After the Nazi regime seized power, the only place where Jewish medical students were allowed to conduct their practicum in Germany were the Jewish hospitals. To identify the Jewish students who, during summer 1933 and later, conducted their practicum and wrote their medical dissertations in the Jewish hospitals, and to identify their tutors. We examined the dissertations at the medical faculty of Berlin that were conducted from the summer of 1933 until the autumn 1937, identifying the students who did their practicum at Jewish hospitals and stood for the MD examination. In total, 29 Jewish students finished their medical practicum and wrote their dissertations either in the Jewish hospitals of Berlin or in other Jewish hospitals outside the capital city after April 1933. Only five of those studies were presented to the MD examination signed by their Jewish tutors. The remaining 24 works were submitted and signed by an Aryan professor. In 10 of those last studies, the names of the Jewish tutors could be uncovered. The Jewish hospitals of Berlin continued their academic activity even after being ejected from Berlin hospital's medical faculty body in April 1933. At that time most of the studies dealt with surgery and gynecology. In most cases the studies were submitted for the MD examination by proxy and signed by an Aryan professor.
Differences in socioeconomic status and ethnicity are linked to disparities in health outcomes, which can affect how consistently patients treat abnormal screening results and cause minority groups to be diagnosed at more advanced stages of disease. To compare epidemiological and clinical parameters between Jewish and Arab women who were diagnosed with cervical cancer at Ziv Medical Center during a 10-year period. We conducted a retrospective study of consecutive women diagnosed with cervical cancer at a single institution between 2014 and 2024. Overall, 83 women diagnosed with cervical cancer in the last 10 years at Ziv Medical Center were included in the study: 53 Jewish (64.6%), 30 Arab (36.2%). The groups were similar in mean age at diagnosis, body mass index, smoking status, Pap history performance prior to the diagnosis, menopause status at diagnosis, stage at diagnosis, and treatment. Arab women had higher parity (< 0.001). According to the results of our study, the percentage of cervical cancer patients undergoing Pap screening, prior to diagnosis from the Arab and Jewish sectors, were 16.7% and 17%, respectively, compared to the national screening rate of 54%. Most of the women were diagnosed at an advanced stage (≥ IIB): 83.3% and 69.8%, respectively, compared to 25% in developed countries. Jewish and Arab women diagnosed with cervical cancer in northern Israel do not differ in epidemiological and clinical parameters, including age at diagnosis and stage. These findings may be attributed to the low performance rate of Pap screening tests in both groups.
Inflammatory bowel disease (IBD) is a chronic relapsing condition affecting millions worldwide, often diagnosed during young adulthood and associated with significant functional impairment. The Israel Defense Forces (IDF) allows citizens with IBD and other chronic medical conditions to volunteer for military service through a special medical volunteer program. No comprehensive study has examined the impact of military service on disease progression or military performance. To evaluate the association between IBD and military service-related outcomes, including service completion and occupational stability, among IDF medical volunteers. In this retrospective study, we examined 734 volunteer soldiers with IBD who served in the IDF between 2019 and 2024. Data were collected from computerized medical records and included demographic, occupational, and medical information. Among 734 IBD volunteers, 96.7% successfully completed their military service. Male sex (odds ratio 3.73) and lower sick leave utilization (odds ratio 3.13) were key predictors of service completion in multivariable analysis. The findings suggest that the vast majority of IBD volunteers successfully completed military service, with male sex and lower sick leave utilization as predictors of completion. Given these outcomes, consideration should be given to including carefully selected IBD patients within the standard medical classification system, based on individualized assessment of disease stability and functional capacity, with a non-combat profile, rather than through the volunteer program.
