Isr Med Assoc J
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Comment Letter
Pregnancy-associated breast cancer and the Nuremberg Code.
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Clinicians' impression of adolescents' alcohol or drug involvement may underestimate substance-related pathology. ⋯ The likelihood of substance abuse is higher in patients presenting with a low level of consciousness, Physicians may accurately assess the likelihood of substance abuse in these patients.
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Manganism is a central nervous system disorder caused by toxic exposure to manganese. Manganism has been related to occupational exposures, liver diseases, prolonged parenteral nutrition, and abuse of illicit drugs. Initially manifested by a reversible neuropsychiatric syndrome (locura manganica), the main symptoms and signs of manganism are emotional lability, compulsive behavior and visual hallucinations. Locura manganica is followed by an irreversible extrapyramidal syndrome, the onset of which occurs years after chronic exposure. ⋯ Prominent Mn depositions, evidenced by T1-weighted hyperintensities in the hippocampus after subacute exposure to Mn, are compatible with the clinical picture of manganism during its early stages, and may explain its pathophysiology.
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The prevalence of chronic pain in the general population ranges from 10% to over 40%, depending on the definition and the population studied. No large study has been conducted in Israel. ⋯ We found a high prevalence of chronic pain in the study population. Chronic pain causes severe disturbance to quality of life. A low rate of referral to pain specialists and complementary medicine was observed.
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Comparative Study
Demographic and clinical parameters of patients with high risk behavior in a general hospital: the use of constant observation.
General hospital staff are often required to care for physically ill patients who arouse concern regarding risk of harm to themselves or others. Some of these patients,will be placed under one-to-one "constant observation." This is the first Israeli study of general hospital patients with high risk behavior. ⋯ Some of our results (predictive factors for constant observation) confirmed the findings of overseas studies. Our finding that a diagnosis of organic brain syndrome was not a predictive factor for constant observation was unexpected and requires further investigation. The correlation between a diagnosis of ischemic heart disease or COPD and duration of observation has not been reported previously and warrants further studies.