18 results on '"Helviz, Yigal"'
Search Results
2. Distribution of Aeration and Pulmonary Blood Volume in Healthy, ARDS and COVID-19 Lungs: A Dual-Energy Computed Tomography Retrospective Cohort Study
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Bogot, Naama R., Steiner, Roee, Helviz, Yigal, Weiss, Chedva, Cherniavsky, Konstantin, Pichkhadze, Olga, Ball, Lorenzo, Frank, Yigal, Levin, Philip, Pelosi, Paolo, Benjaminov, Ofer, and Einav, Sharon
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- 2023
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3. Anemia before in-hospital cardiac arrest and survival from cardio-pulmonary resuscitation—a retrospective cohort study
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Shor, Lior, Helviz, Yigal, and Einav, Sharon
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- 2022
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4. Experimental and Compassionate Drug Use During the First Wave of the COVID-19 Pandemic: A Retrospective Single-Center Study
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Assouline, Or, Ben-Chetrit, Eli, Helviz, Yigal, Kurd, Ramzi, Leone, Marc, and Einav, Sharon
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- 2021
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5. The Effect of Delay Following the Clinical Decision to Perform Tracheostomy in the Critical Care Setting.
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Zimmerman, Frederic S., Shaul, Chanan, Helviz, Yigal, and Levin, Phillip D.
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TRACHEOTOMY ,CRITICALLY ill ,PATIENTS ,DEATH ,PALLIATIVE treatment ,T-test (Statistics) ,RESPIRATORY insufficiency ,HOSPITAL care ,FISHER exact test ,DECISION making in clinical medicine ,RETROSPECTIVE studies ,HOSPITAL mortality ,DESCRIPTIVE statistics ,CHI-squared test ,MANN Whitney U Test ,NEUROLOGICAL disorders ,LONGITUDINAL method ,INTENSIVE care units ,INTENTION ,ARTIFICIAL respiration ,MEDICAL coding ,TREATMENT delay (Medicine) ,GUARDIAN & ward ,EXTUBATION ,COMPARATIVE studies ,DATA analysis software ,CRITICAL care medicine - Abstract
Background: Tracheostomy in patients who are critically ill is generally performed due to prolonged mechanical ventilation and expected extubation failure. However, tracheostomy criteria and ideal timing are poorly defined, including equivocal data from randomized controlled trials and median intubation to tracheostomy times that range from 7-21 d. However, a consistent finding is that only -50% of late tracheostomy groups actually undergo tracheostomy, with non-performance due to recovery or clinical deterioration. Unlike in many jurisdictions, elective surgical procedures in our institution require a court-appointed guardian, which necessitates an approximately 1-week delay between the decision to perform tracheostomy and surgery. This offers a unique opportunity to observe patients with potential tracheostomy during a delay between the decision and the performance. Methods: ICU patients who were ventilated were identified for inclusion retrospectively by an application for guardianship relating to tracheostomy, the intention-to-treat point. The main outcomes of tracheostomy, extubation, or death/palliative care after inclusion were noted. Demographics, outcomes, and event timing were compared for the 3 outcome groups. Results: Tracheostomy-related guardianship requests were made for 388 subjects. Of these, 195 (50%) underwent tracheostomy, whereas 127 (33%) were extubated and 66 (17%) either died before tracheostomy (46 [12%]) or were transitioned to palliative care (20 [5%]). The median time (interquartile range) from guardianship request until a defining event was the following: 6.2 (4.0-11) d for tracheostomy, 5.0 (2.9-8.2) d for extubation (P < .001 as compared to tracheostomy group), and 6.5 (2.5-11) d for death/palliative care (P = .55 as compared to tracheostomy). Neurological admissions were more common in the tracheostomy group and less common in the palliative group. Other admission demographics and hospitalization characteristics were similar. Hospital mortality was higher for subjects undergoing tracheostomy (58/195 [30%]) versus extubation (24/127 [19%]) (P = .03). Conclusions: Delay in performing tracheostomy due to legal requirements was associated with a 50% decrease in the need for tracheostomy. This suggests that decision-making with regard to ideal tracheostomy timing could be improved, saving unnecessary procedures. [ABSTRACT FROM AUTHOR]
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- 2024
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6. Extracorporeal membrane oxygenation in obstetric patients: An Israeli nationwide study.
