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Biomedical subjects

M A Weingarten

Publications and source records attributed to M A Weingarten.

At least 19 recordsLinked to original sources
PubMed1992

Normal fluctuations of leucocyte counts and the response to infection in benign familial leucopenia.

In a long-term follow-up of 47 Yemenite patients with benign familial leucopenia, the mean white-cell count was 4,578 with a standard deviation of 940. During bacterial infections, the average leucocyte increment was the same in leucopenic as in non-leucopenic subjects, leading to total leucocyte counts in the normal range in previously leucopenic subjects. The marked degree of variability makes clinical interpretation difficult when leucocyte counts are found between levels standardised as normal in sick patients previously known to be leucopenic.

Adult↗
PubMed1992

Attitudes to primary-care gynaecology among family physicians and gynaecologists in Israel.

A postal questionnaire was sent to a random sample of Israeli gynaecologists and family physicians to study their attitudes to primary care gynaecology. The gynaecologists (n = 50) tended to think that family physicians should not be involved at all, except for adolescent sex education. The family physicians (n = 60) thought that they should be managing menstrual disorders, vaginal discharges, family planning counselling, prescription of oral contraceptives, insertion of intrauterine devices, routine antenatal and postnatal care, sexually transmitted diseases, breast examinations, and menopausal counselling. Both professions agreed that high risk pregnancies, hospital deliveries, infertility, and PAP smears were in the gynaecologists' domain. The younger family physicians and those in rural practice held these views more strongly than their older colleagues in urban practice. The results are discussed in the light of the patients' and the doctors' diverse interests.

Attitude of Health Personnel↗
PubMed1991

[Hospitalization survey of rural family practice].

Data on hospital admissions were recorded in 3 village clinics in central Israel during the period 1977-1986. This period coincided with the introduction of regionalization of hospitals, as well as with the growth of board-certified family practice in Israel. The age-adjusted rate of admission from these 3 villages was 74/1000/year, considerably lower than the national rate of 124/1000/year. There was an abrupt decrease in admission rate in 1983, the year of the doctors' strike, followed by a compensatory rise the following year, mainly for surgical procedures. During the years of the survey hospital stay decreased progressively, but the average of the survey population for the whole period (8.3 days) was greater than that of the national population (5.8 days). Hospital stay was longer in the tertiary hospital center than in regional hospitals. Relatively low admission rates but with relatively long hospitalization may be characteristic of higher quality community care. There were marked demographic differences between the 3 villages. The different age structures and ethnic origins of the populations affected hospitalization trends. However, differences in economic status had no detectable effect. Community-based hospitalization surveys over long periods may be useful in demonstrating changes in morbidity patterns over the years, as well as the effects of changes in the health care system.

Data Collection↗
PubMed1990

Frequency of clinical gallstone disease among Yemenite Jews in Israel.

The prevalence of gallstones in Yemenites in Israel was reported in an early hospital-based study to be very low. The current prevalence of clinical gallstone disease in this population group was estimated and compared with that in a predominantly European (Ashkenazi) community by a review of 1,000 family practice medical charts in each community. The crude rate in the Yemenite community was 3.1% for those over the age of 20, and the age-adjusted relative risks were 1.1 for men and 3.1 for women, compared with the control population. The regional hospital cholecystectomy rates for the Yemenite community were slightly lower than for the general population, but the Yemenites were more likely to have emergency than elective surgery. The rate of positive findings and complications revealed by clinical ultrasound examinations was also higher among Yemenites than in the general population. This study corrects the mistaken impression that gallstones are a rare phenomenon among Yemenites.

Adult↗
PubMed1989

Computerized protocol for preventive medicine: a controlled self-audit in family practice.

A protocol for adult health maintenance was designed for display on a desk-top microcomputer in the general practitioner's office. Two hundred and twenty-two patients were entered into a randomized study comparing the outcome of the computerized protocol with manual records. The doctor had the option of displaying the single-screen protocol for the experimental group and acting on its prompts in the course of his normal clinical consultations. At the end of 30 months, significantly more preventive medicine items--smoking, height, blood group, tetanus and rubella immunization status and family planning--had been recorded for patients in the computerized group. For other items, requiring more frequent measurements, computerization produced an advantage only for blood pressure and breast examination, but not for weight, occult blood and serum cholesterol. Recording rates increased significantly for patients in both the control and the computerized groups for all the items. Using the computer lengthened the average consultation time from 8.5 minutes to 10 minutes. Such systems are a valuable aid to encouraging doctors to increase the amount of preventive medicine they incorporate into their routine practice.

Clinical Protocols↗
PubMed1988

Age as a major factor affecting adherence to medication for hypertension in a general practice population.

