Harefuah最新文献

{"title":"[AI-BASED HEALTH AND BIOLOGICAL SCIENCES: AN OPPORTUNITY FOR ISRAELI LEADERSHIP].","authors":"Michal Rosen-Zvi, Nir Friedman, Dina Ben Yehuda","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Artificial Intelligence (AI) has become a key tool for the acceleration of scientific discovery, from accelerated drug discovery through automatic-robotic lab to the discovery of new materials that can help reduce air pollution. Israel is blessed with a unique combination of strong expertise in health and biological sciences, as well as advanced AI technologies. Hence, Israel can potentially become a leader in AI based biomedical scientific discovery. This article compares Israel's achievements in AI and in biomedical scientific discovery with the achievements of selected leading nations. It also highlights opportunities and barriers that Israel encounters in its path to becoming a world-wide leader in AI-based biomedical scientific discovery.</p>","PeriodicalId":101459,"journal":{"name":"Harefuah","volume":"163 10","pages":"663-667"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[CEREBROSPINAL FLUID (CSF) LEAK FOLLOWING COVID-19 NASAL SWAB: A CASE REPORT].","authors":"Roee Noy, Arie Gordin, Moni Benifla, Keren Nathan, Jacob T Cohen, Dmitry Ostrovsky","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Coronavirus 19 (Covid-19) emerged as a global pandemic with over 12,900 deaths in Israel alone. On average, more than 40,000 tests to detect the virus daily were performed in Israel. According to the US Centers for Disease Control and Prevention (CDC), the recommended methods for testing are nasopharyngeal swab, mid-turbinate, or anterior nasal swab specimen. Although these methods are generally safe, they are not without risks. Particularly, traumatic or improperly angled test may injure the skull base and lead to a cerebrospinal fluid leak. This rare condition presents with headache, unilateral nasal discharge with a metallic taste, and is aggravated when bending forward. It is essential to recognize this condition since there is an increased risk of meningitis, brain abscess, sepsis, and death. In addition, one should know how to perform nasal swab tests to avoid this complication. This paper presents a case of a five-year-old girl diagnosed with cerebrospinal fluid rhinorrhea following a nasal swab test for Covid-19. In addition, a summary of the clinical, radiological and treatment aspects was prepared.</p>","PeriodicalId":101459,"journal":{"name":"Harefuah","volume":"163 10","pages":"659-662"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[STOCKHOLM SYNDROME IN KIDNAPPED AND HOSTAGES AS A SURVIVAL BEHAVIOR].","authors":"Yam Feinberg, Gil Zalsman","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Stockholm syndrome (SS) is relatively rare, but during the 'Iron Swords' war, several cases were described in which some of the hostages showed identification and empathy with their captors, which presented their families and their caregivers with diagnostic and therapeutic questions. The term SS was coined following a robbery in Stockholm in 1973, after which one of the hostages developed a relationship with the captors. From this and other cases, SS has become a cornerstone in understanding the dynamics of extreme emotional fabric: trauma woven into the survival instinct. Risk factors for SS are described: being in absolute isolation from anyone other than the captor, inability to escape/avoid the situation, receiving gestures of kindness from the captor, all while the victims are under real threat to their physical and emotional integrity. Several theories for the development of SS exist: psychoanalytic theories rely on Ferenczi's concept of \"identification with the aggressor,\" another theory speaks of 'cognitive dissonance' describing the discomfort arising from holding contradictory beliefs and attitudes. A third theory talks about a daily situation where the victims undergo \"brainwashing\". The fourth theory relies on an evolutionary perspective and speaks of a survival mechanism called conciliation/surrender. This theory emphasizes the survival goal of adapting to life-threatening situations through calming the aggressor and identifying with them. We found this explanation practical and most helpful for those suffering from this syndrome and their relatives. From understanding SS as a survival behavior, the therapeutic principle also arises. The important message in meeting with the returnees is to accept their emotional stance without judgment or anger and to normalize their behavior as a known and understood phenomenon. It is important to convey and mediate to the returnees and their families that this is a survival mechanism that indicates strength and resourcefulness.</p>","PeriodicalId":101459,"journal":{"name":"Harefuah","volume":"163 10","pages":"645-649"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[THE IMPORTANCE AND UNIQUENESS OF THE ONCOLOGICAL REHABILITATION PROCESS].","authors":"Sheila Goldberg-Lamensdorf, Hagay Amir","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Rehabilitation is a holistic process that addresses the impairment that causes the disability and tries to restore optimal function. The incidence of cancer has been constantly increasing in recent years and thereby, the damage to the patients' quality of life, as a result of the disease and the oncological treatments. In an attempt to improve this, a unique branch of rehabilitation has been developing in recent years, specializing in improving patients' function throughout the entire disease trajectory, from the day of diagnosis to the most advanced stages. The oncological rehabilitation model adjusts the treatment goals to the stage of the disease. First, pre-habilitative treatment to prevent the expected functional decline around the time of diagnosis. Rehabilitation attempts to restore damaged function during the treatments. As the disease progresses - compensatory mechanisms strive to improve function and provide supportive and palliative treatment for preservation and prevention of complications. The rehabilitation process can lead to a significant improvement in the quality of life of many oncology patients who face long-term consequences of the disease and its treatments. The emerging research indicates the contribution of rehabilitation, throughout all stages of the disease, to the quality of life and in some cases to extending life expectancy. Thanks to the emerging recognition among the two disciplines of care (oncology and physiatry) of the importance of quality of life alongside oncology treatments, it seems that there is a reason for optimism regarding the continued development and establishment of oncology rehabilitation.