Israel Medical Association Journal最新文献_第2页

Studying the Biochemical Profile of Patients after Exertional Heat Stroke: A Case Series. 研究劳累性中暑后患者的生化特征：一个病例系列。

IF 0.8 4区医学

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

Yoram Epstein, Inbal Akavian, Amit Assor, Daniel S Moran, Ziv Talmi Yaakov, Itay Ketko

{"title":"Studying the Biochemical Profile of Patients after Exertional Heat Stroke: A Case Series.","authors":"Yoram Epstein, Inbal Akavian, Amit Assor, Daniel S Moran, Ziv Talmi Yaakov, Itay Ketko","doi":"","DOIUrl":"","url":null,"abstract":"Background: Exertional heat stroke (EHS) is common among individuals engaged in high-intensity physical activity. It can lead to long-term organ damage and be a life-threatening condition when diagnosed and treated incorrectly.Objectives: To track the changes in biomarkers among EHS patients, to suggest a standardized protocol of clinically relevant biomarkers to be followed during hospitalization.Methods: We conducted a retrospective analysis on biomarker changes in seven EHS patients (aged 18-25 years) who were hospitalized for a minimum of 84 hours. Diagnosis of heat stroke was based on extreme body temperature and neurological deficits. Biomarkers indicative of kidney function, liver function, coagulation, muscle breakdown, and systemic inflammation during their hospitalization were analyzed.Results: The initial average rectal temperature (Tre) was 41.1°C. Patients were cooled to approximately 38.5°C before being transferred to the emergency department (ED). Within the first 24-36 hours of hospitalization, biomarker levels reach peak levels depending on EHS severity. Renal biomarkers rose to 1.5-3 times normal values, while transaminases increased 7-15 times. Creatine phosphokinase, indicating muscle injury, reached an average of 100 times its reference range. Within 24-72 hours. all biomarker levels were normalized.Conclusions: There is often a gap between the initial temperature of an EHS patient and the temperature recorded at ED admission after cooling. Accurate assessment is context-specific and requires precise biomarker follow-up. Clinical evaluation should continue for at least 48 hours to track organ damage and guide prognosis.","PeriodicalId":50268,"journal":{"name":"Israel Medical Association Journal","volume":"28 6","pages":"357-362"},"PeriodicalIF":0.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148320295","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

Hunter Syndrome: The Pediatric Surgeon's Point of View. 亨特综合症：儿科外科医生的观点。

IF 0.8 4区医学

Israel Medical Association Journal Pub Date : 2026-05-01

Emmanuelle Seguier-Lipszyc, Keren Kremer, David Hoppenstein, Yaniv Ebner

{"title":"Hunter Syndrome: The Pediatric Surgeon's Point of View.","authors":"Emmanuelle Seguier-Lipszyc, Keren Kremer, David Hoppenstein, Yaniv Ebner","doi":"","DOIUrl":"","url":null,"abstract":"Background: Mucopolysaccharidosis type II (Hunter syndrome [MPS II]) is a rare, progressive, lysosomal storage disorder, often diagnosed late due to nonspecific early features and limited clinical awareness.Objectives: To highlight the role of pediatric surgeons in early recognition based on clinical and surgical presentations.Methods: We retrospectively reviewed patients diagnosed with MPS II at our institution focusing on presenting symptoms, timing of diagnosis, and factors leading to diagnostic suspicion and treatment.Results: Four boys were diagnosed between 2012 and 2021. Three were diagnosed at 2.5-4 years of age following typical systemic manifestations. The fourth patient was suspected earlier by a pediatric surgeon, whose prior familiarity with similar reported cases enabled recognition of the clinical pattern and led to an earlier diagnosis.Conclusions: Increased awareness and clinical familiarity among pediatric surgeons are essential for early recognition of MPS II. Recognition of early surgical patterns, such as hernias and recurrent procedures in early childhood, highlights the role of pediatric surgeons in raising diagnostic suspicion, facilitating earlier diagnosis, and enabling earlier initiation of enzyme replacement therapy before disease progression, ultimately improving clinical outcomes.","PeriodicalId":50268,"journal":{"name":"Israel Medical Association Journal","volume":"28 5","pages":"285-288"},"PeriodicalIF":0.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147965416","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

