Harefuah
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Nausea and vomiting of pregnancy (NVP) is the most prevalent medical condition during gestation. Approximately 85% of pregnant women suffer from some degree of this condition, while hyperemesis gravidarum (HG), the most severe form, affects up to 2% of women. Although being the leading cause for hospitalization during pregnancy, NVP has received little attention from the medical community. ⋯ Various studies have demonstrated the effectiveness and safety of antiemetic therapy in pregnancy. However, fear of teratogenicity and lack of clinical guidelines lead to trial and error NVP management. We present an updated algorithm for the management of NVP.
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Boarding patients awaiting hospitalization in the emergency department increases mortality and complications, and stands in contrast to the recommendations of emergency medicine associations worldwide. Although Israel's Ministry of Health and the media are addressing the issue, boarding patients in emergency departments is common in hospitals throughout the country. There are no current studies that assess the influence of boarding in emergency departments on the patient's mortality and hospitalization. In 2011, a decision was made in our hospital to board patients in a separate section of the emergency department due to the lack of beds in the inpatient wards. ⋯ For the first time, the effects of boarding patients in the emergency department in Israel are studied. The issue of boarding patients in emergency departments should be a central issue addressed by Israel's health system.
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Mild therapeutic hypothermia has been shown to reduce mortality and neurological morbidity in post cardiac arrest survivors. These beneficial effects had initially been reported in retrospective studies and subsequently more evidence has been gathered by two cornerstone randomized control trials. All these studies focused on the acute outcome and the clinical status at the time of hospital discharge. The main goal of this study was to describe the long term effects of therapeutic hypothermia in this population. ⋯ In the current phase of the study, a tendency in favor of mild cooling was observed in the short and medium term outcomes in patients resuscitated after out of hospital cardiac arrest due to fatal arrhythmia. The current results indicate that in spite of high survival rates after the acute stage in the cooling group, the long term mortality rate in this group is still high.
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Idiopathic pulmonary fibrosis (IPF) is a devastating lung disease of unknown cause. The clinical course is unpredictable, but the disease is usually progressive with a median survival of 2-5 years as a result of advanced respiratory failure. ⋯ Despite better understanding of the pathogenesis, there is no effective therapy for the disease. In this review, we present the positive results of recently published clinical trials regarding therapy for IPF, with emphasis on pirfenidone and nintedanib.
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In recent years the city of Eilat has come under threat of rocket attacks. This emphasized the need for an upgrade of the city's medical center capabilities in trauma care. Medical simulation has been used for many years in training and for the improvement of trauma care both at the field Level and in hospitals. Although there was significant improvement in the technological aspects of simulations, the use of simulators was restricted mainly to simulation centers and its effectiveness in training and assessment of trauma teams in situ in emergency departments was still not examined. ⋯ The use of mobile medical simulations combined with instructors from within the hospital enabled the training and assessment of the trauma care in situ and in a short time.