Israel Medical Association Journal最新文献_第4页

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

Pulmonary Embolism in Peripartum Cardiomyopathy: An Unusual Complication.

IF 1.8 4区医学

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

Gassan Moady, Tameemi Abdallah Moady, Alexander Shturman, Shaul Atar

引用次数: 0

Surgery in Mauthausen Concentration Camp: Therapy or Practice?

IF 1.8 4区医学

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

George M Weisz

引用次数: 0

Educating the Physicians of the Future: The Dina Recanati School of Medicine at Reichman University.