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  1. Article: Deep Epicardial Laceration after Cardiopulmonary Resuscitation: A Case Report.

    Fried Regev, Noa / Slutsky, Tzachi / Lev-Ran, Oren / Ishai, Yaron / Schwarzfuchs, Dan

    Rambam Maimonides medical journal

    2021  Volume 12, Issue 4

    Abstract: Effective chest compressions have been proven to be a key element in a successful cardiopulmonary resuscitation (CPR). However, unintended injuries have been described in the medical literature for decades, including major intrathoracic injuries. We ... ...

    Abstract Effective chest compressions have been proven to be a key element in a successful cardiopulmonary resuscitation (CPR). However, unintended injuries have been described in the medical literature for decades, including major intrathoracic injuries. We present a case of an 80-year-old man after a successful CPR who was later diagnosed with deep epicardial laceration as a result of effective chest compressions.
    Language English
    Publishing date 2021-10-25
    Publishing country Israel
    Document type Journal Article
    ZDB-ID 2573657-7
    ISSN 2076-9172
    ISSN 2076-9172
    DOI 10.5041/RMMJ.10455
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Safety of Femoral Nerve Blockade for Hip Fractures inAdult Patients Treated with Anti-Xa Direct Oral Anticoagulants: A Pilot Study.

    Dayan, Roy Rafael / Ayzenberg, Yosef / Slutsky, Tzachi / Shaer, Ela / Kaplan, Alon / Zeldetz, Vladimir

    The Israel Medical Association journal : IMAJ

    2021  Volume 23, Issue 9, Page(s) 595–600

    Abstract: Background: Limited data exist regarding the safety of ultrasound-guided femoral nerve blockade (US-FNB) in patients with hip fractures treated with anti-Xa direct oral anticoagulants (DOAC).: Objectives: To compare the safety outcomes of US-FNB to ... ...

    Abstract Background: Limited data exist regarding the safety of ultrasound-guided femoral nerve blockade (US-FNB) in patients with hip fractures treated with anti-Xa direct oral anticoagulants (DOAC).
    Objectives: To compare the safety outcomes of US-FNB to conventional analgesia in patients with hip fractures treated with anti-Xa DOAC.
    Methods: This observational exploratory prospective study included 69 patients who presented to our emergency department (ED) in 3 years with hip fracture and who were treated with apixaban or rivaroxaban. Patients received either a US-FNB (n=19) or conventional analgesics (n=50) based on their preference and, and the presence of a trained ED physician qualified in performing US-FNB. Patients were observed for major bleeding events during and 30 days after hospitalization. The degree of preoperative pain and opioid use were also observed.
    Results: We found no significant difference in the number of major bleeding events between groups (47.4% vs. 54.0%, P = 0.84). Degree of pain measured 3 and 12 hours after presentation was found to be lower in the US-FNB group (median visual analog scale of pain improvement from baseline of -5 vs. -3 (P = 0.002) and -5 vs.-4 (P = 0.023), respectively. Opioid administration pre-surgery was found to be more than three times more common in the conventional analgesia group (26.3% vs.80%, P < 0.0001).
    Conclusions: Regarding patients treated with Anti-Xa DOAC, US-FNB was not associated with an increase in major bleeding events compared to conventional analgesia, although it was an effective means of pain alleviation. Larger scale randomized controlled trials are required to determine long-term safety and efficacy.
    MeSH term(s) Aged ; Aged, 80 and over ; Analgesics/administration & dosage ; Analgesics, Opioid/administration & dosage ; Cohort Studies ; Emergency Service, Hospital ; Factor Xa Inhibitors/administration & dosage ; Factor Xa Inhibitors/adverse effects ; Female ; Femoral Nerve/diagnostic imaging ; Hemorrhage/epidemiology ; Hemorrhage/etiology ; Hip Fractures/surgery ; Humans ; Male ; Nerve Block/adverse effects ; Nerve Block/methods ; Pain Measurement ; Pain, Postoperative/prevention & control ; Pilot Projects ; Prospective Studies ; Pyrazoles/administration & dosage ; Pyrazoles/adverse effects ; Pyridones/administration & dosage ; Pyridones/adverse effects ; Rivaroxaban/administration & dosage ; Rivaroxaban/adverse effects ; Ultrasonography, Interventional
    Chemical Substances Analgesics ; Analgesics, Opioid ; Factor Xa Inhibitors ; Pyrazoles ; Pyridones ; apixaban (3Z9Y7UWC1J) ; Rivaroxaban (9NDF7JZ4M3)
    Language English
    Publishing date 2021-09-02
    Publishing country Israel
    Document type Comparative Study ; Journal Article ; Observational Study
    ZDB-ID 2008291-5
    ISSN 1565-1088 ; 0021-2180
    ISSN 1565-1088 ; 0021-2180
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 5470: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  3. Article: Modified Shock Index as a Predictor for Mortality and Hospitalization Among Patients With Dementia.

