Harefuah最新文献

{"title":"[NUCHAL TRANSLUCENCY CONCURRENT WITH EARLY ANOMALY SCAN: TIME TO RECONSIDER].","authors":"Ron Maymon, Etty Daniel-Spiegel, Ran Svirsky, Yaakov Melcer, Simcha Yagel","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>During the last decades, a major achievement was reported in detecting Down's syndrome in the first trimester of pregnancy. This is attributed to the use of high-resolution accurate ultrasound machine allowing the detection of a \"nuchal translucency\" in the back of the fetus during 11-14 weeks' gestation. This is considered to be a physiologic finding, but when increased, may alert for chromosomal abnormality (mainly Down's syndrome), cardiac and other organ anomalies and other genetic syndromes. Later additional sonographic findings were found, including nasal bone assessment, and Doppler flow studies of the ductus venosus and tricuspid regurgitation Technology advancement accompanied by sonographers' skills enhancement allows (at the time frame of the nuchal scan) a detailed anomaly scan. Additional screening for pregnancy complication was achieved using first trimester multi marker assessment, alerting for preeclamptic toxemia or placenta accreta. Currently, many national and international professional organizations recommend performing the nuchal scan concurrent with an early anomaly scan both at the same time of gestation. This approach is different than the one performed in Israel, whereas the nuchal scan is conducted separately and 2-3 weeks later an anomaly scan is offered. We call for reconsideration of the sequential approach and performing all the tests in a comprehensive first trimester clinic.</p>","PeriodicalId":101459,"journal":{"name":"Harefuah","volume":"163 3","pages":"174-180"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140178645","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":"[CHARACTERIZATION OF THE ADAPTIVE IMMUNE REPERTOIRE USING NEXT GENERATION SEQUENCING: RECENT DISCOVERIES IN THE FIELD OF PRIMARY IMMUNODEFICIENCY, AND THE UPCOMING FUTURE].","authors":"Tal Beit Halevi, Raz Somech, Yu Nee Lee-Avnir","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>A powerful adaptive immune system, which includes cellular (T lymphocytes) and humoral (B lymphocytes) immunity, depends on its ability to recognize and protect against millions of different foreign antigens. It does so through an enormous diverse array of T-cell and B-cell receptors, collectively referred to as the adaptive immune repertoire. Using high-throughput sequencing as next generation sequencing (NGS) led to multiple breakthroughs in the field of molecular medicine. It has increased our ability to characterize the immune repertoire in primary immunodeficiency (PID) and to identify defects in diversification processes among other parameters as well. Human inborn errors of immunity represent a unique genotype-phenotype model that enable the study of critical genes' and proteins' role in disease and health. Recent studies regarding immune repertoire profiling of PID allowed us to better define genotype-phenotype correlations in diseases with wide clinical spectrum, the underlining patho-mechanism causing the specific genetic disease, the common features of similar diseases as well as the unique molecular signature for each genetic disease. Immune repertoire knowledge is an integral part of PID research, and aids in improving diagnosis and designing personalized treatment. Nevertheless, NGS has created some challenges that emphasize the need for technologies such as cloud-based platforms like Kusto, enabling scalable data analysis and the incorporation of artificial intelligence techniques.</p>","PeriodicalId":101459,"journal":{"name":"Harefuah","volume":"163 3","pages":"164-169"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140178630","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":"[IN VITRO FERTILIZATION (IVF) TREATMENTS IN MACCABI HEALTHCARE SERVICES 2015-2020].","authors":"Noam Orvieto, Yaakov Segal, Shahar Kol","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Previously, we have summarized IVF treatment outcomes for the years 2007-2014. In 2014, the Ministry of Health (MOH) recommended that infertile patients above 39 years of age can be offered IVF as a first line treatment, given the natural age-related decrease in ovarian reserve.</p><p><strong>Objectives: </strong>The purpose of the current publication is to summarize IVF treatment outcomes for the years 2015-2020, and to explore possible changes in IVF treatments following the MOH statement.