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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.
J Cereb Blood Flow Metab ; 30(3): 516-21, 2010 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-19809468

RESUMO

Different methods are used to assess the vasodilator ability of cerebral blood vessels; however, the exact mechanism of cerebral vasodilation, induced by different stimuli, is not entirely known. Our aim was to investigate whether the potent vasodilator agent, acetazolamide (AZ), inhibits the neurovascular coupling, which also requires vasodilation. Therefore, visually evoked flow parameters were examined by transcranial Doppler in ten healthy subjects before and after AZ administration. Pulsatility index and peak systolic flow velocity changes, evoked by visual stimulus, were recorded in the posterior cerebral arteries before and after intravenous administration of 15 mg/kg AZ. Repeated-measures ANOVA did not show significant group main effect between the visually evoked relative flow velocity time courses before and after AZ provocation (P=0.43). Visual stimulation induced significant increase of relative flow velocity and decrease of pulsatility index not only before but also at the maximal effect of AZ. These results suggest that maximal cerebral vasodilation cannot be determined by the clinically accepted dose of AZ (15 mg/kg) and prove that neurovascular coupling remains preserved despite AZ-induced vasodilation. Our observation indicates independent regulation of vasodilation during neurovascular coupling, allowing the adaptation of cerebral blood flow according to neuronal activity even if other processes require significant vasodilation.


Assuntos
Acetazolamida/farmacologia , Circulação Cerebrovascular/efeitos dos fármacos , Circulação Cerebrovascular/fisiologia , Estimulação Luminosa , Vasodilatação/efeitos dos fármacos , Vasodilatadores/farmacologia , Adulto , Pressão Sanguínea/efeitos dos fármacos , Frequência Cardíaca/efeitos dos fármacos , Humanos , Masculino , Pessoa de Meia-Idade , Leitura , Ultrassonografia Doppler Transcraniana , Adulto Jovem
6.
J Vasc Res ; 47(3): 214-20, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-19893318

RESUMO

BACKGROUND/AIMS: In our previous study, impaired visually evoked flow velocity response was demonstrated in young chronic smokers. Our aim was to study whether impaired cerebrovascular reactivity is reversible 6-18 months after smoking cessation. METHODS: Flow velocity changes, evoked by visual stimulus, were recorded in the posterior cerebral arteries in 15 smokers, 15 former smokers and 15 nonsmokers. The stimulation protocol consisted of 10 cycles with a resting phase of 20 s (baseline) and a stimulating phase of 40 s for each cycle. Relative changes of flow velocity were expressed in relation to baseline. Breath holding index, visual evoked potential and intima-media thickness were also examined. RESULTS: Repeated measures ANOVA revealed marked difference in the flow velocity time courses between the 3 groups (p < 0.01). The flow response was significantly worse in former smokers than in nonsmokers (p < 0.002), however, no significant difference was found between former and current smokers (p = 0.0556). CONCLUSION: This is the first transcranial Doppler study demonstrating long-term impairment of visually evoked cerebrovascular response after smoking cessation. These findings indicate that the impairment of neurovascular coupling caused by smoking is due to structural changes of the vessels, rather than acute effect of smoking.


Assuntos
Circulação Cerebrovascular , Estimulação Luminosa , Artéria Cerebral Posterior/fisiopatologia , Abandono do Hábito de Fumar , Fumar/efeitos adversos , Vias Visuais/fisiopatologia , Adulto , Velocidade do Fluxo Sanguíneo , Artéria Carótida Primitiva/diagnóstico por imagem , Potenciais Evocados Visuais , Feminino , Humanos , Masculino , Artéria Cerebral Posterior/diagnóstico por imagem , Artéria Cerebral Posterior/inervação , Recuperação de Função Fisiológica , Mecânica Respiratória , Fatores de Tempo , Ultrassonografia Doppler Transcraniana , Vasodilatação , Adulto Jovem
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