Yehezkel (Hezi) Waisman

Tel Aviv University | TAU · Department of Anesthesiology and Critical Care

Background A host-protein score (BV score) that combines the circulating levels of TNF-related apoptosis-inducing ligand (TRAIL), interferon gamma-induced protein 10 (IP-10) and C-reactive protein (CRP) was developed for distinguishing bacterial from viral infection. This study assessed the potential of the BV score to impact decision making and an...

Background A host-protein score (BV) combining the circulating levels of TRAIL, IP-10 and CRP was developed for distinguishing bacterial from viral infection. BV’s potential to impact decision making at the emergency department (ED) was assessed by comparing BV to physician’s etiological suspicion. Methods Rosetta study participants, aged 3 months...

Introduction: Children and adolescents often lack optimal emergency care. The objective of the study was to assess the level of preparedness of European emergency departments (EDs) for pediatric patients. Methods: This was an international multicenter Internet-based survey of EDs with attending children and adolescents younger than 18 years in 1...

Objective Research in European Paediatric Emergency Medicine (REPEM) network is a collaborative group of 69 paediatric emergency medicine (PEM) physicians from 20 countries in Europe, initiated in 2006. To further improve paediatric emergency care in Europe, the aim of this study was to define research priorities for PEM in Europe to guide the deve...

OBJECTIVE: Research in European Paediatric Emergency Medicine (REPEM) network is a collaborative group of 69 paediatric emergency medicine (PEM) physicians from 20 countries in Europe, initiated in 2006. To further improve paediatric emergency care in Europe, the aim of this study was to define research priorities for PEM in Europe to guide the dev...

We describe a previously healthy adolescent boy who presented with respiratory distress, hypotensive shock, and a diffuse erythematous rash. The final diagnosis was diabetic ketoacidosis. Caregivers should be alert to this unusual combination of symptoms in the emergency department setting in order to improve the recognition and management of child...

Pediatric emergency medicine (PEM) has been developing rapidly but heterogeneously in many European countries in recent years, and many national PEM societies have been founded to improve the quality of care of ill and injured children and adolescents. Key facets of any such improvement are the development, delivery and translation of high-quality...

Objective To identify historical and clinical findings at emergency department presentation associated with severe H1N1 outcome in children presenting with influenza-like illness. Design Multicentre retrospective case-control study. Setting 79 emergency departments of hospitals associated with the Pediatric Emergency Research Networks in 12 countri...

Introduction and purpose of the study With this study we aimed to describe a “true world” picture of severe paediatric ‘community-acquired’ septic shock and establish the feasibility of a future prospective trial on early goal-directed therapy in children. During a 6-month to 1-year retrospective screening period in 16 emergency departments (ED) in...

This work describes the challenges encountered by the author in establishing and developing emergency medicine and pediatric emergency medicine as medical specialties in Israel. Many of the measures were largely based on his training in the United States, including a clinical fellowship in pediatric emergency medicine at the Children's National Med...

Purpose: During the H1N1 pandemic pediatric emergency departments (EDs) worldwide experienced a large peak in total patient volumes due to children presenting with influenza-like illness (ILI). There have been no reports detailing risk factors at ED presentation for morbidity and mortality in such children. Our aim was to identify historical and cl...

Objectives of the Pediatric Emergency Research Network's (PERN's) meeting included (1) learn about each of the participating network's missions, goals, and infrastructure; (2) share important contributions each network has made to the creation of new knowledge; (3) discuss "best practices" to improve each network's effectiveness; and (4) explore th...

Children are the most vulnerable sub-population in mass casualty events (MCEs), however, characteristics of MCE related injuries among children have not been well described. The aim of our study was to characterize childhood injuries resulting from MCEs in Israel including parameters such as magnitude, injury mechanism and severity and use of hospi...

Children with seizures are often referred to the emergency department where they are typically evaluated by a physician with limited knowledge of pediatric epileptology and undergo a costly and extensive work-up that contributes little to the final decision. The aim of this study was to examine the medical management of children with nonfebrile sei...

Mass-Casualty Events and their Toll on the Pediatric Population - Volume 25 Issue S1 - Yehezkel Waisman, Sharon Goldman, Oded Poznanski, Meirav Mor, Kobi Peleg

This is a case study of a 5-week-old child, after prolonged hospitalization in the Neonatal Intensive Care Unit, with fever and urinary tract infection caused by extended-spectrum beta-lactamase (ESBL)-producing, gentamicin-resistant, Escherichia coli. This case highlights the importance of taking risk factors for resistant bacterial infection into...

