Israel Medical Association Journal最新文献_第2页

Refractory Dermatomyositis Skin Disease Successfully Treated with Anifrolumab. 用Anifrolumab成功治疗难治性皮肌炎皮肤病。

IF 1.3 4区医学

Israel Medical Association Journal Pub Date : 2025-09-01

Shiri Keret, Aniela Souval, Alaa Sawaed, Noa Nemesh, Gleb Slobodin

引用次数: 0

Combating Hepatitis C in One Psychiatric Facility: An Integrated Approach. 在一家精神病院抗击丙型肝炎：一种综合方法。

IF 1.3 4区医学

Israel Medical Association Journal Pub Date : 2025-09-01

Vera Dreizin, Yael Delayahu, Raya Shlesinger, Anna Gorodetsky, Itzhak Cohen, Eran Israeli

{"title":"Combating Hepatitis C in One Psychiatric Facility: An Integrated Approach.","authors":"Vera Dreizin, Yael Delayahu, Raya Shlesinger, Anna Gorodetsky, Itzhak Cohen, Eran Israeli","doi":"","DOIUrl":"","url":null,"abstract":"Background: The management of chronic hepatitis C virus (HCV) infection in patients with concurrent severe mental illness and substance use disorder poses significant challenges to treatment initiation, adherence, and completion. Multiple barriers impede successful treatment outcomes in this population, including cognitive impairments associated with mental illness, ongoing psychoactive substance use, and inadequate social and environmental support systems.Objectives: To implement a treatment program for HCV-infected patients during their psychiatric hospitalization. To establish a multidisciplinary task force comprising a hepatologist, psychiatric ward team (psychiatrists, nurses, social workers), and a project administrator.Methods: We conducted a retrospective cohort study of patients hospitalized with dual diagnosis (DD) of severe mental illness and substance use disorder who tested positive for HCV antibodies. Patients underwent clinical evaluations and received treatment with direct antiviral agents during hospitalization under the supervision of the joint team. Demographic and clinical characteristics were analyzed.Results: Between January 2018 and June 2023, 694 DD patients were hospitalized, of whom 119 tested positive for HCV antibodies (prevalence 17.1%). Twenty-seven patients (23%) completed treatment; 17 (63%) achieved confirmed sustained virologic response. Treatment discontinuation occurred primarily post-discharge from the mental health facility. Significant efforts were made to engage community caregivers to maintain continuity of care.Conclusions: Our findings demonstrate that treating HCV in patients with concurrent severe mental illness and substance use disorder requires collaborative efforts across medical disciplines. This integrated approach during psychiatric hospitalization provides a unique opportunity for initiating and monitoring HCV treatment in this complex patient population.","PeriodicalId":50268,"journal":{"name":"Israel Medical Association Journal","volume":"27 9","pages":"556-560"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034534","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

Persistent Challenges in Direct Oral Anticoagulant Prescriptions: Time to Optimize Medication Safety in Hospital and Community Settings. 直接口服抗凝处方的持续挑战：优化医院和社区用药安全的时机。

IF 1.3 4区医学

Israel Medical Association Journal Pub Date : 2025-09-01

Majdi Masarwi, Hely Bassalov, Maya Koren-Michowitz, Sofia Berkovitch, Dorit Blickstein

{"title":"Persistent Challenges in Direct Oral Anticoagulant Prescriptions: Time to Optimize Medication Safety in Hospital and Community Settings.","authors":"Majdi Masarwi, Hely Bassalov, Maya Koren-Michowitz, Sofia Berkovitch, Dorit Blickstein","doi":"","DOIUrl":"","url":null,"abstract":"Background: Direct oral anticoagulants (DOACs) have significantly transformed anticoagulant therapy, improving effectiveness, safety, and convenience in managing thromboembolic conditions. However, concerns persist regarding drug-related problems (DRPs) associated with DOACs, necessitating the establishment of multidisciplinary antithrombotic stewardship programs to optimize the selection, dosing, and monitoring of DOACs.Objectives: To evaluate the incidence and types of DRPs associated with DOACs, the frequency of clinical pharmacist consultations, the acceptance rates of the clinical pharmacist recommendations, and physicians' adherence to appropriate DOACs prescribing practices.Methods: A retrospective cohort study was conducted over 4 months in the internal medicine departments at Shamir Medical Center (Assaf Harofeh), Israel. The study included patients aged 18 years and older who were prescribed DOACs (apixaban, rivaroxaban, and dabigatran). Data on patient characteristics and clinical outcomes were collected from electronic medical records. A clinical pharmacist reviewed and reassessed the appropriateness of DOAC prescribing.Results: During the study period, 415 patients receiving DOACs were identified. Among them, 28.4% had inappropriate DOAC prescriptions leading to 128 recommended interventions. The most common DRP was underdosing (29.7%) followed by unjustified antiplatelet use (26.6%). Clinical pharmacists performed 85.9% of the interventions, with a physician acceptance rate of 72.7%. Patients with inappropriate DOAC prescriptions exhibited increased trends in thromboembolic events and in-hospital mortality.Conclusions: Despite over a decade of clinical experience with DOACs, DRPs remain a significant challenge. Implementing antithrombotic stewardship programs is critical for optimizing DOACs use, reducing DRPs, and enhancing patient safety.","PeriodicalId":50268,"journal":{"name":"Israel Medical Association Journal","volume":"27 9","pages":"577-582"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034615","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

