Israel Medical Association Journal最新文献_第10页

CHA2DS2-VASc Score as a Predictor of Adverse Outcomes after Ischemic Stroke in Patients without Atrial Fibrillation. CHA2DS2-VASc 评分作为无心房颤动患者缺血性脑卒中不良后果的预测指标。

IF 1.6 4区医学

Israel Medical Association Journal Pub Date : 2024-03-01

Amir Aker, Ina Volis, Walid Saliba, Ibrahim Naoum, Barak Zafrir

{"title":"CHA2DS2-VASc Score as a Predictor of Adverse Outcomes after Ischemic Stroke in Patients without Atrial Fibrillation.","authors":"Amir Aker, Ina Volis, Walid Saliba, Ibrahim Naoum, Barak Zafrir","doi":"","DOIUrl":"","url":null,"abstract":"Background: Ischemic stroke is associated with increased risk of morbidity and mortality in future vascular events.Objectives: To investigate whether CHA2DS2-VASc scores aid in risk stratification of middle-aged patients without atrial fibrillation (AF) experiencing ischemic stroke.Methods: We analyzed data of 2628 patients, aged 40-65 years with no known AF who presented with acute ischemic stroke between January 2020 and February 2022. We explored the association between CHA2DS2-VASc scores categorized by subgroups (score 2-3, 4-5, or 6-7) with major adverse cardiac and cerebrovascular events (MACCE) including recurrent stroke, myocardial infarction, coronary revascularization, or all-cause death during a median follow-up of 19.9 months.Results: Mean age was 57 years (30% women); half were defined as low socioeconomic status. Co-morbidities included hypertension, diabetes, obesity, and smoking in 40-60% of the patients. The incidence rate of MACCE per 100 person-years was 6.7, 12.2, and 21.2 in those with score 2-3, 4-5, and 6-7, respectively. In a multivariate cox regression model, compared to patients with score 2-3 (reference group), those with score 4-5 and 6-7 had an adjusted hazard ratio (95% confidence interval [95%CI]) for MACCE of 1.74 (95%CI 1.41-2.14) and 2.87 (95%CI 2.10-3.93), respectively. The discriminative capacity of CHA2DS2-VASc score for overall MACCE was modest (area under curve 0.63; 95%CI 0.60-0.66), although better for myocardial infarction 0.69 (95% CI 0.61-0.77).Conclusions: CHA2DS2-VASc score may predict future MACCE in middle-aged patients with ischemic stroke and no history of AF.","PeriodicalId":50268,"journal":{"name":"Israel Medical Association Journal","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140141073","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

Colporrhaphies versus Colpocleisis Following Vaginal Hysterectomy for the Treatment of Advanced Pelvic Organ Prolapse: A Comparative Study. 治疗晚期盆腔器官脱垂的阴道子宫切除术后结肠切除术与结肠息肉术：比较研究。

IF 1.6 4区医学

Israel Medical Association Journal Pub Date : 2024-03-01

Eiman Shalabna, Nir Haya, Ariel Zilberlicht, Rotem Sadeh, Yoram Abramov

{"title":"Colporrhaphies versus Colpocleisis Following Vaginal Hysterectomy for the Treatment of Advanced Pelvic Organ Prolapse: A Comparative Study.","authors":"Eiman Shalabna, Nir Haya, Ariel Zilberlicht, Rotem Sadeh, Yoram Abramov","doi":"","DOIUrl":"","url":null,"abstract":"Background: Obliterative vaginal procedures may offer lower perioperative morbidity and equal success rates as reconstructive procedures for frail and elderly women who no longer desire future coital function. The combination of vaginal hysterectomy with either reconstructive or obliterative vaginal procedures has not yet been investigated.Objectives: To compare peri- and postoperative outcomes of vaginal hysterectomy with pelvic floor reconstruction (VHR) vs. vaginal hysterectomy with colpocleisis (VHC).Methods: We conducted a retrospective study comparing medical and surgical data of patients undergoing either VHR or VHC between 2006 and 2015. Data were obtained from inpatient and outpatient medical records including peri- and postoperative course, as well as long-term (24 months) follow-up data.Results: We identified 172 patients who underwent VHR and 44 who underwent VHC. Patients in the VHC group were significantly older (71.3 ± 4.5 vs. 68.6 ± 6.5 years, P = 0.01), and more likely to have medical co-morbidities (P = 0.001 and P = 0.029, respectively). Patients in the VHC group experienced shorter operative time (2.3 ± 0.58 vs. 2.7 ± 1.02 hours, P = 0.007), lower perioperative blood loss (P < 0.0001), shorter hospital stay (P < 0.0001), and lower rates of postoperative urinary retention. Long-term pelvic organ prolapse (POP) recurrence rates were significantly higher among the VHR group. Postoperative resolution of both stress urinary incontinence and overactive bladder were common in both groups.Conclusions: VHC is associated with lower perioperative blood loss, shorter operative time, shorter hospital stay, shorter time with an indwelling catheter, and lower long-term objective POP recurrence rates.","PeriodicalId":50268,"journal":{"name":"Israel Medical Association Journal","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140141075","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 Prevalence of Post-traumatic Stress Disorder as Part of Post-ICU Syndrome among Israeli ICU Survivors. 创伤后应激障碍作为重症监护室后综合征的一部分在以色列重症监护室幸存者中的患病率。