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Yahav‐Shafir, Dana, Ilgiyaev, Eduard, Galante, Ori, Gorfil, Dan, Statlender, Liran, Soroksky, Arie, Carmi, Uri, Sinai, Yitzhak Brzezinski, Iprach, Nisim, Haviv‐Yadid, Yael, Makhoul, Maged, Fatnic, Elena, Ginosar, Yehuda, Einav, Sharon, Helviz, Yigal, Fink, Daniel, Sternik, Leonid, and Kogan, Alexander
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EXTRACORPOREAL membrane oxygenation ,COVID-19 ,PERINATAL period ,PULMONARY hypertension ,CRITICAL care medicine ,AMNIOTIC fluid embolism ,ARACHNOID cysts - Abstract
Background: The leading causes of maternal mortality include respiratory failure, cardiovascular events, infections, and hemorrhages. The use of extracorporeal membrane oxygenation (ECMO) as rescue therapy in the peripartum period for cardiopulmonary failure is expanding in critical care medicine. Methods: This retrospective observational study was conducted on a nationwide cohort in Israel. During the 3‐year period, between September 1, 2019, and August 31, 2022, all women in the peripartum period who had been supported by ECMO for respiratory or circulatory failure at 10 large Israeli hospitals were identified. Indications for ECMO, maternal and neonatal outcomes, details of ECMO support, and complications were collected. Results: During the 3‐year study period, in Israel, there were 540 234 live births, and 28 obstetric patients were supported by ECMO, with an incidence of 5.2 cases per 100 000 or 1 case per 19 000 births (when excluding patients with COVID‐19, the incidence will be 2.5 cases per 100 000 births). Of these, 25 were during the postpartum period, of which 16 (64%) were connected in the PPD1, and 3 were during pregnancy. Eighteen patients (64.3%) were supported by V‐V ECMO, 9 (32.1%) by V‐A ECMO, and one (3.6%) by a VV‐A configuration. Hypoxic respiratory failure (ARDS) was the most common indication for ECMO, observed in 21 patients (75%). COVID‐19 was the cause of ARDS in 15 (53.7%) patients. The indications for the V‐A configuration were cardiomyopathy (3 patients), amniotic fluid embolism (2 patients), sepsis, and pulmonary hypertension. The maternal and fetal survival rates were 89.3% (n = 25) and 100% (n = 28). The average ECMO duration was 17.6 ± 18.6 days and the ICU stay was 29.8 ± 23.8 days. Major bleeding complications requiring surgical intervention were observed in one patient. Conclusions: The incidence of using ECMO in the peripartum period is low. The maternal and neonatal survival rates in patients treated with ECMO are high. These results show that ECMO remains an important treatment option for obstetric patients with respiratory and/or cardiopulmonary failure. [ABSTRACT FROM AUTHOR]
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- 2024
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7. Topics and quality of systematic reviews of vasopressor/inotropic treatment for septic shock: an umbrella review
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Cortegiani, Andrea, Ippolito, Mariachiara, Helviz, Yigal, and Einav, Sharon
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umbrella review ,Medicine and Health Sciences ,review ,inotropes ,septic shock ,vasopressors - Abstract
Systematic reviews (SRs) and meta-analyses of pooled data are believed to provide high-quality evidence and as such are often relied upon by clinicians for making important therapeutic decisions. However, previous pooled analyses of SRs have shown flaws in many of the studies – in registration, protocol, search methods and sources, data extraction, analysis, coverage of the reported data and funding disclosure. Poorly conducted SRs are not only a waste of research efforts but may also mislead clinicians, thwarting even the best of efforts to improve patient outcomes. Vasopressors and inotropes are commonly used in the ICU to increase blood pressure in patients suffering from septic shock. In the late 1990s, shortly after standardization of the definition of sepsis and septic shock, the first human trials on the use of vasopressors and inotropes for septic shock began to appear. The Surviving Sepsis Campaign initiative, first launched in 2002, included one of the first systematic reviews of the literature on this topic, and it revealed the paucity of medical literature on the relation between the use of these drugs and patient outcomes. This finding triggered a series of clinical trials, and these have recently been included in systematic reviews. We intend to systematically search the literature for SRs studying the effect of vasopressors and inotropes on the outcomes of adult patients with sepsis. We aim to assess the number of SRs on this topic in relation to the average number of publications they include, to map the PICO questions they have addressed, their quality and their findings in order to highlight gaps in knowledge and quality.
