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Rambam Maimonides Medical Journal

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https://www.readbyqxmd.com/read/29215980/unilateral-vocal-cord-paralysis-of-a-great-jewish-opera-singer
#1
Irit Duek, Jacob T Cohen, Ziv Gil
George London was one of the most compelling vocal artists of the early twentieth century. At the age of 47, the great bass-baritone retired from singing. It has been suggested that the premature ending of his operatic career was due to unilateral vocal cord palsy (UVCP). When London retired, the common belief was that this UVCP was caused by viral hepatitis, although there is no evidence to support such an etiology. London's medical records eliminate the possible etiology of a neck neoplasm, and the long period of time between a heart attack he experienced and his diagnosis of UVCP makes a cardiovascular etiology an unlikely causative factor...
December 6, 2017: Rambam Maimonides Medical Journal
https://www.readbyqxmd.com/read/29135419/the-risk-of-cancer-might-be-lower-than-we-think-alternatives-to-lifetime-risk-estimates
#2
Gilat L Grunau, Shay Gueron, Boris Pornov, Shai Linn
BACKGROUND: Estimates of lifetime cancer risk are commonly used in the clinical setting and in health-care evaluations. These measures are based on lifetime cancer risk estimates and may create an unrealistically frightening perception of cancer risk for an individual. We suggest using two new measures of cancer risk to complement the cancer lifetime risk measure, namely estimates of cancer risk from birth to a specific age or from a specific age to life expectancy. METHODS: We calculated risks using incidence density data from the Israel National Cancer Registry of 2013, applying a well-known formula for calculating risk, for a follow-up time...
October 16, 2017: Rambam Maimonides Medical Journal
https://www.readbyqxmd.com/read/29035696/the-reliability-of-surgical-apgar-score-in-predicting-immediate-and-late-postoperative-morbidity-and-mortality-a-narrative-review
#3
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/29059046/artificial-sperm-new-horizons-in-procreation
#4
REVIEW
Gilad Amiel, Valentin Shabataev, Raanan Tal
Azoospermia, the absence of any sperm cells from the ejaculated semen, poses a real challenge to the fertility urologist. While there are options to create happy families for azoospermic couples, such as the use of donor sperm and adoption, most couples still want to have genetically related offspring. Advances in urology, gynecology, and fertility laboratory technologies allow surgical sperm retrieval in azoospermic men and achievement of live births for many, but not all azoospermic couples. At present, there are extensive research efforts in several directions to create new fertility options by creating "artificial sperm cells...
October 16, 2017: Rambam Maimonides Medical Journal
https://www.readbyqxmd.com/read/29059045/update-on-screening-for-urological-malignancies
#5
REVIEW
Gilad Amiel, Azik Hoffman, Elizabeth E Half
Urological malignancies are a major source of morbidity and mortality in men over 40. Screening for those malignancies has a potential benefit of reducing both. However, even after more than two decades of screening for prostate cancer, the implications of most resulting information are still a matter of debate. Controversy extends over several aspects of prostate cancer screening programs, including age of onset, defining populations at risk, most appropriate intervals, as well as the optimal methods to be used for screening...
October 16, 2017: Rambam Maimonides Medical Journal
https://www.readbyqxmd.com/read/29059044/expanding-the-utilization-of-robotic-procedures-in-urologic-surgery
#6
REVIEW
Gilad Amiel, Tareq Aro, Michael Mullerad, Gilad E Amiel
Although the word "robot" was coined in 1921, only close to 70 years later were robotic devices developed to assist during surgery. Urology has always been at the forefront of endoscopic, minimally invasive, and robotic developments in medicine. Robotic prostatectomy signaled the emerging role of robotic surgery in urology, but since then it has been applied to every urologic laparoscopic procedure.
October 16, 2017: Rambam Maimonides Medical Journal
https://www.readbyqxmd.com/read/29059043/the-urology-residency-program-in-israel-results-of-a-residents-survey-and-insights-for-the-future
#7
Gilad Amiel, Arnon Lavi, Sharon Tzemah, Anan Hussein, Ibrahim Bishara, Nikolay Shcherbakov, Genady Zelichenko, Alon Mashiah, Michael Gross, Michael Cohen
OBJECTIVE: Urology practice has undergone several changes in recent years mainly related to novel technologies introduced. We aimed to get the residents' perspective on the current residency program in Israel and propose changes in it. METHODS: A web-based survey was distributed among urology residents. RESULTS: 61 residents completed the survey out of 95 to whom it was sent (64% compliance). A total of 30% replied that the 9 months of mandatory general surgery rotation contributed to their training, 48% replied it should be shortened/canceled, and 43% replied that the Step A exam (a mandatory written certifying exam) in general surgery was relevant to their training...
October 16, 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
#8
Gilad Amiel, 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...
October 16, 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
#9
REVIEW
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...
October 16, 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
#10
REVIEW
Gilad Amiel, 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...
October 16, 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
#11
Gilad Amiel, Marcia C Javitt, Alexander Kravtsov, Zohar Keidar, Sobhi Abadi, Gilad E 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)...
October 16, 2017: Rambam Maimonides Medical Journal
https://www.readbyqxmd.com/read/28786810/open-communication-and-discussion-facilitate-reconciliation-the-promise-fulfilled
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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