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Search Results: 1 - 10 of 88056 matches for " Avraham I Rivkind "
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Gastric arterio-venous malformation emerging from splenic artery
Ram Elazary, Anthony Verstandig, Avraham I Rivkind, Gidon Almogy
World Journal of Gastroenterology , 2008,
Abstract: In this case report, we present a patient who suffered from gastrointestinal bleeding. The bleeding source was a gastric arterio-venous malformation emerging from the splenic artery. Attempts to stop the bleeding failed and therapeutic angiography succeeded in occluding the vessel. A search at the literature has not yielded any other case report describing this anatomical anomaly.
Therapeutic angiography for giant bleeding gastro-duodenal artery pseudoaneurysm
Ram Elazary, Mahmoud Abu-Gazala, Avraham Schlager, Noam Shussman, Avraham I Rivkind, Allan I Bloom
World Journal of Gastroenterology , 2010,
Abstract: We present the case of an 18-year-old female transferred to our center from an outside hospital due to persistent gastrointestinal bleeding. Two weeks prior to her transfer she underwent duodenal omentopexy for a perforated duodenal peptic ulcer. The patient underwent a computed tomography angiogram which identified the source of bleeding as a giant gastro-duodenal artery (GDA) pseudoaneurysm. The patient was taken to interventional radiology where successful microcoil embolization was performed. We present this rare case of a giant GDA pseudoaneurysm together with imaging and a review of the medical literature regarding prevalence, etiology and treatment options for visceral arterial aneurysms.
Complications of high grade liver injuries: management and outcomewith focus on bile leaks
Miklosh Bala, Samir Gazalla, Mohammad Faroja, Allan I Bloom, Gideon Zamir, Avraham I Rivkind, Gidon Almogy
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine , 2012, DOI: 10.1186/1757-7241-20-20
Abstract: This is a retrospective study of patients with liver injury admitted to Hadassah-Hebrew University Medical Centre over a 10-year period. Grade 3-5 injuries were considered to be high grade. Collected data included the number and types of liver-related complications. Interventions which were required for these complications in patients who survived longer than 24 hours were analysed.Of 398 patients with liver trauma, 64 (16%) were found to have high-grade liver injuries. Mechanism of injury was blunt trauma in 43 cases, and penetrating in 21. Forty patients (62%) required operative treatment. Among survivors 22 patients (47.8%) developed liver-related complications which required additional interventional treatment. Bilomas and bile leaks were diagnosed in 16 cases post-injury. The diagnosis of bile leaks was suspected with abdominal CT scan, which revealed intraabdominal collections (n = 6), and ascites (n = 2). Three patients had continuous biliary leak from intraabdominal drains left after laparotomy. Nine patients required ERCP with biliary stent placement, and 2 required percutaneous transhepatic biliary drainage. ERCP failed in one case. Four angioembolizations (AE) were performed in 3 patients for rebleeding. Surgical treatment was found to be associated with higher complication rate. AE at admission was associated with a significantly higher rate of biliary complications. There were 24 deaths (37%), the majority from uncontrolled haemorrhage (18 patients). There were only 2 hepatic-related mortalities due to liver failure.A high complication rate following high-grade liver injuries should be anticipated. In patients with clinical evidence of biliary complications, CT scan is a useful diagnostic and therapeutic tool. AE, ERCP and temporary internal stenting, together with percutaneous drainage of intra-abdominal or intrahepatic bile collections, represents a safe and effective strategy for the management of complications following both blunt and penetrating he
Indicators of the need for ICU admission following suicide bombing attacks
Miklosh Bala, Dafna Willner, Asaf Keidar, Avraham I Rivkind, Tali Bdolah-Abram, Gidon Almogy
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine , 2012, DOI: 10.1186/1757-7241-20-19
Abstract: A database was collected prospectively from patients who were admitted to Hadassah University Hospital Level I Trauma Centre, Jerusalem, Israel from August 2001-August 2005 following a SBA. One hundred and sixty four victims of 17 suicide bombing attacks were divided into two groups according to ICU and non-ICU admission.There were 86 patients in the ICU group (52.4%) and 78 patients in the non-ICU group (47.6%). Patients in the ICU group required significantly more operating room time compared with patients in the non-ICU group (59.3% vs. 25.6%, respectively, p = 0.0003). For the ICU group, median ICU stay was 4 days (IQR 2 to 8.25 days). On multivariable analysis only the presence of facial fractures (p = 0.014), peripheral vascular injury (p = 0.015), injury ≥ 4 body areas (p = 0.002) and skull fractures (p = 0.017) were found to be independent predictors of the need for ICU admission. Sixteen survivors (19.5%) in the ICU group were admitted to the ICU for one day only (ICU-LOS = 1) and were defined as over-triaged. Median ISS for this group was significantly lower compared with patients who were admitted to the ICU for > 1 day (ICU-LOS > 1). This group of over-triaged patients could not be distinguished from the other ICU patients based on external signs of trauma. None of the patients in the non-ICU group were subsequently transferred to the ICU.Our results show that following SBA, injury to ≥ 4 areas, and certain types of injuries such as facial and skull fractures, and peripheral vascular injury, can serve as surrogates of severe trauma and the need for ICU admission. Over-triage rates following SBA can be limited by a concerted, focused plan implemented by dedicated personnel and by the liberal utilization of imaging studies.We are currently witnessing suicidal attacks in several countries against diverse populations using violence or the threat of violence to attain political, religious, or ideological goals resulting in physical harm and material damages,
Enigma of primary aortoduodenal fistula
Miklosh Bala, Jacob Sosna, Liat Appelbaum, Eran Israeli, Avraham I Rivkind
World Journal of Gastroenterology , 2009,
Abstract: A diagnosis of primary aortoenteric fistula is difficult to make despite a high level of clinical suspicion. It should be considered in any elderly patient who presents with upper gastrointestinal bleeding in the context of a known abdominal aortic aneurysm. We present the case of young man with no history of abdominal aortic aneurysm who presented with massive upper gastrointestinal bleeding. Initial misdiagnosis led to a delay in treatment and the patient succumbing to the illness. This case is unique in that the fistula formed as a result of complex atherosclerotic disease of the abdominal aorta, and not from an aneurysm.
