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1.
Violence Against Women ; : 10778012211035808, 2021 Oct 19.
Artigo em Inglês | MEDLINE | ID: mdl-34665082

RESUMO

This study examines factors associated with screening of female patients for intimate partner violence (IPV) by orthosurgeons in a sample of 100 Israeli orthosurgeons. Findings reveal positive attitudes toward screening female patients but a significant lack of knowledge. Arab orthosurgeons held slightly more negative attitudes toward screening for IPV and had a more prominent lack of knowledge regarding screening for IPV, compared to their Jewish counterparts. Nationality and feeling uncomfortable asking female patients about IPV predicted screening for IPV. The importance of training orthosurgeons on the assessment and treatment of IPV cannot be overemphasized, especially among Arab orthosurgeons.

2.
Isr Med Assoc J ; 23(8): 479-483, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34392621

RESUMO

BACKGROUND: Little is known regarding the impact of the coronavirus disease-2019 (COVID-19) pandemic on the incidence of hip fractures among older adults. OBJECTIVES: To compare the characteristics of patients with a hip fracture following a fall during the COVID-19 pandemic year and during the preceding year. METHODS: We conducted a retrospective cohort study of older patients who had undergone surgery for hip fracture repair in a major 495-bed hospital located in northern central Israel following a fall. Characteristics of patients who had been hospitalized in 2020 (pandemic year, n=136) and in 2019 (non-pandemic year, n=151) were compared. RESULTS: During the pandemic year, patients were less likely to have fallen in a nursing facility, to have had muscle or balance problems, and to have had a history of falls and fractures following a fall. Moreover, the average length of stay (LOS) in the hospital was shorter; however, the average time from the injury to hospitalization was longer. Patients were less likely to have acquired a postoperative infection or to have died. During the pandemic year, postoperative infection was only associated with prolonged LOS. CONCLUSIONS: The COVID-19 pandemic may have had a positive impact on the behavior of older adults as well as on the management of hip fracture patients. However, healthcare providers should be aware of the possible reluctance to seek care during a pandemic. Moreover, further research on the impact of the change in management during COVID-19 on hip fracture survival is warranted.


Assuntos
Acidentes por Quedas , COVID-19 , Fixação de Fratura , Fraturas do Quadril , Controle de Infecções , Complicações Pós-Operatórias , Acidentes por Quedas/prevenção & controle , Acidentes por Quedas/estatística & dados numéricos , Idoso , COVID-19/epidemiologia , COVID-19/prevenção & controle , Feminino , Fixação de Fratura/métodos , Fixação de Fratura/reabilitação , Fixação de Fratura/estatística & dados numéricos , Fraturas do Quadril/epidemiologia , Fraturas do Quadril/etiologia , Fraturas do Quadril/cirurgia , Humanos , Controle de Infecções/métodos , Controle de Infecções/organização & administração , Israel/epidemiologia , Tempo de Internação/estatística & dados numéricos , Masculino , Avaliação de Processos e Resultados em Cuidados de Saúde , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos , SARS-CoV-2/isolamento & purificação
3.
Int J Orthop Trauma Nurs ; 43: 100868, 2021 May 02.
Artigo em Inglês | MEDLINE | ID: mdl-34438357

RESUMO

BACKGROUND: The causes of falls are heterogeneous and represent an interaction between patient and environmental factors. This study aimed to explore the characteristics of patients who fell in an in-patient orthopedic department and explore possible reasons for their falls. METHODS: A retrospective case-control study of adults in an orthopedic in-patient setting at a major hospital, who sustained a fall. Sociodemographic and medical characteristics of randomly sampled patients who fell (cases, n = 128) and their controls (n = 128) were compared. RESULTS: Fallers were younger, had less comorbidities, took less medications, and had a shorter length of stay than non-fallers. Moreover, fallers' reasons for hospitalization were not necessarily associated with limited mobility. Fall events occurred most frequently from the patient's bed, in the bathroom and during night shifts. CONCLUSIONS: Our study portrays atypical fallers; that is, patients who had no obvious risk factors for falls and, thus, were not expected to fall. It appears that reduction in falls among high-risk patients may artificially create a population of atypical fallers. The patients may overestimate their abilities and avoid asking for assistance. Our findings suggest that emphasizing the importance of asking for assistance among both low-risk and high-risk patients as well as male and female patients should be an integral part of patient education in orthopedic departments.

