Harefuah最新文献

{"title":"[ECTOPIC FALLOPIAN TUBE PREGNANCY RELOCATION TO THE UTERINE CAVITY - TRUTH OR FICTION? PRIMUM NON NOCERE].","authors":"Chen Ben David, Udi Ergaz, Yaniv Zipori, Ido Solt","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>In the medical literature there are several case reports of physicians who tried to transfer a gestational sac from the fallopian tube to the uterus. In this article, a review of the scientific literature on the subject was conducted and an answer was provided to the question, truth or fiction? Anyone who deals with early pregnancies, understands the complexity of the implantation process during early pregnancy, and that there is no clear anatomical separation plane in early pregnancy, between the decidua and the early placental villi that penetrate it. Several case reports in the medical literature describe a successful transfer of an ectopic pregnancy from the fallopian tube to the uterine cavity. Those case reports are unreliable, and attempts to reproduce them have not been successful. Currently, attempts should not be made to transfer an ectopic pregnancy into the uterine cavity, as they may endanger the patients' lives - primum non nocere.</p>","PeriodicalId":101459,"journal":{"name":"Harefuah","volume":"164 2","pages":"100-102"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484902","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":"[MANAGEMENT OF LABOR ANESTHESIA IN A PATIENT WITH EHLERS-DANLOS SYNDROME WHY DOES CHATGPT ERR IN SOURCE REFERENCING?]","authors":"Daphna Idan, Rotem Sisso-Avron, Or Degany","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Ehlers-Danlos Syndrome (EDS) encompasses a spectrum of inherited disorders, characterized by joint hypermobility, skin hyperextensibility, and other features. In some patients, EDS involves the vascular walls, posing a significant clinical challenge due to the resultant propensity for rupture with hemorrhagic complications. Such complications, among others that often occur with EDS, may carry particular importance in the context of pregnancy and labor. This paper presents a patient diagnosed with Ehlers-Danlos Syndrome during her first pregnancy. The patient was planned for elective Cesarean delivery and expressed an interest in regional anesthesia. A literature review was conducted to identify similar cases in which the anesthesia techniques and their potential complications were described, as well as additional risks for EDS patients associated with various anesthesia methods. The review identified only low-quality data, which suggested a higher pain threshold in patients with EDS and an increased risk of bleeding. This case was used to assess the ability of ChatGPT to present a literature review based on reliable sources when the evidence is sparse. The model generated a well-worded response using correct medical terminology, but the report was superficial and provided no data to support clinical decision-making. The model also suggested a different anesthetic approach than the human-generated literature review and supported its findings with links to cited sources. These sources were examined, and concerns regarding their reliability were raised. Lack of reliability remains a major challenge for developers and users of large language models. Fine-tuning (i.e. training the model with examples relevant to specific tasks) which may enhance model output accuracy is discussed in this context.</p>","PeriodicalId":101459,"journal":{"name":"Harefuah","volume":"164 2","pages":"74-76"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143485054","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":"[ASPERGILLUS CENTRAL VENOUS CATHETER INFECTION WITH FUNGEMIA IN A PATIENT UNDERGOING HEMODIALYSIS - CASE REPORT].","authors":"Ravit Yakoby, Ami Neuberger, Moran Szwarcwort Cohen, Sigal Mendelsohn, Raya Abu Abas, Anat Stern","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Aspergillus species are an important cause of life-threatening infections in immunocompromised patients. Those considered at high risk include patients with prolonged neutropenia, and patients who underwent bone marrow transplantation. The most common presentation of aspergillosis is invasive aspergillosis (IA) with pulmonary involvement. Microbiologic diagnosis usually involves culture or molecular tests of respiratory tract samples as blood cultures rarely grow this organism. We document an unusual case of Aspergillus fumigatus central venous line infection involving a hemodialysis catheter, with macroscopic mold growing in multiple blood cultures. The infection was probably acquired during hemodialysis treatment in Kenya, while awaiting kidney transplantation.