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[DEVELOPMENT AND IMPROVEMENT OF THE NATIONAL PLAN FOR QUALITY INDICATORS - COMPARISON OF 2016 AND 2020 RESULTS]. [制定和完善国家质量指标计划——2016年和2020年结果比较]。
Harefuah Pub Date : 2022-11-01
Yaron Niv
{"title":"[DEVELOPMENT AND IMPROVEMENT OF THE NATIONAL PLAN FOR QUALITY INDICATORS - COMPARISON OF 2016 AND 2020 RESULTS].","authors":"Yaron Niv","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>The National Plan for Quality Indicators of hospitals was established in 2012. The aim of the plan was to improve and advance the quality of medical treatment by measuring, comparison of hospitals and publication of the achievements to the public. Aims: To evaluate and compare the quality indicators between 2016 and 2020, characterize the different types and their contribution to the quality of patient care.</p><p><strong>Methods: </strong>We calculated the proportion of indicators in every category and medical fields. These data were compared between 2016 and 2020 with Chi-squared tests using SAS software. We compared the success of hospitals over this period over 25 indicators shared by them, when details of the numerator and denominator were available.</p><p><strong>Results: </strong>No significant changes were found in the relative portion of cardiology and pediatrics indicators. An increase was demonstrated in obstetrics, neonatology and psychiatry, and a decrease in neurology, geriatrics and surgery. An increase was also found in result indicators, communication and coordination and in public health. The success rate was higher in 2020 with an increase of 26%. In only 2 indicators, measurement of head circumference in neonates and nutritional assessment in chronic ventilated patients, the success rate was lower in 2020, probably due to significant increase in their required aims and the corona pandemic.</p><p><strong>Conclusions: </strong>The success rate of the quality indicators was significantly higher in 2020 in spite of an annual increase in their aims. Continuous refreshment of the national plan and the addition of safety indicators to the national plan will bring improvement in the quality and safety of patient care.</p>","PeriodicalId":12965,"journal":{"name":"Harefuah","volume":"161 11","pages":"682-686"},"PeriodicalIF":0.0,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10800131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[MATERNAL SERUM ANGIOGENIC FACTORS AS AN AIDING TOOL FOR SCREENING WOMEN WITH SUSPECTED PREECLAMPSIA NEAR DELIVERY - INITIAL DATA AND AN ESTIMATED COST-BENEFIT]. [产妇血清血管生成因子作为产前筛查疑似子痫前期妇女的辅助工具-初步数据和估计的成本效益]。
Harefuah Pub Date : 2022-11-01
Uriel Katz, Ron Maymon, Anna Tsviban, Adi Sharabi-Nov, Ramzia Abu Hamid, Hamutal Meiri, Yifat Wiener
{"title":"[MATERNAL SERUM ANGIOGENIC FACTORS AS AN AIDING TOOL FOR SCREENING WOMEN WITH SUSPECTED PREECLAMPSIA NEAR DELIVERY - INITIAL DATA AND AN ESTIMATED COST-BENEFIT].","authors":"Uriel Katz,&nbsp;Ron Maymon,&nbsp;Anna Tsviban,&nbsp;Adi Sharabi-Nov,&nbsp;Ramzia Abu Hamid,&nbsp;Hamutal Meiri,&nbsp;Yifat Wiener","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Preeclampsia (PE) is a major pregnancy complication, posing considerable morbidity and mortality. The maternal serum angiogenic factors - PlGF and sFlt-1, and their ratio appear to be promising markers to predict PE. Aims: To assess whether the evaluation of PlGF and sFlt-1 adds to the clinical workup of women with suspected PE, and to estimate the cost/benefit.</p><p><strong>Methods: </strong>We prospectively enrolled pregnant women with suspected PE who were admitted to the Maternal-Fetal Medicine Unit (MFM) at Shamir Medical Center. Pregnancy and delivery records were collected from their computerized electronic medical records. PlGF<150pg/ml and sFlt-1/PlGF>38 measured prospectively were used to predict PE.</p><p><strong>Results: </strong>Of 105 women included, 28 were in the control group with unrelated complications and none developed PE. Among 66 women with suspected PE, 27(41%) developed the syndrome, with a positive predictive value (PPV) of 90.3% for PlGF<150 pg/ml and 88.9% for sFlt-1/PlGFabove 38. Out of 11 women with suspected intrauterine growth restriction (IUGR), six developed the syndrome, and among them, the negative predictive value (NPV) was ~ 90%.