Harefuah最新文献

Introduction: Lacertus syndrome is a relatively rare condition that occurs because of median nerve compression at the elbow. Despite its low prevalence, it is important for healthcare professionals to be aware of this condition and its potential symptoms to provide timely and accurate diagnosis and treatment. This review provides a comprehensive overview of lacertus syndrome, including its anatomy and physiology, symptoms, and challenges of diagnosis. In particular, the article highlights the potential for misdiagnosis as carpal tunnel syndrome or other conditions that affect the median nerve and provides guidance on the physical exam and other diagnostic tests that can be used to confirm the diagnosis. The available treatment options for lacertus syndrome are also discussed, including conservative measures such as rest, activity modification and physical therapy, as well as more invasive options such as surgery. Finally, the article concludes with recommendations for future research and practice in the area of lacertus syndrome, highlighting the need for continued education and awareness among healthcare professionals.

Introduction: A 72 YEARS OLD WOMAN WITH A BEADED NECKLACE ON HER NECK.

Introduction: This case series demonstrates the combination of topical 0.05% atropine, wearing a peripheral defocus (MF60) contact lens, and increased outdoor activity during daylight hours to treat myopia's rapid progression in three children. It includes two boys and one girl with an average age of 12.5±0.5 years with spherical equivalent (SE) of -4.06±0.35 diopters (D) and an average axial length (AL) of 25.11±0.49 mm at the beginning of treatment. All children exhibited myopia progression the year before treatment, averaging 1.29±0.13- D SE. The children had not previously undergone myopia management treatment. Due to this rapid progression, a combination of daily instillation of 0.05% atropine and wearing a daily disposable soft contact lens of a unique design was initiated. Cycloplegic refraction was checked, and a slit-lamp examination was conducted every six months. The children's 8-item Contact Lens Dry Eye Questionnaire (CLDEQ-8) score was 19.33±2.52. Over a year, the average myopia progression decreased to -0.34±0.12 diopters, and the average AL growth was 0.16±0.10 mm. This case series reports successful combined treatment for the rapid progression of myopia and a mini-review of the medical literature on the subject.

Introduction: Rosacea is a chronic inflammatory skin disease that affects mostly the facial skin. Possible symptoms include redness, papules, pustules, and changes in the nose and eyes. The cause is unknown, but may be related to diet, alcoholic drinks, demodicosis and more. Some patients seek alternatives to conventional treatments and turn to traditional Chinese medicine, which provides a holistic and alternative approach that includes treatment with medicinal herbs, acupuncture, and more.

Objectives: This article presents a 50-year-old patient suffering from severe rosacea for the past three years, without improvement using conventional treatments. The patient was then treated with Chinese medicine, resulting in significant improvement.

Conclusions: Integrating Chinese medicine into modern medical treatment can help improve the condition of rosacea patients. Further research is needed to establish evidence and prove efficacy, to allow the integration of these tools into guidelines and daily treatment.

Discussion: Rosacea patients turn to complementary therapies due to dissatisfaction and lack of progress with conventional treatments. These patients have explored various treatment paths, including complementary medicine, particularly Traditional Chinese Medicine. Insights from recent studies indicate an improvement in the condition and quality of life of rosacea patients in response to these treatments, compared to both placebo and, in some cases, even modern treatments. The trend of using these complementary therapies requires a broader understanding and evidence-based guidelines, as these treatments are considered relatively safe with minimal side effects and good tolerability.

Introduction: STARVING OUR HOSTAGES IN HAMAS CAPTIVITY.

Introduction: Infection with the intracellular parasite Toxoplasma gondii is a common worldwide infection and is often asymptomatic. A unique risk group that requires identification of such infection is fetuses, and the earlier the infection, the more severe the damage. As pregnancy progresses, the risk of fetal infection increases. The parasite causes inflammatory processes in the placenta, fetal brain, eyes, and heart. The range of damage includes miscarriages, neurological and psychiatric disorders, hearing impairment, visual impairment, and cardiovascular disorders. In order to reduce the incidence of toxoplasmosis in children, awareness and preventive measures are required. Primary prevention is carried out by hand hygiene and avoiding certain foods. Secondary prevention is carried out by early detection through serological screening tests, and tertiary prevention is carried out by early treatment of mothers who have been infected with the parasite, or by testing newborns, who may be asymptomatic at birth but can still develop serious illness. It has been found that in Israel, the relative rate of severe clinical manifestations in children is higher than in European countries. The combination of risk groups, the lack of screening tests for pregnant women, and the lack of appropriate treatment can explain this observation. The aim of this review is to raise awareness of congenital toxoplasmosis and the possibilities of prevention and reduction of harm to fetuses and children. It also provides up-to-date information and recommendations for policy change.

