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        תוצאת חיפוש

        אפריל 1998
        גלית בן אמיתי, יורם נבו, דבורה ליברמן, רוברטו מסטר ושאול הראל

        Cyclic Vomiting Syndrome in Children

         

        G. Ben-Amitay, Y. Nevo, D. Lieberman, R. Mester, S. Harel

         

        Ness Ziona Mental Health Center, Institute for Child Development and Pediatric Neurology Unit, Tel Aviv-Sourasky Medical Center, and Tel Aviv University Medical School

         

        Cyclic vomiting syndrome in children is a manifestation of various etiologies, including gastroenterological and renal disorders, central and autonomic nervous system abnormalities, as well as metabolic and endocrine dysfunction. Frequently no organic cause is found. Personality profiles of children with cyclic vomiting reveal perfectionism, competitiveness, and aggressive behavior. Vomiting attacks have been induced by anxiety and excitement in patients with cyclic vomiting. We describe an 8-year-old girl with cyclic vomiting, frequently associated with occipital headaches, photophobia or dizziness. Psychiatric evaluation indicated a generalized anxiety disorder.

        יצחק גילת וצבי גיל

        Suicidal Calls to a Telephone Emergency Service

         

        Itzchak Gilat, Zvi E. Gil

         

        ERAN (Israel Association for Emotional First Aid)

         

        Suicidal threats and suicidal ideation among callers to the Israeli hot-line (ERAN) were investigated, using 2 methods of analysis. The first, an epidemiological survey based on 8,272 calls received by all 8 ERAN posts during 2 years, reported on their standard form for recording interactions with suicidal callers. The second is content analysis of 42 detailed reports of interactions with such callers. Epidemiological analysis revealed a higher rate of suicidal ideation among callers with a psychiatric history, compared with those without a history. However, the 2 groups did not differ in rate of suicidal threats. In addition, suicidal threats of adolescents were related mainly to problems of identity and self-image, while mental disorders were the main problems among adults. Content analysis identified 2 patterns of terminating the interaction, which represent 2 strategies of intervention to prevent suicide. The first is establishing a contact between the caller and an appropriate individual in the caller's environment who undertakes responsibility to help the caller. The second strategy is reducing the caller's tension, leading to a withdrawal of the suicidal threat. The first pattern is more characteristic of interactions with psychiatric callers, while the second is more frequent among non-psychiatric callers to ERAN. The hot-line makes a unique contribution in helping those threatening suicide, which constitutes a real emergency.

        גריגורי-צבי יזרעאלב

        Delirium Tremens in Israel

         

        G.-Z. Ezrielev

         

        Mental Health Center, Beer Sheba

         

        We discuss pathogenetic aspects (biochemical, pharmacological) of delirium tremens (DT) in accordance with the acute clinical processes, the development of psychosis, and preventive treatment used in the various stages. A typical patient, a 33-year-old man, and the difficulties in diagnosis and treatment are presented and conclusions from the dangerous behavior of the patient are drawn.

        מרץ 1998
        רויטל גרוס, דינה פלדמן, יונתן רבינוביץ, מרים גרינשטיין ואיילת ברג

        Characteristics of Adults with Emotional Distress, and Patterns of Mental Health Services Use

         

        Revital Gross, Dina Feldman, Yonathan Rabinowitz, Miriam Greenstein, Ayelet Berg

         

        Health Policy Research Unit, JDC-Brookdale Institute and Mental Health Division, Ministry of Health, Jerusalem and School of Social Work, Bar Ilan University, Ramat Gan

         

        We sought firsthand data on the extent of perceived mental health needs and on patterns of use of mental health services among Israelis aged 22 and over. The data are from a national survey conducted in 1995. A random sample of phone numbers from the telephone company's computerized listings yielded 1,395 completed questionnaires (response rate, 81%).