IF 0.8 4区医学

Israel Medical Association Journal Pub Date : 2026-05-01

Nabil Abu-Amer, Margarita Kunin, Orit Erman, Sharon Mini, Pazit Beckerman

{"title":"Catheter-related Bloodstream Infections Outcomes among Hemodialysis Patients: A Retrospective Cohort Analysis.","authors":"Nabil Abu-Amer, Margarita Kunin, Orit Erman, Sharon Mini, Pazit Beckerman","doi":"","DOIUrl":"","url":null,"abstract":"Background: Tunneled hemodialysis catheters are frequently used and are a major source of catheter-related bloodstream infections (CRBSI), which result in significant morbidity.Objectives: To examine the adverse outcomes associated with CRBSIs, including hospitalization, recurrence, 1-year mortality, and catheter outcomes in a hemodialysis setting that uses modern preventive catheter-care practices.Methods: We conducted a retrospective cohort study of adults with jugular tunneled hemodialysis catheters who met criteria for CRBSI from 1 January 2015 to 31 December 2020 at a tertiary referral center.Results: Of 380 hemodialysis patients, 75 experienced CRBSI events. The average rate was 1.55 CRBSIs per 100 patient months. The median time from catheter insertion to CRBSI was 179 days; and 68% required inpatient management. Gram-positive bacteria accounted for 53% of isolates, with Gram-negative organisms also being common. Recurrence occurred in 16% of cases and was independently associated with ferritin levels over 500 ng/ml (P = 0.02), albumin levels below 3.5 g/dl (P = 0.011), and uric acid levels under 2.5 mg/dl (P = 0.04). Catheters were removed in 61.3%, exchanged over a guidewire in 24%, and salvaged in 18.6%. The 1-year mortality rate was 28% and was associated with lower weight, catheter salvage, neutrophilia, hypoalbuminemia, and hypokalemia. Using chlorhexidine exit-site dressings was associated with fewer hospital admissions.Conclusions: Among hemodialysis patients with CRBSI, recurrence and mortality might be linked to a patient's nutritional and inflammatory status. Current preventive measures might reduce hospitalization rates, but in this cohort, they were not associated with lower recurrence or mortality rate.","PeriodicalId":50268,"journal":{"name":"Israel Medical Association Journal","volume":"28 5","pages":"307-312"},"PeriodicalIF":0.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147965384","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

Preoperative Biological Therapy and Postoperative Outcomes Following Ileocolic Resection for Crohn's Disease. 回肠结肠切除术治疗克罗恩病的术前生物治疗和术后疗效。

IF 0.8 4区医学

Israel Medical Association Journal Pub Date : 2026-05-01

Hamad Saab, Michal Perets, Shlomo Yellinek, Menahem Ben-Haim, Michael R Freund

{"title":"Preoperative Biological Therapy and Postoperative Outcomes Following Ileocolic Resection for Crohn's Disease.","authors":"Hamad Saab, Michal Perets, Shlomo Yellinek, Menahem Ben-Haim, Michael R Freund","doi":"","DOIUrl":"","url":null,"abstract":"Background: Crohn's disease is a chronic inflammatory condition of the gastrointestinal tract. Biological therapy has transformed disease management; however, its association with postoperative outcomes remains debated.Objectives: To evaluate the association between preoperative biological therapy and postoperative outcomes following ileocolic resection for Crohn's disease, and to identify additional factors associated with postoperative complications.Methods: We conducted a single-center retrospective observational study of Crohn's disease patients who underwent ileocolic resection between 2021 and 2023. Patients were stratified according to preoperative exposure to biological therapy.Results: Of 208 screened patients, 150 met inclusion criteria. Postoperative complications were more common in patients receiving biological therapy compared with controls (56% vs. 36.4%, P = 0.017), which was primarily driven by minor complications (48% vs. 30%, P = 0.022). Rates of major complications and length of hospital stay did not differ between the groups. Patients who developed major complications had significantly lower preoperative serum albumin levels (3.08 vs. 3.7 g/dl, P = 0.021).Conclusions: Preoperative biological therapy was associated with a higher rate of postoperative complications, predominantly minor in severity. Low preoperative serum albumin was associated with major postoperative complications, highlighting the importance of preoperative nutritional assessment and optimization.","PeriodicalId":50268,"journal":{"name":"Israel Medical Association Journal","volume":"28 5","pages":"289-294"},"PeriodicalIF":0.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147965372","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

Outcomes of Symptomatic and Ruptured Abdominal Aortic Aneurysm Repair: A Comparative Analysis Between Open and Endovascular Treatment. 有症状和破裂的腹主动脉瘤修复的结果：切开和血管内治疗的比较分析。

