Harefuah最新文献

Introduction: Medical schools rely on tests for the applicants' academic and nonacademic attributes to select students. The former is based on evidence that students with top past academic achievements outperform other students during the clerkship rotations. Testing for nonacademic attributes responds to the expectation that those selected will perform better as physicians than those chosen by academic standards alone. However, even if nonacademic attributes do contribute to identifying applicants with improved later performance, I believe that their use should be re-examined for two reasons. First, applicants rejected because of poor past academic achievements would understand why they were not admitted. Not so those who "fail" nonacademic tests: their rejection may affect their self-esteem. I am concerned that my profession, guided by the principle of "do no harm," does not consider the harm of admission processes that purport to select virtuous applicants. Second, society needs not only clinicians but also physicians with other subspecialties that require different qualities: compassion is important for people-oriented professions, but less so for technology-oriented professions. Therefore, the selection of medical students that is solely based on their past academic performance would be not only less expensive, but also more responsive to societal needs, and more consistent with the ethical requirement to not harm.

Introduction: Radial head fractures are a common injury of the elbow joint usually occurring after a fall onto an outstretched hand ("FOOSH"). These fractures comprise 30% of all the fractures of the elbow joint in adults and 11% of proximal radius fractures in children. Clinically, these patients present with elbow tenderness and swelling with bruising and pain in pronation and supination. These fractures are usually accompanied by associated injuries such as scaphoid fractures, distal radio-ulnar joint injuries, coronoid process fractures and ligamentous injuries. Diagnosis and classification are based on X-ray radiographs. The radiographic inquiry should include arm and wrist views in order to promptly identify associated injuries, which impact the course of treatment.

Introduction: Lung cancer has been a global epidemic since 1950. It was estimated that during 2018, worldwide, there were about 2.07 million new cases and approximately 1.76 million cases of mortality. The mortality from lung cancer is higher than breast, prostate, colon cancer and leukemia combined. Cigarette smoking is the most preventable risk factor of lung cancer. Treatment modalities include surgery, chemotherapy, radiotherapy and immunological treatment. The tumor's genetics plays a major role in treatment. Desmoid is the most frequent abdominal wall tumor. Metastasis from distant origins to the abdominal wall (besides parietal peritoneum or port site metastasis) are very rare. In this article we report a patient who presented with rectus abdominis mass that was found to be the presenting symptom of metastatic lung adenocarcinoma. To the best of our knowledge, this is the first published case of metastasis to abdominal wall skeletal muscles as the presenting symptom of lung adenocarcinoma.

Introduction: Proliferation of monocytes (MO) occurs in reactive conditions as well as in myeloid neoplasm with clonal monocytosis such as chronic myelomonocytic leukemia (CMML). CMML is a type of clonal hematopoietic disease characterized by a sine qua non condition: sustained peripheral blood monocytosis (absolute monocytes count from ≥1 X109/L, to ≥0.5 X109/L with monocytes accounting for ≥10% of the peripheral white blood cells), accompanied by overlapping changes in bone marrow of myelodysplasia and myeloproliferation, <20% blasts and presence pf clonality. In CMML, there is an inherent risk for leukemic transformation (15% over 3-5 years). The French-American-British (FAB) co-operative group, created in 1976, proposed a uniform system of classification and nomenclature of hemato-oncologic malignancies. Classification of hematopoietic neoplasms is essential for making proper evidence-based treatment decisions and accurately assessing prognosis.

Introduction: The Importance of Cardio-Metabolic Fitness and the Role of Exercise Physiologist in Public Health.

Introduction: Full-length standing radiographs provide a comprehensive assessment of the alignment of the entire lower extremity, widely used for surgical planning. These radiographs are not available in most imaging institutes, and knee radiographs are usually performed only in a standing position.

Aims: Our work aims to evaluate the accuracy of measuring aLDFA (anatomic lateral distal femoral angle) on standard short AP X-rays compared to long-standing X-rays.

Methods: A retrospective study was conducted with 200 sets of radiographs. Each set included a full-length AP lower extremity and a short AP knee radiograph from each leg. Each radiograph was examined blindly by two observers. The aLDFA (lateral distal femoral angles) were measured.

