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Rambam Maimonides Medical Journal

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https://www.readbyqxmd.com/read/29035696/the-reliability-of-surgical-apgar-score-in-predicting-immediate-and-late-postoperative-morbidity-and-mortality-a-narrative-review
#1
Abhijit Nair, Aanchal Bharuka, Basanth Kumar Rayani
Surgical Apgar Score is a simple, 10-point scoring system in which a low score reliably identifies those patients at risk for adverse perioperative outcomes. Surgical techniques and anesthesia management should be directed in such a way that the Surgical Apgar Score remains higher to avoid postoperative morbidity and mortality.
October 13, 2017: Rambam Maimonides Medical Journal
https://www.readbyqxmd.com/read/28914602/initial-clinical-experience-with-a-modulated-holmium-laser-pulse-moses-technology-does-it-enhance-laser-lithotripsy-efficacy
#2
Michael Mullerad, Jonatan R A Aguinaga, Tareq Aro, Alexander Kastin, Oleg Goldin, Alexander Kravtsov, Akram Assadi, Shadie Badaan, Gilad E Amiel
OBJECTIVE: The Lumenis(®) High-power Holmium Laser (120H) has a unique modulated pulse mode, Moses™ technology. Moses technology modulates the laser pulse to separate the water (vapor bubble), then deliver the remaining energy through the bubble. Proprietary laser fibers were designed for the Moses technology. Our aim was to compare stone lithotripsy with and without the Moses technology. METHODS: We designed a questionnaire for the urologist to fill immediately after each ureteroscopy in which the Lumenis 120H was used...
September 13, 2017: Rambam Maimonides Medical Journal
https://www.readbyqxmd.com/read/28872454/review-of-the-clinical-approaches-to-the-use-of-urine-based-tumor-markers-in-bladder-cancer
#3
Timothy Clinton, Yair Lotan
Bladder cancer is a common disease with a stable incidence for the past few decades despite advancements in molecular and genetic determinants of cancer development and progression. Cystoscopy remains the standard for detection and surveillance of bladder cancer, but it is an invasive and potentially costly procedure. With the knowledge of molecular alterations associated with bladder cancer numerous urine-based tumor markers have become commercially available. These urine markers have been evaluated in all clinical scenarios for the detection of bladder cancer including screening, hematuria, atypical cytology evaluation, and surveillance, but given the relative lack of impactful trials they are not routinely utilized...
August 22, 2017: Rambam Maimonides Medical Journal
https://www.readbyqxmd.com/read/28872453/allium-stents-a-novel-solution-for-the-management-of-upper-and-lower-urinary-tract-strictures
#4
Zaher Bahouth, Boaz Moskovitz, Sarel Halachmi, Ofer Nativ
Stents are widely use in endoscopic urological procedures. One of the most important indications is the treatment of urinary tract strictures. Allium(™) Medical has introduced several types of stents for the treatment of different types of urinary tract strictures, based on anatomic location. All the stents are made of nitinol and coated with a co-polymer that reduces encrustations. These stents are self-expandable and have a large caliber and a high radial force. They have different shapes, designed especially for the treatment of each type of stricture...
August 22, 2017: Rambam Maimonides Medical Journal
https://www.readbyqxmd.com/read/28777073/multimodality-image-fusion-with-psma-pet-ct-and-high-intensity-focused-ultrasound-focal-therapy-for-primary-diagnosis-and-management-of-prostate-cancer-a-planned-research-initiative
#5
Marcia C Javitt, Alexander Kravtsov, Zohar Keidar, Sobhi Abadi, Gilad Amiel
Recent developments in diagnostic imaging herald a new approach to diagnosis and management of prostate cancer. Multimodality fusion that combines anatomic with functional imaging data has surpassed either of the two alone. This opens up the possibility to "find and fix" malignancy with greater accuracy than ever before. This is particularly important for prostate cancer because it is the most common male cancer in most developed countries. This article describes technical advances under investigation at our institution and others using multimodality image fusion of magnetic resonance imaging (MRI), transrectal ultrasound (TRUS), and PSMA PET/CT (defined as the combination of prostate-specific membrane antigen [PSMA], positron emission tomography [PET], and computed tomography [CT]) for personalized medicine in the diagnosis and focal therapy of prostate cancer with high-intensity focused ultrasound (HiFUS)...
