Harefuah
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Varicose veins have been described as early as the classical period of ancient Greece, and continue to affect the quality of life of up to one third of the population in the industrialized world. In recent years considerable progress has been achieved in understanding the pathological basis of this condition and in the development of new treatment modalities. The treatment of varicose veins of the lower limbs is primarily aimed at alleviating the symptoms, which include pain, pruritus, heaviness, ulceration, hemorrhage, and at improving unaesthetic appearance, but has also been shown to significantly improve measurable parameters of patients' quality of life and functional scales. ⋯ The remaining invasive interventions are equally efficacious but differ considerably in their demand of skilled personnel and equipment, their adverse effects, the length of expected recovery and their economic costs. The new endovenous interventions can be performed in an ambulatory clinic under local anesthesia. They are at least as efficacious as surgery in short- and medium-term follow-up, but evidence on their long-term efficacy is still Lacking.
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During the Last decade complementary medicine is gradually being integrated within conventional oncology care in Western countries. In 2008, an integrative oncology program was implemented within the Clalit Oncology Service (COS) of the Haifa and Western-Galilee district of Clalit Health Organization aiming to promote patients' well-being during chemotherapy and in advanced disease. ⋯ Asking patients during chemotherapy on their beliefs regarding mind and body connections may be used as a screening question to identify patients interested in experiencing complementary therapies. Integrating physician counseling regarding complementary medicine within the oncology service may address patients' needs and concerns by matching therapies to specific symptoms and chemotherapy side-effects.
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The Israeli medical residents' workload in hospitals is enormous, especially in the internaL wards, due to a severe lack of manpower and the demand to carry out many shifts. The workload of residents who practice in the community is rising as well: family physicians are required to achieve quality objectives in treating chronic diseases while the time dedicated to each patient is shortening. Creating a family usually parallels to this phase, causing home-work conflict among the residents. Consequently, the residents are Liable to develop burnout during their internship. ⋯ It seems that both groups are equally burned-out and need to recover after work. Our article calls for improvement of working conditions in both residencies.
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In March 2010 the United States enacted the most significant health care reform in several decades. The Patient Protection and Affordable Care Act, amongst other provisions, addresses two of the main current shortcomings of the U. S. health system: the large portion of the population that are uninsured and the high percentage of hsealth expenditures (mostly private] which amounts to about 16% of the GDP. ⋯ Overreliance on private, out-of-pocket, spending and lack of support for public practice of medicine (in community and hospital settings) will weaken the public sector, strengthen the private sector, and could result in a tiered lower quality and less accessible public system with greater widening of gaps in health and health care utilization. This paper reviews the main provisions of the U. S. health care reform and the potential implications for the IsraeLi health system.
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Laparoscopic colorectal resection is not common practice, despite its proven advantages. Hand-assisted laparoscopic colectomy (HALC) combines the advantages of a format laparoscopy while minimizing its limits. ⋯ HALC is a safe and effective procedure that enables the preservation of the laparoscopy advantages, in a short operative time, and a rapid learning curve.