4.
J Elder Abuse Negl ; 33(3): 221-229, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34096472

RESUMO

Searching for clinical manifestations of elder abuse may help healthcare professionals identify cases of elder abuse. The aim of the present study was to explore characteristics of older patients with fractures that increase the likelihood that the fracture was associated with abuse. This is a retrospective chart review study of 1,000 patients aged 65 and older who presented to an emergency department in northern-central Israel with a fracture during 2019. The chart review included participant characteristics - sociodemographic data, medical data, data regarding the fracture, and data on the presence of forensic markers of elder abuse in individual patients. Descriptive statistics and regression models were used for the analyses. Older age, presence of dementia, and hand and facial fractures were associated with the presence of forensic markers, and were also found to predict having at least one forensic factor. This study provides further support for the creation of clinical guidelines for identification of elder abuse.


Assuntos
Abuso de Idosos , Idoso , Serviço Hospitalar de Emergência , Medicina Legal , Humanos , Estudos Retrospectivos
5.
Harefuah ; 160(6): 358-360, 2021 Jun.
Artigo em Hebraico | MEDLINE | ID: mdl-34160151

RESUMO

INTRODUCTION: Both the direct and anterior approach (DAA) for total hip replacement (THR) surgery have gained much popularity in recent years. The suggested benefits of the muscle-sparing and nerve-sparing approach which could lead to a faster and easier recovery process, have led to an increase in the prevalence of the anterior approach in THR. These potential benefits have drawn the attention of both orthopaedic surgeons as well as patients as a faster return to their active lifestyle. While the potential advantages and benefits of the DAA for THR are obvious, several disadvantages have been highlighted over the years including technical pitfalls, a relatively long and steep learning curve and characteristic associated complications. In addition, while there has been a surge in published research involving the DAA in recent years, significant differences in terms of clinical outcomes in the mid and long term have not been evident. The current editorial explores the increasing popularity and utilization of the DAA in THR procedures and the various factors influencing it.


Assuntos
Artroplastia de Quadril , Antivirais , Humanos
6.
Harefuah ; 158(12): 789-794, 2019 Dec.
Artigo em Hebraico | MEDLINE | ID: mdl-31823532

RESUMO

INTRODUCTION: Nuclear medicine techniques are suggested to be used in equivocal cases only. Nuclear medicine procedures, specifically labeled leucocytes however, are widely used in the diagnosis of joint infection across Europe. The aim of our study was to determine if Indium 111 labeled leukocyte scintigraphy has a role in the diagnosis of infected prosthetic joints. METHODS: In this retrospective cohort study, the records of a total of 146 prosthetic hip or knee revision surgeries, in 116 patients, performed in our Institute between the years 2013-2016 were reviewed. A total of 34 patients with labeled leukocyte scans were analyzed. Ten patients had more than one scan (two to four times). The scintigraphy result reports were correlated with the outcome with respect to intra-/post-operative diagnosis of prosthetic joint infection. RESULTS: The findings of 42 of 44 scintigraphy tests were negative. One study in a patient who had three prior negative labeled white blood cells (WBC) scintigraphies was equivocal. One study was positive, but a later test in the same patient was negative. Of these 34 patients, nine were demonstrated intra- or post operatively as positive for infected prosthetic joint, including the two positive cases above. The remaining 25 patients went through revision surgery with no evidence of infection; 30 of 38 bone scans were positive. Of these 30 patients, seven were demonstrated intra- or post-operatively as positive for infected prosthetic joint. CONCLUSIONS: In our study population indium labeled leukocyte scintigraphy was found to be a non-sensitive test for the diagnosis of a prosthetic joint infection and had a poor negative predictive value. It is expected that following the guidelines more strictly and choosing the appropriate modality for assessing prosthetic joint infection will improve the diagnostic accuracy of these techniques.


Assuntos
Índio , Infecções Relacionadas à Prótese/diagnóstico , Cintilografia , Europa (Continente) , Humanos , Leucócitos , Estudos Retrospectivos , Sensibilidade e Especificidade
7.
Harefuah ; 157(2): 99-103, 2018 Feb.
Artigo em Hebraico | MEDLINE | ID: mdl-29484865

RESUMO

INTRODUCTION: We are now standing four decades after the 'running revolution' which occurred during the 70's of the previous century. Despite the developments that have occurred in medicine and the large budgets invested in the development of the sport's equipment, the runner's morbidity has not changed. In this article, we would like to review the changes in running that occurred throughout the years, as well as the common risk factors for running injuries. Furthermore, we would like to examine the scientific point of view regarding running shoes and running technique as risk factors for running injuries. A new trend, the "minimalist running", characterized by a unique technique and rigid shod might be the "game changer" in diminishing the injury rates in runners. Note, that minimalist running is not yet a common technique and thus, we might encounter a new set of injuries which we still have to evaluate.


