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עמוד בית
Tue, 10.12.24

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January 2015
Khalil Salame MD, Gilad Regev MD, Ory Keynan MD and Zvi Lidar MD

Background: Most spine tumors are resistant to radiation and chemotherapy. Complete surgical removal provides the best chance for long-term control of the tumor. Total en bloc spondylectomy (TES) is a radical new technique that entails total removal of the tumor and affected vertebras with clean margins.

Objectives: To review our initial experience with TES, focusing on feasibility, surgical challenges and the short-term outcome.

Methods: We retrospectively reviewed the hospitalization charts and follow-up data of all patients treated with TES for spine tumors in the spine unit at Tel Aviv Medical Center.

Results: TES was performed in 12 patients aged 13–78 years. Nine patients had primary spinal tumors and three had metastasis. Total en bloc removal was achieved in all cases with spondylectomy of one to three affected vertebras. There was no perioperative mortality and only one major intraoperative complication of injury to a major blood vessel. Late complications were mainly related to hardware failure.

Conclusions: Total en bloc spondylectomy is feasible and effective for the management of selected patients with extradural spinal tumors. Since the surgical procedure is demanding and carries significant risk, careful preoperative evaluation and collaboration with colleagues from other specialties are crucial.

December 2008
Y. Waisel, A. Eshel, N. Keynan, D. Langgut

The pollen of Ambrosia (ragweed) is one of the major causes of pollen-induced allergy worldwide. This family of plants has apparently evolved in North America but was later spread into Europe and Asia. Flowering of the Ambrosias starts in mid-July and continues throughout the autumn and is a cause of major morbidity to allergic sensitized patients. The invasion of new species of Ambrosia into Israel is still in progress. Plants of Ambrosia artemisiifolia (American short ragweed), Ambrosia trifida (American giant ragweed), Ambrosia confertifolia, Ambrosia grayi and Ambrosia tenuifolia are increasingly found in Israel, mainly in the Hula valley in the eastern Galilee and near the Alexander River in the Sharon plain. From experience it is known that the time it takes to eradicate a new invasive species is limited. Action should be taken immediately or this new invasion will spread and cause a significantly increased burden of morbidity and increased health costs in Israel.

 
 

April 2008
Y. Keynan and D. Rimar
 Reiter’s syndrome is an eponym used to denote the triad of arthritis, urethritis and conjunctivitis. This syndrome is named after Hans Conrad Julius Reiter, who was involved in the activities of the Nazi Racial Hygiene Program related to involuntary sterilization, euthanasia and criminal research projects. Reiter defamed the entire medical profession and it was therefore suggested that the term Reiter’s syndrome be changed to reactive arthritis. We undertook to investigate the use of the eponym Reiter syndrome in medical literature, medical schools in Israel and medical textbooks, compared to the term reactive arthritis, by searching Medline between the years 2003 and 2007, 14 current medical textbooks, curricula of four medical schools in Israel, and computerized patient file systems in Israel. We found a decline in the use of the eponym in articles published between 2003 (18%) and 2007 (9%); however, most textbooks (13/14) still use the eponym. Two of the four medical schools in Israel continue to use the eponym. The eponym appears in the computerized patient files of all four healthcare providers in Israel. We hold that the continued use of the eponym Reiter syndrome in medical textbooks, medical schools and computerized patients files in Israel is honoring an abomination and is inconsistent with medical principles. Awareness is still lacking and we suggest deleting the Reiter syndrome eponym from use, and replacing it with the more appropriate term – reactive arthritis.
July 2006
D. Rimar, Y. Rimar and Y. Keynan
 Today, more than 10 years and 2000 articles since human herpesvirus 8 was first described by Chang et al., novel insights into the transmission and molecular biology of HHV-8[1] have unveiled a new spectrum of diseases attributed to the virus. The association of HHV-8 with proliferative disorders – including Kaposi's sarcoma, multicentric Castleman disease and primary effusion lymphoma – is well established. Other aspects of HHV-8 infection are currently the subject of accelerated research. Primary HHV-8 infection may manifest as a mononucleosis-like syndrome in the immunocompetent host, or in various forms in the immunocompromised host. The association of HHV-8 with primary pulmonary hypertension was observed by Cool et al. in 2003, but six clinical trials evaluating the role of HHV-8 in pulmonary hypertension have not been able to replicate this intriguing observation. It has been speculated that HHV-8 may secondarily infect proliferating endothelium in patients with pulmonary hypertension. HHV-8 epidemiology, modes of transmission, new spectrum of disease and treatment are presented and discussed.







[1] HHV-8 = human herpesvirus 8


March 2005
Z. Feldbrin, M. Singer, O. Keynan, V. Rzetelny and D. Hendel
Background: Coccygectomy is an uncommon procedure that many surgeons are reluctant to perform due to its proximity to the anus and the risk of rectal perforation and infection.

Objectives: To evaluate the diagnostic accuracy and outcome of coccygectomy.

Methods: We retrospectively reviewed the operative results in nine patients (seven females and two males) who underwent coccygectomy for coccygodynia in the last 5 years following conservative treatment failure.

Results: The outcome of the procedure was excellent in five patients, good in one patient and poor in two patients.

Conclusions: It is mandatory to perform bone scanning in every patient with coccygodynia and before coccygectomy in order to rule out the presence of malignancy. Coccygectomy is recommended for patients with isolated coccygodynia.

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