         

         

         

         

         

        ד. זלצר, י. שפירא וש. ברלינר. עמ' 124-126
        עמ'

        ד. זלצר, י. שפירא, ש. ברלינר

        מח' לרפואה פנימית ד' והיחידה לטיפול בנוגדי קרישה, מרכז רפואי סוראסקי תל-אביב והפקולטה לרפואה סאקלר, אוניברסיטת תל- אביב

        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