Resilience, sense of danger, and reporting in wartime: a cross-sectional study of healthcare personnel in a general hospital.

Background And Aims: Maintaining healthcare services and ensuring the presence of healthcare personnel (HCP) during periods of conflict and high-intensity warfare in Israel including the significant security event that occurred on May 2021, pose significant challenges for hospitals in the range of missile attacks. The May 2021 event, marked by intense hostilities and military actions, brought about heightened security escalations and increased risks in the region. Despite the prevailing threat of missile attacks and ongoing security concerns, hospitals in the affected areas were required to sustain their services and uphold care standards.

Combination treatment of persistent COVID-19 in immunocompromised patients with remdesivir, nirmaltrevir/ritonavir and tixegavimab/cilgavimab.

We present a retrospective study on the treatment outcomes of severely immunocompromised patients with persistent COVID-19. The study analyzed data from 14 patients who received a combination of tixegavimab/cilgavimab and antiviral medications. Response was evaluated based on symptom improvement, PCR cycle-threshold values, and C-reactive protein levels.

Clinical impact of the accelerate PhenoTest® BC system on patients with gram-negative bacteremia and high risk of antimicrobial resistance: a prospective before-after implementation study.

Background: The Accelerate PhenoTest® BC system (AXDX) is a novel assay for rapid bacterial identification and antimicrobial susceptibility (AST). We report an evaluation of its impact on treatment of patients with Gram-negative bacteremia (GNB) with a high risk of antimicrobial resistance (AMR).

Methods: A prospective single-center evaluation before and after implementation of AXDX in addition to standard-of-care (SOC) microbiology and antimicrobial stewardship program (ASP).

[IMPLEMENTATION OF AN INNOVATIVE PROGRAM - PROFESSIONAL NURSING COMPETENCE ADAPTED TO CLINICAL NEEDS TO IMPROVE THE PROFESSIONAL QUALITY AND QUALITY OF CARE AT ASSUTA ASHDOD PUBLIC HOSPITAL].

Health systems in Israel and around the world are facing an increase in life expectancy and chronic diseases, along with technological developments, healthcare transparency, and increased customer (patients') requirements. Medical teams must provide high professional responses to these challenges. Nurse training in Israel occurs on both academic and professional levels.

[FIVE YEARS HAVE PASSED SINCE SAMSON ASSUTA ASHDOD UNIVERSITY HOSPITAL WAS OPENED].

Five years have passed since the Samson Assuta Ashdod Hospital was opened for the public, the first hospital founded in Israel after decades. The count started as the doors of the emergency medicine ward opened to the public, thus expressing the point in time when, for the first time, the hospital staff could manage a patient from the time of his entrance to the hospital till the completion of definite care (such as surgery, cardiac catheterization and more). This was in comparison to treatment of only selected (ambulatory and elective) patients in the new hospital during the initial running period that lasted for half a year.

Acute stroke revealing Takayasu's arteritis in a patient with Crohn's disease.

A 36-year-old Caucasian male with Crohn's disease exhibited acute ischaemic stroke as the first manifestation of Takayasu's arteritis. Stroke as the first clinical manifestation of Takayasu's arteritis has been rarely reported. Though rare in Western countries, Takayasu's arteritis should be considered as a possibility in young patients presenting with stroke.

Inflammatory bowel disease in military aviators: 14 cases with return to flying duty.

Inflammatory bowel disease, such as ulcerative colitis or Crohn's disease, is not a rare entity among military aviators. This relapsing inflammatory condition which may also affect extra intestinal organs can cause recurrent symptoms with considerable morbidity. The unpredictable nature of the disease, side effects of medications, and potential surgical procedures are obvious aeromedical concerns let alone the disease's extra-intestinal manifestations, some of which may result in sudden incapacitation.

Return to flight with multiple sclerosis: aeromedical considerations.

Multiple sclerosis (MS) is the most frequent demyelinating disease of the central nervous system, with versatile manifestations--relapsing-remitting or progressive--and an unpredictable course, with prognoses ranging from minimal neurological impairment to severely disabled. Disease modifying agents can minimize relapse rate and slow disease progression. Yet most patients suffer relapses and progression despite use of these agents.

Effects of repeated exposure to acceleration forces (+Gz) and anti-G manoeuvres on cardiac dimensions and performance.

Exposure to acceleration forces (+Gz) and anti-G protective manoeuvres causes changes in cardiac preload and afterload. These changes can result in cardiac hypertrophy or enlargement. Previous studies regarding the effect of acceleration in high-G aviators (HGAs) are few and inconclusive.

Large-scale air-medical transport from a peripheral hospital to level-1 trauma centers after remote mass-casualty incidents in Israel.

Introduction: Mass-casualty incidents (MCIs) result in the evacuation of many patients to the nearest medical facility. However, an overwhelming number of patients and the type and severity of injuries may demand rapid, mass airmedical transport to more advanced medical centers. This task may be challenging, particularly after a MCI in a neighboring country.

Myasthenia gravis and return to flying status.

