Israel Medical Association Journal最新文献_第3页

Prevalence of Breast Edema Following Conservative Breast Therapy in Israeli Patients. 以色列患者保守乳房治疗后乳房水肿的发生率

IF 1.3 4区医学

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

Daniel Kedar, Ortal Nachum, Arik Zaretski, Yoav Barnea

{"title":"Prevalence of Breast Edema Following Conservative Breast Therapy in Israeli Patients.","authors":"Daniel Kedar, Ortal Nachum, Arik Zaretski, Yoav Barnea","doi":"","DOIUrl":"","url":null,"abstract":"Background: Breast edema, characterized by fluid accumulation in breast tissue, is a common yet understudied complication following breast-conserving surgery (BCS) and radiotherapy for breast cancer. Its impact on physical and emotional well-being highlights the need for deeper exploration of its prevalence, risk factors, and clinical management.Objectives: To evaluate the prevalence of breast edema following breast surgery, investigate its association with arm lymphedema, and explore links to surgical interventions.Methods: We analyzed 105 breast cancer patients treated with BCS and axillary interventions, including sentinel lymph node biopsy (SLNB), lymph node sampling, or axillary lymph node dissection (ALND). Comprehensive evaluations included physical exams, arm circumference measurements, and a thorough review of patient demographics, medical history, and disease progression to assess the presence and severity of breast and arm lymphedema.Results: Breast edema prevalence was 7.6%, with rates significantly influenced by surgical extent. None of the SLNB patients exhibited breast edema, compared to 23.5% of ALND patients. Significant predictors included arm lymphedema (OR 57.54, P = 0.024), body mass index (OR 0.65, P = 0.016), and tumor grade (OR 51.78, P = 0.040). Co-occurrence of breast and arm lymphedema was observed in 50% of cases.Conclusions: Breast edema is a significant postoperative complication influenced by surgical extent and lymphatic disruption. Improved diagnostic methods, multidisciplinary care, and innovative surgical strategies are essential for mitigating this condition and enhancing patient outcomes.","PeriodicalId":50268,"journal":{"name":"Israel Medical Association Journal","volume":"27 8","pages":"515-519"},"PeriodicalIF":1.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144862559","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

Ethnic Influence in Breast Reconstruction: A Comparative Study in the Bedouin Population. 种族对乳房再造的影响：贝都因人的比较研究。

IF 1.3 4区医学

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

Meir Retchkiman, Dor Marciano, Idan Farber, Lihie Sheffer, Yuval Krieger, Yaron Shoham, Eldad Silberstein

{"title":"Ethnic Influence in Breast Reconstruction: A Comparative Study in the Bedouin Population.","authors":"Meir Retchkiman, Dor Marciano, Idan Farber, Lihie Sheffer, Yuval Krieger, Yaron Shoham, Eldad Silberstein","doi":"","DOIUrl":"","url":null,"abstract":"Background: Breast reconstruction following oncological resection offers psychosocial benefits. Various factors influence patient reconstruction decisions, including ethnicity, socioeconomic status, and education. We investigated disparities in breast reconstruction among Bedouin and non-Bedouin women in the Negev region.Objectives: To investigate the influence of ethnicity in breast reconstruction decisions between Bedouin and non-Bedouin women in Israel and to identify factors influencing the choice of reconstruction following oncological breast surgery.Methods: In this retrospective cohort study, we examined women undergoing breast cancer surgery, with or without reconstruction, between 2015 and 2021 in a breast cancer referral center. Demographics and detailed medical data were collected from electronic health records. We analyzed the factors that influenced decisions regarding breast reconstruction.Results: The study included 1415 patients who underwent breast resection. Age was a significant factor in breast reconstruction choices, with younger patients being more likely to choose reconstruction. Marital status and education level influenced the decision, whereas socioeconomic status and number of children did not. Ethnicity analysis highlighted distinct demographic and socioeconomic differences between Bedouin and non-Bedouin women. Despite these disparities, surgical choices did not differ significantly between ethnicities.Conclusions: Significant disparities exist between Bedouin and non-Bedouin women in terms of sociodemographic factors. However, these disparities did not affect their breast reconstruction decisions. Age, marital status, and education level influenced the decision to reconstruct the breast.","PeriodicalId":50268,"journal":{"name":"Israel Medical Association Journal","volume":"27 8","pages":"520-525"},"PeriodicalIF":1.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144862555","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 October 7th Terrorist Attack on Israel: Complexity of Burn Care. 10月7日以色列恐怖袭击：烧伤护理的复杂性。

IF 1.3 4区医学

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

Josef Haik, Bar Avrahami, Daniela Jeifetz, Elai Chogeg-Golan, Moti Harats

引用次数: 0

The Use of Dermal Substitutes for Reconstruction of Extensive Foot and Ankle Wounds. 真皮替代物在大面积足踝创伤重建中的应用。

IF 1.3 4区医学

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

Adi Maisel Lotan, Shirly Shohat, Gilad Spiegel, Elad Sela, Rami Binenboim, Yoav Gronovich