</p>","PeriodicalId":101459,"journal":{"name":"Harefuah","volume":"164 2","pages":"87-89"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143485431","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>Hippocrates and language models - Primum Non Nocere - First do no harm.</p>","PeriodicalId":101459,"journal":{"name":"Harefuah","volume":"164 2","pages":"129"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484917","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":"[TIMED BARIUM SWALLOW: CLINICAL UTILITY, INDICATIONS AND HOW TO INTERPRET THE STUDY].","authors":"Fahmi Shibli, Amir Mari, Matan Siterman, Nir Bar, Mark Teshler, Ram Dickman, Yeshai Ron","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Timed barium swallow (TBS) is a simple non-invasive diagnostic test to evaluate esophageal emptying of liquids. TBS was originally described for the assessment of response to treatment in achalasia patients. Since then, its use has been expanded, including assessment of dysphagia in other esophageal motility disorders.</p><p><strong>Objectives: </strong>To provide a clinical review summarizing the main indications, protocol, interpretation and complementary role of TBS in the diagnosis of esophageal motility disorders.</p><p><strong>Methods: </strong>A working group of gastroenterologists specialized in neurogastroenterology and motility disorders and radiologist reviewed the relevant medical literature on TBS.</p><p><strong>Results: </strong>TBS provides an objective measure of esophagogastric junction (EGJ) opening and esophageal clearance. It is a useful diagnostic tool in achalasia, assessing the severity of EGJ obstruction and response to treatment. TBS complements high-resolution manometry (HRM) in symptomatic EGJ outflow obstruction (EGJOO) to help determining a need for treatment. TBS may also play a role in the assessment of absent contractility and other hypomotility disorders. TBS adds objective data on esophageal emptying which can aid decision-making when HRM is unclear or unavailable.</p><p><strong>Conclusions: </strong>TBS is a simple non-invasive diagnostic test for the evaluation of esophageal dysfunction. In achalasia and EGJOO, combined with a clinical evaluation and HRM findings, TBS provides valuable additional data and can guide treatment decisions.</p>","PeriodicalId":101459,"journal":{"name":"Harefuah","volume":"164 2","pages":"108-113"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143485192","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":"Yoav Siegler, Ido Solt, Nir Kugelman, Efraim Siegler","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Hippocrates and language models - Primum Non Nocere - First do no harm.</p>","PeriodicalId":101459,"journal":{"name":"Harefuah","volume":"164 2","pages":"128"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484924","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":"[ODONTOGENIC SINUSITIS].","authors":"Idit Tessler, Arkadi Yakirevitch","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Odontogenic sinusitis originates from dental diseases, accounting for 10-14% of total maxillary sinusitis and up to 75% of unilateral cases. This entity develops due to the violation of the Schneiderian membrane of the maxillary sinus by dental pathology and is characterized by unique bacteriology. The characteristic symptoms include unilateral nasal obstruction and purulent rhinorrhea, often without dental pain. A high index of suspicion is warranted when patients present with unilateral symptoms, especially post-dental procedures. Comprehensive clinical examination is crucial for accurate diagnosis, often supplemented by radiographic imaging methods such as computer tomography scans. A multidisciplinary approach involving otolaryngologists, maxillofacial surgeons, and dental specialists is essential for optimal management. Dental infection elimination is the primary treatment step that usually requires surgery. Despite its frequency, odontogenic sinusitis continues to be under-diagnosed due to its non-specific symptomatology and requires a thorough understanding and collaboration across medical specialties for optimal diagnosis and management. The awareness and knowledge of odontogenic sinusitis can enhance early recognition and treatment, ultimately improving patient outcomes.</p>","PeriodicalId":101459,"journal":{"name":"Harefuah","volume":"164 2","pages":"124-125"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143485061","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":"[ULCERATIVE COLITIS AND PRIMARY SCLEROSING CHOLANGITIS].","authors":"Hana Shpizer, Gil Bachar","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>ULCERATIVE COLITIS AND PRIMARY SCLEROSING CHOLANGITIS.