ISRAEL MEDICAL ASSOCIATION JOURNAL

Perspectives on Half-Century of Combat Casualty Care in the Israel Defense Forces Medical Corps
Salai M, Malkin M, Shlaifer A, Fogel I, Shina A, Gershowitz L and Glasberg E
Military medicine has evolved significantly over the past 50 years, advancing from basic treatments and limited evacuations to sophisticated combat casualty care. Innovations such as hemorrhage control, early blood product administration, and telemedicine have greatly improved battlefield care. Rapid evacuation systems and skilled medical teams have reduced mortality and morbidity rates.
Allergic Rhinitis in Israel: A Multicenter Study of Allergic Rhinitis Across Three Climate Zones
Eisenberg R, Raphael A, Risling M, Asher I and Toker O
Allergic rhinitis (AR) is a common illness. Worldwide prevalence varies between 5% and 50% depending on self-reported surveys, test-based studies, geographic location, and age. Despite the clinical relevance of AR in the Israeli population, few studies have characterized the sensitization profiles and key pollen aeroallergen.
Cardiac and Pleural Involvement in Systemic Light Chain Amyloidosis: A Case Report
Giladi E, Gilboa-Sagy H, Zilberman L, Zyabkin O, Assali A, Tal S and Jarchowsky O
The Utility and Clinical Implications of Calcium Score Measurement: Experience of a Lipids Clinic
Lev Kolnik R, Bergman I and Elis A
The Agatston coronary artery calcium (CAC) score is a decision-guiding aid for risk assessment and personalized management in the primary prevention of atherosclerotic cardiovascular disease.
The Efficacy of Echocardiography-guided Cardiac Implantable Electronic Devices Implantation to reduce Device Related Tricuspid Regurgitation: Long-term Follow-up
Slobodov T, Marincheva G, Rahkovich M, Valdman A, Kogan Y and Laish-Farkash A
Cardiac implantable electronic devices (CIEDs) with endocardial leads crossing the tricuspid valve can lead to or worsen tricuspid regurgitation (TR), causing substantial morbidity and mortality. Despite a recent randomized controlled study revealing a low short-term incidence of device-related TR (DRT) post-CIED implantation, uncertainties persist regarding the efficacy of intra-procedural 2-dimensional transthoracic echocardiography (2DTTE) in preventing long-term TR.
Using Urine Output Trending for the Management of Acute Cardiorenal Syndrome
Rozenfeld A, Goldman A, Stern T, Banai S and Shacham Y
One-third of patients with acute decompensated heart failure (ADHF) develop worsening kidney function, known as type I cardiorenal syndrome (CRS). CRS is linked to higher mortality rates, prolonged hospital stays, and increased readmissions.
Decolonization of Staphylococcus aureus Prior to Cardiac Implantable Electronic Device Implantation: Evaluating Preoperative Yield
Kakzanov Y, Alsana Y, Brosh-Nissimov T, Harari E, Rahkovich M, Kogan Y, Shvets E, Marincheva G, Vasilenko L and Laish-Farkash A
Cardiac implantable electronic devices (CIEDs) are associated with risks of device-related infections (DRI) impacting major adverse outcomes. Staphylococcus aureus (SA) is a leading cause of early pocket infection and bacteremia. While studies in other surgical contexts have suggested that nasal mupirocin treatment and chlorhexidine skin washing may reduce colonization and infection risk, limited data exist for CIED interventions.
Lower Limbs Arterial Discrepancy in Poliomyelitis Patients
Levental S, Schwartz I, Lorber J, Nowotny J and Karmeli R
Isolated peripheral artery aneurysms are very rare, appearing in fewer than 2% of the general population. The literature reports a few case reports of poliomyelitis patients presenting with unilateral leg paralysis that presented with peripheral aneurysms in the contralateral leg.
Asymptomatic Testicular Tumor in Patient with Retroperitoneal Fibrosis as Manifestation of IgG4-related Disease Recurrence: A Case Report
Simshon-Turgeman M, Rosenberg E, Bartal A and Bartal C
Epithelioid Fibrous Papule (Angiofibroma) of the External Auditory Canal: A New Entity?
