Israel Medical Association Journal最新文献_第2页

C-Reactive Protein Is Associated with Severity in Hospitalized Children with Respiratory Syncytial Virus Bronchiolitis.

IF 1.8 4区医学

Israel Medical Association Journal Pub Date : 2025-03-01

Assaf Adar, Aviv D Goldbart, Nitzan Burrack, Neta Geva, Bracha Cohen, Inbal Golan-Tripto

{"title":"C-Reactive Protein Is Associated with Severity in Hospitalized Children with Respiratory Syncytial Virus Bronchiolitis.","authors":"Assaf Adar, Aviv D Goldbart, Nitzan Burrack, Neta Geva, Bracha Cohen, Inbal Golan-Tripto","doi":"","DOIUrl":"","url":null,"abstract":"Background: Acute bronchiolitis, primarily caused by respiratory syncytial virus (RSV), is the leading cause of hospitalization in young children. Despite international guidelines supporting clinical diagnosis, laboratory evaluations are often conducted with limited validity.Objectives: To evaluate the association between C-reactive protein (CRP) serum levels on admission and disease severity in children hospitalized due to RSV bronchiolitis.Methods: This retrospective cohort study included children (0-24 months old) who were hospitalized due to RSV bronchiolitis (2018-2022), CRP levels taken at admission.Results: We included 1874 children (mean age of 6.7 months, 59% males); median CRP level 1.92 mg/dl. Children with elevated CRP (> 1.92 mg/dl) were significantly older (5.1 vs. 3.8 months, P < 0.001) and had higher rates of pneumonia (9.4% vs. 4.3%, P < 0.001), urinary tract infection (UTI), (2.2% vs. 0.2%, P < 0.001), acute otitis media (AOM) (1.7% vs. 0.2%, P < 0.001), admissions to the pediatric intensive care unit (PICU) (7.4% vs. 3.7%, P < 0.001), antibiotic treatment (49.8% vs. 37.2%, P < 0.001), and longer hospitalizations (3.83 vs. 3.31 days, P < 0.001). Multivariable analysis predicted increased risk for UTI, PICU admission, pneumonia, and longer hospitalization (relative risk 11.6, 2.25, 1.98, 1.44, respectively, P < 0.001). CRP thresholds of 3.51, 1.9, and 2.81 mg/dl for PICU admission, UTI, and pneumonia, were calculated using Youden's index with AUC 0.72, 0.62, and 0.61, respectively.Conclusions: Elevated CRP levels at admission are associated with increased disease severity and higher complication rates in children hospitalized with RSV bronchiolitis.","PeriodicalId":50268,"journal":{"name":"Israel Medical Association Journal","volume":"27 3","pages":"165-171"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712027","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 Use of Lung Ultrasound in the Follow-up of Pediatric Patients with Community-acquired Pneumonia.

IF 1.8 4区医学

Israel Medical Association Journal Pub Date : 2025-03-01

Vered Nir, Guy Katsenelenbogen, Rima Karabitski, Vered Schichter-Konfino, Adi Klein

{"title":"The Use of Lung Ultrasound in the Follow-up of Pediatric Patients with Community-acquired Pneumonia.","authors":"Vered Nir, Guy Katsenelenbogen, Rima Karabitski, Vered Schichter-Konfino, Adi Klein","doi":"","DOIUrl":"","url":null,"abstract":"Background: Community-acquired pneumonia (CAP) is a prevalent bacterial infection in children. Lung ultrasound (LUS) is gaining popularity as a diagnostic tool for pneumonia, with the added potential for monitoring disease progression. However, research on the benefits of this modality for monitoring disease progression remains limited.Objectives: To categorize the follow-up sonographic findings of lung inflammation in pediatric patients performed 10-14 days after being diagnosed with CAP.Methods: We conducted a prospective observational study of children aged 0-18 years, diagnosed with CAP between 2020 and 2022. LUS findings at the time of diagnosis and 10-14 days later were recorded and documented.Results: In total, 47 children were recruited, and 22 were included in the analysis. At the time of diagnosis, 20 patients (90%) had B-lines. Air bronchograms were found in all patients, and consolidation findings were observed in seven of the examined patients (32%). At the follow-up LUS 10-14 days later, B-lines were observed in six patients (27%). Air bronchograms were observed in eight patients, and consolidation findings were observed in six (27%). In 13 patients (59%), the follow-up LUS was completely normal. These patients were younger and had lower body weights. Pathological findings persisted in 41% of the patients.Conclusions: For most patients, LUS demonstrated a resolution. Further large-scale studies are needed to validate the findings and determine the role of LUS in pediatric CAP.","PeriodicalId":50268,"journal":{"name":"Israel Medical Association Journal","volume":"27 3","pages":"172-176"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712033","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

Computed Tomography Findings of Combat Casualties During the 2023-2024 Israel-Gaza Armed Conflict.

