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Risk factors for an atherothrombotic event in patients with diabetic macular edema treated with intravitreal injections of bevacizumab

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International Journal of Ophthalmology(English edition) 2020年第9期13卷 1411-1416页

作者： Alon Tiosano Aviel Hadad Noam Yanculovic Department of Ophthalmology Soroka University Medical CenterBen-Gurion University of the NegevBeer Sheva 84101Israel

AIM:To identify risk factors for an atherothrombotic event(ATE)among patients who were treated for diabetic macular edema(DME)with intravitreal bevacizumab ***:This retrospective study enrolled all consecutive patients with DME who were treated by intravitreal bevacizumab from 2009 through 2016 in a single *** were divided into one group treated by bevacizumab and subsequently had an ATE and a second group also treated by bevacizumab and did not have an ***:A total of 455 patients with DME were ***-two of the patients had an ATE.A multivariate model adjusted for age,gender,smoking,body mass index,hemoglobin A1c(HbA1c),duration of diabetes,creatinine,and blood pressure revealed an increased risk for ATE in the patients with diabetic duration of more than 13 y,a systolic blood pressure over 153.5 mm Hg at first treatment,or having been treated by more than 4 intravitreal bevacizumab ***,patients that had an ATE within 3 mo from the last intravitreal treatment underwent more bevacizumab injections(5.2±3.4 vs 3.07±1.86;P153.5 mm Hg,a history of diabetic mellitus for more than 13 y,and treatment with more than 4 intravitreal bevacizumab *** factors need to be borne in mind when bevacizumab is being considered in the management of patients with DME.

关键词： atherothrombotic event bevacizumab diabetic macular edema

Minimizing treatment complexity of combat-related soft tissue injuries using a dedicated tension relief system and negative pressure therapy augmented by high-dose in situ antibiotic therapy and oxygen delivery: a retrospective study

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Burns & Trauma 2021年第1期9卷 454-463页

作者： Moris Topaz Itamar Ashkenazi Oren Barzel Seema Biswas Dan Atar Nurit Shadmi Itzhak Siev-Ner Sheba medical center Ramat GanIsrael Hillel Yaffe medical center HaderaIsrael Rambam medical center HaifaIsrael Galilee medical center NahariyaIsrael soroka medical center Beer ShevaIsrael Adi Negev Rehabilitation Hospital MerhavimIsrael

Background:Following combat-related,extensive soft tissue injury from gunshot wounds or blasts,prolonged duration from injury to full wound closure is associated with infection,increased morbidity and mortality,failure to mobilize,poor functional outcome and increased *** purpose of this study was to evaluate a novel treatment enabling early primary closure of combat ***:This was a retrospective study of 10 soldiers and civilians with extensive combat-related soft tissue limb injuries(5 gunshot wounds,5 blasts)treated using the TopClosure^(■)Tension Relief System(TRS)with simultaneous administration of regulated oxygen-enriched and irrigation negative pressure-assisted wound therapy(ROINPT)via the Vcareα^(■)***:Nine patients were treated during the acute phase of injury and one was treated following removal of a flap due to deep infection 20 years after injury and flap *** patients had upper limb injury and the rest lower limb *** the aid of the TRS and/or ROINPT,immediate primary closure during reconstruction was achieved in 6 patients and delayed primary closure in *** one patient required a skin graft to close a small area of the wound after most of the wound had been closed by delayed primary *** closure was achieved within 0–37 days(median:12.5 days,interquartile range:2.75–19.75)from ***:The TRS is a novel device for effective,early skin stretching and secure wound closure through the application of stress relaxation and mechanical creep,achieving primary closure of large defects using a simplified surgical technique and reducing the need for closure using skin grafts and flaps and the use of tissue *** supplemental oxygen to the wound by ROINPT reverses the reduced oxygen levels inherent in conventional negative pressure-assisted wound therapy,mitigating anaerobic contamination and reducing *** may accelerate the evacuation of infectious materia

关键词： Soft tissue injury Combat injuries Limb injuries Stress relaxation Mechanical creep Tension relief systems

Orchiopexy:one procedure,two diagnoses-different male infertility outcomes

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Asian Journal of Andrology 2024年第5期26卷 472-478页

