Noah Samuels

Technion - Israel Institute of Technology, H̱efa, Haifa District, Israel

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Publications (38)64.84 Total impact

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    ABSTRACT: The purpose of this study is to compare the rationale given by oncology health care practitioners (HCPs) for referral of their patients with breast cancer to a complementary medicine (CM) consultation with patient expectations from the CM treatment process.
    Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer. 07/2014;
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    ABSTRACT: Objective The aim of this study was to assess patient perspectives regarding non-specific effects of a complementary medicine (CM) consultation and intervention within an integrative oncology setting.Methods Patients undergoing chemotherapy in a community-based oncology service were referred by oncology healthcare providers to an integrative oncology physician trained in CM-oriented supportive care. Assessment of concerns and well-being was made using the Measure Yourself Concerns and Wellbeing questionnaire, at baseline and after 3 months of CM treatments, which were designed to improve quality of life (QoL) outcomes. Patients were asked to describe the most important aspects of the integrative treatment process. Free-text narratives were examined using content analysis with ATLAS.Ti software for systematic coding.ResultsOf 152 patients' narratives analyzed, 44% reported an experience of patient-centered care, including CM practitioners' approach of togetherness, uniqueness, and the invoking of an internal process. CM practitioner approach was experienced within a context of an enhanced sense of confidence; gaining a different perspective; and acquiring emotional resilience and empowerment.Conclusions Short patient narratives should be considered for patient-reported outcomes, expressing perspectives of both effects and experience of care. CM may promote patient QoL-related outcomes through non-specific effects, enhancing patient-centered care. The benefits of CM dependent on general therapeutic incidental aspects (i.e., common factors) warrant attention regarding non-specific components of treatment. Copyright © 2014 John Wiley & Sons, Ltd.
    Psycho-Oncology 07/2014; · 3.51 Impact Factor
  • Journal of alternative and complementary medicine (New York, N.Y.) 05/2014; 20(5):A11. · 1.69 Impact Factor
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    ABSTRACT: The use of complementary traditional medicine (CTM) is prevalent among patients with cancer. An understanding of cultural and religious values is needed to design an effective patient-centered supportive treatment program. To examine gender-related demographic and professional characteristics; treatment goals and approaches; and attitudes toward integration among Arab practitioners of CTM. Male and female Arab CTM practitioners treating patients with cancer were located by snowballing through practitioner and clientele networks. Participants underwent semi-structured, in-depth interviews which were analyzed thematically, with a focus on gender-related issues. A total of 27 Arab CTM practitioners participated in the study (17 males, 10 females). Female practitioners were found to be treating women exclusively, with male practitioners treating both genders. Female practitioners tend to be younger, unmarried, urban-based and non-Muslim. Male practitioners set out to "cure" the cancer, while female practitioners focus on symptoms and quality of life. Male practitioners employ a more schematic and structured therapeutic approach; female practitioners a more eclectic and practical one. Male practitioners employ a collectivist approach, involving family members, while female practitioners interact exclusively with the patient. Finally, male CTM practitioners see integration as a means for recognition, increasing their power base. In contrast, female practitioners perceive integration as a foothold in fields from which they have previously been shut out. A number of gender-related issues can have a significant impact on CTM therapy among Arab patients. Further research is needed in order to understand the implications of these differences.
