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2篇 您的检索式:作者名="Yaron Ehrlich"
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1Establishing an integrated gastroenterology service between a medical center and the community显示文摘AIM:To combine community and hospital services inorder to enable improvements in patient management,an integrated gastroenterology service(IGS)was established.METHODS:Referral patterns to specialist clinics were optimized;open access route for endoscopic procedures(including esophago-gastro-duodenoscopy,sigmoidoscopy and colonoscopy)was established;family physicians’knowledge and confidence were enhanced;direct communication lines between experts and primary care physicians were opened.Continuing education,guidelines and agreed instructions for referral were promoted by the IGS.Six quality indicators were developed by the Delphi method,rigorously designed and regularly monitored.Improvement was assessed by comparing 2010,2011 and 2012 indicators.RESULTS:An integrated delivery system in a specific medical field may provide a solution to a fragmented healthcare system impaired by a lack of coordination.In this paper we describe a new integrated gastroenterology service established in April 2010.Waiting time for procedures decreased:3 mo in April 30th 2010 to 3 wk in April 30th 2011and stayed between 1-3 wk till December 30th 2012.Average cost for patient’s visit decreased from 691 to638 NIS(a decrease of 7.6%).Six health indicators were improved significantly comparing 2010 to 2012,2.5%to 67.5%:Bone densitometry for patients with inflammatory bowel disease,preventive medications for high risk patients on aspirin/NSAIDs,colonoscopy following positive fecal occult blood test,gastroscopy in Barrett’s esophagus,documentation of family history of colorectal cancer,and colonoscopy in patients with a family history of colorectal cancer.CONCLUSION:Establishment of an IGS was found to effectively improve quality of care,while being costeffective.Yaron Niv Ram Dickman Zohar Levi Gadi Neumann Dorit Ehrlich Haim Bitterman Jacob Dreiher Arnon Cohen Doron Comaneshter Eyran Halpern 2015World Journal of Gastroenterology2015,21,7:1
2Retrograde intrarenal surgery for lower pole stones utilizing stone displacement technique yields excellent results显示文摘Objective:To evaluate the long-term stone-free rate(SFR)of retrograde intrarenal surgery(RIRS)in the treatment of lower pole renal calculi using only basket relocation and identify independent predictors of stone-free status.Methods:All consecutive patients undergoing RIRS lower pole renal calculi at a single highvolume tertiary center were analyzed retrospectively.Lower pole stones were relocated to the upper pole,where laser lithotripsy was performed.All patients were followed up in the clinic following the surgery and yearly thereafter.The stone-free status was assessed with a combination of an abdominal ultrasound and abdominal X-ray,or an abdominal non-contrast computed tomography if the stones were known to be radiolucent.Results:A total of 480 consecutive patients who underwent RIRS for treatment of lower pole renal calculi,between January 2012 and December 2018,were analyzed from a prospectively maintained database of 3000 ureteroscopies.With a median follow-up time of 18.6 months,the mean SFR was 94.8%.The procedures were unsuccessful in 26(5.4%)patients due to unreachable stones.The median stone size of the unreachable stones was 12 mm(range 10e30 mm).Multivariable logistic regression analysis revealed two predictors of SFR for lower pole stones:a small cumulative stone burden(odds ratio[OR]:0.903,95%confidence interval[CI]:0.867e0.941,p<0.0001)and preoperative ureteral stent insertion(OR:0.515,95%CI:0.318e0.835,pZ0.007).Conclusion:The long-term SFR of RIRS for the treatment of lower pole stones with basket displacement with appropriate patient selection is high.Dor Golomb Hanan Goldberg Shlomi Tapiero Yariv Stabholz Paz Lotan Abd Elhalim Darawsha Ronen Holland Yaron Ehrlich David Lifshitz 2023Asian Journal of Urology2023,10,1:0
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