Biomedical subjects

Yehezkel Caine

Publications and source records attributed to Yehezkel Caine.

3 recordsLinked to original sources

PubMed2006

Nasogastric tube syndrome: a life-threatening laryngeal obstruction in a 72-year-old patient.

Nasogastric tube (NGT) syndrome is a rarely reported complication of NGT use that can cause life-threatening laryngeal obstruction. The syndrome results from post-cricoid ulceration, which affects the posterior cricoarytenoid muscles, thus causing vocal cord abduction paralysis and upper airway obstruction. We describe a case of a 72-year-old patient with this syndrome who was treated successfully and emphasise the difficulty of diagnosis in frail older adults.

Aged↗

PubMed2006

Enteral feeding in end-stage dementia: a comparison of religious, ethnic, and national differences in Canada and Israel.

BACKGROUND: Although enteral feeding in end-stage dementia is thought by many clinicians to be "futile," it is still widely used. We examined rates of tube feeding (gastrostomy or nasogastric) in end-stage dementia in hospitals in both Canada and Israel, and hypothesized that Canadian non-Jewish affiliated hospitals would have the lowest (and Israeli institutions the highest), with Canadian Jewish hospitals exhibiting intermediate rates. METHODS: We conducted a cross-sectional survey of six geriatric long-term hospitals: two in Israel and four in Canada (two Jewish affiliated, two not; two in Ontario, two in Quebec province). Patients with end-stage dementia were assessed and further analyzed for type of feeding. RESULTS: In the six hospitals, 2287 long-term beds were surveyed, of which 1358 (59.4%) were used by demented patients of whom 376 (27.7%) were severely demented (Global Deterioration Scale-level 7). Of these, 24.5% (92) were fed by nasogastric tube or gastrostomy tube. Significant differences in tube-feeding prevalence were found between Canada (11%) and Israel (52.9%), with only 4.7% seen in non-Jewish Canadian institutions. Jewish affiliated hospitals in Canada exhibited an intermediate rate of 19.6%. However, for within-country dyads, wide differences were also found. When we examined patient religion, we found that Canadian non-Jewish patients had the lowest rates (3.2%), Israeli Jewish patients the highest (51.7%), and Canadian Jewish patients exhibited an intermediate rate (19.0%) of tube use. CONCLUSIONS: Despite reservations concerning its utility, feeding tube use is reasonably widespread in patients who have reached the stage of severe dementia. Canadian institutions exhibited a lower prevalence of feeding tube use than did Israeli hospitals. Between-country and between-province differences in practice may be explained by some combination of administrative and/or financial incentives, religion, and culture; within-country and within-ethnic group differences may be caused, at least in part, by differing institutional cultures.

Aged, 80 and over↗

PubMed2003

SCOPE: SCripture Oriented Preventive Education.

BACKGROUND: Counseling to effect lasting change in health behaviors has proven only moderately effective. The Torah, or Five Books of Moses, conveys many of the key messages regularly promulgated by prevention professionals. The promise of synergy with the behavioral messages of preventive medicine among devout Scripture-based adherents led to the development of a SCripture Oriented Preventive Education (SCOPE) tool. METHODS: Forty-eight SCOPE articles were written to complement the weekly Torah portion read throughout the year in Orthodox Jewish synagogues. These were disseminated via newsletter within a modern Orthodox Jewish community in Israel. Two articles are included. An age-stratified, 25% random sample (120/471) of community readership was surveyed to ascertain receptivity to SCOPE and to gauge support for future implementation. RESULTS: Response rate was 76% (92/120). Lifestyle behavior-related articles were most popular (77% found them interesting) and injury prevention the least (41%). Knowledge gained was the most common benefit reported (55% of respondents), followed by attitude change (24%). Those aged 30 to 49 years were significantly more likely than others to report behavior change (p=0.002) and health improvement (p=0.005) secondary to SCOPE. Clinical prevention (p=0.007) and environmental health (p=0.03) articles were significantly more popular in people aged > or =30 and 30 to 49, respectively. Between 69% and 84% supported the implementation of SCOPE in secondary schools, by physicians, and/or rabbis. CONCLUSIONS: SCOPE was designed to deliver prevention materials to faith communities via a Scripture-based vehicle. A postexposure readership survey in an Israeli Orthodox Jewish community demonstrated its effectiveness. SCOPE's ultimate utility as a counseling adjunct in Scripture-adherent communities awaits broader assessment.

Adult↗