The Israel Medical Association journal : IMAJ最新文献

{"title":"Endoscopic Management of Gallstone Ileus with Laser and Mechanical Lithotripsy.","authors":"Rashad Khazen, Yaniv Shilo, Eyal Gal, Guy Pines","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":524150,"journal":{"name":"The Israel Medical Association journal : IMAJ","volume":"28 10","pages":"663-665"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Great Mimicker: Chondrodermatitis Nodularis Helicis Presenting as Malignancy and Managed by Mohs Surgery.","authors":"Sivan Sheffer Levi, Joseph Alcalay","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":524150,"journal":{"name":"The Israel Medical Association journal : IMAJ","volume":"28 10","pages":"675-678"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterization of Patients with Atrial Fibrillation Treated Inadequately with Anticoagulants: Why Hospitalization Is Not an Opportunity to Correct Errors.","authors":"Loai Mreisat, Shir Rubinstein Levy, Niv Ben-Shabat, Howard Amital","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Atrial fibrillation (AF) is a common cardiac arrhythmia. Prevalence increases with age. It is a major public health concern due to high risk of thromboembolic complications such as stroke and systemic embolism. Direct oral anticoagulants (DOACs) have been shown to have improved safety and efficacy profiles and are the preferred therapy in all recent guidelines. However, patients are still discharged from internal medicine wards without appropriate DOAC therapy.</p><p><strong>Objectives: </strong>To investigate the effectiveness of hospitalization in correcting inappropriate therapy for AF in patients who were hospitalized in the internal medicine departments for any reason and discharged without receiving DOAC therapy.</p><p><strong>Methods: </strong>In this retrospective cohort study, we gathered data from electronic medical records at Sheba Medical Center on 222 patients. The patients were divided into three groups based on the anticoagulation therapy they received.</p><p><strong>Results: </strong>The patient cohort (mean age of 77.1 years; 42.3% males; 21.6% presented with cognitive impairment. Researchers identified several potential contraindications for DOACs (renal disease in 24.3%, mechanical valves in 14.4%). When comparing patients with and without DOAC contraindications, there were no statistically significant differences regarding cognitive impairment rates or the lack of anticoagulation therapy. We further divided patients who did not receive DOACs into two groups: 134 due to contraindications and 88 mistakenly. Between these groups, baseline factors showed no statistically significant differences.</p><p><strong>Conclusions: </strong>We found that older patients received less standardized care. Findings emphasize the need to consider individual patient characteristics and co-morbidities to eliminate management errors and improve the quality of clinical care.</p>","PeriodicalId":524150,"journal":{"name":"The Israel Medical Association journal : IMAJ","volume":"28 10","pages":"657-662"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rat-Bite Fever in an Immunocompromised Patient in Israel.","authors":"Tal Apple, Naifeh Krayem, Judith Olchowski","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":524150,"journal":{"name":"The Israel Medical Association journal : IMAJ","volume":"28 10","pages":"666-668"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abnormally High CA 19-9 in an Ovarian Mature Cystic Teratoma: A Case Report.","authors":"Chen Ben David, Dima Khatib, Yoav Siegler, Revital Linder, Amnon Amit, Emad Matanes","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":524150,"journal":{"name":"The Israel Medical Association journal : IMAJ","volume":"28 10","pages":"669-671"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sjögren's Disease and Asymptomatic Anti-Ro/Ss-A Antibodies with Neonatal Lupus Associated with HTLV Infection.","authors":"Luísa Rodrigues Cordeiro, Marjorie Vieira Batista, Jozélio Freire de Carvalho","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":524150,"journal":{"name":"The Israel Medical Association journal : IMAJ","volume":"28 10","pages":"672-674"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness and Accessibility: A Retrospective Comparison of Distal vs. Proximal Greater Occipital Nerve Blocks in Migraine Management.","authors":"Inbal Kish, Gabriel Lichtenstein, Nadav Calderon, Itay Goor-Aryeh, Lior Ungar","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Greater occipital nerve (GON) blocks are used in migraine management. While ultrasound-guided proximal GON blocks at the C2 level (GONC2) have been suggested to provide more sustained benefit, distal landmark-guided GON blocks are used due to their simplicity and accessibility.</p><p><strong>Conclusions: </strong>Distal GON blocks provide meaningful short-term reduction in migraine frequency and represent an effective, accessible initial interventional option. Proximal GONC2 blocks demonstrate sustained benefit and may be considered in selected patients. These findings support a pragmatic, stepwise approach to procedural migraine management.