Harefuah最新文献

{"title":"[REHABILITATION FOR POST-COVID-19 PATIENTS IN HADASSAH DURING 2020-2022].","authors":"Sheer Shabat, Anat Marmor, Jeanne Tsenter, Shimon Shiri, Isabella Schwartz, Zeev Meiner","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Aims: </strong>The COVID-19 pandemic has long-lasting deleterious effects on many aspects of the survivors' life. However, the correlations between the severity of COVID-19 infection and rehabilitation outcomes are still unknown.</p><p><strong>Methods: </strong>Sixty-one post-acute COVID-19 patients underwent a customized rehabilitation program in a rehabilitation daycare facility. The severity of the COVID-19 infection was measured according to the WHO clinical progression scale (CPS). Motor, cognitive, psychological and functional variables were measured using standard and specified scales; 19 out of 61 patients underwent nerve conduction studies.</p><p><strong>Results: </strong>The mean age of participants was 54 years (range 18-84 years), 66% were males, 65% had severe disease according to CPS. The mean length of acute hospitalization was 5.6 ± 4.2 weeks, mean rehabilitation time and mean follow up time was 3.2 ± 2.1 months and 7.2 ± 3.2 months, respectively. A significant improvement was found in activities of daily living (ADL) functions as well as in hand motor strength and walking endurance. A significant correlation was found between higher CPS, prolonged acute hospitalization and ventilation and lower admission functional independence measure (FIM), however no correlation was found between the parameters of acute diseases and FIM at discharge. Moreover, lower CPS was correlated with higher anxiety, depression and lower executive functions score. There was correlation between electrophysiological findings of the median and the peroneal nerves and the motor FIM at discharge.</p><p><strong>Conclusions: </strong>A customized rehabilitation program can overcome initial motor, mental and cognitive impairments and significantly improves the motor function of covid-19 recovered patients. The results of this study highlight the importance of monitoring and treating the emotional status, particularly anxiety, of COVID-19 patients. Nerve conduction measurements in COVID-19 patients are important in order to evaluate prognosis and improvement in rehabilitation outcomes.</p>","PeriodicalId":101459,"journal":{"name":"Harefuah","volume":"163 9","pages":"579-584"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305608","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":"[DISSOCIATION BETWEEN DECLERATIVE AND PROCEDURAL MEMORY IN PATIENTS WITH TRAUMATIC BRAIN INJURY].","authors":"Yaron Sacher, Sharon Shaklai, Avi Karni, Keren Cismariu-Potash","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Converging evidence from studies of patients suffering focal brain lesions and results from animal models led to the notion of two functionally and structurally distinct memory systems, declarative-explicit-episodic and procedural-implicit-skill.</p><p><strong>Aims: </strong>Assessment of skill acquisition and procedural memory in patients after blunt traumatic brain injury (TBI) who suffer from deficit of explicit (episodic) memory in comparison to patients without such a deficit.</p><p><strong>Methods: </strong>Comparison of skill acquisition in the Finger Opposition Sequence task in two patients after TBI presenting with episodic-explicit memory deficit to eight patients without such a deficit.</p><p><strong>Results: </strong>Both subjects demonstrated severe declarative-episodic memory deficits as demonstrated in the Rivermead Behavioural Memory Test (RBMT) but showed robust learning and retention of skill in practicing a finger movement sequence, improving performance speed with no speed-accuracy trade-off. The practice related gains in performance and their retention in a one-month follow-up test were as robust as in patients without explicit memory deficit.</p><p><strong>Conclusions: </strong>The results coincide with previous case reports demonstrating a dissociation between procedural-implicit and declarative-explicit memory systems. The evaluation of the two memory systems may contribute to patient rehabilitation as a residual functioning of one system can be used to compensate for deficit of the other, in order to improve daily functioning.