    Sadeh, Re'em / Shashar, Sagi / Shaer, Ela / Slutsky, Tzachi / Sagy, Iftach / Novack, Victor / Zeldetz, Vladimir

    The Journal of emergency medicine

    2022  Volume 62, Issue 5, Page(s) 590–599

    Abstract: Background: One in four older adults in the Emergency Department (ED) suffers from severe cognitive impairment, creating great difficulty for the emergency physicians who determine the urgency of their patients' condition, which informs decisions ... ...

    Abstract Background: One in four older adults in the Emergency Department (ED) suffers from severe cognitive impairment, creating great difficulty for the emergency physicians who determine the urgency of their patients' condition, which informs decisions regarding discharge or hospitalization.
    Objective: Our objective was to determine whether modified shock index (MSI) can be a clinical mortality and hospitalization predictor when applied to older patients with dementia in the ED.
    Methods: Included in the research were all patients with dementia, > 65 years old, who arrived at the Soroka University Medical Center ED during 2014-2017. The population was divided into three groups according to their MSI score, calculated as heart rate/mean arterial pressure: MSI < 0.7; 0.7 > MSI < 1.3; and MSI > 1.3. We performed multivariable logistic regression as a predictor of death within 30 days, Cox analysis for number of days to death, and a negative binominal regression for predicting the number of admission days.
    Results: Included were 1437 patients diagnosed with dementia. Patients with an MSI > 1.3 vs. those with MSI < 0.7 had an odds ratio of 8.23 (95% confidence interval [CI] 4.64-4.54) for mortality within 30 days, increased mortality risk within 180 days (hazard ratio 4.42; 95% CI 2.64-7.41), and longer hospitalization duration (incidence rate ratio 1.8; 95% CI 1.32-2.45).
    Conclusions: High MSI scores were associated with high mortality rates and longer hospitalization duration for patients diagnosed with dementia who were > 65 years old. We suggest performing prospective studies utilizing the MSI score as an indicator in ED triage settings to classify patients with dementia by their severity of risk, to determine if this benefits health, minimizes expenses, and prevents unnecessary hospitalizations.
    MeSH term(s) Aged ; Dementia ; Emergency Service, Hospital ; Hospitalization ; Humans ; Prospective Studies ; Retrospective Studies ; Shock/diagnosis
    Language English
    Publishing date 2022-02-16
    Publishing country United States
    Document type Journal Article
    ZDB-ID 605559-x
    ISSN 0736-4679
    ISSN 0736-4679
    DOI 10.1016/j.jemermed.2021.12.023
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 1895: Show issues Location:
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    Jg. 1995 - 2021: Lesesall (1.OG)
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  4. Article ; Online: Early Point-of-Care Ultrasound Assessment for Medical Patients Reduces Time to Appropriate Treatment: A Pilot Randomized Controlled Trial.