The coronavirus disease 2019 (COVID-19) pandemic has disrupted healthcare systems globally, affecting chronic disease management like osteoporosis and the prevention of fragility hip fractures. We hypothesized that it led to suboptimal prevention of secondary femoral neck fractures, reduced treatment frequency, and delayed treatment initiation. To evaluate the treatment initiation rate for secondary prevention of femoral neck fractures, comparing pre-COVID-19, COVID-19, and post-COVID periods, considering patient demographics. This retrospective diagnostic cohort study used automated electronic medical records database from Clalit Health Services. Data regarding patients with hip fractures from January 2017 through September 2021 were extracted from the database. Treatment for osteoporosis included one of the following treatments: alendronate, risedronate, zoledronate, abaloparatide, denosumab, romosozumab, and teriparatide. The primary outcome variable in the study is the time taken to initiate appropriate therapy for the secondary prevention of femoral neck fractures. Treatment frequency decreased over time, with rates declining from 40.4% in 2019 to 33.5% in 2021 (P-value < 0.05). However, the percentage of prompt care management (within 3 months) increased between 2020 and 2021 (47.3%-62.5%) and between 2019 and 2021 (48.7%-62.5%), P < 0.05. The COVID-19 pandemic reduced the rate of appropriate treatment initiation following hip fractures. However, adherence to timely treatment within 3 months of the fracture has improved. The findings highlight the effectiveness of the health system response in managing crises and ensuring the timely delivery of critical treatment.
National crises can significantly impact healthcare utilization patterns yet analyses of different types of crises are limited. While the effects of the coronavirus disease 2019 (COVID-19) pandemic on emergency department (ED) utilization have been well-documented, the healthcare impact of the Israel-Hamas war, which began 7 October 2023, remains unexplored. To compare ED utilization patterns for non-traumatic low back pain (LBP) during two distinct national crises. We conducted a retrospective observational study analyzing ED visits for non-traumatic LBP at our medical center. We compared ED utilization patterns, visual analog scale (VAS) pain scores, and surgical rates during 60 days before and after two distinct dates: 7 October 2023 and 19 March 2020 (the start of the COVID-19 lockdown). Statistical analysis included independent t-tests for continuous variables and chi-square tests for categorical variables. Following 7 October, ED visits decreased by 28.6% (504 to 360). Mean VAS scores and surgery rates showed a non-significant increase from 5.5 ± 2.6 to 5.8 ± 2.4, and from 3.0% to 4.2%, respectively. During the COVID-19 lockdown, ED visits declined by 44.2%, with non-significant changes in pain scores (6.0 ± 3.0 to 5.5 ± 2.9) and surgical rates (3.5% to 2.5%). Both events led to significant reductions in ED utilization for non-traumatic LBP, despite the heightened risk factors. Surgical rates remained stable, yet many symptomatic patients may have foregone adequate care. These findings underscore the need for resilient, crisis-specific emergency preparedness strategies to ensure continued access to care.
Transcatheter aortic valve implantation (TAVI) has become the preferred therapeutic method for elderly patients presenting with severe symptomatic aortic stenosis (AS). Most TAVI procedures are performed in patients between 75-85 years of age. A few publications exist on TAVI in patients over 90 years, yet the outcome and complication rates are inconsistent. To identify all patients with AS who underwent TAVI between 2019 and 2020, specifically those age > 90 years at the time of the TAVI. We reviewed the Maccabi Healthcare Services database for all severe/critical AS patients who underwent TAVI between 2019 and 2020, specifically those age > 90 years at the time of TAVI. These patients were compared to all patients aged 80-89 years who underwent TAVI during the same time. Follow-up ended on 31 December 2022. We compared mortality and complications rates in nonagenarians vs. those 80-89 years and evaluated the change in left ventricular ejection fraction before and after the procedure. We identified 36 nonagenarians who underwent TAVI during the study period, mean age 92.3 years, male:female ratio 15:21. During a mean follow-up period of 3 years, 44% of nonagenarians died, 26% of the control patients died (P < 0.01). TAVI in nonagenarians is feasible. Total mortality during follow-up was significantly higher in nonagenarians. Overall complication rates were also higher in nonagenarians, mostly due to vascular complications. Left ventricular dysfunction appeared to improve after TAVI, even in nonagenarians.
Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) are established treatments for peritoneal metastasis from colorectal cancer (PM-CRC). The peritoneal carcinomatosis index (PCI) measures disease burden. To evaluate the effect of PCI on short- and long-term outcomes of patients with PM-CRC who underwent CRS-HIPEC. We retrospectively analyzed 120 PM-CRC patients who underwent CRS-HIPEC, categorizing them into four PCI groups (PCI ≤ 3, PCI 4-6, PCI 7-11, PCI >11). We evaluated perioperative outcomes and long-term survival. Higher PCI scores were associated with increased surgical complexity, longer operative times, more organ resections, and higher blood transfusion requirements. Complete cytoreduction was achieved in 100% of the PCI ≤ 3 group, but only in 70.8% of the PCI > 11 group (P = 0.001). Postoperative outcomes showed a trend toward less major morbidity in low PCI patients (16.7% vs. 28%) and significantly shorter hospital stays (10-13 days vs. 19 days, P = 0.006). The 90-day mortality rate was 0% in the PCI ≤ 3 group compared to 11.5% in the PCI > 11 group. Long-term outcomes revealed significantly better disease-free survival (DFS) and overall survival (OS) for the PCI ≤ 3 group (DFS: 22 months vs. 4-6 months; OS: 79.6 months vs. 21-40 months, P < 0.001). Patients with low PCI scores experience reduced morbidity and improved long-term survival, supporting the use of CRS-HIPEC in this subgroup. Further research is needed to enhance treatment strategies for patients with high PCI scores.
Coronavirus disease 2019 (COVID-19) causes severe complications in 15% of patients, many of whom are pregnant. Most infected women continue their pregnancies until term even though severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) replicates in the decidua. To assess the impact of SARS-CoV-2 infection remote from delivery on obstetric outcomes. Women diagnosed with SARS-CoV-2 infection confirmed by polymerase chain reaction at least 14 days prior to delivery were enrolled prospectively and followed monthly until delivery. Their obstetric outcomes were compared to those of women who gave birth at our center during the year preceding the pandemic. The primary endpoint was a composite of hypertensive disorders of pregnancy, oligohydramnios, and fetal distress or meconium-stained amniotic fluid during labor. Other demographic and obstetric variables were also recorded. The obstetric outcomes of 143 patients were compared to those of 3565 patients who gave birth during the year preceding the pandemic. The composite rate of placental complications was significantly higher in the study group (58 [41%] vs. 593 [17%], respectively), with an odds ratio of 3.4 (95% confidence interval 2.4-4.7). There was also an increased rate of labor induction or advancing the elective cesarean date in the study group (37 [26%] vs. 601 [17%]). No significant differences were found in the Apgar score, cord pH or gestational age at infection. The risk of placental complications remains greater in pregnant women infected with SARS-CoV-2 after acute illness resolution. Those patients should be monitored closely until delivery.
Postoperative atrial fibrillation (POAF) is well recognized after cardiac surgery; however, its incidence and clinical course following non-cardiac surgery (NCS) remain unclear. To evaluate the association between POAF after NCS, patient co-morbidities, and type of surgery. In this retrospective cohort study, patients who underwent NCS at a private hospital network between 2016 and 2023 were included. Patients with a history of atrial fibrillation (AF) were excluded. Patients who developed POAF within 24-48 hours were compared with those who did not. To address baseline differences, propensity score matching (1:10) and inverse probability weighting combined with Firth's penalized logistic regression were applied. Odds ratios with 95% confidence intervals were calculated. POAF developed in 174 patients within 24-48 hours postoperatively, compared with 391,329 controls. Older age, ischemic heart disease, diabetes, and prior stroke were associated with increased odds of POAF, although significance diminished after multivariable adjustment. Weighted regression confirmed these findings with narrower confidence intervals. Higher POAF risk was observed after laparoscopic pancreatectomy, hepatectomy, rectopexy, synovectomy, and gastrectomy. Total knee replacement was the most common procedure among POAF cases, representing 22% of cases and a fourfold increased risk. Advanced age and cardiovascular co-morbidities were associated with increased POAF risk after NCS, although attenuated after adjustment. Consistent findings across statistical models support the robustness of the results. Targeted monitoring in high-risk patients may improve postoperative outcomes.
