Israel Medical Association Journal最新文献

Prevalence of Hearing Impairment Among Young Adults. 年轻人中听力障碍的患病率。

IF 0.8 4区医学

Israel Medical Association Journal Pub Date : 2026-06-01

Mor Rittblat, Nir Tsur, Hodaya Etedgi, Aya Ekshtein, Maya Avni, Oded Ben-Ari

{"title":"Prevalence of Hearing Impairment Among Young Adults.","authors":"Mor Rittblat, Nir Tsur, Hodaya Etedgi, Aya Ekshtein, Maya Avni, Oded Ben-Ari","doi":"","DOIUrl":"","url":null,"abstract":"Background: Noise-induced hearing loss (NIHL) is a prevalent hearing impairment, second only to age-related hearing loss. A change in the listening habits of adolescents may have contributed to the documented increase of hearing impairments in that age group.Objectives: To examine the prevalence of NIHL among healthy young adults.Methods: We conducted a retrospective study to examine audiograms of healthy candidates for the Israeli Air Force flight academy between 2018 and 2023. Hearing tests were performed by an expert audiologist using an audiometer.Results: A total of 1940 audiograms were analyzed. The age range of the patients was 17-19 years. Using the British Society of Audiology classification, 174 (8.97%) audiograms and 313 frequencies were classified as impaired. The 8 kHz was the most affected frequency, accounting for 116 cases (37%).Conclusions: Hearing impairment prevalence increased from 1% at entry into the education system to 8.45% at the end, respectively. Detecting hearing impairments early may minimize future disability and may reduce future disability and rehabilitation costs. Hearing screens for young adults due to the change in listening habits of adolescents may prove useful.","PeriodicalId":50268,"journal":{"name":"Israel Medical Association Journal","volume":"28 6","pages":"348-351"},"PeriodicalIF":0.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148320273","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}

引用次数: 0

Military Medicine: From Experience to Knowledge. 军事医学：从经验到知识。

IF 0.8 4区医学

Israel Medical Association Journal Pub Date : 2026-06-01

Zivan Aviad Beer, Avi Benov

引用次数: 0

Sleep Restriction and Heat Stress as Compounded Risks to Military Cognitive Readiness. 睡眠限制和热应激是军事认知准备的复合风险。

IF 0.8 4区医学

Israel Medical Association Journal Pub Date : 2026-06-01

David Erez, Daniel S Moran, Itay Ketko

引用次数: 0

Asthma in Active Military Aircrew: Long-term Health and Flight Performance. 现役军事机组人员的哮喘：长期健康和飞行性能。

IF 0.8 4区医学

Israel Medical Association Journal Pub Date : 2026-06-01

Omer Angel, Mor Rittblat, Ophir Freund, Daniel Gabbai, Maa'yan Pivko, Aya Ekshtein, Omer Tehori, Amir Bar-Shai, Oded Ben-Ari

{"title":"Asthma in Active Military Aircrew: Long-term Health and Flight Performance.","authors":"Omer Angel, Mor Rittblat, Ophir Freund, Daniel Gabbai, Maa'yan Pivko, Aya Ekshtein, Omer Tehori, Amir Bar-Shai, Oded Ben-Ari","doi":"","DOIUrl":"","url":null,"abstract":"Background: Asthma poses unique challenges in aviation medicine. While strict criteria typically dictate waiver approvals in military aviators with asthma, the Israeli Air Force (IAF) applies a more individualized approach. Still, evidence to guide correct management is scarce.Objectives: To assess the characteristics and long-term outcomes of military aircrew diagnosed with asthma.Methods: This retrospective study included active and reserve aircrew who were diagnosed with asthma during annual assessments at the Israeli Aeromedical Unit between 1998 and 2024. Baseline characteristics, treatment regimes, pulmonary function tests (PFTs), and asthma exacerbations were analyzed.Results: Thirty-two aircrew personnel (median age 30 years at diagnosis) were included in the study, with 44% serving at high-performance platforms. Six participants (19%) were classified as Global Initiative for Asthma step 4 or 5. Over an average follow-up period of 18.5 years, seven exacerbations were documented (4.0 per 100 patient-years), with no safety incidents reported. Participants' pulmonary function remained stable. Forced expiratory volume in 1 second (FEV1) and FEV1/forced vital capacity (FVC) declined around asthma diagnosis (median of 82% predicted and 0.73, respectively) but recovered remarkably while on treatment (median 91% predicted and 0.78, respectively). Aircrew who experienced exacerbations had no statistically significant differences in demographics, disease severity or baseline PFTs.Conclusions: With individualized management and regular monitoring, a new diagnosis of asthma in military aircrew was not associated with a significant impact on service. Our study supports a flexible, individualized approach to aeromedical management of aircrew with asthma.","PeriodicalId":50268,"journal":{"name":"Israel Medical Association Journal","volume":"28 6","pages":"363-368"},"PeriodicalIF":0.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148320354","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}