</p>","PeriodicalId":101459,"journal":{"name":"Harefuah","volume":"164 1","pages":"56-57"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392797","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":"[EMBOLIZATION OF MIDDLE MENINGEAL ARTERY AS A TREATMENT FOR CHRONIC SUBDURAL HEMATOMA].","authors":"Dan Zharia Milikovsky, Oz Haim, Sharif Basal, Tali Jonas Kimchi, Udi Sadeh","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic subdural hemorrhage (CSDH) is one of the most common reasons for neurosurgical intervention. The incidence and prevalence of this condition is expected to grow due to aging of the population and the increase in anticoagulation and anti-aggregation prescription drugs. Traditionally, it was accepted that the bleeding originates from bridging veins that drain the brain towards the dural sinuses. However, recent findings exposed an additional underlying mechanism. Trauma leads to separation of the dural border cell layer which induces an inflammatory process that starts positive feedback of leaky blood vessels formation (angidysgensis), which causes blood product leakage that further increases the inflammation. For many years, the disease has been treated conservatively in cases of mild clinical and imaging features, or by surgical evacuation of the hematoma in more severe cases. The literature shows a consistent high recurrence rate of around 30% following a surgical removal of the blood. The newly discovered mechanism inspired the development of a novel treatment method for this entity. Endovascular embolization of the middle meningeal artery (MMA). This method has an excellent efficacy and safety profile, and it can be performed alone or in combination with surgical evacuation. This review presents the epidemiology and mechanisms underlying CSDH, in addition to possible treatment methods, and eventually discuss MMA embolization to increase the awareness of the medical community in Israel to this new approach.</p>","PeriodicalId":101459,"journal":{"name":"Harefuah","volume":"164 1","pages":"35-38"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392908","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":"[USE OF DIGITAL SERVICES IN A PRIMARY CARE CLINIC IN THE BEDOUIN SECTOR IN SOUTHERN ISRAEL].","authors":"Badran Abu Zaid, Kayan Alnemer, Rawan Abo Aiesh, Roni Peleg, Tamar Freud","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>\"Digital Health\" includes a variety of health services delivered through technological means, such as: booking an appointment, talking to a doctor, viewing personal information and more. The use of digital services in Clalit Health Services (CHS) clinics in the Bedouin sector is low compared to the general sector.</p><p><strong>Objectives: </strong>To examine the usage of digital services, the characteristics of users, and the barriers to use it among patients from the Bedouin sector at the Segev Shalom Clinic of CHS.</p><p><strong>Methods: </strong>A cross-sectional study among visitors to the CHS Segev Shalom clinic, aged 18-65 years during the period 17.05.2023-31.05.2023). The clinic's members belong to the Bedouin sector and have a low socioeconomic level. About 50% of the clinic's members live around the settlement of Segev Shalom. The visitors were interviewed using a structured research questionnaire that examined the use and barriers to use of telehealth services among the Arab population in Israel.</p><p><strong>Results: </strong>A total of 196 clinic visitors were interviewed. Of these, 37.3% were males, average age 34.5±11.2 years and 58% live in a permanent settlement. About 44% of the respondents do not book a doctor appointment in advance but come to the clinic when necessary; 38.8% book an appointment by phone, and only 16.8% book an appointment through digital services. The main reason for not using digital services (80.5% of respondents) was lack of knowledge on how to use the service. In a logistic regression model for predicting patients who will not make a doctor's appointment in advance, it was found that the influential factors are: gender (male) (OR=1.92, (p=0.04), age in years (OR=1.03, p=0.01), little/very little consent that fast service can be obtained via digital services (OR=2.24, p=0.02) and smartphone ownership (OR=0.08, p=0.02).</p><p><strong>Conclusions: </strong>Among the study population, there is a lack of awareness of digital services and a lack of knowledge of its operation. Work should be taken to raise awareness and knowledge in a variety of ways at the clinic level, the community level and the sector level.</p>","PeriodicalId":101459,"journal":{"name":"Harefuah","volume":"164 1","pages":"18-24"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392800","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}