Israel Medical Association Journal最新文献_第6页

Why Is Goiter Depicted So Often in Early Classical Paintings? 为什么甲状腺肿大在早期古典绘画中如此常见？

IF 1.3 4区医学

Israel Medical Association Journal Pub Date : 2026-03-01

Zvi Weizman

引用次数: 0

Yellow Dialyzer: A Rare Manifestation of Profound Hyperbilirubinemia. 黄色透析器：深度高胆红素血症的一种罕见表现。

IF 1.3 4区医学

Israel Medical Association Journal Pub Date : 2026-03-01

Alon Bnaya, Thaer Barakat, Omar Abu Libdeh, Nour Elayan, Linda Shavit

引用次数: 0

Evaluating the Performance of a ChatGPT Model in Rheumatology Exams. 在风湿病检查中评估ChatGPT模型的性能。

IF 0.8 4区医学

Israel Medical Association Journal Pub Date : 2026-03-01

Fadi Hassan, Basem Hijazi, Mohammad E Naffaa

{"title":"Evaluating the Performance of a ChatGPT Model in Rheumatology Exams.","authors":"Fadi Hassan, Basem Hijazi, Mohammad E Naffaa","doi":"","DOIUrl":"","url":null,"abstract":"Background: Large language models (LLMs) are rapidly advancing, with the potential to improve healthcare. While LLM performance on medical licensing exams were studied extensively, their performance in rheumatology exams requires specific evaluation.Objectives: To assess Chat Generative Pre-Trained Transformer (ChatGPT) performance on 200 validated Israeli rheumatology board exam questions.Methods: ChatGPT performance was evaluated using 200 multiple-choice questions from the 2023 and 2024 Israeli official rheumatology board examinations. Three gpt-4-turbo based variants were assessed: base model (Model 1), few-shot chain of thought (CoT) model (Model 2), and knowledge-augmented prompting model incorporating rheumatology guidelines (Model 3). Model 1 was assessed using both the original Hebrew and a validated English translated version, while Models 2 and 3 were assessed using the English version only.Results: Overall, Model 3 achieved the highest numerical accuracy (81%), followed by Model 1 (English, 77%), Model 2 (75%), and Model 1 (Hebrew, 74.5%); however, these differences were not statistically significant. Performance varied markedly by question type. For text-only questions (n=177), accuracies ranged from 78.5% to 83.1%, with Model 3 showing the highest point estimate (83.1%). In contrast, all models demonstrated substantially lower performance on questions that included images (n=23), with accuracies ranging from 34.8% to 65.2%. Model 3 yielded the highest numerical accuracy (65.2%).Conclusions: The study highlights the potential role of LLMs in rheumatology board examinations but also emphasizes their critical limitations. Future research should focus on addressing limitations, especially image interpretation and management of complex cases to enable efficient application of LLMs in rheumatology.","PeriodicalId":50268,"journal":{"name":"Israel Medical Association Journal","volume":"28 3","pages":"162-167"},"PeriodicalIF":0.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147379426","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

Clinical Features and Outcomes of Acute Myocarditis in Patients with Swab-Confirmed Respiratory Viral Pathogens. 拭子确认呼吸道病毒病原体患者急性心肌炎的临床特征和结局。

IF 0.8 4区医学

Israel Medical Association Journal Pub Date : 2026-03-01

Wesam Mulla, Dafna Yahav, Anat Wieder, Gershon Davydov, Amitai Segev, Michael Arad, Shlomi Matetzky, Roy Beigel, Anan Younis