Introduction: Myasthenia gravis (MG) is a common primary disorder of neuromuscular transmission. Although MG was once a fatal disease, today treatment with immunomodulating agents and cholinomimetic medications with good supportive care have improved the prognosis and the ability of patients to adapt to their workplaces, including the flight environment.

Cases: The diagnosis of MG in two aircrew members illustrates the range of severity for MG from isolated ocular symptoms to relentlessly progressive generalized disease, as well as the unpredictability of the disease and difficulty in treatment.

Screening echocardiography of military aircrew candidates: aeromedical implications.

Objectives: Cardiovascular evaluation has a significant aspect in the medical screening process of aircrew candidates. Echocardiography may identify asymptomatic cardiac abnormalities which can jeopardize the aviator and flight safety, as well as conditions which may progress and disqualify a trained aviator. We assessed the value of adding routine echocardiography to the aeromedical screening process.

Unilateral optic disc swelling in a fighter pilot.

Optic disc swelling occurs when there is an obstruction to axonal transport at the level of the lamina cribrosa. This may result from compression, ischemia, inflammation, or metabolic and toxic etiologies. Some of these etiologies may be life threatening and others may be self-limited.

Role of air-medical evacuation in mass-casualty incidents--a train collision experience.

Background: On 21 June 2005, a passenger train collided with a truck near Revadim, Israel. The collision resulted in a multiple-scene mass-casualty incident in an area characterized by difficult access and a relatively long distance from trauma centers. A major disaster response was initiated by civilian and military medical forces including the Israeli Air Force (IAF) Search and Rescue teams.

Tuberous sclerosis in a military pilot.

Tuberous sclerosis (TS) is a multisystem disorder characterized by hamartomas in various organs. It usually manifests itself during infancy or childhood with neurological features, including mental retardation and seizures. We present the case of a military pilot who was diagnosed with TS at 22 yr.

Pitfalls in aeromedical and ground crew engagement: lessons learned.

Aeromedical (AM) evacuation of trauma victims from action is an integral part of trauma care. The Israeli Air Force Rescue and Evacuation Unit is responsible for nearly all AM evacuations in Israel. We present three recent cases, within 1 year of operation, of engagement process failure during evacuations performed by the Rescue and Evacuation Unit.

Dietary intake of pilots in the Israeli Air Force.

The purpose of this study was to evaluate the dietary intake of pilots in the Israeli Air Force and to determine whether reported consumption met the Military Dietary Reference Intakes. Thirty-one pilots completed a 24-hour dietary recall and physical activity questionnaire. Blood parameter values were collected from medical records.

Detection of occult lung impairment in welders by induced sputum particles and breath oxidation.

Background: We evaluated particulate matter in combined induced sputum (IS) and oxidation in exhaled breath condensate (EBC) to test whether underlying inflammatory changes are present in asymptomatic welders.

Methods: Thirty welders from the Israel Defense Forces exposed to aluminum/iron (Group 1) or to cadmium/chromium/iron/lead/nickel (Group 2, N = 16) and 27 non-exposed administrators were studied. IS was recovered, particle size distribution, hydrogen peroxide and pH were measured, and exhaled breath condensate was collected.

Sinusitis in pilots of different aircraft types: is allergic rhinitis a predisposing factor?

Background: Despite the high association of allergic rhinitis and acute sinusitis, their exact relationship remains unclear, especially in pilots. The purpose of this study was to analyze the possible relationship of a history of allergic rhinitis with the occurrence of acute sinusitis in Israeli air force pilots. A comparative case series was conducted.

Postmortem computed tomography in victims of military air mishaps: radiological-pathological correlation of CT findings.

A thorough medical inquiry is included in every aviation mishap investigation. While the gold standard of this investigation is a forensic pathology examination, numerous reports stress the important role of computed tomography in the postmortem evaluation of trauma victims. To characterize the findings identified by postmortem CT and compare its performance to conventional autopsy in victims of military aviation mishaps, we analyzed seven postmortem CT examinations.

Posturography as an indicator of fatigue due to sleep deprivation.

Background: Fatigue is one of the main causes for accidents in transportation. This study was designed to assess the efficacy of a short objective posturographic test as an indicator of fatigue due to sleep deprivation.

Objectives: To assess the efficiency of a short objective posturographic test as an indicator of fatigue due to sleep deprivation.

Physical examination and ECG screening in relation to echocardiography findings in young healthy adults.

Background And Aims: Cardiovascular screening in young adults is an important tool in many occupational settings. Our aim was to test whether screening physical examination and ECG influence the rate of abnormal echocardiogarphic findings in young healthy subjects.

Methods: Consecutive echocardiography results of 18- to 20-year-old flight candidates were analyzed retrospectively.

Effect of a computerized online grading system on patient satisfaction in a military primary health care setting.

Patient satisfaction is gaining recognition as an important determinant of the quality of medical care. We conducted an analysis to evaluate the effect of a computerized online system that comparatively displays grades of patient satisfaction among primary care military infirmaries. Fifteen Israel Air Force primary care infirmaries served as the intervention group, and 130 Israel Defense Force infirmaries were the control group.