Blast injuries impair hearing through several mechanisms that are distinct from other causes of acute acoustic trauma (AAT). To compare blast injured patients to those exposed to noise alone in their auditory response to hyperbaric oxygen (HBO) therapy with oral steroids. Adult patients with evidence of a previously undocumented ≥ 30 dB pure-tone threshold within 30 days of AAT were treated with a combination of one 2.5 atm HBO therapy session for 90 minutes daily with oral prednisone. Exposure was classified by history as blast (for explosion-induced AAT) or noise. The change in high pure tone average (HPTA) was the primary outcome. Of 598 ears (387 patients) included in the final analysis, 259 were exposed to blast and 339 to noise. Before treatment, the blast injured patients had significantly more abnormal findings on otoscopy (87% vs. 95%, P = 0.003), higher pure-tone average (18 ± 11 dB vs 12 ± 9 dB; P < 0.001), and higher speech reception thresholds (16 ± 14 dB vs 10 ± 8 dB, P < 0.001). Following treatment, these patients exhibited a significantly smaller improvement in HPTA (6 ± 17 dB vs 10 ± 14 dB P = 0.022) with pure tone thresholds remaining significantly worse across all frequencies in the blast exposed group (mean difference ranging from 3.2 to 6.8 dB, all P < 0.05). Blast injuries result in unique auditory characteristics and responses to HBO therapy compared to other causes of AAT.
Tunneled hemodialysis catheters are frequently used and are a major source of catheter-related bloodstream infections (CRBSI), which result in significant morbidity. To examine the adverse outcomes associated with CRBSIs, including hospitalization, recurrence, 1-year mortality, and catheter outcomes in a hemodialysis setting that uses modern preventive catheter-care practices. We conducted a retrospective cohort study of adults with jugular tunneled hemodialysis catheters who met criteria for CRBSI from 1 January 2015 to 31 December 2020 at a tertiary referral center. Of 380 hemodialysis patients, 75 experienced CRBSI events. The average rate was 1.55 CRBSIs per 100 patient months. The median time from catheter insertion to CRBSI was 179 days; and 68% required inpatient management. Gram-positive bacteria accounted for 53% of isolates, with Gram-negative organisms also being common. Recurrence occurred in 16% of cases and was independently associated with ferritin levels over 500 ng/ml (P = 0.02), albumin levels below 3.5 g/dl (P = 0.011), and uric acid levels under 2.5 mg/dl (P = 0.04). Catheters were removed in 61.3%, exchanged over a guidewire in 24%, and salvaged in 18.6%. The 1-year mortality rate was 28% and was associated with lower weight, catheter salvage, neutrophilia, hypoalbuminemia, and hypokalemia. Using chlorhexidine exit-site dressings was associated with fewer hospital admissions. Among hemodialysis patients with CRBSI, recurrence and mortality might be linked to a patient's nutritional and inflammatory status. Current preventive measures might reduce hospitalization rates, but in this cohort, they were not associated with lower recurrence or mortality rate.
Flumazenil has been available since 1991 for the treatment of acute benzodiazepine overdose, yet many physicians remain reluctant to use it. To evaluate the frequency of flumazenil use for benzodiazepine overdose at a large, urban, tertiary care center. To assess its effectiveness and associated adverse events. The study was conducted in an emergency department with approximately 220,000 annual visits. Medical records of patients who received a medical toxicology consultation and were treated with flumazenil between 1 January 2019, and 31 December 2023 were reviewed. Data collected included patient demographics, medical history, substances involved, presence of seizures, indications for flumazenil use, clinical response, and adverse effects. Of 263 patients evaluated for suspected benzodiazepine overdose and referred to medical toxicology, 79 received flumazenil and comprised the study cohort. Among them, 64 cases involved intentional overdose. Indications for flumazenil administration included severe overdose with impaired consciousness and ventilatory failure (37 patients) or without ventilatory failure (42 patients). Co-ingestion of tricyclic antidepressants was documented in 4 patients and other antidepressants or antipsychotics in 35. Clinical improvement, including enhanced consciousness and/or reduced need for mechanical ventilation, was observed in all 79 patients. No adverse effects, including seizures, were reported. In this retrospective cohort, flumazenil was administered without serious adverse events and was associated with improved alertness and ventilation. While caution is required, particularly in mixed overdoses, flumazenil may have a role in managing benzodiazepine-induced respiratory depression when guided by toxicology consultation.
