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Biomedical subjects

J Urkin

Publications and source records attributed to J Urkin.

15 recordsLinked to original sources
PubMed2000

Pediatric emergency room response to community pediatricians' expectations.

BACKGROUND: In Israel the pediatric emergency room functions as an urgent primary care clinic in addition to dealing with life-threatening situations. Due to health insurance stipulations, most patients come to the PER with a referral from the community clinic. The relationship between the referring physician's expectations and the subsequent management of the referred patient in the PER is not well defined. OBJECTIVES: To evaluate the relationship between the expectations of the primary care physician and the management of referred patients in the PER, assess the type of information provided by the referring physician, and examine the effect of additional information obtained from the referring physician on patient management in the PER. METHODS: We reviewed the records of patients presenting at the PER with referrals from primary care physicians as well as additional information obtained by telephone interviews with the referring physicians. RESULTS: The expectations of the referring physicians were not fully documented in the referral form. The PER responded to the patient as if the PER was the initial contact. There was no significant difference in the response of PER physicians with or without additional information from the referring physicians. CONCLUSIONS: The PER acts as an independent unit with no obligation to satisfy the expectations of the referring physicians. The relationship between the PER and the referring physicians needs to be clarified. Guidelines and structured PER referral forms should be implemented in all primary care clinics to improve patient management and communication between health providers.

Child↗
PubMed2000

Suction purpura.

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Child↗
PubMed2000

Do not disturb!

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Humans↗
PubMed1997

Efficacy of Auralgan for treating ear pain in children with acute otitis media.

OBJECTIVE: To determine the efficacy of Auralgan otic solution (combination product of antipyrine, benzocaine, and glycerin) compared with an olive oil placebo in the management of moderate to severe ear pain in children with acute otitis media (AOM). DESIGN: Children 5 years or older who presented with ear pain and eardrum findings indicative of AOM were randomly assigned to treatment with Auralgan or olive oil drops instilled into the external auditory canal(s) of the affected ear(s). All children were also treated with 15 mg/kg of acetaminophen in a single dose. Ear pain was assessed by means of 2 visual analog seales-a linear scale and a color scale-at study entry and 10, 20, and 30 minutes later (T0, T10, T20, and T30, respectively). Results of the measurements on the 2 scales were evaluated independently and were averaged to determine an ear pain score. A baseline ear pain score of at least 3 points was required for study entry. Four outcome measures regarding ear pain score at T10, T20, and T30 were used: (1) proportion of subjects who showed 50% reduction, (2) proportion of subjects who showed 25% reduction, (3) proportion of subjects who showed a 1 or more point reduction, and (4) mean score over time. SETTING: Primary care center and emergency department of a children's hospital. PARTICIPANTS: Fifty-four children aged 5 to 19 years with ear pain and AOM. RESULTS: The Auralgan and placebo groups were comparable regarding age, sex, race, laterality of AOM, and T0 ear pain score. By each of the 4 measures used, the response to treatment consistently favored the Auralgan group, but only at T30 were any differences statistically significant. CONCLUSION: In children with AOM-associated ear pain who are treated with acetaminophen, topically applied Auralgan appears likely to provide additional relief in varying degree within 30 minutes.

Acute Disease↗
PubMed1994

Physician use of a computerized medical record system during the patient encounter: a descriptive study.

The computerized medical record program, CLINIC, specifically designed at Ben-Gurion University of the Negev to be used on-line in a primary care clinic during a patient encounter by healthcare professionals, has been in use for over 6 years in two community clinics. In order to analyse the effectiveness and use of CLINIC, four physicians were video recorded during working sessions before and after the introduction of CLINIC. While using CLINIC did not change the total mean encounter time, the lengths of the encounter components and record use did change. The physicians' work style changed from a 'conversational pattern' (continuous data recording) to a 'blocked pattern' (data entry at intervals).

Attitude of Health Personnel↗
PubMed1991

[Henbane (Hyoscyamus reticulatus) poisoning in children in the Negev].

During 1984-1989, 19 Bedouin children, 4-8 years old, were hospitalized because of henbane plant (Hyoscyamus reticulatus) poisoning. There were 14 cases in the autumn, 3 in the spring and 2 in the summer. The most prominent signs were altered state of consciousness (including deep coma in 3) and flushed dry, warm skin in all. Pupils were dilated in 18 of the 19 and restlessness and hallucinations were present in 17. Less common were vomiting, increased tendon reflexes, convulsions, involuntary movements, ataxia, hypertension, hyperpyrexia and tachycardia. Therapy included intravenous physostigmine in 7 and sedatives (diazepam and triclofos) in 6. All were free of symptoms within 24 hours of admission. Henbane may grow as an annual or biennial. Renewed growth of leaf rosettes occurs before the first rains and they attract attention in the fields. The parts of the plant eaten by most of the children were the roots, which are easily mistaken for the edible roots of other plants. The main alkaloids in henbane are atropine (hyoscyamine) and scopolamine (hyoscine) which explains the clinical picture of mixed stimulation and depression of the brain. Educational measures should be undertaken to prevent poisoning of Bedouin children by eating such plants.

Child↗
PubMed1991

[Anemia in children: hemoglobin changes in mild, acute infections].

Anemia is commonly discovered in children when a complete blood count is routinely performed during acute and febrile illnesses. In this study-recovery of hemoglobin levels in children after acute infections was evaluated. Hemoglobin levels were measured in capillary blood of 70 patients who visited a community primary pediatric clinic with an acute infectious illness (37 boys, 33 girls; mean age 22 months, mode 18; 58 had fever of 38 degrees or higher). The most frequent diagnoses were upper respiratory tract infection, acute otitis media and pharyngitis. Follow-up hemoglobin measurements were performed after at least 3 days without fever and when the children were considered well by their parents. The average time between the 2 measurements was 12 +/- 9 days.

Acute Disease↗
PubMed1988

Prevalence of CMV antibodies among women of childbearing age in different social environments in southern Israel.

The prevalence rate of IgG antibodies to cytomegalovirus (CMV) was determined in a sample of 567 women of childbearing age in the southern part of Israel by the immunoperoxidase assay to membrane antigen (IPAMA) technique. Urban Jewish women of Afro-Asian origin showed significantly higher rates of seropositivity than urban Jewish women of European-American origin (80% vs 65%, respectively, P less than 0.001), closely resembling the level of CMV seropositivity found in Afro-Asian and European-American countries in the same age and sex population groups. The Bedouin women showed slightly lower rates of CMV seropositivity (75%) than Jewish women of Afro-Asian origin. Particularly high rates of CMV seropositivity were detected in women who live in a kibbutz environment: 96% in women of Afro-Asian origin and 80% in women of Euro-American origin. Multiple discriminant analysis also singles out the kibbutz environment as a major contributor to the variance between the groups tested (P less than 0.003).

Adult↗
PubMed1988

Transient protein-losing gastropathy (Menetrier's disease) in childhood.

Two cases of transient protein-losing gastropathy (PLG) or Menetrier's disease in childhood are described. Both cases presented with an abrupt onset of edema due to hypoalbuminemia and were diagnosed by an upper gastrointestinal series. One of the cases was further diagnosed and followed by ultrasound. We believe that this is the first description of the ultrasonic picture of transient PLG in children. In both cases complete recovery was evident after a few weeks.

Child, Preschool↗