Chaim Sheba Medical Center at Tel HaShomer (Hebrew: המרכז הרפואי ע"ש חיים שיבא – תל השומר), also Tel HaShomer Hospital, is the largest hospital in Israel, located in the Tel Aviv District city of Ramat Gan at Tel HaShomer neighborhood, Israel. In 2020, Newsweek ranked it as the 9th-best hospital in the world. In 2021, it was ranked as the 10th best hospital in the world, scoring the highest for an Israeli hospital.
Higher chronic physical morbidity has been reported in Holocaust survivors. Despite evidence of potential intergenerational effects, data on their offspring’s physical health remain limited. This exploratory study aimed to compare outcomes of cancer, diabetes, stroke, end-stage renal disease, bariatric surgery utilization, multi-morbidity, and mortality between offspring of female child Holocaust survivors and their counterparts, using national registry data. This cohort study compared offspring (born 1960–1990) of Jewish female Holocaust survivors born during 1940–1945 in European countries that were under the Nazi regime (exposed) and same-age offspring of same-age European-origin Jewish women unexposed to the Holocaust. The dataset was cross-linked with national disease, procedure, and mortality registries. Multivariable logistic regression and proportional hazards models were adjusted for birth cohort and sex. Exposed individuals (N = 20,193; 51
Abstract Background Oculopharyngeal muscular dystrophy (OPMD) is a late-onset autosomal dominant myopathy, caused by a (GCN)n/polyalanine repeat expansion in the PABPN1 gene. In Israel, OPMD is particularly prevalent among individuals of Jewish Bukharian descent due to a (GCN)13 repeat expansion. In this retrospective study, we collected genetic and clinical data of OPMD patients who visited the Israeli reference clinic from its opening in 2022 through September 2025 and were enrolled in the Israeli OPMD registry (IsrO-PMD). Results A total of 102 Jewish individuals with OPMD symptoms and a confirmed molecular diagnosis were identified (52 males, 51.0%). The heterozygous (GCN)13 repeat allele (10/13 genotype) was found in 95 patients (93.1%), of whom 89 (93.7%) were of Bukharian descent, five (5.6%) were of Bulgarian origin, and a single patient was from Georgia. In this 10/13 genotype group (n = 95), initial symptoms were dysphagia and ptosis, which occurred at a similar mean age of 53.0 ± 8.3 and 53.9 ± 7.2 years, respectively. Symptoms of limb muscle weakness occurred significantly later, at a mean age of 57.9 ± 10.2 years. Overall, the onset of symptoms occurred approximately 4 years earlier in females (48.9 ± 7.9, n = 48) than in males (52.6 ± 7.1, n = 47), and this difference was statistically significant (p = 0.02). However, the difference did not reach significance when calculated for each of the three symptoms separately. On evaluation, at a mean age of 61.6 ± 10.7 years, dysphagia was present in 92/95 (96.8%) of patients, ptosis in 85/95 (89.5%), and limb muscle weakness in 56/95 (58.9%) of cases, most notably of hip flexion and abduction. Different genotypes were detected in seven patients: Three of Bukharian descent were homozygous for (GCN)13 repeats, three of Karaite descent were homozygous for (GCN)11 repeats, and one of Tunisian origion was heterozygous for (GCN)15 repeats (10/15 genotype). Discussion While most OPMD patients in Israel are of Jewish Bukharian descent, patients from other origins were also identified. Dysphagia and ptosis are the common initial symptoms, and overall, the onset of symptoms was reportedly earlier in females. Proximal muscle weakness becomes common with disease progression. Further studies are required to delineate genotype-phenotype correlations.
Foslevodopa/foscarbidopa (LDp/CDp) is a nonsurgical 24-h continuous subcutaneous infusion for patients with advanced Parkinson’s disease (aPD) and motor fluctuations uncontrolled on oral medications. We present the first multicountry real-world data from routine clinical practice. ROSSINI (NCT06107426) is an ongoing 3-year multicountry, prospective, observational study of adults with aPD who are LDp/CDp-naïve (cohort A) or transitioning from LDp/CDp open-label extension studies (NCT04379050/NCT04750226, cohort B). For this interim analysis, the primary endpoint was change from baseline to 6 months in OFF time [Movement Disorder Society Unified Parkinson’s Disease Rating Scale Part IV (MDS-UPDRS-IV) modified item 4.3]. Safety was assessed by monitoring adverse events (AEs). Interim results for 105 cohort A patients enrolled ≥ 6 months by March 24, 2025 are presented only; cohort B results were limited (n = 5). Mixed-effects models for repeated measurements (continuous outcomes) were utilized, adjusted for country. Cohort A patients had a mean (SD) age of 68.5 (9.5) years, PD duration of 12.1 (5.3) years, and least squares mean (SE) OFF time of 5.2 (0.6) h at baseline. Patients on LDp/CDp showed statistically significant reductions (95
Endoscopic management offers acceptable oncologic control in select patients with upper tract urothelial carcinoma (UTUC) while preserving renal function. Adjuvant intracavitary treatment with chemotherapy or Bacillus Calmette-Guérin (BCG) has been proposed to reduce recurrence risk. We aimed to evaluate the impact of adjuvant intracavitary treatment on ipsilateral UTUC recurrence following endoscopic management. We queried a multi-institutional cohort of patients who underwent endoscopic management for UTUC. Treatment groups were defined as no instillation, single post-operative instillation, or multiple instillations. Ipsilateral UTUC recurrence-free survival (RFS) was estimated using Kaplan-Meier curves and Cox proportional hazards models evaluated factors associated with recurrence. A total of 599 renal units, of which 43 received single instillation and 86 multiple instillations, in 334 patients treated endoscopically for UTUC were analyzed. The median follow-up time for patients without recurrence was 12 months (IQR 4–33). Multiple adjuvant instillations of any intracavitary treatment were associated with a significantly improved RFS (HR 0.52, 95
Functional pituitary adenomas often require multimodal therapy when surgery and medical treatment do not achieve durable endocrine remission. Stereotactic radiosurgery (SRS) is commonly used for residual or recurrent hormone-secreting tumors, achieving high tumor control rates but variable rates of biochemical remission. To evaluate endocrine response, tumor control, and treatment-related toxicity after linear accelerator (LINAC)-based SRS for functional pituitary adenomas. We retrospectively reviewed 24 patients treated with single-fraction LINAC SRS between 1995 and 2012 for adrenocorticotropic hormone (ACTH)-secreting (n = 6), growth hormone (GH)-secreting (n = 10), or prolactin (PRL)-secreting (n = 8) pituitary adenomas. All patients had prior transsphenoidal resection; most had failed or intolerant medical therapy. Two patients underwent repeat SRS for persistent disease, yielding 26 total SRS sessions. Endocrine outcomes were categorized as complete biochemical remission off medication, biochemical control while still requiring suppressive medical therapy, partial biochemical improvement without normalization, or persistent hypersecretion. Radiographic tumor control and late complications were assessed on long-term follow-up. After initial SRS, complete biochemical remission off medication was achieved in 3 of 6 patients with ACTH-secreting adenomas (50