作者： Nitza Heiman Newman Idan Farber Eitan Lunenfeld Atif Zeadna Iris Har Vardi Zaki Assi Faculty of Health Sciences Ben Gurion University of the NegevBeer Sheva 84105Israel Department of Pediatric Surgery Soroka University Medical CenterBeer Sheva 84101Israel Adelson School of Medicine Ariel UniversityAriel 40700Israel IVF Unit Diviation of Obstetrics and GynecologySoroka University Medical CenterBeer Sheva 84010Israel

Infertility,affecting one in six couples,is often related to the male partner’s congenital and/or environmental conditions or complications *** retrospective study examines the link between orchiopexy for undescended testicles(UDT)and testicular torsion(TT)in childhood and adult fertility as assessed through sperm *** study involved the analysis of semen samples from 7743 patients collected at soroka University medical center(Beer Sheva,Israel)between January 2009 and December *** were classified into two groups based on sperm concentration:those with concentrations below 5×10^(6)sperm per ml(AS group)and those above(MN group).medical records and surgical histories were reviewed,categorizing orchiopexies by surgical *** 140 individuals who had undergone pediatric surgery,83(59.3%)were placed in the MN group and 57(40.7%)in the AS group.A higher likelihood of being in the MN group was observed in Jewish compared to Arab patients(75.9%vs 24.1%,P=0.006).In cases of childhood UDT,45(78.9%)patients exhibited sperm concentrations below 5×10^(6)sperm per ml(P<0.001),and 66(76.7%)had undergone unilateral and 18(20.9%)bilateral *** orchiopexy was significantly associated with lower sperm concentration,total motility,and progressive motility than unilateral cases(P=0.014,P=0.001,and P=0.031,respectively).Multivariate analysis identified UDT as a weak risk factor for low sperm concentration(odds ratio[OR]:2.712,P=0.078),with bilateral UDT further increasing this risk(OR:6.314,P=0.012).Jewish ethnicity and TT diagnosis were associated with a reduced risk of sperm concentrations below 5×10^(6)sperm per *** findings indicate that initial diagnosis,surgical approach,and ethnicity markedly influence male fertility outcomes following pediatric orchiopexy.

关键词： male infertility orchiopexy sperm analysis testicular torsion undescended testicle

Erdheim chester-A rare disease with unique endoscopic features

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World Journal of Gastroenterology 2014年第25期20卷 8309-8311页

作者： Gil Ben-yaakov Daniela Munteanu Ignacio Sztarkier Alexer Fich Doron Schwartz Institute of Gastroenterology and Hepatology Soroka University Medical Center Faculty of Health Science Ben Gurion University of the NegevBeer sheva 84101Israel Institute of Pathology Soroka University Medical Center Faculty of Health Science Ben Gurion University of the Negev Beer sheva 84101 Israel

Erdheim-Chester disease(ECD) is a rare inflammatory syndrome in which systemic infiltration of non-Langerhans cell histiocytes occurs in different sites. Both the etiology and pathophysiology of ECD are unknown, but CD68 positive CD 1a/S100 negative cells are characteristic. The presentation of ECD differs according to the involved organs. This case report describes a patient with ECD and the gastrointestinal manifestations and unique endoscopic appearance as seen in gastroscopy and colonoscopy with histological proof of histiocyte infiltration of the lamina propria. The clinical and endoscopic findings of this unique case, to our knowledge, were never described before, so were the features of the gastrointestinal involvement in this disease.

关键词： Erdheim chester Histiocytes Lamina propria Colon Stomach

Manipulation of the intestinal microbiome-a slow journey to primetime

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World Journal of Clinical Cases 2023年第21期11卷 4975-4988页

作者： Ofra Kriger-Sharabi Stephen D H Malnick David Fisher Institute of Gastroenterology Assuta Medical CenterAshdod 7747629Israel Department of Internal Medicine Kaplan Medical CenterRehovot 76100Israel Department of Endocrinology Soroka Medical CenterBeer Sheva POB 151Israel

The gut microbiota has important functions in the regulation of normal body *** of the microbiota are being increasingly linked to various disease *** microbiome has been manipulated via the administration of stool from animals or humans,for more than 1000 ***,fecal microbiota transplantation can be performed via endoscopic administration of fecal matter to the duodenum or colon or via capsules of lyophilized *** recently fecal microbial transplantation has been shown to be very effective for recurrent Clostridoides difficile infection(CDI).In addition there is some evidence of efficacy in the metabolic syndrome and its hepatic manifestation,metabolic associated fatty liver disease(MAFLD),irritable bowel syndrome(IBS)and inflammatory bowel disease(IBD).We review the current literature regarding the microbiome and the pathogenesis and treatment of CDI,MAFLD,IBS and IBD.