Hemobilia due to hepatic artery aneurysm as the presenting sign of fibro-muscular dysplasia
Noam Shussman, Yair Edden, Yoav Mintz, Anthony Verstandig, Avraham I Rivkind
World Journal of Gastroenterology , 2008,
Abstract: Fibro-muscular dysplasia (FMD) is a rare but well documented disease with multiple arterial aneurysms. The patients, usually women, present with various clinical manifestations according to the specific arteries that are affected. Typical findings are aneurysmatic dilatations of medium-sized arteries. The renal and the internal carotid arteries are most frequently affected, but other anatomical sites might be affected too. The typical angiographic picture is that of a "string of beads". Common histological features are additionally described. Here we present a case of a 47-year-old woman, who was hospitalized due to intractable abdominal pain. A routine work-up revealed a liver mass near the portal vein. Before a definite diagnosis was reached, the patient developed massive upper gastrointestinal bleeding. In order to control the hemorrhage, celiac angiography was performed revealing features of FMD in several arteries, including large aneurysms of the hepatic artery. Active bleeding from one of these aneurysms into the biliary tree indicated selective embolization of the hepatic artery. The immediate results were satisfactory, and the 5 years follow-up revealed absence of any clinical symptoms.
Clinical review: The Israeli experience: conventional terrorism and critical care
Gabriella Aschkenasy-Steuer, Micha Shamir, Avraham Rivkind, Rami Mosheiff, Yigal Shushan, Guy Rosenthal, Yoav Mintz, Charles Weissman, Charles L Sprung, Yoram G Weiss
Critical Care , 2005, DOI: 10.1186/cc3762
Abstract: Every hospital should be able to respond to a multiple-casualty terror attack as it can occur anywhere and anytime [1]. Over the past four years there have been 93 multiple-casualty terrorist attacks in Israel, 33 of them in Jerusalem. The Hadassah-Hebrew University Medical Center is the only Level I trauma center in Jerusalem and has therefore gained important experience in caring for the critically injured patients. Despite the violence, all surgical services continued providing all routine services, including our general intensive care unit (GICU). To do so we developed a highly flexible operational system for managing the GICU. The focus of this report will be on the organizational steps needed to provide operational flexibility. In addition, issues related to the diagnosis and management of specific injuries associated with terror events will be discussed.A retrospective review of the hospital's response to multiple-casualty terror incidents occurring between 1 October 2000 and 1 September 2004 was performed. Information was assembled from the medical center's trauma registry and from GICU patient admission and discharge records. The information we collected included the following: type of attack, number of victims at the location, number of patients treated and admitted to the intensive care unit (ICU), location before admission to the ICU [operating rooms, imaging department or emergency department (ED)], trauma injury severity score (ISS), time for admission to the ED, time to admission to the ICU, length of stay in the ICU and mortality in the ICU.The hospital intensive care facilities include 29 surgical ICU beds (11 general, 6 pediatric, 6 neurosurgical, and 6 cardiothoracic). When these ICUs are full, patients are treated in the 14-bed post-anesthesia care unit (PACU), which is adjacent to the GICU. In addition, nine medical intensive care beds are available. The GICU is part of the Department of Anesthesiology and Critical Care Medicine. All ICU attendi
New Product Development—Experience from Distance Learning and Simulation-Based Training  [PDF]
Avraham Shtub
Creative Education (CE) , 2016, DOI: 10.4236/ce.2016.71011
Abstract: This paper presents our experience teaching how to manage New Product Development (NPD) projects to students from several universities—members of an international school network. A combination of lectures, problem solving and hands-on experience provided by a Simulation-Based Learning platform made it possible for students from universities distributed around the globe to work as NPD teams that develop new products in a virtual environment.
Local Dynamics in Trained Recurrent Neural Networks
Alexander Rivkind,Omri Barak
Quantitative Biology , 2015,
Abstract: Learning a task induces connectivity changes in neural circuits, thereby changing their dynamics. To elucidate task related neural dynamics we study trained Recurrent Neural Networks. We develop a Mean Field Theory for Reservoir Computing networks trained to have multiple fixed point attractors. Our main result is that the dynamics of the network's output in the vicinity of attractors is governed by a low order linear Ordinary Differential Equation. Stability of the resulting ODE can be assessed, predicting training success or failure. Furthermore, a characteristic time constant, which remains finite at the edge of chaos, offers an explanation of the network's output robustness in the presence of variability of the internal neural dynamics. Finally, the proposed theory predicts state dependent frequency selectivity in network response.
Some New Features and Algorithms for the Study of DFA  [PDF]
Avraham N. Trahtman
Open Journal of Discrete Mathematics (OJDM) , 2012, DOI: 10.4236/ojdm.2012.22008
Abstract: The work presents some new algorithms realized recently in the package TESTAS. The package decides whether or not DFA is synchronizing, several procedures find relatively short synchronizing words and a synchronizing word of the minimal length. We check whether or not a directed graph has a road coloring that turns the graph into a synchronizing deterministic finite automaton (DFA). The algorithm finds the coloring if it exists. Otherwise, the k-synchronizing road coloring can be found. We use a linear visualization of the graph of an automaton based on its structural properties.
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