Harefuah
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Recently, a new Law, named the "derivative law" (first addition, schedule drug change--2010), was accepted in the Israeli parliament. It will mean that dangerous substances that are closely related structurally to a drug that is listed in the dangerous drugs ordinance will automatically enter the dangerous drugs ordinance. The dangerous drugs that were sold in kiosks were related to 4 major groups: Amphetamines, methamphetamines, cathinone and methcathinone. ⋯ In an urgent meeting of the multi-ministry committee on psychotropic substances held in December 2010 in the Israel Anti-Drug Authority, it was decided to recommend to the Minister of Health to insert an inclusive group of "synthetic cannabinoids" into the control drug list in Israel. On April 5, 2011, after receiving the approval of the health and welfare committee in the Israeli parliament, the dangerous drugs ordinance (new version)--5732-1973 was amended with the addition of an inclusive group of "synthetic cannabinoids". These include: JWH-018, JWH-133, JWH-073, CP 47, 497, CP 55, 940, HU-331, HU-210, HU-211, HU-250.
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In many European countries the use of opioids for long-term treatment of non-malignant pain has dramatically increased during the last decade in order to improve the patient's quality of life, to allow social activities and the return to work. Therefore, the issue of driving by patients regularly taking opioids, and its medico-legal aspects, concerns physicians, patients and society. ⋯ The decision to allow patients to drive under stable long-term opioid therapy is always individually based and should be founded on relevant and up-to-date clinical data, including both physical and mental evaluations. The patient, on the other hand, should also be responsible for his condition before and during driving.
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Attention deficit hyperactivity disorder (ADHD) often persists into adulthood. Stimulants, including methylphenidate, as well as non-stimulants, have shown efficacy in treating adult ADHD. ⋯ Methylphenidate treatment is recommended in cases when ADHD diagnosis was confirmed. Follow-up is required with special attention to possible cardiovascular, psychiatric and abusive side effects.
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The management of knee osteoarthritis (OA) focuses on reducing the levels of pain and disability. Recently, a novel biomechanical device and treatment methodology (AposTherapy) was shown to reduce the knee adduction moment while simultaneously challenging the neuromuscular control system through perturbation. ⋯ Our results suggest an overall improvement in the gait patterns, level of pain, function and quality of life of patients with knee OA following three months of AposTherapy.
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Robot-assisted laparoscopic surgery is a rapidly evolving technology, becoming widely applied as an alternative to open or laparoscopic gynecologic surgeries. The penetration of robot-assisted laparoscopic surgery into gynecologic surgeries in the past 6 years has been remarkable. The greatest advantages of this surgical technique are smaller incisions, leading to lower morbidity, less postoperative pain and shorter hospital stays. ⋯ In Israel, approximately 45,000 gynecological surgeries are performed every year, and about tenth of these are hysterectomies. In this issue, Mejia-Gomez et al. describe the results of the first experience with robot-assisted Laparoscopic hysterectomy in Israel in 14 women in Hadassah Ein Kerem Hospital. Whilst debate continues about the evidence-based superiority of robot-assisted Laparoscopic hysterectomy, it appears that where robot-assisted systems exist, most patients will opt for the robotic-assisted approach and gynecologists will step forward to fill this niche because of its minimally invasive characteristics and clinical benefits, despite the lack of level I evidence.