Harefuah最新文献_第10页

[TRAUMA-INFORMED CARE IN THE PUBLIC HEALTH SYSTEM: CLINICAL IMPORTANCE, PRACTICAL IMPLICATIONS AND GUIDING PRINCIPLES]. [公共卫生系统中的创伤知情护理：临床重要性、实际意义和指导原则]。

Harefuah Pub Date : 2025-01-01

Anna Padoa, Tanya Oren-Chipman, Yifat Ben David-Dror, Inbal Brenner, Muli Linder, Daphna Armon

引用次数: 0

[EMERGING THERAPIES FOR LI-FRAUMENI SYNDROME AND RHABDOMYOSARCOMA: CAN CHAT GPT ASSESS THE THERAPIES IT SUGGESTS USING THE BRADFORD-HILL CRITERIA?] [李-弗劳米尼综合征和横纹肌肉瘤的新疗法：聊天GPT能否使用布拉德福德-希尔标准评估其建议的疗法？］

Harefuah Pub Date : 2025-01-01

Rotem Sisso-Avron, Or Degany, Sharon Einav

{"title":"[EMERGING THERAPIES FOR LI-FRAUMENI SYNDROME AND RHABDOMYOSARCOMA: CAN CHAT GPT ASSESS THE THERAPIES IT SUGGESTS USING THE BRADFORD-HILL CRITERIA?]","authors":"Rotem Sisso-Avron, Or Degany, Sharon Einav","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: Li-Fraumeni syndrome is a rare genetic disorder caused by a mutation in the TP53 gene. The syndrome is characterized by a variety of malignancies that manifest in early childhood. In this article, we present a young patient diagnosed with Li-Fraumeni syndrome following recurrent rhabdomyosarcoma. A personalized literature search was performed to identify novel therapeutics that may be appropriate for this patient. In the absence of randomized, double-blind studies, the relevance of each potential treatment was evaluated using the Bradford-Hill criteria. These criteria underlie the medical logic used for assessing causation. This case was then used to explore the ability of the large language model ChatGPT to conduct a similar review and assess its treatment suggestions using the Bradford-Hill criteria. In-depth exploration suggested that ChatGPT treatment suggestions based solely on the presentation of the case and a general question are insufficiently informative. Targeted prompts (instructions for structuring the response, formulated as questions) lead to the generation of more accurate and clinically useful model responses but these, too, should be approached with caution.","PeriodicalId":101459,"journal":{"name":"Harefuah","volume":"164 1","pages":"4-6"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392879","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}

引用次数: 0

[A PROPOSAL FOR CHANGING THE PROTOCOL FOR ANATOMICAL SCANS IN TWIN PREGNANCIES IN ISRAEL FOLLOWING OUR EXPERIENCE IN THE PROSPECTIVE EVALUATION AND CLINICAL MANAGEMENT OF TWIN PREGNANCIES]. [根据我们在双胎妊娠的前瞻性评估和临床管理方面的经验，提出改变以色列双胎妊娠解剖扫描方案的建议]。

Harefuah Pub Date : 2025-01-01

Ron Maymon, Nadav Kugler, Narine Galoyan, Adi Orenstein, Hamutal Meiri, Ran Svirsky

{"title":"[A PROPOSAL FOR CHANGING THE PROTOCOL FOR ANATOMICAL SCANS IN TWIN PREGNANCIES IN ISRAEL FOLLOWING OUR EXPERIENCE IN THE PROSPECTIVE EVALUATION AND CLINICAL MANAGEMENT OF TWIN PREGNANCIES].","authors":"Ron Maymon, Nadav Kugler, Narine Galoyan, Adi Orenstein, Hamutal Meiri, Ran Svirsky","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: Twin pregnancies are associated with a high incidence of fetal structural and genetic malformations. Early detection will improve pregnancy outcomes and offer early intervention when necessary.Methods: A prospective, observational study in twin pregnancies, including multiple sonographic scans at different gestational ages to identify fetal structural anomalies.Results: We enrolled 120 women (240 fetuses) with di- or mono-chorionic live twins. All fetuses had an anomaly scan performed in the first, early (13+6-17+6gestational weeks), second, and third trimester. A total of 15 significant structural anomalies were identified. Five anomalies (33%) were identified in the first trimester, another 5 cases (33%) were identified in the early scan, an additional 3 (20%) at the second-trimester scan, and finally, two more (12.3%) were identified in the third-trimester scan. A total of 6 fetuses demised spontaneously. Four fetuses were reduced. Two women (4 fetuses) left the study. Altogether, 216 fetuses were delivered, and no anomaly was identified post-partum.Conclusions: In twin pregnancies, the unification of the nuchal and the early anomaly scan in the first trimester and the performance of the second and third-trimester scans will result in the identification of most fetal malformations without added cost. We recommend the performance of three anomaly scans, one in each trimester. Our conclusion should be confirmed in a larger cohort.Discussion: Over 86% of significant prenatal structural anomalies were identified until the midst of pregnancy. A model of three complete anomaly scans, one in every trimester, is proposed. Our experience allowed us to identify all the anomalies at a similar cost to the current model of four scans (including first-trimester NT and third-trimester weight assessment).","PeriodicalId":101459,"journal":{"name":"Harefuah","volume":"164 1","pages":"25-31"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392905","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}

