Oropharyngeal injuries in children.

Background: Oral cavity and oropharyngeal injuries are common among pediatric patients seen in emergency rooms for head and neck trauma. The appropriate treatment of such injuries is often controversial.

Patients And Methods: Audit of 6 months' admissions to the pediatric emergency room in a secondary care referral center.

Foreign bodies in the esophagus.

Background: One third of foreign bodies retained in the gastrointestinal tract are present in the esophagus. Their management depends on the anatomic location, shape and size of the foreign body, and duration of impaction.

Methods: Between 1971 and 2001, 32 patients with foreign bodies in the esophagus were admitted to our service in the Wolfson Medical Center.

The patient with recurrent (sub) obstruction due to Crohn's disease.

Stricturing Crohn's disease (CD) occurs in 12-54% of the CD patient population and is associated with significant morbidity and impaired quality of life. The detailed pathophysiology of stricture formation has not been fully elucidated, but is primarily associated with luminal narrowing secondary to inflammation and the fibrosis that ensues during mucosal healing. The diagnosis of stricturing disease is based on clinical signs and symptoms along with imaging modalities.

Rhabdomyolysis: another complication after prolonged surgery.

We present the case of a young patient who underwent a prolonged urological procedure in the lateral decubitus position. The patient's postoperative course was complicated by rhabdomyolysis manifested by elevated levels of serum creatine phosphokinase and the presence of myoglobin in urine and blood. To prevent renal failure, we managed the patient in the intensive care unit with generous volumes of intravenous fluids, forced diuresis, and urine alkalization.

Expanding use of ureteral access sheath for stones larger than access sheath's internal diameter.

The internal diameter of the ureteral access sheath limits the size of stones that can be removed during flexible ureteroscopy. We describe a technique that allows removal of larger stones, which are entrapped and removed en bloc with the access sheath. This new technique was shown to be efficient and safe.

Hemorrhagic corpus luteum is associated with ovarian edema.

Background: Most cases of ovarian edema are thought to result from intermittent ovarian/adnexal torsion. This study describes how, in some cases, this etiology was ruled out even though the edema was unexplained.

Study Objective: To evaluate the association between ovarian edema and hemorrhagic corpus luteum.

Depression in infancy.

The evolution of the concept of depression in infancy (0-3 years) is relatively new and follows a path similar to the history of depression in adolescence, then in childhood, and in preschool years. It started with Spitz observation of a depressive clinical syndrome, named anaclitic depression, followed by Bowlby's description of three phases in the development of infants who have been separated from their caregiver. Kreisler linked life-threatening feeding disorders with depression in infancy.

Modified endoscopic swallowing test for improved diagnosis and prevention of aspiration.

Laryngopharyngeal sensation is important in the normal process of swallowing, it is often impaired after neurological events and it has been common practice in such an occurrence to order non-oral tube feeding to prevent aspiration. This study assesses a novel approach to the evaluation of the laryngopharyngeal sensation that allows for improved triage of aspiration risk and more lenience towards oral feeding. This is a case series with follow-up period ranging from 6 to 24 months.

Anaphylaxis to omeprazole: diagnosis and desensitization protocol.

Background: Omeprazole is an inhibitor of the parietal cell enzyme H+/K+ adenosine triphosphatase. Immediate-type hypersensitivity reactions, such as urticaria, angioedema, and hypotension, induced by omeprazole and other proton pump inhibitors are rare.

Objectives: To confirm the immediate-type mechanism of recurrent anaphylactic reactions to the repeated administration of omeprazole using skin testing and to enable safe administration of the drug after successful oral desensitization.

Resting anal pressure following hemorrhoidectomy and lateral sphincterotomy.

Purpose: The role of high anal pressure in the pathophysiology of hemorrhoids and anal fissures is debated. We compared resting anal pressures following left lateral sphincterotomy and hemorrhoidectomy in a prospective manometric study with emphasis on the recovery of the internal anal sphincter activity.

Methods: Included in the study were 38 patients with third-degree or fourth-degree symptomatic hemorrhoids who underwent hemorrhoidectomy, 50 patients with anal fissure who underwent sphincterotomy, and 12 healthy patients who served as controls.

The feasibility of sharing simulation-based evaluation scenarios in anesthesiology.

Unlabelled: We prospectively assessed the feasibility of international sharing of simulation-based evaluation tools despite differences in language, education, and anesthesia practice, in an Israeli study, using validated scenarios from a multi-institutional United States (US) study. Thirty-one Israeli junior anesthesia residents performed four simulation scenarios. Training sessions were videotaped and performance was assessed using two validated scoring systems (Long and Short Forms) by two independent raters.

The effect of mianserin add-on, on the intensity of opioid withdrawal symptoms during detoxification program--a randomized, double blind, placebo controlled, prospective study.

Background: Based on pre-clinical studies regarding the interaction of various antidepressant drugs with the opioid system, we designed a clinical study to be carried out in the 'in-patient detoxification unit' within a large community centre for treatment of drugs dependent people. We evaluated the effect of mianserin add-on, on the intensity of opioid withdrawal symptoms in opiate dependent subjects undergoing medication-supported physical detoxification and integrated psychosocial and psychotherapeutic intervention for the treatment of dependence.

