ilan Shelef - Academia.edu (original) (raw)
Papers by ilan Shelef
Archives of Otolaryngology-head & Neck Surgery, Oct 1, 2007
Clinical Otolaryngology, 2012
Background: Ilio-psoas abscess (IPA) is uncommon in children. It has varied clinical presentation... more Background: Ilio-psoas abscess (IPA) is uncommon in children. It has varied clinical presentation causing difficulties in diagnosis. We present our experience with management of psoas abscess in 23 children. Materials and methods: Records of 23 patients managed at a tertiary institute between March 2011 and December 2016 were reviewed and retrospectively analysed on the basis of age at presentation, presenting complaints, clinical and radiological findings and management. Results: Age of presentation ranged between 20 days and 11 years. Most of the patients presented with fever (n = 20) followed by abdominal pain (n = 11), hip pain (n = 9) and back pain (n = 6). Abscess volume ranged from 20 ml to 300 ml. Ten patients with unliquified abscesses were managed by intravenous antibiotics. Six patients underwent USG-guided aspiration of abscesses (volumes: 20 ml to 150 ml). Pigtail catheter was inserted in 7 patients with partially liquefied abscesses of volume 150 to 300 ml. Clinical response was rapid. The catheter was removed after drainage was stopped and USG confirmed the absence of residual collection. The 15 patients with fixed flexion deformity underwent skin traction. Bacteriological examination was performed in 13 patients-there was no growth in 4 patients, methicillinresistant Staphylococcus aureus (MRSA) in 1 patient, methicillin-sensitive Staphylococcus aureus (MSSA) in 6 patients and acid-fast bacilli (AFB) in 2 patients. Conclusion: IPA is a rare disease in children. Intravenous antibiotics covering S. aureus and image-guided percutaneous drainage are effective in managing most patients. Open drainage is required if percutaneous drainage fails to completely resolve the abscess and clinical symptoms deteriorate despite antibiotic treatment.
European Neuropsychopharmacology, 2014
arXiv: Image and Video Processing, 2020
The problem of inter-rater variability is often discussed in the context of manual labeling of me... more The problem of inter-rater variability is often discussed in the context of manual labeling of medical images. The emergence of data-driven approaches such as Deep Neural Networks (DNNs) brought this issue of raters' disagreement to the front-stage. In this paper, we highlight the issue of inter-rater bias as opposed to random inter-observer variability and demonstrate its influence on DNN training, leading to different segmentation results for the same input images. In fact, lower overlap scores are obtained between the outputs of a DNN trained on annotations of one rater and tested on another. Moreover, we demonstrate that inter-rater bias in the training examples is amplified and becomes more consistent, considering the segmentation predictions of the DNNs' test data. We support our findings by showing that a classifier-DNN trained to distinguish between raters based on their manual annotations performs better when the automatic segmentation predictions rather than the ac...
Harefuah, 2019
INTRODUCTION Lumbar disc herniation is a medical condition in which obscurity exists in the relat... more INTRODUCTION Lumbar disc herniation is a medical condition in which obscurity exists in the relation between the clinical and the radiological definition. The following paper was written by both surgeons and a radiologist, who are engaged in the field of spine surgery. The aim is to provide clear definitions as to the different pathologies involving disc herniation. The secondary goal of this article is to differentiate between the radiological picture and the clinical syndrome which are not necessarily connected. We hope this review will illuminate these issues and simplify the definitions and make it easier for all to use, primary care practitioners, general orthopedics and trauma care providers.
