Harefuah
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Intussusception is a relatively common pediatric emergency. The accepted treatment is closed reduction using barium or air enema and surgery when it has failed. We present our 13-year experience using air enema for treatment of intussusception, emphasizing the reduction with repeated delayed air enema. ⋯ Air enema is an efficient and safe diagnostic and therapeutic tool for intussusception in the pediatric population.
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In the state of Israel there are no clear guidelines of decision-making for terminally ill patients. However, physicians do make decisions concerning life sustaining treatment. The rate of these decisions in medical wards in Israel is not known. ⋯ However, on the basis of multi-regression analysis, only functional impairment prior to the hospitalization significantly affected the decision-making by the physician. The findings of this study support the essential need for accelerating legislation concerning decision-making for patients at the end of life. The adoption of the recommendations of the public committee on this subject, recently presented to the Minister of Health, provide legal validity to advance medical directives and may assist in ethical issues for end of life decision-making.
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Sexual dysfunction is characterized by disturbances in sexual desire and/or psycho-physiological changes associated with the sexual response cycle in men and women. Studies suggest that it is prevalent in 10-52% of women and 25-63% of men, and could have a tremendous impact on the individual, interpersonal relations, and on the family quality of life. ⋯ Family physicians consider themselves to be the main address for the patient for sexual dysfunction problems. Physicians believe they need more training to overcome lack of knowledge barriers and they need to organize their time to adequately address their patients sexual dysfunction problems.
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Since time immemorial the attitude toward the dying patient has been one of the most difficult issues in medical ethics. The diversity of philosophical, religious, social and legal approaches does not enable one to reach a universal consensus to solve the many problems involved in end-of-life decisions. Within the health care system in Israel there is currently no consensual practice concerning the dying patient. ⋯ It establishes a clear position on euthanasia, physician-assisted suicide, withdrawing treatment and withholding treatment. It establishes a hierarchy of decision-making agents, and it validates advanced medical directives. It also promotes a legally-binding requirement of modern palliative care.