Kfir Lavi, Vered Nir, Erez Nadir, Adi Klein, Eias Kassem
{"title":"Changes in the Seasonality of Bronchiolitis Caused by Respiratory Syncytial Virus During and After the COVID-19 Pandemic.","authors":"Kfir Lavi, Vered Nir, Erez Nadir, Adi Klein, Eias Kassem","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Prior to the coronavirus disease 2019 (COVID-19) pandemic, bronchiolitis caused by respiratory syncytial virus (RSV) was primarily observed during the winter months. Recently, however, an increase in incidence during the warmer months has been noted. This trend suggests an interaction between RSV and coronavirus, as well as the impact of public health measures, such as hand hygiene, mask-wearing, and social distancing.</p><p><strong>Objectives: </strong>To characterize bronchiolitis cases in children under 2 years old caused by RSV during the COVID-19 pandemic in Israel from 2018 to 2022.</p><p><strong>Methods: </strong>We conducted retrospective study by analyzing medical records of children hospitalized with bronchiolitis from January 2018 to December 2022. A comparison was made between cases before and after the first COVID-19 lockdown.</p><p><strong>Results: </strong>A total of 922 children with bronchiolitis were studied: 276 cases occurred before the lockdown and 646 cases afterward. We found an increase in bronchiolitis frequency during the summer following the lockdown and a decrease during the winter (P < 0.0001). In addition, there was a shift in the pathogenic profile, with a notable rise in mixed infections after the lockdown (P < 0.0001). No significant differences in clinical presentation were observed between pre- and post-lockdown periods.</p><p><strong>Conclusions: </strong>There was a change in bronchiolitis seasonality after the lockdown, with a significant increase in cases during the summer and a rise in mixed infections. Further studies are needed to assess whether this shift is a lasting consequence of the pandemic or a temporary change.</p>","PeriodicalId":50268,"journal":{"name":"Israel Medical Association Journal","volume":"27 5","pages":"278-282"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144038741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Osnat Jarchowsky Dolberg, Shani Ben Dori, Martin H Ellis, Boaz Amichai
{"title":"Baboon Syndrome after Percutaneous Coronary Intervention.","authors":"Osnat Jarchowsky Dolberg, Shani Ben Dori, Martin H Ellis, Boaz Amichai","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":50268,"journal":{"name":"Israel Medical Association Journal","volume":"27 5","pages":"334"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fadwa Sharabati, Elchanan Parnasa, Nur Magadle, Maor Vanunu, Iddo Z Ben-Dov
{"title":"Pheochromocytoma Presenting with Myalgia: A Case Report.","authors":"Fadwa Sharabati, Elchanan Parnasa, Nur Magadle, Maor Vanunu, Iddo Z Ben-Dov","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":50268,"journal":{"name":"Israel Medical Association Journal","volume":"27 5","pages":"316-318"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Avishag Laish-Farkash, Ella Yahud, Michael Rahkovich, Yonatan Kogan, Lubov Vasilenko, Emanuel Harari, Gergana Marincheva, Emma Shvets, Eli I Lev, Uri Farkash
{"title":"Implanting Cardiac Electronic Devices with Uninterrupted Antithrombotic Therapy: A Novel Approach to Reduce Pocket Hematoma.","authors":"Avishag Laish-Farkash, Ella Yahud, Michael Rahkovich, Yonatan Kogan, Lubov Vasilenko, Emanuel Harari, Gergana Marincheva, Emma Shvets, Eli I Lev, Uri Farkash","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Uninterrupted antithrombotic treatment (ATT) during cardiac implantable electronic device (CIED) implantation increases bleeding and device-related infections (DRI) risk. The wide-awake-local-anesthesia-no-tourniquet (WALANT) technique, using large-volume local anesthesia and adrenaline, is successful in hand surgeries but its potential to mitigate bleeding risk in CIED implantations remains unknown.</p><p><strong>Objectives: </strong>To investigate whether WALANT protocol for CIED implantations reduces clinically significant pocket hematoma in patients with a high bleeding risk or is a contraindication for interrupting ATT.</p><p><strong>Methods: </strong>We conducted a prospective, double-blind, randomized controlled trial with CIED surgery patients on uninterrupted ATT. They received WALANT protocol (lidocaine 1% with adrenaline 1:100,000) or standard protocol (lidocaine 1%). Following implantation, patients were blindly monitored in the ward and pacemaker clinic. Patients were monitored for bleeding outcomes post-implantation.