关键词： Gut microbiota Fecal microbiota transplantation Clostridoides difficile Metabolic associated fatty liver disease Irritable bowel syndrome Inflammatory bowel disease

Pegylated interferon alfa and ribavirin for children with chronic hepatitis C

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World Journal of Gastroenterology 2013年第7期19卷 1098-1103页

作者： Irit Rosen Michal Kori Orly Eshach Adiv Baruch Yerushalmi Nataly Zion Ron Shaoul Pediatric Gastroenterology and Nutrition Unit Meyer Children's HospitalRambam Medical CenterBruce Rappaport Faculty of MedicineTechnionHaifa 31096Israel Pediatric Gastroenterology and Nutrition Unit Kaplan Medical CenterRehovot 76100Israel Pediatric Gastroenterology and Nutrition Unit Soroka Medical CenterBen Gurion University Faculty of MedicineBe'er Sheva 84101Israel

AIM:To study current treatment options for pediatric hepatitis C infection and their associated success ***:We retrospectively reviewed charts of thirty children who had been treated with combination therapy of pegylated interferon alfa plus ribavirin for chronic hepatitis C *** had been treated with ribavirin(15 mg/kg per day) and either pegylated interferon alfa 2a(180 mg/m 2 once weekly) or pegylated interferon alfa 2b(1.5 mg/kg once weekly).Patients' follow-up included subjective assessment of complaints,physical examination including weight and height,as well as laboratory evaluations for viral load [before treatment,at 12 wk,and 6 mo following treatment completion,as determined by sustained viral response(SVR)],complete blood count,liver enzymes,alkaline phosphatase,bilirubin,renal function tests,and thyroid function *** patients not achieving a two log decrease in viral load at treatment week 12,treatment was discontinued and the patient was considered a treatment ***:Thirty children aged 3-18 years were included in the *** patients(11 males,9 females) received pegylated interferon alfa 2b and ten patients(6 males,4 females) received pegylated interferon alfa ***-three patients were infected with genotype 1,six patients were infected with genotype 3,and one patient was infected with genotype *** patients(67%) achieved *** success rates were 90% with pegylated interferon alfa 2a vs 55% with pegylated interferon alfa *** a trend was noted for improved outcomes in the group receiving pegylated interferon alfa 2a,there were no statistically significant outcome differences between the two treatment groups(P = 0.1).Treatment success was 56.5% for patients infected with genotype 1 virus,compared to 100% for patients infected with other genotypes(P = 0.064).There was no difference in treatment response between males and females.A cut-off age of twelve years was used to dichotomize

关键词： Hepatitis C virus Interferon alfa Ribavirin Children Sustained viral response

Regulation of spermatogenesis by paracrine/autocrine testicular factors

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Asian Journal of Andrology 2004年第3期6卷 259-268页

作者： Mahmoud Huleihel Eitan Lunenfeld Department of Microbiology and Immunology and BGU Cancer Research center Faculty of Health Sciences Ben-Gurion University of the NegevBeer-ShevaIsraelDepartment of Obstetrics and GynecologySoroka University Medical Center Faculty of Health SciencesBen-Gurion University of the NegevBeer-ShevaIsrael

Spermatogenesis is a complex process regulated by endocrine and testicular paracrine/autocrine factors. Gonadotropins are involved in the regulation of several testicular paracrine factors, mainly of the IL-1 family and testicular hormones. Testicular cytokines and growth factors (such as IL-1, IL-6, TNF, IFN-γ, LIF and SCF) were shown to affect both the germ cell proliferation and the Leydig and Sertoli cells functions and secretion. Cytokines and growth factors are produced by immune cells and in the interstitial and seminiferous tubular compartments by various testicular cells, including Sertoli, Leydig, peritubular cells, spermatogonia, differentiated spermatogonia and even spermatozoa. Corresponding cytokine and growth factor receptors were demonstrated on some of the testicular cells. These cytokines also control the secretion of the gonadotropins and testosterone in the testis. Under pathological conditions the levels of pro-inflammatory cytokines are increased and negatively affected spermatogenesis. Thus, the expression levels and the mechanisms involved in the regulation of testicular paracrine/autocrine factors should be considered in future therapeutic strategies for male infertility.

