Reliability of blood tests taken from the peripheral intravenous catheter.

We aimed to compare the reliability of laboratory blood tests using 2 sampling methods, via a peripheral venous catheter (PVC) vs direct venipuncture stab (DVS), we evaluated the effect of time elapsed since PVC insertion, PVC diameter, and administration of saline and/or antibiotic infusion through PVC on the blood test results. A prospective comparative study was conducted between May 2018 and July 2019. Patients aged ≥ 18 years and admitted to our department with a 20G/22G PVC inserted within the last 24 hours were enrolled.

Carbapenem-resistant Acinetobacter baumannii: Colonization, Infection and Current Treatment Options.

Carbapenem-resistant Acinetobacter baumannii (CRAB) causes colonization and infection predominantly in hospitalized patients. Distinction between the two is a challenge. When CRAB is isolated from a non-sterile site (soft tissue, respiratory samples, etc.

Nonhepatic hyperammonemic encephalopathy complications following bariatric surgery: a case report and review of the literature.

Background: Hyperammonemic encephalopathy, a rare but fatal condition, is increasingly being reported as a possible complication of bariatric surgery. Here, we present a case of hyperammonemic encephalopathy, focusing on the clinical presentation, diagnostic measures, and our treatment methods, which resulted in a rare favorable outcome, emphasizing the unique role of renal replacement treatment. We also provide a detailed discussion of the mechanism through which hyperammonemia occurs secondarily to bariatric surgery.

Delirium in Internal Medicine Departments in a Tertiary Hospital in Israel: Occurrence, Detection Rates, Risk Factors, and Outcomes.

The aim of the study was to assess the occurrence rate of delirium among elderly hospitalized patients in the medicine wards of a large tertiary hospital, to identify risk factors, and to evaluate the diagnostic rate for delirium among the medical teams. A 3-month prospective study of patients 65 years of age and above in three medicine wards: in two wards patients were examined by trained study team members using the Confusion Assessment Method (CAM), while the third was a control ward where CAM was not administered. The third ward served to control for the effect of the presence of investigators in the other wards as a potential confounding factor.

Recurrent diabetic ketoacidosis.

Objective: The purpose of this study is to examine risk factors for recurrence of diabetic ketoacidosis and determine interventions to prevent future admissions.

Materials And Methods: Review article.

Results: Recurrent diabetic ketoacidosis is a serious and not uncommon health problem.

Clinical, Epidemiological, and Etiological Changes in Erythema Nodosum.

Background: Erythema nodosum (EN) is the most common type of panniculitis, commonly secondary to infectious diseases.

Objectives: To elucidate the causative factors and the clinical presentation of patients with EN (2004-2014) and to compare their data to those reported in a previous study.

Methods: A retrospective study was conducted of all patients diagnosed with EN who were hospitalized at Soroka University Medical Center (2004-2014).

Comparison of Clinical Characteristics and Prognosis in Patients with Right- and Left-sided Infective Endocarditis.

Objective: Right-sided endocarditis (RSE) accounts for 5%-10% of all cases of infective endocarditis (IE) and frequently has different etiological, pathogenetic, and clinical presentations compared with left-sided endocarditis (LSE). The aims of this study were to evaluate the epidemiologic and clinical characteristics and prognosis of RSE patients and to compare them with those of LSE patients. This study's importance relates to the local understanding of RSE and LSE, since Israeli demographics are different compared to the Unites States and Europe with regard to intravenous drug abuse and rheumatic valvular disease prevalence.

Drug-induced eosinophilic pneumonia: A review of 196 case reports.

Background And Objective: Eosinophilic pneumonia (EP) is an important subset of patients who present with pulmonary infiltrates and eosinophilia (PIE). EP is classified by chronicity and etiology and drug-induced EP is the main cause of secondary EP. The primary goal of this review was to examine all the case reports published since the syndrome was defined in 1990.

Effectiveness of Inferior Vena Cava Filters without Anticoagulation Therapy for Prophylaxis of Recurrent Pulmonary Embolism.

Objective: The optimal treatment of deep vein thrombosis (DVT) is anticoagulation therapy. Inferior vena cava filter (IVC) placement is another option for the prevention of pulmonary embolism (PE) in patients with deep vein thrombosis. This is used mostly in patients with a contraindication to anticoagulant therapy.

Anaphylactic reactions in adult patients in Southern Israel.

Background: Southern Israel is inhabited by Jews and Bedouins. Children from these populations differ in the epidemiology of anaphylactic reactions; however, the effects of ethnicity on the epidemiology of anaphylactic reactions in adults in these populations are unknown.

Methods: Retrospective review of medical records of patients with anaphylactic reactions treated in a single institution during 2008-2012.

Headache in the presentation of noncephalic acute illness.

Background: Headache is a frequent symptom of many systemic diseases that do not involve cranial structures. In this observational study, we assessed factors associated with headache in the acute presentation of systemic conditions in a nonsurgical emergency department (ED).

Methods: Consecutive patients, admitted to Soroka University Medical Center ED due to noncephalic illness, were prospectively surveyed using a structured questionnaire focused on the prevalence and characteristics of headache symptoms.