Syndromic inborn errors of immunity (IEIs) are a heterogeneous group of disorders characterized by immune dysfunction associated with congenital anomalies and multisystem involvement. Tricho-hepato-enteric syndrome (THES) is an ultra-rare autosomal recessive syndromic IEI caused by biallelic pathogenic variants in TTC37 or SKIV2L. Delayed recognition is common because of its broad clinical spectrum. To describe the clinical, immunologic, genetic, and histopathologic characteristics of two children with THES and to highlight a structured diagnostic approach for syndromic immunodeficiencies. We retrospectively reviewed the clinical presentation, laboratory investigations, immune phenotyping, endoscopic and histopathologic findings, and molecular analyses of two unrelated children diagnosed with THES at a tertiary pediatric immunology center. Molecular confirmation was obtained by whole-exome sequencing. Both patients presented during early infancy with intractable diarrhea, severe failure to thrive, characteristic dysmorphic features, brittle woolly hair, and inflammatory enteropathy requiring prolonged nutritional support. Immunologic evaluation demonstrated immune dysregulation, including inverted CD4/CD8 ratios, abnormalities of humoral immunity, and impaired vaccine-specific antibody responses. Histopathology revealed chronic active colitis with crypt distortion, inflammatory infiltrates, and crypt abscesses, consistent with very-early-onset inflammatory bowel disease-like enteropathy. Whole-exome sequencing identified homozygous pathogenic variants in SKIV2L in one patient and TTC37 in the other, establishing the diagnosis. Management included nutritional support, immunoglobulin replacement, antimicrobial prophylaxis, and immunomodulatory therapy. Recognition of syndromic phenotype combined with comprehensive immune evaluation and early genomic testing facilitates prompt diagnosis, multidisciplinary management, genetic counseling, and consideration of emerging targeted therapies.
Co-infection with human immunodeficiency virus (HIV) and hepatitis C virus (HCV) affects approximately 2.2 million people globally and is associated with accelerated liver disease progression, increased morbidity, and reduced quality of life (QoL). While direct-acting antivirals (DAAs) have revolutionized HCV treatment with high cure rates, evidence of their long-term impact on liver-related QoL and associated metabolic or immunologic shifts in HIV/HCV co-infected populations remains limited. To evaluate the effect of achieving sustained virologic response (SVR) with DAAs on long-term QoL in HIV/HCV co-infected patients and to examine associated changes in CD4 count, kidney function, and glucose levels. This retrospective observational study was conducted at the Rambam Health Care Campus, between 2015 and 2019. We collected demographic, clinical, and laboratory data from all patients with HIV/HCV co-infection. QoL was evaluated for at least 6 months after the end of treatment. Metabolic variables were collected before and after treatment to test the effects of treatment. All 70 patients in the cohort achieved SVR. Successful treatment with DAAs resulted in a significant decrease in liver enzymes and globulin levels, and a substantial increase in CD4. A significant improvement in QoL after treatment was noticed in both sexes, regardless of liver fibrosis stage. FIB-4 calculations 6 months and 1 year after the end of therapy showed improved fibrosis levels after SVR. The use of DAAs in HCV/HIV co-infected patients has improved the long-term QoL, metabolic factors, and fibrosis stage.