Nutrients, 2021
Background: Dihydrolipoamide dehydrogenase (DLD lipoamide dehydrogenase, the E3 subunit of the py... more Background: Dihydrolipoamide dehydrogenase (DLD lipoamide dehydrogenase, the E3 subunit of the pyruvate dehydrogenase complex (PDHC)) is the third catalytic enzyme of the PDHC, which converts pyruvate to acetyl-CoA catalyzed with the introduction of acetyl-CoA to the tricyclic acid (TCA) cycle. In humans, PDHC plays an important role in maintaining glycose homeostasis in an aerobic, energy-generating process. Inherited DLD-E3 deficiency, caused by the pathogenic variants in DLD, leads to variable presentations and courses of illness, ranging from myopathy, recurrent episodes of liver disease and vomiting, to Leigh disease and early death. Currently, there is no consensus on treatment guidelines, although one suggested solution is a ketogenic diet (KD). Objective: To describe the use and effects of KD in patients with DLD-E3 deficiency, compared to the standard treatment. Results: Sixteen patients were included. Of these, eight were from a historical cohort, and of the other eight, f...
International Ophthalmology, 2020
Objective To examine the association between exposure to radiation from computed tomography (CT) ... more Objective To examine the association between exposure to radiation from computed tomography (CT) studies and the incidence of cataract. Methods In a nested case-control study, all cataract cases and their matched controls were sampled from a retrospective cohort of Israeli residents who underwent CT scans or ultrasonic tests in Soroka Medical Center, Beer-Sheva, Israel, between the years 1996 and 2014. The risk of cataract associated with head, neck or the rest of the body CT was assessed using Poisson survival analysis. Results The nested matched sample included 3841 cataract cases and their age-and sex-matched controls (n = 228,743). CT radiation exposure was more frequent in the cataract group, with 9.7% head CT, 1.2% neck CT and 6.6% other CT, compared to 5%, 0.7% and 3.7% among person-years without cataract (p \ 0.001). In a multivariate analysis, a similar increased risk of cataract associated with head (hazard ratio (
NeuroImage, 2021
reported being hypertensive and diabetic, both controlled. In extra-oral physical examination, a ... more reported being hypertensive and diabetic, both controlled. In extra-oral physical examination, a nodular, rounded mass was observed in the region of the left zygomatic bone, resilient to palpation, 4 cm in diameter. In the excisional biopsy a total removal of the lesion was performed. During surgery, a whitish pasty content was appreciable. Microscopic sections revealed a virtual cystic cavity covered by orthokeratinized, stratified pavement epithelium with well-marked granular layer, filled with keratin blades. Underlying delicate fibrous capsule was noted. The diagnosis based on the clinical and microscopic characteristics was a dermoid cyst. Fifteen days after surgery the stitches were removed. After 1 month, there was no recurrence of the lesion, he had excellent healing, and he was discharged.
Journal of Pediatric Surgery, 2020
Background: Ileocolic intussusception is a common abdominal emergency in children, diagnosed rout... more Background: Ileocolic intussusception is a common abdominal emergency in children, diagnosed routinely with ultrasound and treated most frequently with fluoroscopic pneumatic reduction without sedation. Alternatively, ultrasound can also be used to obviate ionizing radiation and sedation can be used to avoid discomfort from the procedure. The purpose of this study was to present our experience with sedation using saline enema under ultrasound guided control to reduce ileocolic intussusception. Materials and methods: This is a retrospective study of patients with ileocolic intussusception presenting to a tertiary care hospital between 1998 and 2018. We excluded the data of patients that underwent either fluoroscopic guided reduction with barium enema or primary surgery. All patients received sedation with propofol and subsequently underwent our sedated ultrasound guided saline reduction (SUR) protocol until reduction was confirmed. Results: 414 total reductions were performed in the 338 children who underwent our SUR protocol, of which 86.0% were successful. Zero perforations occurred during attempted reduction. 58 patients required surgery after a failed reduction (14.0%). There were 76 recurrent episodes that underwent our SUR protocol, of which 93.4% had a successful reduction. Conclusion: The success rate of reduction was high and compared similarly to techniques that either use pneumatic reduction under radiation or refrain from administering a sedative prior to enema. Level of evidence: Treatment study level III.
