Harefuah
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The reasons for admission to the Acute Coronary Care Unit (ACCU) have changed in the past few years. The classical cause of acute coronary syndrome sets aside the causes of acute heart failure and post-procedural complications. There is also a change in the demographic characteristics and co-morbidities of the admitted patients. ⋯ We have presented the current trend of admission to the ACCU with a shift from ACS to other cardiac causes such as acute heart failure, shock or peri-procedural complications. The rate of co-morbidities and hospital complications is increasing as the patients' age increases. This shift of patients' characteristics requires a re-examination of the role of the medical staff in this new era. There is a need to increase funding for acquiring new technology, staff education and reinforcing current staff.
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In the last decade, a number of integrative oncology programs have been established within leading oncology departments in Israel aiming to provide consultations that address patients' concerns and improve their quality of life (QOL). ⋯ Arab cancer patients support QOL-oriented integrated medicine programs provided in oncology settings. Integrative medicine consultation should provide patients with an evidence-based recommendation on efficacy and safety of herbs commonly used concomitant with chemotherapy. We recommend designing integrative oncology training courses for physicians who will provide evidence-based consultation attuned with Arab patients' needs, concerns and cultural-sensitive orientation.
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The best surgical approach for patients with moderate ischemic mitral regurgitation (IMR) is still undetermined. We examined long term outcomes in patients with moderate IMR undergoing coronary bypass (CABG), and compared outcomes between those undergoing isolated CABG to those undergoing concomitant restrictive annuloplasty. ⋯ In patients with moderate ischemic MR, neither operative mortality nor long term survival are affected by the performance of a restrictive annuloplasty. For patients with CHF, mitral repair may be beneficial in terms of survival.
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Pregnancy related carpal tunnel syndrome (PRCTS) is the most frequent mononeuropathy during pregnancy. The reported incidence of PRCTS varies widely and ranges from 0.8% to 70% depending on the diagnostic method and the physician. The etiology for PRCTS is related to hormonal fluctuations, fluid accumulation, glucose level fluctuations, median nerve hypersensitivity etc. ⋯ Treatment of PRCS is mostly conservative, and if there is lack of improvement local intracarpal injection of a steroid is indicated. Intracarpal injections have demonstrated a significant decrease in symptoms and low recurrence in comparison to the general population, and do not put the fetus or his mother at risk. A surgical intervention is rarely indicated during pregnancy.
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For the last 20 years the classic treatment for relapsing remitting multiple sclerosis was based on injectable disease-modifying drugs, interferon-β and glatiramer acetate (copaxone). Currently, new disease-modifying drugs have been added to the clinician's arsenal with similar and even improved efficacy and safety profiles. Some of these drugs are given orally and are recommended as first line treatment. In this review we will discuss the various innovative and emerging disease-modifying drugs including the method of administration, mechanism of action, efficacy, safety and major side effects.