Harefuah最新文献

{"title":"[INNOVATIONS IN ORTHOPEDIC SURGERY].","authors":"Nimrod Rozen, Guy Rubin","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>The health system in Israel, and in particular the field of orthopedics, stands at the forefront of medical practice, and serves as a model of excellence, innovation, and boundless dedication. In recent years, we have experienced impressive technological and scientific advances that have brought about a real revolution in our ability to treat complex situations and improve the quality of life of our patients. The current issue of 'Harefuah' presents research and review articles that reflect the new technologies - from advanced imaging, robotics, smart implants, and innovative surgical approaches that allow us to achieve unprecedented precision, reduce risks, and significantly improve the results of treatment and rehabilitation.</p>","PeriodicalId":101459,"journal":{"name":"Harefuah","volume":"164 4","pages":"208-209"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063389","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":"[INCORPORATING INTRAOPERATIVE DIGITALIZATION SOFTWARE IN ORTHOPEDIC TRAUMA: REDUCING OPERATIVE TIME IN PERTROCHANTERIC FRACTURE FIXATION].","authors":"Guy Feldman, Nadav Bandel, Ram Mosheiff, Amit Davidson, Yoram Weil, Mahmoud Jamal, Nimrod Rozen, Meir Libergall","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Integration of an intraoperative digitalization tool aims to improve daily work in the operating room by improving communication between staff members, patient safety and creating a database for future research.</p><p><strong>Aims: </strong>To evaluate the effect of intraoperative digitalization tools on total operative time, procedure standardization and fluoroscopy use.</p><p><strong>Methods: </strong>This retrospective study examined patients with pertrochanteric fracture, treated with closed reduction and internal fixation with a short cephalomedullary nail using the Proximal Femoral Nailing System (TFNA). The surgical protocol was displayed on a screen and controlled by a foot pedal. The data collected included the total surgical time and the amount of radiation emitted in millisievert (mSv). The cases were divided into four groups in a chronological fashion according to yearly quarters. The total operative time was compared to the literature.</p><p><strong>Results: </strong>Sixty operations were performed, forty-four by competent surgeons and 16 by expert surgeons. The average procedure time was 59.66 minutes. A decrease in operative time was observed for all surgeons (reduction of 2.27 minutes per month, p=0.0232, and reduction of 1.71 minutes per month, p=0.0093, for expert and competent surgeons, respectively). No difference was observed after standardization (p=0.201). Average operative time of group 4, which included the cases operated during the latest period (n=15) was 42.37 minutes, below the value accepted in the literature of 60.62 minutes (p=0.00117). Fluoroscopy use averaged 7.14 mSv, showing no change (p=0.414).</p><p><strong>Conclusions: </strong>Although digitalization led to decreased operative time, no improvement was observed after standardization. This was attributed to the small sample size.</p><p><strong>Discussion: </strong>Implementation of an intraoperative digitalization tool showed reduction in operative time for all surgeons, with no reduction in the use of fluoroscopy.</p>","PeriodicalId":101459,"journal":{"name":"Harefuah","volume":"164 4","pages":"229-232"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039696","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":"[COMPETENCY-BASED MEDICAL EDUCATION (CBME) PROPOSAL OF AN ORTHOPEDIC SKILLS-BASED SPECIALIZATION PROGRAM IN ISRAEL].","authors":"Ronen Debi, Omri Lubovsky","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Competency-based medical education (CBME) is an approach to medical education that focuses on assessing learners, based on their ability to perform skills or acquire specific skills. This approach is characterized by gradual training, oriented towards clinical training goals, according to the needs of the patient and the health system. To train an orthopedic surgeon, one must develop diverse clinical and surgical skills. Until recently, the orthopedic training course in Israel was characterized by significant gaps between the periphery and the center. Among the interns who complete the internship program, there were gaps, both in terms of the acquisition of knowledge and in terms of the independence required from a clinical and surgical point of view. To face the challenge, a national team was established, to rebuild the specialization program, under an outline of skills-based medical education. A program was built based on advanced learning tools and feedback. The program is characterized by gradualness, depending on the level of the intern, with a division into the introductory phase, core A, core B, and finally the professionalization phase.