IF 0.8 4区医学

Israel Medical Association Journal Pub Date : 2026-05-01

Victor Bilman, Ilan Davidov, Sarit Malayev, Chen Speter, Avner Bar-Dayan, Michal Fish, Asher Rotenberg, Moshe Halak, Daniel Silverberg

{"title":"Outcomes of Symptomatic and Ruptured Abdominal Aortic Aneurysm Repair: A Comparative Analysis Between Open and Endovascular Treatment.","authors":"Victor Bilman, Ilan Davidov, Sarit Malayev, Chen Speter, Avner Bar-Dayan, Michal Fish, Asher Rotenberg, Moshe Halak, Daniel Silverberg","doi":"","DOIUrl":"","url":null,"abstract":"Background: The management of symptomatic abdominal aortic aneurysms (AAA) remains a surgical challenge.Objectives: To compare the outcomes of endovascular aneurysm repair (EVAR) versus open surgical repair (OSR) in patients with symptomatic AAA.Methods: Patients treated for symptomatic AAA between April 2020 and April 2025 were retrospectively analyzed, comparing perioperative mortality and major adverse events between EVAR and OSR.Results: A total of 494 AAA patients were identified, 49 (9.9%) were symptomatic (40 [81.6%] EVAR group, 9 [18.4%] OSR group). Patients undergoing OSR had a higher rate of juxtarenal involvement (OSR 6/9 [66.7%] vs. EVAR 3/40 [7.5%]; P < 0.001). Any signs of rupture were more prevalent in the EVAR group (27/40 [67.5%] vs. OSR 2/9 [22.2%]; P = 0.013). Technical success was achieved in 83.7% (n=41/49). In-hospital mortality was 22.4% (n=11/49), with no difference between groups (EVAR 9/40 [22.5%] vs. OSR 2/9 [22.2%]; P = 0.986). At logistic regression analysis, open repair was associated with a significantly higher risk of major complications (odds ratio [OR] 16.9, 95% confidence interval [95%CI] 1.79-158.3, P = 0.013), and a shock index > 0.9 remained an independent predictor of intra-hospital mortality (OR 372.5, 95%CI 1.58-87889.4, P = 0.034). During a mean follow-up of 28.8 ± 18.6 months, late mortality was 18.4% (n=7/38). Estimated survival analysis over 60 months did not demonstrate a significant difference between groups (log-rank test, P = 0.317).Conclusions: Both EVAR and OSR yield satisfactory technical outcomes. Hemodynamic instability at presentation remains a critical predictor of mortality.","PeriodicalId":50268,"journal":{"name":"Israel Medical Association Journal","volume":"28 5","pages":"277-284"},"PeriodicalIF":0.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147965443","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

Inappropriate Use of Indwelling Urinary Catheters in Internal Medicine Patients. 内科病人留置导尿管的不当使用。

IF 0.8 4区医学

Israel Medical Association Journal Pub Date : 2026-05-01

Zvi Shimoni, Vered Hermush, Paul Froom

{"title":"Inappropriate Use of Indwelling Urinary Catheters in Internal Medicine Patients.","authors":"Zvi Shimoni, Vered Hermush, Paul Froom","doi":"","DOIUrl":"","url":null,"abstract":"Background: Indwelling catheters are commonly used in non-intensive care internal medicine patients. They are associated with significant side effects.Objectives: To determine the proportion of warranted indwelling catheters and factors associated with inappropriate use.Methods: We included consecutive patients hospitalized in three internal medicine departments from 2020 to 2021. We determined the proportion of urinary catheters inserted in the emergency department that were retained inappropriately for monitoring urine outputs. The area under the curve (AUC) was used to determine the ability of the logistic regression model to predict inappropriate use of urinary catheterizations.Results: Of 11,542 patients, 625 (5.4%) were excluded because they were admitted with a permanent catheter. The urinary indwelling catheterization rate was 13.3% (1454/10,917), which was appropriate in 4.9% (n=533). Patients with an unjustified indwelling catheter had a 3.75-fold (95% confidence interval 3.2-4.4) increase of prolonged hospitalization. Approximately 13 cases of a catheter associated urinary tract infection and 9% (83/921) of those with an unjustified indwelling catheter were discharged with the catheter in place. Older age, female sex, nursing assessments of patient frailty, urinary tract diseases, congestive heart failure, respiratory tract, and infectious diseases were independently associated with inappropriate use (AUC 0.847, 95% confidence interval 0.841-0.854).Conclusions: Indwelling urinary catheters are justified in less than 5% of non-intensive care internal medicine patients and associated with significant side effects. Efforts to reduce inappropriate catheterizations might focus on frail elderly patients with infections and those presenting with urinary tract diseases, congestive heart failure, respiratory tract, and other infectious diseases.","PeriodicalId":50268,"journal":{"name":"Israel Medical Association Journal","volume":"28 5","pages":"301-306"},"PeriodicalIF":0.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147965391","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