Merkel Cell Carcinoma: A Rare and Underdiagnosed Entity. 默克尔细胞癌：一种罕见且未被诊断的肿瘤。

IF 1.3 4区医学

Israel Medical Association Journal Pub Date : 2025-08-01

Ronen Toledano, Adi Maisel Lotan, Hadas Yarimi, Yoav Gronovich

{"title":"Merkel Cell Carcinoma: A Rare and Underdiagnosed Entity.","authors":"Ronen Toledano, Adi Maisel Lotan, Hadas Yarimi, Yoav Gronovich","doi":"","DOIUrl":"","url":null,"abstract":"Background: Merkel cell carcinoma (MCC) is a rare and aggressive neuroendocrine skin tumor with an increasing incidence in Western countries. Predominantly affecting older individuals, MCC represents less than 1% of malignant skin tumors.Objectives: To characterize the clinical presentation, therapeutic interventions, and follow-up outcomes of MCC patients. To promote heightened clinical awareness regarding the early recognition and diagnosis of MCC.Methods: We conducted a retrospective cohort study analyzing medical records of MCC patients at the Shaare Zedek Medical Center between 2015-2022. From 19 initially identified patients, 17 met the inclusion criteria. Data collection included demographic, epidemiological, clinical, and pathological characteristics.Results: The study included 17 patients, predominantly of Jewish origin, with a mean age of 70.06 years; 58.8% female. Medical co-morbidities included 64.7% hypertension and 35.3% diabetes. MCC tumors were predominantly left-sided (58.8%), with varied locations including limbs, trunk, and face. Surgical treatment consisted of excision and primary closure (64.7%) or skin grafting (23.5%). The average tumor diameter was 3.41 cm clinically and 3.83 cm pathologically. Lymph node involvement occurred in 29.4% of cases; 23.5% showed metastatic disease at diagnosis, with metastases diffused in different body areas. Kaplan-Meier survival analysis showed no statistically significant differences across most variables, except for a significantly lower survival rate in patients with ischemic heart disease (P = 0.009).Conclusions: Our study reveals unique characteristics of MCC, predominance of female patients, and a slightly younger average diagnosis age compared to existing literature. The 2-year survival rate in our cohort was 82%. The study underscores the importance of early detection and diagnosis of MCC, thereby enhancing clinical awareness and improving patient outcomes.","PeriodicalId":50268,"journal":{"name":"Israel Medical Association Journal","volume":"27 8","pages":"504-509"},"PeriodicalIF":1.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144862557","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

Selective Serotonin Reuptake Inhibitor and the Risk of Postsurgical Bleeding: A literature Review. 选择性血清素再摄取抑制剂与术后出血风险：文献综述。

IF 1.3 4区医学

Israel Medical Association Journal Pub Date : 2025-08-01

Ahlam Adawi, Eyal Franco, Lior Har-Shai, Rita Kreichman, Miriam Segal, Leonid Bryzgalin, Bluma Nae, Yaron Har-Shai, Issa Metanes

引用次数: 0

Who By Fire? Sepsis in the Adult Burn Patient: Prognostic Factors. 谁被火了？成人烧伤患者的脓毒症：预后因素。

IF 1.3 4区医学

Israel Medical Association Journal Pub Date : 2025-08-01

Yoav Y Pikkel, Yoav A Levy, Yitzchack Ramon, Tal Tobias, Assaf A Zeltzer

{"title":"Who By Fire? Sepsis in the Adult Burn Patient: Prognostic Factors.","authors":"Yoav Y Pikkel, Yoav A Levy, Yitzchack Ramon, Tal Tobias, Assaf A Zeltzer","doi":"","DOIUrl":"","url":null,"abstract":"Background: Modern medicine has improved survival rates in burn care. However, this progress has led to a new challenge of sepsis, which has become the leading cause of death in burn patients, accounting for over 50% of mortality. The diagnosis and treatment of sepsis in the burn care unit pose significant challenges due to the hypermetabolic state of the patient, which can mask septic signs and symptoms. This situation underscores the urgent need for improved strategies in sepsis management in burn patients.Objectives: To assess the predictors of morbidity and mortality among severe burn patients.Methods: Rambam Health Care Campus is the referral center for burn patients in northern Israel. We reviewed 5 years of patient records, noting information regarding sepsis, laboratory results, infections, and overall morbidity and mortality. In addition, a comparative cohort of burn patient records without sepsis was compared.Results: Thirty patients had recorded sepsis. Total and direct bilirubin were associated with higher mortality (P < 0.05). Elevated white blood cell count and platelet count at admission were also associated with mortality (P < 0.05). The most prominent burn areas were the arms, head, and legs. The leading cause of injury was fire, followed by an explosion. Burns of total body surface area ≥ 40% was associated with sepsis.Conclusions: Sepsis is a complex challenge when diagnosing and treating burned patients. Identifying specific traits and prognostic factors is crucial to adequately treat these patients. Research in burn care and sepsis management is essential.","PeriodicalId":50268,"journal":{"name":"Israel Medical Association Journal","volume":"27 8","pages":"487-491"},"PeriodicalIF":1.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144862565","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 Extended Forehead Flap: Expanding the Armamentarium for Forehead and Anterior Scalp Reconstruction. 扩大额部皮瓣：扩大额部及前部头皮重建的工具。

