Prof. Eitan Kerem
Director of the Center and
Specialist in Pediatric Respiratory Medicine.
Phone number - 972-2-5844430
Fax - 972-2-5844427
Email - ek@cc.huji.ac.il
The Cystic Fibrosis Center cares for patients with cystic fibrosis, a devastating genetic disease that affect 1 out of 5000 children. The Center provides integrated, multidisciplinary care designed to optimally treat the multiple problems associated with this disease. Patients visiting the center receive same day medical advice and therapy from physicians, nutritionists, physiotherapists, and social workers.
One of the most important characteristics of our Center is that we work with a multidisciplinary team approach. This team is made up of : pediatric pulmonologists, pediatric gastroenterologists and nutritionists, nurses, dieticians, physiotherapists, social workers, psychologists, pulmonary function technicians and a National Service worker. Our services also include clinic workshops for art and handicrafts as well as the service of volunteers.
Whenever a patient comes in for a clinic visit he receives consultation from the staff, mainstreaming their work together to answer any questions the families may have immediately, according to the needs of each individual patient. We believe that only through this type of concentrated effort can each staff member achieve the highest level of professionalism possible, availing ourselves to each patient as teachers, counselors and supporters, to accompany and encourage our patients and their families.
The entire staff meets once a week to ensure coordination and cooperation of each team member to achieve the highest quality of care for each of our patients. Each month the staff attends learning seminars led by members of the team or guest lecturer on various subjects pertinent to Cystic Fibrosis or it's clinical implications.
Treatment & Frequency of Clinic Visits
Upon diagnosis the patient is usually hospitalized for a short time to undergo a comprehensive evaluation and to prepare the family for care at home. Subsequent visits to the clinic vary from once a month to once every six months, according to the needs of the patient. Younger patients, or those ion a friable state, come into the clinic as dictated by their health needs, even as often as once a week, if necessary. As their health improves, frequency of visits is adjusted accordingly. As an average, we suggest clinic visits once every 1-2 months.
Conventional Tests Available at our Center
At each clinic visit the patient undergoes various different tests that include pulmonary and dietary evaluations. These conventional tests include: Measurement and recording of weight, height, Oxygen saturation, sputum culture and pulmonary function.
General blood tests are taken once every 3-6 months. Chest x-ray and stomach sonogram are performed routinely once a year.
Additional Tests Available at our Center
Diagnostic Tests:
§ Sweat Test
§ Nasal Potential Difference- This tests the electrical potential of the nasal membranes. This test enables us to diagnose C.F. in patients whose sweat test is borderline or within normal limits.
§ Genetic Testing
§ Allergic Bronchopulmonary Aspergillosis (ABPA)- The presence of this fungus in the lungs can be detected through blood/skin tests.
§ Vitamin A & E Tests
§ Immunoreactive Trysinogen (IRT)- This supplies information pertaining to pancreatic function.
§ Stool Elastase Levels
§ Stool Collection for Fat Analysis
Detailed instruction is given to the patients and their families by the dietician. This instruction includes menu planning strategies , personally tailored to each patient, taking into consideration his general health status, his pulmonary function, his pancreatic function and blood glucose levels. Patient teaching is directed towards proper adherence to medication schedules, caloric enrichment and endogenous pancreatic enzyme supplements. Patient teaching emphasizes nutritional enrichment with minerals such as Calcium and Iron, and the necessary addition of salt on extremely hot days or accompanying physical exertion.
The Center's physiotherapists supply instruction for the patient's, their families and any professional caregivers in the home on a variety of subjects, including:
§ Techniques for improving pulmonary toilet
§ Techniques for improving lung aeration
§ Exercises for strengthening muscles in the chest, shoulders and back. These exercises are aimed towards easing and improving breathing and coughing as well as augmenting stability and improved body image.
§ Exercises to increase lung/heart resistance in order to minimize the body's Oxygen demand.
Our physiotherapists are constantly updated on new and promising perspectives in pulmonary care. Nowadays an aged home care is by and large replacing hospitalization. We encourage and support our patients to undergo intravenous (IV) antibiotic treatment in their homes. Home care enables the patient to continue with his routines of day to day living (work, school, after school activities, hobbies, friends) in his natural atmosphere. Supplies for home care are ordered and delivered directly to the patient's home with no need for hospitalization. Instructions for home care and all the accompanying paraphernalia is given by the Center's nurse, allowing for personalization suiting each patient's individual needs. Instructions for use of any and all machinery for the patient's care is provided by the Center's nurse ( such as inhalation machines, monitoring equipment or enteral feeding pumps).