    Journal of Immigrant and Minority Health 04/2014; · 1.16 Impact Factor
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    ABSTRACT: Background The integration of complementary medicine is gradually becoming an accepted part of standard care for patients with cancer. In our integrative oncology program we have encountered difficulties in recruiting Arab patients. In order to understand the special needs of this population, we conducted interviews among Arab practitioners of complementary and traditional medicine (CTM). The characteristics of practitioners and their views regarding the therapeutic process were examined. Methods Semi-structured qualitative interviews were administered to 27 Arab practitioners of CTM whose clientele was comprised primarily of Arab cancer patients. Conventional content analysis of the transcribed interviews and field notes were performed in order to identify key themes. Result Three groups of CTM practice were identified: Folk-herbal medicine (n=9); complementary medicine (CM; n=14); and religious healing (n=4). Seven factors were identified in the practitioner accounts: the duration and scheduling of treatment sessions; the language of communication; the presence of family members; the appearance of the practitioner; the definition of treatment goals; the discussion of behavioral and lifestyle changes; and finally, the use of tangible elements in treatment. Conclusions The study of Arab CTM practitioner recommendations may help facilitate a culture-sensitive encounter with Arab patients with cancer. This approach may also have implications for other ethno-culturally unique populations. [207 words]
    EXPLORE The Journal of Science and Healing 01/2014; · 0.92 Impact Factor
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    ABSTRACT: Patients with cancer are frequently turning to complementary medicine (CM), often with the goal of improving quality of life outcomes. The purpose of the present study was to assess the adherence of patients referred by oncology practitioners to a CM consultation and treatment program. A prospective registry protocol-based, preference study was conducted at a conventional oncology department. Patients undergoing chemotherapy were referred by participating oncology practitioners to a CM-trained integrative physician (IP) for consultation. Adherence to the integrative care (AIC) program was defined as attendance by patients at ≥4 CM treatment sessions, with an interval of no more than 30 days between each session. A total of 282 patients were referred by the study health-care professionals (HCPs), of whom 243 (85.8 %) were eventually seen by the study IP. Of these, 160 were found to be adherent to the treatment plan (AIC group), and 83 were nonadherent (non-AIC group). No significant differences were found between the two groups with respect to demographic characteristics, medical history, site of malignancy and/or recurrence, chemotherapy regimen, or severity of symptoms at baseline. The AIC group reported significantly greater rates of CM use for noncancer-related indications than the non-AIC group (EXP(B) = 2.174, 95 % confidence interval (C.I.) = 1.1-4.295, p = 0.025). Patients in the non-AIC group were referred more frequently by their HCP for gastrointestinal concerns than those in the AIC group (p = 0.022). Previous use of CM for noncancer-related outcomes was found to be predictive of patient adherence to a CM treatment regimen provided within conventional oncology service.
    Supportive Care in Cancer 10/2013; · 2.09 Impact Factor
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    ABSTRACT: To explore oncology healthcare providers' (HCPs') patterns of referral of women undergoing chemotherapy to a complementary medicine (CM) consultation integrated within a conventional oncology service. Oncology HCPs used a structured referral system for referral to an integrative physician (IP) for CM consultation. Referral goals were in accordance with a specified list of quality-of-life (QOL) outcomes. In total, the study HCPs referred 282 female patients, of whom 238 (84.4%) underwent CM consultation by the study IP: 59 (24.8%) with gynecologic cancer and 179 (75.2%) with non-gynecologic cancer. Use of CM for cancer-related outcomes was significantly higher among referred patients with gynecologic cancer than those with non-gynecologic cancer (69.5% vs 46.9%; P=0.003). Oncologists initiated most of the referrals in the gynecologic oncology group, whereas oncologic nurses referred most patients in the non-gynecologic oncology group. Among patients with gynecologic cancer, the correlation between HCP indication and patient expectation was high for gastrointestinal concerns (κ 0.41). The integration of a structured and informed process of referral to CM consultation may enhance patient-centered care and QOL during chemotherapy.
    International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics 10/2013; · 1.41 Impact Factor
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    ABSTRACT: CONTEXT: Many cancer patients are using non-herbal nutritional supplements (NHNS), often without informing their oncologists. OBJECTIVES: To review the literature and summarize the beneficial effects and safety of NHNS in the prevention and reduction of treatment-related symptoms. METHODS: Databases were searched for randomized, controlled clinical trials (Jadad score ≥ 2) using AltHealthWatch, Cochrane Database of Systematic Reviews, Embase, MEDLINE, Memorial Sloan-Kettering Integrative Medicine Service Database, Natural Standard Database, and PubMed. The key words searched were the following: alternative and/or complementary medicine, nutritional and/or dietary supplements, quality of life, symptoms and/or side effects, specific toxicities (e.g., neuropathy, mucositis), and specific supplements (e.g., vitamin E, glutamine, etc.). RESULTS: A number of NHNS products were found to be effective. The incidence and severity of peripheral sensory neuropathy associated with taxane-agents such as paclitaxel can be reduced with vitamin E, glutamine, and acetyl-L-carnitine. Vitamin E and glutamine also have been shown to reduce oral mucositis resulting from radiation and chemotherapy, and glutamine and probiotics can reduce chemotherapy-induced diarrhea. CONCLUSION: There is a need to develop an open and nonjudgmental dialogue between oncologists and cancer patients, addressing the needs of the patient while dealing with issues related to the efficacy and safety of these products. Referral of patients to an integrative medicine consultant may help achieve these goals, providing both parties with the option of reaching an informed and respectful decision about treatment.
