חדשות המחקר
Khalaf Kridin: Autoimmune pre-disease (Autoimmun Rev)
Approximately 5% of the world-wide population is affected by autoimmune diseases. Overall, autoimmune diseases are still difficult to treat, impose a high burden on patients, and have a significant economic impact. Like other complex diseases, e.g., cancer, autoimmune diseases develop over several years. Decisive steps in the development of autoimmune diseases are (i) the development of autoantigen-specific lymphocytes and (often) autoantibodies and (ii) potentially clinical disease manifestation at a later stage. However, not all healthy individuals with autoantibodies develop disease manifestations. Identifying autoantibody-positive healthy individuals and monitoring and inhibiting their switch to inflammatory autoimmune disease conditions are currently in their infancy.
Edo Y Birati: Trends in Veno-Arterial Extracorporeal Life Support With and Without an Impella or Intra-Aortic Balloon Pump for Cardiogenic Shock (J Am Heart Assoc . )
Background Mechanical circulatory support devices, such as the intra-aortic balloon pump (IABP) and Impella, are often used in patients on veno-arterial extracorporeal life support (VA-ECLS) with cardiogenic shock despite limited supporting clinical trial data. Methods and Results Hospitalizations for cardiogenic shock from 2016 to 2018 were identified from the National Inpatient Sample. Trends in the use of VA-ECLS with and without an IABP or Impella were assessed semiannually....
Johnny S Younis: Endometriosis-Associated Ovarian Cancer: What Are the Implications for Women with Intact Endometrioma Planning for a Future Pregnancy? A Reproductive Clinical Outlook (Biomolecules . )
Endometriosis is a chronic, universal, and prevalent disease estimated to affect up to 1:10 women of reproductive age. Endometriosis-associated ovarian cancer (EAOC) developing at reproductive age is challenging and of concern for women and practitioners alike. This outlook review focuses on the occurrence of EAOC, especially in infertile women or those planning for a future pregnancy, from the perspective of a reproductive endocrinologist, based on recent evidence.
Gassan Moady, Shaul Atar: Ventricular Assist Devices: Challenges of the One-device Era (Card Fail Rev .)
Heart failure (HF) is linked to to high mortality rates and recurrent hospitalisations despite medical and device-based achievements. The use of left ventricular assist devices (LVADs) has improved survival among patients with advanced HF. Significant progress has been achieved with the new generation of continuous-flow devices, particularly with the fully magnetically levitated HeartMate 3. In June 2021, Medtronic announced the abrupt withdrawal of the HeartWare device from the market. This decision has introduced a new era in which the field of mechanical support for advanced HF patients is dominated by a single device - the HeartMate 3. The direct clinical and economic consequences of this change will necessitate new surgical considerations. Because of the expected need for HeartWare device replacement in small patients, new surgical techniques and device adaptation will be needed. The new single-device era will hopefully encourage scientists and engineers to create innovations in the advanced HF arena. Special considerations should be taken during the COVID-19 pandemic when treating patients with LVADs.
Liza Grosman-Rimon, Shachar Yehezkeel, Sagi Gleitman, Erez Kachel:Predictors of prolonged hospitalization in modified sternoplasty following postoperative mediastinitis (J Card Surg . )
Deep sternal wound infection (DSWI) is a serious complication following cardiac surgery, and demands early intervention as any delay in diagnosis and management may lead to increased morbidity and mortality. DSWI is associated with increased length of hospitalization (LOH) and economic burden in this patient population. The aim of this study was to determine predictors for increased length of hospitalization in patients who underwent the Modified Sternoplasty technique for deep sternal wound infection following cardiac surgery.
Hilel Frankenthal: Validation of the Algorithmic Prediction of Failure Modes in Health Care Methodology: Applied to the Department of Sterile Supply and Equipment (Am J Med Qual . )
Failure mode and effect analysis (FMEA) is a leading tool for risk management in health care. The term "blanket" approach FMEA describes a comprehensive simultaneous look at the variety of interrelated factors that may directly and indirectly affect patient safety. Applying FMEA with the "blanket" approach is not common, due to FMEA's limitations. Algorithmic prediction of failure modes in health care (APFMH) is leaner and enables the application of the "blanket" approach, but, like FMEA, it lacks formal validation. The authors set out to validate the APFMH method while applying a "blanket" approach.
Ala Aiob, Raneen Abu Shqara, Susana Mustafa Mikhail, Avishalom Sharon, Marwan Odeh, Lior Lowenstein: The impact of the COVID-19 pandemic on ectopic pregnancy presentation and treatment: A retrospective cohort study (J Gynecol Obstet Hum Reprod . )
We examined ectopic pregnancy (EP) incidence, presentation and management, before and during the COVID-19 pandemic, and following initiation of vaccination against COVID-19.