IF 1.8 4区医学

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

Hagar Olshaker, Dana Brin, Larisa Gorenstein, Vera Sorin, Eyal Klang, Nisim Rahman, Michal Marianne Amitai

{"title":"Computed Tomography Findings of Combat Casualties During the 2023-2024 Israel-Gaza Armed Conflict.","authors":"Hagar Olshaker, Dana Brin, Larisa Gorenstein, Vera Sorin, Eyal Klang, Nisim Rahman, Michal Marianne Amitai","doi":"","DOIUrl":"","url":null,"abstract":"Background: On 7 October 2023, an armed conflict erupted between Hamas and Israel, leading to numerous combat casualties.Objectives: To describe computed tomography (CT) findings of combat casualties at a tertiary medical center during the first 3 months of the conflict.Methods: A retrospective observational study was conducted on patients admitted between 7 October 2023 and 7 January 2024. Adults with conflict-related trauma who underwent chest, abdomen, and pelvis (body) trauma protocol CT scans were included.Results: Of 272 patients who underwent body trauma protocol CT, 112 combat-related adults were included, mean age of 27 years and one female. In total, 82 patients (73%) underwent additional scans of the head and neck or extremities. Fractures were observed in 53 patients (47%). Vascular injuries were present in 40 patients (35%). Limb injuries were most common, affecting 37 patients (33%), which prompted a protocol update. Lung injuries were the most common in body CT: 30 patients (27%). Head and neck injuries were seen in 21 patients (18%). Multisystem trauma was present in 24 patients (21%). A total of 83 patients (74%) underwent surgery, mostly orthopedic/soft tissue surgeries (63%); 15 (13%) underwent abdominal surgery, with bowel injuries confirmed in eight cases.Conclusions: CT scans are an important tool in conflict trauma management. Limb injuries were the most frequent, necessitating protocol adjustments. Lung injuries were the most common body injury; 21% of patients had multisystem trauma. Most patients required surgery.","PeriodicalId":50268,"journal":{"name":"Israel Medical Association Journal","volume":"27 1","pages":"17-22"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392347","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

A Systematic Review of Remote Cardiac Rehabilitation Utilizing Wearable Monitors.

IF 1.8 4区医学

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

Oren Yagel, Habib Helou, Bruria Hirsh-Raccah, Emil Aliev, Shirel Shtraikh, Arik Eisenkraft, Rinat Tzach-Nahman, Offer Amir, Dean Nachman

引用次数: 0

Utilizing 2D Strain in Routine Echocardiography Examinations: Position paper of the Israeli Society of Echocardiography.

IF 1.8 4区医学

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

Marina Leitman, Shemy Carasso

引用次数: 0

Internal Medicine at Home: Three Years of Experience with a Novel Model.

IF 1.8 4区医学

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

Jamal Qarawany, Yoav Weber, Zivit Zalts, Carmit Steinberg, Doron Cohn-Schwartz, Eyal Braun, Zaher S Azzam, Avi Magid, Henda Darawsha, Rizan Sakhnini, Gidon Berger