</p><p><strong>Conclusions: </strong>Angiogenic factors are reliable in predicting PE near delivery. Of 8355 annual deliveries, 584 were admitted for suspected PE. The annual test cost was NIS 66,576 (NIS 140 per single test). Cost-saving was NIS 2.18 million, the ratio of cost saved vs. test cost was 32.7.</p><p><strong>Discussion: </strong>The angiogenic factors are efficient and cost-saving in PE prediction near delivery. A larger study is necessary to determine the inclusion of angiogenic factors in the workup for suspected PE.</p>","PeriodicalId":12965,"journal":{"name":"Harefuah","volume":"161 11","pages":"673-681"},"PeriodicalIF":0.0,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10800132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[DE QUERVAIN'S TENOSYNOVITIS - CLINICAL PRESENTATION AND TREATMENT]. [de quervain氏腱鞘炎-临床表现及治疗]。
Harefuah Pub Date : 2022-11-01
Tomer Keidan, Shadi Saleh, Shani Svorai Band, Gil Gannot, Amir Oron
{"title":"[DE QUERVAIN'S TENOSYNOVITIS - CLINICAL PRESENTATION AND TREATMENT].","authors":"Tomer Keidan,&nbsp;Shadi Saleh,&nbsp;Shani Svorai Band,&nbsp;Gil Gannot,&nbsp;Amir Oron","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>De-Quervain tenosynovitis, named after the Swiss surgeon Fritz De Quervain, is a condition characterized by pain and tenderness over the first extensor compartment of the wrist. This compartment contains the extensor pollicis brevis (EPB) and abductor pollicis longus (APL) tendons in their individual retinacular sheath. Non-inflammatory thickening of the tendinous sheath leads to entrapment of the individual tendons and increased friction. The condition is more common in women, particularly aged 30-50 years old and those 4-6 weeks in their post-partum period. It can be associated with trauma or repetitive motion but is typically of unknown etiology. While most cases are self-limiting, treatment is often required and comprises of non-operative treatment: anti-inflammatory medication, wrist splints and local steroid injection; and operative treatment: surgical release of the 1st dorsal compartment.</p>","PeriodicalId":12965,"journal":{"name":"Harefuah","volume":"161 11","pages":"706-708"},"PeriodicalIF":0.0,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10800137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[SUICIDES DURING PSYCHIATRIC HOSPITALIZATION - CHARACTERISTICS AND WAYS OF COPING]. [精神病住院期间的自杀-特征和应对方法]。
Harefuah Pub Date : 2022-11-01
Gad Lubin, Vladislav Fainstein, Liat Keysar Gersht
{"title":"[SUICIDES DURING PSYCHIATRIC HOSPITALIZATION - CHARACTERISTICS AND WAYS OF COPING].","authors":"Gad Lubin,&nbsp;Vladislav Fainstein,&nbsp;Liat Keysar Gersht","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>It is known as a circumstantial background to suicide that patients with psychiatric disorders admitted to a psychiatric hospital are at risk of suicide. Most of the reasons offered for suicide during hospitalization link them to the circumstances of the need for psychiatric hospitalization: the existence of a significant mental disorder and the condition of a crisis, that in many cases, cover a complete life span: psychological, social and medical. In Israel, the multi-year average number (1990-2013) of suicides during psychiatric hospitalization is about 13.6, which account for 3.4% of the total of 400 suicide incidents per year. It reflects one suicide incident in 1,614 hospitalizations. Hanging and then jumping are the most common suicide methods during hospitalization. Other common measures are self-suffocation, overdose of drugs, self-ignition, vein / arterial cutting. The highest risk group is of schizophrenic patients that express one of the following manifestations: depressive symptoms, suicidal attempts in the past, and a history of many hospitalizations. The most prominent risk factors identified among all patients are a history of self-harming attempts, feelings of hopelessness, guilt, sense of inadequacy, low mood, suicidal thinking, and a history of suicide in the family. The response of the psychiatrists and the treatment teams to a suicide event in their unit is traumatic, at a level that significantly affects future therapeutic decisions, decreases morale in the team, and even affects the quality of their personal lives. The two most important tools for preventing suicide during hospitalization are: firstly, reducing the availability of measures in the context of the hospitalization medium, ie, creating a physically safe environment that includes appropriate design of walls, ceilings, doors, toilets and showers. A second tool is the therapeutic relationship and its level of availability.