引用次数: 0

[SEX AND GENDER DIFFERENCES IN EXPOSURE TO CHILDHOOD VIOLENCE AND ITS EFFECT IN ADULTHOOD ON CHRONIC PHYSICAL MORBIDITY]. [童年时期遭受暴力的性别差异及其对成年后慢性病发病率的影响]。

Harefuah Pub Date : 2025-01-01

Lena Abayev, Inbal Mandler, Lior Baruch

{"title":"[SEX AND GENDER DIFFERENCES IN EXPOSURE TO CHILDHOOD VIOLENCE AND ITS EFFECT IN ADULTHOOD ON CHRONIC PHYSICAL MORBIDITY].","authors":"Lena Abayev, Inbal Mandler, Lior Baruch","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: Childhood exposure to violence and abuse has a long-term effect on physical and mental health. Recent research shed light on the connection between childhood maltreatment and an increase in chronic physical morbidity later in life. In this narrative review, we sought to look at this relationship through a gender lens. One major difference between genders is the nature of insults, whereas sexual abuse and chronic insults are more common among girls compared to boys. These differences manifest clinically during adulthood, and provide another explanation for the differences in epidemiology, pathophysiology, and clinical manifestations among women and men. In this review, we will demonstrate the connection between exposure to violence at a young age and the development of diseases according to body systems, including the immune, cardiovascular, respiratory, digestive and neurologic systems. The gender perspective can be found not only in the clinical and epidemiological fields, but also in basic sciences. In the last decade, new technological developments have made it possible to identify mechanisms that explain the clinical connection between early exposure to violence and chronic morbidity. Sex-dependent characteristics have been found when researching epigenetic changes, structural and functional changes in the central nervous system, disturbances in autonomic regulation and endocrine effects. We hope that this review will contribute to a multidimensional understanding of some overlooked risk factors for common chronic diseases and will open a new frontier for preventive medicine and early intervention.","PeriodicalId":101459,"journal":{"name":"Harefuah","volume":"164 1","pages":"46-50"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392791","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}

引用次数: 0

[LISTENING FOR SAFETY]. （听着安全）。

Harefuah Pub Date : 2025-01-01

Mayer Brezis

{"title":"[LISTENING FOR SAFETY].","authors":"Mayer Brezis","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: Medical errors pose a significant risk to public health. A mistake can often be prevented by timely access to the information that was unnoticed by the decision maker. Communication failure within the team is responsible for most errors that cause patient harm. This article reviews literature on challenges in reducing errors through a culture of listening within the team. A significant barrier to good team communication is fear of speaking up. According to surveys in the USA and Israel, nearly a third of the staff testified to fear reporting something that could endanger a patient. The difficulty of expressing oneself freely prevents the correction of failures and causes burnout at work. Improved communication is related to psychological safety in the organizational culture: the leader demonstrates humility, curiosity and gratitude towards the opinions of the team members and makes sure that no one gets hurt if they express an idea, question, concern or report a mistake. Training juniors and seniors by providing tools to improve communication within the team may be useful and can be facilitated through a simulation-based workshop. The challenge of listening to prevent disasters was learned in a tragic way at the National Aeronautics and Space Administration (NASA), and more recently, in Israel when repeated ominous warnings were ignored before the October 7th monstrous terror attack. Respectful listening is an essential key to cooperation and success in society in general and health organizations in particular.","PeriodicalId":101459,"journal":{"name":"Harefuah","volume":"164 1","pages":"51-55"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392785","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}

引用次数: 0

[KERATOCONUS: DIAGNOSIS AND INNOVATIONS]. [快速增长的近视的联合治疗：一个病例系列]。

Harefuah Pub Date : 2025-01-01

Nir Erdinest, Dror Ben Ephraim-Noyman, Or Shmueli, David Landau, Itay Lavy, Abraham Solomon

