Metabolic and functional factors associated with a change in resting metabolic rate among older adults with type 2 diabetes- results from the CEV-65 randomized trial.

Aims: This study evaluated the effects of circuit resistance training (CRT), a vegetarian/Mediterranean diet (VegMedD), and empagliflozin on Resting Metabolic Rate (RMR) in older adults with Type 2 Diabetes (T2DM).

Methods: 67 participants from CEV-65 trial (≥65 years, 61 % female) were randomly assigned to CRT, VegMedD, or empagliflozin for 10 weeks. Assessments included RMR, medical, metabolic, nutritional, anthropometric and functional measurements.

Adherence to diabetes quality indicators in primary care and all-cause mortality: A nationwide population-based historical cohort study.

Background: In the last three decades, much effort has been invested in measuring and improving the quality of diabetes care. We assessed the association between adherence to diabetes quality indicators and all-cause mortality in the primary care setting.

Methods: A nationwide, population-based, historical cohort study of all people aged 45-80 with pharmacologically-treated diabetes in 2005 (n = 222,235).

Validation of a novel Artificial Pharmacology Intelligence (API) system for the management of patients with polypharmacy.

Objective: Medication management of patients with polypharmacy is highly complex. We aimed to validate a novel Artificial Pharmacology Intelligence (API) algorithm to optimize the medication review process in a comprehensive, personalized, and scalable way.

Materials And Methods: The study was conducted on anonymized retrospective electronic health records (EHR) of 49 patients.

Multimodal Machine Learning for Prediction of 30-Day Readmission Risk in Elderly Population.

Background: Readmission within 30 days is a prevalent issue among elderly patients, linked to unfavorable health outcomes. Our objective was to develop and validate multimodal machine learning models for predicting 30-day readmission risk in elderly patients discharged from internal medicine departments.

Methods: This was a retrospective cohort study which included elderly patients aged 75 or older, who were hospitalized at the Hadassah Medical Center internal medicine departments between 2014 and 2020.

Multi-Dimensional Validation of the Integration of Syntactic and Semantic Distance Measures for Clustering Fibromyalgia Patients in the Rheumatic Monitor Big Data Study.

This study primarily aimed at developing a novel multi-dimensional methodology to discover and validate the optimal number of clusters. The secondary objective was to deploy it for the task of clustering fibromyalgia patients. We present a comprehensive methodology that includes the use of several different clustering algorithms, quality assessment using several syntactic distance measures (the Silhouette Index (SI), Calinski-Harabasz index (CHI), and Davies-Bouldin index (DBI)), stability assessment using the adjusted Rand index (ARI), and the validation of the internal semantic consistency of each clustering option via the performance of multiple clustering iterations after the repeated bagging of the data to select multiple partial data sets.

Pediatric overweight and obesity increased in Israel during the COVID-19 period.

Reports from many settings suggest that pediatric overweight and obesity increased in 2020 and 2021, presumably due to lifestyle changes associated with the COVID-19 pandemic. Many of these previous reports have relied on convenience samples or subsets of the population. Here, we present results of a longitudinal study of the entire population of Israel, a nation of approximately 9 million people, with the proportion with underweight, normal weight, overweight, and obesity at age 7 and at age 14-15, across the years 2017-2021.

Advanced Hemodynamic Monitoring Allows Recognition of Early Response Patterns to Diuresis in Congestive Heart Failure Patients.

There are no clear guidelines for diuretic administration in heart failure (HF), and reliable markers are needed to tailor treatment. Continuous monitoring of multiple advanced physiological parameters during diuresis may allow better differentiation of patients into subgroups according to their responses. In this study, 29 HF patients were monitored during outpatient intravenous diuresis, using a noninvasive wearable multi-parameter monitor.

Validation of a multi-frequency bioelectrical impedance analysis device for the assessment of body composition in older adults with type 2 diabetes.

Background: Aging and type 2 diabetes (T2DM) are associated with an increased risk of sarcopenia. Diagnosis of sarcopenia is commonly done using dual-energy X-ray absorptiometry (DXA) in specialized settings. Another available method for assessing body composition is direct segmental multi-frequency bioelectrical impedance analysis (DSMF-BIA).

Longitudinal Adherence to Diabetes Quality Indicators and Cardiac Disease: A Nationwide Population-Based Historical Cohort Study of Patients With Pharmacologically Treated Diabetes.

Background Evidence of the cardiovascular benefits of adherence to quality indicators in diabetes care over a period of years is lacking. Methods and Results We conducted a population-based, historical cohort study of 105 656 people aged 45 to 80 with pharmacologically treated diabetes and who were free of cardiac disease in 2010. Data were retrieved from electronic medical records of the 4 Israeli health maintenance organizations.

Israeli COVID lockdowns mildly reduced overall use of preventive health services, but exacerbated some disparities.

Background: During 2020, Israel experienced two COVID-19-related lockdowns that impacted the provision of primary and secondary preventive care.

Methods: We examined the month-by-month performance of selected preventive care services using data from Israel's national Quality Indicators in Community Healthcare program. Process of care measures included hemoglobin A1c (HbA1c) testing, cholesterol testing, colon cancer screening and mammography.

