Biomedical subjects

Pesach Shvartzman

Publications and source records attributed to Pesach Shvartzman.

24 records · Page 2Linked to original sources

PubMed2002

Outcomes of an intervention programme for treatment of asthma in a primary care clinic for Bedouins in southern Israel.

BACKGROUND: Asthma is one of the most common disorders affecting children and adults. There is a large variation in the theoretical and practical knowledge and skills of physicians, and patients often do not receive optimal treatment. Thus, asthma represents a great challenge to the primary health care system. OBJECTIVE: Our aim was to evaluate an intervention programme for the optimization of treatment of asthma in a primary care clinic in the Muslim Bedouin sector in southern Israel. METHODS: Over a 3-month period, data were collected on the number of nebulizer treatments received by asthma patients in the clinic, referrals to the emergency room, hospitalizations and availability of electric nebulizer equipment or space chambers in the homes of children with asthma. Following this, an intervention programme was designed and implemented to improve treatment of asthma. At the end of the intervention 1 year later, the same data were again collected in the same season as the pre-intervention data. RESULTS: Of 3428 children registered in the clinic, 267 were diagnosed with asthma (7.8%). During the 3-month period before the intervention, 73 children had home inhalation equipment, 61 referrals to the emergency room were documented and six children were hospitalized for exacerbation or complications of the disease. Over this time period, 5.54 nebulizer treatments were conducted in the clinic per month per 100 children and adults. Following the intervention, the number of referrals to the emergency was reduced to six children, none of whom was hospitalized. The number of children with home nebulizers was doubled. The number of nebulizer treatments in the clinic dropped to 4.7 per month per 100, a reduction of 15%. CONCLUSIONS: An intervention including self-management of asthma with an emphasis on the proper use of inhalers and medications, together with improved disease management at the clinic itself, led to a reduction in the episodes of asthma and its complications.

Arabs↗

PubMedDate not supplied

Low-dose intravenous lidocaine as treatment for proctalgia fugax.

BACKGROUND: Proctalgia fugax is characterized by a sudden internal anal sphincter and anorectic ring attack of pain of a short duration. OBJECTIVE: Description of the influence of intravenous lidocaine treatment for proctalgia fugax. CASE REPORT: A 28-year-old patient suffering of proctalgia fugax for 8 months. Conventional treatment efforts did not improve his condition. A single dose of an intravenous lidocaine infusion completely stopped his pain attacks. CONCLUSIONS: Based on the experience reported in this case and the potential benefit of this treatment for proctalgia fugax, controlled studies comparing intravenous lidocaine with placebo should be conducted to confirm the observation and to provide a more concrete basis for the use of intravenous lidocaine for this indication.

Adult↗

PubMedDate not supplied

Clinical and laboratory profile of febrile respiratory infections in general practice.

BACKGROUND: Respiratory tract infection (RTI) is a common diagnosis in the primary care setting. The aim of the study was to characterize the clinical course and laboratory manifestations of febrile RTI in Israeli adults presenting to primary care clinics. METHODS: A prospective study over a 3-month winter period in 3 urban university primary care clinics of 122 consecutive adult patients seen by their family practitioners. All participants were interviewed and had chest radiographs, tests of oxygen saturation, and blood tests. RESULTS: Study group included 122 adults (mean age, 44.8 +/- 14.2 years; men, 38%). Fever lasted for a mean of 4.0 +/- 1.7 days, and the mean number of days off work/activities was 5.3 +/- 1.0. Pneumonia was clinically suspected in 33 patients (27%), but documented in 7 (6%). Antibiotics were given to 94 patients (77%). The group of treated patients had a lower mean oxygen saturation (P <.05) and a higher erythrocyte sedimentation rate (P <.05). Blood tests were found to be abnormal, although not clinically significant, in some patients, and all resolved spontaneously. CONCLUSIONS: RTIs are usually of short duration with a benign course where laboratory blood tests have no clinical implication. Radiographs may distinguish the 6% of patients having pneumonia from the 27% with suspected cases.

Adult↗

PubMedDate not supplied

Urine culture collected from gel-based diapers: developing a novel experimental laboratory method.

BACKGROUND: Urinary tract infection diagnosis is based on urine culture, taken from a midstream collection. Obtaining samples in this manner is difficult in elderly patients suffering from incontinence and in infants. OBJECTIVES: (1) Develop a method for urine collection using gel-based diapers and (2) compare culture results from gel-based diapers with those of the same urine, examined by accepted methods. METHODS: Urine was collected and cultured by standard bacteriologic techniques at the microbiology laboratory of Soroka Medical Center, Beer-Sheva, Israel. Gel-based diapers were manually dampened with the same urine samples, and samples from diapers were cultured 0 to 3 hours after dampening. RESULTS: Comparison showed good correlation between direct urine cultures and cultures obtained from gel based diapers (R = 1.000). Total sensitivity was 100% and specificity 97%. CONCLUSIONS: (1) Urine can be cultured from gel-based diapers and (2) a larger sample of in vivo trials will be needed to make this technique clinically applicable in an outpatient setting.

Cell Culture Techniques↗

PubMedDate not supplied

High-dose fentanyl patch for cancer pain.

OBJECTIVE: To describe a successful experience with a high dose (1000 microg/hr) of transdermal fentanyl for cancer pain relief. CASE REPORT: A 62-year-old man suffering from rectal carcinoma was treated by our home care hospice unit during his last 3.5 months of life. At admission to our home care unit, he suffered mostly from severe anal pain (verbal pain scale of 10/10) due to advanced disease. He was then on 150 microg/hr transdermal fentanyl. Adjuvant therapy with amitriptyline 50 mg/day and dexamethasone 4 mg/day was added, but it did not relieve his pain. The dose of transdermal fentanyl was increased gradually to 1000 microg/hr with good pain control (verbal pain scale of 1 to 4/10 most of the time). Before his death, he was mentally alert with good pain control. CONCLUSIONS: High doses of transdermal fentanyl (1000 microg/hr; 10 patches) should be considered for pain relief in cancer patients.

Administration, Cutaneous↗

PubMedDate not supplied

Where should family medicine papers be published - following the impact factor?

Academic institutions weigh the research contribution of family physicians and take this factor into account when determining eligibility for the candidates' promotion. Among other parameters, these institutions consider the journals in which family physicians publish. In this respect, the impact factor (IF) has gained a foothold as one of the most accepted means to measure this contribution. The IF may be a measure of the main importance of a scientific journal. IF has a huge, but controversial, influence on the perception and evaluation of published scientific research. It is important for family physicians to understand and be aware of the importance of the IF and the way it is calculated. The IF is one consideration in the decision-making process of a researcher as to where to publish because the IF of most family medicine journals is less than 2.0. Thus publication in these journals might not yield the proper "score" for academic promotion in many institutions. On the other hand, publication in journals with higher IF that are not necessarily widely read by primary care physicians could result in a small impact of their findings on direct patient care.

Bibliometrics↗