August 3, 2017: Rambam Maimonides Medical Journal
https://www.readbyqxmd.com/read/28786810/open-communication-and-discussion-facilitate-reconciliation-the-promise-fulfilled
#6
EDITORIAL
Shraga Blazer
No abstract text is available yet for this article.
July 31, 2017: Rambam Maimonides Medical Journal
https://www.readbyqxmd.com/read/28459665/roderigo-lopez-physician-in-chief-to-queen-elizabeth-i-of-england
#7
George M Weisz, Donatella Lippi
Roderigo Lopez, former Physician-in-Chief to Queen Elizabeth I of England, was a controversial figure in his time and continues to be the subject of controversy. Much has been written about his religious practice, politics, and guilt, or lack thereof, with regard to charges of treason to the Crown. However, the fact remains that Lopez was the only physician to the Crown to be sentenced to death. All evidence points to an anti-Semitic mindset that played in the background. Yet Lopez so endeared himself to the Queen that although he was indeed sentenced to death, almost all of his property was restored to his family...
July 31, 2017: Rambam Maimonides Medical Journal
https://www.readbyqxmd.com/read/28459664/the-development-of-robotic-technology-in-cardiac-and-vascular-interventions
#8
REVIEW
Ali Pourdjabbar, Lawrence Ang, Ryan R Reeves, Mitul P Patel, Ehtisham Mahmud
Robotic technology has been used in cardiovascular medicine for over a decade, and over that period its use has been expanded to interventional cardiology and percutaneous coronary and peripheral vascular interventions. The safety and feasibility of robotically assisted interventions has been demonstrated in multiple studies ranging from simple to complex coronary lesions, and in the treatment of iliofemoral and infrapopliteal disease. These studies have shown a reduction in operator exposure to harmful ionizing radiation, and the use of robotics has the intuitive benefit of alleviating the occupational hazard of operator orthopedic injuries...
July 31, 2017: Rambam Maimonides Medical Journal
https://www.readbyqxmd.com/read/28448252/hypothyroidism-in-carcinoma-of-the-tongue-with-adjuvant-treatment
#9
Sabita Kumari, Jonathan Gondi, Hemantkumar Nemade, L M Chandra Sekhara Rao, Deleep Gudipudi, T Subramanyeshwar Rao
OBJECTIVE: The objective of this study was to evaluate the incidence of hypothyroidism with adjuvant treatment in oral tongue carcinoma patients treated primarily with surgery. MATERIALS AND METHODS: A retrospective review was carried out to analyze hypothyroidism incidence and its relation to adjuvant treatment (radiation/radio-chemotherapy) in oral tongue carcinoma after the primary surgical ablation and neck dissection. Hypothyroidism was analyzed in relation with dose of radiation, gender, and adjuvant treatment modality...
July 31, 2017: Rambam Maimonides Medical Journal
https://www.readbyqxmd.com/read/28786812/the-role-of-exercises-in-osteoporotic-fracture-prevention-and-current-care-gaps-where-are-we-now-recent-updates
#10
REVIEW
Helen Senderovich, Henry Tang, Samuel Belmont
INTRODUCTION: The primary non-pharmacological management recommended for patients with osteoporosis (OP) is exercise, but whether it should be high-force, resistive, or other means can be obscure. OBJECTIVE: To describe the role of exercises in osteoporotic fracture prevention, identify effects and potential risks of high-force exercises, detect the optimal exercises to combat OP, and explore the challenges that might arise from interventions. METHODS: A search on MEDLINE and Cochrane databases was conducted on the role of exercises in preventing osteoporotic fractures from 1989 onwards, leading to 40 results, including op-ed pieces, qualitative studies, randomized clinical trials (RCTs) (n=5), and RCT follow-up studies (n=1)...