关键词： spermatogenesis paracrine autocrine cytokine growth factor

Parental acceptability of the watchful waiting approach in pediatric acute otitis media

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World Journal of Clinical Pediatrics 2016年第2期5卷 198-205页

作者： Arnon Broides Olga Bereza Noga Lavi-Givon Yariv Fruchtman Eli Gazala Eugene Leibovitz Pediatric Emergency Department Soroka University Medical Center Faculty of Health Sciences Ben-Gurion University of the Negev Family Medicine Department Soroka University Medical Center Faculty of Health Sciences Ben-Gurion University of the Negev Pediatric Infectious Disease Unit Soroka University Medical Center Faculty of Health Sciences Ben-Gurion University of the Negev Child Health Community center Soroka University Medical Center Faculty of Health Sciences Ben-Gurion University of the Negev

AIM: To determine parental knowledge about acute otitis media(AOM) and its antibiotic therapy, antibiotic resistance and the willingness to comply with the watchful waiting(WW) approach in primary care settings in southern ***: The study was conducted in 3 primary care clinics and the pediatric emergency room of soroka University medical center. Questionnaires(20 questions on education background, previous AOM experience, knowledge on antimicrobial resistance and attitude vs the WW approach) were filled by 600 parents(150 at each centers) of children < 6 years of ***: Mothers represented 69% of parents; 2% had an education of < 10 school years, 46% had high-school education and 17% had an academic degree. 69% parents reported previous experience with AOM and 56% thought that antibiotics represent the only treatment for AOM. Knowledge on bacterial resistance to antibiotics was reported by 57% of the parents; 86% parents were willing to accept/probably accept the WW approach for their children. Logistic regression analysis revealed a significant association between parental education and knowledge about bacterial resistance to antibiotics and that previous experience with AOM was significantly associated with reluctance to accept the WW approach. More parents with knowledge on bacterial resistance were willing to accept the WW approach compared with parents without such knowledge. No correlation was found between the education level and willingness to accept the WW approach. CONCLUSION: A significant correlation was found between previous parental education and experience with AOM and the knowledge about antibiotic use, bacterial resistance and acceptance of the WW approach.

关键词： Acute otitis media Children Antibiotics Parents Watchful waiting Bacteria Resistance

Decompressive Craniectomy for Posterior Reversible Encephalopathy Syndrome (PRES): Case Report

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Case Reports in Clinical Medicine 2015年第5期4卷 169-174页

作者： Amit Azriel Israel Melamed Ilan Shelef Yuval Sufaro Micky Gidon Vladimir Merkin Alexandr Shtreizent Avi Cohen Department of Neurosurgery Soroka Medical Center Be’er-Sheva Israel Diagnostic Imaging Institute Soroka Medical Center Be’er-Sheva Israel Department of Neurosurgery The Royal Melbourne Hospital Melbourne Australia

Background: Posterior reversible encephalopathy syndrome (PRES) is an uncommon clinical-neuroradiological syndrome with an unclear pathophysiology. Correlation between PRES and the use of immunosuppressant drugs have previously been described, as well as correlation between elevated blood pressure and PRES. Characteristic brain MRI manifestations include hyperintense lesions on T2 and FLAIR (fluid-attenuated inversion recovery) images. PRES is usually reversible within a short period of time after discontinuation of the presumably offending drug. Some cases of PRES might complicate with intracranial hemorrhage, refractory status epilepticus or expansive vasogenic brain edema (also regarded as “tumefactive” PRES). Methods: We present a case of a young man diagnosed with Hodgkin’s lymphoma, following a laparotomy due to cecal volvulus. The patient received glucocorticoids and elevated blood pressure values were recorded. Brain imaging studies were performed due to generalized epileptic seizures, demonstrating neuroradiological findings consistent with PRES. Neurological and neuroradiological deterioration was noted, necessitating urgent neurosurgical intervention. A complete neurological and functional rehabilitation was achieved. Conclusion: The uncommon cases of complicated PRES should be taken under consideration whenever clinical deterioration is noted following the diagnosis of PRES. Early neuroradiological evaluation should be sought, together with aggressive medical and surgical treatment in cases of life threatening mass effect.

关键词： PRES Posterior Reversible Encephalopathy Syndrome Brain Edema Craniectomy