Harefuah
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Various methods exist for rewarming hypothermia casualties. Most of these methods necessitate sophisticated medical equipment or vigorous hemodynamic and electrolytic monitoring. Therefore, only a few methods remain suitable for pre-hospital scenarios. ⋯ In moderate or severe hypothermia casualties, hypothermia (rectal temperature below 32 degrees C) however, is characterized by suppressed or deficient endogenous heat producing mechanisms. Passive rewarming is not enough in these cases, necessitating the addition of active, central or peripheral rewarming methods. Studies regarding the use of various active rewarming methods in severe hypothermia casualties revealed low rewarming efficacy for the low heat capacity methods, such as warm air inhalation, and a high rewarming efficacy for the high heat capacity methods, such as forced air methods.
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A 9 month old girl at the emergency room appeared with an acute onset of restlessness, drooling and suspected foreign body ingestion. An X-Ray revealed an open safety pin in the child's upper aero-digestive tract. ⋯ Open safety pins in the aero-digestive tract are difficult to manage and great care must be taken during removal to prevent further injury. Parents should be counseled regarding the presence of safety pins in the child's surroundings in order to prevent such hazards.
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Intussusception is a relatively common pediatric emergency. The accepted treatment is closed reduction using barium or air enema and surgery when it has failed. We present our 13-year experience using air enema for treatment of intussusception, emphasizing the reduction with repeated delayed air enema. ⋯ Air enema is an efficient and safe diagnostic and therapeutic tool for intussusception in the pediatric population.
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Since time immemorial the attitude toward the dying patient has been one of the most difficult issues in medical ethics. The diversity of philosophical, religious, social and legal approaches does not enable one to reach a universal consensus to solve the many problems involved in end-of-life decisions. Within the health care system in Israel there is currently no consensual practice concerning the dying patient. ⋯ It establishes a clear position on euthanasia, physician-assisted suicide, withdrawing treatment and withholding treatment. It establishes a hierarchy of decision-making agents, and it validates advanced medical directives. It also promotes a legally-binding requirement of modern palliative care.
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Sexual dysfunction is characterized by disturbances in sexual desire and/or psycho-physiological changes associated with the sexual response cycle in men and women. Studies suggest that it is prevalent in 10-52% of women and 25-63% of men, and could have a tremendous impact on the individual, interpersonal relations, and on the family quality of life. ⋯ Family physicians consider themselves to be the main address for the patient for sexual dysfunction problems. Physicians believe they need more training to overcome lack of knowledge barriers and they need to organize their time to adequately address their patients sexual dysfunction problems.