</p>","PeriodicalId":101459,"journal":{"name":"Harefuah","volume":"164 4","pages":"245-250"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060894","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":"[PATIENTS' AGE AS A PREDICTOR FOR FRACTURE PATTERN AND POST-OPERATIVE MORTALITY IN PERTROCHANTERIC FRACTURES].","authors":"Tal Frenkel Rutenberg, Kirstine Husum Hoyem, Shai Shemesh, Yona Kosashvili","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Fragility hip fractures are a major cause for morbidity and mortality in the elderly population. Half of these fractures occur in the intertrochanteric area.</p><p><strong>Aims: </strong>To evaluate the correlation between the patients' age and the intertrochanteric fracture pattern, as well as the correlation between the patients' age, fracture pattern and the risk for 1-year post-operative mortality.</p><p><strong>Methods: </strong>A retrospective cohort study of patients who underwent osteosynthesis for intertrochanteric fractures in the Kaplan Medical Center between 2010-2013. Demographic data, including 1-year survival was gathered. An analysis of patients X-ray imaging at presentation was performed and fractures were classified according to the AO classification system and for fracture stability. A regression model was used to evaluate for the correlation between patients' age and fracture patterns and for predictors of 1-year survival.</p><p><strong>Results: </strong>Overall, 644 patients were treated during the study period, of whom 544 met the inclusion criteria. Patients' age did not correlate either with the fractures AO classification or with fracture stability. Male sex and age were found to relate with increased mortality risk, as men have OR of 1.77 for mortality (95% CI 1.079- 2.603, p.= 0.022) and each additional year increased mortality by 8.3%.</p><p><strong>Conclusions: </strong>The patients' age did not correlate with fracture pattern and stability. Increasing age and male sex were found to be associated with reduced 1-year survival following surgery.</p>","PeriodicalId":101459,"journal":{"name":"Harefuah","volume":"164 4","pages":"215-219"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040693","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":"[BLEACHER COLLAPSE - A UNIQUE MASS-CASUALTY ORTHOPAEDIC EVENT].","authors":"Amit Davidson, Alan Katz, Amos Peyser, Rami Mosheiff, Yoram A Weil, Meir Liebergall","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>On 16 May 2021 a mass-casualty incident (MCI) was declared in Jerusalem after a bleacher (tribune) collapsed in a synagogue in a nearby town. All the injured patients were transferred to three hospitals. The aim of this study is to describe the injuries and management of this unique MCI to help better understand and prepare us and other institutions for similar events in the future with the same mechanism of injury.</p><p><strong>Methods: </strong>Data was collected from the hospitals' electronic database. Documented cases of the injured in the mass casualty event were included in the study. Collected data includes demographics, diagnosis of orthopedic injuries, treatment, duration of hospitalization, and follow-up.</p><p><strong>Results: </strong>In this mass casualty event, 265 patients were treated; all the patients were males with a mean age of 17.4 years (range 9-47). Two patients died at the accident scene and one patient died a week after admission, he suffered from a major head injury. Thirteen patients were admitted to the intensive care unit. Regarding the orthopedic injuries, ninety-six fractures were documented. Forty-three orthopedic surgeries were performed on patients in the cohort. Seventeen surgeries were conducted during the 24 hours from the time of the patients' admission, twenty after 24 hours, and 6 surgeries were returns to the operation theatre for various of reasons. The average time of patient hospitalization was 3.4 days (range 1-53 days). Only 66 patients sought follow-up care at their initial-treating hospital after discharge.</p><p><strong>Conclusions: </strong>Bleachers are widely used throughout the world for various events. Our experience shows that hospitals should be prepared for this type of unique mass-casualty accident that leads to many musculoskeletal injuries.</p>","PeriodicalId":101459,"journal":{"name":"Harefuah","volume":"164 4","pages":"220-224"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036242","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":"[CAN WE USE ASPIRIN AS A PRIMARY PREVENTION FOR CARDIOVASCULAR DISEASE?]","authors":"Arnon Blum, Yehuda Shoenfeld","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Aspirin was considered for primary prevention of cardiovascular disease (CVD) for dozens of years, but clinical trials from the last decade suggest that the use of aspirin for primary prevention depends on the subject's risk factors for CVD. Recent guidelines from the U.S. Preventive Services Task Force (USPSTF) recommends aspirin for primary prevention of CVD events only for people aged 40 to 59 with a 10-year CVD risk of 10% or greater. For subjects 60 years and older the benefits are less clear, and aspirin is not recommended for primary prevention.