{"title":"The Use of Dermal Substitutes for Reconstruction of Extensive Foot and Ankle Wounds.","authors":"Adi Maisel Lotan, Shirly Shohat, Gilad Spiegel, Elad Sela, Rami Binenboim, Yoav Gronovich","doi":"","DOIUrl":"","url":null,"abstract":"Background: Soft-tissue defects of the lower limb pose a reconstructive challenge. Soft tissue loss with exposed bone, tendon, or cartilage often requires free flap reconstruction. Dermal substitutes are used for treatment of extensive burns to replace damaged skin and may be ideal for lower limb reconstruction in selected cases.Objectives: To present our experience with reconstruction of lower limb wounds using Integra® Bilayer Wound Matrix (Integra LifeSciences Corp., Plainsboro, NJ, USA) and MatriDerm® (MedSkin Solutions Dr. Suwelack AG, Billerbeck, Germany).Methods: This single center retrospective study comprised 10 patients who underwent reconstruction of extensive tissue defects of the distal lower limbs with dermal matrices and split-thickness skin grafts.Results: All patients were successfully reconstructed and resumed normal ambulation. Six patients had complete and four partial graft takes that was treated conservatively until full wound healing. Older patients with medical co-morbidities or history of wound infection were more likely to have partial graft take. One postoperative infection was recorded in the study.Conclusions: Dermal substitutes are easy to apply and safe, show minimal donor site morbidity, provide good functional and aesthetic outcomes, and should be used for reconstruction of complex lower limb wounds.","PeriodicalId":50268,"journal":{"name":"Israel Medical Association Journal","volume":"27 8","pages":"492-497"},"PeriodicalIF":1.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144862564","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

Radiation-Induced Scalp Malignancies Following Childhood Treatment for Tinea Capitis: Clinical Experience and a Skin-Sparing Surgical Approach. 儿童头癣治疗后放射诱发的头皮恶性肿瘤：临床经验和保留皮肤的手术方法。

IF 1.3 4区医学

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

Tal Shachar, Dafna Shilo Yaacobi, Lia Schoenfeld, Avraham Amir, Ofir Zavdy, Nir Tzur, Sagit Meshulam-Derazon, Dean D Ad-El, Tamir Shay, Asaf Olshinka

引用次数: 0

Deep Inferior Epigastric Perforator Flap Breast Reconstruction in a Private Clinic: Clinical Outcomes from 2013 to 2024. 2013 - 2024年私人诊所腹壁深下穿支皮瓣乳房重建术的临床效果

IF 1.3 4区医学

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

Rivi Haiat Factor, Hagit Ofir, Haim Kaplan

{"title":"Deep Inferior Epigastric Perforator Flap Breast Reconstruction in a Private Clinic: Clinical Outcomes from 2013 to 2024.","authors":"Rivi Haiat Factor, Hagit Ofir, Haim Kaplan","doi":"","DOIUrl":"","url":null,"abstract":"Background: The incidence of autologous breast reconstruction has been steadily increasing in recent years. Deep inferior epigastric perforator (DIEP) flap reconstruction is considered the gold standard for breast reconstruction despite its demanding technical expertise, time intensiveness, and rigorous postoperative monitoring.Methods: We retrospectively collected data from 102 DIEP flaps utilized for breast reconstruction in 70 patients treated at private clinics between 2013 and 2024. All surgeries were performed by a single, experienced surgeon.Results: The mean age at surgery was 42.2 ± 8 years. Immediate reconstructions were conducted in 34 patients (48%); 46% of patients had prior radiation therapy. Only one patient received adjuvant radiation therapy. Free DIEP flaps vascularized by one (53%), two (32%), or three (10%) perforators were preferentially anastomosed to the internal mammary vessels. One patient underwent a muscle-sparing procedure due to the absence of available perforators. Total flap failure occurred in four cases (3.9%), three occurred as a unilateral loss in patients who underwent bilateral reconstruction. Postoperative revisions of the microvascular anastomosis were performed in three patients, with successful flap salvage in two (67%). Fat necrosis was diagnosed in 26 breasts (25%), only a minority of cases required follow-up surgery. All patients were managed completely in a private clinic, with none requiring hospitalization in the public system.Conclusions: Free DIEP flap breast reconstruction necessitates meticulous surgical planning, a well-coordinated surgical team, and close postoperative monitoring. Nevertheless, this surgery can be safely and effectively performed in a private clinic setting, with complication rates comparable to that of the public setting.","PeriodicalId":50268,"journal":{"name":"Israel Medical Association Journal","volume":"27 8","pages":"510-514"},"PeriodicalIF":1.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144862554","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

Comparison of the Prognostic Significance of Inflammatory and Thrombotic Indices in Patients with Cardiovascular and Infectious Diseases. 心血管和感染性疾病患者炎症和血栓指标对预后意义的比较

IF 1.3 4区医学

Israel Medical Association Journal Pub Date : 2025-07-01

Nir Roguin, Amir Cohen, Ella Yahud, Gabriel Bryk, Michal Cipok, Nadav Sorek, Eyal Ben-Assa, Eli I Lev