The Journal of Neuroscience, 2017
Ipsilateral motor areas of cerebral cortex are active during arm movements and even reliably pred... more Ipsilateral motor areas of cerebral cortex are active during arm movements and even reliably predict movement direction. Is coding similar during ipsilateral and contralateral movements? If so, is it in extrinsic (world-centered) or intrinsic (joint-configuration) coordinates? We addressed these questions by examining the similarity of multivoxel fMRI patterns in visuomotor cortical regions during unilateral reaching movements with both arms. The results of three complementary analyses revealed that fMRI response patterns were similar across right and left arm movements to identical targets (extrinsic coordinates) in visual cortices, and across movements with equivalent joint-angles (intrinsic coordinates) in motor cortices. We interpret this as evidence for the existence of distributed neural populations in multiple motor system areas that encode ipsilateral and contralateral movements in a similar manner: according to their intrinsic/joint coordinates.SIGNIFICANCE STATEMENTCortica...
Medicine & Science in Sports & Exercise, 2016
PURPOSE: Examine the effect of β-hydroxy-β-methylbutyrate Free Acid (HMB) supplementation on chan... more PURPOSE: Examine the effect of β-hydroxy-β-methylbutyrate Free Acid (HMB) supplementation on changes in immune and inflammatory responses and physical performance measures during highly intense military training. METHODS: Thirteen soldiers from an elite combat unit were randomly assigned to either a HMB (n=6) or placebo (PL; n=7) group. Soldiers were provided with 3 g•day-1 of either HMB or PL for 23 days. During the final week of supplementation (days 18-23) soldiers participated in extreme physical training, which included night navigation of 6-8 hours across difficult terrain with approximately 35 kg of equipment on their back. During daylight hours, soldiers remained in camouflaged positions with minimal recovery. Due to a severe environmental stress (37°C and a sand storm) navigational training was performed on only the first two evenings of the week. Still, soldiers continued to be subjected to excessive physical training. During the 6 days of intense training the soldiers slept a total of 22.5 hours (3.8 ± 3.0 h per night). Fasting blood draws (IL-6, INFγ, TNFα, IL-8, IL-1b, IL-1ra, IL-10, G-CSF, GM-CSF, MCP-1, and CX3CL1) and physical performance measures (vertical jump power, push-ups, isometric strength, speed [100m]) were performed prior to and following the supplementation period. All assessments were performed at the same time of day. Data was analyzed using a two-way mixed factorial ANOVA. To complement null hypothesis testing, magnitude based inferences were examined to provide inferences on the true effects HMB may have had on blood and performance variables, compared to PL, calculated from 90% confidence intervals. RESULTS: Changes in IL-6 for the HMB group (-10.04±11.9 pg•ml-1) was significantly different (p=0.017) from the change in the PL group (+6.2±7.3 pg•ml-1). The effect of HMB was very likely (97 to 98% Likelihood) to lower IL-6 and INFγ compared with the effect of PL. In addition, HMB ingestion was likely (75 to 94% likelihood) to reduce TNFα, IL-8, G-CSF and time to complete 100m compared to PL. CONCLUSIONS: HMB ingestion appeared to attenuate inflammatory and immune responses, while having a positive effect on speed performance during intense military training.
The Israel Medical Association Journal Imaj, Dec 1, 2011
Journal of Clinical Gastroenterology, 1998
BJU International, 1998
Case reports Case 1 An 81-year-old man was admitted to the Urology Department with complaints of ... more Case reports Case 1 An 81-year-old man was admitted to the Urology Department with complaints of a right scrotal swelling and two-stage voiding, initially emptying normally then voiding after manual compression of the hernia. Physical examination revealed a large right scrotal hernia; besides having undergone TURP for BPH his past history was unremarkable. He was referred to the Radiology Department for ultrasonography which detected passage of fluid from the bladder through the right inguinal canal into the scrotum (Fig. 1). The large anechoic mass in the scrotum diminished after micturition. Subsequently he underwent retrograde cystography; when he was upright this showed a right bladder hernia protruding towards the inguinal canal, with a narrow neck and lying in the right scrotum (Fig. 2). He underwent surgery to remove the bladder hernia from the inguinal canal and to repair the hernia.