[ANTIBIOTIC USE IN COMMUNITY HEALTHCARE IN ISRAEL AS REFLECTED IN THE NATIONAL PROGRAM FOR QUALITY INDICATORS].

Aims: We sought to evaluate the extent of overall and second-line systemic antibiotic use in the Israeli community, to compare them to international data and to monitor temporal trends.

Background: Antibiotic overuse is prevalent and has grave implications, primarily the emergence of resistant pathogens - an urgent public health concern worldwide.

Methods: The Israel National Program for Quality Indicators in Community Healthcare (QICH) obtains data from electronic medical records from the 4 health-plans, covering the entire civilian population.

The quality of primary care provided to the elderly in Israel.

Background: In view of increasing global and local trends in population ageing and the high healthcare utilization rates among the elderly, this study assesses the quality of primary care provided to the elderly population in Israel. It examines changes in quality over time, how quality varies across sub-groups of the elderly, and how quality in Israel compares with other countries. Data originate from the National Program for Quality Indicators in Community Healthcare (QICH), which operates in full collaboration with Israel's four HMOs.

Trends in the performance of quality indicators for diabetes care in the community and in diabetes-related health status: an Israeli ecological study.

Background: Israel is one of the few countries that have a national program for quality assessment of community healthcare. We aimed to evaluate whether improved performance in diabetes care was associated with improved health of diabetic patients on a national level.

Methods: We conducted a nationwide ecological study estimating improvements in diabetes-related quality indicators and health outcomes.

Cancer and Aging - the Inflammatory Connection.

Aging and cancer are highly correlated biological phenomena. Various cellular processes such as DNA damage responses and cellular senescence that serve as tumor suppressing mechanisms throughout life result in degenerative changes and contribute to the aging phenotype. In turn, aging is considered a pro-tumorigenic state, and constitutes the single most important risk factor for cancer development.

Physician-facilitated designation of proxy decision-makers: family physician perceptions.

Background: Among the challenges encountered during the care of patients at the end-of-life (EOL), eliciting preferences of patients with whom there is no ability to communicate is common and stressful for all those concerned and charged with patient care. Legal facilities available include patient delegation of proxy decision-makers (PDM) prior to communication incapacity. We sought to estimate family physician awareness and attitude with regard to these aspects of patient care.

The older patient with diabetes: a practical approach.

Type 2 diabetes mellitus is very prevalent among persons aged 60-80 years old. This population is expected to increase in number and is characterized by the presence of comorbidities, long standing diabetes, frailty, high rate of cognitive impairment and limited life expectancy. These characteristics have a significant impact on diabetes and treatment among the elderly, much as diabetes predisposes to these conditions.

Community healthcare in Israel: quality indicators 2007-2009.

Background: The National Program for Quality Indicators in Community Healthcare in Israel (QICH) was developed to provide policy makers and consumers with information on the quality of community healthcare in Israel. In what follows we present the most recent results of the QICH indicator set for 2009 and an examination of changes that have occurred since 2007.

Methods: Data for 28 quality indicators were collected from all four health plans in Israel for the years 2007-2009.

Severe malnutrition due to systemic lupus erythematosus associated protein losing enteropathy.

Systemic lupus erythematosus most often targets organs such as joints, serosa, skin, bone marrow, and the kidneys. Gastrointestinal complications are uncommon, and among these, protein losing enteropathy is particularly rare. We present a young woman who suffered from chronic abdominal pain and diarrhea, developed severe malnutrition, and was eventually diagnosed with systemic lupus erythematosus and associated protein losing enteropathy.

Janus Kinase V617F mutation in cigarette smokers.

The JAK2 V617F mutation is responsible for the constitutive activation of the erythropoietin receptor signaling pathway in most cases of polycythemia vera (PV). The mutation has also been described in healthy people. As smoking may result in secondary polycythemia, the goal of this trial was to examine the effect of smoking on the prevalence of the JAK2 mutation and its correlation to erythrocytosis.

[Additional remedies for the failing departments of internal medicine].

An evolving crisis within the departments of internal medicine in Israel reflects increase in the number of patients, age and morbidity, with a concomitant shortage of appointed personnel, the outcome of anachronistic manpower standards. Consequently, the extremely high occupancy rate and work burden are among the leading causes of growing dissatisfaction among the medical personnel and the evolving shortage of recruited trainees in internal medicine. In addition to the unequivocal necessity to adjust manpower standards to the growing needs, the authors critically review processes involved in hospital admissions and patients' discharge that intensify the growing crisis.

Risk factors for prescribing and transcribing medication errors among elderly patients during acute hospitalization: a cohort, case-control study.

Background: Medication errors are the cause of common and dangerous adverse effects on patients. They occur as a result of preventable failures in the prescribing (ordering), transcribing, dispensing and administration of medications.

Objective: The aim of this study was to determine the relationship between patient characteristics and prescribing and transcribing medication errors during acute hospitalization of elderly patients in an internal medicine ward.