Publications by authors named "Alan Jotkowitz"

Background: Medical oaths and ethical codes play a crucial role in guiding physicians through their professional responsibilities. This study extends prior research on ethical codes created by students at the Medical School for International Health (MSIH) by analysing codes from the years 2007 to 2022.

Objective: The objective of this study is to evaluate changes in the ethical principles emphasised by MSIH students over time and to compare these with previous cohorts.

View Article and Find Full Text PDF

Early activation of the emergency medical service (EMS) is crucial for the care of patients with STEMI. A retrospective cohort study of patients hospitalized with STEMI was conducted. Two groups of patients were compared: Bedouins and Jews.

View Article and Find Full Text PDF
Article Synopsis
  • - The study examined clinical features and outcomes of patients admitted for diabetic ketoacidosis (DKA) outside of internal medicine from 2005 to 2022, focusing on differences between internal and non-internal medicine cases.
  • - Among 429 patients, those outside of internal medicine were generally older and had higher rates of diabetes complications, with poorer outcomes such as lower glucose levels and increased need for mechanical ventilation.
  • - The findings suggest that patients admitted for surgical or obstetrical conditions are at a higher risk for severe DKA complications, necessitating further research to understand these unique patient characteristics better.
View Article and Find Full Text PDF

Background: Diabetic ketoacidosis (DKA) is an acute metabolic, life-threatening complication of diabetes mellitus with a mortality rate that now stand at less than 1%. Although mortality is coupled with the etiology of DKA, literature on the influence of DKA etiology on patient outcome is scarce.

Objectives: To study different triggers for DKA and their effect on outcomes.

View Article and Find Full Text PDF

Rationale And Objectives: The use of imaging in medicine has increased considerably over the previous decades, contributing to significant inefficiency of use. Radiology education varies amongst institutions without standardized learning objectives. Consequently, many physicians and student doctors are unprepared to make appropriate choices regarding imaging.

View Article and Find Full Text PDF

Diabetic ketoacidosis (DKA) is an acute life-threatening emergency in patients with diabetes, it can result in serious morbidity and mortality. Management of DKA requires reversing metabolic derangements, correcting volume depletion, electrolyte imbalances and acidosis while concurrently treating the precipitating illness. There are still controversies regarding certain aspects of DKA management.

View Article and Find Full Text PDF

Purpose: To describe the evolution of COVID-19 related publications in the field of ophthalmology.

Methods: All articles published in the field of ophthalmology and relevant to COVID-19 were identified by conducting a search on PubMed and Scopus databases using the string ((ophthalmology) OR (eye) OR (ocular)) AND ((corona) OR (COVID-19) OR (pandemic)). Search was conducted on September 30, 2020.

View Article and Find Full Text PDF

Objective: Diabetic ketoacidosis (DKA) during pregnancy is a life-threatening emergency for both the mother and the fetus. The pathophysiology of DKA in pregnancy has its own characteristics due to multiple factors, such as insulin resistance, accelerated starvation and respiratory alkalosis, thus creating ketosis-prone state, with DKA occurring at milder degrees of hyperglycemia, even in normoglycemic levels, which can result in delayed diagnosis and treatment with potential for adverse metabolic consequences.

Study Design: In this article, we presented 8 clinical cases of DKA during pregnancy.

View Article and Find Full Text PDF

Background: Coronavirus disease-19 (COVID-19) impacted medical education and led to the significant modification or suspension of clinical clerkships and rotations.

Objectives: To describe a revised surgery clerkship curriculum, in which we divided in-person clinical teaching into smaller groups of students and adopted online-based learning to foster student and patient safety while upholding program standards.

Methods: The third-year surgery core clerkship of a 4-year international English-language program at the Medical School for International Health at Ben Gurion University of the Negev, Beer Sheva, Israel, was adapted by dividing students into smaller capsules for in-person learning and incorporating online learning tools.

View Article and Find Full Text PDF

A 36-year-old male with diffuse large B-cell lymphoma on maintenance rituximab therapy presented to the emergency department with high fever and fatigue. A chest X-ray showed a lobar infiltrate, 40 days before admission the patient suffered from a mild coronavirus disease 2019 (COVID-19) infection and fully recovered. PCR nasopharyngeal swab was negative for COVID-19.

View Article and Find Full Text PDF

Aims: To identify risk factors for recurrent episodes of DKA that may allow the development of an effective prevention strategies.

Methods: Retrospective analysis of admissions for DKA in adult patients between 2004, and 2017 in a tertiary hospital. The clinical characteristics and outcomes of DKA of patients were stratified into an isolated episode of DKA (group 1) and recurrent episodes (group 2).

View Article and Find Full Text PDF

Background: Previous studies have shown a correlation between acute pancreatitis and several different risk factors that vary in different countries and ethnic groups. The aims of this study are to examine the clinical characteristics and outcomes of acute pancreatitis in patients of Jewish and Bedouin origin.

Methods: We performed a retrospective cohort study of patients hospitalized with acute pancreatitis in the Soroka University Medical Center between the years 2012 and 2016 and compared two groups of patients: patients of Jewish and Bedouin origin.