Case Reports in Surgery, 2015
Herniation of the urinary bladder into the inguinal canal is an uncommon finding, observed in 0.5... more Herniation of the urinary bladder into the inguinal canal is an uncommon finding, observed in 0.5–4% of inguinal hernias (Curry (2000)). It is usually associated with other conditions that increase intra-abdominal pressure such as bladder neck obstruction due to prostatic hypertrophy. Consequently, in men, it is usually associated with some degree of urinary retention. We present a 42-year-old man in whom herniation of the urinary bladder was the cause of urinary retention, and not vice versa. The patient was on tumor necrosis factor alpha antagonist (TNFA) (Etanercept) for severe Ankylosing spondylitis. Initially, the urinary retention was thought to be a side effect of the medication, but after the drug was discontinued, urinary retention persisted. CT and MRI demonstrated huge herniation of the urinary bladder into the inguinal canal. Immediately after the hernia was repaired, bladder function was restored. TNF treatment was restarted, and no further urinary symptoms were observe...
Frontiers in Neuroscience, 2022
Depression is a common and serious complication following traumatic brain injury (TBI). Both depr... more Depression is a common and serious complication following traumatic brain injury (TBI). Both depression and TBI have independently been associated with pathologically elevated extracellular brain glutamate levels. In the setting of TBI, blood glutamate scavenging with pyruvate has been widely shown as an effective method to provide neuroprotection by reducing blood glutamate and subsequent brain glutamate levels. Here we evaluate pyruvate as a novel approach in the treatment and prevention of post-TBI depression-like behavior in a rat model. Rats were divided into five groups: (1) sham-operated control with pyruvate, (2) sham-operated control with placebo, (3) post-TBI with placebo, (4) post-TBI given preventative pyruvate, and (5) post-TBI treated with pyruvate. These groups had an equal number of females and males. Rats were assessed for depressive-like behavior, neurological status, and glutamate levels in the blood and brain. Post-TBI neurological deficits with concurrent elevat...
Frontiers in Neuroscience, 2019
Kuts et al. Novel Rodent Post-stroke Assessment slices. There was no difference in the Evans blue... more Kuts et al. Novel Rodent Post-stroke Assessment slices. There was no difference in the Evans blue extravasation index for the brain tissue samples without TTC compared to brain tissue samples incubated in TTC. Our results demonstrate that measuring cerebral edema, infarct zone and BBB permeability following MCAO can accurately be measured in the same set of brain samples.
Journal of neurosurgery. Pediatrics, 2008
Intravertebral disc herniation is common in adults, often due to degenerative processes. The occu... more Intravertebral disc herniation is common in adults, often due to degenerative processes. The occurrence of disc herniation is rare in children and is usually related to traumatic injury. The authors present an unusual case of a 13-month-old boy with L5-S1 lumbar disc herniation. The disc was removed via a unilateral partial hemilaminectomy approach, sparing the spinal midline structural elements. Although rare, lumbar disc herniation should be in the differential diagnosis for children presenting with low-back pain and/or neurological deficit of the lower limbs.
The Israel Medical Association journal : IMAJ, 2011
Heart, 2020
BackgroundA Mediterranean diet is favourable for cardiometabolic risk.ObjectiveTo examine the res... more BackgroundA Mediterranean diet is favourable for cardiometabolic risk.ObjectiveTo examine the residual effect of a green Mediterranean diet, further enriched with green plant-based foods and lower meat intake, on cardiometabolic risk.MethodsFor the DIRECT-PLUS parallel, randomised clinical trial we assigned individuals with abdominal obesity/dyslipidaemia 1:1:1 into three diet groups: healthy dietary guidance (HDG), Mediterranean and green Mediterranean diet, all combined with physical activity. The Mediterranean diets were equally energy restricted and included 28 g/day walnuts. The green Mediterranean diet further included green tea (3–4 cups/day) and a Wolffia globosa (Mankai strain; 100 g/day frozen cubes) plant-based protein shake, which partially substituted animal protein. We examined the effect of the 6-month dietary induction weight loss phase on cardiometabolic state.ResultsParticipants (n=294; age 51 years; body mass index 31.3 kg/m2; waist circumference 109.7 cm; 88% men...
