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Biomedical subjects

M Ehrenfeld

Publications and source records attributed to M Ehrenfeld.

At least 55 records · Page 3Linked to original sources
PubMed1998

Battered women: dilemmas and care.

Domestic violence is a complex problem, and its victims are women from all social classes and positions. The "cycle of beating" where tension accumulates, and then assault is followed by excuses and reconciliation, puts the battered women in dilemma. One conflict is that of exposure of intimate family details, and the other the guilt for the consequences of external intervention in family situations. The modern society has several tools to treat domestic violence and to assist battered wives. They include the police, legislation, courts and probation officers, besides shelters, legal aid and social services. Specific training of nursing and medical personnel is pivotal for the proper identification of women is such distress.

Adult↗
PubMed1997

Reasons for student attrition on nursing courses: a study.

Student attrition (dropping out) wastes time and resources which schools of nursing can ill afford. This study from Israel sets out to identify the reasons for student attrition and finds that academic failure is only one factor. The authors suggest some ways in which high risk students can be identified and helped.

Education, Nursing, Baccalaureate↗
PubMed1997

[Microneural reconstruction after iatrogenic lesions of the lingual nerve and the inferior alveolar nerve. Critical evaluation].

As microneural repair techniques of the sensory mandibular branches enter the third decade of their clinical use, there are but a few long-term investigations into the value of these procedures in the treatment of iatrogenic injury to the lingual (LN), inferior alveolar (IAN) or mental (MN) nerve. To establish the efficacy of microneural repair in lesions of the LN, IAN or MN with loss of continuity, the outcome of sensory recovery was evaluated in a series of 92 patients (LN: direct coaptation n = 39, coaptation + sural nerve grafting n = 23; IAN: direct coaptation n = 11 coaptation + sural nerve grafting n = 10; MN: direct coaptation n = 11). The minimum duration of follow-up was 14 months postoperatively. The persistent sensory deficit was assessed using standardized neurosensory testing and gustometric stimuli. In addition the patients answered a multiple-choice questionnaire containing a list of complaints. To obtain a numeric estimate for interindividual and intergroup comparison the information from clinical measurements and patient reports was condensed into a 'neurological score' and a 'complaint score', respectively. Furthermore, adequate items from both scores were combined to affirm or deny the return of sensory function in terms of protective and discriminative sensation. The overall results show a broad range of variation in the scores, sometimes reflecting severe degrees of persistent sensory impairment. The lowest scores, corresponding to the best regeneration, were found after direct coaptation of the LN, IAN and NM, but even the best results did not provide sensory recovery to a preinjury level. After direct coaptation of LN 69% of the patients exhibited protective sensation and 41% regained discriminative function. In contrast, LN grafting was ensued from restoration of protective function in 39% and discriminative function in 17% of the patients. More striking differences were found between coaptation and grafting of the IAN (IAN coaptation: 91% protective function; 18% discriminative function; IAN grafting: 60% protective function, 0% discriminative function). In the LN coaptation group low scores and improved taste perception were convincingly associated with short periods since injury (i.e. timing of repair). In conclusion, we feel there is sufficient justification to optimize the potential results of microneural repair by immediate (LN/MN) or early (IAN) reexposure of the injured site in order to clarify the precise nature of the underlying nerve damage and prevent delay, if patients present with complete loss of sensory function subsequent to dentoalveolar or oral surgery. However, clinical and electrophysiologic findings suggesting impairment or partial loss of sensory function are considered a contraindication to microneural intervention, in view of the limited prospects of sensory recovery after surgical repair.

Adolescent↗
PubMed1997

Preliminary studies on temperature selection and activity cycles of Triatoma infestans and T. spinolai (Heteroptera:Reduviidae), Chilean vectors of Chagas' disease.

Preferred temperature and activity patterns of Triatoma infestans Klug and Triatoma spinolai Porter were studied, both are vectors of Chagas' disease in Chile. In the laboratory, 24 T. spinolai and 18 T. infestans were exposed to a temperature gradient between 50 and 15 degrees C and a photoperiod of 14:10 (L:D) h. Temperature and hourly position of bugs in an experimental chamber were recorded for 24 h. Both species showed a cycle of preferred temperature, and both selected higher temperatures beginning at 1600 hours, although T. infestans maintains this preference over a longer period. For both species, activity patterns were synchronized with the light-dark cycle, although these activity rhythms were significantly different. T. spinolai had higher activity during the photophase, and T. infestans showed a lower activity in the photophase and a higher one during the scotophase. The similar pattern of preferred temperatures may facilitate the selection of similar environments in the event of colonization of houses by T. spinolai. Diurnal activity of this species might be a disadvantage (in terms of more exposure to defensive responses of the vertebrate hosts) but may allow T. spinolai to share the same habitat with T. infestans without competitive interference.

