Soroka Medical Center Research Articles

Ataxia with Vitamin E Deficiency

Vitamin E adminstration (100 U/kg daily) resulted in improvements in ataxia, motor strength, and mobility in 2 siblings of a consanguineous Bedouin family with Friedreich ataxia and low serum vitamin E levels treated at Soroka Medical Center, Beer Sheva, Israel.

Uterine sarcoma in the south of Israel: study of 36 cases.

Uterine sarcomas are rare, charaterized by rapid clinical progression and poor prognosis, and their management has been a challenge. The purpose of this study was to investigate the clinical and histologic findings, treatment, and outcome of patients with uterine sarcoma in the south of Israel. Data from the files of 36 patients with uterine sarcoma who were managed at the Soroka Medical Center between January 1961 and December 1994 were evaluated. The 5-year survival rate was 32% overall; 63% for 9 patients with endometrial stromal sarcoma (ESS). 30% for 14 patients with mixed mesodermal sarcoma (MMS) and 18% for 13 patients with leiomyosarcoma (LMS): 41% for 22 patients with Stage I and 19% for 14 patients with Stages II, III, and IV. Only the difference in the 5-year survival rate between ESS and LMS was statistically significant (P < 0.05). Eleven patients (30.6%) were treated with surgery alone, 4 (11.1%) with surgery followed by pelvic radiotherapy, 11 (30.6%) with surgery followed by chemotherapy, 8 (22.2%) with surgery followed by pelvic radiotherapy and chemotherapy, one (2.8%) with chemotherapy alone, and one (2.8%) had no treatment. Uterine sarcomas are aggressive tumors with a poor prognosis. The treatment is surgery generally followed by adjuvant pelvic radiotherapy and/or systemic chemotherapy.

Resident Education and Unreviewed Material

To the Editor: Over the past year, we have witnessed a virtual explosion of unreviewed information on the Internet. In the field of anesthesiology, a wide range of material, including case reports and treatment protocols, has been placed on the Internet for comment and discussion. On the positive side, placing such material on the Internet may update readers with clinical and scientific information and serve as a format for discussion of new ideas. On the other hand, there is a danger that this easy-to-read material will become the main reading material of our residents, who prefer it to peer-reviewed articles. Of particular concern is the presentation of treatment protocols with no peer review. We have been astonished to hear residents quote material from the Internet as they would material from text books or peer-reviewed articles. It seems to us that the International Anesthesia Research Society is an appropriate forum to state these concerns regarding the quality of unreviewed material. We are especially concerned for our residents, whose way of thinking and attitudes toward the profession of anesthesiology are not yet consolidated. Yoram Shapira, MD, PhD Daniel Talmor, MD Division of Anesthesiology Ben-Gurion University of the Negev Soroka Medical Center Beer-Sheva, Israel Alan A. Artru, MD Arthur M. Lam, MD Department of Anesthesiology University of Washington School of Medicine Seattle, WA 98195-6540

Decreased Cerebrospinal Fluid Pressure with Mannitol and Hypocapnia

To the Editor: We read with interest the manuscript by Mutch et al. [1] and were impressed by the potential for applying the results to clinical practice. The authors devoted little of the Discussion section to speculation on the mechanism(s) by which mannitol and hypocapnia may decrease cerebrospinal fluid (CSF) pressure. It is well known that CSF volume and cerebral blood volume (CBV) are important determinants of CSF pressure. It is also well known that when the osmolarity of blood is increased, CSF formation rate decreases. In previous work from our laboratory, we reported that mannitol decreased CSF formation rate [2] and caused a transient increase of CBV followed by a sustained decrease of CBV. By comparison, hypocapnia decreased CBV [3] and caused no significant change in CSF formation rate [4]. Yoram Shapira, MD, PhD Department of Anesthesiology Soroka Medical Center Beer-Sheva, Israel Alan A. Artru, MD Department of Anesthesiology University of Washington School of Medicine Seattle, WA 98195-6540

