Harefuah
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A recent report in Harefuah has introduced cardiopulmonary exercise testing (CPX), presenting its physiological basis and key parameters. Despite the fact that multiple guideline documents and scientific statements have been published in the last few years by the leading European and American societies summarizing the incremental information added by the addition of ventilatory gas exchange measurements, CPX continues to be underutilized by the practicing clinician. ⋯ In this review we will describe the current clinical and emerging applications of CPX, and try to simplify interpretation and reporting of CPX test data. We will also review CPX findings in selected clinical populations and the implication of these observations to the clinical evaluation of patients with heart and/ or lung diseases.
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Lateral pain of the hip with point tenderness at the Greater Trochanter is a common musculoskeletal complaint. It is frequently diagnosed as trochanteric bursitis; however, this term is inaccurate because of evident non-inflammatory pathologies, particularly of the abductor tendons of the hip. It is important to differentiate this extra-articular source from an intra-articular or a lower back source of pain. ⋯ Nevertheless, despite the above treatments, about one third of the patients suffer from chronic pain and disability. These patients may be candidates for operative intervention. Currently, there are endoscopic surgical techniques for local decompression, bursectomy and suture of torn tendons similar to surgery used in the shoulder.
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Arabin cervical pessary is a silicone ring pessary for the prevention of preterm birth (PTB] for pregnant women at risk with second trimester short uterine cervix. Progesterone supplementation has been found to prevent PTB. ⋯ The use of cervical pessary in conjunction with intravaginal progesterone is safe and feasible. Patients with twin pregnancies had a significantly higher rate of preterm birth compared to singleton pregnancies. Further research is needed to assess device efficacy.
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Transfers of nursing home residents to emergency departments can result in iatrogenic complications, morbidity, and excess health care expenditure. Some of these transfers are potentially avoidable. ⋯ The implementation of such an intervention can reduce the rate of transfers of nursing home residents to emergency departments. Such interventions might lead to quality improvement in nursing homes and should be further evaluated in larger randomized controlled trials.