David Azoulay, Galia Stemer: Brain-Derived Neurotrophic Factor (BDNF) Is Associated with Platelet Activity and Bleeding Tendency in Patients with Gaucher Disease (Int J Mol Sci . )
Bleeding tendency, a prominent feature of patients with Gaucher disease (GD), is associated with abnormal platelet function. Brain-derived neurotrophic factor (BDNF) is a protein with neuroprotective potential stored in alpha granules of circulating platelets. Here we studied BDNF levels in 50 patients with type I GD (GD1) and their correlation with platelet activity and bleeding tendency.
Avi Benov: Isolated limb fractures - the underestimated injury in the Israeli Defence Forces (IDF) (Injury . )
Musculoskeletal injuries dominate warfare-related trauma and differ from civilian settings in higher hospitalization costs, morbidity, and mortality. Partly due to introduction of personal protective equipment in the Israel Defence Force (IDF) to minimize head and torso injuries while the extremities remained unprotected. This study describes military extremity injury patterns, prehospital treatment and injury sequela regarding return-to-duty and disability compensation.
Johnny S Younis: What is the recommended management of a young woman with an intact endometrioma desiring future fertility? (Front Endocrinol (Lausanne) . )
Endometriosis is a common, chronic, and inflammatory illness, with endometrioma a distinct advanced and progressive manifestation of the disease associated with reproductive dysfunction, infertility, and the need for ART treatment. Endometrioma is the most frequently diagnosed form of the disease, identified in up to 44% of affected women. However, the temporal management of endometriomas in women wishing to conceive or relative to ART treatment is not standardized, with surgery frequently advised pre-conceptually and before IVF treatment. Despite recent guidelines suggesting that clinicians may consider laparoscopy to treat infertility, routine endometrioma removal before ART is not indicated. Reevaluation of this practice within a critical framework that addresses the impact of endometrioma on ovarian reserve and whether its removal is beneficial in terms of fecundity and efficacy of ART treatment is, therefore, timely. This commentary explores recent evidence in a pragmatic question-driven approach and proposes a suggested clinical management strategy.
Ohad Ronen: Pathogenesis, diagnosis and therapy of facial synkinesis: A systematic review and clinical practice recommendations by the international head and neck scientific group (Front Neurol . )
Post-paralytic facial synkinesis after facial nerve injury produces functional disabilities and mimetic deficits, but also cosmetic and non-motor psychosocial impairments for the patients. These patients typically have a high and continuous high motivation for rehabilitation. The aim is to inform the affected patients and their therapeutic professionals (otorhinolaryngologist - head and neck surgeons; oral-maxillofacial surgeons, plastic and reconstructive surgeons, neurosurgeons, neurologists, and mime therapists be it speech and language therapy- or physiotherapy-based) and to provide practical recommendations for diagnostics and a stepwise systematic treatment approach of facial synkinesis.
William Nseir, Lior Masika, Raymond Farah: Impact of Prior Statin Therapy on 1-year Recurrence and Length of Hospitalization for Acute Idiopathic Pericarditis (Isr Med Assoc J .)
Statins have anti-inflammatory effects that are independent of their lipid-lowering activity. Objectives: To examine whether prior statins therapy affects the clinical course of the first episode of acute idiopathic pericarditis (AIP) as the 1-year recurrence and length of hospitalization (LOH).
Raymond Farah, Nicola Makhoul, Alexander Samohvalov, William Nseir: Plasma Glycated Hemoglobin A1c Could Predict 30-Day All-cause Mortality of Intensive Care Unit Patients with Hyperglycemia (Isr Med Assoc J .)
An increased serum glucose level is a common finding among patients admitted to hospital with acute illness, including the intensive care unit (ICU), even without a history of previous diabetes mellitus (DM). Glycated hemoglobin (HbA1c) is not only a diagnostic tool for DM but may also has prognostic value for diabetic and non-diabetic populations.
To assess the relationship between HbA1c level on admission and clinical outcome among patients admitted to the ICU due to cardiopulmonary disorders with hyperglycemia.
Maamoun Basheer, Elias Saad, Faris Milhem, Dmitry Budman, Nimer Assy: Regen-COV-2 Antibody Cocktail Mediated Clearance of SARS-COV-2 in an Immunocompromised Patient (Isr Med Assoc J .)
Coronavirus disease 2019 (COVID-19) affects different people in different ways. Most infected people develop mild to moderate illness and recover without hospitalization. This case report presents a patient who had difficulty eradicating the corona virus due to being treated with rituximab, which depletes B lymphocytes and therefore disables the production of neutralizing antibodies.
Samih Badarny: Management of advanced Parkinson's disease in Israel: Clinicians viewpoint and action items (Front Aging Neurosci . )
Parkinson's disease (PD) is taking a staggering toll on healthcare systems worldwide, with the bulk of the expenditures invested in the late stages of the disease. Considering the rising life expectancy and the increasing prevalence of PD across the globe, a clear understanding of the early signs and treatment options available for advanced PD (APD), will facilitate tailoring management programs and support services. This task is complicated by the lack of both global consensus in defining APD and standardized care guidelines. This perspective prepared by a panel of movement disorder specialists, proposes to extend and optimize currently accepted PD coding to better reflect the diverse disease manifestations, with emphasis on non-motor features.