Acute Appendicitis Non-Operative Management Rate Trends Over Two Decades (2000 to 2019): The Israel experience.

Background: Acute appendicitis (AA) is a medical emergency. The standard of care for AA had been surgical appendectomy. Recently, non-operative management (NOM) has been considered, mainly for uncomplicated AA.

Trends of Bacterial Meningitis Incidence Rate over 20 Years (2000 to 2019): The Israel Experience.

Background: Bacterial meningitis (BM) remains a considerable cause of morbidity.

Objectives: To evaluate BM incidence rate trends in diverse age groups.

Methods: We conducted a retrospective cohort study based on the Israeli national registry.

Daily output measures of Emergency Department in association with seasonality and day of the week: A retrospective cohort observational study.

To evaluate the daily output measures of the emergency department (ED) in association with seasonality and the day of the week. A retrospective cohort of ED visits to tertiary medical centers between 2016 and 2020. The research unit was each day during the study period.

Gender specific survival rates after deceased donor liver transplantation: A retrospective cohort.

Background: According to the literature, there are sex allocation inequalities in liver transplantation (LT). Sex disparities in outcomes after LT have been debated. This study aimed to evaluate sex-specific outcomes after LT, specifically short-term mortality and long-term survival rates.

Reducing infantile anemia: insight on patterns of process and outcome indicators by ethnicity and socioeconomic class during a 10-year intervention program and 5 years after.

Background: In 2005, Clalit Health Services (CHS), the largest health maintenance organization in Israel, initiated an intervention program aimed at reducing the prevalence rate of infantile anemia (IA). This study evaluated the progress made during the intervention (2005-2014) and its yield 5 years after it ended (2019).

Methods: The CHS database was retrospectively reviewed twice yearly from 2005 to 2014 for repetitive samples of children aged 9 to 18 months regarding the previous half-year interval, and a single sample in 2019.

Sex-Specific Long-Term Height and Body Mass Index Trajectories of Children Diagnosed with Attention-Deficit/Hyperactivity Disorder and Treated with Stimulants.

Objectives: To evaluate the sex-specific effects of stimulants in children with attention-deficit/hyperactivity disorder (ADHD) on body mass index (BMI) z and height z trajectories.

Study Design: A retrospective cohort study using the database of Israel Clalit Health Services was performed. Participants included 5- to 18-year-old insured patients with documentation of at least 2 consecutive prescriptions of stimulant drugs for ADHD.

Do Israeli Children's Anthropometrics Comply with World Health Organization and U.S. Centers for Disease Control and Prevention Height and Body Mass Index Tables?

Background: Evaluation of children's anthropometrics poses challenges due to age-related changes. The main focus is on height and weight. However, since weight is height-dependent, body mass index (BMI) is the best surrogate measurement of adiposity.

Should every candidate for cataract extraction be scheduled to the preoperative clinic? The Rabin Medical Center experience.

Background: Cataract surgery is one of the most common elective surgeries. We present a novel approach of preoperative triage using community-based ophthalmologist referral letters for scheduling surgery, thus reducing both patient and physician time prior to surgery. Since most patients are not routinely examined in a preoperative clinic, day of surgery cancelations are a possibility.

The Sudden Infant Death Syndrome mechanism of death may be a non-septic hyper-dynamic shock.

Background: Sudden Infant Death Syndrome (SIDS) mechanisms of death remains obscured. SIDS' Triple Risk Model assumed coexistence of individual subtle vulnerability, critical developmental period and stressors. Prone sleeping is a major risk factor but provide no clues regarding the mechanism of death.

The Cardiovascular Reserve Index-A Noninvasive Clinical Insight Into Heat Intolerance.

Objective: To noninvasively explore the heat intolerance condition during exercise-heat stress by assessing cardiovascular (CV) performance.

Design: Prospective study of participants undergoing a standard heat-tolerance test (HTT).

Setting: Institutional study.

Implementation of a competency-based medical education approach in public health and epidemiology training of medical students.

Background: There is increasing agreement among medical educators regarding the importance of improving the integration between public health and clinical education, understanding and implementation of epidemiological methods, and the ability to critically appraise medical literature. The Sackler School of Medicine at Tel-Aviv University revised its public health and preventive medicine curriculum, during 2013-2014, according to the competency-based medical education (CBME) approach in training medical students. We describe the revised curriculum, which aimed to strengthen competencies in quantitative research methods, epidemiology, public health and preventive medicine, and health service organization and delivery.

[EARLY IN-HOSPITAL MORTALITY IN INTERNAL MEDICINE WARDS (WITHIN 24 HOURS): A POTENTIAL QUALITY INDICATOR OR A VARIABLE AFFECTED BY MULTIPLE FACTORS?].

Aims: To evaluate in-hospital mortality rate within 24 hours in internal medicine wards and to evaluate if it may be used as quality indicator.

Background: In-hospital mortality rate is an outcome measure which apparently reflects quality of care. There are debates on whether it may be considered a quality indicator since it is difficult to compare different case-mixes between hospitals.

Cardio-vascular reserve index (CVRI) during exercise complies with the pattern assumed by the cardiovascular reserve hypothesis.

Objectives: The Cardio-vascular reserve index (CVRI) had been empirically validated in diverse morbidities as a quantitative estimate of the reserve assumed by the cardiovascular reserve hypothesis. This work evaluates whether CVRI during exercise complies with the cardiovascular reserve hypothesis.

