Harefuah最新文献

{"title":"[GASTROCNEMIUS RUPTURE - DIAGNOSIS AND TREATMENT].","authors":"Gal Shaham, Nir Gafni, Amir Herman, Maria Oulianski, Dana Avraham","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Gastrocnemius muscle ruptures are frequent in both recreational and competitive athletes. The superficial posterior compartment of the leg includes the gastrocnemius and soleus muscles, and a tear can occur in either one of them or both. Gastrocnemius injuries usually occur in young adult male athletes in their 40s. Moreover, they are common in sport involving eccentric lower extremity movements such as football, basketball, and tennis. Injuries are more common in athletes who have not warmed up adequately or are fatigued. The diagnosis is based on the patient's history and physical examination. Patients will complain of pain, swelling, difficulty to flex the ankle joint, Furthermore, patients will usually have difficulty bearing weight on the affected leg. Imaging is rarely needed for diagnosing a gastrocnemius muscle rupture, although ultrasound may be helpful to weigh the severity of the injury and to monitor recovery. Conservative treatment will include rest, anti-inflammatory drugs, lifestyle modifications, cooling regimens and physical therapy. Surgical treatment is rarely indicated and can be suggested for the treatment of the complete rupture, patients with prolonged (4-6 months) pain and large intramuscular hematomas that might impair clinical progress. An acute complication is a compartment syndrome which is an indication for urgent surgery.</p>","PeriodicalId":101459,"journal":{"name":"Harefuah","volume":"164 6","pages":"383-386"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328356","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 INTERFACE OF THE SENIOR PHYSICIAN AND GOOGLE FOR DIAGNOSING INTRIGUING CLINICAL RIDDLES].","authors":"Haim Mayan","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>THE INTERFACE OF THE SENIOR PHYSICIAN AND GOOGLE FOR DIAGNOSING INTRIGUING CLINICAL RIDDLES.</p>","PeriodicalId":101459,"journal":{"name":"Harefuah","volume":"164 6","pages":"387"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328366","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":"[LIVER ABSCESSES IN A PATIENT WITH BEHCET'S DISEASE].","authors":"Shiri Keret, Alaa Sawaed, Aniela Shouval, Abid Awisat, Eli Odi, Elias Nizar","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Behçet's disease is an autoimmune inflammatory disorder manifested by oral and genital ulcers along with heterogeneous involvement of various organs including eyes, skin, and blood vessels. Aseptic abscesses are a rare manifestation of autoinflammatory diseases and have been reported in isolated cases as part of Behçet's disease. We present a case of an 18-year-old patient with a new diagnosis of Behçet's disease who presented with aseptic liver abscesses. After an extensive negative infectious workup, the patient was treated with steroids, resulting in rapid and complete clinical and laboratory resolution. This case highlights the importance of clinician awareness of this rare complication to achieve correct diagnosis and appropriate treatment.</p>","PeriodicalId":101459,"journal":{"name":"Harefuah","volume":"164 6","pages":"347-350"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328359","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":"[THYROTOXICOSIS WITH PROLONGED CARDIAC EFFECT DUE TO EXCESS LIOTHYRONINE CONSUMPTION 'OVER THE COUNTER': A CASE REPORT AND RECOMMENDATIONS FOR POLICY MAKERS].","authors":"Yaniv S Ovadia, Liza Paley, Ronny Berkovitz, Emile Hai, Svetlana Turkot","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Exogenous excessive thyroid hormone intake may result in severe thyrotoxicosis and might be harmful to human health. In spite of this, a growing number of people consume over-the-counter (OTC) products that also contain Triiodothyronine (T3) and Thyroxine (T4). We report a case of Liothyronine-containing tablets consumption causing T3-induced thyrotoxicosis. A 33-year-old obese man (BMI=40 kg/m2) with no thyroid disease had typical signs of substantial thyrotoxicosis (including wide complex tachycardia and chest pain), which were confirmed by endocrine tests: both low thyrotropin (TSH) and free T4 as well as elevated free T3 (FT3). Prior to hospitalization, he had not been exposed to iodinated radiocontrast media and had not taken medications containing iodine, such as amiodarone. However, we discovered that the patient consumed tablets containing Liothyronine (135 µg/tablet) for five days prior to hospitalization following the suggestion of a non-registered individual, who introduced himself as a nutritionist. The tablets were misleadingly presented to the patient as a \"weight loss\" dietary supplement. The tablets were discontinued and a short term therapy that included Amiodarone (before FT3 arrived) was initiated along with Cholestyramine. After three days in the intensive care unit, the patient's heart rate stabilized and his FT3 level decreased substantially. Following investigations, the Israeli Ministry of Health (MOH) published a warning on its website advising the public to avoid these tablets. After follow-up in the community, a repeat echocardiogram revealed a borderline left ventricle dysfunction. During the four years since the patient was released from our hospital, his TSH levels have been normal.