Administration of medications via the intraosseous (IO) route has proven to be a lifesaving procedure in critically ill or injured children. Two mechanical IO infusion devices have been approved for use in children, the spring-loaded IO infusion device (Bone Injection Gun, BIG) and the battery-powered IO infusion drill (EZ-IO). The objective of thi...

Acute appendicitis after abdominal trauma, although rare, has been described in the past. We herein report, for the first time, a case of acute appendicitis after a blunt trauma to the perineum in a boy. Clinicians taking care of children with injuries to the abdomen or perineal area should be aware of the possibility that they can develop posttrau...

A case of bilateral primary spontaneous pneumothorax ("buffalo chest") in a previously healthy man is described. The clinical presentation and treatment options are discussed.

C-reactive protein (CRP) values are clinically useful in differentiating viral from bacterial illnesses in children, but the regular test is impractical in the emergency department (ED) setting. To investigate the validity and feasibility of the 2-min bedside Quick Read (QR)-CRP test in the prediction of bacterial pneumonia in children in the ED. F...

To determine the clinical usefulness of the bedside Quick-Read (QR) C-reactive protein (CRP) test for predicting bacterial gastroenteritis in the pediatric emergency department. We tested for CRP in 44 children who presented to the emergency department with gastroenteritis and underwent blood tests and stool culture. C-reactive protein was measured...

Intramuscular dexamethasone is an effective, but painful, treatment for croup. The effectiveness of betamethasone, an oral, palatable, and equally potent glucocorticoid has not been studied. The purpose of this study was to compare the effectiveness of a single oral dose of betamethasone with intramuscular dexamethasone in the outpatient treatment...

To describe a combined program for ongoing medical education and quality assurance in the pediatric emergency department. Between January and June 2003, all residents and students working in the emergency department of a major tertiary pediatric center were required to participate in a structured 1-h morning session every weekday conducted by the a...

Israel has been subject to hundreds of violent acts against the civilian population in the last several years, many of them mass casualty incidents involving children. The pediatric age group is characterized by unique anatomical, physiological, and developmental traits that make the treatment of traumatic injury particularly difficult. The aim of...

The Pediatric Advanced Life Support course of the American Heart Association/American Academy of Pediatrics was established in Israel in 1994 and has since been presented to over 3,108 medical and paramedical personnel. To assess the achievements of participants in the PALS course, as a cohort and by professional group, and their evaluations of dif...

To investigate the contribution of diagnosis-specific information sheets at discharge from the emergency department on parental understanding of the discharge instructions. The study group consisted of a convenience sample of parents of children discharged home from the emergency department of an urban tertiary care pediatric facility (n=95). At di...

To characterize the injuries to children by acts against civilian populations (AACP). Only 2 articles have focused on the spectrum and severity of injuries to children by AACP. A retrospective case study of children 0 to 18 years old who were entered into the Israel National Trauma Registry as a result of AACP between September 29, 2000, and June 3...

The object of this study was to provide data for policy making and prevention program planning in Israel. The study examined all visits to the Department of Emergency Medicine at the Schneider Children's Medical Center in 1996 (41,279 visits in total). Approximately 22.6% of the emergency room patients were admitted following injury. Most (97%) wer...

To describe the development of emergency medicine (EM) in Israel and review the specific problems faced by the discipline and describe the solutions that were found. A comprehensive literature search was conducted for data on development of EM in the UK and in North America, and the personal knowledge of two of the authors (PH and YW) was used in p...

In the past 2 years hundreds of children in Israel have been injured in terrorist attacks. There is a paucity of data on the epidemiology of terror-related trauma in the pediatric population and its effect on the health care system. The objective of this study was to review the accumulated Israeli experience with medical care to young victims of te...

Understanding discharge instructions is crucial to optimal healing but may be compromised in the hectic environment of the emergency department. To determine parents' understanding of ED discharge instructions and factors that may affect it. A convenience sample of parents of children discharged home from the ED of an urban tertiary care pediatric...

To review and analyze the cumulative two-year, Israeli experience with medical care for children victims of terrorism during the prehospital and hospital phases. Data were collected from the: (1) Magen David Adom National Emergency Medical System Registry (prehospital phase); (2) medical records from the authors' institutions (pediatric triage); an...