Hospitalized patients’ satisfaction with caregivers’ conduct and physical surroundings

The study examined the relative contribution of caregivers' conduct and physical conditions of the hospital setting to patients' global satisfaction with health care, while controlling for self-assessed health status. The study was performed in the Soroka Medical Center, which is the only inpatient facility for a population of 360,000 in southern Israel. Patients were interviewed using a structured questionnaire. Inclusion criteria were patients over 17 years of age, fluency in Hebrew, and hospitalization in the internal medicine wards for 24 hours or more. The dependent variable was "global satisfaction." The independent variables were "satisfaction with caregivers' conduct," "satisfaction with physical surroundings and conditions," and "self-assessment of health." The three independent variables accounted for 36.8% of the variation in patients' satisfaction with care, of which 87% relate to "satisfaction with caregivers' conduct." In conclusion, hospital patients value the caregivers' conduct more than the physical environment.

Legionella Species Community-Acquired Pneumonia: A Review of 56 Hospitalized Adult Patients

In a prospective study, Legionella species (Lsp) was identified as the causative agent in 56 (16.2%) of 346 adult patients hospitalized over the course of 1 year with community-acquired pneumonia (CAP), in the Soroka Medical Center, Beer-Sheva, Israel. To characterize patients with Lsp CAP in our study. The diagnosis of infection with Lsp was based on serologic testing of antibodies using the indirect immunofluorescent method. In 35 (62.5%) of the patients, at least one other etiologic agent for CAP was identified in addition to Lsp. The patient population was relatively young, with relatively low rates of chronic comorbidity, and a broad spectrum of disease severity compared with previously published studies. No single epidemiologic, clinical, laboratory, or radiographic characteristic differentiated between Lsp CAP and other CAP patients in our study. Three patients (5.4%) who were not treated with erythromycin died. However, in contrast, nine patients who were treated with beta-lactam antibiotics recovered completely. Lsp is a common cause of CAP in our region, usually as a coinfection with another causative agent. Lsp CAP, which cannot be characterized on the basis of clinical, routine laboratory, or radiographic data, requires specific microbiologic or serologic diagnosis. Treatment with erythromycin appears to be important to reduce mortality from this disease, but in a significant number of patients, the disease may be self-limited.

Reply to the Editor:

Pacing and Clinical ElectrophysiologyVolume 19, Issue 3 p. 383-384 Reply to the Editor: I. Eli Ovsyshcher M.D., Ph.D., I. Eli Ovsyshcher M.D., Ph.D. Director, EP & Pacemaker Unit Cardiology, Soroka Medical Center and Ben-Gurion University Beer Sheva, IsraelSearch for more papers by this author I. Eli Ovsyshcher M.D., Ph.D., I. Eli Ovsyshcher M.D., Ph.D. Director, EP & Pacemaker Unit Cardiology, Soroka Medical Center and Ben-Gurion University Beer Sheva, IsraelSearch for more papers by this author First published: March 1996 https://doi.org/10.1111/j.1540-8159.1996.tb03351.xAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Volume19, Issue3March 1996Pages 383-384 RelatedInformation

Factors related to successful rehabilitation after hip fracture: a case-control study.

A case-control study was performed to evaluate factors associated with successful rehabilitation in elderly patients who sustained hip fractures. All 170 patients with fractured hips hospitalized in the geriatrics ward of the Soroka Medical Center in Beer-Sheva, Israel between 1987 and 1991 were studied. Success of rehabilitation was determined by staff evaluation of the patient's ability to walk and perform activities of daily living. The independent variables, including sociodemographic and medical variables, and mental and functional assessments, were assessed by chart reviews, staff evaluation and mental tests. One-hundred and twenty-nine patients (75.9%) were successfully rehabilitated. A normal mental state (p < 0.0001), female gender (p < 0.02) and absence of diabetes mellitus (p < 0.008) were associated significantly with successful rehabilitation.