</p>","PeriodicalId":12965,"journal":{"name":"Harefuah","volume":"161 11","pages":"695-700"},"PeriodicalIF":0.0,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10800134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[MEDIAN NERVE COMPRESSION BY LIPOMA CAN MIMIC CARPAL TUNNEL SYNDROME]. [脂肪瘤压迫正中神经可引起腕管综合征]。
Harefuah Pub Date : 2022-11-01
Ayman Khoury, Gil Gannot, Amir Oron
{"title":"[MEDIAN NERVE COMPRESSION BY LIPOMA CAN MIMIC CARPAL TUNNEL SYNDROME].","authors":"Ayman Khoury,&nbsp;Gil Gannot,&nbsp;Amir Oron","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Lipoma of the nerve is an uncommon tumor, and usually has the highest incidence in the upper limb, especially in the median nerve. When the lesion is large it can cause peripheral neuropathy such as carpal tunnel syndrome. Therefore, a physical examination is paramount for correct surgery and patient preparation. In this article we present a case that was mainly diagnosed by a complete physical examination, which led to the selection of appropriate surgery for the patient.</p>","PeriodicalId":12965,"journal":{"name":"Harefuah","volume":"161 11","pages":"668-669"},"PeriodicalIF":0.0,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10800133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[A CASE OF MALARIA IN A CHILD RETURNING FROM ETHIOPIA]. [一个从埃塞俄比亚回来的儿童患疟疾的病例]。
Harefuah Pub Date : 2022-11-01
Mai Shiber, Nadav Shalev, Uri Rubinstein, Nechama Sharon
{"title":"[A CASE OF MALARIA IN A CHILD RETURNING FROM ETHIOPIA].","authors":"Mai Shiber,&nbsp;Nadav Shalev,&nbsp;Uri Rubinstein,&nbsp;Nechama Sharon","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Malaria is an infectious disease caused by the Plasmodium protozoa and transmitted by the female Anopheles mosquitos. Delayed diagnosis or treatment could evolve to life threatening complications and mortality that typically occur in children or travelers to endemic areas. In this article, we describe a case of a 6 year old healthy child, who travelled with his family to an endemic area in Ethiopia. A week prior to his hospitalization, the patient developed intermittent fever. The disease, its' risk factors and characteristics are described throughout this article.</p>","PeriodicalId":12965,"journal":{"name":"Harefuah","volume":"161 11","pages":"670-672"},"PeriodicalIF":0.0,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10800136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[MICROSPORIDIUM KERATITIS: A CASE SERIES]. [微孢子虫性角膜炎:一个病例系列]。
Harefuah Pub Date : 2022-11-01
Asaf Shemer, Iliya Simantov, Adi Einan Lifshitz, Michael Mimouni, Yoav Nahum
{"title":"[MICROSPORIDIUM KERATITIS: A CASE SERIES].","authors":"Asaf Shemer,&nbsp;Iliya Simantov,&nbsp;Adi Einan Lifshitz,&nbsp;Michael Mimouni,&nbsp;Yoav Nahum","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Microsporidia is a phylum of intracellular parasites that secrete spores and stay in water sources. These parasites can cause infection in humans by invading the digestive system, the urinary system, the muscular system and the eye. Recently, the Israeli Ministry of Health announced that dozens of people in Israel were suspected of being infected with microsporidial keratitis after bathing in the waters of the Kinneret (Sea of Galilee). Here we present a brief overview of this microsporidial keratitis as well as three case presentations.</p>","PeriodicalId":12965,"journal":{"name":"Harefuah","volume":"161 11","pages":"664-667"},"PeriodicalIF":0.0,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10457253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[PRESCRIBING CONTRACEPTIVES TO MINORS WITHOUT PARENTAL CONSENT]. [未经父母同意给未成年人开避孕药]。