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- 2022
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8. Altered somatic hypermutation patterns in COVID-19 patients classifies disease severity.
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Safra, Modi, Tamari, Zvi, Polak, Pazit, Shiber, Shachaf, Matan, Moshe, Karameh, Hani, Helviz, Yigal, Levy-Barda, Adva, Yahalom, Vered, Peretz, Avi, Ben-Chetrit, Eli, Brenner, Baruch, Tuller, Tamir, Gal-Tanamy, Meital, and Yaari, Gur
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COVID-19 ,B cell receptors ,ANTIGEN receptors ,SARS-CoV-2 ,HUMAN body - Abstract
Introduction: The success of the human body in fighting SARS-CoV2 infection relies on lymphocytes and their antigen receptors. Identifying and characterizing clinically relevant receptors is of utmost importance. Methods: We report here the application of a machine learning approach, utilizing B cell receptor repertoire sequencing data from severely and mildly infected individuals with SARS-CoV2 compared with uninfected controls. Results: In contrast to previous studies, our approach successfully stratifies noninfected from infected individuals, as well as disease level of severity. The features that drive this classification are based on somatic hypermutation patterns, and point to alterations in the somatic hypermutation process in COVID-19 patients. Discussion: These features may be used to build and adapt therapeutic strategies to COVID-19, in particular to quantitatively assess potential diagnostic and therapeutic antibodies. These results constitute a proof of concept for future epidemiological challenges. [ABSTRACT FROM AUTHOR]
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- 2023
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9. Vasopressor and inotrope treatment for septic shock: An umbrella review of reviews
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Einav, Sharon, Helviz, Yigal, Ippolito, Mariachiara, and Cortegiani, Andrea
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To review the characteristics, findings and quality of systematic reviews (SRs) on the effect of any vasopressor/inotrope on outcomes in adult patients with sepsis compared with either no treatment, another vasopressor or inotrope or fluids.
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- 2021
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10. Vasopressor and inotrope treatment for septic shock: An umbrella review of reviews
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Yigal Helviz, Mariachiara Ippolito, Andrea Cortegiani, Sharon Einav, Einav, Sharon, Helviz, Yigal, Ippolito, Mariachiara, and Cortegiani, Andrea
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Adult ,Inotrope ,medicine.medical_specialty ,Blinding ,media_common.quotation_subject ,Review ,Critical Care and Intensive Care Medicine ,Norepinephrine (medication) ,Sepsis ,Norepinephrine ,03 medical and health sciences ,Catecholamines ,0302 clinical medicine ,parasitic diseases ,medicine ,Humans ,Multicenter Studies as Topic ,Vasoconstrictor Agents ,media_common ,Selection bias ,Septic shock ,business.industry ,030208 emergency & critical care medicine ,Publication bias ,medicine.disease ,Shock, Septic ,Systematic review ,030228 respiratory system ,Emergency medicine ,business ,Cardiotonic agents ,Systematic Reviews as Topic ,medicine.drug - Abstract
Purpose To review the characteristics, findings and quality of systematic reviews (SRs) on the effect of any vasopressor/inotrope on outcomes in adult patients with sepsis compared with either no treatment, another vasopressor or inotrope or fluids. Materials and methods We systematically searched Cochrane Central Register of Controlled Trials, PubMed and Embase (January 1993–March 2021). Descriptive statistics were used. Results Among the 28 SRs identified, mortality was the primary outcome in most (26/28) and mortality was usually (23/28) studied using randomised controlled trials (RCTs). Fifteen SRs focused exclusively on patients with sepsis or septic shock. Sepsis and septic shock were always grouped for the analysis. Publication bias was consistently low when studied. The most consistent findings were a survival advantage with norepinephrine versus dopamine, which disappeared in analyses restricted to 28-day mortality, and more arrhythmias with dopamine. However, these analyses were dominated by a single study. Only 2 SRs were judged to be of moderate-high quality. Lack of blinding and attrition bias may have affected the outcomes. Conclusions The quality of SRs on the effect of vasopressors/inotropes on the outcomes of adult patients with sepsis can be improved, but high-quality, multicenter, RCTs should be preferred to additional SRs on this topic.
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- 2021
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