    Ben-Baruch Golan, Yael / Sadeh, Re'em / Mizrakli, Yuval / Shafat, Tali / Sagy, Iftach / Slutsky, Tzachi / Kobal, Sergio L / Novack, Victor / Fuchs, Lior

    Ultrasound in medicine & biology

    2020  Volume 46, Issue 8, Page(s) 1908–1915

    Abstract: Numerous studies emphasize the diagnostic importance of point-of-care ultrasound (POCUS), but the level of evidence remains low as most data are gathered from observational studies. We conducted a pilot, randomized controlled trial to evaluate the effect ...

    Abstract Numerous studies emphasize the diagnostic importance of point-of-care ultrasound (POCUS), but the level of evidence remains low as most data are gathered from observational studies. We conducted a pilot, randomized controlled trial to evaluate the effect of POCUS exam on medical patient's management and clinical outcomes. Patients presenting with chest pain or dyspnea were enrolled and randomly allocated to an early POCUS scan group and a control group. POCUS assessment, within 24 h of internal ward admission, was conducted only for the intervention group. The primary outcome was time to correct diagnosis. Secondary outcomes included time to appropriate treatment, POCUS-related rate of primary diagnosis alteration and new clinically relevant findings and time to hospital discharge. Sixty patients were enrolled. Thirty patients were randomly allocated to each study arm. The POCUS exam revealed clinically relevant findings among 79% of patients and led to alteration of the primary diagnosis among 28% of patients. Time to appropriate treatment was significantly shorter among patients in the POCUS group compared with the control group (median time of 5 h [95% confidence interval: 0.5-9] vs. 24 h [95% CI: 19-29] p = 0.014). The time needed to achieve correct diagnosis by the primary team was shorter in the POCUS group compared with the control group, yet it did not reach statistical significance (median time of 24 h [95% CI: 18-30] vs. 48 h [95% CI: 20-76], p = 0.12). These results indicate that POCUS assessment conducted early among patients with dyspnea or chest pain improves diagnostic accuracy and shortens significantly the time to appropriate treatment.
    MeSH term(s) Aged ; Aged, 80 and over ; Humans ; Pilot Projects ; Point-of-Care Testing ; Time Factors ; Ultrasonography/methods
    Language English
    Publishing date 2020-05-16
    Publishing country England
    Document type Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
    ZDB-ID 186150-5
    ISSN 1879-291X ; 0301-5629
    ISSN (online) 1879-291X
    ISSN 0301-5629
    DOI 10.1016/j.ultrasmedbio.2020.03.023
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 963: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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    Jg. 1995 - 2021: Lesesall (1.OG)
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  5. Article ; Online: The Presence of Snoring as Well as its Intensity Is Underreported by Women.

    Westreich, Roi / Gozlan-Talmor, Aya / Geva-Robinson, Shahar / Schlaeffer-Yosef, Tal / Slutsky, Tzachi / Chen-Hendel, Efrat / Braiman, Dana / Sherf, Yehonatan / Arotsker, Natan / Abu-Fraiha, Yasmeen / Waldman-Radinsky, Liat / Maimon, Nimrod

    Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine

    2019  Volume 15, Issue 3, Page(s) 471–476

    Abstract: Study objectives: Women are underrepresented and thus sleep conditions are underdiagnosed at sleep clinics that evaluate sleep-disordered breathing. The most common sign of obstructive sleep apnea (OSA) is snoring; therefore, it is one of the main red ... ...