Archives of Otolaryngology-head & Neck Surgery, Oct 1, 2007
Clinical Otolaryngology, 2012
Background: Ilio-psoas abscess (IPA) is uncommon in children. It has varied clinical presentation... more Background: Ilio-psoas abscess (IPA) is uncommon in children. It has varied clinical presentation causing difficulties in diagnosis. We present our experience with management of psoas abscess in 23 children. Materials and methods: Records of 23 patients managed at a tertiary institute between March 2011 and December 2016 were reviewed and retrospectively analysed on the basis of age at presentation, presenting complaints, clinical and radiological findings and management. Results: Age of presentation ranged between 20 days and 11 years. Most of the patients presented with fever (n = 20) followed by abdominal pain (n = 11), hip pain (n = 9) and back pain (n = 6). Abscess volume ranged from 20 ml to 300 ml. Ten patients with unliquified abscesses were managed by intravenous antibiotics. Six patients underwent USG-guided aspiration of abscesses (volumes: 20 ml to 150 ml). Pigtail catheter was inserted in 7 patients with partially liquefied abscesses of volume 150 to 300 ml. Clinical response was rapid. The catheter was removed after drainage was stopped and USG confirmed the absence of residual collection. The 15 patients with fixed flexion deformity underwent skin traction. Bacteriological examination was performed in 13 patients-there was no growth in 4 patients, methicillinresistant Staphylococcus aureus (MRSA) in 1 patient, methicillin-sensitive Staphylococcus aureus (MSSA) in 6 patients and acid-fast bacilli (AFB) in 2 patients. Conclusion: IPA is a rare disease in children. Intravenous antibiotics covering S. aureus and image-guided percutaneous drainage are effective in managing most patients. Open drainage is required if percutaneous drainage fails to completely resolve the abscess and clinical symptoms deteriorate despite antibiotic treatment.
European Neuropsychopharmacology, 2014
arXiv: Image and Video Processing, 2020
The problem of inter-rater variability is often discussed in the context of manual labeling of me... more The problem of inter-rater variability is often discussed in the context of manual labeling of medical images. The emergence of data-driven approaches such as Deep Neural Networks (DNNs) brought this issue of raters' disagreement to the front-stage. In this paper, we highlight the issue of inter-rater bias as opposed to random inter-observer variability and demonstrate its influence on DNN training, leading to different segmentation results for the same input images. In fact, lower overlap scores are obtained between the outputs of a DNN trained on annotations of one rater and tested on another. Moreover, we demonstrate that inter-rater bias in the training examples is amplified and becomes more consistent, considering the segmentation predictions of the DNNs' test data. We support our findings by showing that a classifier-DNN trained to distinguish between raters based on their manual annotations performs better when the automatic segmentation predictions rather than the ac...
Harefuah, 2019
INTRODUCTION Lumbar disc herniation is a medical condition in which obscurity exists in the relat... more INTRODUCTION Lumbar disc herniation is a medical condition in which obscurity exists in the relation between the clinical and the radiological definition. The following paper was written by both surgeons and a radiologist, who are engaged in the field of spine surgery. The aim is to provide clear definitions as to the different pathologies involving disc herniation. The secondary goal of this article is to differentiate between the radiological picture and the clinical syndrome which are not necessarily connected. We hope this review will illuminate these issues and simplify the definitions and make it easier for all to use, primary care practitioners, general orthopedics and trauma care providers.
Nutrients, 2021
Background: Dihydrolipoamide dehydrogenase (DLD lipoamide dehydrogenase, the E3 subunit of the py... more Background: Dihydrolipoamide dehydrogenase (DLD lipoamide dehydrogenase, the E3 subunit of the pyruvate dehydrogenase complex (PDHC)) is the third catalytic enzyme of the PDHC, which converts pyruvate to acetyl-CoA catalyzed with the introduction of acetyl-CoA to the tricyclic acid (TCA) cycle. In humans, PDHC plays an important role in maintaining glycose homeostasis in an aerobic, energy-generating process. Inherited DLD-E3 deficiency, caused by the pathogenic variants in DLD, leads to variable presentations and courses of illness, ranging from myopathy, recurrent episodes of liver disease and vomiting, to Leigh disease and early death. Currently, there is no consensus on treatment guidelines, although one suggested solution is a ketogenic diet (KD). Objective: To describe the use and effects of KD in patients with DLD-E3 deficiency, compared to the standard treatment. Results: Sixteen patients were included. Of these, eight were from a historical cohort, and of the other eight, f...
