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עמוד בית
Tue, 23.04.24

December 2016 (Issue 34)


Introduction
Brigadier General Dr. Dudu Dagan
The December 2016 issue is the third to be published in the last half of the year, since the return of the journal "Military Medicine" for publication in its regular order. The newspaper's system experiences the feedback of scientific revival from all units and industries in the corps, with the proliferation of research, writing and the desire to share and publish - a desire to stand out and reach the JIMM pages.
Reviews
Capt. Neta Gery-Golomb Lt. Reuben Haber, Lt. Col. Yuval Heled, Capt. Barliz Waissengrin, Col. Ram Sagi
Hypothermia is a condition in which the core body temperature
drops to below 35 degrees Celsius, and its severity can be
divided into mild, moderate and severe. The current Israel
Defense Force (IDF) medical guidelines state that in all
cases of suspected hypothermia in the field, patients must
be evacuated to a hospital, regardless of the degree of
hypothermia. The relevance of these guidelines in cases of
mild hypothermia has been called into question, with the aim
to helping medical officers in the field deal with these cases.
We have performed a literature review focusing on the
complications of hypothermia, of varying degrees, with an
emphasis on cardiovascular complications. In addition to
accidental hypothermia, we have looked at outcomes from
iatrogenic hypothermia, used in varying medical situations.
From the currently available data, it would appear that lifethreatening
complications of hypothermia occur only in
moderate-severe cases, and not in its mild form. Despite
there being cases of electrocardiographic changes seen in
mild hypothermia (such as PVTs and prolongation of the QT
interval), these have not been scientifically proven to be lifethreatening.
In addition, mild hypothermia did not contribute
to excessive complications in those treated with iatrogenic
hypothermia.
In light of the fact that there is a significant difference
between complications seen in moderate-severe hypothermia
compared to mild hypothermia, and that the available
literature regarding accidental hypothermia in a young,
healthy population is limited, we recommend to deepen the
investigation of the hypothermia cases in the IDF, and to
consider updating the current guidelines if necessary.
Raya Madar ,Limor Aharonson-Daniel, Ygal Plakht, Bruria Adini
It has recently been proven that during the civil war
currently raging in Syria, Sarin gas was used, causing
numerous casualties and deaths. Chemical warfare agents,
as a component of mass casualty weapons, have the ability
to cause massive injury, mortality and destruction. There
is concern that chemical warfare will be used against
civilians not only in wartime, but also as an act of terror.
Thus, preparedness of hospitals to manage such disasters
is required. Effective management of chemical warfare
casualties depends on medical staff’s ability to operate
in an appropriate way. Although hospital staff is expected
to respond to chemical incidents only rarely, it is crucial
that it maintains a high level of competency in order to
ensure provision of optimal care when necessary. Effective
management of such incidents necessitates proficiency
of hospitals’ staff regarding characteristics of chemical
agents, mechanism of action, protection measures,
clinical signs and symptoms of victims and principles of
decontamination and treatment. Various training methods
for medical teams were described. However, identifying the
optimal strategy and its impact on knowledge retention are
still controversial. Examining the effectiveness of training
programs is challenging, mainly due to the difficulty of
evaluating staff performance during real-time events. It is
essential that the overall policy of emergency management
includes components of training, exercises and evaluation
based on improvement of performance. This article reviews
the existing methodologies to train hospital personnel
Case Reports
Capt. Inna Lipnitzki, Maj. Gennady Mainshlos, Maj. Avi Gilad, Col. Ram Sagi, Maj. Leeor Plot
A 34 years old female was admitted to a local hospital due
to a non-resolving pneumonia. Imaging studies done in the
emergency room, demonstrated a lung abscess located in
the right upper lobe. In this article we present the case and
discuss the possible causes, the diagnostic approach and
the treatment options in lung abscess – based on current
literature review. •
Lt. Col. Barak Gordon, Maj. Tal Yemini, Shlomi Matetzky, Gil Hirschhorn
A 48 year old jet fighter pilot presented to the aeromedical
unit with a non-sustained ventricular tachycardia on an
exercise test performed because of abdominal pain. The pilot
was grounded and a thorough investigation was performed
including computed tomography of the coronary arteries,
holter monitoring, and a cardiac magnetic resonance
imaging (MRI) and a cardiologist consultation. A small
amount of scar tissue was found on the MRI. All other tests
were normal. After six month of exercise, echocardiography
was normal, holter monitoring was interpreted as normal,
and small scar tissue was found on repeat MRI. An expert
committee convened in the aeromedical unit, and after
deliberations it was decided that the pilot would be qualified
for low-performance planes only. In the article we present
the case, the aeromedical considerations, the relevant
medical literature and relevant policies from other aviation
agencies
Conference Reports
S. Moshe
The PREMUS 2016 conference dealt with musculoskeletal disease from an occupational source. The conference is held once every three years, under the auspices of the International Occupational Health Association (ICOH) and the scientific committee of the PREMUS organization. About 400 participants attended this year's conference in Toronto, Canada
N. Yavnai
The 12th annual conference on military medicine research was hosted for the second time at the Battalion House Museum in Moshav Avihail. The conference is a central stage for the presentation of research papers in a variety of fields in military medicine, and is invited to the staff of the Medical Corps from all professional settings and fellow researchers from industry and academic institutions. This year the conference was also held to mark the change of position of head of the academic branch. The chairman of the conference, the head of the incoming academy branch, Lt. Col. Dr. Adi Leiba, presented his teaching and called on the young faculty to be included in medical research.
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