Harefuah
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Increasing attention is being paid by staffs of hospitals and directors of our national health agencies to providing emergency medical services for trauma care. The results of a nationwide survey documenting the structure and process components of trauma care in all 24 acute care hospitals in Israel are presented. ⋯ The results show extreme interhospital variation in physical structure of trauma services and in manpower, protocols and critical resource. However, it is evident that the main focus for intervention in the quality of initial trauma care in hospitals in Israel, is to establish and implement organizational standards.
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We present our initial experience with laparoscopic colonic resection in 15 patients: adenocarcinoma of the colon, 10 cases, giant villous adenoma (2), arteriovenous malformation (2), and a case of benign stricture. Mean operating time was 190 minutes and there were no intraoperative complications. The margins of resection and number of resected lymph nodes in patients with malignancy were comparable to those in the conventionally operated. ⋯ During a maximum follow-up of 15 months there were no wound or trocar-site recurrences. We conclude that laparoscopic colonic resection is technically feasible and safe. However, its use for treating malignant diseases of the colon needs further study.
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Foreign body aspiration (FBA) should be suspected in every child with acute onset of cough or wheezing. Although a choking episode occurs in 80-90% of cases of FBA, it is not necessarily diagnostic. ⋯ Bronchoscopy is therefore mandatory when there is a convincing history of FBA, regardless of physical or radiologic findings. This can be done with either the flexible or rigid bronchoscope, or with both.