Results: The mean age of subjects was 71.17 years (6.37SD), BMI 32.98 (6.53SD), females represented 74.5% of the patients. No significance was found between short and long X-ray films for aLDFA ( p=0.69), and no significance was seen comparing the left to the right leg (p=0.592). the observers' agreement level was high. We observed a small size effect of 0.04.

Conclusions: Full-length radiographs are non-superior for preoperative planning for kinematic alignment total knee arthroplasty (TKA) regarding aLDFA.

Discussion: Our study results support the hypothesis that no difference exists between short and full-length radiographs in the aLDFA measurements.

Introduction: In recent years, there has been a rapid increase in the number of joint replacement surgeries. This surge can be attributed to two primary factors. Firstly, the aging demographic of the population plays a significant role. Secondly, the substantial enhancements in surgical outcomes have contributed to the growing prevalence of these procedures. Over the past two decades, surgeons have incorporated robotic assistance into joint replacement surgeries. During this period, a substantial body of evidence has accumulated, endorsing the effectiveness of robotic joint replacement procedures in achieving favourable clinical and radiographic results. The continuous evolution of technology has led to the development of various robotic systems, each distinct in its features and underlying principles. These distinctions encompass the extent of robotic involvement in surgery, the compatibility of the robotic system with different implant types, and the specific imaging modalities required during pre-operative preparations. This review aims to provide an overview of the current literature pertaining to the diverse range of robotic systems in use. It includes a comparative analysis of clinical and radiographic outcomes achieved through robotic replacements and concludes by discussing the necessary adaptations and considerations in light of these findings.

Introduction: Naegleria fowleri is an amphizoic, thermophilic, flagellate amoeba, also known as the brain eating amoeba. It can survive in water, soil, and mostly in the human host's central nervous system. It thrives in fresh water and a hot climate. Naegleria fowleri causes infection in children as well as adults, following aspiration of fresh water into the nostrils. It causes a deadly infection called primary meningoencephalitis [PAM]. PAM is more common in developing countries; a few cases occurred in developed countries such as the USA, and even in Israel.

Introduction: Thoracolumbar compression fractures are common among the osteoporotic aging population, and a commonly accepted surgical treatment is kyphoplasty.

Aims: Our study aims to demonstrate the change in the known radiologic evaluation methods before and after the surgery.

Methods: A retrospective study, 54 patients with compression A1 fractures were included and evaluated for demographic data. Two observers independently collected data from preoperative, intra-operative, and postoperative lateral and AP radiographs. The collected data included middle vertebral height - MVH/U/D, percentage of middle height compression (PMHC), posterior vertebral height (PVH), anterior vertebral height (AVH), the width of the vertebra, calculated kyphotic angle (CKA), Kobb's and kyphotic angle.

Results: Mean age 71.3 years (11.53 SD), mean comorbidity score was 3.65 (2.0 SD), 80% were females (32), most frequent fractures were L1 and T12 (32% and 22%). Good inter-observer results were obtained in all the measurements between the two observers; 37.5 % of cases showed leakage in the postoperative films. There is a significant difference between before and after (M = 84.8, SD = 18.7), p < .001, the operation in the PMHC measurement.

Conclusions: Our study demonstrated significant improvements in many parameters, wWith great improvement in the PMHC ratio from 65% to 84%. Further studies with a greater sample of patients and patient-reported outcomes measures (PROMs) are needed to define the success of the surgery.

Introduction: The health system in Israel, and in particular the field of orthopedics, stands at the forefront of medical practice, and serves as a model of excellence, innovation, and boundless dedication. In recent years, we have experienced impressive technological and scientific advances that have brought about a real revolution in our ability to treat complex situations and improve the quality of life of our patients. The current issue of 'Harefuah' presents research and review articles that reflect the new technologies - from advanced imaging, robotics, smart implants, and innovative surgical approaches that allow us to achieve unprecedented precision, reduce risks, and significantly improve the results of treatment and rehabilitation.