Introduction: Obesity is a feature affecting nearly all life aspects. As the burden of obesity is increasing steadily, it leads to the increasing prevalence of diabetes, and most other common non-communicable diseases. A comprehensive approach for the prevention of obesity appears to constitute the most effective intervention to reduce their prevalence worldwide. In this review, we highlight pregnancy as a key period in a woman's life, which can improve compliance with different types of diet, physical activity, and behavioural programs, affecting the next generation's health, and breaking the vicious cycle of family obesity.

Introduction: Plantar Fasciitis is a common reason for heel pain. The pain caused by structural changes in the plantar fascia aponeurosis insertion to the calcaneus bone. Risk factors include obesity, prolonged standing, dorsiflexion limited range of motion, excessive running, and pes planus or pes cavus. Diagnosis is based on the patient's history and physical examination. The patient will complain of heel pain during their first steps after sleep or prolonged rest, palpation will provoke pain on the plantar medial aspect of the calcaneus. Physicians rarely use imaging to verify the diagnosis. The use of imaging may take place in cases of intractable pain regardless of conservative treatment in order to eliminate different causes for heel pain. Conservative treatment is effective for over 90% of the patients. Patients with plantar fasciitis chronic pain for over 6 mounts may consider a Pain Clinic or planter fasciotomy surgery.

Introduction: Ehlers-Danlos Syndrome (EDS) encompasses a spectrum of inherited disorders, characterized by joint hypermobility, skin hyperextensibility, and other features. In some patients, EDS involves the vascular walls, posing a significant clinical challenge due to the resultant propensity for rupture with hemorrhagic complications. Such complications, among others that often occur with EDS, may carry particular importance in the context of pregnancy and labor. This paper presents a patient diagnosed with Ehlers-Danlos Syndrome during her first pregnancy. The patient was planned for elective Cesarean delivery and expressed an interest in regional anesthesia. A literature review was conducted to identify similar cases in which the anesthesia techniques and their potential complications were described, as well as additional risks for EDS patients associated with various anesthesia methods. The review identified only low-quality data, which suggested a higher pain threshold in patients with EDS and an increased risk of bleeding. This case was used to assess the ability of ChatGPT to present a literature review based on reliable sources when the evidence is sparse. The model generated a well-worded response using correct medical terminology, but the report was superficial and provided no data to support clinical decision-making. The model also suggested a different anesthetic approach than the human-generated literature review and supported its findings with links to cited sources. These sources were examined, and concerns regarding their reliability were raised. Lack of reliability remains a major challenge for developers and users of large language models. Fine-tuning (i.e. training the model with examples relevant to specific tasks) which may enhance model output accuracy is discussed in this context.

Introduction: Israel's public funding policy for in vitro fertilization (IVF) is unique globally, with only minor restrictions. In late 2017, a program was launched to shift IVF treatments from private to public funding in an attempt to reduce waiting times, allowing IVF treatment in both public and private centers within the health basket.

Objectives: The study aimed to analyze the impact of this program on IVF treatment outcomes using data from the Clalit-Dan district.

Methods: Data from the Clalit-Dan District Health Insurance Fund (2014-2021) were analyzed, comparing IVF outcomes cumulative live birth rates (using Kaplan-Meier curves) in public and private centers.

Results: Between the years 2014 and 2021, 14,509 IVF treatment cycles were performed within the health basket in the Dan District. After implementing the 2017 aforementioned programe, IVF cycles in private centers increased, with no change in public centers. Live birth rates were slightly higher in public centers compared to private centers (10.02% vs. 9.04%), but without statistical significance (p=0.13). A noticeable decline in live birth rates was observed after 2018, especially in fresh cycles. No significant differences were found between public and private centers for women aged 20-39 years, but for those aged 40-45 years, public centers had significantly higher live birth rates, particularly in fresh cycles.

Conclusions: The 2017 program to shift IVF activity from private to public funding increased the burden on private centers and led to a decline in live birth rates, particularly for women over 40 years of age. The Ministry of Health, being entrusted, among other things, with the supervision and control of the IVF units in Israel, must examine and provide an adequate response to the issues raised above.