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case communications because of complaints of right ear pain associated with a mucopurulent discharge that lasted a month. He denied fever, night sweats or joint pain. His appetite was good and he was not on any regular medication. He had been treated empirically with antibiotics by his family physician without any improvement. On admission the patient was(More)
Frequent attenders (FA) pose a significant issue to a family practice and are considered to be a major burden on the physician and on resources utilization. The socioeconomic and psychological characteristics of FA are well known, however we know little about the management of these patients. The authors reviewed the literature on the bio-psychosocial(More)
Paget's disease is a chronic disease in which osteoclast mediated bone resorption precedes imperfect osteoblast mediated bone repair. Symptoms include bone pain, pathological fractures, osteoarthritis and neurological symptoms. There is evidence that genetic and viral component are involved in the etiology. Hypercalcemia is rare and when it is diagnosed,(More)
BACKGROUND Increasing global expenditures on health, together with increased patient demand for quality and service, have created a need for health care management tools based on economic and quaLity-based criteria. Despite the recognition of this need, decision-support tools are Lacking. In the Israel Defense Forces (IDF), policy change and budgetary and(More)
Measurement of the ratio of ankle to brachial systolic blood pressure (pressure index) is an integral part of the Doppler ultrasound investigation of lower limb arterial disease. The recovery of this index following exercise gives further information regarding the clinical significance of the disease. However, serial sphygmomanometry may prolong recovery(More)
The use of continuous wave Doppler ultrasound for lower limb arterial assessment is a well established technique in most district hospitals. Patients found to have disturbances in blood flow attributable to arterial plaques are often referred for arteriographic visualization of the disease with its inherent risks and complications. The availability of(More)
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