Assuntos
Traumatismos em Atletas/etiologia , Corrida , Sapatos , Humanos
8.
Disabil Rehabil ; 40(3): 302-308, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-27866425

RESUMO

PURPOSE: To explore the role of physical status versus mental status in predicting the quality of life (QOL) of patients with lumbar disk herniation (LDH). METHOD: In this correlative study 51 patients with LDH were recruited in their conservative stage of treatment. After profiling their physical status, all participants reported about pain level (according to VAS), pain perception using the Pain Catastrophizing Scale (PCS), and disability level (according to Oswestry Low Back Pain Disability Questionnaire). Their mental status was evaluated using the Spielberger's State-Trait Anxiety Inventory (STAI) and the Beck Depression Inventory (BDI-II). Their QOL was evaluated by the World Health Organization Quality of Life Questionnaire, brief version (WHOQOL-BREF). RESULTS: Physical status/disability level correlated with anxiety and depression. While Physical status predicted physical QOL, mental status, and mainly anxiety and depression were the significant predictors of psychological, social, and environmental QOL. CONCLUSIONS: Mental status may play a significant role in reducing most QOL domains among patients with LDH. The evaluation and intervention process should consider both physical and mental status and their relation to the person's QOL. Since QOL is a major parameter in determining intervention type and success this elaborated perspective may contribute to the intervention planning and outcomes. Implications for rehabilitaion A significant mental distress may accompany the physical disability of patients with LDH. The role of this mental distress in reducing the QOL of patients with LDH may be greater than that of their physical disability. The evaluation and intervention for patients with LDH should refer to both physical and mental status and explore their impacts on quality of life in order to elevate intervention success.


Assuntos
Degeneração do Disco Intervertebral/psicologia , Deslocamento do Disco Intervertebral/psicologia , Qualidade de Vida , Adolescente , Adulto , Idoso , Ansiedade/psicologia , Depressão/psicologia , Avaliação da Deficiência , Feminino , Humanos , Degeneração do Disco Intervertebral/fisiopatologia , Deslocamento do Disco Intervertebral/fisiopatologia , Vértebras Lombares/fisiopatologia , Masculino , Pessoa de Meia-Idade , Escala Visual Analógica , Adulto Jovem
9.
Isr Med Assoc J ; 18(5): 272-4, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-27430082

RESUMO

BACKGROUND: Kite surfing is one of the trendiest water sports worldwide. With its growing popularity evidence has begun to accumulate regarding its potential for injuries which range from minor insults to death. OBJECTIVES: To define the epidemiology and distribution of common kite surfing injuries among recreational athletes. METHODS: An open letter was published on the web calling for surfers to report injuries inflicted during recreational kite surfing. In addition, we received data from the National Center for Trauma and Emergency Medicine Research. RESULTS: Our survey yielded only a small series of 48 injuries. Most kite surfing injuries are isolated injuries, although some are life threatening as occurred in two surfers who died due to severe head injuries. Among the injuries, 72.9% are related to the musculoskeletal system, followed by head and chest injuries (18.7% and 14.6%, respectively). Of the orthopedic injuries 48.6% are fractures, the majority in the lower limbs (58.8%). CONCLUSIONS: Our findings combined with those of previous articles on kite surfing-associated injuries contribute to a better understanding of such injuries, raise awareness among emergency department personnel, and indicate precautions needed to avoid or lessen incapacitating and potentially life-threatening injuries.