{"title":"Clinical Features and Outcomes of Acute Myocarditis in Patients with Swab-Confirmed Respiratory Viral Pathogens.","authors":"Wesam Mulla, Dafna Yahav, Anat Wieder, Gershon Davydov, Amitai Segev, Michael Arad, Shlomi Matetzky, Roy Beigel, Anan Younis","doi":"","DOIUrl":"","url":null,"abstract":"Background: Acute myocarditis (AM) is an inflammatory cardiac condition with heterogeneous clinical manifestations that often overlap with other acute cardiac syndromes, making diagnosis challenging.Objectives: To characterize the prevalence, clinical profile, and outcomes of AM patients with respiratory viral pathogen detection on nasopharyngeal swabs at admission.Methods: We retrospectively analyzed all patients admitted to the Sheba Medical Center with confirmed AM between January 2005 and December 2020. Diagnosis was based on compatible presentation, elevated cardiac biomarkers, and supportive imaging findings. Nasopharyngeal swab results, when performed, were reviewed for respiratory viral detection.Results: Among 425 identified AM cases, 146 (34%) underwent swab testing; 11 (8%) tested positive for respiratory viral pathogens, most commonly influenza A (n=5) and adenovirus (n=3). With one exception, all positive cases occurred during winter or early spring (10/77, 13%). Compared with swab-negative patients, swab-positive individuals were older (47 ± 22 vs. 35 ± 14 years, P = 0.03), more frequently female (45% vs. 14%, P = 0.007), and more often presented with dyspnea (55% vs. 25%, P = 0.036) but less commonly with ST-segment elevation (27% vs. 70%, P = 0.003). No differences were observed in inflammatory markers, imaging findings, or hospital stay.Conclusions: Respiratory viral detection in AM is uncommon and predominantly seasonal. Nasopharyngeal swabbing is a simple, non-invasive tool that may help identify treatable viral pathogens and guide patient management. These data provide a pre-COVID-19 reference for future studies investigating the impact of viral infection on myocardial injury.","PeriodicalId":50268,"journal":{"name":"Israel Medical Association Journal","volume":"28 3","pages":"141-145"},"PeriodicalIF":0.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147379470","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

Imaging Evaluation of the Native Lung Outcomes in Patients Undergoing Single Lung Transplantation for Pulmonary Fibrosis. 肺纤维化单肺移植患者原生肺预后的影像学评价。

IF 0.8 4区医学

Israel Medical Association Journal Pub Date : 2026-03-01

Gilad Borisovsky, Mordechai Reuven Kramer, Osnat Livne-Streichman, Shlomit Tamir, Hanna Bernstine, Zipi Scochat, Ahuva Grubstein

{"title":"Imaging Evaluation of the Native Lung Outcomes in Patients Undergoing Single Lung Transplantation for Pulmonary Fibrosis.","authors":"Gilad Borisovsky, Mordechai Reuven Kramer, Osnat Livne-Streichman, Shlomit Tamir, Hanna Bernstine, Zipi Scochat, Ahuva Grubstein","doi":"","DOIUrl":"","url":null,"abstract":"Background: Idiopathic pulmonary fibrosis (IPF) is a progressive, fatal lung disease leading to end-stage lung disease (ESLD). Single lung transplantation (SLT) is the primary treatment option for IPF; however, the native lung continues to influence post-transplant outcomes.Objectives: To determine whether the native lung continues to deteriorate under post-transplantation immunosuppression treatment by assessing chest computed tomography (CT) and perfusion scans.Methods: We conducted a single-center retrospective analysis of patients who underwent SLT for IPF between 2016 and 2023. Serial chest CT scans assessed native lung changes. CT signs of fibrosis were scored for severity according to published criteria for defining pulmonary fibrosis disease progression. Lung volumes and perfusion were calculated.Results: Among 57 patients (mean age 57 years; 33% female), 42% died during follow-up (median survival 95 months). The most common immunosuppressive regimen (54% of patients) included prednisone, calcineurin inhibitor, and mycophenolate mofetil. CT analysis demonstrated that in 41/57 (72%) patients, fibrosis signs continued to deteriorate. There was also a significant correlation decline in native lung volume and perfusion scans over time (P = 0.0003, P < 0.0001, respectively) (r = 0.82, P = 0.03).Conclusions: Fibrotic progression in the native lung persists after SLT as demonstrated by both chest CT and nuclear perfusion scan, thus highlighting the importance of ongoing monitoring for accuracy and complications assessment, integrating it into routine surveillance, and ensuring it is consistently considered in post-transplant assessments.","PeriodicalId":50268,"journal":{"name":"Israel Medical Association Journal","volume":"28 3","pages":"180-184"},"PeriodicalIF":0.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147379427","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

Infant Neck Knots Unveiled: Diagnosing Fibromatosis Colli with Point of Care Ultrasound. 揭示婴儿颈结：用护理点超声诊断结肠纤维瘤病。

IF 1.3 4区医学

Israel Medical Association Journal Pub Date : 2026-02-01

Gidon Test, Or Kaplan, Idan Lendner, Oren Tavor, Inbal Kestenbom

引用次数: 0

Osteosarcopenia May Be Associated with Complications after Colectomy for Diverticulitis. 骨骼肌减少可能与憩室炎结肠切除术后的并发症有关。

IF 0.8 4区医学

Israel Medical Association Journal Pub Date : 2026-02-01

Saed Khalilieh, Mor Azhari, Ronny Maman, Ely Erez, Alon Israeli, Noa Avishay, Dan Assaf, Edward Ram, Nir Horesh, Yaniv Zager