Harefuah Pub Date : 2022-11-01
Orly Goldstick, Maya Peled-Raz
{"title":"[PRESCRIBING CONTRACEPTIVES TO MINORS WITHOUT PARENTAL CONSENT].","authors":"Orly Goldstick,&nbsp;Maya Peled-Raz","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>The Israeli Legal Capacity and Guardianship Law, denies minors the right to decide upon medical treatment, and regards medical treatment of minors, including contraception, without parental consent as an infringement of parental autonomy. Yet, adolescent girls occasionally ask doctors to prescribe them contraceptives, while refusing parental involvement. This article reviews the relevant legal situation, examines some comparative legal stances and refers to the ethical aspects that should be considered during contraceptive advice to minors, in light of the United Nations Convention on the Rights of the Child. Seeking contraception is an example of mature behaviour, and when a minor asks for contraception, the physician has to act in her best interests. In the decision to prescribe contraceptives without parental consent or even knowledge, doctors should consider the girl's ability to understand their advice, the risks associated with lack of parental involvement, the significance of parental autonomy infringement, the risks to the girl if the parents will be informed contrary to her request, and the girl's risks of unintended pregnancy, associated with not using contraception. In this article we suggest means and modes of action in a situation when an adolescent needs contraception and denies any parental involvement.</p>","PeriodicalId":12965,"journal":{"name":"Harefuah","volume":"161 11","pages":"709-713"},"PeriodicalIF":0.0,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10509823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[FROM OPTIC NERVE EDEMA TO POLYSOMNOGRAPHY - ANOTHER WAY TO DIAGNOSE OBSTRUCTIVE SLEEP APNEA]. [从视神经水肿到多导睡眠图——另一种诊断阻塞性睡眠呼吸暂停的方法]。
Harefuah Pub Date : 2022-10-01
Shahar Luski, Elchanan Parnasa, Josh M Kruger
{"title":"[FROM OPTIC NERVE EDEMA TO POLYSOMNOGRAPHY - ANOTHER WAY TO DIAGNOSE OBSTRUCTIVE SLEEP APNEA].","authors":"Shahar Luski,&nbsp;Elchanan Parnasa,&nbsp;Josh M Kruger","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Some systemic diseases have ophthalmic manifestations. Findings on examination of the fundus can assist in the diagnosis and treatment of these diseases. In this manuscript, we present two ophthalmic conditions that cause optic disc edema and are highly associated with obstructive sleep apnea (OSA). The conditions are non-arteritic anterior ischemic optic neuropathy (NAION), and Papilledema associated with the Pickwickian syndrome. When these conditions are suspected, the patient should be referred for a polysomnography examination.</p>","PeriodicalId":12965,"journal":{"name":"Harefuah","volume":"161 10","pages":"642-644"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40436576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[OCULAR MANIFESTATIONS IN SYSTEMIC DISEASES]. [全身性疾病的眼部表现]。
Harefuah Pub Date : 2022-10-01
Radgonde Amer, Haneen Jabaly-Habib
{"title":"[OCULAR MANIFESTATIONS IN SYSTEMIC DISEASES].","authors":"Radgonde Amer,&nbsp;Haneen Jabaly-Habib","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Uveitis and neuro-ophthalmic manifestations may indicate an underlying systemic and/or neurologic condition. A systematic approach to patients in the form of comprehensive anamnesis and thorough ocular and physical examination helps to reveal an undiagnosed condition or an evolving illness. Prompt diagnosis is of utmost importance in such cases because of potential sight-threatening and life-threatening nature of such conditions. Both subspecialties of neuro-ophthalmology and uveitis require, in many instances, a multidisciplinary approach, as emphasized in this special issue.</p>","PeriodicalId":12965,"journal":{"name":"Harefuah","volume":"161 10","pages":"599-602"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40673454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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