{"title":"Internal Medicine at Home: Three Years of Experience with a Novel Model.","authors":"Jamal Qarawany, Yoav Weber, Zivit Zalts, Carmit Steinberg, Doron Cohn-Schwartz, Eyal Braun, Zaher S Azzam, Avi Magid, Henda Darawsha, Rizan Sakhnini, Gidon Berger","doi":"","DOIUrl":"","url":null,"abstract":"Background: Hospital-at-Home (HaH) programs offer medical services in the patient's home as an alternative to hospitalization across various medical fields. Previous studies have demonstrated that HaH provides several benefits for patients and the healthcare system. Rambam Health Care Center was the pioneer hospital in introducing HaH in Israel. Since April 2021, in collaboration with Maccabi Healthcare Services, the center has been providing home hospitalization services for patients with acute internal medicine illnesses based on an innovative model.Objectives: To describe demographic data, background diseases, indications for HaH admissions, length of stay (LOS), 1-month and 1-week readmission rates, home mortality, and 1-month mortality.Results: The study included 262 patients (135 men, 127 women), mean age 69.7 years (range 24-98, median 73). Patients had significant co-morbidities, with a Charlson Comorbidity Index score of 6.7. Among the patients, 170 were independent, 61 were incapacitated, and the remainder had various functional limitations. Most admissions were from internal medicine departments, 39 originating from the emergency department and the rest from other acute care wards. The primary indications for HaH admission included pneumonia, urinary tract infections, and cellulitis. The average hospital LOS was 48.9 hours, while the HaH LOS was 3.43 days. Readmission rates for the same initial conditions were 10% within 1 week and 14% within 1 month. Twenty-one patients died within 1 month of discharge from HaH, including one death during the HaH period.Conclusions: This study highlighted the feasibility of home hospitalization as a viable alternative to traditional inpatient care in internal medicine.","PeriodicalId":50268,"journal":{"name":"Israel Medical Association Journal","volume":"27 1","pages":"49-53"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392350","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

Lack of Clinical Prognostic Power for Ventilated Critical COVID-19 Patients in the Intensive Care Unit.

IF 1.8 4区医学

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

Yigal Helviz, Frederic S Zimmerman, Daniel Belman, Yaara Giladi, Imran Ramlawi, David Shimony, Meira Yisraeli Salman, Nir Weigert, Mohammad Jaber, Shai Balag, Yaniv Hen, Raed Jebrin, Daniel Fink, Eli Ben Chetrit, Michal Shitrit, Ramzi Kurd, Phillip D Levin

{"title":"Lack of Clinical Prognostic Power for Ventilated Critical COVID-19 Patients in the Intensive Care Unit.","authors":"Yigal Helviz, Frederic S Zimmerman, Daniel Belman, Yaara Giladi, Imran Ramlawi, David Shimony, Meira Yisraeli Salman, Nir Weigert, Mohammad Jaber, Shai Balag, Yaniv Hen, Raed Jebrin, Daniel Fink, Eli Ben Chetrit, Michal Shitrit, Ramzi Kurd, Phillip D Levin","doi":"","DOIUrl":"","url":null,"abstract":"Background: Prognostication is complex in patients critically ill with coronavirus disease 2019 (COVID-19).Objectives: To describe the natural history of ventilated critical COVID-19 patients.Methods: Due to our legal milieu, active withdrawal of care is not permitted, providing an opportunity to examine the natural history of ventilated critical COVID-19 patients. This retrospective cohort included COVID-19 ICU patients who required mechanical ventilation. Respiratory and laboratory parameters were followed from initiation of mechanical ventilation for 14 days or until extubation, death or tracheostomy.Results: A total of 112 patients were included in the analysis. Surviving patients were younger than non-survivors (62 years [range 54-69] vs. 66 years [range 62-71], P = 0.01). Survivors had a shorter time to intubation, shorter ventilation duration, and longer hospital stay. Respiratory parameters at intubation were not predictive of mortality. Nevertheless, on ventilation day 10, many of the ventilatory parameters were significantly better in survivors. Regarding laboratory parameters, neutrophil counts were significantly higher in non-survivors on day 1 and C-reactive protein levels were significantly lower in survivors on day 10. Modeling using a generalized estimating equation showed small dynamic differences in ventilatory parameters predictive of survival.Conclusions: In ventilated COVID-19 patients when there is no active care withdrawal, prognostication may be possible after a week; however, differences between survivors and non-survivors remain small.","PeriodicalId":50268,"journal":{"name":"Israel Medical Association Journal","volume":"27 1","pages":"34-41"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392353","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

Advancing Preclinical Education: A New Model for Medical Education. The Experience of the Dina Recanati School of Medicine at Reichman University.

IF 1.8 4区医学

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

Efrat Wertheimer, David Maiershon, Jonathan Giron, Yehuda Shoenfeld, Arnon Afek, Miri Mizrahi Reuveni

引用次数: 0

Development and Validation of a Clinical Protocol in COVID-19 Patients to Assess Disease Severity and Outcomes.