View Article and Find Full Text PDF

Objective: Acute pancreatitis is a serious diagnosis with an increasing incidence in the Western world. In this study we sought to investigate the incidence of idiopathic AP and to compare clinical and prognostic characteristics of idiopathic cases with cases of AP with known etiology.

Methods: In this retrospective study of adult hospitalized patients diagnosed with acute pancreatitis between 2012 and 2015, a comparison was made between admissions of patients with known etiology and those for whom no cause was found.

View Article and Find Full Text PDF

Background: COVID-19 has erupted into our lives and forced rapid changes in all fields of medicine, causing a rush for publications that inevitably caused a shift away from the paradigm of evidence-based medicine (EBM). The objective of the present report is to assess and quantify this process.

Methods: We compared the levels of EBM of the publications in the ophthalmic literature on COVID-19 at the beginning of the pandemic and compared it to those of articles published the prior year during April 2019 for the three highest ranking journals in the field of comprehensive ophthalmology.

View Article and Find Full Text PDF

COVID-19, the illness caused by the SARS-CoV-2 virus, has reached pandemic proportions. Although the virus can cause disease in anyone, it is particularly dangerous for those with various "co-morbidities" such as heart disease, hypertension, diabetes, obesity and others. Furthermore, advancing age (from about 60 on), even in those older persons without any accompanying illnesses, is a strong and independent risk factor for pneumonia, need for an ICU bed and death from the virus.

View Article and Find Full Text PDF

Objective: To present our hybrid telehealth medical retina clinic service with intravitreal injections (IVI) treatment as a safe alternative to in-person visits and examination during COVID-19 pandemic disease.

Methods: Due to exposure to a COVID-19 positive retina fellow, our retina service, in quarantine, evaluated patients' medical files and retinal scans using a telemedicine approach. A different protocol for patients coming for IVI during the COVID-19 pandemic was established for IVI administration.

View Article and Find Full Text PDF

Background: The impact of sex on the presentation, etiology, and outcomes of infective endocarditis (IE) has not been adequately studied. The aim of the present research was to analyze the impact of sex on the presentation, etiology, and outcomes of IE.

Methods: We performed a retrospective study of 214 adult patients (131 male and 83 female) with IE.

View Article and Find Full Text PDF

Context: The COVID-19 pandemic led to shutting of education faculties, including clinical clerkships for medical students.

Objective: To review a selective for a course in diagnostic pathology geared toward undergraduate medical students, including its design, technical implementation, instructor and student evaluations, and suggestions for options for further adjusting and optimizing the selective.

Design: Whole slide images (WSI) were anonymized and students were given remote access to university computers, which were prepared with two freely available WSI viewers.

View Article and Find Full Text PDF

The current COVID-19 pandemic has raised many questions and dilemmas for modern day ethicists and healthcare providers. Are physicians, nurses and other healthcare workers morally obligated to put themselves in harm's way and treat patients during a pandemic, occurring a great risk to themselves, their families and potentially to other patients? The issue was relevant during the 1918 influenza epidemic and more recently severe acute respiratory syndrome epidemic in 2003. Since the risk to the healthcare workers was great, there was tension between the ethical duty and responsibility to treat and the risk to one's own life.

View Article and Find Full Text PDF

The novel COVID-19 pandemic has placed medical triage decision-making in the spotlight. As life-saving ventilators become scarce, clinicians are being forced to allocate scarce resources in even the wealthiest countries. The pervasiveness of air travel and high rate of transmission has caused this pandemic to spread swiftly throughout the world.

View Article and Find Full Text PDF

Objectives: Much of the research previously done on diabetic ketoacidosis (DKA) was based on a young population with type 1 diabetes mellitus (type 1 DM). But substantial numbers of DKA episodes occur in patients with a prior history of type 2 diabetes mellitus (type 2 DM). There is a lack of Data are lacking about DKA in older adults.

View Article and Find Full Text PDF

Objectives: Stress has extensively been shown to trigger fibromyalgia syndrome (FM). Nursing is associated with high levels of stress. Our hypothesis was that nurses suffer from an increased prevalence of FM symptoms, and that these symptoms correlate with the levels of stress to which they are exposed in the course of their occupation.

View Article and Find Full Text PDF

Takotsubo cardiomyopathy is a left ventricular dysfunction that typically occurs after sudden intense emotional or physical stress and mimics myocardial infarction. We describe a case of a 60-year-old woman that presented to the emergency department with chest pain after she attended a wedding and ate a large amount of wasabi, assuming it to be an avocado. To the best of our knowledge, this is the first report of takotsubo cardiomyopathy triggered by wasabi consumption.

View Article and Find Full Text PDF

Objective: The purpose of this study is to examine risk factors for recurrence of diabetic ketoacidosis and determine interventions to prevent future admissions.

Materials And Methods: Review article.

Results: Recurrent diabetic ketoacidosis is a serious and not uncommon health problem.

View Article and Find Full Text PDF