IF 1.3 4区医学

Israel Medical Association Journal Pub Date : 2025-08-01

Eran Hadad, Shaked Menashe, Andre Ofek, Moshe Faigenbaum, Lior Heller, Alex Sorkin

{"title":"The Extended Forehead Flap: Expanding the Armamentarium for Forehead and Anterior Scalp Reconstruction.","authors":"Eran Hadad, Shaked Menashe, Andre Ofek, Moshe Faigenbaum, Lior Heller, Alex Sorkin","doi":"","DOIUrl":"","url":null,"abstract":"Background: The forehead and scalp play a crucial role in the aesthetic appearance of the face. Extensive oncological resections that result in significant defects create challenges for reconstruction and require various surgical techniques.Objectives: To present the planning and surgical technique required for a simple, reproducible one-stage flap to reconstruct an extensive forehead defect.Methods: A cohort of six patients underwent reconstruction of large anterior forehead or scalp defects using a one-stage axial fasciocutaneous flap. All procedures were conducted under general anesthesia. The defects resulted from tumor resections. The sizes ranged from 5.5 cm to 11 cm. The flap was used to reconstruct various forehead and anterior scalp regions.Results: All the flaps were successful. The aesthetic outcomes were favorable, and no significant complications were noted.Conclusions: The extended forehead flap is a versatile option for safe, simple, and reproducible one-stage reconstruction of large forehead and anterior scalp defects that yields satisfactory aesthetic results.","PeriodicalId":50268,"journal":{"name":"Israel Medical Association Journal","volume":"27 8","pages":"498-503"},"PeriodicalIF":1.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144862562","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

Israeli Society of Plastic and Aesthetic Surgery. 以色列整形美容外科学会。

IF 1.3 4区医学

Israel Medical Association Journal Pub Date : 2025-08-01

Coral Tepper, Yossef Levi, Josef Haik

引用次数: 0

Plastic Surgery in Israel: From Wartime Readiness to Elective Excellence. 以色列的整形手术：从战时准备到择优选择。

IF 1.3 4区医学

Israel Medical Association Journal Pub Date : 2025-08-01

Adi Maisel Lotan, Josef Haik

引用次数: 0

A Comparative Analysis of the Complication Rate in "Mommy Makeover" Procedures and Abdominoplasty. “妈咪改头换面”手术与腹部成形术并发症的比较分析。

IF 1.3 4区医学

Israel Medical Association Journal Pub Date : 2025-08-01

Yoram Wolf, Yifat Fainzilber-Goldman, Ron Skorochod

{"title":"A Comparative Analysis of the Complication Rate in \"Mommy Makeover\" Procedures and Abdominoplasty.","authors":"Yoram Wolf, Yifat Fainzilber-Goldman, Ron Skorochod","doi":"","DOIUrl":"","url":null,"abstract":"Background: Abdominoplasties are among the most common procedures in aesthetic plastic surgery. The target audience are patients after massive weight loss who are left with excess skin and post-partum patients. Due to the efficacy of abdominoplasties in improving the abdominal contour, it became a mainstay procedure in plastic surgery. Claims have been made that abdominal surgeries can be safely combined with breast surgeries, and thereby decrease the risk associated with anesthesia for two separate procedures as well as the recovery period. The benefits of the combined procedures led to a surplus of patients seeking consultations.Objectives: To examine the safety of the mommy makeover procedure compared to sole abdominoplasty.Methods: Patients who previously underwent abdominoplasty by the senior author were divided into two groups based on whether breast surgery was performed in addition to the abdominoplasty. Groups were compared based on demographical, clinical, and surgical variables.Results: The study cohort included 726 patients, of whom 15% underwent \"Mommy-makeovers\". Groups differed only in liposuction volume, resection weight and number of drains. Regarding surgical outcomes, surgical site infections were seen at a greater rate in the isolated abdominoplasty procedure. Further analyses accounting for potential confounders found no difference between the groups in terms of adverse events.Conclusions: Mommy makeovers do not display a safety concern when compared to isolated abdominoplasties. Surgeons must consider various patient characteristics to ensure optimal results.","PeriodicalId":50268,"journal":{"name":"Israel Medical Association Journal","volume":"27 8","pages":"526-530"},"PeriodicalIF":1.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144862553","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