Assuntos
Traumatismos em Atletas , Traumatismos Craniocerebrais , Extremidade Inferior/lesões , Adulto , Traumatismos em Atletas/classificação , Traumatismos em Atletas/epidemiologia , Traumatismos em Atletas/etiologia , Traumatismos Craniocerebrais/etiologia , Traumatismos Craniocerebrais/mortalidade , Feminino , Humanos , Incidência , Israel/epidemiologia , Masculino , Traumatismo Múltiplo/epidemiologia , Traumatismo Múltiplo/etiologia , Esportes , Índices de Gravidade do Trauma
10.
Harefuah ; 153(7): 407-10, 432, 2014 Jul.
Artigo em Hebraico | MEDLINE | ID: mdl-25189032

RESUMO

Low back pain (LBP) is one of the common reasons for people to seek treatment from a physician. A familiar cause of LBP and radicular pain is disc bulge or protrusion. The treatment for this indication is diverse and suited to the type pathology and its severity. The treatment can be conservative ranging from a diversity of minimal invasive surgical methods to an open discectomy. The classification of disc herniation is based on the severity of the bulge, whereby the lowest degree is protrusion/ prolapse, then extrusion and the most severe level is sequestered disc. This classification is important when considering the treatment options. One of the known possible treatments for disc protrusion is Nucleoplasty or disc Coblation. This percutaneous surgical method is used to treat discogenic back pain and radicular pain. This method is based on reducing disc volume by using radio frequency energy. During the last decade, many medical centers worldwide used this procedure. In recent years, this method is rising in popuLarity due to its percutaneous approach, low complication rate, good results at the post surgical stage reflecting improvement in symptoms and facilitating rapid return to normal life. The accepted indications for Nucleoplastia are discogenic radicular pain, contained disc herniation according to an MRI scan with intact annulus fibrosus, insufficient response to conservative treatment and absence of a medical emergency as in the case of Cauda Equina syndrome. Patient selection according to those parameters is very important. Today this surgical method is still controversial. In recent years many studies regarding Nucleoplasty have been published, although more research is necessary in order to evaluate long term results and tailor it to the appropriate patient and pathology.


Assuntos
Deslocamento do Disco Intervertebral/cirurgia , Dor Lombar/etiologia , Vértebras Lombares/cirurgia , Humanos , Deslocamento do Disco Intervertebral/patologia , Vértebras Lombares/patologia , Imageamento por Ressonância Magnética , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Dor/etiologia , Seleção de Pacientes , Índice de Gravidade de Doença
11.
Orthopedics ; 36(2): e241-3, 2013 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-23383625

RESUMO

This article describes a case of severe metallosis in a 67-year-old woman who initially underwent primary total hip arthroplasty with a ceramic-on-ceramic articular bearing. This was subsequently revised to a metal-on-polyethylene articulation due to ceramic liner fracture. She presented with severe hip pain and a pelvic mass. Infective workup was negative. Perforation of the cobalt-chrome femoral head was observed intraoperatively. In addition, signs of extensive metallosis, including embedded ceramic debris from the primary procedure, were observed. To the authors' knowledge, this is the first report of a ceramic fracture that led to cobalt-chrome femoral head perforation after subsequent revision total hip arthroplasty. The patient underwent successful revision surgery with a ceramic-on-ceramic coupling. Ceramic materials are increasingly being used in total hip arthroplasty in younger patients. They have excellent tribological properties. However, they also have a lower elasticity and plasticity, which makes them susceptible to sudden material failure. Ceramic fracture is an uncommon yet problematic complication of total hip arthroplasty. Previous authors have reported the importance of performing thorough synovectomy following ceramic liner fracture. Revision surgery using couplings that have a lower hardness, such as metal-on-polyethylene, are best avoided due to their susceptibility to undergo abrasive wear from remaining ceramic particles. The authors advocate revision with ceramic-on-ceramic couplings after ceramic liner fracture.


Assuntos
Artroplastia de Quadril/efeitos adversos , Prótese de Quadril/efeitos adversos , Osteoartrite do Quadril/cirurgia , Falha de Prótese , Idoso , Materiais Biocompatíveis , Cerâmica , Cromo , Cobalto , Feminino , Humanos , Reoperação , Tomografia Computadorizada por Raios X
12.
Harefuah ; 152(11): 649-53, 688, 2013 Nov.
Artigo em Hebraico | MEDLINE | ID: mdl-24416822