July 1, 2017: Rambam Maimonides Medical Journal
https://www.readbyqxmd.com/read/28786811/nurturing-a-society-of-learners-suggestions-from-traditional-jewish-pedagogy-for-medical-education
#11
REVIEW
Jacob Urkin, Edward Fram, Allen Jotkowitz, Sody Naimer
Historically speaking, in many societies a select few carried the burden of preserving and transferring knowledge. While modern society has broadened the scope of education, this is not enough in the medical sciences. We must ensure that all those who pursue a career in medicine become life-long learners who will grow and contribute well beyond their years in medical school. In considering how to attain this goal, we were intrigued by the similarities between generations-old wisdom of teaching and learning methods in Jewish culture and modern educational principles...
July 1, 2017: Rambam Maimonides Medical Journal
https://www.readbyqxmd.com/read/28786809/alfred-nobel-and-his-prizes-from-dynamite-to-dna
#12
REVIEW
Marshall A Lichtman
Alfred Nobel was one of the most successful chemists, inventors, entrepreneurs, and businessmen of the late nineteenth century. In a decision later in life, he rewrote his will to leave virtually all his fortune to establish prizes for persons of any nationality who made the most compelling achievement for the benefit of mankind in the fields of chemistry, physics, physiology or medicine, literature, and peace among nations. The prizes were first awarded in 1901, five years after his death. In considering his choice of prizes, it may be pertinent that he used the principles of chemistry and physics in his inventions and he had a lifelong devotion to science, he suffered and died from severe coronary and cerebral atherosclerosis, and he was a bibliophile, an author, and mingled with the literati of Paris...
July 1, 2017: Rambam Maimonides Medical Journal
https://www.readbyqxmd.com/read/28786808/flipping-patients-and-frames-the-patient-in-relational-medicine
#13
Henri Zukier
Medicine has evolved in two opposite directions. Evidence-based medicine focuses more on laboratory and computer data than on the patient. Yet experimental data also provide growing evidence for the importance of the patient's social-psychological "demand" side of medicine, to complement the doctor's bio-cognitive "supply" side. The patient's mindset has major diagnostic and therapeutic effects. The patient's experience is shaped by perceptions of four dimensions: meaning, agency, self-image, and temporal focus...
July 1, 2017: Rambam Maimonides Medical Journal
https://www.readbyqxmd.com/read/28467769/fear-of-vaginal-penetration-in-the-absence-of-pain-as-a-separate-category-of-female-sexual-dysfunction-a-conceptual-overview
#14
David Rabinowitz, Lior Lowenstein, Ilan Gruenwald
Functional sexual pain disorders in women are a particular challenge to the gynecologist, inasmuch as phobic avoidance and guarding on the part of the patient lead to difficulties in the gynecological examination and diagnosis. In some such cases examination may even be impossible. Vaginismus is the commonly diagnosed etiology of such cases. This article offers an overview of vaginismus and approaches to its treatment but also examines a subset of penetration-avoidant patients who do not appear to have a pain component...
April 28, 2017: Rambam Maimonides Medical Journal
https://www.readbyqxmd.com/read/28467768/gnrh-agonist-triggering-of-ovulation-replacing-hcg-a-30-year-old-revolution-in-ivf-practice-led-by-rambam-health-care-campus
#15
REVIEW
Shahar Kol, Ofer Fainaru
Final oocyte maturation is a crucial step in in vitro fertilization, traditionally achieved with a single bolus of human chorionic gonadotropin (hCG) given 36 hours before oocyte retrieval. This bolus exposes the patient to the risks of ovarian hyperstimulation syndrome (OHSS), particularly in the face of ovarian hyper-response to gonadotropins. Although multiple measures were developed to prevent OHSS, gonadotropin-releasing hormone (GnRH) agonist triggering is now globally recognized as the best approach to achieve this goal...