</p><p><strong>Results: </strong>Forty-six consecutive patients (73.6 ± 9 years, 72% male) were enrolled. In the WALANT group (n=24) no intra-pocket pro-hemostatic agents were needed, compared to 45% in the control group (P = 0.0002). Postoperative pressure dressings were used in 12.5% vs. 68% (P = 0.0002). WALANT patients had smaller hematoma areas (median 3.7 cm2 IQR [1-39] vs. 46 cm2 [IQR 24-76], P = 0.0004) 1-day postoperative. ATT interruption occurred in 12.5% vs. 18% (P = 0.7). Superficial skin infection rates were 4% vs. 9% (P = 0.6). No DRI occurred. No WALANT-related side effects were observed.</p><p><strong>Conclusions: </strong>WALANT protocol in CIED implantation with uninterrupted ATT reduced pro-hemostatic agents, pressure-dressing need, and hematoma size. Larger studies are needed to assess its impact on infection rates.</p>","PeriodicalId":50268,"journal":{"name":"Israel Medical Association Journal","volume":"27 5","pages":"307-313"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Marron Daud, S Nahum Goldberg, Dotan Cohen, Gili Dar, Shiran Levy, Adam Nevo, Jacob Sosna, Naama Lev-Cohain
{"title":"Optimal Window Settings for Detection and Characterization of Ground-Glass Opacities on Computed Tomography in COVID-19 Patients Using a Simplex Algorithm-Based Approach.","authors":"Marron Daud, S Nahum Goldberg, Dotan Cohen, Gili Dar, Shiran Levy, Adam Nevo, Jacob Sosna, Naama Lev-Cohain","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Coronavirus disease-2019 (COVID-19) chest computed tomography (CT) involves ground-glass opacity (GGO) and denser consolidations, which are crucial for diagnosis.</p><p><strong>Objectives: </strong>To determine optimal window settings for characterization and detection of GGO and dense consolidation on CT imaging in COVID-19 patients using a Simplex-based approach.</p><p><strong>Methods: </strong>The study included 54 conventional CTs of COVID patients in two phases. First, CT images of 14 patients with GGO and 4 with dense consolidation were included. Seven radiologists evaluated representative images in different windows of varied width and center. They were graded for adequacy of characterization and detection. A Simplex algorithm was used to iteratively determine the optimal window settings. Surface response maps expressing the relationship between window settings and overall reader grades were constructed. Next, the reviewers compared manufacturer recommendations to the new optimal windows found on CT images of 40 patients.</p><p><strong>Results: </strong>Overall, 12 different window settings were evaluated over a total of 1176 reads. Optimal characterization and detection of pure GGO was seen with a center of 630 HU and width 1460 HU, producing higher grades for both detection and characterization than the manufacturer window settings (P = 0.005). Optimal windowing for dense consolidation was like manufacturer measures (-585 HU and 1800 HU). In phase 2, an overwhelming preference of 78% favoring the optimal window compared to conventional settings was found.</p><p><strong>Conclusions: </strong>GGO lung opacities characteristic for COVID-19 can be best seen using a lower CT windowing width than the manufacturer's recommendations, unlike denser consolidations, possibly due to differences in underlying pathophysiology.</p>","PeriodicalId":50268,"journal":{"name":"Israel Medical Association Journal","volume":"27 5","pages":"283-289"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dana Madorsky Feldman, Yael Laitman, Dana Albagli, Jacob Korach, Eitan Friedman
{"title":"CA125 Serum Levels in BRCA1/BRCA2 Pathogenic Sequence Variant Carriers as an Ovarian Cancer Screening Tool: A Longitudinal Study.","authors":"Dana Madorsky Feldman, Yael Laitman, Dana Albagli, Jacob Korach, Eitan Friedman","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>BRCA1/BRCA2 female pathogenic sequence variant (PSV) carriers in Israel are offered semiannual cancer antigen 125 (CA125) serum level determination and transvaginal ultrasound until performing risk reducing salpingo-oophorectomy (RRSO), even with the lack of proven efficacy of these procedures in providing adequate early detection of ovarian cancer.</p><p><strong>Objectives: </strong>To report the results of longitudinal CA125 measurements in BRCA1/BRCA2 carriers as a tool for ovarian cancer detection in a single medical center in Israel.</p><p><strong>Methods: </strong>Asymptomatic BRCA1/BRCA2 PSV carriers attending the Meirav High Risk Clinic at Sheba Medical Center for more than 3 years were eligible. Data on specific PSV, risk reducing surgeries, and cancer diagnoses were obtained from participant records. We used chi-square and Wilcoxon-Rank tests for statistical analyses.