Activity Cycles↗
PubMed1997

Feelings of anger among caregivers of patients with Alzheimer's disease.

The purpose of this article is to examine the caregiver's feelings of anger, the causes of these feelings as described by the caregivers and their reactions. Twenty female caregivers of Alzheimer's disease patients participated in a support group at a psychogeriatric centre for 3 years. The group was directed by a registered nurse and a social worker. Frequently, anger was raised as a major issue in the caregiving. The group directors constructed two models that emerged from the support group's meetings. The first model showed the sources of the anger felt by the caregivers and the second model showed coping strategies. The caregivers said that the most infuriating behaviours of patients Alzheimer's disease were: aggressive behaviour, sleeplessness and verbal or behavioural repetition. The caregiver's reactions to the two models are discussed in this paper together with their feelings, which expressed by the women in their own words.

Adaptation, Psychological↗
PubMed1997

Ethical dilemmas concerning sexuality of elderly patients suffering from dementia.

This study endeavoured to clarify the ethical dilemmas concerning sexuality encountered by nurses caring for elderly patients suffering from dementia, and to assist the decision-making process of the nurses and staff who handle dilemmas of this nature. Many of the staff in geriatric institutions report difficulties, confusion, embarrassment and helplessness as well as negative responses and rejection when encountering sexual situations between patients of the same or different sex, patients and staff members or between patients and visitors. Embarrassment over sexuality is felt by staff members, visitors and family. This embarrassment may result in elderly patients being treated like children, and being separated from their partners. A response of this nature can provoke anger in the patients, sometimes leading to violence. The central dilemma on the subject of sexuality in a geriatric institution is the fact that staff are in conflict between the desire to protect the elderly patients and maintain their dignity and the patients' desire to fulfil their sexual needs. Since no single, definitive prescription can be provided for conduct acceptable to the staff, the patients and their families, it was decided to work with the staff on the basis of case studies to help them in selecting ways of coping.

Aged↗
PubMed1997

Young people considering nursing as a career: starters vs. non-starters.

This study focused on applicants who were accepted to a nursing education program but did not begin their studies, thus wasting time, effort and money. Of 953 accepted applicants, 27% did not enter the program. Significant variables differentiating starters from non-starters were higher psychometric score, higher paternal education, lower priority for nursing studies, older age, non-Israeli country of birth and not completed army service. The study relating to starters vs. non-starters is one aspect of a large study (Ehrenfeld, Rotenberg, Sharon, & Bergman, 1995). In most nursing education programs the number of applicants exceed the faculty's capacity, and suitable candidates must be rejected. It is therefore both wasteful and disappointing when accepted applicants change their mind and do not actually begin in the program. In light of the costs and complexities involved in the student screening process and the continuous efforts extended today all over the world to raise the standards of nursing education and care, the factors differentiating starters from non-starters may have important implications. The aim of the present study was to evaluate the screening process at the Tel Aviv University baccalaureate nursing program and determine which variables were predictive of starters and non-starters among accepted applicants.

Discriminant Analysis↗
PubMed1996

Pleural effusion as a presenting manifestation of giant cell arteritis.

Pulmonary involvement is rare in giant cell arteritis (GCA). Only a few cases have been reported, manifested by interstitial infiltration, pulmonary nodules, pulmonary artery vasculitis, and granuloma formation. Moreover, only 3 previous cases of pleural effusion associated with GCA have been described. Herein we report a 67-year-old woman with biopsy-proven temporal arteritis, presented with prolonged fever, weight loss, cough and pleural effusion. ELISA test for the presence of anti- proteinase-3 antibodies was negative. The importance of the anti-neutrophil cytoplasmic-antibodies (ANCA) examination in the differential diagnosis from other vasculitides with pulmonary involvement is discussed.

Aged↗
PubMed1996

Aspergillosis in systemic lupus erythematosus.

Infection is the major cause of morbidity and mortality in systemic lupus erythematosus (SLE). Although various fungi account for a substantial number of these lethal infections, aspergillosis, an important opportunistic infection in immunosuppressed patients, is described rarely. Only 23 cases have been reported in the English-language medical literature. Risk factors for acquiring aspergillosis in these patients were high grade disease activity, granulocytopenia, use of steroids and other immunosuppressive treatment and presence of bacterial infection. The diagnosis in most patients was delayed and they died. Here, we describe three SLE patients with invasive aspergillosis. Features of our patients' diseases were similar to those reported previously. Aspergillosis appeared while they had active SLE treated with high dose corticosteroids. In 2 patients the fungal infection was systemic and diagnosed post mortem. Both were leukopenic and had concurrent bacterial infection and one received amphotericin B prior to death. In the third, the infection was localized to a transplanted kidney and was cured by nephrectomy. Aspergillosis should be suspected in patients with active SLE, who are immunocompromised and sustain concomitant bacterial infections. The currently poor prognosis may be improved with more aggressive diagnostic investigation and treatment.

