Harefuah
-
Chronic pain is a common, yet frequently overlooked and undertreated complaint among older patients. It may result in an impairment of the function and quality of life of these patients. Chronic pain is a syndrome, which influences and is influenced by many potential factors (physiological psychological and social), all of which require treatment to achieve an optimal clinical outcome. ⋯ In older people, a host of factors can impede assessment and drug management, including multiple medical problems and many potential sources of pain, sensory impairment, depression, disability and impaired cognitive function. In addition, pharmacokinetics and pharmacodynamics unique to the geriatric population make this group vulnerable to adverse medication effects. By using appropriate pharmacological combined with non-pharmacological treatment, it is often possible to improve function ability to a greater extent than the severity of pain reduced.
-
To evaluate the fusion achieved by posterior lumbar interbody fusion--PLIF [B-TWIN, Disc-O-Tech) stand-alone in terms of intervertebral fusion on the basis of radiograph imaging. ⋯ A fusion rate of 93% was achieved. The findings suggested a tendency for better results in the female group and better results in the spinal stenosis group compared with the spondylolisthesis group and the degenerative disc disease group. There is a need for further investigation in order to establish our findings.
-
Circa 2700 burn victims require hospitalization in Israel each year. Most of these burns happen as household accidents, caused by hot liquids and involve less than 20% of the total body surface area. ⋯ In most centers, the joint treatment of the most severe cases, provided by plastic surgeons and intensive care specialists allows the use of advanced techniques and treatment protocols, improving outcome. In order to further improve the quality of care for the burn patients, to allow improved national capability to contend with scenarios of disaster and mass casualty, to provide a sound database for future planning and billing, and also to produce appropriate intervention plans, Israel should have a system similar to the US's National Burn Repository.
-
Overlap syndrome is a term which specifies the existence of both chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) in the same patient. The prevalence of OSA in COPD patients equals its prevalence in the general population. ⋯ They also have a greater prevalence of pulmonary hypertension and right heart failure, and suffer higher morbidity. Due to these consequences of the overlap syndrome, it is recommended to actively search for its existence in COPD patients, and to treat it with continuous positive airway pressure (CPAP) concurrently with oxygen and optimal pharmacological treatment of COPD.
-
The aim of this study was to evaluate demographic and polysomnographic characteristics of positional (PPJ) and non-positional obstructive (NPP) sleep apnea (OSA) patients in 2077 OSA patients diagnosed in our Sleep Disorders Unit during a period of 10 years. An OSA patient is defined as positional if he has twice as many or more breathing abnormalities (apnea and hypopneas) while he sleeps in his supine posture compared to the lateral ones. Of the 2077 OSA patients, 1118 (53.8%) were positional and 959 (46.2%) were non-positional. ⋯ As AHI and BMI increase, the Likelihood to be a positional patient decreases. NPP have breathing abnormalities in the supine and lateral postures, thus, for them without question, CPAP is the treatment of choice. Since avoiding the supine posture during sleep may significantly improve the sleep quality and daytime alertness of many positional patients, it is imperative to carry out a high-quality study to evaluate if this is a real therapeutic alternative for many positional patients.