</p><p><strong>Conclusions: </strong>Liothyronine consumption has been associated with substantial thyrotoxicosis and cardiac damage. The Liothyronine tablets were provided to the patient by an unauthorized party, as a weight losing nutritional supplement. However, this was done without a medical examination or indication. The increase in demand for \"weight-losing\" products 'over the counter', the lack of effective enforcement in the chain, the way these products are presented and the possibility of those who are not authorized to market and supply them, emphasize the need to settle the regulation of this issue as soon as possible.</p>","PeriodicalId":101459,"journal":{"name":"Harefuah","volume":"164 6","pages":"358-362"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328367","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":"[A MODEL FOR TRAUMA- SENSITIVE MEDICAL EXAMINATION TUTORING STRATEGY].","authors":"Orna Tal, Netta Shamir-Kaholi, Maayan Gal-Cochav, Shani Naor-Ravel, Anna Padoa, Ron Maymon","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>The patient-doctor encounter encompasses a comprehensive information and decision-making situation. It involves a gap in knowledge and feelings between the doctor and the patient, which intensifies in sensitive situations, in particular gynecology. It may be accompanied by loss of control, violation of privacy, embarrassment and discomfort. This emotional gap has deepened in the past year following the October 7th terror attack. The current training of medical students and residents is insufficient.</p><p><strong>Objectives: </strong>To formulate a comprehensive learning model for trauma-informed treatment.</p><p><strong>Methods: </strong>A steering committee mapped out principles for formulating and implementing the training: dealing with patients who have experienced trauma and identifying the characteristics of the phenomenon, the type and scope of communication skills required, and the tools for its implementation, and processing the therapist's feelings to provide professional confidence relevant to the situation. The patients' expressions were collected as a platform for workshops that included theoretical lectures, patient testimonies and actors' simulations.</p><p><strong>Results: </strong>A total of 27 residents (in Shamir Hospital) and 35 senior gynecologists from 15 health institutions countrywide were trained. An analysis of the insights reflected the perceived benefit of professionalism, the importance of acquiring professional tools and the need for additional knowledge while enhancing the experience of providing care and service. Participants noted the deepening of the ability to identify the phenomenon and deal with patients who have experienced trauma.</p><p><strong>Conclusions: </strong>It is important to promote trauma-sensitive testing among gynecologists at a national level, especially in the fields of urogynecology, fertility, pregnancy and obstetrics, alongside other clinical fields (urology, surgery, etc.). We recommend exposing medical students in clinical settings and interns during any internship in order to enhance patient-doctor encounter dialogue. This process will improve professional skills and patient experience at a national level, and increase the overall quality of medical services provided in Israel.</p>","PeriodicalId":101459,"journal":{"name":"Harefuah","volume":"164 6","pages":"351-357"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328353","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":"[MATERNAL MORTALITY IN ISRAEL - ACHIEVEMENTS AND ONGOING CHALLENGES].","authors":"Asher Bashiri, Omri Zamstein","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Israel has one of the lowest maternal mortality rates globally, at 2.6 per 100,000 births. Most deaths occur between the late second trimester and the postpartum period, primarily due to obstetric complications such as postpartum hemorrhage, sepsis, and amniotic fluid embolism. Unlike the U.S.A., where leading causes include violence and substance abuse, maternal deaths in Israel are predominantly obstetric. A major challenge is distinguishing between preventable and non-preventable deaths. Research suggests that more than 60% of maternal deaths could be avoided with better diagnosis, timely intervention, and improved emergency response. Severe maternal morbidity often serves as a precursor to mortality, emphasizing the need for early detection and intervention. Postpartum hemorrhage, a leading cause of preventable maternal deaths, demonstrates how structured protocols, rapid response systems, and better coordination among medical teams can significantly reduce mortality. In contrast, amniotic fluid embolism remains largely unpredictable and untreatable, highlighting the current limits of medical intervention and the urgent need to intensify research into its underlying mechanisms and potential therapies. Despite Israel's achievements, further reductions in maternal mortality may still be possible. Strengthening medical training, improving emergency responses, and fostering interdisciplinary collaboration could save lives. Every preventable death underscores the need for continuous improvement in maternal care.