Hyperemesis gravidarum: epidemiologic features, complications and outcome

During the period of 4 years between 1985 and 1988, 190 patients suffering from hyperemesis gravidarum (HG) were hospitalized at the Soroka Medical Center. From the 190 patients, 164 were followed up throughout their pregnancies and delivered at our Medical Center. The epidemiology of HG as well as the incidence of maternal complications and pregnancy outcome were analyzed and compared with 209 controls. The incidence of HG in our patient population was 6.3/1000 live births. The patients in the study group had fewer pregnancies and deliveries and more spontaneous abortions in the past than in the control population. Premature contractions and vaginal bleeding during the first trimester were more common among women with HG. Other complications of pregnancy were no more common than among controls. Women with HG in their current pregnancy had a lower incidence of spontaneous abortions (3.1%) as compared with previously reported rates in the general population (15%). Perinatal outcome was no different in women with HG than in the controls. Women with severe HG did not have statistically significant differences in the incidence of pregnancy complications and their pregnancy outcome was the same as in those without severe HG.

Severe Complications of Measles Requiring Intensive Care in Infants and Young Children

To evaluate the characteristics of severe complications of measles in patients admitted to a pediatric intensive care unit. Clinical description of a case series. The Pediatric Intensive Care Unit of Soroka Medical Center, Beer-Sheva, Israel, during a measles epidemic. Fifteen pediatric patients with measles requiring intensive care. Fifteen of 237 hospitalized children with measles required intensive care in the Pediatric Intensive Care Unit. Eleven patients were malnourished; none had been vaccinated for measles. All 15 patients required mechanical ventilation for pneumonia that had caused severe respiratory distress. Twelve of 15 patients were severely hypoxemic before intubation. Seven had a clinical syndrome consistent with adult respiratory distress syndrome. Other complications on admission to the intensive care unit included spontaneous pneumothorax in three patients, empyema in two, encephalopathy in seven, shock in three, sepsis in five, hypocalcemia in 11, thrombocytopenia in eight, and coagulopathy in seven. Complications during treatment included pneumothorax in four patients, fibrosing alveolitis in one, brain infarct in one, thrombus formation in three, and nosocomial sepsis in one. Four patients had long-term sequelae (chronic lung disease, subacute sclerosing panencephalitis, hemiplegia, and partial amputation of a limb), and seven patients recovered uneventfully. Four patients died; all had adult respiratory distress syndrome, three had pneumothorax, and one had nosocomial sepsis. Patients with measles who require intensive care have a high risk for death or long-term complications, even when treated in a modern pediatric intensive care unit. Adult respiratory distress syndrome and air leaks were the most severe complications in these patients. To reduce the severity of these complications, mechanical ventilation should be based on using the lowest possible inspiratory pressure and fraction of inspired oxygen, while accepting an arterial oxygen pressure less than 60 mm Hg. Secondary bacteremia was an early and prominent complication, and antibiotic treatment should be instituted early in patients with measles requiring intensive care.

Disruption of colonic cell-cell interactions induces apoptosis: [formula omitted], B. Schwartz, Sylvie Pollak-Charcon and S.A. Lamprecht, Gastroenterology Department and Clinical Biochemistry Unit, Soroka Medical Center, Ben-Gurion University of the Negev, Beer-Sheba, and Institute of Pathology, Sheba Hospital, Ramat-Gan, Israel

Disruption of colonic cell-cell interactions induces apoptosis: [formula omitted], B. Schwartz, Sylvie Pollak-Charcon and S.A. Lamprecht, Gastroenterology Department and Clinical Biochemistry Unit, Soroka Medical Center, Ben-Gurion University of the Negev, Beer-Sheba, and Institute of Pathology, Sheba Hospital, Ramat-Gan, Israel