International Ophthalmology, 2020
Objective To examine the association between exposure to radiation from computed tomography (CT) ... more Objective To examine the association between exposure to radiation from computed tomography (CT) studies and the incidence of cataract. Methods In a nested case-control study, all cataract cases and their matched controls were sampled from a retrospective cohort of Israeli residents who underwent CT scans or ultrasonic tests in Soroka Medical Center, Beer-Sheva, Israel, between the years 1996 and 2014. The risk of cataract associated with head, neck or the rest of the body CT was assessed using Poisson survival analysis. Results The nested matched sample included 3841 cataract cases and their age-and sex-matched controls (n = 228,743). CT radiation exposure was more frequent in the cataract group, with 9.7% head CT, 1.2% neck CT and 6.6% other CT, compared to 5%, 0.7% and 3.7% among person-years without cataract (p \ 0.001). In a multivariate analysis, a similar increased risk of cataract associated with head (hazard ratio (
NeuroImage, 2021
reported being hypertensive and diabetic, both controlled. In extra-oral physical examination, a ... more reported being hypertensive and diabetic, both controlled. In extra-oral physical examination, a nodular, rounded mass was observed in the region of the left zygomatic bone, resilient to palpation, 4 cm in diameter. In the excisional biopsy a total removal of the lesion was performed. During surgery, a whitish pasty content was appreciable. Microscopic sections revealed a virtual cystic cavity covered by orthokeratinized, stratified pavement epithelium with well-marked granular layer, filled with keratin blades. Underlying delicate fibrous capsule was noted. The diagnosis based on the clinical and microscopic characteristics was a dermoid cyst. Fifteen days after surgery the stitches were removed. After 1 month, there was no recurrence of the lesion, he had excellent healing, and he was discharged.
Journal of Pediatric Surgery, 2020
Background: Ileocolic intussusception is a common abdominal emergency in children, diagnosed rout... more Background: Ileocolic intussusception is a common abdominal emergency in children, diagnosed routinely with ultrasound and treated most frequently with fluoroscopic pneumatic reduction without sedation. Alternatively, ultrasound can also be used to obviate ionizing radiation and sedation can be used to avoid discomfort from the procedure. The purpose of this study was to present our experience with sedation using saline enema under ultrasound guided control to reduce ileocolic intussusception. Materials and methods: This is a retrospective study of patients with ileocolic intussusception presenting to a tertiary care hospital between 1998 and 2018. We excluded the data of patients that underwent either fluoroscopic guided reduction with barium enema or primary surgery. All patients received sedation with propofol and subsequently underwent our sedated ultrasound guided saline reduction (SUR) protocol until reduction was confirmed. Results: 414 total reductions were performed in the 338 children who underwent our SUR protocol, of which 86.0% were successful. Zero perforations occurred during attempted reduction. 58 patients required surgery after a failed reduction (14.0%). There were 76 recurrent episodes that underwent our SUR protocol, of which 93.4% had a successful reduction. Conclusion: The success rate of reduction was high and compared similarly to techniques that either use pneumatic reduction under radiation or refrain from administering a sedative prior to enema. Level of evidence: Treatment study level III.