</p>","PeriodicalId":101459,"journal":{"name":"Harefuah","volume":"164 6","pages":"368-371"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328361","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":"[OCULOPLASTICS AND ORBITAL SURGERY SECTION: EYELID PTOSIS].","authors":"Daphna Landau","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Oculoplastics is a subspecialty of ophthalmology that focuses on a wide range of disorders affecting the eyelids, lacrimal system, and orbit. Common conditions include ptosis (eyelid drooping), nasolacrimal duct obstruction, thyroid eye disease, orbital fractures, and others.</p>","PeriodicalId":101459,"journal":{"name":"Harefuah","volume":"164 6","pages":"395-396"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328363","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":"[IMAGING OVER-DIAGNOSIS OF LOW BACK PAIN IN PRIMARY CARE].","authors":"Reem Samir Abboud, Gill E Sviri","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Lower back pain (LBP) is a common symptom among the general population. Most LBPs are classified as non-specific back pain, which is a common reason for seeking medical treatment. However, only a minority will experience a serious etiology whereas most will often present additional risk factors or symptoms.</p><p><strong>Aims: </strong>Analyzing the current literature and common guidelines to understand the various aspects of overdiagnosing LBP in primary care.</p><p><strong>Methods: </strong>A current literature review was conducted to investigate the connections between the data and qualitative-quantitative analysis of the data to create a structured summary. Qualitative and quantitative articles discussing, directly or indirectly, the various aspects of overdiagnosis of LBP among primary care providers were included.</p><p><strong>Results: </strong>Most international clinical guidelines have prioritized non-medical approaches for patients with LBP. Many healthcare providers are not designed to support this approach when guideline-compliant clinical implementation requires system-wide changes.</p><p><strong>Conclusions: </strong>LBP treatment and diagnosis should pay more attention to primary care physicians as better education and regulation should be implemented to reduce overdiagnosis.</p><p><strong>Discussion: </strong>Overdiagnosis of LBP in primary care burdens the system and harms patients for many and varied reasons. The existing guidelines must be organized and assimilated among primary care physicians, along with the establishment of a sufficient and uniform comprehensive system that supports the current approach.</p>","PeriodicalId":101459,"journal":{"name":"Harefuah","volume":"164 6","pages":"376-382"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328357","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":"[SYNDACTYLY OF THE FINGERS: DIAGNOSIS, EVALUATION AND TREATMENT].","authors":"Raphael Israeli, Gil Ganot, Helit Guy-Chen, Amir Oron","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Syndactyly release is a surgical procedure aimed at restoring hand and finger function while maintaining the natural appearance of the interdigital web space (commissure) as much as possible. The timing of surgery depends on the complexity of the fusion, the patient's age, and their overall medical condition. The traditional technique is based on a zigzag incision and the use of skin grafts combined with local flaps. However, it is associated with a relatively high incidence of complications, such as web creep, hypertrophic scars, flap necrosis, and contractures. This article provides a general overview of syndactyly and reviews an alternative surgical technique that minimizes the need for skin grafts, shortens recovery time, and improves both aesthetic and functional outcomes.</p>","PeriodicalId":101459,"journal":{"name":"Harefuah","volume":"164 6","pages":"372-375"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328364","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 MESENTERIC ISCHEMIA].","authors":"Avi Duchno, Gil Bachar","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>A 61-year-old man with a complex cardiovascular history and chronic kidney disease was hospitalized with an anterior STEMI and found on catheterization to have severe occlusions in multiple coronary arteries. He underwent PCI followed by urgent coronary artery bypass surgery. On the day after the surgery, he developed acute abdominal pain, and a CTA revealed thrombosis of the superior mesenteric artery (SMA) with ischemia of the small intestine - a condition that was treated surgically with bowel resection and thrombectomy.</p>","PeriodicalId":101459,"journal":{"name":"Harefuah","volume":"164 6","pages":"388-389"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328354","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}