Biomedical subjects

Z Alon

Publications and source records attributed to Z Alon.

4 recordsLinked to original sources

PubMed1998

[Urgent, unscheduled self-referrals by ambulatory patients].

Direct self-referral to a consultant is common in the Israeli health system. Yet patients' reasons for their urgent, unscheduled self-referrals for ambulatory consultations (UUSR) have not been explored. We studied such consultations in an urban multi-disciplinary consultation center serving a population of approximately 100,000. Over a 3-month period such consultations in ophthalmology, ear-nose-and-throat and dermatology clinics were treated by a duty family physician (FP). The FP was instructed to focus on the urgent complaint and either to give definitive treatment and schedule a consultation when needed, or refer the patient for immediate specialist consultation. Patients treated by the FP were asked to fill an anonymous questionnaire, which 347/645 (55.4%) did. Among the reasons for UUSR were that the patient thought that his/her complaints should be treated by a consultant (29%), the patient was sent by the FP without a consultation note (13.9%), the FP was not available (10.4%), or the patient wished to see the consultant for a second opinion (8.2%). In only 7.8% had the patient noted that his complaint needed urgent consultation. Duration of complaints, but not prior efforts to schedule a consultation, were associated with different reasons for asking for an UUSR. For various reasons patients preferred an UUSR rather than seeing their own FP. Patients' opinions regarding self-referrals are important in planning primary care facilities and FP training.

Consultants↗

PubMed1997

Urgent self-referrals to ambulatory consultant--a prospective evaluation of triage by a qualified family physician.

Direct self-referrals to a consultant, especially on an urgent basis, has not been widely explored before. The health insurance system in Israel permits elective direct self-referrals to various specialists, but the range and reasons of urgent self-referrals has not yet been evaluated. Our aim was to evaluate urgent self-referrals to ambulatory consultants and to see to what extent a qualified family physician can triage and treat those patients. The setting was an urban ambulatory multi-disciplinary consultation center in the city of Ashdod in central Israel, serving a population of approximately 150,000. Over a three-month period, all patients who made urgent self-referrals for an ambulatory consultant in Ophthalmology, Ear, Nose and Throat (ENT) and Dermatology were triaged by an on-duty qualified family physician. The physician was instructed to take care of the patient in one of three ways: 1) immediate referral to a specialist; 2) begin treatment and schedule the patient for a specialist consultation; 3) administration of definitive treatment. Eight hundred and ninety-eight patients aged 46 +/- 22 years were treated by the triaging family physician. Forty-six percent had ophthalmological symptoms, 26% had dermatological symptoms and 20% had ENT-related symptoms. A symptom duration of less than 24 hours was reported by 36% of the patients. Eye problems were more commonly of short duration (p < 0.001). Sixty percent of the patients were given a definitive treatment, another 19% were given immediate treatment and scheduled for elective consultation with a specialist and 21% were referred for an immediate specialist consultation. Of the immediate consultations, 73% were ophthalmological and 27% came from a range of other complaints (p < 0.001). Our conclusion was that a family physician can treat most of the urgent self-referrals to ambulatory consultations in the three domains that were evaluated. A triage system is particularly suitable for urgent self-referrals to ENT as well as dermatological problems.

Adolescent↗

PubMed1994

Gallbladder size: is it affected by the oral intake of water or dilute contrast medium?

Examinations of the gallbladder are performed by ultrasonography while patients are in a fasting state. In contrast, computed tomography of the abdomen is carried out in fasting patients who were given 2% meglumine diatrizoate (Urografin) solution to opacify the gut. Sonographic examination was performed to establish whether the weight of fluids given to patients had any effect on the volume of the gallbladder. Gallbladder size was measured in subjects with a normal gallbladder. The gallbladder also was measured in 117 people in the fasting state, and 10 and 30 minutes later, it was measured again after an intake of 500 ml of water or a dilute solution of contrast medium. Both groups showed evidence of gallbladder contraction, but no significant statistical difference between them was apparent. It appears, therefore, that the contrast medium solution given before abdominal computed tomography may cause some gallbladder contraction.

Adolescent↗

PubMed1993

Partial multiseptate gallbladder: sonographic appearance.

Multiseptate gallbladder, a rare congenital anomaly, is characterized by the presence of multiple thin septa dividing the gallbladder lumen into various sized chambers, often with a honeycomb appearance. In nearly all cases described previously, the entire gallbladder lumen was traversed by the septa. We describe three children, ages 3, 9, and 16 years, with sonographic features of multiseptate gallbladder, in which the septa were confined to the body and neck of the gallbladder in two, and to the fundus in one. The CT features of the anomaly also are described in one patient.

Adolescent↗