Age is a well-established prognostic factor in civilian trauma, where adverse outcomes increase with ages. Whether this pattern holds true in military trauma, where populations, injury mechanisms, and systems of care differ fundamentally, remains uncertain. A large-scale mobilization of Israeli Defense Forces (IDF) reservists provided an opportunity to examine this association. To clarify whether older service members experienced less favorable outcomes compared with younger counterparts. This retrospective cohort study included IDF casualties recorded in the IDF Trauma Registry and the Israel National Trauma Registry between 27 October 2023 and 19 January 2025. Participants were categorized by age: 18-21 years, 22-39 years, and ≥ 40 years. Primary outcomes included 24-hour and 30-day mortality, intensive care unit admission (ICU), and hospitalization ≥ 7 days. Of 4905 casualties, 40.4% were 18-21 years of age, 54.2% were 22-39, and 5.4% were ≥ 40. Injury severity, evacuation times, pre-hospital interventions, and admission vital signs were similar across groups. Adjusted analyses showed no significant age-related differences in mortality, ICU admission, or prolonged hospitalization. Subgroup analysis of casualties with injury severity score ≥ 16 yielded comparable results. In this large military trauma cohort, no significant association was found between age and mortality, ICU admission, or prolonged hospitalization. These findings were observed in a generally healthy military population receiving organized trauma care and suggest that, within this context, chronological age alone may not be an appropriate criterion for determining reserve service eligibility.
Post-traumatic stress disorder (PTSD) remains a significant and often refractory mental health condition. Hyperbaric oxygen (HBO) therapy has demonstrated promise in alleviating symptoms of PTSD but optimal dosing and treatment duration remain unclear. To evaluate the clinical efficacy and dosing effects of two HBO protocols in patients with PTSD. We conducted a randomized controlled trial comparing two HBO protocols: 60 daily sessions of 90 minutes at either 2.0 atmospheres absolute (ATA) or 2.5 ATA (HBO15). Adults with severe PTSD (Clinician Administered PTSD Score [CAPS]-5 ≥ 33) were randomized to treatment arms. CAPS-5 scores were recorded every 2 weeks. Secondary outcomes include measures of depression, sleep, executive function, and safety. Preliminary results are presented for the first nine patients who completed therapy (HBO10: n=5; HBO15: n=4). Participants in HBO15 were younger (mean age 39 vs. 59 years, P = 0.2). Baseline PTSD severity (CAPS-5) was higher in HBO15 (median 61.5 vs. 48.0, P = 0.4). Other baseline psychological scores were similar between groups. Mean CAPS-5 improvement (ΔCAPS) was greater in HBO15 (-14.0 ± 21.2) vs. HBO10 (-5.3 ± 19.6), although not statistically significant (P = 0.8). Both groups demonstrated the largest symptom reduction by weeks 6-8, with a plateau observed thereafter despite continued treatment through week 12. Preliminary data suggest both HBO protocols are associated with symptomatic improvement in PTSD, with a trend toward greater effect in the higher-pressure group (2.5 ATA). Improvements appear to peak around 6-8 weeks, potentially indicating a shorter optimal treatment duration.
Exertional heat stroke (EHS) is common among individuals engaged in high-intensity physical activity. It can lead to long-term organ damage and be a life-threatening condition when diagnosed and treated incorrectly. To track the changes in biomarkers among EHS patients, to suggest a standardized protocol of clinically relevant biomarkers to be followed during hospitalization. We conducted a retrospective analysis on biomarker changes in seven EHS patients (aged 18-25 years) who were hospitalized for a minimum of 84 hours. Diagnosis of heat stroke was based on extreme body temperature and neurological deficits. Biomarkers indicative of kidney function, liver function, coagulation, muscle breakdown, and systemic inflammation during their hospitalization were analyzed. The initial average rectal temperature (Tre) was 41.1°C. Patients were cooled to approximately 38.5°C before being transferred to the emergency department (ED). Within the first 24-36 hours of hospitalization, biomarker levels reach peak levels depending on EHS severity. Renal biomarkers rose to 1.5-3 times normal values, while transaminases increased 7-15 times. Creatine phosphokinase, indicating muscle injury, reached an average of 100 times its reference range. Within 24-72 hours. all biomarker levels were normalized. There is often a gap between the initial temperature of an EHS patient and the temperature recorded at ED admission after cooling. Accurate assessment is context-specific and requires precise biomarker follow-up. Clinical evaluation should continue for at least 48 hours to track organ damage and guide prognosis.