IF 1.6 4区医学

Israel Medical Association Journal Pub Date : 2024-03-01

Shiri Zarour, Esther Dahan, Dana Karol, Or Hanoch, Barak Cohen, Idit Matot

{"title":"The Prevalence of Post-traumatic Stress Disorder as Part of Post-ICU Syndrome among Israeli ICU Survivors.","authors":"Shiri Zarour, Esther Dahan, Dana Karol, Or Hanoch, Barak Cohen, Idit Matot","doi":"","DOIUrl":"","url":null,"abstract":"Background: Survivors of critical illness are at increased risk of long-term impairments, referred to as post-intensive care unit (ICU) syndrome (PICS). Post-traumatic stress disorder (PTSD) is common among ICU survivors with reported rates of up to 27%. The prevalence of PTSD among Israeli ICU survivors has not been reported to date.Objectives: To evaluate the prevalence of new onset PTSD diagnosed in a post-ICU clinic at a tertiary center in Israel.Methods: We conducted a retrospective, single center, cohort study. Data were collected from medical records of all patients who visited the Tel Aviv Sourasky Medical Center post-ICU clinic between October 2017 and June 2020. New onset PTSD was defined as PTSD diagnosed by a certified board psychiatrist during the post-ICU clinic visit. Data were analyzed using descriptive statistics.Results: Overall, 39 patients (mean age 51 ± 17 years, 15/39 females [38%]) attended the post-ICU clinic during the study period. They were evaluated 82 ± 57 days after hospital discharge. After excluding 7 patients due to missing proper psychiatric analysis, 32 patients remained eligible for the primary analysis. New PTSD was diagnosed in one patient (3%).Conclusions: We found lower incidence of PTSD in our cohort when compared to existing literature. Possible explanations include different diagnostic tools and low risk factors rate. Unique national, cultural, and/or religious perspectives might have contributed to the observed low PTSD rate. Further research in larger study populations is required to establish the prevalence of PTSD among Israeli ICU survivors.","PeriodicalId":50268,"journal":{"name":"Israel Medical Association Journal","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140141005","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

Radiology and Histology of a Rheumatoid Pulmonary Nodule. 类风湿肺结节的放射学和组织学。

IF 1.6 4区医学

Israel Medical Association Journal Pub Date : 2024-03-01

Brittany Bass, Kuaybe Gulen, Liying Han, Kassem Harris, Oleg Epelbaum

引用次数: 0

A Leak Post One Anastomosis Gastric Bypass Following Misoprostol Treatment. 米索前列醇治疗后的单吻合胃旁路术后渗漏。

IF 1.6 4区医学

Israel Medical Association Journal Pub Date : 2024-03-01

Amram Kupietzky, Roi Dover, Ata Maden, Nachum Emil Eliezer Lourie, Ronit Grinbaum

引用次数: 0

Prevalence and Clinical Implications of Nontuberculous Mycobacteria Isolation and Infection among Patients with Bronchiectasis in the Jerusalem Area. 耶路撒冷地区支气管扩张症患者中非结核分枝杆菌分离和感染的流行率及临床意义。