The Journal of Neuroscience, 2017
Ipsilateral motor areas of cerebral cortex are active during arm movements and even reliably pred... more Ipsilateral motor areas of cerebral cortex are active during arm movements and even reliably predict movement direction. Is coding similar during ipsilateral and contralateral movements? If so, is it in extrinsic (world-centered) or intrinsic (joint-configuration) coordinates? We addressed these questions by examining the similarity of multivoxel fMRI patterns in visuomotor cortical regions during unilateral reaching movements with both arms. The results of three complementary analyses revealed that fMRI response patterns were similar across right and left arm movements to identical targets (extrinsic coordinates) in visual cortices, and across movements with equivalent joint-angles (intrinsic coordinates) in motor cortices. We interpret this as evidence for the existence of distributed neural populations in multiple motor system areas that encode ipsilateral and contralateral movements in a similar manner: according to their intrinsic/joint coordinates.SIGNIFICANCE STATEMENTCortica...
Medicine & Science in Sports & Exercise, 2016
PURPOSE: Examine the effect of β-hydroxy-β-methylbutyrate Free Acid (HMB) supplementation on chan... more PURPOSE: Examine the effect of β-hydroxy-β-methylbutyrate Free Acid (HMB) supplementation on changes in immune and inflammatory responses and physical performance measures during highly intense military training. METHODS: Thirteen soldiers from an elite combat unit were randomly assigned to either a HMB (n=6) or placebo (PL; n=7) group. Soldiers were provided with 3 g•day-1 of either HMB or PL for 23 days. During the final week of supplementation (days 18-23) soldiers participated in extreme physical training, which included night navigation of 6-8 hours across difficult terrain with approximately 35 kg of equipment on their back. During daylight hours, soldiers remained in camouflaged positions with minimal recovery. Due to a severe environmental stress (37°C and a sand storm) navigational training was performed on only the first two evenings of the week. Still, soldiers continued to be subjected to excessive physical training. During the 6 days of intense training the soldiers slept a total of 22.5 hours (3.8 ± 3.0 h per night). Fasting blood draws (IL-6, INFγ, TNFα, IL-8, IL-1b, IL-1ra, IL-10, G-CSF, GM-CSF, MCP-1, and CX3CL1) and physical performance measures (vertical jump power, push-ups, isometric strength, speed [100m]) were performed prior to and following the supplementation period. All assessments were performed at the same time of day. Data was analyzed using a two-way mixed factorial ANOVA. To complement null hypothesis testing, magnitude based inferences were examined to provide inferences on the true effects HMB may have had on blood and performance variables, compared to PL, calculated from 90% confidence intervals. RESULTS: Changes in IL-6 for the HMB group (-10.04±11.9 pg•ml-1) was significantly different (p=0.017) from the change in the PL group (+6.2±7.3 pg•ml-1). The effect of HMB was very likely (97 to 98% Likelihood) to lower IL-6 and INFγ compared with the effect of PL. In addition, HMB ingestion was likely (75 to 94% likelihood) to reduce TNFα, IL-8, G-CSF and time to complete 100m compared to PL. CONCLUSIONS: HMB ingestion appeared to attenuate inflammatory and immune responses, while having a positive effect on speed performance during intense military training.
The Israel Medical Association Journal Imaj, Dec 1, 2011
Journal of Clinical Gastroenterology, 1998
BJU International, 1998
Case reports Case 1 An 81-year-old man was admitted to the Urology Department with complaints of ... more Case reports Case 1 An 81-year-old man was admitted to the Urology Department with complaints of a right scrotal swelling and two-stage voiding, initially emptying normally then voiding after manual compression of the hernia. Physical examination revealed a large right scrotal hernia; besides having undergone TURP for BPH his past history was unremarkable. He was referred to the Radiology Department for ultrasonography which detected passage of fluid from the bladder through the right inguinal canal into the scrotum (Fig. 1). The large anechoic mass in the scrotum diminished after micturition. Subsequently he underwent retrograde cystography; when he was upright this showed a right bladder hernia protruding towards the inguinal canal, with a narrow neck and lying in the right scrotum (Fig. 2). He underwent surgery to remove the bladder hernia from the inguinal canal and to repair the hernia.