    Journal of pain and symptom management 05/2013; · 2.42 Impact Factor
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    ABSTRACT: OBJECTIVE: To examine attitudes toward and use of complementary and alternative medicine (CAM) by obstetricians during pregnancy and childbirth. METHODS: Between 2010 and 2011, obstetricians from 7 medical centers (n=170) in Israel completed questionnaires examining the use and recommendation of CAM treatments during pregnancy and childbirth. Attitudes were examined via the CAM Health Belief Questionnaire (CHBQ). RESULTS: Over half of the participants (58.8%) reported using at least 1 CAM treatment, and nearly two-thirds had recommended or would recommend CAM to pregnant patients. By contrast, use of CAM during childbirth was recommended by only 26% of respondents. The total CHBQ score was moderately high (mean±SD, 40.4±7.30; possible range, 7.0-70.0), indicating an overall positive attitude toward CAM. Female board-certified specialists answered more favorably regarding attitudes toward CAM (P=0.004). The structural validity of the CHBQ was examined using varimax rotation factor analysis, which produced a 3-factor solution explaining 63.1% of the variance. CONCLUSIONS: Most obstetricians exhibited positive attitudes toward CAM and recommended its use during pregnancy, but did not support CAM use during childbirth. This discrepancy might be partly due to the involvement of Israeli obstetricians in predominantly high-risk cases of childbirth requiring intervention.
    International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics 03/2013; · 1.41 Impact Factor
  • Noah Samuels, Elad Schiff, Eran Ben-Arye
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    ABSTRACT: Patients with breast cancer frequently turn to complementary medical therapies, including non-herbal nutritional supplements (NHNS). A number of NHNS products have been shown to potentially reduce the incidence and severity of adjuvant treatment-related symptoms. We review the literature and summarise the potential beneficial effects of these products and address issues regarding the safety of this practice. We offer an evidence-based approach for advancing a dialogue between doctors and patients interested in NHNS for adjuvant treatment-related toxicities.Taxane agents such as paclitaxel are frequently complicated by peripheral sensory neuropathy. The findings from several studies suggest that supplementation with vitamin E, glutamine and acetyl-L-carnithine may reduce the incidence and severity of paclitaxel-induced neuropathy. Glutamine has also been shown to reduce the incidence and severity of chemotherapy-induced and radiation-induced oral mucositis. Selenium can reduce upper limb lymphoedema following surgery and radiation treatments, and an antioxidant supplement has exhibited a protective effect against radiation-induced dermatitis. Finally, vitamin D has been shown to be effective in reducing the incidence and severity of arthralgia resulting from treatment with the aromatase inhibitor letrozole. The use of coenzyme Q10 was not found to be of benefit for cancer-related fatigue.There is a need to develop an open and non-judgmental dialogue between doctors and their patients with breast cancer, respecting the needs of the patient while addressing issues related to the efficacy and safety of NHNS products. Referral of patients to an integrative medicine consultant may help achieve these goals.