The effect of neoplasia on electrogenic sodium transport in rat distal colon: [formula omitted], M Sterlin, L Chalfen, Y Niv, B Schwartz. Dept. Gastroenterology and Clinical Biochemistry Unit, Soroka Medical Center and Ben-Gurion University of the Negev, Beer Sheba, Israel

The effect of neoplasia on electrogenic sodium transport in rat distal colon: [formula omitted], M Sterlin, L Chalfen, Y Niv, B Schwartz. Dept. Gastroenterology and Clinical Biochemistry Unit, Soroka Medical Center and Ben-Gurion University of the Negev, Beer Sheba, Israel

Q-fever pneumonia in the Negev Region of Israel: A review of 20 patients hospitalised over a period of one year

Three-hundred and forty-six patients with community acquired pneumonia were included in a prospective study of patients hospitalised over a 12-month period in the Soroka Medical Center in Beer-Sheva, Israel. Q-fever pneumonia (QFP) was diagnosed in 20 patients (5.8%). A detailed epidemiological and clinical description of this disease, is presented. QFP was diagnosed by conventional criteria using a commercial immunofluorescent assay. The age of patients was 41 +/- 14 years (mean +/- S.D., range 20-69). Twelve of the patients were males. No concomitant or chronic disease was present in 16 patients. Chest radiograms revealed alveolar or air space pneumonia in 10 patients, bronchopneumonia in nine and interstitial pneumonia in one patient. The mean febrile period was 10.5 +/- 5.3 days. There was serological evidence of co-infection with Mycoplasma pneumonia in six patients, and with Legionella pneumophila in one patient. Patients treated with beta-lactam antibiotics recovered as quickly as those treated with tetracyclines or erythromycin. The Negev region of Israel is an endemic area for Q-fever. The diagnosis of QFP can be made only on the basis of a specific serological test. Clinical, radiologic or laboratory findings are not diagnostically definitive. The importance of specific therapy is unclear.

Hematologic evidence that the human fetus participates in the process leading to preterm parturition: [formula omitted], S. Berry, R. Gomez x, H. Muñoz x, M. Mazor x, Y. Sorokin x, F. Ghezzi x, D.B. Cotton. Wyne State University/Hutzel Hospital, Detroit, MI, Perinatology Research Branch, NICHD, Bethesda; MD, Soroka Medical Center, Ben-Gurion University, Beer-Sheva, Israel

Hematologic evidence that the human fetus participates in the process leading to preterm parturition: [formula omitted], S. Berry, R. Gomez x, H. Muñoz x, M. Mazor x, Y. Sorokin x, F. Ghezzi x, D.B. Cotton. Wyne State University/Hutzel Hospital, Detroit, MI, Perinatology Research Branch, NICHD, Bethesda; MD, Soroka Medical Center, Ben-Gurion University, Beer-Sheva, Israel

The interaction of nitric oxide and superoxide in the human fetal-placental vasculature: [formula omitted]2x, W. Kossenjans 1x, M. Miodovnik 1, L. Myatt 1x. Department of Obstetrics & Gynecology, University of Cincinnati, Cincinnati, OH 1. Department of Obstetrics and Gynecology, Soroka Medical Center, Beer Sheeba, Israel 2

The interaction of nitric oxide and superoxide in the human fetal-placental vasculature: [formula omitted]2x, W. Kossenjans 1x, M. Miodovnik 1, L. Myatt 1x. Department of Obstetrics & Gynecology, University of Cincinnati, Cincinnati, OH 1. Department of Obstetrics and Gynecology, Soroka Medical Center, Beer Sheeba, Israel 2

Medical students' contribution to the development of a smoke-free hospital policy in a university medical centre: a relevant learning experience.