April 28, 2017: Rambam Maimonides Medical Journal
https://www.readbyqxmd.com/read/28467767/impact-of-endometrial-preparation-protocols-for-frozen-embryo-transfer-on-live-birth-rates
#16
Maria Cerrillo, Leyre Herrero, Alfredo Guillén, Mercedes Mayoral, Juan Antonio García-Velasco
BACKGROUND: It has been reported that a natural cycle (NC) is similar to or even better than hormone replacement therapy (HRT) in patients with regular cycles who undergo frozen embryo transfer (FET). Hundreds of FETs are managed yearly in our clinic. Scheduling these cycles is critical in a busy unit like ours. This is why we have to prove if a NC really shows a better outcome than other endometrium preparation protocols. METHODS: Hence we carried out a prospective study between June 2011 and June 2012, which included 530 patients (570 FET cycles) randomly allocated to two study groups: Group 1 (n=280 cycles), artificial cycle (HRT); or group 2 (n=290 cycles), natural cycle...
April 28, 2017: Rambam Maimonides Medical Journal
https://www.readbyqxmd.com/read/28467766/was-the-military-operation-protective-edge-a-risk-factor-for-pregnancy-complications
#17
Ohad Gluck, Yossi Mizrachi, Sophia Leytes, Jacob Bar, Michal Kovo
OBJECTIVE: During July-August 2014, the military operation "Protective Edge" presented Israel with a threat of missile attacks. We aimed to investigate the influence of the "Protective Edge" operation on the rate of pregnancy complications among the population exposed to missile attacks, compared to the population not exposed. STUDY DESIGN: This was a retrospective study. Pregnancy outcomes were compared between women who during pregnancy were exposed to the stress of the military operation (exposed group, n=4,673) and gave birth at the Wolfson Medical Center, and women who gave birth in the previous year (unexposed group, n=4,735)...
April 28, 2017: Rambam Maimonides Medical Journal
https://www.readbyqxmd.com/read/28467765/rambam-hospital-is-the-birthplace-of-the-modern-version-of-transvaginal-ultrasound
#18
Ilan E Timor-Tritsch
The worldwide use of the transvaginal scanning route has revolutionized obstetrical and gynecologic imaging. The long, slow, and at times challenging aspects of its acceptance by the obstetrical and gynecologic community are the subject of this article. From its inception to its recent use, the dedicated doctors in the Department of Obstetrics and Gynecology at Rambam Medical Center, Haifa, Israel, were instrumental in conceiving and then collaborating with an Israeli manufacturer in the construction and worldwide use of the transvaginal ultrasound probe, resulting in the now well-known field of transvaginal sonography...
April 28, 2017: Rambam Maimonides Medical Journal
https://www.readbyqxmd.com/read/28467764/anovulatory-patients-demonstrate-a-sharp-decline-in-lh-levels-upon-gnrh-antagonist-administration-during-ivf-cycles
#19
Linoy Segal, Ofer Fainaru, Shahar Kol
To evaluate the decrease in luteinizing hormone (LH) levels following gonadotropin-releasing hormone (GnRH) antagonist administration in in vitro fertilization (IVF) cycles, data were retrospectively collected from 305 consecutive IVF or intracytoplasmic sperm injection (ICSI) cycles of patients who underwent ovarian stimulation with gonadotropins and were treated with GnRH antagonist for the prevention of premature luteinization. We compared the percent change in LH concentration from stimulation start to that observed before ovulation triggering in patients with or without anovulation...
April 28, 2017: Rambam Maimonides Medical Journal
https://www.readbyqxmd.com/read/28467763/surgical-updates-in-the-treatment-of-pelvic-organ-prolapse
#20
REVIEW
Julia Geynisman-Tan, Kimberly Kenton
Pelvic organ prolapse affects approximately 8% of women, and the demand for pelvic organ prolapse surgery is expected to increase by nearly 50% over the next 40 years. The surgical techniques used to correct pelvic organ prolapse have evolved over the last 10 years, with multiple well-designed studies addressing the risks, outcomes, reoperation rates, and optimal surgical approaches. Here we review the most recent evidence on the route of access, concomitant procedures, and synthetic materials for augmenting the repair...
April 28, 2017: Rambam Maimonides Medical Journal
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