</p>","PeriodicalId":101459,"journal":{"name":"Harefuah","volume":"163 10","pages":"631-635"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[HIPPOCRATES AND LANGUAGE MODELS - PRIMUM NON NOCERE - FIRST, DO NO HARM].","authors":"Sharon Einav, Or Degany, Yehuda Shoenfeld","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>For millennia, the ethos of \"First, Do No Harm\", attributed to Hippocrates, has been a cornerstone of medicine. This principle emphasizes the responsibility and ethical commitment of the clinician to the benefit of their patient. Recently, the rapid development of artificial intelligence (AI) is transforming the medical world, significantly affecting not only diagnosis, treatment plans, research, medical education, and medical ethics, but also the way we think. To maximize the benefits of AI, understand its limitations, and prevent potential harm to patients, clinicians should be aware of the principles underlying artificial intelligence. Such familiarity will enable the clinician to correctly assess outputs generated by AI tools; from medical recommendations proposed by targeted systems (such as a decision-support system for the interpretation of chest radiography) to diagnoses and treatment plans proposed by non-specific AI tools such as large language models. Developments in computing power, algorithms, and data storage have enabled significant progress in the world of AI, including the emergence of generative AI. This review bridges fundamental medical research concepts with stages of AI development, encompassing neural networks, and deep learning principles. It offers a glossary of commonly used AI terms and provides insights into the development and functioning of large language models. The potential influence of AI on the patient-physician relationship is also discussed. Several proposals are presented for actionable items that may improve the integration of AI into clinical work while maintaining the basic ethical principles of beneficence, non-maleficence, justice, and autonomy. They include proper model training, regulation, and involvement of the medical community in the development and integration of these models into clinical practice. Such involvement will ensure that the ethical principles of medicine remain at the forefront, and are not compromised by the interests of the developing entities. Disclosures: Prof. Sharon Einav and Or Degany are employed by Medint Medical Intelligence.</p>","PeriodicalId":101459,"journal":{"name":"Harefuah","volume":"163 10","pages":"668-672"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[THE TIME HAS COME TO CHANGE THE FACE OF MEDICINE: THE TRANSITION FROM A SINGLE PROFESSIONAL TO A MULTIDISCIPLINARY TEAM TO IMPROVE THE QUALITY OF CARE AND WITHSTAND THE PERSONAL AND PROFESSIONAL BURNOUT OF THE PHYSICIAN].","authors":"Gad Segal, Uri Manor, Vered Robinson, Liat Negro, Eyal Zimlichman, Yitzhak Kreis","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>The Israeli health system is experiencing an ongoing manpower crisis that will deepen soon with the increase in the number of patients and the overcrowding in clinics and hospitals. The core of the crisis is the need to staff the hospitalization departments and clinics with quality manpower. Alongside the initial staffing, there is an obligation to ensure the survivability of the professional personnel in the system over the years, and this must be done while constantly preventing the process of professional burnout. In the present article, we propose to change the face of medicine by moving from relying on a single professional (physician) to the operation of a multidisciplinary team, while ensuring that the various professionals operate at the peak of their skill envelope. At the base of the team is a physician who devotes himself to direct contact with the patient and his family while applying analytical and humanistic thinking based on a body of knowledge accumulated during his training.</p>","PeriodicalId":101459,"journal":{"name":"Harefuah","volume":"163 10","pages":"621-626"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[THERAPEUTIC INTERVENTIONS IN ACUTE STRESS DISORDER (ASD)].","authors":"Carmel Kalla, Michal Lifshitz, Leah Shelef, Lucian Tatsa-Laur, Eyal Fruchter, Amit Lotan","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Acute stress disorder (ASD) is a disorder that appears after exposure to a life-threatening event and lasts between three days and a month. In this article, we review therapeutic approaches to this disorder. The information collected, to date, has not demonstrated the effectiveness of drug therapy in preventing the development of post-traumatic stress disorder (PTSD), and therefore, there is no recommendation for providing drug therapy as a routine treatment for ASD. The only drug treatment that has proven to have prophylactic effectiveness is pain treatment given when the ASD is also accompanied by a painful physical injury. When symptomatic treatment of anxiety symptoms is required, it is recommended to use it in a limited way. The first line treatment is trauma-focused cognitive behavioral therapy (TF-CBT). It includes psychoeducation, cognitive construction and exposure. In armies around the world, the therapeutic approaches are characterized by the principles of proximity to the place of combat, immediacy in providing the therapeutic response and emphasizing the expectation to return to function (PIE). The effectiveness of psychological debriefing treatment has not been proven, and it is not recommended as a treatment for ASD. The authors of the article recommend building research systems that will allow quality research in this field. It is recommended to train therapists in the field of trauma-focused cognitive behavioral therapy (TF-CBT) in preparation for events on the scale of a national disaster.