Methods: Mianserin (or placebo) was added to the routine medication protocol, during the 3-week in-patient phase of detoxification in a prospective, randomized, double blind, placebo controlled study.

The effects of an external nasal dilator on labor.

Background: The aim of this study was to assess the effect of an external nasal dilator on several variables characterizing labor in both mother and fetus.

Methods: One hundred and fifty primigravida women in active labor were randomized to wear, throughout labor, either a dilator spring-loaded nasal strip or a placebo device. Data were obtained during labor and compared between the groups.

Oxidative stress, induced by 6-hydroxydopamine, reduces proteasome activities in PC12 cells: implications for the pathogenesis of Parkinson's disease.

Mutations in familial Parkinson's disease (PD) have been associated with the failure of protein degradation through the ubiquitin-proteasome system (UPS). Impairment of proteasome function has also been suggested to play a role in the pathogenesis of sporadic PD. We examined the proteasome activity in PC12 cells treated with 6-hydroxydopamine (6-OHDA), the dopamine synthetic derivate used in models of PD.

Nasal teeth associated with rhinosinusitis.

Intranasal ectopic dentition is a rare clinical entity. It may be asymptomatic or can be associated with different symptoms. In 25% of the reported cases an association with rhinosinisitis is suspected.

Spontaneous mediastinal emphysema.

Objective: Spontaneous mediastinal emphysema is uncommon. Its cause has not been determined precisely, but the entity is usually associated with suddenly raised alveolar pressure.

Methods: Between 1980 and 2001, 114 patients with mediastinal emphysema of various causes were hospitalized in the Wolfson Medical Center.

Quality of life following parotidectomy for malignant and benign disease.

Parotidectomy is performed for benign or malignant tumors and for selected benign inflammatory and autoimmune conditions. Possible associated complications include facial nerve paralysis, pain, loss of sensation, gustatory sweating, and facial scarring. Global quality of life in patients undergoing parotidectomy has not been reported.

Resolved abdominal aortic aneurysms following stent graft treatment: a report of five cases.

Complete aneurysm resolution is the hallmark of successful endoluminal stent-graft treatment. We describe 5 patients in whom an abdominal aortic aneurysm (AAA) disappeared completely at mid-term follow-up after endovascular stent-graft placement. We reviewed 45 patients (43 men and 2 women) who underwent AAA repair using an endovascular technique, from April 1997 to December 2001.

Nasal teeth associated with rhinosinusitis.

Intranasal ectopic dentition is a rare clinical entity. It may be asymptomatic or can be associated with different symptoms. In 25% of the reported cases an association with rhinosinusitis is suspected.

Radiotherapy for spinal cord compression in patients with soft-tissue sarcoma.

Purpose: Spinal metastases of soft-tissue sarcoma (STS) occur rarely and pose a therapeutic problem. Although wide resection is warranted for best local control, it is rarely feasible. A radiotherapy (RT) dose of 70 Gy is usually needed to treat limb STS, but only 45 Gy can be given to the spine.

Lung cancer in patients with HIV infection: is it AIDS-related?

HIV-infected individuals have an increased risk of malignancy, especially non-Hodgkin's lymphoma and Kaposi's sarcoma. Recently, several workers have noted a raised prevalence of lung cancer in HIV-positive subjects. We describe the diagnosis and clinical course for four HIV-seropositive patients who presented with lung cancer.

The antinociceptive effect of amisulpride in mice is mediated through opioid mechanisms.

Antinociceptive effects of various neuroleptics in animal acute pain-models have been described, mediated trough different pathways including the opioid system. In this study, we assessed the antinociceptive effects of the atypical neuroleptic drug amisulpride, which acts as a selective blocker of dopamine D2 and D3 receptors. Furthermore, at low doses amisulpride has a selective preference for presynaptic dopamine autoreceptors, while at high doses it manifests a preferential action at post-synaptic dopamine receptors.

Suppressive effect of aspirin on aberrant crypt foci in patients with colorectal cancer.

Background: and aims: Aspirin and other non-steroidal anti-inflammatory drugs have been shown to reduce the risk of colorectal cancer (CRC). Animal models have shown that aspirin is also effective in reducing the density of aberrant crypt foci (ACF). The aim of the study was to evaluate the effect of chronic administration of aspirin on the distribution pattern and histological characteristics of ACF in patients with CRC.

Papillary adenocarcinoma in a thymic cyst: a pitfall of thoracoscopic excision.

Carcinoma arising in a thymic cyst is very rare. We performed thoracoscopic subtotal resection of an assumed benign cyst. The patient had a reoperation when the diagnosis of papillary adenocarcinoma was established.

Exposure to terrorism, stress-related mental health symptoms, and coping behaviors among a nationally representative sample in Israel.

Context: The terrorist attacks on Israeli society have been ongoing since September 2000. However, few studies have examined the impact of terrorism on nationally representative population samples, and no study has examined the psychological impact of ongoing terrorism in Israel.

Objectives: To determine the level of exposure to terrorist attacks and the prevalence of traumatic stress-related (TSR) symptoms, symptoms of posttraumatic stress disorder (PTSD), and sense of safety after 19 months of terrorism in Israel, and to identify correlates of the psychological sequelae and the modes of coping with the terrorism.