{"title":"Osteosarcopenia May Be Associated with Complications after Colectomy for Diverticulitis.","authors":"Saed Khalilieh, Mor Azhari, Ronny Maman, Ely Erez, Alon Israeli, Noa Avishay, Dan Assaf, Edward Ram, Nir Horesh, Yaniv Zager","doi":"","DOIUrl":"","url":null,"abstract":"Background: Diverticulitis is a common cause of acute abdominal conditions, often requiring urgent or elective surgical intervention. Both psoas muscle area (PMA) and bone mineral density (BMD) have been linked to postoperative outcomes, but their role in diverticulitis remains unclear.Objectives: To evaluate the relationship between PMA, BMD, and their combined effect on surgical outcomes in patients undergoing colectomy for diverticulitis.Methods: In this retrospective, single-center study, we analyzed patients who underwent colectomy for diverticulitis. PMA and BMD were measured using preoperative computerized tomography. Statistical analysis assessed the association between postoperative outcomes and PMA, BMD, and their combined product (PMA × BMD).Results: The cohort included 66 patients; median age 68.5 years (range 34-94); 41 (62.12%) females. Of the cases, 42 (63.63%) were urgent. Postoperative complications occurred in 38 patients (57.58%). Patients who developed major postoperative complications had lower PMA (1116.74 ± 716.31 mm² vs. 1948.01 ± 0.01 mm², P = 0.02). The area under the curve (AUC) for major postoperative complications was 0.94 for BMD. The AUC for postoperative ileus was 0.73, 0.69, and 0.76 for PMA, BMD, and PMA × BMD, respectively. The AUC for 30-day mortality was 0.66, 0.7, and 0.73. The AUC for ostomy reversal was 0.71, 0.71, and 0.76.Conclusions: PMA and BMD were associated with postoperative complications after colectomy for diverticulitis. Their combined assessment may improve predictive accuracy. Current evidence regarding the impact of body composition on surgical outcomes in diverticulitis remains limited and inconsistent. Further research is warranted.","PeriodicalId":50268,"journal":{"name":"Israel Medical Association Journal","volume":"28 2","pages":"88-92"},"PeriodicalIF":0.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147285929","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

Pseudo-uterine Contractions: A New Entity in Obstetrics. 假子宫收缩：产科的一个新实体。

IF 0.8 4区医学

Israel Medical Association Journal Pub Date : 2026-02-01

Chen Ben David, Lama Abboud, Naphtali Justman, Udi Ergaz, Ido Solt

{"title":"Pseudo-uterine Contractions: A New Entity in Obstetrics.","authors":"Chen Ben David, Lama Abboud, Naphtali Justman, Udi Ergaz, Ido Solt","doi":"","DOIUrl":"","url":null,"abstract":"Background: Listening to patients and obtaining a thorough history are fundamental in clinical practice. Some pregnant women, particularly in late or preterm gestation, report regular, painful uterine contractions that may not correspond to true labor. In some cases, patients admitted to feigning contractions using the Valsalva maneuver to gain secondary benefits. Misdiagnosing such cases may lead to unnecessary interventions, including iatrogenic prematurity.Objectives: To explore the phenomenon of pseudo-uterine contractions and assess whether maternal heart rate (HR) can help differentiate them from true contractions.Methods: We performed a prospective case-crossover study, which included 30 pregnant women in their third trimester who presented to Rambam Health Care Campus. Participants underwent 20 minutes of standard external monitoring followed by 10 minutes of repeated Valsalva maneuvers (every 2 minutes). Maternal and fetal HRs were recorded and compared during baseline, pseudo-, and true contractions.Results: During pseudo-contractions, maternal HR decreased by approximately 10 bpm (P < 0.001), while fetal HR increased by 8 bpm (P < 0.001). In contrast, true contractions resulted in a maternal HR increase of 15 bpm (P < 0.001) and a fetal HR rise of 12 bpm (P < 0.001).Conclusions: Maternal HR patterns differ significantly between true and false contractions. A decline in maternal HR during contractions may indicate Valsalva-induced pseudo-contractions, while an increase suggests true labor. This simple observation could aid in preventing unnecessary interventions in suspected cases.","PeriodicalId":50268,"journal":{"name":"Israel Medical Association Journal","volume":"28 2","pages":"73-76"},"PeriodicalIF":0.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147285974","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

Presence of Autoantibodies against the Autonomic Nervous System in Primary Achalasia. 原发性失弛缓症中抗自主神经系统自身抗体的存在。