    Abstract Study objectives: Women are underrepresented and thus sleep conditions are underdiagnosed at sleep clinics that evaluate sleep-disordered breathing. The most common sign of obstructive sleep apnea (OSA) is snoring; therefore, it is one of the main red flags for suspected OSA. The aim of this study is to determine whether self-reported snoring and snoring intensity by women and men correlates with snoring volume measured objectively during sleep laboratory study.
    Methods: Consecutive patients who were referred to a polysomnography (PSG) study in a university hospital over a 2-year period had their snoring volume quantified by means of a calibrated digital sound survey meter. Participants were given a questionnaire in which they were asked to rate the severity of their snoring. The correlation between objective snoring intensity as measured during PSG and the self-reported snoring intensity was evaluated.
    Results: A total of 1,913 patients were enrolled in the study. A positive correlation was found between objectively measured snoring intensity and the intensity listed by each participant in the questionnaire. Measurement of the volume of snoring revealed that women snored as loudly as men; however, 28% of the females (189/675) considered themselves to be nonsnorers compared to only 6.9% of men (
    Conclusions: In a population of individuals referred to a PSG study, although no difference in snoring intensity was found between sexes, women tend to underreport the fact that they snore and to underestimate the loudness of their snoring. Improved awareness of this discrepancy may increase women's access to sleep laboratories, and improve diagnostic rates of sleep apnea in females.
    MeSH term(s) Female ; Humans ; Male ; Middle Aged ; Polysomnography ; Self Report ; Severity of Illness Index ; Sex Factors ; Snoring/diagnosis ; Snoring/epidemiology ; Snoring/psychology ; Surveys and Questionnaires
    Language English
    Publishing date 2019-03-15
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2397213-0
    ISSN 1550-9397 ; 1550-9389
    ISSN (online) 1550-9397
    ISSN 1550-9389
    DOI 10.5664/jcsm.7678
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    Zs.A 6590: Show issues Location:
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  6. Article ; Online: Single-Operator Ultrasound-Guided Central Venous Catheter Insertion Verifies Proper Tip Placement.

    Galante, Ori / Slutsky, Tzachi / Fuchs, Lior / Smoliakov, Alexander / Mizrakli, Yuval / Novack, Victor / Brotfein, Evgeni / Klein, Moti / Frenkel, Amit / Koifman, Leonid / Almog, Yaniv

    Critical care medicine

    2017  Volume 45, Issue 10, Page(s) e994–e1000

    Abstract: Objectives: To evaluate whether a single-operator ultrasound-guided, right-sided, central venous catheter insertion verifies proper placement and shortens time to catheter utilization.: Design: Prospective observational study with historical controls. ...

    Abstract Objectives: To evaluate whether a single-operator ultrasound-guided, right-sided, central venous catheter insertion verifies proper placement and shortens time to catheter utilization.
    Design: Prospective observational study with historical controls.
    Setting: Adult ICUs.
    Patients: Sixty-four consecutive patients undergoing ultrasound-assisted right-sided central venous catheterization compared with 92 serial historic controls who had unassisted central catheter insertion at the same sites.
    Interventions: Subcostal transthoracic echocardiography during catheter insertion.
    Measurements and main results: The primary outcome was the correct placement of the catheter tip determined by postprocedural chest radiography. The subclavian site was used in 41 patients (64%) (inserted without ultrasound guidance) in the ultrasound-assisted group and 62 (67%) in the control group, whereas the jugular vein was used in the remaining patients. The tip was accurately positioned in 59 of 68 patients (86.7%) in the ultrasound-assisted group compared with 51 of 94 (54.8%) in the control group (p < 0.001). The median time from end of the procedure to catheter utilization after chest radiography approval was 2.4 hours.
    Conclusions: A single-operator ultrasound-guided central venous catheter insertion is effective in verifying proper tip placement and shortens time to catheter utilization.
    MeSH term(s) Catheterization, Central Venous/methods ; Echocardiography ; Female ; Historically Controlled Study ; Humans ; Intensive Care Units ; Jugular Veins/diagnostic imaging ; Male ; Middle Aged ; Point-of-Care Systems ; Prospective Studies ; Radiography, Thoracic ; Subclavian Vein/diagnostic imaging ; Ultrasonography, Interventional
    Language English
    Publishing date 2017-05-23
    Publishing country United States
    Document type Journal Article ; Observational Study
    ZDB-ID 197890-1
    ISSN 1530-0293 ; 0090-3493
    ISSN (online) 1530-0293
    ISSN 0090-3493
    DOI 10.1097/CCM.0000000000002500
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 1261: Show issues Location:
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