In a research methodology course, second-year medical students conducted a survey on 'Enforcing a Smoking Ban in the Soroka Medical Center: a Survey of Hospital Employees on Facilitating Factors and Obstacles'. They defined the study objectives and design, developed the study instrument, carried out the survey, coded and entered the data into mainframe computers, analysed the computer output, and prepared oral and written reports. The aims of the project were twofold: to survey employees' attitudes to a hospital smoking ban and to train medical students in the planning and conduct of a research project on public health or preventive medicine. Twelve students conducted a cross-sectional survey of 208 hospital employees (10% of the hospital staff). Employees were surveyed regarding smoking status, interest in quitting smoking, knowledge of the law banning smoking in public places, knowledge of the health effects of passive smoking, attitudes towards a hospital smoking ban and potential obstacles to its implementation. The students rated the course as excellent. They gained important research skills, as well as practical medical and public health experience through active participation in the design and execution of a study project with public health implications. At the first meeting of the hospital committee appointed to enforce a smoke-free hospital, the students' findings were reported in full, and their recommendations have guided policy decisions.

Term and preterm parturition are associated with an increased bioavailability in dehydroephiandrosterone-sulfate concentration: [formula omitted], R. Romero, W. Chaim x, R. Hershkowitz x, A. Wiznitzer, J. Levy x, Y. Sharoni x. Department of Obstetrics and Gynecology and Clinical Biochemistry Unit, Soroka Medical Center of Kupat Holim, Ben-Gurion University of the Negev School of Medicine, Beer-Sheva, Israel; Wayne State University, Detroit,

Term and preterm parturition are associated with an increased bioavailability in dehydroephiandrosterone-sulfate concentration: [formula omitted], R. Romero, W. Chaim x, R. Hershkowitz x, A. Wiznitzer, J. Levy x, Y. Sharoni x. Department of Obstetrics and Gynecology and Clinical Biochemistry Unit, Soroka Medical Center of Kupat Holim, Ben-Gurion University of the Negev School of Medicine, Beer-Sheva, Israel; Wayne State University, Detroit,

Early detection of Pseudomonas infection using a Wood's lamp

Clinical and Experimental DermatologyVolume 19, Issue 5 p. 449-449 Early detection of Pseudomonas infection using a Wood's lamp B. Amichai, B. Amichai Department of Dermatology, Soroka Medical Center of Kupal Holim, Ben-Gurion University of the Negev Beer-Sheva, IsraelSearch for more papers by this authorE. Finkelsten, E. Finkelsten Department of Dermatology, Soroka Medical Center of Kupal Holim, Ben-Gurion University of the Negev Beer-Sheva, IsraelSearch for more papers by this authorS. Halevy, S. Halevy Department of Dermatology, Soroka Medical Center of Kupal Holim, Ben-Gurion University of the Negev Beer-Sheva, IsraelSearch for more papers by this author B. Amichai, B. Amichai Department of Dermatology, Soroka Medical Center of Kupal Holim, Ben-Gurion University of the Negev Beer-Sheva, IsraelSearch for more papers by this authorE. Finkelsten, E. Finkelsten Department of Dermatology, Soroka Medical Center of Kupal Holim, Ben-Gurion University of the Negev Beer-Sheva, IsraelSearch for more papers by this authorS. Halevy, S. Halevy Department of Dermatology, Soroka Medical Center of Kupal Holim, Ben-Gurion University of the Negev Beer-Sheva, IsraelSearch for more papers by this author First published: September 1994 https://doi.org/10.1111/j.1365-2230.1994.tb02713.xCitations: 5AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article.Citing Literature Volume19, Issue5September 1994Pages 449-449 RelatedInformation

Medical sequelae and complications of acute otitis media

From the Department of Otolaryngology tDMF, Ala and the Pediatric Infectious Disease Unit cRID. The Soroka Medical Center, and the Faculty of Health Sciences, Ben Gurion University of Negev, Beer Sheva, Israel.

Methylprednisolone, Head Trauma, and Brain Protection

Division of Anesthesiology, Soroka Medical Center, Beer-Sherva 84 101, Israel(Shapira) Department of Anesthesiology, University of Washington School of Medicine, Seattle, WA 98195 (Artu)