引用次数: 0

Knowledge Gaps in Our Understanding of Hyperbaric Oxygen Therapy in Post-traumatic Stress Disorder: Current Evidence, Proposed Solutions, and Preliminary Results. 我们对创伤后应激障碍高压氧治疗的理解中的知识缺口：目前的证据，提出的解决方案和初步结果。

IF 0.8 4区医学

Israel Medical Association Journal Pub Date : 2026-06-01

Ivan Gur, Dror Ofir, Afek Moravia, Shir Orenstein, Carmel Kalla

{"title":"Knowledge Gaps in Our Understanding of Hyperbaric Oxygen Therapy in Post-traumatic Stress Disorder: Current Evidence, Proposed Solutions, and Preliminary Results.","authors":"Ivan Gur, Dror Ofir, Afek Moravia, Shir Orenstein, Carmel Kalla","doi":"","DOIUrl":"","url":null,"abstract":"Background: Post-traumatic stress disorder (PTSD) remains a significant and often refractory mental health condition. Hyperbaric oxygen (HBO) therapy has demonstrated promise in alleviating symptoms of PTSD but optimal dosing and treatment duration remain unclear.Objectives: To evaluate the clinical efficacy and dosing effects of two HBO protocols in patients with PTSD.Methods: We conducted a randomized controlled trial comparing two HBO protocols: 60 daily sessions of 90 minutes at either 2.0 atmospheres absolute (ATA) or 2.5 ATA (HBO15). Adults with severe PTSD (Clinician Administered PTSD Score [CAPS]-5 ≥ 33) were randomized to treatment arms. CAPS-5 scores were recorded every 2 weeks. Secondary outcomes include measures of depression, sleep, executive function, and safety. Preliminary results are presented for the first nine patients who completed therapy (HBO10: n=5; HBO15: n=4).Results: Participants in HBO15 were younger (mean age 39 vs. 59 years, P = 0.2). Baseline PTSD severity (CAPS-5) was higher in HBO15 (median 61.5 vs. 48.0, P = 0.4). Other baseline psychological scores were similar between groups. Mean CAPS-5 improvement (ΔCAPS) was greater in HBO15 (-14.0 ± 21.2) vs. HBO10 (-5.3 ± 19.6), although not statistically significant (P = 0.8). Both groups demonstrated the largest symptom reduction by weeks 6-8, with a plateau observed thereafter despite continued treatment through week 12.Conclusions: Preliminary data suggest both HBO protocols are associated with symptomatic improvement in PTSD, with a trend toward greater effect in the higher-pressure group (2.5 ATA). Improvements appear to peak around 6-8 weeks, potentially indicating a shorter optimal treatment duration.","PeriodicalId":50268,"journal":{"name":"Israel Medical Association Journal","volume":"28 6","pages":"376-382"},"PeriodicalIF":0.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148320315","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}

引用次数: 0

Decompression Sickness; Not Only in Divers: Altitude as a Risk Factor. 减压病;海拔高度不仅是潜水员的危险因素。

IF 0.8 4区医学

Israel Medical Association Journal Pub Date : 2026-06-01

Oded Ben-Ari, Daniel Gabbai, Idan Nakdimon

{"title":"Decompression Sickness; Not Only in Divers: Altitude as a Risk Factor.","authors":"Oded Ben-Ari, Daniel Gabbai, Idan Nakdimon","doi":"","DOIUrl":"","url":null,"abstract":"Background: Decompression sickness (DCS) is a clinical syndrome caused by a substantial reduction in barometric pressure. DCS is more common among divers but may also occur during flight or altitude chamber (hypobaric chamber) training. DCS is classified according to symptoms as either Type 1 (musculoskeletal and skin involvement) or Type 2 (neurological and pulmonary involvement). DCS may be life threatening and often necessitates treatment with hyperbaric oxygen therapy (HBOT).Objectives: To examine the risk for altitude decompression sickness (ADCS) in altitude chamber training and to compare ADCS symptoms and treatment to those of DCS in divers (DDCS).Methods: We conducted a retrospective cohort study that included all cases of ADCS in the Israeli Air Force between 2015 to 2022. We collected demographic, flight platform, altitude chamber training, clinical manifestations, and treatment data. Data regarding DDCS was obtained via a literature review.Results: There were 2279 altitude chamber trainees and aviation physiology instructors. Of these, 11 presented ADCS, leading to a calculated ADCS risk of 0.5%. An additional four cases were reported following combat flights. Musculoskeletal involvement was the most common symptom in both DDCS and ADCS. A shorter HBOT protocol was used in 53% of the ADCS cases but only in 30% of the DDCS cases.Conclusions: Overall, ADCS is a rare event, occurring in less than 1% of altitude chamber trainees. The common manifestation is of musculoskeletal involvement, and the mainstay of treatment remains HBOT.","PeriodicalId":50268,"journal":{"name":"Israel Medical Association Journal","volume":"28 6","pages":"352-356"},"PeriodicalIF":0.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148320362","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}