Ronel N, Sukmanov O, Lahav G, Sharav S, Kiderman D and Yosepovich A
The Challenges of Forensic Medicine in Victim Identification in the Wake of the October 7th (2023) Mass Casualty Event
Kugel C, Nachman RP, Katz I, Dotan A, Zandman-Goddard G and Shoenfeld Y
The massive terrorist attack on a mixed population of civilians, soldiers, and foreigners on October 7, 2023, resulted in 1200 casualties and led to many major personal identification issues. At the Israel National Center for Forensic Medicine (INCFM), addressing the mass casualty incidents required precision that included technical, ethical, and humanitarian dimensions. Many obstacles arose that were attributable to the vast number and diversity of victims and the heavy workload in the setting of a small forensic team.
Resilience Unveiled: Myxedema Coma in a Hostage Survivor
Fried-Regev N, Slutsky T, Frenkel A, Klein M, Codish S and Schwarzfuchs D
Does This Image Reveal a Fourth Cranial Nerve Palsy?
Gelfman DM
Hospitalization Outcomes of Patients with Type 2 Diabetes Mellitus Complicated with Diabetic Ketoacidosis
Keler M, Vlasov P, Elkan M, Koren S and Koren R
Diabetic ketoacidosis (DKA) poses a significant medical emergency in both type 1 (T1DM) and type 2 diabetes mellitus (T2DM) patients. Recent attention has focused on the emergence of euglycemic DKA associated with sodium-glucose cotransporter-2 (SGLT2) inhibitors.
Cholesterol Levels and Lipid Lowering Treatment in Coronary Heart Disease Patients Hospitalized Because of Anginal Syndrome
Raiyan A and Elis A
Coronary heart disease (CHD) patients are considered high cardiovascular risks. Guidelines recommend low-density lipoprotein cholesterol (LDL-C) target levels below 55 mg/dl with > 50% reduction from baselines. These levels can be reached by a combination of statins, ezetimibe, and anti-protein convertase subtilisin/kexin type 9 (anti-PCSK9) agents. Our clinical impression was that CHD patients do not reach LDL-C target levels, despite the wide availability.
Introduction of a New Toxicology Consult Service in a Large Tertiary Care Teaching Hospital
Segev O, Hoyte C, Taylor N, Katz A, Scolnik D, Zandberg E, Hassoun E and Glatstein M
Clinical toxicology is not a certified specialty in Israel, consequently there are a limited number of toxicologists and toxicology services available for consultation.
The Association Between Serum Ferritin Levels and Main Systemic Sclerosis Features: A Retrospective Study from a Tertiary Center
Markovich Sholomon S, Giryes S, Shataylo V, Braun-Moscovici Y and Balbir-Gurman A
Serum ferritin is a sensitive inflammatory biomarker reflecting cell damage and oxidative stress in inflammatory rheumatic diseases. The use of ferritin for assessment of systemic sclerosis (SSc) activity, severity, and prognosis has not been fully elucidated.
Epidural Abscess Caused by Aggregatibacter Aphrophilus
Mouallem M, Fridlander A, Shrot S and Shoenfeld Y
A Novel CLCN1 Gene Mutation Associated with Hypokalemic Periodic Paralysis in a Pregnant Woman
Atrash J, Abu Libdeh O, Fteiha B, Abu Sneineh M, Bnaya A and Shavit L
Kidney Transplantation in a Patient with Scleroderma
Bear L, Agmon Levine N, Ghinea R, Hod T, Nachmany I and Mor E
Kidney involvement in systemic sclerosis (SSc) is common with altered kidney function present in approximately half of the patients [1]. Scleroderma renal crisis (SRC), the most severe kidney manifestation, occurs in about 20% of patients with this autoimmune disorder [1]. SRC mainly affects patients with the diffuse cutaneous systemic sclerosis (dcSSc) subtype of the disease, and particularly in those who are seropositive to anti RNA polymerase III antibodies [2]. In recent years, the prevalence of SRC has decreased following the initiation of medication therapy with angiotensin-converting-enzyme inhibitors (ACE-i). Previously, SRC mortality rates were as high as 78%. Contemporary studies in the post-ACE-i era suggest lower rates, with mortality rate ranging from 30% to 36% [3]. Nevertheless, progression to end-stage renal disease (ESRD) is evident and may require renal replacement therapies (RRTs). While renal transplant rates in SSc have increased, they constitute a small proportion of SSc-SRC patients (3-8%) and SSc-ESRD patients (4-17%).
Novelties in the Hyperferritinemic Syndrome: New Insights from Systemic Sclerosis
Ruscitti P