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Although the association between balance and hearing thresholds at different frequencies in the right/left ear is crucial, it has received scant empirical attention. Balance is widely ignored when evaluating hearing in adults. This study examined the relative contribution of left versus right ear hearing at different frequencies to balance, and the mediating role of suprathreshold speech perception on age-balance associations. Pure tone hearing thresholds (500-4000 Hz), suprathreshold speech perception, balance, and risk of falling were evaluated in 295 adults. The results indicate that the right ear contributes more to balance than the left ear. This might imply dominance of the left hemisphere in processing hearing cues for balance. Frequencies within the speech range (500/1000/2000 Hz) were correlated with balance and mediated the interaction between age and balance. These results should be considered when tailoring hearing and balance rehabilitation programs., (© 2022. The Author(s).)

Background: Failure modes and effects analysis (FMEA) is used for the identification of potential risks in health care processes. We used a specific FMEA - based form for direct referral for colonoscopy and assessed it for procedurerelated perforations., Methods: Ten experts in endoscopy evaluated and computed the entire referral process, modes of preparation for the endoscopic procedure, the endoscopic procedure itself and the discharge process. We used FMEA assessing for likelihood of occurrence, detection and severity and calculated the risk profile number (RPN) for each of the above points. According to the highest RPN results we designed a specific open access referral form and then compared the occurrence of colonic perforations (between 2010 and 2013) in patients who were referred through the open access arm (Group 1) to those who had a prior clinical consultation (non-open access, Group 2)., Results: Our experts in endoscopy (5 physicians and 5 nurses) identified 3 categories of failure modes that, on average, reached the highest RPNs. We identified 9,558 colonoscopies in group 1, and 12,567 in group 2. Perforations were identified in three patients from the open access group (1:3186, 0.03%) and in 10 from group 2 (1:1256, 0.07%) (p = 0.024). Direct referral for colonoscopy saved 9,558 pre-procedure consultations and the sum of $850,000., Conclusions: The FMEA tool-based specific referral form facilitates a safe, time and money saving open access colonoscopy service., Discussion: Our form may be adopted by other gastroenterological clinics in Israel.

Objective: To compare perceptions of patients and gastroenterologists regarding irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD)., Methods: The Illness Perception Questionnaire-Revised was sent to 150 randomly selected hospital-based and community-based gastroenterologists nationwide. Participants were instructed to refer their responses to either IBS or IBD. Patients were recruited during a regular visit to the Gastroenterology Department of a tertiary medical center and completed the same questionnaire. Findings were analyzed according to illness and group., Results: Questionnaires were returned by 55 physicians (29 referred to IBS, 26 to IBD) and 58 patients. Physicians and patients stated that IBD has more severe consequences and benefits more from medical treatment (P<0.05), and that patient coherence is higher for IBD than IBS (P<0.05). Physicians stated that psychological attributes and accidents/injuries play a greater causative role in IBS than in IBD (P<0.01 and P<0.05, respectively). Conversely, patients found no such difference. More patients than physicians attributed both illnesses to risk factors (P=0.07). Both groups believed that the immune system is a more important causative factor in IBD than IBS (P<0.01)., Conclusion: The different views of gastroenterologists and patients in terms of the involvement of psychological attributes, risk factors, and accidents/injuries in IBD and IBS could affect the patient-health provider relationship and adversely impact treatment outcome.

Objective: Irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) have similar symptoms, and both adversely affect patients' quality of life. The objective of this study was to compare the perceptions of physicians and nurses regarding IBS and IBD., Methods: The Illness Perception Questionnaire Revised, adapted for medical staff, was sent at random to 300 physicians and nurses of gastroenterology departments and outpatient clinics nationwide to assess perceptions of IBS or IBD. Responses were statistically analyzed by illness and professional group., Results: Fifty-five physicians and 43 nurses returned the questionnaire (response rate, 32.6%). Fifty-two questionnaires pertained to IBS and 46 to IBD. More physicians than nurses stated that the course of both illnesses does not improve over time (P<0.05). Both groups showed that medical treatment is of greater benefit for IBD than IBS (P<0.05) and that patients with IBD better understand their illness than patients with IBS (P<0.05)., Conclusion: Physicians and nurses hold different attitudes to and perceptions of IBD and IBS in terms of chronicity, severity of the consequences, treatment efficacy, personal control, and illness coherence. These differences may have important effects on the patient-health provider relationship and should be addressed.

