Oneillwoodward4857
Cholesteatoma is the most severe middle ear disease. In most cases cholesteatoma results from under-aeration of the middle ear cleft. It is characterized by otorrhea and hearing loss, and may lead to severe complications, intra- and extra-cranial. There is no non-surgical treatment for cholesteatoma. Surgical treatment is the only option. Cholesteatoma is diagnosed by micro-otoscopy. When cholesteatoma is suspected and otoscopy is inconclusive, imaging is mandatory. The goal of treatment in cholesteatoma is to achieve a stable and safe ear. In most cases, upon diagnosis, cholesteatoma is quite extensive and mastoidectomy is needed. Choice of surgery [Canal wall up mastoidectomy with tympanoplasty (the more conservative alternative), Canal wall down (radical) mastoidectomy with meatoplasty or Canal wall down (radical) mastoidectomy with reconstruction of external ear canal, tympanoplasty and mastoid obliteration], depends on the extent of the disease, the anatomic relationship between the sensitive structurering devices. Cholesteatoma has a high recidivism rate that leads to repeated surgery. In order to diagnose and treat cholesteatoma recidivism, a structured follow-up is needed after cholesteatoma surgery, with periodical otoscopy (every 6-12 months) and MRI (every 1-2 years). When cholesteatoma recidivism is diagnosed, surgery is indicated before the disease grows and becomes infected.
Alcohol consumption during pregnancy has become a prevalent phenomenon worldwide in general, as well as in Israel in particular. This habit is associated with an increase in various complications during pregnancy - mainly fetal alcohol syndrome and post-natal fetal alcohol spectrum disorder. There is no "safe limit" for alcohol consumption during pregnancy and alcohol drinking may be detrimental to the fetus or to the newborn when consumed at any stage of the pregnancy. The negative effects of alcohol consumption during pregnancy are also related to a shortage of key nutritional elements due to this habit. The main negative results of this habit are fetal alcohol syndrome and fetal alcohol spectrum disorders. Pregnant women after infertility treatment are also not deterred from drinking alcohol. Education of pregnant women is currently regarded as the best treatment.
Alcohol consumption during pregnancy has become a prevalent phenomenon worldwide in general, as well as in Israel in particular. This habit is associated with an increase in various complications during pregnancy - mainly fetal alcohol syndrome and post-natal fetal alcohol spectrum disorder. There is no "safe limit" for alcohol consumption during pregnancy and alcohol drinking may be detrimental to the fetus or to the newborn when consumed at any stage of the pregnancy. The negative effects of alcohol consumption during pregnancy are also related to a shortage of key nutritional elements due to this habit. The main negative results of this habit are fetal alcohol syndrome and fetal alcohol spectrum disorders. Pregnant women after infertility treatment are also not deterred from drinking alcohol. Education of pregnant women is currently regarded as the best treatment.
Neurologic symptoms are an extremely rare presentation of Kikuchi-Fujimoto disease. We report a case of a young female patient diagnosed with Kikuchi-Fujimoto disease, presenting with neurologic symptoms compatible with aseptic meningitis, along with radiographic findings which improved with steroidal treatment. Despite the rarity of these findings, they were reported as part of the disease manifestation, however, since Kikuchi-Fujimoto disease is associated with other diseases, such as systemic lupus erythematosus (SLE), other diagnoses cannot be ruled out.
Neurologic symptoms are an extremely rare presentation of Kikuchi-Fujimoto disease. We report a case of a young female patient diagnosed with Kikuchi-Fujimoto disease, presenting with neurologic symptoms compatible with aseptic meningitis, along with radiographic findings which improved with steroidal treatment. Despite the rarity of these findings, they were reported as part of the disease manifestation, however, since Kikuchi-Fujimoto disease is associated with other diseases, such as systemic lupus erythematosus (SLE), other diagnoses cannot be ruled out.
Total knee arthroplasty is the most prevalent operation with a high success rate in the treatment of primary osteoarthritis. However, patients with complex secondary osteoarthritis remained marginalized to the surgical response or otherwise exposed to high risk conventional surgery. Early decades of life, surgical history, technical complexity, high surgical morbidity, variability of pathology and anatomy and poor clinical outcome are a few of the reasons. The assimilation of modern technology shifted the concept and practice in the field of arthroplasty, opening a window of treatment opportunities for patients with secondary osteoarthritis with patient specific implants (PSI).
Evaluate safety, efficacy and applicability limitations of PSI as an alternative to conventional total knee arthroplasty in complex clinical settings. Furthermore, the study aimed to conduct assessments of clinical outcome and technical aspects.
This was a prospective cohort clinical study, based on Western Ontario and McMaster Uation.
A first time presentation of focused, isolated and specified characteristics of a patient population with secondary osteoarthritis where PSI establishes a step forward in the treatment and outcome of patients with complex clinical presentation.