引用次数: 0

Hyperbaric Oxygen Therapy for Acute Acoustic Trauma: Blast versus Noise-Induced Hearing Loss. 高压氧治疗急性声损伤：爆炸与噪音引起的听力损失。

IF 0.8 4区医学

Israel Medical Association Journal Pub Date : 2026-06-01

Ivan Gur, Inbar Gur, Tomer Jerdev, Yuval Nov

{"title":"Hyperbaric Oxygen Therapy for Acute Acoustic Trauma: Blast versus Noise-Induced Hearing Loss.","authors":"Ivan Gur, Inbar Gur, Tomer Jerdev, Yuval Nov","doi":"","DOIUrl":"","url":null,"abstract":"Background: Blast injuries impair hearing through several mechanisms that are distinct from other causes of acute acoustic trauma (AAT).Objectives: To compare blast injured patients to those exposed to noise alone in their auditory response to hyperbaric oxygen (HBO) therapy with oral steroids.Methods: Adult patients with evidence of a previously undocumented ≥ 30 dB pure-tone threshold within 30 days of AAT were treated with a combination of one 2.5 atm HBO therapy session for 90 minutes daily with oral prednisone. Exposure was classified by history as blast (for explosion-induced AAT) or noise. The change in high pure tone average (HPTA) was the primary outcome.Results: Of 598 ears (387 patients) included in the final analysis, 259 were exposed to blast and 339 to noise. Before treatment, the blast injured patients had significantly more abnormal findings on otoscopy (87% vs. 95%, P = 0.003), higher pure-tone average (18 ± 11 dB vs 12 ± 9 dB; P < 0.001), and higher speech reception thresholds (16 ± 14 dB vs 10 ± 8 dB, P < 0.001). Following treatment, these patients exhibited a significantly smaller improvement in HPTA (6 ± 17 dB vs 10 ± 14 dB P = 0.022) with pure tone thresholds remaining significantly worse across all frequencies in the blast exposed group (mean difference ranging from 3.2 to 6.8 dB, all P < 0.05).Conclusions: Blast injuries result in unique auditory characteristics and responses to HBO therapy compared to other causes of AAT.","PeriodicalId":50268,"journal":{"name":"Israel Medical Association Journal","volume":"28 6","pages":"369-375"},"PeriodicalIF":0.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148320270","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}

引用次数: 0

The Impact of Age on Military Trauma Outcomes: A Retrospective Analysis. 年龄对军事创伤结果的影响：回顾性分析。

IF 0.8 4区医学

Israel Medical Association Journal Pub Date : 2026-06-01

Danielle Akler, Daniel Gelman, Irina Radomislensky, Zivan Aviad Beer, Avi Benov, Roy Nadler

{"title":"The Impact of Age on Military Trauma Outcomes: A Retrospective Analysis.","authors":"Danielle Akler, Daniel Gelman, Irina Radomislensky, Zivan Aviad Beer, Avi Benov, Roy Nadler","doi":"","DOIUrl":"","url":null,"abstract":"Background: Age is a well-established prognostic factor in civilian trauma, where adverse outcomes increase with ages. Whether this pattern holds true in military trauma, where populations, injury mechanisms, and systems of care differ fundamentally, remains uncertain. A large-scale mobilization of Israeli Defense Forces (IDF) reservists provided an opportunity to examine this association.Objectives: To clarify whether older service members experienced less favorable outcomes compared with younger counterparts.Methods: This retrospective cohort study included IDF casualties recorded in the IDF Trauma Registry and the Israel National Trauma Registry between 27 October 2023 and 19 January 2025. Participants were categorized by age: 18-21 years, 22-39 years, and ≥ 40 years. Primary outcomes included 24-hour and 30-day mortality, intensive care unit admission (ICU), and hospitalization ≥ 7 days.Results: Of 4905 casualties, 40.4% were 18-21 years of age, 54.2% were 22-39, and 5.4% were ≥ 40. Injury severity, evacuation times, pre-hospital interventions, and admission vital signs were similar across groups. Adjusted analyses showed no significant age-related differences in mortality, ICU admission, or prolonged hospitalization. Subgroup analysis of casualties with injury severity score ≥ 16 yielded comparable results.Conclusions: In this large military trauma cohort, no significant association was found between age and mortality, ICU admission, or prolonged hospitalization. These findings were observed in a generally healthy military population receiving organized trauma care and suggest that, within this context, chronological age alone may not be an appropriate criterion for determining reserve service eligibility.","PeriodicalId":50268,"journal":{"name":"Israel Medical Association Journal","volume":"28 6","pages":"383-388"},"PeriodicalIF":0.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148320360","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}