An audit of the treatment of hypertension in a general practice revealed that 51 out of 246 patients prescribed medication did not collect their monthly supply of drugs. There were no significant differences between the adherers and the non-adherers in sex, severity of hypertension, type or complexity of medication. The patient's age was the only factor which was associated with adherence. Patients under the age of 55 years or over 65 years had significantly lower adherence than those aged 55-64 years. Most previous studies coming from hospital-based or clinical trial populations have failed to demonstrate this association with age which may be characteristic of an unselected general practice population. The results may not be applicable to populations of different social or cultural background but they suggest appropriate directions for health promotion efforts in our community.

Adult↗
PubMed1987

Local cooperation between a health centre and a social services department: seven years' experience.

For seven years a health centre and the local social services department have worked in close cooperation in a small immigrant town in Israel. A detailed analysis is provided of the content of this cooperation which included area teams, a health centre social worker, group work with patients, health-related community work, inter-agency meetings and directors' meetings. The process of learning how to work together is put in the context of the different needs and expectations of the two agencies and of the community. Our experience is discussed briefly in the light of broader theoretical considerations from the literature.

Aged↗
PubMed1986

A procedure for handling complaints against general practitioners.

Patient dissatisfaction with the care they receive in general practice is sometimes expressed as a formal complaint. We report our experience with an hierarchical complaints procedure. The annual rate of complaints received by the area medical director of a local health centre serving 11 500 patients was 100 per 10 000 registered patients. The medical officer for the region (regional population 160 000) received 4 complaints per 10 000 patients. The regional Public Complaints Committee received 0.1 complaint per 10 000 patients per year and the Israeli National Health Service Ombudsman received 0.2 complaints per 10 000 patients per year from the same region. Almost all dissatisfaction relating to style of practice was dealt with at the local level, while complaints relating to matters of substance or ethics quickly reached the higher authorities. The complaints procedure was thus shown to distinguish between temporary breakdowns of the doctor-patient relationship and inadequacies of the system of care and to handle the relevant complaints appropriately.

Adult↗
PubMed1986

Serum lipoproteins in Israeli "Bnei Israel" Indians.

Serum lipoprotein concentrations differ markedly in the various ethnic groups which compose Israel's immigrant population. A group of subjects belonging to a community of "Bnei Israel" Indians, consisting of 21 women and 16 men between the ages of 30 and 60 years, was studied 10 years after immigration. The women had lipoprotein levels comparable with the Israeli-born population. The men had significantly lower mean cholesterol levels and significantly higher HDL/total cholesterol ratios and a tendency for lower triglycerides than an age-matched Israeli-born group, and a higher HDL/LDL cholesterol ratio than the women of the same origin. These results are consistent with the observed low incidence of coronary heart disease in Israeli Bnei Israel men who appear to have a "healthier" lipoprotein profile than the women in this community.

Adult↗
PubMed1985

Off the cuff consultations.

Over six months I recorded 198 off the cuff consultations that occurred at social gatherings, at chance meetings, and in medical settings outside my surgery. More men than women made such consultations, roughly two thirds were a request for health information, and just under half of consultations were with other doctors' patients. It seemed that many patients were seeking a second medical opinion.

Family Practice↗
PubMed1985

The effect of direct charges on consultations in family practice: a study of a doctors' strike.

Experience accumulated during the doctors' strike of 1983 in Israel was analysed to compare the effect on the work of the family doctor of direct-charge as against pre-paid insurance arrangements, in three different settings--suburban, rural and working-class small town. The imposition of direct charges greatly reduced the consultation rate; more of the patients consulting received prescriptions, especially for antibiotics; laboratory investigation, referral and admission to hospital were unchanged, but referral for specialist consultation was reduced; the most frequently seen diagnostic categories remained respiratory diseases and undefined signs or symptoms, but pneumonia was seen much more frequently; there was no change in the proportion of follow-up visits, but house calls were more frequent. These trends were stable over the four-month period of the strike, and partial reimbursement of the fee did not change the picture significantly. The evidence did not conclusively support the hypothesis that direct charges selectively deter trivial complainers.

Adolescent↗
PubMed1985

A pilot study of the multidisciplinary management of childhood asthma in a family practice.

A small, controlled trial of joint treatment of childhood asthma by a doctor, a physiotherapist, a psychologist, and a social worker, working together in the family setting, demonstrated an improvement in ventilatory capacity. The limited scope of this trial does not permit more general conclusions as to the effect of such treatment on the severity and frequency of attacks, but the observation that some measurable physiological improvement occurred suggests that the place of multidisciplinary nonpharmaceutical management of childhood asthma should be investigated in more detail.

Adolescent↗