Harefuah
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Informing parents of a severe developmental disability (SDD) in their child is a frequent, yet extremely challenging part of care at any child developmental center. In this study, which was the first to address this issue in Israel, we asked parents for feedback on their experiences in receiving such news at our center, in order to help us develop a set of guidelines for improving clinical practice. ⋯ Parents are not inevitably dissatisfied with meetings at which they are informed that their child has a SDD. Our findings point to concrete steps that clinicians can take in order to increase the chances of parental satisfaction with these meetings.
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Radiofrequency (RF) lesions have been used for over 25 years in the treatment of intractable pain of spinal origin. The conventional idea is that the heat generated in the tissue surrounding the electrode tip leads to destruction of nerve fibers. In case of mechanical back pain, an electrode positioned adjacent to the medial branch of the dorsal root may reduce the input of noxious nerve stimuli and alleviate pain. For treatment of patients with severe radicular pain the authors often apply pulsed radiofrequency current. This technique enables the application of a relatively high voltage near the dorsal root ganglion, avoiding the deleterious thermal effect of the current. It was found to exert a beneficial effect in cases of intractable radicular pain. This study reports the result of pulsed RF in 28 patients suffering from severe radicular pain treated by pulsed radiofrequency current with follow-up at periods of 3, 6 and 12 months after treatment. There were 20 cases of low back pain and 8 with neck pain, with an average age of 56.7 years. The first follow-up after 3 months revealed the following results: excellent results in 2 cases (7.1%), good results in 12 cases (42/9%), fair in 9 (32/1%) and 5 (17/9%) reported that their condition have not changed. Results after 6 and 12 months were excellent in 2 (both groups), good in 7 and 6 respectively, 11 fair (both groups) and unresponsiveness to treatment was noticed in 8 patients after 6 and 9 after 12 months. Significant reduction was found in the Visual Analog Scale for pain from an average of 8.8 to 4.2 after 3 months, 4.8 after 6 months and 4.9 after 1 year. ⋯ Pulsed RF treatment is a safe and simple procedure to control radicular pain in the cervical and lumbar regions. Following the current study the authors stress the need for further prospective, double-blind studies for better investigation of this technique.
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Procedural pain includes any pain or discomfort inflicted by medical care or treatment. Procedural pain is the leading cause of pain and discomfort in children with malignancies. ⋯ The research retrospectively studied the effectiveness of this approach in reducing pain. The authors also compared the advantages and disadvantages of their approach to different options described in the literature and available in other institutions.
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University Departments from many countries recruit their faculty members for academic duties without prior formal training (specific for their jobs). This has been the common approach in Israel. Other countries however, have created faculty development (FD) programs to help new faculty accomplish their new tasks. ⋯ Twenty-three family physicians enrolled in the course. Half of the participants were born and trained in medicine in Israel. After completing the first year of this program, both participants and teachers provided positive feedback and requests were received for a second course for new participants.
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Obstructive sleep apnea syndrome is defined as a condition of repeated episodes of apnea and hypopnea during sleep, accompanied by excessive daytime sleepiness. This syndrome is common among the adult population, and is related to an increased risk for significant complications, during and immediately after surgery. ⋯ Although this syndrome is common, there is low awareness of its expression in elective surgery in-patients. We present a case report of a patient who suffered from obstructive sleep apnea related respiratory distress following total knee replacement surgery.