</p><p><strong>Results: </strong>Overall, 739 (399 BRCA1, 336 BRCA2, 4 BRCA1 + BRCA2) PSV carriers were included. Mean age at the start of follow-up was 38.96 ± 11.13 years, mean follow-up time was 7.93 ± 2.34 years, (5860.80 women/years). Most participants (490/739 [66.3%]) had stable CA125 levels (± 5 U/µl). Of participants, 61 had CA125 levels > 35 U/µl at least twice (n=42) or at least doubling of marker levels to a minimum of 20 U/µl (n=19), results that have led to further cancer defining investigations. Of these, 14 and 4 were diagnosed with breast and ovarian cancer, respectively.</p><p><strong>Conclusions: </strong>Longitudinally stable CA125 levels were noted in most BRCA1/BRCA2 PSV carriers and elevated levels were a poor marker for ovarian cancer development.</p>","PeriodicalId":50268,"journal":{"name":"Israel Medical Association Journal","volume":"27 5","pages":"297-300"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Forsan Jahshan, Helen Turner, Winnie Yeung, Isaac Shochat, Yujay Ramakrishnan
{"title":"Potts Puffy Tumor Drainage with Needle Aspiration: A Case Series of Three Adult Patients During the COVID-19 Pandemic.","authors":"Forsan Jahshan, Helen Turner, Winnie Yeung, Isaac Shochat, Yujay Ramakrishnan","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":50268,"journal":{"name":"Israel Medical Association Journal","volume":"27 5","pages":"275-277"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Higher Polyp Detection Rate and Cecum Intubation Rate in Morning Shift Compared to Afternoon Shift: A Multicenter Large Cohort Retrospective Study.","authors":"Rawi Hazzan, Tarek Saadi, Revital Guterman, Ruhama Elhayany, Avraham Yitzhak, Naim Abu-Freha","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Colorectal cancer (CRC) is the third most commonly occurring cancer worldwide. There are conflicting reports on whether colonoscopies performed during the morning shift have higher adenoma detection rates.</p><p><strong>Objectives: </strong>To investigate the differences in polyp detection rate (PDR) in colonoscopies between morning and afternoon shifts.</p><p><strong>Methods: </strong>In a retrospective, multicenter study involving a large cohort, we analyzed all colonoscopies conducted between 2016 and 2023 across seven endoscopy departments. The PDR was compared between morning and afternoon shifts.</p><p><strong>Results: </strong>We included 368,997 colonoscopies: 213,795 (57.9%) performed during the morning shift and 155,202 (42.1%) during the afternoon shift. Patients undergoing colonoscopies during the morning shift were more frequently female (53.8% vs. 51%, P < 0.001) and tended to be older compared to those in the afternoon shift (average age of 56.97 ± 12.6 vs. 55.6 ± 12.9, P < 0.001). Colonoscopies conducted during the morning shift exhibited a higher cecum intubation rate (CIR) (96.7% vs. 95.6%, P < 0.001). During the morning shift, higher rates of PDR (32.9% vs. 29.9%, P < 0.001) were observed. In the multivariate analysis, after adjusting for other variables, age, male sex, polyp follow-up, fecal occult blood test, morning shift, familial history of CRC, and rectal bleeding demonstrated statistically significant associations (P < 0.001) for PDR.</p><p><strong>Conclusions: </strong>Colonoscopies during the morning shift yielded a higher PDR and CIR than those in the afternoon. To improve this rate, endoscopists working the afternoon shift must be provided with the right conditions.</p>","PeriodicalId":50268,"journal":{"name":"Israel Medical Association Journal","volume":"27 5","pages":"301-306"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Emergent Pulmonary Hypertension and Right Ventricular Impairment Following Gemcitabine Therapy for Metastatic Breast Cancer.","authors":"Shira Gabizon-Peretz, Rinat Yerushalmi, Mordehay Vaturi, Inbar Nardi Agmon","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":50268,"journal":{"name":"Israel Medical Association Journal","volume":"27 5","pages":"319-321"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maguli S Barel, Majeed E Zahalka, Ofer M Kobo, Adham Zidan, Rami Abu Fanne, Simcha R Meisel, Ariel Roguin
{"title":"A Cluster of Severe Cardiac Events in Fit Individuals During Standup Paddleboard Surfing.","authors":"Maguli S Barel, Majeed E Zahalka, Ofer M Kobo, Adham Zidan, Rami Abu Fanne, Simcha R Meisel, Ariel Roguin","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":50268,"journal":{"name":"Israel Medical Association Journal","volume":"27 5","pages":"328-333"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}