Retrospective study of the incidence of unstable and shock patients presenting to the emergency room.

Background: Over a period of three decades, medical personnel working in our emergency room observed that fewer severe cases presented to the emergency department. The objective of this study is to assess whether a genuine change in the presentation rates of clinically unstable non-trauma patients to the emergency room indeed exists.

Methods: We conducted a retrospective review of patients treated in the shock room.

The role of icatibant-the B2 bradykinin receptor antagonist-in life-threatening laryngeal angioedema in the ED.

Angioedema is a localized, sudden, transient, and often recurrent swelling of the deeper layers of the skin or mucosa with no epidermal component. It is caused by vasoactive substances that produce a transient increase in endothelial permeability. Angioedema involving the laryngeal components is a life-threatening situation for the patient,and it is a challenge for the emergency medicine physician to rapidly achieve a safety airway.

Postexposure prophylaxis of tick-borne relapsing fever: lessons learned from recent outbreaks in Israel.

Tick-borne relapsing fever (TBRF) is endemic in Israel. Military activities pose a particular risk for TBRF, and its prevention is based on heightened awareness and risk stratification by active surveillance of tick bites and selective postexposure prophylaxis (PEP) with doxycycline for tick-bitten individuals. We report three outbreaks of TBRF affecting 35 exposed military personnel, with an average recognized tick bite rate of approximately 50% and an attack rate of 25-50%.

Haiti earthquake 2010: a field hospital pediatric perspective.

On January 12 2010, a 7.0-magnitude earthquake struck Haiti. The region had suffered an estimated 316,000 fatalities with approximately 300,000 injured and more than 1 million people who lost their houses.

QuikClot Combat Gauze use for hemorrhage control in military trauma: January 2009 Israel Defense Force experience in the Gaza Strip--a preliminary report of 14 cases.

Background: Standard gauze field dressings and direct pressure occasionally are inadequate for the control of hemorrhage. QuikClot® Combat Gauze™ (QCG) combines surgical gauze with an inorganic material and is approved by the Food and Drug Administration and by the Israeli Standards Institute for external hemorrhage control. The purpose of this article is to report clinical use of this dressing during Operation Cast Lead in the Gaza strip during January 2009.

Early disaster response in Haiti: the Israeli field hospital experience.

The earthquake that struck Haiti in January 2010 caused an estimated 230,000 deaths and injured approximately 250,000 people. The Israel Defense Forces Medical Corps Field Hospital was fully operational on site only 89 hours after the earthquake struck and was capable of providing sophisticated medical care. During the 10 days the hospital was operational, its staff treated 1111 patients, hospitalized 737 patients, and performed 244 operations on 203 patients.

The role of thromboelastometry and recombinant factor VIIa in trauma.

Purpose Of Review: Recombinant factor VIIa (rFVIIa) and thromboelastography have acquired increasing importance in patients with severe bleeding and coagulopathy. This article reviews the current opinions regarding their use, with the purpose of clarifying the ambiguities that exist in dealing with trauma patients.

Recent Findings: Recent evidence encourages the early use of rFVIIa and thromboelastography in the severe trauma patient with hemorrhagic shock, as a component of the damage control strategy.

Coagulopathic patients with traumatic intracranial bleeding: defining the role of recombinant factor VIIa.

Background: The combination of coagulopathy and intracranial bleeding (ICB) is a well-recognized cause of morbidity and mortality in the neurosurgical patient because of the risk of hematoma expansion. Although recombinant factor VIIa (rFVIIa) has been shown to be useful in intracerebral hemorrhage, its use in other forms of ICB such as subdural hematomas (SDHs) has rarely been described.

Methods: The clinical and laboratory features of a prospectively followed up case-series of 15 patients with traumatic ICB (mainly isolated SDHs) and coagulopathy international normalized ratio (INR) >1.

An outbreak of leptospirosis among Israeli troops near the Jordan River.

An outbreak of leptospirosis that involved 7 of a team of 27 Israeli troops occurred following a military exercise in northern Israel near the Jordan River. The organism implicated in the outbreak was Leptospira interrogans serovar Hardjo. The clinical course was uncomplicated and all patients fully recovered.

Unmasking of carnitine palmitoyltransferase deficiency during an acute exacerbation of asthma complicated by rhabdomyolysis in a soldier.

Rhabdomyolysis is a life-threatening condition that may result from various etiologies. We report a rare case of severe rhabdomyosis in a soldier after a mild acute asthma exacerbation. Further work-up revealed an underlying deficiency of type II carnitine palmitoyltransferase.

Helmet noninvasive ventilation for weaning from mechanical ventilation.

We saw a patient who presented with carbon dioxide narcosis and acute respiratory failure due to an exacerbation of chronic obstructive pulmonary disease. We intubated and 12 hours later he had recovered consciousness and could cooperate with noninvasive ventilation, at which point we extubated and used a helmet to provide noninvasive positive-pressure ventilation in assist/control mode, and then during the ventilator-weaning process, pressure support, and finally continuous positive airway pressure. The patient had no complications from the helmet, and he was discharged from intensive care 48 hours after helmet ventilation was initiated.