</p>","PeriodicalId":101459,"journal":{"name":"Harefuah","volume":"163 9","pages":"558-563"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305605","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":"[ON SWORDS WAR - THE BATTLE FOR THE SOUL].","authors":"Eyal Fruchter, Marina Kupchik","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>The Iron Swords War broke out with an unprecedented attack of brutality, leaving soldiers, civilians, residents of the Israeli settlements surrounding Gaza, and participants of the Nova Festival severely traumatized. Israel was exposed to loss, bereavement, sexual abuse, kidnapping of civilians and soldiers, including children, women, and the elderly. Identification of bodies to be brought to honorable burial, while simultaneously organizing for combat and the ongoing war, resulted in physical and mental injuries. This prolonged war has also led to the evacuation of communities from the areas surrounding Gaza and from the cities and settlements on Israel's northern borders to safer locations, causing them to be displaced persons in their own country. At the outbreak of the war, the public mental health system was at an unprecedented low, lacking professional therapists, with long waiting lists for treatment across all domains of mental health care. Psychiatric hospitals, health funds' mental health clinics and non-governmental organizations (NGOs), and the military mental health care system have been working tirelessly to train therapists to seek more effective trauma treatment and to maximize treatment capacity. The activities resulting from this intensive effort, are reflected in the articles in this special issue. This issue, is primarily dedicated to saluting the efforts of mental health care providers, while looking forward and understanding that the mental damage from the war, the displacement, the captivity, the sexual abuse, and more, will need to be addressed and treated for many years to come. Many works were submitted for this special issue, and the number of articles accepted were beyond the normal range of the issue. We could not have faced the challenge of handling these materials without the support (and tireless leadership) of Mrs. Rena Kurs, to whom we are deeply grateful. We all look forward to the return of all the hostages and a return to focusing on health and normality.</p>","PeriodicalId":101459,"journal":{"name":"Harefuah","volume":"163 8","pages":"480-483"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141904125","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 ROLE OF STRESS IN MANIC-PSYCHOTIC EPISODE DURING THE TERROR ATTACK OF OCTOBER 7 - CASE REPORT].","authors":"Bar Gold, Adar Avnun, Libi Hertzberg, Ariel Ben Yehuda","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>The bio-psycho-social model is mostly used to understand the etiology and pathogenesis of psychiatric disorders. Even though in our era, the biological factors became more dominant in the field, the stress-diathesis model is quite acceptable to explain and understand the evolution of psychotic as well as affective disorders.</p><p><strong>Background: </strong>In this case report we present a patient, in her late 40's, admitted to our department with a manic-psychotic episode for the first time in her life, after the massive terror attack of October 7, and in which we suggest that the signs and symptoms might be explained using the psycho-dynamic theory.</p><p><strong>Conclusions: </strong>We conclude suggesting that the equilibrium of the bio-psycho-social model, should be adjusted in the context of time and space, especially during a situation of catastrophic scale in the patient environment.</p><p><strong>Discussion: </strong>Although stress is a risk factor for the development of affective disorders and especially manic-psychotic episodes, there is scarce literature to support it. On the other hand, psycho-dynamic theories sometimes consider stressful life events as a causative factor for the development of depressive as well as manic episodes.</p>","PeriodicalId":101459,"journal":{"name":"Harefuah","volume":"163 8","pages":"507-509"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141904130","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":"[STRATEGIES FOR COPING WITH CAPTIVITY - THE CASE OF CIVILIANS KIDNAPPED BY HAMAS].","authors":"Nizan Shabat, Uzi Bechor, Dana Skrotzki, Rotem Ben Avraham, Lucian Tatsa-Laur, Leah Shelef","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Studies that focus on coping strategies, especially among civilian hostages, are scant. Research findings may help predict the chances of readjustment upon return from captivity. The present study aimed to examine the challenges that the civilian hostages faced during captivity and how they dealt with the conditions of captivity. The study was based on seventeen interviews conducted with citizens who returned from Hamas captivity in the first release of hostages. All interviews were conducted by experienced journalists and were broadcast on the main television networks between 11.12.2024 and 4.1.2024. Two main themes were identified using inductive thematic analysis-difficulties in captivity (e.g., dealing with uncertainty, dependent relationships, conditions of isolation, and boredom). The second theme included coping strategies (e.g., hope, regaining control, building certainty, etc.). In each of these themes, several sub-themes that detail the difficulties in captivity and the ways of dealing with them were identified. In addition, the citizens who returned from captivity described using two coping strategies: problem-focused, which aims to manage the problem by \"removing\" or changing the stressful factor (e.g., planning, building certainty), and emotion-focused coping, which aims to reduce or eliminate the emotional stress and emotions that arise following the trauma (such as distraction, appeal to beliefs, humor, etc.). The themes revealed attempts to regain resources while trying to understand the situation, interpret it, reduce the emotional stress, and act in threatening situations effectively in order to make it possible to survive.