Case Reports in Surgery, 2015
Herniation of the urinary bladder into the inguinal canal is an uncommon finding, observed in 0.5... more Herniation of the urinary bladder into the inguinal canal is an uncommon finding, observed in 0.5–4% of inguinal hernias (Curry (2000)). It is usually associated with other conditions that increase intra-abdominal pressure such as bladder neck obstruction due to prostatic hypertrophy. Consequently, in men, it is usually associated with some degree of urinary retention. We present a 42-year-old man in whom herniation of the urinary bladder was the cause of urinary retention, and not vice versa. The patient was on tumor necrosis factor alpha antagonist (TNFA) (Etanercept) for severe Ankylosing spondylitis. Initially, the urinary retention was thought to be a side effect of the medication, but after the drug was discontinued, urinary retention persisted. CT and MRI demonstrated huge herniation of the urinary bladder into the inguinal canal. Immediately after the hernia was repaired, bladder function was restored. TNF treatment was restarted, and no further urinary symptoms were observe...
Frontiers in Neuroscience, 2022
Depression is a common and serious complication following traumatic brain injury (TBI). Both depr... more Depression is a common and serious complication following traumatic brain injury (TBI). Both depression and TBI have independently been associated with pathologically elevated extracellular brain glutamate levels. In the setting of TBI, blood glutamate scavenging with pyruvate has been widely shown as an effective method to provide neuroprotection by reducing blood glutamate and subsequent brain glutamate levels. Here we evaluate pyruvate as a novel approach in the treatment and prevention of post-TBI depression-like behavior in a rat model. Rats were divided into five groups: (1) sham-operated control with pyruvate, (2) sham-operated control with placebo, (3) post-TBI with placebo, (4) post-TBI given preventative pyruvate, and (5) post-TBI treated with pyruvate. These groups had an equal number of females and males. Rats were assessed for depressive-like behavior, neurological status, and glutamate levels in the blood and brain. Post-TBI neurological deficits with concurrent elevat...
Frontiers in Neuroscience, 2019
Kuts et al. Novel Rodent Post-stroke Assessment slices. There was no difference in the Evans blue... more Kuts et al. Novel Rodent Post-stroke Assessment slices. There was no difference in the Evans blue extravasation index for the brain tissue samples without TTC compared to brain tissue samples incubated in TTC. Our results demonstrate that measuring cerebral edema, infarct zone and BBB permeability following MCAO can accurately be measured in the same set of brain samples.
Journal of neurosurgery. Pediatrics, 2008
Intravertebral disc herniation is common in adults, often due to degenerative processes. The occu... more Intravertebral disc herniation is common in adults, often due to degenerative processes. The occurrence of disc herniation is rare in children and is usually related to traumatic injury. The authors present an unusual case of a 13-month-old boy with L5-S1 lumbar disc herniation. The disc was removed via a unilateral partial hemilaminectomy approach, sparing the spinal midline structural elements. Although rare, lumbar disc herniation should be in the differential diagnosis for children presenting with low-back pain and/or neurological deficit of the lower limbs.
The Israel Medical Association journal : IMAJ, 2011
Heart, 2020
BackgroundA Mediterranean diet is favourable for cardiometabolic risk.ObjectiveTo examine the res... more BackgroundA Mediterranean diet is favourable for cardiometabolic risk.ObjectiveTo examine the residual effect of a green Mediterranean diet, further enriched with green plant-based foods and lower meat intake, on cardiometabolic risk.MethodsFor the DIRECT-PLUS parallel, randomised clinical trial we assigned individuals with abdominal obesity/dyslipidaemia 1:1:1 into three diet groups: healthy dietary guidance (HDG), Mediterranean and green Mediterranean diet, all combined with physical activity. The Mediterranean diets were equally energy restricted and included 28 g/day walnuts. The green Mediterranean diet further included green tea (3–4 cups/day) and a Wolffia globosa (Mankai strain; 100 g/day frozen cubes) plant-based protein shake, which partially substituted animal protein. We examined the effect of the 6-month dietary induction weight loss phase on cardiometabolic state.ResultsParticipants (n=294; age 51 years; body mass index 31.3 kg/m2; waist circumference 109.7 cm; 88% men...