Carbohydrate counting (CC), a recommended method for managing insulin bolus in patients with Type 1 diabetes mellitus (T1DM), depends on patient cognitive ability and motivation, and often does not account for ethnic foods. We have developed a simplified, accessible, patient-specific carbohydrate counting tool (SCC) to serve our very diverse population. To retrospectively evaluate the long-term efficacy of the SCC with an emphasis on patients with moderate to poor glycemic control. The SCC tool is tailored to each patient's insulin:carbohydrate ratio (I:C), insulin sensitivity (IS), and dietary pattern. It includes two tables written in the patient's preferred language. The first lists the units of insulin needed to correct pre-meal blood glucose to target glucose. The second contains a list of food items derived from participant's personal eating habits, carbohydrate content, and the number of insulin units needed. At a median follow-up period of 6 months, we examined the change in hemoglobin A1c (HbA1c) in 212 patients with T1DM who utilized the SCC. At follow-up, HbA1c in the study population decreased by 1.07% (22.43 mmol/mol) (95% confidence interval 0.8-1.3, P < 0.001). The variables sex and diabetes duration were nearly statistically significant in relation to the change in HbA1c levels (P = 0.059, P = 0.056). While not influenced by age, sex, ethnicity, socioeconomic status, education, insulin delivery method, duration of diabetes, or residence, the SCC tool is designed to help adult patients with T1DM with moderate to poor glycemic control.
Noise-induced hearing loss (NIHL) is a prevalent hearing impairment, second only to age-related hearing loss. A change in the listening habits of adolescents may have contributed to the documented increase of hearing impairments in that age group. To examine the prevalence of NIHL among healthy young adults. We conducted a retrospective study to examine audiograms of healthy candidates for the Israeli Air Force flight academy between 2018 and 2023. Hearing tests were performed by an expert audiologist using an audiometer. A total of 1940 audiograms were analyzed. The age range of the patients was 17-19 years. Using the British Society of Audiology classification, 174 (8.97%) audiograms and 313 frequencies were classified as impaired. The 8 kHz was the most affected frequency, accounting for 116 cases (37%). Hearing impairment prevalence increased from 1% at entry into the education system to 8.45% at the end, respectively. Detecting hearing impairments early may minimize future disability and may reduce future disability and rehabilitation costs. Hearing screens for young adults due to the change in listening habits of adolescents may prove useful.
Studies have shown that approximately half of the female population may experience some degree of pelvic organ prolapse (POP) during their lifetime, although only 3-6% report symptomatic prolapse. To evaluate the clinical and adverse outcomes associated with transvaginal repair using partially absorbable lightweight polypropylene Seratom PA MR MN® mini mesh for enhanced apical support in the treatment of advanced POP. A retrospective study was conducted on 114 patients who underwent transvaginal repair with the Seratom partially absorbable lightweight polypropylene mini mesh between August 2013 and January 2016. Data collected included demographic, surgical, adverse symptoms, and anatomical characteristics assessed via the modified Pelvic Organ Prolapse Quantification system (POP-Q). Postoperative pain was assessed using the Visual Analog Scale. Significant improvements were observed in POP-Q measurements (P-value < 0.001). Subjective outcomes demonstrated significant pre- to 4-month postoperative reductions in urinary stress incontinence and overactive bladder (P < 0.001). No cases of mesh erosion were reported. Immediate complications included bleeding (3.5%), fever (1.7%), and urinary obstruction (0.9%). The recurrence rate was 12.3%. Patient satisfaction scores were consistently high, with an average of 95.96% at 1 month, 94.73% at 4 months, and 91.33% at the most recent follow-up. Transvaginal repair with the Seratom PA MR MN® partially absorbable mini mesh demonstrated significant improvements in anatomical and subjective outcomes, with few complications, and low recurrence rates. Further studies are necessary to validate these outcomes and optimize patient selection.