Rambam Maimonides Medical Journal最新文献

{"title":"Identifying Settler Colonial Determinants of Health (SCDH) as the Upstream Cause of Palestinian Ill Health Is Both Incorrect and Harmful.","authors":"Linda Young Landesman, Maya Korin, Stacey Plichta, Brian Englander, Ora Paltiel","doi":"10.5041/RMMJ.10544","DOIUrl":"https://doi.org/10.5041/RMMJ.10544","url":null,"abstract":"<p><p>Extremism, displacement, and ongoing conflict have affected Palestinians and Israelis personally and collectively, endangering their health and lives. A theory circulating in public health publications posits that settler colonial determinants of health (SCDH) are the root cause of health inequities in the region. We argue that this assertion is misleading, ignores key facts, and exacerbates polarization, thus harming health. Public health is an evidence-based, scientific discipline based on hypotheses, research, and analysis. Throughout the scientific process, careful assessments of bias are essential. Knowledge is subsequently translated into policy and action. The SCDH theory rejects this approach as tainted by \"colonialism.\" We also argue that the SCDH concept, as applied to health disparities in Israel-Palestine, is an ideologically driven theory in search of evidence. Rather than developing testable hypotheses, the promoters of SCDH use selective evidence to support its relevance to health in the region. The theory collapses when examined against relevant facts related to regional history and the health status of Israelis and Palestinians. It invokes one-sided racism as a driver of health inequities in a context-inappropriate manner, and ignores many upstream determinants including actions of the Palestinian leadership, and their role as drivers of health. It denigrates peace-building and collaboration which are key to future health and wellbeing in the region, and which have a proven record in improving health outcomes. We call on public health professionals to distance themselves from unfounded rhetoric that polarizes the communities, and undermines the discipline's scientific integrity, while contributing nothing to promote health in the region.</p>","PeriodicalId":46408,"journal":{"name":"Rambam Maimonides Medical Journal","volume":"16 2","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12053806/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144034625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor: There Should Be a Clear Distinction Between Legitimate Protest and Antisemitism.","authors":"Yasmeen Abu Fraiha, Akiva Leibowitz","doi":"10.5041/RMMJ.10546","DOIUrl":"https://doi.org/10.5041/RMMJ.10546","url":null,"abstract":"","PeriodicalId":46408,"journal":{"name":"Rambam Maimonides Medical Journal","volume":"16 2","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12053807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Breathlessness to Better Living: Transforming COPD Care with Home-based Pulmonary Rehabilitation.","authors":"Abins Thozhuthinkal Kasim, Ravi Gaur, Nitesh Manohar Gonnade, Nagma Sheenam, Chinchu Kolakkanni, Sarankumar Ganesan, Adharshna Thangamalai Kannan","doi":"10.5041/RMMJ.10543","DOIUrl":"https://doi.org/10.5041/RMMJ.10543","url":null,"abstract":"<p><strong>Background: </strong>Chronic respiratory diseases, such as chronic obstructive pulmonary disease (COPD), significantly impact patients' quality of life by limiting physical function, mobility, and overall well-being. Pulmonary rehabilitation (PR), particularly home-based programs, has emerged as a vital non-pharmacological intervention to address these limitations. However, comprehensive assessments of the impact of home-based PR on both lung function and disability in COPD patients remain limited.</p><p><strong>Objective: </strong>This study aimed to evaluate the effectiveness of a 12-week home-based PR program on pulmonary function and disability in COPD patients, using pulmonary function tests (PFTs) and the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) to assess outcomes across multiple domains.</p><p><strong>Methods: </strong>A prospective, single-arm pre-post interventional study was conducted among 62 COPD patients at All India Institute of Medical Sciences, Jodhpur. Participants completed a 12-week home-based PR program, which included endurance exercises, breathing techniques, and self-management education. Pulmonary function tests were conducted, and disability levels were assessed using WHODAS 2.0 at baseline and after completing the program.