The Talmud describes several illnesses attributed to Rabbi Judah ha-Nasi, one of the foremost leaders of the Jewish people after the destruction of the Second Temple, and the compiler of the canonical Mishnah. Among these conditions, Tzafedina of the oral cavity is mentioned, characterized by severe and persistent pain lasting for seven years. Although many modern scholars tend to identify this condition with scurvy, the Talmudic accounts of Rabbi Judah’s diet and lifestyle do not support a state of nutritional deficiency. Moreover, scurvy is not typically associated with oral pain. Instead, it is more plausible that the term Tzafedina functioned as an umbrella designation for a spectrum of oral disorders, potentially involving the teeth or gingiva. When applied to Rabbi Judah ha-Nasi, the Talmudic narrative appears to emphasize the psychological and symbolic dimensions of suffering. Thus, in addition to the possibility of organic oral pathologies with psychosomatic components that may manifest in the gingiva, the account may also correspond to chronic oral pain syndromes recognized in contemporary oral medicine.
Introduction: Polypharmacy carries the potential for increased risk and severity of adverse reactions. Deprescribing may reduce adverse events and possibly hospitalizations, although evidence on hard outcomes such as mortality is mixed. As the medication experts responsible for the close monitoring of their patient, doctors, nurses, and pharmacists play a crucial role in the process of medication deprescribing. They are involved in the therapeutic process and contribute to the appropriate use of medications and the proper discontinuation of those that no longer benefit the patient or are harmful. This role is particularly important for vulnerable groups, such as older people, who often take chronic medication.
Objective: This study aims to review the literature on polypharmacy and the importance of suspending unnecessary or harmful medications in older people, emphasizing the role of healthcare professionals in the process.
Methods: A narrative review of recent publications (articles from 2023 to 2025) in Web of Science, PubMed, and Scopus databases, addressing polypharmacy and deprescribing in older adults was conducted.
Conclusions: A multidisciplinary team including doctors, nurses, and pharmacists plays a pivotal role in this process by reviewing patients’ therapeutic regimens, identifying inappropriate medications, and monitoring the withdrawal process. Their intervention can support more appropriate medication use, may improve patients’ quality of life, and has the potential to reduce healthcare costs.
While individual Jewish plastic surgeons have been recognized in the literature for their groundbreaking achievements, a comprehensive review of their collective contributions to plastic surgery is lacking. The goal of this review is to document and highlight the major advancements made by Jewish physicians whose work significantly impacted plastic and reconstructive surgery from its inception as a discipline to the present day. A comprehensive literature search was conducted to identify key developments in the history of plastic surgery, which were then narrowed to those made by Jewish practitioners. The Jewish identity of these practitioners, along with the significance of their work, was verified through historical records, newspaper archives, and peer-reviewed publications. Contributions were then organized chronologically to construct a cohesive historical narrative. Beginning in the 1800s and accelerating through the 20th century, Jewish plastic surgeons have been instrumental in shaping the field. Their innovations include advancements in the treatment of facial deformities, the development of the lumpectomy with adjunctive radiation therapy as a less invasive alternative to radical mastectomy, and the founding of key institutions such as the American Society of Plastic Surgeons and the International College of Surgeons. Additional breakthroughs include the use of albumin in burn management, foundational work in angiogenesis physiology, and numerous innovations in cosmetic surgery. The history of plastic and reconstructive surgery is a rich tapestry of discovery and evolution. Fully understanding its development is not possible without acknowledging the enduring and transformative contributions of Jewish surgeons and researchers.
Objectives: This study explored the relationship between visual perceptual skills and participation performance in 4–6-year-old children diagnosed with autism spectrum disorder (ASD).
Methods: A cross-sectional design was employed for children diagnosed with ASD. Visual perceptual abilities were assessed using the Motor-Free Visual Perception Test–Fourth Edition (MVPT-4), and participation levels were measured using the Children Participation Questionnaire (CPQ). Statistical analysis was done using SPSS version 26, employing one-sample t-tests and Pearson correlation analysis.