</p>","PeriodicalId":524150,"journal":{"name":"The Israel Medical Association journal : IMAJ","volume":"28 10","pages":"652-656"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multidisciplinary Operational Leadership and Proactive Risk Management for Safe Hospital Relocation During Operation Roaring Lion.","authors":"Tamar Etzioni, Adi Kibari, Vitali Yurin, Eliad Modiano, Liat Bergman-Raskin, Ahuva Tal, Avi Goldberg","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>During Operation Roaring Lion, Carmel Medical Center, a 500-bed tertiary hospital, relocated nearly half of its inpatient activity to the fortified underground facility of Rambam Health Care Campus while maintaining independent clinical and managerial responsibility. Returning patients after hostilities subsided represented a complex organizational transition requiring preservation of patient safety and continuity of care.</p><p><strong>Objectives: </strong>To describe a multidisciplinary operational leadership model and evaluate the use of failure mode and effects analysis (FMEA) to support safe wartime hospital relocation.</p><p><strong>Methods: </strong>A prospective quality improvement study used multidisciplinary FMEA before patient relocation. The relocation pathway was divided into four phases, and potential failure modes were scored by severity, occurrence, and detectability to prioritize mitigation strategies. Interventions included centralized command, real-time patient tracking, structured clinical handoffs, standardized transfer checklists, medication reconciliation, risk stratification, and enhanced post-transfer monitoring. Outcomes included patient safety events, falls, resuscitation events, unplanned intensive care unit (ICU) admissions within 24 hours, multidrug-resistant organism (MDRO) cross-transmission, and departmental feedback.</p><p><strong>Results: </strong>During 55 days of wartime activity, 843 patients were hospitalized in the underground facility. In total, 84 medically complex patients were relocated in three operational waves. The highest-risk domains involved communication, documentation, operational coordination, staffing, and clinical monitoring. No predefined patient safety events, falls, resuscitation events, unplanned ICU admissions within 24 hours, or documented MDRO cross-transmission were identified. Department leaders reported high organizational preparedness and improved operational control.</p><p><strong>Conclusions: </strong>A multidisciplinary operational leadership model integrating proactive FMEA enabled coordinated management of clinical, informational, operational, and infection-related risks during complex wartime hospital relocation.</p>","PeriodicalId":524150,"journal":{"name":"The Israel Medical Association journal : IMAJ","volume":"28 10","pages":"623-627"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expanding Treatment Landscape for Inborn Errors of Immunity.","authors":"Erez Rechavi","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":524150,"journal":{"name":"The Israel Medical Association journal : IMAJ","volume":"28 10","pages":"617-622"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Diabetic Foot Ulcer Treatment and Possible Ways for Improvement: A Retrospective Cohort Study.","authors":"Maxim Gurevich, Oleg Udovichenko, Noraden Kabha, Loai Takrori, Merav Ben Natan, Eyal Behrbalk","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Diabetic foot (DF) is a dangerous complication of diabetes mellitus (DM). Modern treatment modalities and good organization of care can improve prognosis.</p><p><strong>Objectives: </strong>To analyze results of DF treatment in a tertiary care setting and the degree of implementation of international guidelines in practice.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 90 patients treated for DF ulcers/wounds in our center (May-December 2023). Thirty-five patients received only outpatient care. The median age was 65 (37-90) years, 96% had type 2 DM.</p><p><strong>Results: </strong>Median wound duration was 29 (1-1461) days. Previous treatment was conducted by a family doctor in 30%, at a local wound clinic in 7%, by other medical specialists in 27%, or by the patient/relatives in 29%. At this stage off-loading devices were prescribed for 37%, and 35% were referred to a vascular surgeon. Limb ischemia occurred in 44 patients (49%), revascularization was conducted for 16 patients. At 6 months, healing rates were 48%. Minor or major amputation rates were 4% and 5%, respectively; 6% died, 29% stayed unhealed, and 8% were lost to follow-up. Multivariable analysis revealed independent predictors of non-healing (ethnic group and impossibility of revascularization) and of amputation (previous major amputation, presence of osteomyelitis, and white blood cell count).</p><p><strong>Conclusions: </strong>To prevent diabetes-related amputations, healthcare professionals must prioritize preventive care, provide regular podiatry services for high-risk patients, ensure early specialist treatment for any foot ulcer, implement international guidelines at all levels of DF care, and increase the capacity of secondary wound clinics and access to revascularization.</p>","PeriodicalId":524150,"journal":{"name":"The Israel Medical Association journal : IMAJ","volume":"28 10","pages":"640-645"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}