</p><p><strong>Results: </strong>Improvements were observed in pulmonary function, with forced vital capacity (FVC), and forced expiratory volume in one second (FEV1), showing substantial increases (FVC: 2.50±0.43 L to 2.85±0.59 L; FEV1: 1.53±0.33 L to 1.63±0.34 L; P<0.001). The WHODAS 2.0 scores demonstrated notable reductions in disability, particularly in the life activities and participation domains (P<0.001). Cognitive and self-care scores remained stable, while improvements in mobility were observed but not significant. Regression analysis revealed a strong negative correlation between increases in FVC and reductions in WHODAS 2.0 total scores (r=-0.65), highlighting FVC as a key predictor of disability reduction.</p><p><strong>Conclusion: </strong>The 12-week home-based PR program improved lung function and reduced disability in COPD patients. These findings support the role of home-based PR as a viable, patient-centered alternative to traditional rehabilitation, addressing both physical and social dimensions of health. Future research should focus on long-term outcomes, the potential for broader implementation, and expanding access to underserved populations.</p>","PeriodicalId":46408,"journal":{"name":"Rambam Maimonides Medical Journal","volume":"16 2","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12053948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144002684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Ethnicity and Treatment Preferences in Patients with Irritable Bowel Syndrome.","authors":"Vered Richter, Efrat Broide, Tzippora Shalem, Daniel L Cohen, Tawfik Khoury, Atallah Mansour, Timna Naftali, Amir Mari","doi":"10.5041/RMMJ.10542","DOIUrl":"https://doi.org/10.5041/RMMJ.10542","url":null,"abstract":"<p><strong>Background and aims: </strong>Irritable bowel syndrome (IBS) poses a significant healthcare challenge, characterized by chronic gastrointestinal and extraintestinal symptoms impacting individuals' well-being. Treatment preferences may vary among patients from different ethnic groups, such as Arab and Jewish Israelis, necessitating tailored approaches.</p><p><strong>Methods: </strong>A bilingual (Hebrew/Arabic) questionnaire assessing patients' preferences regarding treatment goals was developed. It was administered online in Israeli IBS Facebook groups, as well as in two hospital gastroenterology clinics.</p><p><strong>Results: </strong>The study included 267 IBS patients (91 Arabs and 176 Jews). Demographic analysis revealed a higher proportion of females in both groups, with a significantly greater percentage among Jews compared to Arabs (84% versus 64.8%, respectively, P<0.001). The median age was 32 years for both Arabs and Jews (interquartile ranges of 26-42 and 24-62, respectively). Arabs exhibited higher rates of mixed-type IBS and constipation, while Jews had a higher prevalence of predominant diarrhea IBS. Arabs reported more bloating, higher rates of IBS-related comorbidities, and more medication usage. When asked to rate the importance of treatment goals, both populations preferred improvement in abdominal pain, bloating, and regular defecation, while assigning lower importance to improving difficulty in mental and/or physical aspects of intercourse, as well as arthralgia and myalgia. Arab patients assigned lower importance scores to various symptoms compared to their Jewish counterparts.</p><p><strong>Conclusion: </strong>This study highlights the impact of ethnicity on patients' treatment goals. Understanding patients' preferences will enable tailoring an individual approach to each IBS patient.</p>","PeriodicalId":46408,"journal":{"name":"Rambam Maimonides Medical Journal","volume":"16 2","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12053809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to Babar and to Abu Fraiha and Leibowitz-No Place for Unprofessionalism Including Offensive Antisemitic Symbols and Regalia at Medical School Commencement Ceremonies.","authors":"Steven Roth, Hedy S Wald","doi":"10.5041/RMMJ.10547","DOIUrl":"https://doi.org/10.5041/RMMJ.10547","url":null,"abstract":"","PeriodicalId":46408,"journal":{"name":"Rambam Maimonides Medical Journal","volume":"16 2","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12053937/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fostering Professionalism and Addressing Antisemitism at Medical School Commencements.","authors":"Anas Babar","doi":"10.5041/RMMJ.10545","DOIUrl":"https://doi.org/10.5041/RMMJ.10545","url":null,"abstract":"","PeriodicalId":46408,"journal":{"name":"Rambam Maimonides Medical Journal","volume":"16 2","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12053808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive Impairments in Viral Hepatitis Patients: Causes, Manifestations, and Impact on Quality of Life.","authors":"Tatyana Vasiliyevna Polukchi","doi":"10.5041/RMMJ.10539","DOIUrl":"10.5041/RMMJ.10539","url":null,"abstract":"<p><p>Viral hepatitis, primarily caused by hepatitis B virus and hepatitis C virus, is widely recognized for its impact on liver function, but emerging evidence suggests it also affects cognitive function. This