RESUMO

Joint arthroplasty is one of the commonest surgical procedures in orthopedic surgery. In recent years there was an increase in the number of procedures, patient satisfaction and implant survival. Originally, these operations were designed for old patients in order to relieve pain and to enable ambulation. Over the past few years, these operations have become common in younger patients which desire to return to activity, including sports activities. The importance of physical activity is a well known fact. In recent years it became clear that with the proper physical activity the outcomes of the operations are better. There are several types of arthroplasty. Many factors influence the outcome of the operation apart from the post-surgery physical activity. These factors include patient factors, surgical technique and type of arthroplasty. This review summarizes the recommendations for sports activities after hip and knee arthroplasties. These activities are evaluated according to surgeons' recommendations, stress applied on the implant and long term outcomes. The recommended sports activities after joint arthroplasties are walking, swimming and cycling. Soccer, basketball and jogging are not advised. Tennis, downhill skiing and horse riding are recommended with previous experience. There are many more sports activities that patients can participate in, and it is important that the patient discuss the different options prior to the operation. Since these operations are so common, many non-orthopedic physicians encounter these patients in their practice. They should be acquainted with the recommendations for sports activities and encourage them.


Assuntos
Artroplastia de Quadril/reabilitação , Artroplastia do Joelho/reabilitação , Esportes/fisiologia , Fatores Etários , Artroplastia de Quadril/métodos , Artroplastia do Joelho/métodos , Exercício Físico/fisiologia , Humanos , Período Pós-Operatório , Fatores de Tempo
13.
Harefuah ; 149(11): 726-8, 748, 2010 Nov.
Artigo em Hebraico | MEDLINE | ID: mdl-21250415

RESUMO

Cycling is currently one of the most popular recreational activities. Hence, there are increases in the numbers of injuries resulting from cycling. Most of the injuries are to the knee and are of non-contact nature and therefore, preventable. The majority of pain syndromes are non-traumatic and caused by overuse, inadequate preparation, inappropriate equipment, poor technique and lack of training. The treatment of non-traumatic knee injuries is regularly conservative, including: rest, ice, NSAID's training programs modification and adequate equipment. Delayed treatment can cause chronic injuries.


Assuntos
Ciclismo/lesões , Traumatismos do Joelho/etiologia , Anti-Inflamatórios não Esteroides/uso terapêutico , Ciclismo/educação , Desenho de Equipamento , Humanos , Gelo , Traumatismos do Joelho/epidemiologia , Traumatismos do Joelho/terapia , Descanso
14.
Arch Oral Biol ; 52(1): 36-43, 2007 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-17092480

RESUMO

OBJECTIVE: It has been suggested that oxidative stress plays a role in the pathogenesis of chronic obstructive pulmonary disease (COPD), though this role has yet to be fully elucidated. The purpose of this study was to further evaluate this role as concomitantly expressed in the saliva and broncho-alveolar lavage (BAL/'lavage'). DESIGN: Forty consenting patients (mean age 62+/-13-year-old), with/without COPD and/or smoking habit, participated in the study. The following antioxidant profile was examined both in saliva and lavage of the patients: total antioxidant status (TAS), uric acid (UA), peroxidase and super oxide dismutase (SOD). Total protein (TP) and albumin (Alb) were also evaluated in both saliva and lavage while amylase was measured only in saliva. RESULTS: Increase of TAS (by 100%) and of SOD activity levels (by 60%) in the lavage of COPD patients indicated oxidative stress. The salivary UA in COPD patients was 125% higher (p = 0.05) while the peroxidase was 20% higher. Another novel finding was that levels of salivary antioxidants in smoking versus non-smoking COPD patients were lower by 25-48% (for all four: TAS, UA, peroxidase and SOD) while the albumin was significantly reduced by 60% (p = 0.018). CONCLUSION: Oxidative-stress-related changes demonstrated both in the lavage and saliva of the COPD and/or smoking patient indicate cumulative effects of both, also emphasizing the pathogenetic role of free radicals in COPD. Salivary analysis, which is less invasive and much easier to perform as compared with lavage analysis, is suggested as a new and effective diagnostic tool in COPD patients.


Assuntos
Líquido da Lavagem Broncoalveolar/química , Estresse Oxidativo/fisiologia , Doença Pulmonar Obstrutiva Crônica/metabolismo , Saliva/metabolismo , Adulto , Idoso , Idoso de 80 Anos ou mais , Albuminas/análise , Amilases/análise , Antioxidantes/análise , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Peroxidase/análise , Peroxidase/sangue , Doença Pulmonar Obstrutiva Crônica/etiologia , Saliva/enzimologia , Proteínas e Peptídeos Salivares/análise , Fumar/metabolismo , Superóxido Dismutase/análise , Superóxido Dismutase/sangue , Ácido Úrico/análise , Ácido Úrico/sangue
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