Masked uncontrolled hypertension (MUCH), describes a mismatch between normal office measurements and out of range home blood pressure. 3,4-Dichlorophenyl isothiocyanate manufacturer Although it is often underdiagnosed, it is associated with high risk of hypertensive complications and morbidity. Ambulatory blood pressure monitoring (ABPM) is defined as the "reference standard" for diagnosing hypertension and is especially effective in cases of MUCH. Although there are many references on the advantages of ABPM, very few studies consider its limitations. To the best of our knowledge, false-positive ABPM has not previously been reported. We report a case in which a positive ABPM result obtained during a stressful situation became normal after being repeated in a non-stressful time. We, therefore, suggest implementing routine pre-test assessment of stressful situations in patients undergoing ABPM. This strategy will lead to improving the accuracy of ABPM and avoiding false-positive results.
Masked uncontrolled hypertension (MUCH), describes a mismatch between normal office measurements and out of range home blood pressure. Although it is often underdiagnosed, it is associated with high risk of hypertensive complications and morbidity. Ambulatory blood pressure monitoring (ABPM) is defined as the "reference standard" for diagnosing hypertension and is especially effective in cases of MUCH. Although there are many references on the advantages of ABPM, very few studies consider its limitations. To the best of our knowledge, false-positive ABPM has not previously been reported. We report a case in which a positive ABPM result obtained during a stressful situation became normal after being repeated in a non-stressful time. We, therefore, suggest implementing routine pre-test assessment of stressful situations in patients undergoing ABPM. This strategy will lead to improving the accuracy of ABPM and avoiding false-positive results.
The COVID-19 pandemic posed unique challenges to medical teams in general and in the field of obstetrics in particular, where the provision of medical services could not be postponed. Optimal care during the COVID-19 outburst required rapid adjustment to changes, ensuring staff and patients' safety while maintaining close and direct contact with patients.
To explore obstetricians' experiences during the first outburst, focusing on their challenges, needs and ways of coping.
Semi-structured in-depth interviews were conducted online with 13 senior physicians and residents (7 women, 6 men) from four hospitals, who worked in obstetrics. The interviews were analyzed using the Immersion/Crystallization method developed in medicine focused on their experiences.
The findings revealed that alongside the impressive mobilization of the teams during this period, physicians encountered various challenges. These included being overwhelmed with the ever-changing and often conflicting guidelines; a feeling of lack ofprovide high-quality safe care.
Immunization against coronavirus disease 2019 (COVID-19) in Israel began on December 2020, using the BNT162b2 mRNA vaccine. Individuals aged 60 years or older and medical staff were prioritized in COVID-19 immunization, and currently individuals aged 16 years or older are eligible to receive the vaccine. To achieve levels of community immunity (herd immunity) immunization of 60-70% of the population is required. As of mid-February 2021, about 42% of the population in Israel received the first vaccine dose, and the coverage exceeded 70% in individuals aged 50 years or older. Despite this success, the rates of COVID-19 immunization are lower in the ultraorthodox and Arab populations compared to the general Jewish population. We reviewed factors that might affect acceptance of COVID-19 vaccines. Factors that might influence the individual's willingness to be vaccinated against COVID-19 include concerns about the safety of the vaccine, recommendations by employers and treating physicians. Moreover, differences e vaccinated according to socio-demographic characteristics, such as employment, age and gender groups, and even political affiliation. Minority populations are vulnerable to misinformation about vaccines. The Arab and the ultraorthodox populations are the main minority groups in Israel, and characterized by lifestyle, and low socio-economic status, which increased, among other factors, the incidence of COVID-19 in these populations. To improve vaccine uptake in the ultraorthodox and Arab populations, there is an urgent need for better tailored solutions to the unique needs of these minority populations, which comprise main risk groups for misinformation related to COVID-19 vaccines. Moreover, a better understanding of the reasons for low uptake of COVID-19 vaccine in these populations is warranted. These activities should be undertaken in parallel to continuous efforts towards reducing socio-economic disparities between sub-population groups.
The COVID-19 pandemic has forced countries worldwide to face major issues and challenges. Among those challenges is breastfeeding from the first hours after birth until late infancy, in hospitals and communities. There is a consensus throughout the world and among leading international professional medical associations that breastfeeding is of significant importance for short- and long-term health outcomes in mothers and infants, as well as for its public health impact and reduction of national health expenditures. Moreover, breastfeeding or human milk feeding have been shown to reduce morbidity, specifically respiratory infections, among infants and children. This is not the first time health systems are dealing with coronavirus outbreaks, although currently, in the COVID-19 pandemic, there is still much that is unknown. Dealing with the unknown can lead to guidelines that may not fully take into consideration relevant risk benefit ratios for individuals and groups. In this review, we aim to summarize the guidelines of different leading professional groups around the world dealing with the COVID-19 pandemic.
