Cultural Differences between American and Israeli Medical Students Regarding Their Perceptions of the Medical Profession and Satisfaction with Studies

Background: Cultural differences have been discussed as a potential factor influencing students' perception and motivation towards their studies. At the Sackler Faculty of Medicine, Tel-Aviv University, two separate programs coexist for American and Israeli medical students. Both are taught at the same sites and by the same faculty, thus enabling cultural comparisons. Our aim was to examine the differences of two medical student groups, American and Israeli, regarding their satisfaction with studies, view of the educational workload, and their perceptions of physician characteristics.  Methods: During the academic year 2007-2008 we administered an anonymous questionnaire to the two groups immediately after their first clinical clerkship in internal medicine. The response rate was 82% (90 out of 110) for the Israelis and 93% (53 out of 57) for the Americans.Results:  Americans, compared to the Israelis, are significantly more satisfied with their medical studies, consider fewer alternatives to future careers in clinical medicine, feel less of a workload, and hold a more positive opinion of physician characteristics.Conclusions:  Cultural differences affect students' perception of their studies, mentors and future careers. Medical educators should be sensitive to the effects of students' background which influence academic and professional attitudes and find ways to strengthen their commitment to the profession

Is There More to This Case than Mere Pulmonary Alveolar Proteinosis? A Clinical Case Presentation

Introduction: Pulmonary alveolar proteinosis (PAP) is a rare disease, associated with excess accumulation of surfactant proteins and lipids in the alveoli. Clinical presentation: We report the case of a 46-year-old woman with a combined presentation of PAP, myelodysplasia and recurrent miscarriages. Conclusions: The concomitant presentation of the above might be compatible with a mutation of the haematopoietic transcription factor gene GATA2

Transvenous lead extraction with laser reduces need for femoral approach during the procedure.

IntroductionCardiac implantable electronic device (CIED) trans venous lead extraction (TLE) is technically challenging. Whether the use of a laser sheath reduces complications and improves outcomes is still in debate. We therefore aimed at comparing our experience with and without laser in a large referral center.MethodsInformation of all patients undergoing TLE was collected prospectively. We retrospectively compared procedural outcomes prior to the introduction of the laser sheath lead extraction technique to use of laser sheath.ResultsDuring the years 2007-2017, there were 850 attempted lead removals in 407 pts. Of them, 339 (83%) were extracted due to infection, device upgrade/lead malfunction in 42 (10%) cases, and other (7%). Complete removal (radiological success) of all leads was achieved in (88%). Partial removal was achieved in another 6% of the patients. Comparison of cases prior to and after laser technique introduction, showed that with laser, a significantly smaller proportion of cases required conversion to femoral approach [31/275 (6%) laser vs. 40/132 (15%) non-laser; pConclusionIntroduction of laser lead removal resulted in decreased need to convert to femoral approach, albeit without improving success rates or preventing major complications