Results: A total of 48 participants were included in the study: mean age, 4.98±0.82 years; 66.7% were male; 79.2% attended regular schools. One-sample t-tests indicated significant deficits across all CPQ dimensions (P<0.001). Visual perception was negatively correlated with autism severity (r=-0.429, P=0.002) and positively correlated with participation diversity (r=0.404, P=0.004). In the activities of daily living (ADL) and instrumental ADL (IADL) occupations, visual perception was significantly associated with all CPQ elements. Conversely, play and leisure occupations showed mostly negative correlations with the CPQ occupations, while social participation and education showed mixed results. Visual perception was positively correlated with most elements but negatively associated with enjoyment (r=-0.428; P=0.002).
Conclusions: Preschool children with ASD demonstrate significant participation restrictions. Visual perception emerged as a critical determinant of participation, particularly in ADL and educational contexts. Early interventions targeting visual perception skills may enhance independence and functional engagement, though interventions should also address the enjoyment and emotional experience occupations to ensure holistic participation outcomes.
Background: The Circassian community in Israel represents a unique, endogamous population residing in two villages in the northern region of Israel: Kfar Kama (209 meters above sea level [m.a.s.l.]) and Rihaniya (674 m.a.s.l.).
Objectives: This study sought to investigate whether the small difference in altitude between these two locations (465 m) affects red blood cell (RBC) and hemoglobin (Hb) parameters in the residents.
Methods: We examined the data from 2,517 blood samples collected from adult Israeli Circassians over 2.5 years (January 2020–June 2022). To ensure independent observations, analysis was limited to each participant’s most recent complete blood count (CBC). Subjects were stratified by sex, age, anemia status, and residential location.
Results: Our analysis revealed that a difference of about 465 meters in residential altitude significantly elevated Hb, RBC count, and hematocrit (HCT) levels in non-anemic male and female cohorts. This elevation was accompanied by a small but significant decrease in mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH). Furthermore, we found that the effect of altitude on most RBC characteristics differed in anemic individuals of both sexes, although their RBC count still increased.
Conclusions: Even minor differences in residential altitude can significantly influence Hb and RBC parameters. This observation appears only in non-anemic individuals, probably reflecting physiological altitude Hb adaptation mechanisms. While further research is needed to fully elucidate the underlying mechanisms, our findings provide new data on the physiological impact of altitude on human health, particularly at low altitudes.
Background: Chronic hypoxemia in patients with COPD is associated with increased morbidity and mortality. Although arterial partial pressure of oxygen (PaO2) is widely used, it does not adequately reflect systemic oxygen transport. Arterial oxygen content (CaO2) may provide a more comprehensive assessment.
Objective: This study aimed to evaluate whether or not CaO2 is a better predictor of mortality than PaO2 in patients with COPD.
Methods: This retrospective observational cohort study included 147 COPD patients aged ≥45 years. Patients were categorized according to CaO2 levels (low, normal, high). Mortality at 1, 3, and 5 years was analyzed. Statistical methods included ROC curves, Kaplan–Meier survival analysis, and Cox regression models.
Results: A total of 66 deaths (45.2%) occurred in the study cohort. Mortality was highest in the low CaO2 group. The CaO2 demonstrated better predictive performance than PaO2 (AUC 0.73 vs 0.53, respectively). Low CaO2 was associated with a 2.5-fold increased risk of mortality. Despite improvements in PaO2 after long-term oxygen therapy, CaO2 did not significantly change.
Conclusions: The CaO2 is a more informative marker of oxygen transport and mortality risk than PaO2 in COPD patients. It should be considered a complementary parameter in clinical assessment.
Mifepristone (RU-486), the first clinically effective progesterone antagonist, was initially identified as having antiglucocorticoid activity. Although early interest focused on its role as a glucocorticoid receptor antagonist, recognition of its antiprogesterone effects led to studies of its role in pregnancy termination. This article reviews the steps leading to its use as an abortifacient, from its initial identification for this indication and draws on the author’s direct involvement in the field with reflections on his contribution to the early clinical development of mifepristone. These studies established the efficacy of mifepristone in pregnancy termination. Unfortunately, its wider therapeutic applications have received limited attention.
