Yshai Levy

Publications (2)2.53 Total impact

• Article: [Hypophosphatemia in the hospitalized patient].

  Irit Chermesh, Carmit Meshulam, Ada Tamir, Rami Eliakim, Yshai Levy
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  ABSTRACT: Phosphate is an obligatory component of cellular function. Serum, levels are maintained within narrow levels by regulatory mechanisms. The normal range of phosphate concentration is 2.5-4.5 mg/dL. In certain clinical situations these mechanisms are insufficient and hypophosphatemia ensues. This study aimed to compare hospitalization course and clinical outcome of patients with moderate hypophosphatemia (1.0-2.0 mg/dl) with patients with extreme hypophosphatemia (< 1.0 mg/dL). Patients who had at least one measurement of serum phosphate level of 1.0 mg/dL or less comprised the extreme hypophosphatemic group. Patients with at least one serum, phosphate level of between 1.0 and 2.0 mg./dL, but never had a phosphate level of less than 1.0 mg/dL comprised the moderate hypophosphatemic group. Files of 50 consecutive patients who had extreme hypophosphatemia and 100 consecutive patients with moderate hypophosphatemia were retrieved and analyzed. The two groups of patients were similar with reference to age, gender ratio, background disease and indication for hospitalization. There was a higher proportion of obese patients in the moderate hypophosphatemia group. There was a higher proportion of patients who consumed alcohol on a regular basis before hospitalization in the extreme hypophosphatemic group. Patients suffering from extreme hypophosphatemia were more likely to be hospitalized in the intensive care unit and ventilated on hospitalization. Length of hospitalization was longer for the extreme hypophosphatemia group than for the moderate hypophosphatemia group. When comparing the group outcomes it was found that more patients with severe hypophosphatemia died. Severe hypophosphatemia is a severe metabolic derangement. It appears in critically sick patients, who should be followed closely and treated properly. The clinical relevance of moderate hypophosphatemia was not checked in this study.
  Harefuah 11/2006; 145(11):786-8, 864.
• Article: Antibiotic utilization prevalence: prospective comparison between two medical departments in a tertiary care university hospital.

  Inna Gendel, Zaher S Azzam, Eyal Braun, Yshai Levy, Norberto Krivoy
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  ABSTRACT: The aim of this study was to analyze prospectively antibiotic utilization, comparing two in-patient Internal Medicine units. Data on individual antibiotic utilization pattern and antibiotic costs were collected prospectively from hospitalized patient charts over a 12-month period, using the prescription-point prevalence method twice a month, for a total of 24 encounters for each admission unit. The antibiotic volume/patient (number of prescriptions), using the prescription-point prevalence methodology, was 330 and 557 in Internal Medicine B and D, respectively, resulting in 1.29 and 1.25 antibiotic courses/patient for each of the two units, respectively (p = 0.91). Thirty-five percent and 39% of the patients received at least one anti-microbial prescription. The total defined daily dose (DDD) and drug utilization 90% (DU90%) index for the units were 432.7 DDD, DU90% 389.7 and 727.8 DDD, DU90% 660.4, respectively (p = 0.01). The drug cost 90% index (DC90%) placed piperacillin-tazobactam in the first place in both units, while amoxycillin-clavulanic acid was in first place when the DU90% index was applied. A significant statistical difference was found in the anti-microbial cost analyzes of DDD, DU90% and DC90% indexes of the two units, using the prescription-point prevalence methodology. The intervention of a clinical pharmacology specialist in one of the units was effective in reducing the costs registered in that unit.
  Pharmacoepidemiology and Drug Safety 11/2004; 13(10):735-9. · 2.53 Impact Factor