引用次数: 0

Military Service Outcomes among Volunteers with Inflammatory Bowel Disease in the Israel Defense Forces: A Retrospective Cohort Study. 以色列国防军炎症性肠病志愿者的兵役结果：一项回顾性队列研究

IF 0.8 4区医学

Israel Medical Association Journal Pub Date : 2026-06-01

Yarden Gavron, Shlomi Abuhasira, Yigal Chechik

{"title":"Military Service Outcomes among Volunteers with Inflammatory Bowel Disease in the Israel Defense Forces: A Retrospective Cohort Study.","authors":"Yarden Gavron, Shlomi Abuhasira, Yigal Chechik","doi":"","DOIUrl":"","url":null,"abstract":"Background: Inflammatory bowel disease (IBD) is a chronic relapsing condition affecting millions worldwide, often diagnosed during young adulthood and associated with significant functional impairment. The Israel Defense Forces (IDF) allows citizens with IBD and other chronic medical conditions to volunteer for military service through a special medical volunteer program. No comprehensive study has examined the impact of military service on disease progression or military performance.Objectives: To evaluate the association between IBD and military service-related outcomes, including service completion and occupational stability, among IDF medical volunteers.Methods: In this retrospective study, we examined 734 volunteer soldiers with IBD who served in the IDF between 2019 and 2024. Data were collected from computerized medical records and included demographic, occupational, and medical information.Results: Among 734 IBD volunteers, 96.7% successfully completed their military service. Male sex (odds ratio 3.73) and lower sick leave utilization (odds ratio 3.13) were key predictors of service completion in multivariable analysis.Conclusions: The findings suggest that the vast majority of IBD volunteers successfully completed military service, with male sex and lower sick leave utilization as predictors of completion. Given these outcomes, consideration should be given to including carefully selected IBD patients within the standard medical classification system, based on individualized assessment of disease stability and functional capacity, with a non-combat profile, rather than through the volunteer program.","PeriodicalId":50268,"journal":{"name":"Israel Medical Association Journal","volume":"28 6","pages":"389-393"},"PeriodicalIF":0.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148320350","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}

引用次数: 0

Intraoperative Metal Detection vs. Preoperative computed tomography for Combat-related Shrapnel Localization: A Cadaveric Comparison. 术中金属探测与术前计算机断层扫描对战斗相关弹片定位：尸体比较。

IF 0.8 4区医学

Israel Medical Association Journal Pub Date : 2026-06-01

Erez Hassidov, Dan Paz, Felicity Kassis, Eyal Sela, Ohad Ronen

{"title":"Intraoperative Metal Detection vs. Preoperative computed tomography for Combat-related Shrapnel Localization: A Cadaveric Comparison.","authors":"Erez Hassidov, Dan Paz, Felicity Kassis, Eyal Sela, Ohad Ronen","doi":"","DOIUrl":"","url":null,"abstract":"Background: Combat-related penetrating neck injuries (PNI) present distinct challenges in surgical settings. Accurate identification and removal of metallic fragments are crucial for minimizing complications. Although computed tomography (CT) remains the gold standard for preoperative assessment, use of intraoperative metal detectors may offer supplementary advantages by enhancing surgical accuracy and efficiency.Objectives: To assess the technical feasibility of intraoperative metal detector assistance vs. a CT-guided primary approach.Methods: Cadaver heads were implanted with metallic fragments from verified military-grade ordnance and subsequently underwent a CT scan. Two extraction approaches were evaluated: intraoperative metal detector assistance vs. CT-guided primary approach. Key metrics included incision length, dissection time, incision extension, and surgeon workload as assessed by the Surgery Task Load Index questionnaire.Results: Metal detector-assisted extraction resulted in reduced initial incision lengths (3.50 cm vs. 4.87 cm) and smaller incision extensions (0.33 cm vs. 0.67 cm), indicating improved precision. However, the average dissection time was longer in the metal detector group (15:00 vs. 12:20 minutes), likely due to learning curves and additional scanning requirements. Surgeons reported lower situational stress (2.25 vs. 4.5) and reduced task complexity (4.0 vs. 4.5) when using a metal detector, despite noting increased mental demand associated with interpreting device signals during surgery.Conclusions: Intraoperative metal detection technology shows significant potential as an adjunctive modality for shrapnel localization in combat-associated PNIs. It facilitates minimized incisions and improved surgical precision. While further optimization and clinical adaptation are necessary, this method holds promise for improving outcomes in both military and civilian trauma scenarios.","PeriodicalId":50268,"journal":{"name":"Israel Medical Association Journal","volume":"28 6","pages":"394-398"},"PeriodicalIF":0.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148320352","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}

引用次数: 0