Arie Markel

Haemek Medcial Center · Internal

Background: Recent studies show that vaccination of health care workers (HCW) might reduce influenza transmission and mortality among hospitalized patients. No studies have compared the incidence of laboratory-proven influenza in vaccinated versus unvaccinated hospital HCW. Objectives: To evaluate the effectiveness of influenza vaccination among...

Introduction: venous thromboembolism (VTE) is the third most common cause of death and the leading cause of sudden death in hospitalized medical patients. Despite the existence of guidelines for prevention and treatment of this disorder, their implementation in everyday life is not always accomplished. Methods: We performed a survey among direct...

Medical patients worldwide are undertreated with venous thromboembolism prophylaxis. Our hypothesis was that the rate of prophylactic anticoagulation therapy for high-risk patients would improve with the use of a coagulation nurse liaison. Six months after appointing a nurse for this role, prophylaxis rates significantly improved, and patients were...

Rapid restoration of nutrients and electrolytes after prolonged starvation could result in a life threatening condition characterized by sensory and neurological dysfunction and severe metabolic imbalance that has been designated as refeeding syndrome. Its diagnosis is frequently missed resulting in severe complications and even death. We describe...

Peripheral arterial disease (PAD) in the context of this review refers to the presence of atherosclerotic disease in the arteries of the lower limbs. PAD is the third main site of atherosclerosis, after coronary heart disease and cerebrovascular disease. Intermittent claudication (IC) is the most known clinical manifestation of PAD, although most p...

Peripheral arterial disease (PAD) is one of the most frequent manifestations of atherosclerosis and is associated with atherosclerosis in the coronary and carotid arteries, leading to a highly increased incidence of cardiovascular events. Major risk factors of PAD are similar to those that lead to atherosclerosis in other vascular beds. However, th...

Wilson's disease is a rare disorder of copper transport in hepatic cells, and may present as cholestatic liver disease; pancreatitis and cholangitis are rarely associated with Wilsons's disease. Moreover, cases of Wilson's disease presenting as pigmented gallstone pancreatitis have not been reported in the literature. In the present report, we desc...

Infectious disease is a leading cause of hospitalization. We investigated trends in infectious disease hospitalizations among the elderly in the last decade. A total of 81,077 hospitalizations of elderly patients between 2001 and 2010 were available on the computerized database of the Ha'emek Medical Center, Israel. The proportion of hospitalizatio...

The aim of this document is to provide a clear and concise account of the evidence regarding efficacy or harm for various methods available to prevent and manage venous thromboembolism (VTE).

Agenesis of the inferior vena cava (IVC) as a cause of recurrent deep vein thrombosis (DVT) is uncommon. A 33-year-old male with no family history of thrombophilia, who had experienced multiple recurrent episodes of DVT over a 15-year period of unknown cause, was admitted into our hospital because of cellulitis in the right leg. Computer tomography...

Hypercholesterolemia is one of the main factors in the development of atherosclerotic cardiovascular disease. The advent of statins led to huge progress in the treatment of hypercholesterolemia, yet the proportion of patients with prohibitive lipid values and the high incidence of cardiovascular events despite treatment are still very high. Niacin,...

Familial adenomatous polyposis (FAP) is an inherited disease characterized by the presence of multiple polyps in the colon or other areas of the gastrointestinal tract. In Gardner's syndrome, which is considered by some as a variant of FAP, polyps in the colon present with extracolonic manifestations, such as osteomas, lipomas, fibromas or other so...

Hyperuricemia is present in approximately 5% of the population. The vast majority is asymptomatic and at no clinical risk. Allopurinol, an analog of hypoxanthine, has been widely used in clinical practice for more than 30 years for the treatment of hyperuricemia and gout. Two percent of patients develop a mild exanthema when on this drug, which usu...

Hyperuricemia is present in approximately 5% of the population, the vast majority of whom are asymptomatic and at no clinical risk. Complications, including renal calculi, uric acid nephropathy and gout, occur in a small proportion of patients. Allopurinol, an analog of hypoxanthine, has been widely used in clinical practice for over 30 years for t...

Deep vein thrombosis (DVT) is a disorder frequently affecting the deep veins of the lower limbs; its onset is induced by known risk factors. The main complications of DVT are pulmonary embolism and postthrombotic syndrome (PST). Clinical pulmonary embolism occurs in a high proportion of cases of untreated proximal DVT and is associated with a morta...

Although recanalization occurs after an episode of venous thrombosis, the exact timing for this process, the rate of clearing at the different venous segments and the nature of the mechanisms involved and their progression are not well known. Recognition of these competing events is important in understanding the natural history and the mechanisms...

The prevalence of coronary heart disease (CHD) is markedly increased in diabetic patients compared with non-diabetic individuals, and its prognosis is less good. Serum total and low-density lipoprotein (LDL) cholesterol concentrations have been shown to be powerful predictors of CHD morbidity and mortality in patients with type 2 diabetes. The avai...

Background The prevalence of coronary heart disease (CHD) is markedly increased in diabetic patients compared with non-diabetic individuals, and its prognosis is less good. Serum total and low-density lipoprotein (LDL) cholesterol concentrations have been shown to be powerful predictors of CHD morbidity and mortality in patients with type 2 diabete...

Pericardial involvement and cardiac tamponade are rare complications of multiple myeloma (MM) and in most reported cases it has been diagnosed only at autopsy. Three cases of multiple myeloma with pericardial involvement seen at a single institution are described. The approach to the treatment is discussed and the literature on this rare complicati...