{"title":"Comparison of the Prognostic Significance of Inflammatory and Thrombotic Indices in Patients with Cardiovascular and Infectious Diseases.","authors":"Nir Roguin, Amir Cohen, Ella Yahud, Gabriel Bryk, Michal Cipok, Nadav Sorek, Eyal Ben-Assa, Eli I Lev","doi":"","DOIUrl":"","url":null,"abstract":"Background: Inflammatory and thrombotic markers play crucial roles in risk stratification for various diseases.Objectives: To investigate the relative importance of inflammation, measured by C-reactive protein (CRP), and platelet turnover, indicated by immature platelet fraction (IPF), in predicting outcomes for patients with cardiovascular disease, coronavirus disease 2019 (COVID-19), and bacterial infections.Methods: In this retrospective observational study, we analyzed data from 1473 individuals admitted to the Samson Assuta Ashdod University Hospital between 2018 and 2022. Patients were categorized based on CRP and IPF levels, with a focus on 280 patients in the high CRP/low IPF or high IPF/low CRP tertiles.Results: The high CRP low IPF group demonstrated significantly higher mortality rates compared to the low CRP high IPF group (13.5% vs. 0.8%, P < 0.001). Logistic regression analysis revealed that the high CRP and low IPF combination was the strongest predictor of mortality (odds ratio 12.951, 95% confidence interval 1.409-119.020, P = 0.024).Conclusions: The combination of inflammatory (CRP) and thrombotic (IPF) markers provides superior prognostic information compared to individual disease diagnoses in patients with cardiovascular disease, COVID-19, and bacterial infections.","PeriodicalId":50268,"journal":{"name":"Israel Medical Association Journal","volume":"27 7","pages":"442-447"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692273","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

Real-world Experience and Trends of Initiating Sodium-Glucose Cotransporter 2 Inhibitors among Hospitalized Patients with Acute Heart Failure. 急性心力衰竭住院患者启动钠-葡萄糖共转运蛋白2抑制剂的现实经验和趋势

IF 1.8 4区医学

Israel Medical Association Journal Pub Date : 2025-07-01

Saleh Sharif, Emran El Ukbi, Herschel Horowitz, Eran Kalmanovich, Dror Cantrell

{"title":"Real-world Experience and Trends of Initiating Sodium-Glucose Cotransporter 2 Inhibitors among Hospitalized Patients with Acute Heart Failure.","authors":"Saleh Sharif, Emran El Ukbi, Herschel Horowitz, Eran Kalmanovich, Dror Cantrell","doi":"","DOIUrl":"","url":null,"abstract":"Background: Initiating oral antidiabetic therapy, such as sodium-glucose cotransporter 2 (SGLT2) inhibitors, is generally not recommended during hospitalization. However, guidelines since 2021 have supported their use in heart failure with reduced ejection fraction (HFrEF), and since 2023 in preserved ejection fraction (HFpEF).Objectives: To assess the safety and outcomes of initiating SGLT2 inhibitors during hospitalization for acute heart failure (HF).Methods: We conducted a historical cohort study of 307 patients admitted with acute HF between October 2018 and April 2022. Patients were grouped as chronic SGLT2i users, new initiators during hospitalization, or controls who did not receive SGLT2i.Results: Among the 307 patients, 50.4% had HFrEF, 30.8% HFpEF, and 18.8% HF with mildly reduced ejection fraction. In-hospital mortality was 3.6% (11 patients); 2-year mortality was 37.7% (116 patients). New SGLT2i initiators had the lowest 2-year mortality (22.2%) compared to controls (43.9%) and chronic users (41.8%) (P = 0.008). They also had the lowest 1-year rehospitalization rates (18.3% vs. 35.5% vs. 32.8%; P = 0.025). Multivariable analysis identified older age and co-morbidities as independent predictors of mortality. SGLT2i initiation was associated with reduced rehospitalization. Adverse effects occurred in 15.6% of SGLT2i users, mainly acute kidney injury.Conclusions: In-hospital SGLT2 inhibitor initiation in patients with HF appears safe and is associated with reduced post-discharge mortality and readmission rates.","PeriodicalId":50268,"journal":{"name":"Israel Medical Association Journal","volume":"27 7","pages":"448-453"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692278","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

Chronic Cough Caused by Arnold's Nerve Ear-Cough Reflex. 由阿诺德神经耳咳反射引起的慢性咳嗽。

IF 1.8 4区医学

Israel Medical Association Journal Pub Date : 2025-07-01

Mor Amital, Yehuda Shoenfeld, Arkadi Yakirevitch

引用次数: 0

Missile Alarm as a Trigger for Vasovagal Syncope: A Case Report from a Conflict Zone. 导弹警报触发血管迷走神经性晕厥：一个来自冲突地区的病例报告。

IF 1.8 4区医学

Israel Medical Association Journal Pub Date : 2025-07-01

Adam Folman, Maguli S Barel, Ariel Roguin

引用次数: 0