Adolescent↗
PubMed1996

The use of flash visual evoked potentials in the early diagnosis of suspected optic nerve lesions due to craniofacial trauma.

Craniofacial trauma encroaching on the orbital apex and optic canal can result in direct or indirect optic nerve lesions, leading to visual impairment or blindness. Early diagnosis of a visual loss and immediate therapy are generally considered crucial for a successful restoration of vision in indirect trauma. However, in comatose or sedated patients the assessment of optic nerve function by testing pupillary reactivity may be severely compromised or impossible because of tensely swollen eyelids, conjunctival oedema, concussion of the ciliary muscle or pharmacological effects. In the event that clinical ophthalmic examination, computer tomography or nuclear magnetic resonance scanning fail to clarify the state of the optic nerve, visual evoked potentials (VEPs) to flash stimulation appear to provide reliable information on function within the visual pathway. On this basis, treatment with corticosteroids and/or surgical decompression can be rapidly initiated. Our results in a preliminary patient series confirm the value of acutely monitored VEPs as an objective test of optic nerve function in cases of suspected optic nerve injury immediately after admission to the emergency care unit. The imaging techniques usually applied may be complemented by VEPs to show the functional significance of structural abnormalities found in the vicinity of the optic nerve.

Adult↗
PubMed1996

Congenital palatal ulcers in newborn infants with cleft lip and palate: diagnosis, frequency, and significance.

Congenital decubital ulcers were found in 94% of newborn infants with unilateral cleft lip and palate in the course of a systematic study of a large cohort study (N = 52). The procedures for diagnosis, documentation, and follow-up are described. The ulceration area at birth varied over a wide range. The ulcerations were usually located in the posterior part of the vomer. Sonographic evidence supports the hypothesis that the ulcerations are caused mechanically by the motor activity of the tongue during the fetal and newborn period. The decubital ulcer disappeared in each case within 5 days following the implementation of a palatal plate.

Cleft Lip↗
PubMed1996

Comparison of clinical and laboratory parameters for systemic lupus erythematosus activity in Israelis versus Europeans.

The clinical activity of systemic lupus erythematosus (SLE) may be influenced by ethnic and environmental factors. The Consensus group on Activity Criteria for SLE attempted in a multicenter study to determine well-accepted criteria for disease activity. Of the 704 randomly assigned patients, 41 (5.8%) were from Israel. A detailed history including epidemiological, clinical and laboratory data was recorded. Significant differences were found between Israeli and European patients in the occurrence of Raynaud's phenomenon [12 (30%) vs. 358 (51%), respectively (P < 0.05)] and skin vasculitis [6 (15%) vs. 216 (34%), respectively (P < 0.05)]. In addition to those clinical differences, significant differences were also found in the occurrence of VDRL, low complement levels and lupus anticoagulant. Additional differences were found in some laboratory data, indicating differences in the sensitivity of the various laboratories. We conclude that the differences between the Israeli and European groups in the clinical data can be attributed mainly to environmental factors (weather, viruses), and in the laboratory data to ethnic differences (e.g., HLA) and to the different diagnostic methods used.

Adult↗
PubMed1996

Insulin-like growth factor I and its binding proteins 3 and 4 are increased in Human inflammatory synovial fluid.

OBJECTIVE: To measure insulin-like growth factor I (IGF-I) and its binding proteins (IGFBP) in human synovial fluid (SF), as IGF-I resistance in the chondrocyte was implicated in the pathogenesis of inflammatory arthritis. METHODS: Ten patients with inflammatory arthritis and 7 controls were evaluated. IGF-I and IGFBP-3 were measured by radioimmunoassay while all IGFBP were evaluated by Western ligand blotting. RESULTS: Serum IGF-I did not differ between patients and controls (22.3 +/- 2.9 vs 22.0 +/- 3.0 nmol/l), while significantly higher values were found in inflammatory SF compared with noninflammatory SF (14.7 +/- 1.5 vs 10.2 +/- 1.2 nmol/l; p = 0.05). IGFBP-3 and IGFBP-4 were the most prominent bands found in inflammatory SF by Western ligand blotting. The 24 kDa IGFBP-4 band appeared faintly in 2 noninflammatory effusions and was nearly absent in others. IGFBP-3 levels in sera from the 2 groups did not differ (2.9 +/- 0.3 vs 2.5 +/- 0.3 mg/l), but were significantly higher in inflammatory compared with noninflammatory effusions (1.5 +/- 0.2 vs 0.9 +/- 0.2 mg/l; p = 0.05). CONCLUSION: The pattern of IGFBP in SF differs in inflammatory versus noninflammatory joints.

Adult↗