    Supportive and Palliative Care 02/2013;
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    ABSTRACT: The treatment of breast cancer invariably results in severe and often debilitating symptoms that can cause significant distress and severely impair daily function and quality-of-life (QOL). We treated a series of 20 female breast cancer patients with the botanical compound LCS101 as adjuvant to conventional chemotherapy. At the end of the treatment regimen, patients rated their symptoms. 70% reported that they had either no or mildly severe levels of fatigue; 60% none to mildly severe weakness; 85% none to mildly severe pain; 70% none to mildly severe nausea; and 80% none to mildly severe vomiting. Only 20% reported severe impairment of overall function, and only 40% severely impaired QOL. No toxic effects were attributed by patients to the LCS101 treatment, and 85% reported that they believed the botanical compound had helped reduce symptoms. The effects of LCS101 on clinical outcomes in breast cancer should be tested further using randomized controlled trials.
    Integrative Medicine Insights 01/2013; 8:1-8.
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    ABSTRACT: Background and aim: Current treatment of gingival recession (GR) is limited to surgical procedures. We describe a case series of 18 patients with GR who were treated with a botanical patch and rinse following standard conservative therapy. Case series description: A total of 22 sites with GR > 1 mm were studied. Following scaling and root planing (SRP) and oral hygiene instruction, patients received two courses of patch treatment (3 days each) and botanical rinse administered twice daily throughout the treatment period. Outcome measures (GR, gingival index (GI) and gingival thickness (GT) were taken at baseline; at 1 to 2 weeks; 2 to 4 weeks; and at 6 to 8 weeks. Miller classifcation and plaque index (PI) were measured at baseline and at 6 to 8 weeks. At the end of the treatment period, mean GR decreased from 4.18 ± 1.74 mm to 3.31 ± 1.51 mm (20.8%); Miller grade from 1.86 ± 0.56 to 1.06 ± 0.43; GI scores from 1.45 ± 0.63 to 0.17 ± 0.38 (88.3%); and PI scores from 1.33 ± 0.59 to 0.78 ± 0.94. GT increased from 0.74 mm ± 0.40 to 1.21 ± 0.39 (63.5%). No adverse effects were reported with either the patch or rinse treatments. Conclusion: We observed a decrease in GR and GI scores in 18 patients (22 sites) treated with the study patch and rinse, with increased GT. Clinical significance: A combined botanical patch-rinse treatment may be effective as adjuvant treatment to standard conservative care for GR. Further research is needed to verify these fndings. Keywords: Gingival recession, Inflammation, Botanical compounds, Topical patch, Mouthrinse, Case series. How to cite this article: Levine WZ, Samuels N, Sheshet MEB, Grbic JT. A Novel Treatment of Gingival Recession using a Botanical Topical Gingival Patch and Mouthrinse. J Contemp Dent Pract 2013;14(5):948-953. Source of support: Dr Levine is Chief Executive Offcer and Drs Samuels and Grbic have provided consulting services for Izun Pharma, Israel. The study medications were provided free of charge by Izun Pharma, Israel, who funded the statistical analysis of the data as well. Izun Oral Rinse® and PerioPatch® are products of Izun Pharmaceuticals Corporation New York, NY. Confict of interest: None declared.
    The journal of contemporary dental practice 01/2013; 14(5):948-53.
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    ABSTRACT: To examine the effects of LSC101, a botanical compound, on adaptive and innate immunity. LCS101 preparations were tested for batch-to-batch consistency using high-performance liquid chromatography. T-cell activation was quantified in murine spleen cells using 3H-thymidine incorporation, and cytokine production analyzed with enzyme-linked immunosorbent assay. Natural killer cell activity was tested on human blood cells using flow cytometry, and cytotoxicity measured by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide and apoptosis using a FACSCalibur. Effects on interferon-γ production in fluorouracil/doxorubicin-treated mice were tested with enzyme-linked immunosorbent assay. High-performance liquid chromatography analysis demonstrated batch-to-batch consistency. T-cell proliferation was increased, and a dose-dependent activation of natural killer cells and macrophage tumor necrosis factor-α secretion were observed with LCS101 treatment. Interferon-γ levels, reduced following fluorouracil treatment, were corrected in treated animals. No toxicity or compromised treatment outcomes were associated with LCS101 exposure. LCS101 demonstrated significant effects on a number of immune processes. Further research is needed in order to understand the molecular immunomodulatory pathways affected by this compound, as well as clinical implications for treatment.
