Harefuah
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Tuberculosis (TB) is a major infectious cause of morbidity and mortality, mainly in developing countries. Since the incidence of TB has decreased in the developed countries, the role of diagnosis and treatment of latent TB infection (LTBI), has assumed increasing importance as a public health measure to control TB. ⋯ However, levels of adherence to treatment of LTBI are consistently low, and non-compliance constitutes the major barrier for achieving the full benefits of LTBI treatment, emphasizing the pressing need to implement compliance-enhancing interventions. We present a review of studies in which various interventions aimed at enhancing LTBI treatment adherence were applied.
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The new Israeli Organ Transplant Law grants priority in organ allocation to candidates for transplantation who have registered as organ donors at least 3 years prior to being listed or have been Live organ donors or have a first degree relative who has been a deceased donor. This unique law resurrects the old ethical principle of reciprocal altruism in which each partner in society helps the other while he helps himself. ⋯ The law aims to eliminate the "free riding" phenomenon of candidates for organ transplantation who do not accept brain death and therefore object to organ donation after death yet do not abstain from waiting for such donation. The morality of such behavior is discussed along with the ethical appraisal of its solution in the law, suggesting it to be just and fair.
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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.