Harefuah最新文献

Introduction: During the first waves of COVID-19 in 2020, the public was confined to their homes due to closure instructions that applied to gatherings, celebrations, and restaurants, as well as voluntary self-isolation for fear of contagion. This seclusion affected, among other things, pre-hospital emergency medical services (EMS), which experienced a general decrease in their activity for trauma cases and routine medical problems. Other immediate life-saving events are cases of anaphylaxis. The change in public behavior may have led to a change in the scope of acute anaphylaxis attacks.

Objectives: The purpose of this study is to determine if there was a change in the number of pre-hospital EMS calls for anaphylaxis and pre-hospital EpiPen use during the period of COVID-19.

Methods: A retrospective comparative study evaluated data for "anaphylaxis" cases diagnosed by EMS between 2019 (pre-epidemic period) versus 2020 (epidemic period). The information analyzed included age and use of an EpiPen. All data were obtained from the control and control system used by Magen David Adom (MDA) - Israel's National Pre-hospital Emergency Medical Services System.

Results: During the study period, there were a total of 4,089 emergency responses to anaphylaxis with a negligible difference in the volume of EMS visits from 2019 to 2020. In contrast, there was a significant increase in the frequency of visits where an EpiPen was used between 2019, 5.7%, and 2020, 7.5% (p = 0.02). Age was not found to be a significant variable in this analysis (p=0.15).

Conclusions: This study shows that, unlike many other medical emergencies where there was a decrease in the response of EMS during the period of the first waves in 2020, the number of calls for anaphylaxis remained similar. However, there was a statistically significant increase in EMS responses requiring the use of an EpiPen during the pandemic. These results raise the need for follow-up studies about the behavior of the population suffering from allergies during epidemics and periods of crisis and the need for increased awareness to save lives during these times.

Introduction: The inter-relationship between botany, medicine and horticulture started long before the 20th century, but it became an important modality during World War 1. Horticulture became an essential part of the multi-disciplinary approach to the treatment of patients and disabled people with physical or mental problems. It enhances calmness, and enjoyment together with other modalities like music and art therapies, therapy with animals and more.

Introduction: Soft sonographic markers, such as an intracardiac echogenic focus, are demonstrated in one out of 150 live births and are associated with a slightly increased risk of trisomy 21 and 18. In the case of an isolated soft marker, the recommendation to perform invasive tests such as amniocentesis or placental cyst testing depends to a large extent on the results of biochemical first and second trimester maternal serum screening. In the case of two soft markers, the women are referred to genetic counseling, and invasive testing is funded by the Ministry of Health.

Objectives: To estimate the risk for clinically significant copy number variants (CNVs) in pregnancies with two soft markers.

Methods: This retrospective cohort study included all prenatal microarray tests performed during 2013-2021, due to demonstration of two soft markers (namely: echogenic intracardiac foci, choroid plexus cyst, single umbilical artery and mild pyelectasis). The rates of clinically significant (pathogenic and likely pathogenic) microarray findings were compared to a previously published cohort of 7235 pregnancies with normal ultrasound, in which 87 (1.2%) abnormal CNVs were noted.

Results: Of the 150 pregnancies with two soft markers, two (1.3%) clinically significant CNVs were found. The rate of abnormal microarray findings did not differ from baseline risk in pregnancies with normal ultrasound - relative risk of 1.11 (95% confidence interval 0.28-4.40).

Conclusions: The risk for abnormal microarray findings in pregnancies with two soft markers was not significantly increased in comparison to control group of pregnancies with normal sonography.

Discussion: These results undermine the current national policy of genetic counseling and Ministry of Health-funded invasive testing in pregnancies with a combination of two soft markers. These findings are important for additional countries with similar management, and may facilitate the genetic counseling and informed decision-making in such cases.

Introduction: The article, which focuses only on the prevention of the sperm and/or the frozen embryo mix-up, will begin by elaborating on the acute need to prevent the next gamete and zygote mix-up scenario. Afterwards, it will explore the practical methods already existing and the technologies. The main chapter will suggest the possible artificial intelligence technologies in the narrow field of artificial insemination for achieving that goal.