</p>","PeriodicalId":101459,"journal":{"name":"Harefuah","volume":"163 8","pages":"515-520"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141904128","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":"[EMOTIONAL CHALLENGES, RESILIENCE, AND CONTINUOUS EXPOSURE TO TRAUMATIC STRESS AMONG THE SOROKA UNIVERSITY MEDICAL CENTER STAFF: CASE DESCRIPTION].","authors":"Yael Levaot, Dror Dolfin","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>We present a case study dealing with the emotional coping of a physician's exposure to continuous traumatic stress starting with the events of Oct. 7, 2023 and during the following months.</p><p><strong>Background: </strong>The medical staff at Soroka Medical Center in southern Israel have faced unprecedented challenges over the past months due to ongoing conflict along the Gaza border. Since October 7, 2023, over 2,550 wounded patients have been treated at Soroka for injuries of varying severity, with more than 250 requiring life-saving surgeries. As the region's largest trauma center, Soroka's staff have endured continuous exposure to traumatic stress, suffering, distress and grief - both within the hospital and in their personal lives.</p><p><strong>Conclusions: </strong>While the long-term impacts remain to be seen, preliminary findings suggest that organizational efforts during routine may help mitigate potential negative effects of exposure to traumatic stress in the course of emergency. Further research is needed to understand how cumulative exposure interacts with process of recovery and growth.</p><p><strong>Discussion: </strong>The current report presents the different layers of traumatic exposure, the associated risk and resilience factors and a perception that was instilled in the hospital in the years preceding the current war which promoted a culture of proactive peer discourse about emotional hardship and normalization of referral for professional help when needed. We also present coping behaviors that were common among many staff members and organizational responses, considering the uniqueness of the current challenges, their scope and duration.</p>","PeriodicalId":101459,"journal":{"name":"Harefuah","volume":"163 8","pages":"496-500"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141904121","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":"[HORROR, SHAME AND GUILT IN THE BEDROOM: THE EFFECTS OF EXPOSURE TO TRAUMA ON SEXUAL FUNCTION].","authors":"Tali Samson, Itzhak Zahy Ben-Zion","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Since the brutal October 7, 2023 attacks on Israel, the encroachment of the battlefield into the daily lives of all Israelis has impacted both civilians and combatants in various ways. The development of post-traumatic stress reactions has far-reaching effects across numerous aspects of life. One of the lesser-discussed consequences is the onset of sexual dysfunction. Reactions to such distressing events can adversely affect sexual desire, arousal, orgasm, the frequency of sexual activities, and satisfaction derived from them. These issues may present directly in clinical settings, or indirectly through other symptoms. The impact of trauma on sexual function can be attributed to disruptions in biological mechanisms, cognitive impairments, mood changes, and diminished motivation. This review explores how responses to post-traumatic stress relate to sexual function. We present case studies of patients recovering from such events, describe the underlying mechanisms that trigger these adverse reactions, and discuss interventions that can enhance sexual health, which can be implemented in primary care settings. It is advisable for assessments of sexual function to be included in routine evaluations by primary care physicians. Early identification of sexual dysfunction can help prevent the progression of more persistent issues and enhance overall quality of life for patients.</p>","PeriodicalId":101459,"journal":{"name":"Harefuah","volume":"163 8","pages":"501-506"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141904122","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":"[Letters to the Editor].","authors":"Uri Freund, Gideon Eshel","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Letter about JEWISH MEDICAL STUDENTS FROM BRITISH MANDATE PALESTINE/ERETZ ISRAEL -THEIR FINAL MD EXAMINATION IN BERLIN DURING THE THIRD REICH, by Uri Freund Letter about JEWISH MEDICAL STUDENTS FROM BRITISH MANDATE PALESTINE/ERETZ ISRAEL -THEIR FINAL MD EXAMINATION IN BERLIN DURING THE THIRD REICH, by Gideon Eshel Letter about THE UNACCEPTED RELATIONSHIP BETWEEN THE EDUCATIONAL MEDICAL SYSTEM IN GERMANY AND THE JEWISH PHYSICIANS DURING THE NAZI REGIME, by Gideon Eshel.