IF 1.6 4区医学

Israel Medical Association Journal Pub Date : 2024-03-01

Rottem Kuint, Henny Azmanov, Adi Shalom, Neville Berkman

{"title":"Prevalence and Clinical Implications of Nontuberculous Mycobacteria Isolation and Infection among Patients with Bronchiectasis in the Jerusalem Area.","authors":"Rottem Kuint, Henny Azmanov, Adi Shalom, Neville Berkman","doi":"","DOIUrl":"","url":null,"abstract":"Background: Bronchiectasis is an obstructive chronic lung disease characterized by structural changes in large and small airways, namely permanent widening of bronchial lumen resulting in chronic inflammation and infection. Nontuberculous mycobacteria (NTM) are environmental mycobacteria that may cause human infection or colonization with over 150 species identified to date. Bronchiectasis with NTM colonization or infection is often encountered but with varying prevalence and unknown clinical or prognostic significance.Objectives: To find the prevalence of NTM among patients with bronchiectasis in the Jerusalem district. To assess whether there were clinical differences between patients with bronchiectasis who were isolated with NTM and those without.Methods: In this retrospective observational research study, we reviewed all computerized medical charts of patients over 18 years of age, who were diagnosed with bronchiectasis at Hadassah Medical Centers in Jerusalem between 2012 and 2017. We assessed the prevalence of NTM pulmonary disease. To compare patients with and without NTM, we reviewed and analyzed clinical, radiological, and microbiological data of all NTM patients and a group of controls in a 4:1 ratio.Results: Prevalence of NTM among bronchiectasis patients was 5.1%, slightly lower than previously reported in Israel. We did not find clinically or radiological significant differences in patients with NTM disease compared to controls. This result included a similar number of exacerbations, hospitalization rates, number of lobes involved, and pulmonary function tests.Conclusions: Bronchiectasis patients with isolation of Pseudomonas aeruginosa experienced more exacerbations than patients with other isolates, consistent with previous studies.","PeriodicalId":50268,"journal":{"name":"Israel Medical Association Journal","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140141000","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

Establishing a Center for Innovation and Artificial Intelligence in a Tertiary Medical Center: Successes and Challenges. 在三级医疗中心建立创新与人工智能中心：成功与挑战。

IF 1.6 4区医学

Israel Medical Association Journal Pub Date : 2024-02-01

Nadav Loebl, Eytan Wirtheim, Leor Perl

{"title":"Establishing a Center for Innovation and Artificial Intelligence in a Tertiary Medical Center: Successes and Challenges.","authors":"Nadav Loebl, Eytan Wirtheim, Leor Perl","doi":"","DOIUrl":"","url":null,"abstract":"Background: The field of artificial intelligence (AI) is poised to significantly influence the future of medicine. With the accumulation of vast databases and recent advancements in computer science methods, AI's capabilities have been demonstrated in numerous areas, from diagnosis and morbidity prediction to patient treatment. Establishing an AI research and development unit within a medical center offers multiple advantages, particularly in fostering research and tapping into the immediate potential of AI at the patient's bedside.Objectives: To outline the steps taken to establish a center for AI and big data within an innovation center at a tertiary hospital in Israel.Methods: We conducted a retrospective analysis of projects developed in the field of AI at the Artificial Intelligence Center at the Rabin Medical Center, examining trends, clinical domains, and the predominant sectors over a specific period.Results: Between 2019 and 2023, data from 49 AI projects were gathered. A substantial and consistent growth in the number of projects was observed. Following the inauguration of the Artificial Intelligence Center we observed an increase of over 150% in the volume of activity. Dominant sectors included cardiology, gastroenterology, and anesthesia. Most projects (79.6%) were spearheaded by physicians, with the remainder by other hospital sectors. Approximately 59.2% of the projects were applied research. The remainder were research-based or a mix of both.Conclusions: Developing technological projects based on in-hospital medical data, in collaboration with clinicians, is promising. We anticipate the establishment of more centers dedicated to medical innovation, particularly involving AI.","PeriodicalId":50268,"journal":{"name":"Israel Medical Association Journal","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139991709","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

Artificial Intelligence in Cardiology. 心脏病学中的人工智能。

IF 1.6 4区医学

Israel Medical Association Journal Pub Date : 2024-02-01

Leor Perl, Nadav Loebl, Ran Kornowski

引用次数: 0

Artificial Intelligence in Ophthalmology: Present and Future Directions. 眼科人工智能：现在和未来的方向。

IF 1.6 4区医学

Israel Medical Association Journal Pub Date : 2024-02-01

Orly Gal-Or, Alon Tiosano, Inbar Perchik, Yogev Giladi, Irit Bahar

引用次数: 0

The Use of Artificial Intelligence-based Technologies in Palliative Care: Advancing Patient Well-being at the End-of-life and Enhancing the Implementation of the Dying Patient Act. 人工智能技术在姑息治疗中的应用：促进临终病人的福祉，加强《临终病人法案》的实施。

IF 1.6 4区医学

Israel Medical Association Journal Pub Date : 2024-02-01

Shani Ben Shetrit, Jamal Daghash, Daniel Sperling

引用次数: 0