    OncoTargets and Therapy 01/2013; 6:437-45. · 2.07 Impact Factor
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    ABSTRACT: OBJECTIVE: To study non-vitamin, non-mineral (NVNM) supplements use and disclosure of among hospitalized internal medicine patients. METHODS: A convenience sample of patients completed an interviewer-administered questionnaire examining use of and perceptions regarding NVNM supplements, and disclosure to medical personnel. RESULTS: 280 patients were interviewed (54% female), 15.4% reporting NVNM supplement use. This practice was more prevalent among female patients (p=0.045), more educated (p<0.001) and patients with more impaired quality-of-life, measured by the SF-12 tool (p<0.020). The most common factor influencing NVNM supplement use was a physician's recommendation. Most (74%) patients using NVNM supplements reported having disclosed this practice to community-based physicians, with only 23.7% disclosing to hospital staff. Six patients reported using supplements at the exclusion of conventional medication, with potentially serious implications. CONCLUSION: While the majority of patients using NVNM supplements are sharing this information with their primary-care physicians, there is little disclosure of this practice to hospital staff. This may be due to a perceived negative attitude of medical professionals to complementary medicine, and a lack of awareness by hospital staff regarding such practices. PRACTICE IMPLICATIONS: Hospital-based medical professionals need to be aware of the use of NVNM supplements and the resulting implications by their internal medicine patients.
    Patient Education and Counseling 07/2012; · 2.60 Impact Factor
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    ABSTRACT: The purpose of this study was to examine the effect of acupuncture on bone/joint pain, headache and fatigue, as well as quality of life in patients with Gaucher disease (GD), within the framework of an integrated treatment programme. Patients with GD suffering from any of the above symptoms were offered a series of 10-12 weekly acupuncture treatment sessions. Prior to initiation of treatment, participants were asked to score the severity of pain, as well as to complete the Functional Assessment of Chronic Illness Therapy-Fatigue measure (FACIT-F) and the Medical Outcomes Study (MOS) Short-Form (SF) questionnaire. These tools were evaluated again at the end of the treatment period. A total of 12 patients were evaluated. While the only pain outcome reduced by acupuncture was knee pain, a significant improvement was observed with respect to nearly all FACIT-Fatigue measures, including the Physical Well Being (PWB) subscales and the SF-12 Physical Composite Score (PCS), though not for the Mental Composite Score (MCS). Patients reported satisfaction with the treatment process, and no significant side effects were reported. Acupuncture may play a beneficial role for patients with GD when used in conjunction with conventional therapy, reducing fatigue and improving physical function. The preliminary finding of this observational study should encourage further research.
    Complementary therapies in medicine 06/2012; 20(3):131-4. · 1.95 Impact Factor
  • Article: In Reply.
    The Oncologist 04/2012; · 4.10 Impact Factor
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    ABSTRACT: Gingivitis is a chronic inflammatory condition, resulting from gingival bacteria and bacterial byproducts. Antiplaque oral rinses reduce inflammation by removing or inhibiting plaque formation. The purpose of this pilot study was to examine the anti-inflammatory effects of HM-302, a mouth rinse based on natural products, on gingival inflammation. A prospective, double-blinded, randomized parallel-group controlled trial involving 62 patients was conducted to assess efficacy and safety. During a 2-week period with no dental hygiene, subjects were randomized to receive either the study rinse (HM-302); a cetylpyridinium chloride (CPC) rinse; an essential oils (EO) rinse; or a water-only preparation. The gingival index (GI), plaque index (PI), and number of bleeding sites were measured at baseline and at the end of the study period. Progression of gingival inflammation resulting from lack of dental hygiene was lowest in patients treated with the HM-302 rinse, and was significantly less marked than in patients treated with the water-only preparation. When compared to the CPC and EO treatments, HM-302 was the only mouth rinse that was significantlybetter than the control, with respect to both the change in absolute GI scores (p = .006) and to the percent increase in GI scores (p = .012). No serious adverse effects were noted in any of the study groups. HM-302 is a safe and effective treatment for preventing the development of gingival inflammation in an experimental gingivitis model. Further research is needed to evaluate its long-term effects.
