Isr Med Assoc J
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Historical Article
Reflections on the Nuremberg declaration of the German medical assembly.
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Since clinical signs of meningeal irritation in infants may be absent or misleading, the American Academy of Pediatrics in 1996 recommended that a lumbar puncture be performed in young children following a febrile seizure. Recent evidence supports a conservative approach in children who do not look ill at the time of the physician's assessment. Moreover, seizures as the presenting or sole symptom of bacterial meningitis are very rare. ⋯ Compliance with the Academy's recommendations was low, as emergency room physicians based their decision whether to obtain a lumbar puncture solely on clinical grounds. No case of bacterial meningitis was detected among 278 young children with a febrile seizure, including those who did not undergo the puncture.
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Historical Article
In remembrance of the victims of Nazi medicine Nuremberg, May 2012.
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While many are familiar with postpartum depression, the phenomenon of postpartum post-traumatic stress disorder (PTSD) is less well known and investigated. ⋯ The study results indicate the importance of inquiring about previous pregnancy and birthing experiences and the need to identify at-risk populations and increased awareness of the disorder. The importance of addressing anticipatory concerns of pain prior to delivery as well as respecting dignity and minimizing the undressed state during childbirth should not be underestimated. A short questionnaire following childbirth may enable rapid identification of symptoms relevant to PTSD.
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Establishing the etiology of a large pericardial effusion is of crucial importance since it is likely the result of a serious underlying disease. However, there is a paucity of literature on the diagnostic management of patients with large hemorrhagic effusions. ⋯ All cases of pericardial effusion resolved after rapid diagnosis and initiation of specific treatment. Pulmonary embolism in situ may be a complication of large pericardial effusions that does not require anticoagulation treatment after the effusion resolves.