Introduction: The change in the world of medicine and in the future generation of doctors, also requires the world of medical education and training to change, so that we do not find ourselves extinct like the dinosaurs. As Charles Darwin famously once said, "It is not the strongest of the species that survive, nor the most intelligent, but the one most adaptable to change".

Introduction: Upper gastrointestinal (UGI) symptoms are very common in the general adult population. Dysphagia, heartburn, regurgitation and non-cardiac chest pain are the most common signs. The clinical approach in managing these symptoms starts with upper GI endoscopy in order to exclude inflammatory, neoplastic and fibrotic disorders that involve the esophagus. Upper GI endoscopy is mandatory especially when alarm signs exist. In patients with no structural abnormalities, physiological testing might aid to better understand the origin of the symptoms and to improve management.

Introduction: Sperm banks have shifted from assisting heterosexual couples with male infertility to primarily serving single women and female couples through medical services, reflecting advances in fertility treatments and societal changes.

Aims: Evaluate demographic changes among single women who have applied for sperm donation during 30 years in the State of Israel.

Methods: This retrospective cohort study includes 4265 single women who received sperm donation between January 1992 and December 2021, at a tertiary medical center. We divided the follow-up period into 6 groups of 5 years each. A comparison was made of the demographic characteristics of single women applying for sperm donation in different periods according to: 1) age at the beginning of the treatment; 2) ethnic origin - 7 ethnic groups.

Results: The average age of single women who received sperm donation was 38.2±4.4 years. The average age of patients decreased from 39.58 years in 1997-1992 to 38.08 years in 2017-2021 (p-value<0.05). Ashkenazic Jews (38.4%) and Sephardic Jews (37.7%) were the most common ethnic origins among single women, with Arab women comprising only 0.2%. Single Jewish women of Ashkenazi descent seek sperm donation treatment almost a year earlier than their Sephardic counterparts (Arab countries and North Africa).

Conclusions: Single Israeli women opting for early sperm donation carries significant clinical, social, and economic implications. Women from conservative social backgrounds appear to be less inclined to seek sperm donation as single individuals or tend to delay this option until a later age, in contrast to women from liberal backgrounds.

Introduction: Weight stigma, or weight bias, refers to biased beliefs and negative opinions towards people with excess weight. This phenomenon manifests in prejudice and negative attitudes towards people with obesity, including disrespectful treatment, bullying, discrimination and even abuse, and leading to long-term negative consequences on physical and mental health. The purpose of the current review was to examine the relationship between gender and manifestations of weight stigma. Studies listed in this review show that the phenomenon of weight stigma is more common and severe among women, in numerous life areas, which include education, employment, the healthcare system, social media, sports industry, and interpersonal relationships. Possible reasons for such differences include the existing discrimination against women in various areas of life, and the emphasis on external appearance and the ideal of thinness, which relates mainly to women. In light of the serious consequences of weight stigma on public health and individual well-being, efforts must be made to prevent weight stigma, including the education of the general population, changing policies of healthcare, education and media systems, and legislation to prevent weight-based discrimination.

Introduction: Fibromyalgia syndrome (FMS) is a chronic pain syndrome, prevalent in women more than men. The main symptoms are widespread musculoskeletal pain, fatigue, and weakness. To date, the pathophysiological mechanisms are unclear, and there are several pathogenic theories elucidating this condition. In this review, we summarized articles published in the past few years, regarding the effect of musculoskeletal dysfunction on FMS. We focused on the musculoskeletal system and central nervous system (CNS) disarrays.

Introduction: We report on cases of isolated fourth extensor compartment tenosynovitis without evidence of systemic inflammation that occurred in the context of alteration in the work environment due to the COVID-19 epidemic. Early identification of the deleterious effects of virtual/technologically-dependent work from home can aid in treatment and prevention of these conditions. We describe the phenomenon and suggest a treatment approach.