</p><p><strong>Methods: </strong>IVF treatments and live birth data were collected from Maccabi Healthcare Services' fertility treatments registry. We have included only autologous fresh and frozen embryo transfer (FET) cycles. A successful treatment cycle was defined if a live birth was recorded between 6 to 10 months of its initiation.</p><p><strong>Results: </strong>Mean patients' age increased from 36.2 years in 2011 to 37.5 years in the 6 years surveyed (2015-2020). While the number of fresh cycles was stable, the number of FET cycles increased from 4,507 in 2015 to 6,795 in 2020. The percentage of cycles performed in private hospitals increased gradually from 72% in 2015 to 77% in 2020. The number of patients over 40 years of age increased from 3,204 in 2011, to 3,648 in 2014, and to 3,915 in 2020.</p><p><strong>Conclusions: </strong>The total number of IVF cycles increased gradually from 2015 to 2020, mainly due to significant increase in FET cycles. The continued increase in mean patients' age may reflect the change in MOH recommendations.</p>","PeriodicalId":101459,"journal":{"name":"Harefuah","volume":"163 3","pages":"151-155"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140178644","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 IMPACT OF REGULATION AND CENTRAL MANAGEMENT ON PATIENT SAFETY IN ISRAEL].","authors":"Yaron Niv, Yossi Tal","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>An adverse event is defined as an unwanted and unexpected occurrence in a medical process that may end in harm to the patient. In the USA the number of deaths due to failures reaches 253,000 per year. In Israel, over 10,000 deaths occur per year due to errors in the medical treatment of hospitalized patients, the third most common cause of death after heart disease and cancer. The main cause of failures in medical diagnosis and treatment is the complexity of the medical profession. A large number of caregivers in different medical disciplines are needed to treat one patient, therefore there are many errors, especially regarding communication between therapists. The Israeli health system has been operating with a budget deficit for many years and an addition of at least NIS 20 billion is needed to bring it to optimal functioning. The number of doctors, nurses, and hospital beds per 1000 inhabitants is significantly less than the average of the OECD countries. When there was a 30% increase in the population of Israel it was necessary to enhance the existing situation, with the addition of 7700 hospital beds, but only 1400 were added. This caused a decrease from 2.1 beds per 1000 residents to 1.8 beds per 1000 residents. There is an urgent need to change the elements of treatment safety in the Ministry of Health's strategic plan. An administration for quality, treatment safety, risk management in medicine, and accreditation should be established which, in addition to the care quality division, will include a safety division with investigation and monitoring units and will prepare strategic improvement plans, and a university-level research institute with researchers, computing, statistics, and information gathering units. The institute will receive all reports of adverse events, results of investigations, inspection committees, control and quality committees, relevant verdicts, and updated literature reviews, for research and systemic learning. Strategic plans will be prepared to prevent failures in diagnosis and medical treatment, leading to a decrease in mortality due to adverse events and the significant expenses involved.</p>","PeriodicalId":101459,"journal":{"name":"Harefuah","volume":"163 3","pages":"170-173"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140178648","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":"[EVALUATION OF DIFFERENT TIMINGS OF EARLY CARDIAC REHABILITATION AFTER MYOCARDIAL INFARCTION AND EXAMINATION OF DRUG THERAPY BASED ON THE SYNTHESIZED PEPTIDE TO BALANCE THE MITOCHONDRIAL DYNAMICS PROCESSES].","authors":"Rani Wainer Shlomo, Offir Ertracht, Ron Golan, Shaul Atar, Nir Qvit","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Cardiovascular diseases are the main cause of mortality in the world. Their most common expression is ischemic heart disease (IHD) such as myocardial infarction (MI). Physical rehabilitation is a common practice for IHD patients. Yet, there is no definition of when is the most effective time to start physical rehabilitation. However, it is recommended to start it as soon as possible. There is a growing interest in understanding the relationship between IHD and cardiomyocytes mitochondrial dynamics processes. Mitochondrial imbalance after MI accelerates cardiac damage. Peptide-based drugs are an effective and safe treatment option.