IF 0.8 4区医学

Israel Medical Association Journal Pub Date : 2026-02-01

Dana Ben-Ami Shor, Nihaya Waii, Arad Dotan, Nir Bar, Gilad Halpert, Roie Tzadok, Einat Ritter, Harald Heidecke, Guy A Weiss, Yishai Ron, Yehuda Shoenfeld

{"title":"Presence of Autoantibodies against the Autonomic Nervous System in Primary Achalasia.","authors":"Dana Ben-Ami Shor, Nihaya Waii, Arad Dotan, Nir Bar, Gilad Halpert, Roie Tzadok, Einat Ritter, Harald Heidecke, Guy A Weiss, Yishai Ron, Yehuda Shoenfeld","doi":"","DOIUrl":"","url":null,"abstract":"Background: Primary achalasia is a rare disorder but a significant cause of esophageal motor dysfunction. The pathophysiology of achalasia is still unknown, although an autoimmune etiology is suspected.Objectives: To examine the presence of autoantibodies against autonomic nervous system receptors among primary achalasia patients.Methods: In this observational cross-sectional study, we measure the levels of serum autoantibodies targeting G protein-coupled receptors of the autonomic nervous system, including adrenergic, muscarinic, endothelin, and angiotensin receptors. The study included 40 primary achalasia patients and 40 healthy controls without known history of achalasia, autoimmune diseases, or symptoms of an esophageal motility disorder.Results: A statistically significant low level of autoantibodies against the M2 muscarinic receptor was observed in the serum of primary achalasia patients compared with the control group (P < 0.009). When exploring the two common achalasia types, a statistically significant low level of autoantibodies against type M1, M2, and M5 muscarinic receptors was observed among type 2 achalasia patients compared to patients with type 1 achalasia.Conclusions: The finding of reduced levels of autoantibodies targeting the M2 muscarinic receptor in the serum of primary achalasia patients provides a valuable insight into the underlying pathogenesis of the disease.","PeriodicalId":50268,"journal":{"name":"Israel Medical Association Journal","volume":"28 2","pages":"104-109"},"PeriodicalIF":0.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147285963","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

Massive Honeybee Envenomation: A Case Series of Simultaneous Multiple Casualties. 大规模蜜蜂中毒：一系列同时造成多人伤亡的案例。

IF 0.8 4区医学

Israel Medical Association Journal Pub Date : 2026-02-01

Amir Givon, Rotem Tal-Ben Ishay, Lior Naveh, Adi Lakritz, Adi Braun, Michael Kogan, Avinoah Irony, Nancy Agmon-Levin, Soad Hajyahia, Karina Glick, Haim Mayan, Ronen Loebstein

{"title":"Massive Honeybee Envenomation: A Case Series of Simultaneous Multiple Casualties.","authors":"Amir Givon, Rotem Tal-Ben Ishay, Lior Naveh, Adi Lakritz, Adi Braun, Michael Kogan, Avinoah Irony, Nancy Agmon-Levin, Soad Hajyahia, Karina Glick, Haim Mayan, Ronen Loebstein","doi":"","DOIUrl":"","url":null,"abstract":"Background: Mass honeybee envenomation (MHE) is a rare occurrence, with possible life-threatening or fatal consequences.Objectives: To present the first description of multiple simultaneous casualties in a single incident of MHE.Methods: Nine young men were simultaneously attacked by a large honeybee swarm. All patients were hemodynamically stable on arrival to Sheba Medical Center. One had fiberoptic evidence of laryngeal edema. Eight (89%) of the patients had leukocytosis and laboratory evidence of rhabdomyolysis. Eight patients were hospitalized in an internal medicine ward. The patient who had the most (over 300) stings removed presented with severe rhabdomyolysis and acute renal failure (ARF) and was admitted to the intensive care unit.Results: Most patients had a benign clinical course and were discharged within 2 days. One patient developed severe rhabdomyolysis and was treated with fluids and urine alkalinization with significant improvement. The clinical course of another patient was complicated by ARF consistent with acute tubular necrosis. His creatinine peaked at 3.04 mg/dl and improved over several days until his discharge.Conclusions: In our case series, we demonstrated the spectrum of clinical presentations associated with MHE and highlighted the importance of stings load as a prognostic factor, which may dictate early therapeutic intervention.","PeriodicalId":50268,"journal":{"name":"Israel Medical Association Journal","volume":"28 2","pages":"99-103"},"PeriodicalIF":0.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147285829","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