{"title":"[KERATOCONUS: DIAGNOSIS AND INNOVATIONS].","authors":"Nir Erdinest, Dror Ben Ephraim-Noyman, Or Shmueli, David Landau, Itay Lavy, Abraham Solomon","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: The importance of early detection of keratoconus lies in early treatment to prevent complications resulting from disease progression and in planning optimal follow-up or screening schedules for family members, considering the genetic component of the disease. In the past, with the absence of accessible, adequate imaging technology such as corneal topography to detect subtle manifestations of the disease, keratoconus was considered rare. This resulted in later detection when the disease had progressed to a more advanced, severe state, with many patients requiring corneal transplants. Currently, early detection can have significant consequences because of the possibility of early intervention, such as corneal cross-linking‏, which slows disease progression. Early detection of mild ectatic changes in the cornea is essential when screening candidates for refractive surgery to prevent postsurgical ectasia. In recent years, the detection of keratoconus has focused on the molecular level, such as identifying inflammatory biomarkers, and in corneal imaging. The progress in corneal imaging technology now provides detailed imaging of the epithelial and Bowman layers, which augment the ability to detect minimal changes, revealing disease development at a very early stage. Analyzing anterior corneal high-order aberrations also assists in identifying keratoconus. Corneal biomechanics evaluation likewise contributes to early keratoconus diagnosis. The latest frontier in keratoconus diagnosis is employing artificial intelligence, which has been combined in the past few years with corneal imaging devices. The following review will focus on the most current developments concerning keratoconus diagnosis, concentrating on the most novel tools and strategies.","PeriodicalId":101459,"journal":{"name":"Harefuah","volume":"164 1","pages":"39-45"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392907","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}

引用次数: 0

[MAIGNE'S THORACOLUMBAR JUNCTION SYNDROME]. [maigne 's胸腰椎交界综合征]。

Harefuah Pub Date : 2024-12-01

Atzmon Tsur, Avi Ohry

引用次数: 0

[Books Review: A Family of Heroes, OUTLIVE, Literature and medicine in German literature between the two world wars]. [书评：《英雄家族》、《活得长久》、《两次世界大战期间德国文学中的文学与医学》]。

Harefuah Pub Date : 2024-12-01

Bilha Paryente, Yehuda Shoenfeld, Mordechai Ravid

引用次数: 0

[THE SURGICAL INTELLIGENCE REVOLUTION - APPLYING AI TO IMPROVE SURGICAL QUALITY AND SAFETY]. 【手术智能革命——应用人工智能提高手术质量和安全性】。

Harefuah Pub Date : 2024-12-01

Yuval Mirkin, Dotan Asselman, Sari Maril, Michal Guindy, Tamir Wolf

引用次数: 0

[EOSINOPHILIC ESOPHAGITIS: MUCH MORE IS UNKNOWN YET THAN DISCOVERED]. [嗜酸性粒细胞食管炎：未知的比发现的多得多]。

Harefuah Pub Date : 2024-12-01

Jawad Hindy, Zahava Vadasz, Tova Rainis

{"title":"[EOSINOPHILIC ESOPHAGITIS: MUCH MORE IS UNKNOWN YET THAN DISCOVERED].","authors":"Jawad Hindy, Zahava Vadasz, Tova Rainis","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: Eosinophilic esophagitis (EoE) is a chronic inflammatory disease of the esophagus, which is mediated by Th2 cells that could start at any age, from early childhood to adulthood. The pathogenesis of the disease is not fully understood, but apparently it consists of a combined interaction between hereditary and environmental factors. Over the years, EoE has become an increasingly diagnosed disease in the context of esophageal symptoms. Nowadays, it is considered the second most common cause of chronic esophagitis and dysphagia (after GERD which is the leading cause on the list). The hallmark of the disease is the presence of eosinophils in the esophageal mucosa (> 15 eosinophil/HPF). Clinically, EoE is characterized by various esophageal symptoms, ranging from mild dysphagia to complications that eventually appear, including esophageal food impaction which usually requires urgent endoscopic removal. Long term complications occur as a result of a defective remodeling process of the inflamed esophagus, which includes histological changes of fibrosis, angiogenesis, and smooth muscle hypertrophy. Due to its progressive course, treatment of the disease requires a close and long-term managerial and therapeutic strategy. There are currently a variety of treatment options for the disease depending on its degree and severity, starting with dietary treatment, pharmacological therapy and ending with esophageal dilations if necessary.","PeriodicalId":101459,"journal":{"name":"Harefuah","volume":"163 11","pages":"710-716"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848795","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}

引用次数: 0