ABSTRACT
Varicocele is a well-known and highly prevalent medical problem in young obligatory service recruits. Still, there are many questions regarding its management. Is there a clear relation between varicocele and infertility? Can early varicocelectomy in young soldiers prevent future infertility? Is there a role for varicocelectomy in pain relief in physically active soldiers? And finally, what are the pros and cons of the open surgical, laparoscopic, or radiographic techniques in this specific population? Answering these questions should help military physicians in varicocele patients' care. It should also help decision makers to build cost-effective and evidence-based health policy. In this article, we review the literature regarding the controversies in the management of varicocele in young adults and delineate the current policy of the Israel Defense Forces Medical Corps.
Subject(s)
Military Personnel , Varicocele/complications , Varicocele/therapy , Age Factors , Embolization, Therapeutic , Humans , Infertility, Male/etiology , Israel , Ligation , Male , Pain/etiologyABSTRACT
On 17 August 1999 at 3:04 a.m., an earthquake of 7.4 magnitude (Richter scale) struck the Marmara region in Turkey. The city of Adapazari suffered 2,680 fatalities with approximately 5,300 injured. The Israeli Defence Forces (IDF) field hospital arrived at Adapazari, on day four after the quake. The team consisted of 102 personnel. The field hospital acted as a secondary referral centre. A total of 1,205 patients were treated in the field hospital between day four and day 14 of the earthquake. The frequency distribution of the medical problems seen in the field hospital was 32 per cent internal medicine, 13 per cent general surgery including plastic, 21 per cent orthopaedic surgery, 23 per cent paediatric disease, 10 per cent obstetrics and gynaecology and 1 per cent major psychiatric disorders. A mean number of 35 patients per day were hospitalised in the field hospital for between 24 hours to one week. The rapid establishment of the field hospital enabled the local medical facilities to 'buy time' in order to organise and restore surgical and hospitalisation abilities in this disastrous situation.
Subject(s)
Civil Defense , Disasters , Emergency Medical Services , Relief Work , Emergency Medical Services/statistics & numerical data , Hospitalization/statistics & numerical data , Humans , Israel , Medicine/statistics & numerical data , Specialization , Turkey , Wounds and Injuries/epidemiologyABSTRACT
We report a 16-year-old girl with acute intermittent porphyria who had abdominal pain, generalized tonic-clonic and simple partial seizures, and inappropriate antidiuretic hormone secretion. Because most antiepileptic drugs are contraindicated in porphyria, she was treated with magnesium sulfate i.v. Soon after starting treatment, seizures stopped, returned, and then again responded in several trials with discontinuation and reinstitution of i.v. magnesium sulfate. Our experience encourages the use of magnesium sulfate for treatment of seizures in patients with porphyria.