</p>","PeriodicalId":101459,"journal":{"name":"Harefuah","volume":"164 4","pages":"251-255"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056987","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":"[3D TECHNOLOGIES IN ORTHOPEDIC ONCOLOGY].","authors":"Yoav Levy, Amit Benady, Liat Tsoran, Solomon Dadia, Yair Gortzak","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Over the past decades, advancements in adjuvant treatments of bone sarcomas have catalyzed development of novel surgical technologies that continue to improve limb salvage surgeries. To date, these technologies have made limb salvage surgery the mainstay of treatment, while the amount of limb amputations became negligible. These advancements include pre-and intra-operative imaging technologies enabling accurate 3D-preoperative planning, and intraoperative patient-specific instruments allowing accurate execution of surgical plans. The introduction of customized 3D-printed porous titanium implants gave surgeons more freedom to retain surrounding healthy tissue and optimize reconstruction fit, thereby improving quality of life, and reducing comorbidities post-operatively. Creating these custom implants has brought forth novel processes, materials and technologies and given rise to a new era in orthopedic oncology.</p>","PeriodicalId":101459,"journal":{"name":"Harefuah","volume":"164 4","pages":"233-239"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061548","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":"[COMPETENCE BASED MEDICAL EDUCATION].","authors":"Eyal Anteby","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Since the 1950s medical education focused on integrated topics across traditional disciplines such as organ systems. In the 1990s competency-based medical education (CBME) was introduced. In a traditional educational system, the unit of progression is time and it is teacher-centered. In a competence-based system, the unit of progression is mastery of specific knowledge and skills and is learner-centered. The CBME movement started to redefine the doctor in more general competency terms. The Canadian and American medical education directives proposed several roles of the doctor including medical expert, professional, communicator, manager, scholar and health advocate.</p>","PeriodicalId":101459,"journal":{"name":"Harefuah","volume":"164 4","pages":"260-264"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061835","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":"[SILENT SINUS SYNDROME].","authors":"Ben Gvili, Arkadi Yakirevitch","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Silent sinus syndrome (SSS) is a rare condition, usually consisting of asymptomatic spontaneous collapse of the sinus walls and orbit floor. It is often found incidentally on MRI or CT imaging for other pathology work-up. The etiology of SSS remains controversial. Patients typically deny preexisting sinus disease or orbitofacial trauma. Clinical appearance usually consists of asymptomatic enophthalmos and altered facial appearance. Nevertheless, diplopia, nasal discharge, post-nasal drip, facial pressure, or pain may also be present. Most authors postulate that the collapse of the inferior orbital wall is induced by negative pressure generated by the resorption of gas after a natural ostium occlusion.</p>","PeriodicalId":101459,"journal":{"name":"Harefuah","volume":"164 3","pages":"143-144"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712681","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":"[COGAN SYNDROME - CASE PRESENTATION WITH PROGRESSIVE OCULAR INVOLVEMENT].","authors":"Amir Abd Elkader, Irit Bahar, Eitan Livny","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>A 74-year-old female patient suffering from Cogan's syndrome, presented to our department with slow progression bilateral corneal clouding, leading to reduced vision in her right eye. Recently, the patient underwent combined surgery of penetrating keratoplasty with cataract extraction, which improved her vision significantly. Cogan syndrome is a rare progressive systemic disease with potentially severe visual impairment. Disease diagnosis is challenging and is conducted by exclusion. Patients can benefit from keratoplasty in progressive disease manifestation.</p>","PeriodicalId":101459,"journal":{"name":"Harefuah","volume":"164 3","pages":"158-162"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712703","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}