International medical aid after natural disasters may take various forms, ranging from self-sufficient military forces to single experts or specialists who function primarily as advisers. A model integrating foreign and local medical staff has not previously been reported. In response to the call for international aid by the Honduran and El Salvado...

To determine whether the pediatric advanced life support (PALS) course contributes to the knowledge required by health care providers for pediatric resuscitation and whether differences in achievement exist between professional groups. Physicians, nurses, and paramedics from across Israel who registered for PALS were administered a standardized tes...

International medical aid after natural disasters may take various forms, ranging from self-sufficient military forces to single experts or specialists who function primarily as advisors. A model integrating foreign and local medical staff has not been previously reported. In response to the call for international aid by the Honduran government in...

To review the emergency department management of children with aseptic meningitis and compare the clinical features, laboratory findings, and short-term follow-up of those who were hospitalized or discharged to determine guidelines for discharge. Retrospective chart review study. Emergency department of an inner-city teaching, level III, children's...

To determine the validity of the Uriscreen, a rapid diagnostic test based on the detection of urine catalase for the early detection of urinary tract infection (UTI) in children, compared with standard urinalysis and dipstick tests. STUDY DESIGN. Cross-sectional study. Children 1 month to 17 years of age who presented to the emergency department of...

The worldwide increase in the incidence, prevalence, and severity of asthma may suggest that environmental factors play a role in these epidemiologic changes. To examine the correlations between air pollutants, weather conditions, airborne allergens, and the incidence of emergency room (ER) visits of children with acute asthma attacks. One-year pro...

To compare treatment of ongoing seizures using intramuscular (IM) midazolam versus intravenous (IV) diazepam. Controlled clinical trial. Children with motor seizures of at least 10 minutes' duration. Time to cessation of seizures. Twenty-four patients were enrolled (13 midazolam, 11 diazepam). Initial treatment with either midazolam or diazepam was...

We read with interest the article by Drs Flores and Weinstock1 regarding the preparedness of pediatricians' offices to deal with emergencies. There is no doubt that lack of preparedness may affect the outcome of an unexpected emergency. Although such a study, to our knowledge, has not been performed in Israel, based on personal information from ped...

Emergency medicine is in its infancy in Israel but is developing rapidly. Medical and government authorities such as the Israeli Medical Association and the Israeli Ministry of Health have already recognized the need for this field in Israel, although it remains for emergency medicine to be recognized as an independent medical specialty. Those invo...

We conducted a controlled clinical trial to determine the efficacy of single-dose intramuscular ceftriaxone for the treatment of acute otitis media. Fifty-four children aged 18 months to 6 years with clinical and tympanometric evidence of otitis media were randomized to receive either 50 mg/kg ceftriaxone or 10 days of oral cefaclor 40 mg/kg/day. R...

We investigated the effects of recombinant granulocyte colony-stimulating factor (G-CSF) in a canine model of septic shock. Awake 2-yr-old beagles were studied before and after intraperitoneal placement of an Escherichia coli-infected clot. Nine days before and until 3 days after clot placement, animals received daily high-dose (G-CSF (5 microgram/...

Although controversy still exists about dispensing medical advice over the telephone, such services are widely offered by pediatricians in the USA. In Israel, however, such services have not yet been developed. In a joint project of the Moked Keshev (a private medical help line) at Magen David Adom (national ambulance service) and the Children's Me...

We compared the clinical and bacteriologic response of 5-day treatment with cefixime, 8 mg/kg per day, with the response to trimethoprim-sulfamethoxazole (TMP-SMX), 10-50 mg/kg per day, the currently recommended therapy. Of the assessable children with acute, culture-proven shigellosis, 38 received cefixime and 39 received TMP-SMX. Pretreatment dat...

Because nationally accepted guidelines for the management of children with epiglottitis during transport have not been published, we surveyed physicians attending the 1990 Pediatric Critical Care Transport Leadership Conference in order to delineate current practices and to test for correlations between complications and methods of management. A 22...

We investigated the effects of a murine monoclonal antibody directed against the canine leukocyte CD11/18 adhesion complex (MAb R15.7) in a canine model of septic shock. Awake 2-yr-old purpose-bred beagles were studied 7 days before and 1, 2, 4, and 10 days after intraperitoneal placement of an Escherichia coli-infected fibrin clot. Starting 12 h b...

We examined the ability of commonly used clinical parameters to quantify acute hemorrhage in dogs. Eight animals were bled 40 ml/kg body wt over 100 min. Ten hemodynamic and 20 blood laboratory parameters were obtained every 10 min to construct, with use of linear regression analysis, models that quantify blood loss. During model construction, the...