Cross-linked fibrin degradation products have been used to detect venous thrombosis. While the sensitivity of plasma D-dimer measured by ELISA in the diagnosis of deep vein thrombosis (DVT) is high, the utility of ELISA methods is limited in a clinical setting. This study analysed the diagnostic value of a rapid D-dimer assay performed on whole blo...

Deep vein thrombosis (DVT) has known morbidity and mortality. New noninvasive techniques such as B-mode scanning and Doppler ultrasonography (duplex) are highly accurate in the diagnosis of this problem but are relatively expensive and time consuming. Continuous-wave Doppler, a precursor noninvasive technique, is simple, cheap, and easy to perform...

Deep vein thrombosis (DVT) has known morbidity and mortality. New noninvasive techniques such as B-mode scanning and Doppler ultrasonography (duplex) are highly accurate in the diagnosis of this problem but are relatively expensive and time consuming. Continuous-wave Doppler, a precursor noninvasive technique, is simple, cheap, and easy to perform...

A sixty-five-year-old woman was admitted to the hospital complaining of weight loss and melena. She had a history of five vascular operations including aortobifemoral bypass. During hospitalization, she developed sepsis with Streptococcus milleri bacteremia. A computed tomographic scan and gastroduodenoscopy suggested aortoduodenal fistula, which w...

This study was designed to test the results of Valsalva's maneuver and limb compression against the standing-cuff inflation-deflation method for the detection of venous valvular reflux. The study was conducted in 67 patients (134 extremities) who had an episode of deep vein thrombosis. An ultrasonic duplex scanner was used to evaluate two methods o...

Dieulafoy's ulcer is a submucous vascular malformation usually located in the gastric fundus. This lesion can be the cause of recurrent, massive gastrointestinal bleeding that can cause a high fatality rate if the condition remains unrecognized. Because the lesion is very small it can be easily overlooked at endoscopy. The authors describe a case o...

We report a patient with chronic active hepatitis in whom one of the initial findings was retroperitoneal lymphadenopathy, detected by abdominal ultrasound examination. Extrahepatic presenting findings of chronic active hepatitis may include arthritis, urticaria, pleurisy and pericarditis, while abdominal lymphadenopathy has been only rarely descri...

Group A beta-hemolytic streptococcus is an infrequent cause of endocarditis. Left-sided endocarditis in intravenous drug abuse is likewise uncommon; it carries a poor prognosis. A case of left-sided group A beta-hemolytic streptococcal endocarditis in a 20-year-old male drug addict with mitral valve prolapse is presented. This association has not b...

A patient with an 8 year history of insulin-dependent diabetes mellitus was admitted to the emergency ward for hypoglycaemic coma (blood glucose 1.11 mmol/l). The initial electrocardiogram revealed a junctional rhythm and major ischaemia with an ST depression of 6-7 mm. Sinus rhythm and normal repolarization were recovered 15 minutes after administ...

Commencing December 1986 and over the course of 4 years, the diagnosis of acute deep vein thrombosis (DVT) was established by duplex scanning in 286 patients referred to the University of Washington Medical Center in order to rule out this problem. From this group 107 patients (123 legs with DVT) were placed in a long-term follow-up program. The do...

Twenty healthy males were divided into two groups: 10 subjects were supplemented for 2 weeks with 400 ml of red wine (11% alcohol) per day and the other 10 subjects were given 400 ml of white wine (11% alcohol) per day for a similar period. Blood samples were drawn prior to wine supplementation, after 1 week and at the end of the study. No signific...

Gastric ulcer in a diaphragmatic hernia is a specific clinical entity, different from other gastric ulcerations. A 71-year-old man with a perforated and bleeding gastric ulcer in a diaphragmatic hernia, complicated by a posterior mediastinal abscess, is presented.

Although venous valvular insufficiency is well recognized as the most important etiologic mechanism in the development of the postthrombotic syndrome, the factors contributing to valve incompetence after deep venous thrombosis remain obscure. To establish the relationship between recanalization and valve competence, 113 patients with acute deep ven...

Anticoagulant therapy for lower extremity deep-vein thrombosis (DVT) has been shown to reduce mortality from pulmonary embolism, but subsequent morbidity from the postthrombotic syndrome remains high. Thrombolytic therapy produces higher lysis rates of venous thrombi than heparin alone. Some studies suggest a lower incidence of postthrombotic seque...

In the past, most inferior vena cava (IVC) filters have been placed via internal jugular or common femoral vein cutdown. Percutaneous placement of IVC filters in the radiology suite has potential advantages, particularly if its use is followed by an acceptably low incidence of complications and satisfactory prevention of pulmonary emboli. We have b...

Background.— Anticoagulant therapy for lower extremity deep-vein thrombosis (DVT) has been shown to reduce mortality from pulmonary embolism, but subsequent morbidity from the postthrombotic syndrome remains high. Thrombolytic therapy produces higher lysis rates of venous thrombi than heparin alone. Some studies suggest a lower incidence of postth...

The location and extent of thrombosis in the deep venous system will determine immediate and long-term outcome. During the past 3 years, we have studied by duplex scanning 833 patients with suspected deep vein thrombosis. In this group, 209 patients (25%) had a positive study. The findings relative to location and extent of involvement are as follo...