review explores the causes, manifestations, and impact of cognitive impairments in patients with viral hepatitis, to better understand this often-overlooked aspect of the disease. A literature review was conducted, focusing on studies published in PubMed up to August 2024. Key areas covered include the pathophysiological mechanisms behind cognitive impairment in viral hepatitis, clinical manifestations observed in affected patients, the implications for their daily functioning and overall well-being, and the tools used in cognitive assessments. Common manifestations included deficits in attention, memory, executive function, and psychomotor speed. These cognitive challenges can significantly impact daily activities, occupational performance, and social interactions, contributing to reduced quality of life. Cognitive impairments in viral hepatitis patients represent a significant concern that extends beyond liver health. Recognizing and addressing these cognitive issues are crucial for improving patient outcomes. Enhanced diagnostic strategies and targeted interventions are needed to better manage cognitive symptoms and support affected individuals in maintaining their quality of life. This narrative review aims to enhance clinical practice and inform future research directions.</p>","PeriodicalId":46408,"journal":{"name":"Rambam Maimonides Medical Journal","volume":"16 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11779499/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The \"Immigrant Medical Services\" Organization from the End of the British Mandate Through the First Years of Israel (1944-1953).","authors":"Dorit Weiss","doi":"10.5041/RMMJ.10541","DOIUrl":"10.5041/RMMJ.10541","url":null,"abstract":"<p><p>The aftermath of the Second World War and the Holocaust triggered mass migration of Jewish refugees to British Mandatory Palestine and, after 1948, the nascent State of Israel. Responding to this crisis, Jews in the Diaspora increased their commitment to facilitate immigration to Israel, particularly by supporting medical services to the Yishuv (pre-state Jewish Settlement). This paper explores the critical role played by Hadassah and other organizations in establishing direct medical services for Jewish immigrants during two key periods of Israel's history: the end of British Mandatory Palestine (1944-1948) and the early years of the State of Israel (1948-1953). While the Immigrant Medical Services organization faced numerous challenges, this organization was essential in addressing the pressing healthcare needs of a burgeoning population amid morbidity and mortality concerns. An emphasis is placed on the challenges faced by these organizations and the commitment and resourcefulness of all involved, which ultimately shaped the foundation of Israel's healthcare infrastructure.</p>","PeriodicalId":46408,"journal":{"name":"Rambam Maimonides Medical Journal","volume":"16 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11779496/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is Minimally Invasive Surgery the Standard of Care for Ventral Hernia Repair?","authors":"Kaushik Bhattacharya","doi":"10.5041/RMMJ.10540","DOIUrl":"https://doi.org/10.5041/RMMJ.10540","url":null,"abstract":"","PeriodicalId":46408,"journal":{"name":"Rambam Maimonides Medical Journal","volume":"16 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11779498/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antisemitism in Medicine: An International Perspective.","authors":"Michael Gordon, Jerome Teitel, Ted Rosenberg, Ruth Oratz, Naomi Katz, David Katz","doi":"10.5041/RMMJ.10536","DOIUrl":"10.5041/RMMJ.10536","url":null,"abstract":"<p><p>Throughout history, Jewish people have long been recognized for their achievements in the world of medical science. For example, prior to the Holocaust, many outstanding physicians in Germany were Jewish. However, even in the 1930s, refugee European Jewish doctors faced significant barriers when they tried to escape and practice elsewhere because of long-standing prejudices and anti-Jewish quotas in medical schools and hospitals around the world. Eventually quotas fell, and the period after World War II once again saw a tremendous growth in numbers of Jews excelling in medicine internationally. Since the Hamas attack on Israel on October 7, 2023, there has been a resurgence of antisemitism worldwide. It is especially noticeable in the world of healthcare. This article evaluates and highlights examples of antisemitism in four countries by authors from each of these jurisdictions.</p>","PeriodicalId":46408,"journal":{"name":"Rambam Maimonides Medical Journal","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11779495/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142907778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}