Multiple Tophi and Tophus Aspirate in a Gouty Patient. 痛风患者多通风石和通风石抽吸。

IF 1.3 4区医学

Israel Medical Association Journal Pub Date : 2026-05-01

Jozélio Freire de Carvalho, Carlos Ewerton Rodrigues

引用次数: 0

Transcholecystic Access to the Common Bile Duct: A Contemporary Review and Institutional Experience. 经胆囊进入胆总管：当代回顾和机构经验。

IF 1.3 4区医学

Israel Medical Association Journal Pub Date : 2026-05-01

Mai Mazarieb, Nabeih Mazarieb, Yackov Romanenko, Gil N Bachar

引用次数: 0

MRI-based CT-like Sequence vs. Conventional CT for the Assessment of Structural Lesions in Patients with Suspected Sacroiliitis. 基于mri的CT样序列与常规CT对疑似骶髂炎患者结构病变的评估

IF 0.8 4区医学

Israel Medical Association Journal Pub Date : 2026-05-01

Yiftach Barash, Iris Eshed

{"title":"MRI-based CT-like Sequence vs. Conventional CT for the Assessment of Structural Lesions in Patients with Suspected Sacroiliitis.","authors":"Yiftach Barash, Iris Eshed","doi":"","DOIUrl":"","url":null,"abstract":"Background: Ultra-short-echo magnetic resonance imaging (MRI) sequences improve visualization of bone cortex and enable the generation of an MRI-based computed tomography (CT)-like (CT-l) images.Objectives: To compare the agreement between CT-l images derived from merged fast-field echo (MFFE) sequence with conventional CT (cCT) for detecting sacroiliitis-associated structural lesions.Methods: Consecutive MRI and conventional CT examinations (maximum one-year interval) of the sacroiliac joints (SIJ) of patients with suspected sacroiliitis, performed between 2022 and 2023 were retrospectively evaluated by a musculoskeletal radiologist and a third-year resident who evaluated half of the study's images for the presence of erosions, sclerosis, and ankylosis on semicoronal CT-l and cCT-SIJ images. Cohen's kappa was used to compare the results between the two modalities. The diagnostic performance of the CT-l was analyzed using cCT as the reference standard. Inter-reader reliability was assessed using intraclass correlation coefficients (ICCs) between the two readers.Results: Sacroiliitis was detected in 11 patients (21%). Erosions, sclerosis, and ankylosis were detected in 44%/31%, 48%/42%, 4%/4% on CT-l/cCT, respectively. Statistical analysis regarding ankylosis was not feasible due to its low prevalence. Cohen's kappa agreement between modalities was substantial for erosions (0.68) and almost perfect for sclerosis (0.92). Sensitivity and specificity of CT-l were 0.90 and 0.69 for erosions and 0.72 and 0.91 for sclerosis, respectively. The ICC on CT-l/cCT for detecting erosions was 0.72/0.68 and 0.84/0.91 for sclerosis.Conclusions: CT-l MRI sequence is a promising, radiation-free alternative to conventional CT for detecting structural lesions in SIJs, with high diagnostic performance and inter-reader agreement.","PeriodicalId":50268,"journal":{"name":"Israel Medical Association Journal","volume":"28 5","pages":"295-300"},"PeriodicalIF":0.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147965419","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

First Successful Implantation of the CARMAT Aeson® Total Artificial Heart as a Bridge to Heart Transplantation in Israel. 以色列首次成功植入CARMAT Aeson®全人工心脏作为心脏移植的桥梁。

IF 1.3 4区医学

Israel Medical Association Journal Pub Date : 2026-05-01

Daniel Ronen, Alexander Lipey-Diamant, Ayman Murar, Amit Korach, Ehud Rudis, Ralitsa Stoynova, Loui Mahameed, Meirav Goldstein-Luria, Yuval Shtark, Mordechai Golomb, Offer Amir, Rabea Asleh

引用次数: 0