</p><p><strong>Aims: </strong>To examine rehabilitation and peptide intervention post-MI to assess optimal time to start a physical activity and mitochondrial function post-MI.</p><p><strong>Background: </strong>Early training as well as peptide treatment will protect the cardiac muscle post-MI from accelerated damage.</p><p><strong>Methods: </strong>Sixty rats will be divided into 6 groups: Six groups will undergo ischemia-reperfusion (I/R) surgery, by a 30 minute occlusion of their left anterior descending artery (LAD) followed by reperfusion. Three groups will start moderate-intensity exercise training for 8 weeks at different time-points post-MI (3, 7, or 21 days). Another group will be injected with synthetic peptide 5' pre-reperfusion. A sedentary group and a sham group will be used as controls. Results will be assessed by a mitochondrial function test, echocardiography, blood inflammatory and biochemical markers, pressure/volume loops, an exercise test and histology.</p><p><strong>Results: </strong>Improvement of cardiac physiology following exercise training, and mitochondrial treatment will shed light on the preferred timing of cardiac rehabilitation and the mitochondrial damage post-MI.</p>","PeriodicalId":101459,"journal":{"name":"Harefuah","volume":"163 2","pages":"88-92"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140023913","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":"[TEN-HOUR INTERMITTENT FASTING PLUS MEDITERRANEAN DIET VERSUS MEDITERRANEAN DIET ALONE FOR TREATMENT OF NONALCOHOLIC FATTY LIVER DISEASE (NAFLD)].","authors":"Yael Milgrom, Muhammad Massarwa, Wadi Hazou, Asher Shafrir, Eliana Mishraki, Suha Sanduka, Rifaat Safadi, Ariel Benson","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Nonalcoholic Fatty Liver Disease (NAFLD) has become the leading cause of liver morbidity. The Mediterranean diet can improve NAFLD and may be offered as treatment. Intermittent fasting has been shown to improve aspects of the metabolic syndrome, but its effect on NAFLD is inconclusive.</p><p><strong>Objectives: </strong>A randomized - controlled study assessed the outcomes of the effect of the Mediterranean diet alone versus the Mediterranean diet in combination with intermittent fasting for 16 weeks in patients with NAFLD (1:2 ratio) and subsequent long term follow-up. Outcomes parameters included the response to treatment as measured by body mass index (height and weight), waist-hip ratio, and levels of steatosis and fibrosis as measured by transient elastography. In addition, satisfaction and compliance were assessed via questionnaires (ten-point Likert scale).</p><p><strong>Results: </strong>Sixteen out of 40 recruited patients completed the study (69% men, mean age 45.8 ± 12.1 years, mean baseline BMI 33 ± 4.5), of which nine patients were included in the arm of diet in combination with intermittent fasting. The two groups were similar at baseline with regard to age, gender, height, weight, BMI, waist to hip ratio, and levels of steatosis and fibrosis. At the study end, a significant decrease was observed (p-value = 0.01) in the degree of steatosis from 316.4 ± 50.4 to 279 ± 35.7 DB/m. The improvement in steatosis was significant (p-value = 0.01) in the intermittent fasting group (an improvement of 13.8 ± 20.9%) as compared to the group without intermittent fasting (4.2 ± 20.9%, no statistical significance). The other physical outcome measures did not show a statistically significant change between values at the beginning of the study and study end (16 weeks). Participant questionnaires were completed at a mean follow-up of 1.6 ± 0.2 years and showed a high level (8.3 ± 1.69) of compliance at the beginning of the study in both groups. In addition, both study groups expressed a similar degree of difficulty in adhering to the assigned diet. By study end, participant adherence was significantly higher (p-value = 0.04) among the Mediterranean diet group alone (7 ± 2) as compared to the group in combination with intermittent fasting (4.9 ± 2). Furthermore, those in the Mediterranean diet alone group were more willing (9.7 ± 0.8) to continue the dietary treatment after completing the study as compared to the intermittent fasting group (6.4 ± 0.7) (p-value = 0.03). Study participants in both groups reported that their dietary treatment was overall beneficial (7.9 ± 2.2).