Biomedical subjects
Publications and source records attributed to S Mor-Yosef.
There is a general agreement that infants with hyperextension in breech presentation should be delivered by Cesarean section in order to prevent spinal cord injuries and neonatal deaths. The following case report illustrates complete spinal cord transection in a fetus with hyperextended head in breech presentation delivered by Cesarean section who died 8 days after delivery.
Two sisters of reproductive age with Von Willebrand's disease experienced ovarian hemorrhage. The possibility of such a hemorrhage should be considered in such patients even though it is rare.
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Grandmultiparity has been considered as an obstetric hazard both to the mother and the fetus. Since high paritius tend to be more common in the lower socioeconomic groups, the effect of the socioeconomic status on perinatal outcome was evaluated in this study. This survey covers all the deliveries in Israel (22,815) in a 3 month period. The 1542 grand-multiparous women were divided into two groups: low socioeconomic group (947) and high socioeconomic group (595). Perinatal mortality and low birth weight were found to be in correlation with low socioeconomic status but not with grand multiparity. Maternal diseases complicating pregnancy were found to be significantly more common for grand multipara for both socioeconomic groups. This study shows that the grave association of parity and mortality found for the total population was due to the predominance of parturients of low socioeconomic class in the high birth order group.
OBJECTIVE/DESIGN: Changes in the health system in Israel have led to an increasingly competitive environment, decentralization, and economic constraints. We evaluated the use of a continuous quality improvement (CQI) program. SETTING: Three medical departments and three administrative wings in a 700-bed, tertiary-care, teaching hospital in Jerusalem. INTERVENTION: The program was planned as a short-term pilot project for long-term extension throughout the institution. The objectives were improved institutional efficiency and provision for change. The program was implemented through departmental improvement teams under a hospital management team and a steering committee, guided by an outside consultant firm. RESULTS: The Orthopedics Department experienced a 3-day reduction in patient length of stay (P<.008). The Emergency Room experienced a significant reduction in time to discharge through reduced waiting times for consulting physicians (P<.007) and for blood tests (P<.001). The Office of Patient Admissions streamlined procedures for admission and discharge, accomplished physical restructuring, and installed a telephone hot line. In Medical Records, a significant improvement in records availability was realized. In Outpatient Clinics, reductions in waiting times were realized, but were not statistically significant. The Supply Division showed savings on monthly orders and increased efficiency, with 95% of orders completed promptly and accurately. CONCLUSIONS: Several factors were identified as essential to the success of the program, including staff cooperation and commitment. We conclude that the CQI program was a useful tool to help our tertiary-care medical center adjust to changes in the Israeli healthcare system. It also served as a valid vehicle for maintaining and furthering optimal quality of care.
Semen samples of 209 males of infertile couples were evaluated by the sperm hypoosmotic swelling (HS) test, the in vitro human sperm zona-free hamster ovum penetration assay (SPA), and by the three main parameters of the spermatogram (concentration, motility, and morphology). Whereas the HS test and SPA were poorly correlated with one another, the former showed a correlation with motility, particularly in oligo-, astheno-, and teratospermic semen samples. The simple and inexpensive HS test may prove a worthwhile tool in the diagnosis of male infertility.