    Compendium of continuing education in dentistry (Jamesburg, N.J.: 1995) 03/2012; 33(3):204-6, 208-11.
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    ABSTRACT: Sites of inflammation were identified on subjects with moderate-to-severe chronic periodontitis, and were allocated to either patch placement or untreated controls, both for 24 hours. Conventional treatment with scaling and root planing was postponed during the study period. Inflammation was evaluated measuring neutrophilic activity using gingival crevicular fluid (GCF) beta-glucuronidase (b-glu) levels, and clinical response was evaluated using the gingival index (GI). A total of 26 patients were recruited and 36 sites examined, with 22 sites on which the patch was placed and 14 controls. GCF b-glu levels at 24 hours were reduced following patch placement, significantly more so than with controls (17/22 vs. 3/14 sites, respectively; p = 0.002). The patch placement resulted in a significant reduction in mean b-glu levels (-2.52 +/- 1.62), with a reduction from baseline of 29.7%. This compared to untreated controls, for whom the mean b-glu levels and percent change from baseline increased (2.14 +/- 0.89 and 33%, respectively). At 24 hours, GI response rate for treated sites was better than for control sites (18/21 vs. 7/14; p = 0.053). No adverse events were reported in either group. This pilot study indicates that a topical gingival patch promotes reduction of gingival inflammation. Further clinical testing of this novel treatment of gingival inflammation is warranted.
    The Journal of clinical dentistry 01/2012; 23(2):64-7.
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    ABSTRACT: We present a case of eosinophilic pleural effusion due to valproic acid (VPA), a rare adverse event that has been reported previously. A 30-year-old male patient presented with respiratory symptoms and right-sided pleuritic pain, within days of initiation of VPA treatment for a generalized seizure. Chest radiography revealed a moderate-sized right-sided pleural effusion, which was an exudate with a pH of 7.54 and 48% eosinophils. Symptoms resolved soon after discontinuation of the drug, as did the effusion in a repeat radiograph 3 weeks later. The likelihood that VPA was the cause of the effusion is examined.
    The Neurologist 01/2012; 18(1):39-40. · 1.48 Impact Factor
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    ABSTRACT: An 81-year-old woman with adenocarcinoma of the rectosigmoid presented with progressive muscle weakness and difficulty swallowing, with symptoms worsening following successful resection of the tumor. On examination, she had weakness primarily of lower limb proximal muscles, with no other abnormal findings. Laboratory tests showed significant elevation of creatine kinase, and EMG findings indicated myositis of the proximal muscles. While MRI showed increased signal intensity on T2-weighted images of the leg muscles, indicating inflammation, muscle biopsy found widespread necrosis with only weak and focal lymphocytic infiltration. A diagnosis of paraneoplastic necrotizing myopathy (PNM) was made, and immunomodulatory treatment initiated, with little response. Four months later she returned with exacerbation of symptoms, this time with skin changes pathognomonic of dermatomyositis (DM). A repeat MRI showed progression of inflammation, as well as necrotic foci. It is important to distinguish between paraneoplastic myopathies such as DM and PNM, with implications regarding treatment and prognosis.
    Rheumatology International 12/2011; · 2.21 Impact Factor

Publication Stats

102 Citations
64.84 Total Impact Points


  • 2013
    • Technion - Israel Institute of Technology
      H̱efa, Haifa District, Israel
  • 2008–2013
    • Shaare Zedek Medical Center
      • Center for Integrative Complementary Medicine
      Yerushalayim, Jerusalem District, Israel
  • 2011–2012
    • Bikur Holim Hospital,
      Yerushalayim, Jerusalem District, Israel
  • 2010
    • Sheba Medical Center
      Gan, Tel Aviv, Israel
  • 2005
    • Tel Aviv Sourasky Medical Center
      Tell Afif, Tel Aviv, Israel