</p><p><strong>Conclusions: </strong>This study, given the limitations of a small sample size, suggests that a Mediterranean diet in combination with intermittent fasting improves steatosis in NAFLD patients over the long term as compared to Mediterranean diet without time restricted eating.</p>","PeriodicalId":101459,"journal":{"name":"Harefuah","volume":"163 2","pages":"93-96"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140023917","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":"[TRANSLATIONAL MEDICINE IN DERMATOLOGY- FURTHER PROMOTING PSORIASIS RESEARCH].","authors":"Shani Fisher, Michael Ziv","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Psoriasis is a chronic inflammatory skin disorder that affects approximately 2-3% of the population worldwide. Translational medicine, which focuses on treating and analyzing diseases caused by translational factors, is becoming increasingly relevant in the field of psoriasis research. This review aims to display the current literature on the role of translational medicine in the treatment and understanding of psoriasis. We found that translational factors such as protein kinases and cytokines play a key role in the development and progression of psoriasis. Additionally, current treatments for psoriasis, such as biologics, target these translational factors to reduce inflammation and improve skin condition. Furthermore, studies have shown that genetic variations in translational-related genes can also contribute to the development of psoriasis. This highlights the importance of translational medicine in understanding the underlying mechanisms of psoriasis and developing increasingly effective treatments for this debilitating disease.</p>","PeriodicalId":101459,"journal":{"name":"Harefuah","volume":"163 2","pages":"109-113"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140023919","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":"[TRANSLATIONAL MEDICINE IN MALIGNANT HEMATOLOGY].","authors":"Moshe Mittelman","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Translational medicine is a relatively new field, bridging between basic research and the practice of medicine, resulting in improved patient management. The outcomes of science are applied in methods of disease prevention, diagnosis and treatment of various diseases. Malignant hematology is among the fields in which translational medicine has significantly contributed to the current practice.</p>","PeriodicalId":101459,"journal":{"name":"Harefuah","volume":"163 2","pages":"125-132"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140023920","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":"[ETHICAL PERSPECTIVES AND DILEMMAS IN PRESCRIBING AND DISPENSING MEDICINAL PRODUCTS IN ISRAEL].","authors":"Eyal Schwartzberg, Eli Marom, Miri Trainin, Ophir Lavon, Segev Shani","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Drug therapy is a central pillar in the provision of medical care. A significant number of doctor-patient encounters conclude with a prescription for a drug. These are subsequently followed by a pharmacist-patient interaction that ends with the dispensing of prescription drugs and/or a recommendation for an over-the-counter drug and other products. In Israel, the fields of medicine and pharmacy are highly regulated with extensive legislation.</p>","PeriodicalId":101459,"journal":{"name":"Harefuah","volume":"163 2","pages":"79-84"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140023912","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":"[GENE THERAPY: FROM TECHNOLOGY TO REALITY].","authors":"Eithan Galun","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Gene therapy has made major achievements in the last few decades. These were in numerous medical disciplines, including metabolic, oncologic, infectious and regenerative. As of today, regulatory agencies, both in the USA and Europe, approved for clinical usage numerous gene therapy treatments. However, we are still facing a number of significant obstacles including: 1. Efficient delivery systems, 2. Immunological responses, and 3. recently we have learned that many gene therapy approaches are very expensive. The COVID-19 pandemic was a period in which genetic vaccination had proved its efficacy, by which RNA in a synthetic delivery system was very effective. This review will focus on three fast developing technologies in gene therapy: 1. CAR-T cells, 2. CRISPR-Cas and 3. RNAi.</p>","PeriodicalId":101459,"journal":{"name":"Harefuah","volume":"163 2","pages":"97-101"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140023915","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}