        At some point in their lives, 27% had experienced emotional distress or mental health problems with which they had difficulty coping alone; 13.4% reported that they had such an experience during 1995. According to multivariate analysis, those more likely to report mental health problems were women, those with a chronic disease, Russian immigrants, divorced or widowed adults, those with a low level of education, and members of the Clalit sick fund. 38% of those who had ever had emotional or mental health problems had asked for help. The proportion of those seeking help was high among respondents aged 35-55, Hebrew speakers (compared to speakers of Russian or Arabic), and city dwellers, and the rate was low among members of the Clalit sick fund. Of those who did seek help, 39% went to a psychologist or a psychiatrist, 25% to their family doctor, 19% to a family member or friend, 7% to a social worker or social service agency, 6% to other medical personnel, and 4% to a psychiatric hospital. 30% turned for assistance to the private sector and 70% to the public sector.

        These findings have special significance in view of the impending reform of the mental health services. As mandated by the new National Health Insurance Law, mental health services are to be included in the basket of health services provided by the sick funds. The data can be of use in the management of sick funds and for physicians working in the community, as they prepare for this change. In addition, the data will be of aid to national policy makers in planning services suited to the needs of different population groups and to allocate resources more rationally.

        פברואר 1998
        חיים קנובלר, שלומית כץ, אינסה פוליאקוב ורמונה דורסט

        Enhancing Cultural Sensitivity of Psychiatrists from Russia

         

        Haim Y. Knobler, Shlomit Katz, Inessa Poliakova, Rimona Durst

         

        Jerusalem Mental Health Center, Kfar Shaul Hospital, Jerusalem

         

        The importance of understanding the local culture and enhancing cultural sensitivity became evident during supervision of immigrant psychiatrists from the former Soviet Union. The aim of the present study was to describe enhancement of this cultural sensitivity in the supervision of 2 immigrant psychiatrists. In the first, understanding the patient's cultural world helped the immigrant psychiatrist form the therapeutic alliance. In the second, the immigrant psychiatrist's understanding of the patient's cultural background led him to change both diagnosis and treatment. In both cases, development of cultural sensitivity through supervision enabled successful treatment. Enhancement of cultural sensitivity may accelerate absorption of the immigrant psychiatrists themselves. Discussing cultural issues during work may accelerate the absorption of all immigrant physicians.

        אברהם זינרייך, בוריס גוחשטיין, אלכסנדר גרינשפון, מרים מירון, יהודית רוזנמן ויששכר בן-דב

        Recurrent Tuberculosis in a Psychiatric Hospital

         

        A. Zeenreich, B. Gochstein, A. Grinshpoon, M. Miron, J. Rosenman, I. Ben-Dov

         

        Pulmonary and Radiology Institutes, Chaim Sheba Medical Center, Tel Hashomer and Tel Aviv University; Israel Ministry of Health; and Gan Meged Hospital

         

        During 1987-1996, 39 of 720 patients hospitalized (most for severe schizophrenia) were diagnosed as having active pulmonary tuberculosis (5.4%, 975 per 105 per year). In 1992-1993, after a cluster of 5 cases was found, all patients were screened by PPD skin test and chest X-ray and 16 more cases were identified. Diagnosis was confirmed bacteriologically in only 10 of them but there were typical radiological findings in the others. 39 were treated with a multi-drug regimen. In addition, 333 exposed patients and 21% who had converted their skin tests were given isoniazid preventive therapy. A small increase in levels of liver enzymes was common, but significant abnormality (over 4 times the upper limit of normal) was found in only 7 patients, in whom therapy was therefor stopped or changed. During a follow-up period of 4 years, 2 more developed tuberculosis and 33 converted their PPD reactivity status. We conclude that an outbreak of tuberculosis in a psychiatric hospital can be controlled with a relatively low rate of side-effects by using systematic diagnostic and therapeutic measures. However, single step screening is not sufficient. Routine screening of all new patients, a high index of suspicion and contact investigation are needed.

        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