</p>","PeriodicalId":101459,"journal":{"name":"Harefuah","volume":"163 8","pages":"533-535"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141904123","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":"[PREPARING CITIZENS RETURNING FROM CAPTIVITY TO ISRAEL AND MEETING THEIR FAMILY MEMBERS: INITIAL PROTOCOL FOR RECEPTION FROM THE RED CROSS UNTIL TRANSFER TO THE HOSPITALS IN ISRAEL].","authors":"Uzi Bechor, Ravit Rubinstein, Ofir Levi, Yael Shoval-Zuckerman, Lucian Tatsa-Laur, Leah Shelef","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Delivery of the returnees from captivity by the Red Cross to military mental and medical professionals until they transfer to the medical staff in the hospitals and meetings with their families is a decisive challenge for the returnees and the professionals. The absorption time places the returnees in an exposed and vulnerable situation, in an intermediate space between captivity and reintegration into reality. The feelings of terror, the helplessness, and the danger to life that accompanied the kidnapping and the stay in captivity may develop into situations related to survival and adaptation to the conditions of captivity, including life-saving strategies. In addition, captivity is characterized by asymmetrical and distorted relationships. These distorted relationships, acquired in captivity without any choice, can have long-term consequences on future relationships and the process of adapting to life upon returning to Israel. Moreover, the fact that the reality that surrounded the returnees involved the loss of family members or others who were with them at the time of the kidnapping or during their stay in captivity adds to the complexity and the necessity of a sensitive and specially adapted professional reference on the part of the professional system. The expected reactions at the time of absorption can be varied and range from joy and euphoria to sadness, a feeling of alienation, anxiety, and disconnection. The initial reception time may be a window of opportunity during which interventions can be made to achieve effective adaptive responses upon returning to Israel. The purpose of the present article is to describe the preparations made in a relatively short period for the reception of the returnees and the development of the protocol for their initial reception to provide the best response to their needs. The protocol that is at the center of this article was formulated in the combat reaction unit, taking into account the needs of the returnees and the expected responses. Critical professional principles are applied, including an initial mental assessment, connection to personal, family, and community resources, as well as connection to the medical team, for continued treatment in the medical centers.</p>","PeriodicalId":101459,"journal":{"name":"Harefuah","volume":"163 8","pages":"521-527"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141904126","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":"[ACUTE MENTAL HEALTH INTERVENTIONS AFTER THE OCTOBER 7 ATTACKS AND THE IRON SWORDS WAR: CASE SERIES].","authors":"Inbal Reuveni, Zivya Seligman, Keren Aviram, Gabi Aisenberg Romano, Zohar Porat, Roey Sar-El, Shai Itamar, Lital Feldinger, Oren Tene, Renana Eitan","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>On October 7, 2023, terrorist organizations led by Hamas, launched an extensive attack on Israel. Within days following the initial attack, there was a clear need to provide psychological support to individuals who were exposed to the horrors of the October 7 attacks. Hence, the Tel Aviv Sourasky Medical Center opened the \"Ichilov Otef Nefesh\" clinic to provide psychological first aid to the first-line victims of the war. As the fighting spread, the services were extended to the entire population. The guiding principle of the intervention was that it is crucial in the acute phase after exposure to significant trauma, and its main purpose is to support the natural course of one's recovery processes. This case series describes three representative cases from among the hundreds of people who applied to the clinic. The intervention provided was guided by an integrated approach that promotes introspection and connectedness to one's environment and community, enhancing cognitive functions, emotional regulation and utilizing available resources to reduce distress. The main themes that emerged shifted between feelings of helplessness and a sense of agency; a breach in basic trust and renewed trust, guilt and self-compassion; anger, abandonment and alienation versus solidarity and connecting to the present and the future, despair versus hope and loss versus acceptance and connectedness. In face of these, the therapists endorsed techniques of validation, restoring self-agency, promoting a sense of self-agency and self-compassion, creating a link between the past and present, and finding connection and hope.</p>","PeriodicalId":101459,"journal":{"name":"Harefuah","volume":"163 8","pages":"491-495"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141904120","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}