IF 1.8 4区医学

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

Milena Tocut, Yousef Abuleil, Mona Boaz, Amos Gilad, Gisele Zandman-Goddard

{"title":"Development and Validation of a Clinical Protocol in COVID-19 Patients to Assess Disease Severity and Outcomes.","authors":"Milena Tocut, Yousef Abuleil, Mona Boaz, Amos Gilad, Gisele Zandman-Goddard","doi":"","DOIUrl":"","url":null,"abstract":"Background: The coronavirus disease 2019 (COVID-19) pandemic showed the need to evaluate disease severity promptly at the time of hospital admission.Objectives: To establish an admission protocol, which included clinical and laboratory findings.Methods: We conducted a retrospective study at Wolfson Medical Center, Israel, for a period of 19 months (2020-2021). We established a protocol for patients who were admitted with COVID-19 infection. The protocol parameters included demographic data, co-morbidities, immune status, oxygen level at room air on admission, oxygen demand, lymphopenia, C-reactive protein (CRP) level, lactate dehydrogenase, D-DIMER, creatinine, aspartate transferase, alanine aminotransferase, and ferritin. Based on this protocol, we defined the severity of COVID-19 at the beginning of hospitalization and started treatment without delay. This protocol included ferritin levels as a guide to severity and outcome of patients. A database was established for all the parameters of the patients included in the study.Results: The study included 407 patients; 207 males (50.9%), 200 females (49.1%). The age range was 18-101 years. Hyperferritinemia (> 1000 ng/dl) was one of the strongest and most significant predictors for severe disease in these patients (P < 0.001). Lymphopenia, high levels of CRP, alanine aminotransferase, aspartate transferase, lactate dehydrogenase, and creatinine also correlated with severe disease, complications, and death.Conclusions: Abnormal ferritin levels were a very significant and clear indicator of the development of severe COVID-19. The addition of ferritin levels to our protocol aided in finding which patients were at increased risk for morbidity and mortality.","PeriodicalId":50268,"journal":{"name":"Israel Medical Association Journal","volume":"27 1","pages":"28-33"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392348","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

Iodinated Contrast Media Allergy and Its Management in a Large Cohort in the Hospital Setting.

IF 1.8 4区医学

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

Isca Hershkowitz, Joshua Moss, Jacob Sosna, Eyal Netser, Avivit Cahn, Alon Y Hershko

{"title":"Iodinated Contrast Media Allergy and Its Management in a Large Cohort in the Hospital Setting.","authors":"Isca Hershkowitz, Joshua Moss, Jacob Sosna, Eyal Netser, Avivit Cahn, Alon Y Hershko","doi":"","DOIUrl":"","url":null,"abstract":"Background: Management of patients with reported iodinated contrast media (ICM) allergy is not supported by sufficient data. It is assumed that these patients are at risk for severe reactions, and that premedication provides protection.Objectives: To examine current practice and prognosis in hospitalized patients with ICM allergy.Methods: In this retrospective study, we analyzed data of 17,356 patients who were hospitalized between 2018 and 2022 and referred for imaging. No-allergy and allergy groups were matched by age, sex, co-morbidities, and indications for imaging. Statistical analysis compared demographic, clinical, and imaging-related parameters.Results: Our study included records of 501 patients with ICM allergy and 16,855 with no allergy. Patients with allergy were older (70.92 ± 16.25 vs. 59.02 ± 23.74 years, P < 0.001), female preponderance (male proportion 42.5% vs. 54%, P < 0.001), and those with increased cardiovascular and metabolic co-morbidities. The rate of ICM injection was similar among patients with ICM allergy (34%) and no allergy (36%). Most patients with ICM allergy did not receive premedication. Allergic patients demonstrated increased mortality (25.9% vs. 16.5%, P < 0.001); however, this result was not associated with the diagnosis of allergy, anaphylactic reactions, or premedication.Conclusions: ICM allergy is mostly reported in patients with advanced age and multiple co-morbidities. Mortality was not increased when compared to matched non-allergic individuals. Among patients with reported allergy who were injected with ICM, anaphylaxis was not a cause of death, although fewer than half received premedication. Prospective trials are warranted to revise the clinical approach to ICM allergy.","PeriodicalId":50268,"journal":{"name":"Israel Medical Association Journal","volume":"27 1","pages":"42-48"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392351","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