Design: Retrospective study based on a database of patients who underwent cardio-pulmonary exercise testing (CPX) for diverse indications.

The approximated cardiovascular reserve index complies with haemorrhage related hemodynamic deterioration pattern: A swine exsanguination model.

Background: To estimate the cardiovascular reserve we formulated the Cardiovascular Reserve Index (CVRI) based on physiological measurements. The aim of this study was to evaluate the pattern of CVRI in haemorrhage-related haemodynamic deterioration in an animal model simulating combat injury.

Methods: Data were collected retrospectively from a research database of swine exsanguination model in which serial physiological measurements were made under anesthesia in 12 swine of haemorrhagic injury and 5 controls.

A novel hypothesis comprehensively explains shock, heart failure and aerobic exhaustion through an assumed central physiological control of the momentary cardiovascular performance reserve.

Background: Heart failure (HF) and shock are incomprehensively understood, inconclusively defined and lack a single conclusive test. The proceedings that preceded and triggered clinical manifestations are occult. The relationships in between different shock and HF types and between each HF type and its matched shock are poorly understood.

Diabetic foot cellular hypoxia may be due to capillary shunting--a novel hypothesis.

Diabetic foot is traditionally attributed to a triad of neuropathy, ischemia and infection. Cellular hypoxia in diabetic foot can neither be attributed to an occlusive large artery disease (which are mostly patent) nor to the so called diabetic small vessel disease (where such occlusion was never proved). The physiological findings that accompany cellular hypoxia are confusing: elevated local blood flow and high oxygen saturation in both the tissue and its collecting veins.

A case and a series of published cases of esthesioneuroblastoma (ENB) in which long-standing paraneoplastic SIADH had preceded ENB diagnosis.

Esthesioneuroblastoma (ENB) is a rare tumor of the olfactory mucosa. We treated a 50-year-old man with an ENB in the right ethmoid sinus who had been diagnosed 16 years earlier with syndrome of inappropriate antidiuretic hormone secretion (SIADH) of unknown cause. When the ENB was surgically removed, the patient's osmoregulation returned to normal-that is, his SIADH resolved completely, which suggested that the SIADH was paraneoplastic in nature.

Immigrants' mortality patterns in the short- and long-term point toward origin-related diversities: the Israeli experience.

Immigrant mortality studies reveal conflicting results that were attributed to diversity in immigrant definition, different classifications, and lack of appropriate comparisons. This work studied mortality patterns of the immigrations absorbed in Israel. Short-term mortality was evaluated by comparing the Standardized Mortality Rate (SMR) of the first year after immigration to the SMR of the second to fifth years.

Novel surgical performance evaluation approximates Standardized Incidence Ratio with high accuracy at simple means.

Background: Excess adverse events may be attributable to poor surgical performance but also to case-mix, which is controlled through the Standardized Incidence Ratio (SIR). SIR calculations can be complicated, resource consuming, and unfeasible in some settings. This article suggests a novel method for SIR approximation.

A novel heart rate control model provides insights linking LF-HRV behavior to the open-loop gain.

Background: Low-frequency heart rate variability (LF-HRV) at rest has already been successfully modeled as self-sustained oscillations in a nonlinear control loop, but these models fail to simulate LF-HRV decreases either during aerobic exercise or in heart failure patients. Following control engineering practices, we assume the existence of a biological excitation (dither) within the heart rate control loop that softens the nonlinearity and studied LF-HRV behavior in a dither-embedded model.

Methods: We adopted the Ottesen model with some revisions and induced a dither of high-frequency stochastic perturbations.

Therapeutic equivalent substitute that is new or unfamiliar to the chronic patient may result in medication error.

Purpose: The developing generic market has huge advantages of availability and affordability of therapy. The question of whether a therapeutic equivalent substitute under an unfamiliar name may cause confusion that leads to medical errors has not been sufficiently studied. This paper seeks to answer this question.

Obesity plays an independent worsening modifying effect on nocturnal hypoxia in obstructive sleep apnea.

Objective: Obesity's association with obstructive sleep apnea syndrome (OSAS) is well established. The aim of this study was to examine the impact of obesity on nocturnal hypoxia.

Methods: Twenty two thousand seven hundred and ninety three patients aged 21-80 years who underwent whole night polysomnography during 2000-2009 were included in the study.

Hypothesis: Low frequency heart rate variability (LF-HRV) is an input for undisclosed yet biological adaptive control, governing the cardiovascular regulations to assure optimal functioning.

Cardiovascular regulation is considered today as having three levels: autoregulations, neural regulations and hormonal regulations. We hypothesize that the cardiovascular regulation has an additional (fourth) control level which is outer, hierarchical (adaptive) loop where LF-HRV amplitude serves as a reference input which the neural cardiovascular center detects and responses in order to maintain LF-HRV around some prescribed level. Supporting evidences: LF-HRV absence during artificial cardiac pacing may be associated with "pacemaker syndrome" which had not been sufficiently understood regardless of apparently unimpaired cardiovascular performance.

Does haptoglobin genotype affect early onset of diabetic retinopathy in patients with type 2 diabetes?

Purpose: There are 2 common alleles for Hp (Hp-1 and Hp-2) and 3 common Hp genotypes: Hp1-1, Hp2-1, and Hp2-2. The haptoglobin genotype may play a dual role in morbidities of diabetes: Hp1-1, protective and Hp2-2, provocative. This study investigated the possible association of haptoglobin genotypes with onset of retinopathy in Type 2 diabetes (DM2).