PubMed Health⌕ Search

Biomedical subjects

Arie Dekel

Publications and source records attributed to Arie Dekel.

7 recordsLinked to original sources
PubMed2005

[Kos and lesbos or the physician and the lesbian patient].

Two to twelve percent of women define themselves as lesbians. Based on this data it has been estimated that 3-6% of patients who visit a physician are lesbians. In light of the growing awareness to gay/lesbian issues during the last decade, the special medical needs of the lesbian population have been sought and defined. This review presents an array of such special medical needs. Furthermore, the issue of physician-lesbian patient interaction, which is the key element in improving medical service to this unique population of women, is discussed.

Female↗
PubMed2004

Lost levonorgestrel IUD: diagnosis and therapy.

A lost intrauterine device (IUD) is an uncommon event. Recently, a new levonorgestrel-releasing intrauterine system was introduced. In view of several cases of an unusual diagnostic discrepancy in the location of a lost levonorgestrel-releasing IUD in our department, we sought to determine if the extrauterine location of lost levonorgestrel-releasing IUDs differs from that of lost copper IUDs. The medical files of all patients with a diagnosis of lost IUD who were admitted to Rabin Medical Center from 2000 to 2003 were reviewed. Fourteen women were identified, 9 with levonorgestrel-releasing IUDs and 5 with copper IUDs. In six of the nine cases of a lost levonorgestrel-releasing IUD, there was a clear discrepancy between the presumed location of the device by diagnostic evaluation and its actual location on surgical extraction. All six devices were embedded in the omentum; four were located in the upper abdomen. No such discrepancies were noted for the copper IUDs (0 vs. 66%, p < 0.05). No significant difference in peritoneal adhesions was noted between the groups (55% vs. 66%, respectively, p = 0.095). It is concluded that lost levonorgestrel-releasing IUDs are associated with a higher rate of localization errors by clinical evaluation than copper IUDs. Lost levonorgestrel-releasing IUDs might be found in the mid-upper abdomen, embedded in omentum tissue, and this area should be explored first during laparoscopy.

Adult↗
PubMed2003

Effects of preemptive analgesia on pain and cytokine production in the postoperative period.

BACKGROUND: The postoperative period is associated with increased production of proinflammatory cytokines, which are known to augment pain sensitivity, among other effects. In a previous study, the authors found that patients treated with patient-controlled epidural analgesia (PCEA) exhibited attenuated proinflammatory cytokine response in the postoperative period. In the present study, the authors examined whether preemptive analgesia continued with PCEA may further attenuate the proinflammatory cytokine response and reduce pain sensitivity in the postoperative period. They compared cytokine production in two groups of patients, one receiving PCEA, the other receiving preemptive epidural analgesia continued by PCEA. METHODS: Female patients hospitalized for transabdominal hysterectomy were randomly assigned to one of two pain management techniques: PCEA or preemptive epidural analgesia followed by PCEA (PA + PCEA). Postoperative pain was assessed using the visual analog scale. Blood samples were collected before, 24, 48, and 72 h following surgery. Production of the following cytokines was assessed in stimulated peripheral blood mononuclear cells: interleukin (IL)-1beta, tumor necrosis factor alpha, IL-6, IL-1ra, IL-10, and IL-2. RESULTS: Patients of the PA + PCEA group exhibited lower pain scores throughout the 72 h postoperatively, compared with patients of the PCEA group. In patients of the PA + PCEA group in the postoperative period, production of IL-1beta, IL-6, IL-1ra, and IL-10 was significantly less elevated, while IL-2 production was significantly less suppressed. CONCLUSIONS: Proinflammatory cytokines are key mediators of illness symptoms, including hyperalgesia. The present results suggest that preemptive epidural analgesia is associated with reduced postoperative pain and attenuated production of proinflammatory cytokines.

Adult↗
PubMed2002

[Epulis during pregnancy].

Epulis is a hyperplastic lesion, which originates from the buccal mucosa and mainly from gingival tissues. It is characterised by several histologic types, of which the prevalent type during pregnancy is the granulomatous type, which is composed mainly of capillary vessels and endothelial proliferation. This lesion is referred to as "pregnancy tumor". The true prevalence of this lesion during pregnancy is unknown, though its peak incidence is during the third decade of life--compatible with pregnancy age. Furthermore, epulis is more prevalent among women than men (1:4-7). Normally, epulis appear on the frontal part of the maxilla during the third trimester. The lesion usually causes no symptoms apart from its very presence. Etiologic factors are improper maintenance of oral hygiene which lead to chronic gingivitis and high gingival levels of active progesterone which acts in a yet unindefined mechanism. Treatment includes firstly removal of irritating factors and secondly surgical conservative excision of the lesion.

Adult↗