Aerosolized racemic epinephrine, but not L-epinephrine, is commonly used in treating croup. The efficacy and adverse effects of nebulized racemic and L-epinephrine in the treatment of laryngotracheitis were compared. Children 6 months to 6 years of age with a croup score of 6 or above were assigned in a randomized double-blind fashion to receive ei...

Esophageal variceal bleeding owing to portal hypertension is a potential threat in pediatric patients awaiting liver transplantation. We report a case of a three-year-old boy with severe congenital hepatic fibrosis, Caroli's disease, and portal hypertension who developed a life-threatening variceal hemorrhage for the first time in his life during c...

We performed a clinical trial of a new tympanic thermometer to test its accuracy in a pediatric emergency department. Tympanic temperature was compared to oral or rectal glass and electronic temperature, depending on the developmental age of the child. Results were controlled for age of the child, cooperation, quantity of cerumen, and the presence...

We studied the effect of parenteral morphine and naloxone administration on intestinal mucosal Prostaglandin E2 (PGE2) and 3',5' cyclic adenosine monophosphate (cAMP) levels and on indomethacin-induced intestinal ulceration in the rat. Compared to the control group, morphine significantly decreased whereas naloxone markedly increased both PGE2 and...

We report a 12-year-old boy with multiple lentigines (Leopard) syndrome who was evaluated for learning difficulties and Gerstmann tetrad syndrome (i.e., dyscalculia, left-right disorientation, finger agnosia, and dysgraphia). Cranial computed tomography revealed left ventriculomegaly, more pronounced in the occipital horn suggesting mild atrophy of...

We cared for twin females with severe lamellar extoliation of the newborn (collodlon babies) and a family history of death of two brothers at age 3 months. The twins were given a controlled trial of etretinate (Ro 10-9359, Tigason) after not responding to other therapeutic modalities. One of the infants received 1 mg/kg body weight of the drug for...

The therapeutic effect of sucralfate on ulcerated gastric and duodenal mucosa is well known. There is, however, almost no information about its activity in colitis. Experimental colitis was produced in rats by rectal instillation of 1 ml of 10 percent acetic acid, and 1.5 ml of a 20 percent suspension of sucralfate was then administered every 12 ho...

The therapeutic effects of sucralfate on ulcerated gastric and duodenal mucosa is well known. There is, however, very little information about its effect on the mucosa of the small intestine. We studied the possible protective effect of sucralfate against indomethacin-induced intestinal ulceration in the rat. Sucralfate was found to possess a marke...

Three cases of stress fracture, in which diagnosis was aided by sequential radiographs and radionuclide scanning are presented; and a procedure for their management, which attempts to eliminate the need for invasive investigations, is suggested.

The possible protective effects of pentagastrin on indomethacin-induced small intestinal ulceration were investigated in rats. Ulcers were induced by subcutaneous injection of 30 mg/kg indomethacin, 30 min after refeeding rats fasted for 24 h. Administration of pentagastrin at a dose of 250 or 400 micrograms/kg i.p., 3 h prior to refeeding, reduced...

Naloxone, an opiate antagonist, was reported to protect against stress ulcers in dogs and rats. We studied its possible protective effect against indomethacin-induced intestinal ulceration in the rat. Naloxone was indeed found to possess a marked protective effect on the intestinal mucosa (ulcer index 73.3 +/- 13.6 vs. 273.8 +/- 21.8, p less than 0...

In 1965, Aicardi described a syndrome consisting of infantile spasms, chorioretinopathy, agenesis of corpus callosum, costovertebral anomalies, and mental subnormality. By 1979, about 60 cases had been reported in the medical literature. All the described patients were females. In this report, some of the problems raised in the differential diagnos...

We studied a population of RA patients to determine the presence of cold-reacting lymphocytotoxins and a possible correlation with disease activity.

Our finding of lymphocytotoxins in RP is another laboratory feature shared by many of the autoimmune diseases. The significance of these antibodies is uncertain. Their presence did not correlate with other features of the disease or with disease activity. Until further studies elucidate the nature and specificty of the lymphocytotoxins in RP, they...

A 19-day-old neonate who presented to the emergency department (ED) due to supraventricular tachycardia (SVT) was found to have a coagulaion disorder on physical examination. Laboratory work-up was consistent with hepatitis and disseminated intravascular coagulopathy (DIC). The source was later traced to an enteroviral infection. There was no evide...