Harefuah
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140 consecutive patients with MI, all those admitted during 1 month to 3 general hospitals in Haifa, were interviewed and their records reviewed. Only 17.3% had been transferred by a mobile coronary care unit (MCCU). The rates of utilization were lower among residents of the Mount Carmel area and among those hospitalized in Carmel Hospital. ⋯ Only 13% referred to hospitals by physicians in the community were transferred by MCCU, in contrast to 33% of those referred by Magen David Adom stations. 67% of the patients had prior knowledge of the MCCU, but this was not associated with rate of usage. We conclude that the use of the MCCU in the Haifa area is not consistent with its original objectives. The reasons are both patient- and service-related.
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104 home visits carried out by family physicians in an insured population of 5324 covered by a family practice teaching clinic in Haifa were analyzed. The study included a 3-month period (March, July and December 1986). The rate of home visits was 0.08/person/year. 75% of the visits were to those over the age of 65. 25% of the visits were initiated by the physician, while 20% of visits initiated by the patients, their relatives or others were considered unjustified. However, not all visits initiated by physicians were considered justified. 35% of all visits were considered contributory to the general care of the patients.
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Unilateral pulmonary edema is uncommon and is usually associated with prolonged surgical procedures or rapid evacuation of a hydro- or pneumothorax. Unilateral pulmonary edema due to left heart failure in the absence of known lung disease is rare. ⋯ In both cases several other diagnoses were considered, but the cardiac origin of the infiltrates was supported by the rapid clearing of the lung after diuretic therapy. Awareness of this unusual clinical condition is important for the early institution of proper therapy.