Additional Services
Our Center has established and developed support groups manned by our Psychologist and Social Worker. These groups meet once a month and provide:
§ Support groups for Mothers
§ Support groups for siblings
§ Fun Activity Days for the families together with the staff.
Our staff includes:
Dr. David Shoseyov
Specialist in Pediatric Respiratory Medicine.
Phone number- 972-2-5844440
Operator- 972-2-5844111
E-mails: Dshosey@md2.huji.ac.il
Shoseyov@hadassah.org.i9l
Dr. Michael Wilschanski
Specialist in Pediatric Gastroenterology and Nutrition.
Phone number – 02-5844430
E-mail: Michael@hadassah.org.il
Mrs. Becky Shechter
CF Center secretary.
Phone number - 972-2-5845320
Fax- 972-2-5844427
Mrs. Shoshana Armoni
CF Center Nurse
Phone number - 972-2-5845325
Fax - 972-2-5844427
Mrs. Hila Elyashar-Earon
Nutritionist
Phone number 972-2-5844111 beeper 148
E-mail: elyashar@netvision.net.il
Mrs. Noa Nezer
Nutritionist
Phone number 972-2-5844111 beeper 497
Mrs. Iris Eisenstadt
Physiotherapist
Phone number - 972-2-5845030
E-mail: daveisen@internetzahav.net
Mrs. Shifra Kurtz
Social worker
Phone number - 972-2-5844430
Dr. Chane Deither
Clinical Psychologist
Phone number - 972-2-5844341
Mrs. Ronit Balisha
Pulmonary Function Technician.
Phone number - 972-2-5845029
Current Research Projects
Genotype-phenotype correlation in CF . In these studies we combine extensive phenotype definitions and collaboration with molecular biology research. The studies lead to better understanding of the molecular basis for disease variability in CF.
Researcher: Prof. Eitan Kerem with collaboration of Prof. Batsheva Kerem at the Hebrew University.
Inherited and clinical risk factors affecting the prognosis of CF.
Researcher:
Prof. Eitan Kerem
Correction of defective CFTR function in patients carrying stop mutations. In these studies we measure nasal potential difference in CF patients before and after topical gentamicin administration.
Researchers:
Dr. Michael Wilschanski
Ms. Chagit Femini
Prof. Eitan Kerem.
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Use of nasal potential difference measurements to diagnose patients with atypical and questionable CF disease.
Researchers:
Dr. Michael Wilschanski
Ms. Chagit Femini
Prof. Eitan Kerem
Oxidants status and Antioxidants in CF: In the past years there is increasing interest in antioxidants and oxidative stress in chronic diseases. In CF an increased oxidative stress was found and low levels of different antioxidants. We are measuring the influence of a pulmonary exacerbation on the oxidative stress. Our aim is to support our patients with the proper amount of antioxidants during an exacerbation to prevent further damage to the lungs.
Researchers: Mrs. Hila Weisberg
Dr. Roni Cohen (Hebrew University)
Dr Nachum Vaisman
Dr. Michael Wilschanski
Prof. Eitan Kerem
Osteoporosis in CF - Recently many patients with CF where diagnosed with osteopenia or osteoporosis. All our patients over 6 years are being screened in DXA (hologic) in these days and go through different biochemical tests. We hope to help clarifying the mechanism for bone depletion in CF.
Researchers:
Ms. Hila Weisberg
Prof. Eitan Kerem
Patients who are interested to participate in the studies after discussing this with their CF center physician are welcomed to call Prof. Eitan Kerem.
Clinic Hours: Sunday and Thursday between the hours of 8:00- 16:00.
To make an appointment please call the Pediatric Day Care Secretary at (02)5845325 or the Department of Pediatrics Secretary at (02)5844430. The switchboard operator for Hadassah, Mount Scopus can be reached at (02)5844111.
Address of the CF Association:
79 Krinizy St. Ramat Gan 54423
Tel: 03-6702323
Fax: 03-6702324
E-mail: cf@netvision.net.il
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