</p>","PeriodicalId":101459,"journal":{"name":"Harefuah","volume":"163 10","pages":"640-644"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[MENTAL HEALTH SUPPORT BEYOND BOUNDARIES - MENTAL HEALTH SERVICES FOR THE EVACUATED POPULATION DURING THE \"IRON SWORD\" WAR].","authors":"Shimon Burshtein, Inbal Yarkoni, Gad Cohen Rappaport, Yechiel Levkovich","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>The terrorist attack by Hamas and other organizations on October 7th, 2023 surprised the State of Israel. The Western Negev region, where most of the damage occurred, is a conflict zone. In view of this fact, emergency plans were prepared, including for the response in the field of mental health. These plans included the provision of emotional support and mental health services by the regional resilience centers. Several factors led to the fact that the resilience centers were not able to provide full service to the evacuated population. In general, mental health services in the State of Israel on the eve of October 7th were significantly lacking and in non-optimal availability. The events of October 7th created a new reality in which it was no longer possible to rely on the resilience centers, which were also damaged by the events. Actually, tens of thousands of people were evacuated to widespread areas, requiring emergency preparedness by the Ministry of Health. On October 13th, 2023, the mental health medical centers were requested to respond to this need in a spatial distribution for 4 weeks until the recovery of the resilience centers or the response by the health funds (\"Kupot Holim\").</p>","PeriodicalId":101459,"journal":{"name":"Harefuah","volume":"163 10","pages":"636-639"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[COPING WITH A DISABILITY - A CLASSIFICATION OF COPING STYLES].","authors":"David Kuzari, Julia Gouzman","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Coping with illness or physical disability and its consequences, including a decrease in daily function, is a stressful situation that poses various challenges for the person and the family. Rehabilitation is a complex ongoing process targeting to help return to functioning as close as possible to the status prior to the illness. There are different styles of coping with disease/disability, which affect the rehabilitation process and its success.</p><p><strong>Objectives: </strong>This article aims to conceptualize and prepare a framework for coping of patients with physical disabilities in order to assist rehabilitative teams in providing care for these patients.</p><p><strong>Methods: </strong>Clinical observations were conducted at the rehabilitation clinic in the central district of Maccabi, for mapping styles of coping with physical disability. Between February 2020 and July 2022, 240 patients who were suitable for the current study were examined. The sample included patients in the sub-acute phase, after the end of the diagnostic phase and the curative treatment of a medical condition, which caused a functional decline.</p><p><strong>Results: </strong>Clinical observations indicate that the most effective coping style is flexibility, which allows a person to receive the assistance provided under the rehabilitation program and to adjust his or her lifestyle to the current functional status.</p><p><strong>Conclusions: </strong>It is important for professionals to be familiar with coping styles to help patients move between them. Acceptance and Commitment Therapy (ACT) may help increase a person's psychological flexibility. It is recommended to combine it as part of the multi-professional rehabilitation to maximize the results of the rehabilitation.</p>","PeriodicalId":101459,"journal":{"name":"Harefuah","volume":"163 10","pages":"627-630"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[LANTHANUM DEPOSITS AS A RARE DIFFERENTIAL DIAGNOSIS OF VILLOUS ATROPHY].","authors":"Rachel Gingold-Belfer, Matan Siterman, Shira Goldman, Lucille Hayman Manzur","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Up to 5% of patients with newly diagnosed celiac disease have negative serology. Although seronegative celiac, is the most common cause for villous atrophy, there are other differential diagnoses that should be ruled out when we find villous blunting without positive serology for celiac disease. The aetiologies are usually divided into 5 categories: immune-mediated, infectious, iatrogenic, inflammatory and infiltrative. We hereby report a case of 39 years old male, with end-stage renal failure and pancreatic insufficiency. He was treated with peritoneal dialysis and was a candidate for combined kidney-pancreas transplantation. Hyperphosphatemia is a common complication in patients with end-stage renal disease. In order to reduce his serum phosphate levels, he was treated with a high dose of lanthanum carbonate, one of the most effective and safe non-calcium-based phosphate binders. During weight loss investigation, he underwent gastroscopy that demonstrated duodenal denudated mucosa with villous blunting. Biopsy showed complete villous atrophy and accumulation of foreign material in mucosal histiocytes. Von Kossa staining, that was performed, emphasized the depositions of the foreign material that has been identified as lanthanum. Consequently, the treatment with lanthanum was stopped and replaced by another phosphate binder. This case illustrates a rare differential diagnosis of villous atrophy typical for end-stage renal disease patients, that can be categorized as an iatrogenic and infiltrative aetiology for villous atrophy. Since the long-term consequences of lanthanum deposition in tissue are unknown, this case also emphasizes the need for a multidisciplinary approach for treating dialysis patients, in order to understand which phosphate binder was provided.</p>","PeriodicalId":101459,"journal":{"name":"Harefuah","volume":"163 10","pages":"655-658"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}