Background: The widespread use of new sources of energy for ablation of atrial fibrillation (AF) raised concerns regarding the safety and efficacy of the various devices. This article describes the results of our technique using a combination of bipolar radiofrequency (RF) and cryoablation., Methods: From February 2004 till July 2006 this method was used on 94 patients. Fifty patients had persistent atrial fibrillation (53%), thirty-one suffered from permanent AF (33%) and thirteen patients had paroxysmal AF (14%). Lesions set similar to Maze III procedure were used with the addition of right atrial isthmus lesion in the area of coronary sinus and without right atrial appendage amputation and septal lesion., Results: There were no procedure-related complications and no death or major morbidity in general. Average time for ablation procedure was 30 minutes (range 27-36 minutes) for biatrial and 16 minutes (range 15-19) for left atrial procedures. Seventy-one patients (75%) were discharged in sinus rhythm. At the end of the follow-up, seventy-five patients (80%) were in sinus rhythm. Mean follow-up was 21 months (1-32 months). Predictor for recurrent AF or atrial flutter after procedure was preoperative permanent AF for more than 10 years (p = 0.037) and cardiac surgery in the past (p = 0.012)., Conclusion: The use of bipolar RF device with cryoprobe is an appealing combination. It enables the completion of a Maze III lesion set in an easy, safe and efficient way.

Purpose: The study aimed to quantitatively investigate the effect of PCNL on global and regional function using quantitative single photon emission computerized tomography (SPECT) measurement of Tc-dimercaptosuccinic acid (DMSA) uptake by the kidneys (QDMSA)., Methods: Seventy nine patients with nephrolithiasis undergoing PCNL were studied by sequential QDMSA examination. There were 42 (53%) males and 37 (47%) females with mean age of 47 +/- 16 years. The initial study was conducted before PCNL procedure and the follow-up studies were performed 1.5-24 months after PCNL. Among 60 of the 79 (76%) patients, in whom PCNL was performed using upper or lower pole access, regional renal function of affected and non-affected pole of operated kidney was calculated separately., Results: There was no statistically significant difference between the uptake of treated kidney before and after PCNL procedure (11.9% +/- 5% vs 11.6% +/- 5%; t = 0.9, p = 0.368). The total renal functional volume of treated kidney was to be slightly decreased from 235cc +/- 62cc to 224cc +/- 59cc (t = 2.7; p = 0.011). The percent of injected dose per ml.. of renal tissue of treated kidney was not affected statistically (0.051 +/- 0.02 vs 0.053 +/- 0.02; t = 0.86, p = 0.296). In the assessment of the regional renal function of treated kidney, a statistically significant decrease in the functional renal volume was revealed at the part which underwent PCNL procedure (91cc +/- 30cc vs 82cc +/- 27cc; t = 2.64, p = 0.013). Regarding percent of injected dose per ml. of renal tissue, no statistically significant difference was found between the part of treated kidney, which underwent PCNL and non-affected area of the same kidney (0.049 +/- 0.02 vs 0.05 +/- 0.02; t = 0.693, p = 0.494). The function of contralateral kidney remained unchanged (13.4% +/- 5.2% vs 13.6% +/- 4.8%; t = 0.68, p = 0.5). Function volume, neither total percent uptake, nor percent of injected dose per ml. of renal tissue were reduced significantly. Further studies with long term follow-up of treated kidney are required.