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Background: Inflammatory bowel disease (IBD) presents unique challenges in elderly patients due to comorbidities and treatment-related risks. Objectives: This study evaluates ustekinumab (UST) and vedolizumab (VDZ) efficacy and safety in elderly Crohn's disease (CD) patients. Design: A retrospective cohort study at a tertiary medical center. Methods: CD patients aged ⩾60 years (elderly) treated with UST, compared to non-elderly (<60 years) patients treated with UST and elderly patients treated with VDZ. Clinical response was evaluated using the Harvey–Bradshaw index (HBI) and clinical biomarkers, alongside monitoring steroid use, hospitalization rates, treatment persistence, and surgical interventions. Results: The study included 166 CD patients: 32 elderly and 65 non-elderly patients treated with UST, and 69 elderly patients treated with VDZ. The mean duration of follow-up was 10.8 ± 2.8 months in the non-elderly group, 9.97 ± 3.28 months in the elderly UST group, and 10.0 ± 3.29 months in the VDZ group. Elderly UST patients were more likely to receive corticosteroids at initiation than non-elderly UST patients (44% vs 14%, p = 0.001). At 12 months, clinical response rates did not significantly differ between elderly and non-elderly UST groups, respectively (48% vs 40%, p = 0.5). However, elderly UST patients exhibited higher hospitalization rates over time compared to non-elderly UST patients (6-month: 19% vs 6.2%, p = 0.077; 12-month: 19% vs 4.6%, p = 0.055; log-rank p = 0.004). No significant differences were observed in clinical response and remission rates between elderly UST and elderly VDZ patients at 6 and 12 months. At 6 months, a higher hospitalization rate was observed in the UST group (19% vs 4.3% p = 0.027), but this difference did not persist over time. Conclusion: UST and VDZ are effective and safe treatments for elderly CD patients, despite higher hospitalization rates compared to non-elderly patients, likely due to age-related complications. Plain language summary: Short term effectiveness and safety of ustekinumab and vedolizumab in elderly and non-elderly patients with Crohn's disease – a comparative study In older adults with Crohn's disease, managing treatment can be complex due to age-related health issues. This study examined how two medications, ustekinumab (UST) and vedolizumab (VDZ), perform in patients aged 60 and older. Researchers compared UST's effectiveness in elderly patients to its use in younger adults and VDZ's performance in the elderly. They found that while elderly patients starting UST were more likely to need corticosteroids initially, their 12-month clinical response rates were similar to younger patients. However, elderly UST users had higher hospitalization rates over time. Results also showed no significant difference in outcomes between elderly patients using UST versus VDZ, despite initial concerns about hospitalizations. Overall, both UST and VDZ appear safe and effective for elderly Crohn's disease patients, although hospitalization risks remain higher compared to younger adults, reflecting age-related health challenges. [ABSTRACT FROM AUTHOR]

Background: The skin–gut axis, characterized by bidirectional communication between the skin and gut, plays a crucial role in the pathogenesis of psoriasis and inflammatory bowel diseases (IBD). Objectives: We aimed to explore the association between psoriasis and IBD and identify predictors associated with IBD development among patients with psoriasis. Design: Retrospective cohort study. Methods: A retrospective study which utilized an electronic database from the Meuhedet Health Maintenance Organization (MHMO) in Israel. Psoriasis was categorized as severe if any systemic agent or phototherapy was administered. Univariate and multivariate logistic regressions were used to identify specific predictors for IBD, with adjustments made for potential confounders. The study received approval from the Ethical Committee of the MHMO. Results: In total, 61,003 adult patients who were diagnosed with psoriasis between 2000 and 2022 were included. Among them, 1495/61,003 patients (2.4%) were diagnosed with IBD, as compared to 3834/244,012 patients (1.6%) in the non-psoriasis group [adjusted odds ratio (OR): 1.47; 95% confidence interval (CI): 1.37–1.56; p < 0.001]. Increased age (OR: 1.01; 95% CI: 1.01–1.02; p < 0.001), male gender (OR: 1.22; 95% CI: 1.03–1.45; p = 0.024), and Jewish ethnicity (OR: 2.5; 95% CI: 1.2–4.1; p < 0.001) were identified as significant risk factors for IBD. Spondyloarthropathies, including psoriatic arthritis (OR: 2.27; 95% CI: 1.86–2.77; p < 0.001) and ankylosing spondylitis (OR: 2.82; 95% CI: 1.5–5.32; p < 0.05), were associated with a higher prevalence of IBD. Furthermore, severe psoriasis was significantly associated with a higher likelihood of IBD, compared to mild psoriasis (OR: 16.03; 95% CI: 11.02–23.34; p < 0.001). Conclusion: A significant association between psoriasis and IBD was demonstrated, including its subtypes: Crohn's disease and ulcerative colitis. Moreover, such association may depend on psoriasis severity as determined by the treatment used. This association warrants further investigation and implies a potential need for closer monitoring of patients with severe psoriasis. Plain language summary: Association between psoriatic disease severity and risk of inflammatory bowel diseases 1- Gut and skin barrier play an integral role in psoriasis and inflammatory bowel disease (IBD) development. 2- Shared genetic and environmental factors could explain the association between both diseases. 3- We report increased association between psoriasis and IBD, a relationship that is more pronounced in patients with severe psoriasis. 4- Patients with spondyloarthritis related diseases have a stronger association with IBD. [ABSTRACT FROM AUTHOR]

Este artículo da a conocer un responsum único conservado en la colección Taylor-Schechter de la Guenizá de El Cairo. Se edita el texto y se explica el contenido halájico e histórico del responsum, si bien, desde ese punto de vista no contiene muchas innovaciones. Su singularidad radica en que está escrito en castellano en caracteres hebreos. Aunque en la órbita de los países musulmanes hubo un desarrollo de escritos halájicos en árabe judío (hasta su desaparición en un periodo tardío), el uso de lenguas distintas del hebreo o el arameo para contenidos halájicos había sido raro en Europa. Según nuestra estimación, este responsum se compuso en el siglo xv y es uno de los conservados de este periodo. El texto enriquece nuestro conocimiento de la lengua de los judíos en la península, y además arroja luz acerca de su vida cultural y religiosa. El autor del texto es «R. Jacob Ca[n]pantón», del que se sugiere que sería padre del conocido R. Isaac Campantón. La información sobre aquél era limitada, y hasta ahora no conocíamos escritos halájicos suyos. Si nuestra identificación es correcta, el texto serviría para arrojar luz acerca de la personalidad de este sabio judío.

Background: Guidelines issued by professional organizations recommend that all patients with psychotic disorders who have had several psychotic relapses, continue maintenance anti-psychotic treatment. However, some patients discontinue anti-psychotics and do not later relapse. This study attempted to characterize those patients with psychotic disorders early in their disease not taking maintenance antipsychotics, who were not later hospitalized., Study Design: This population-based cohort study combined registry data on patients diagnosed in their first psychotic episode (ICD 10 code: F20-29) from Sweden (n = 20 848), and Israel (n = 10 045), and followed them for up to 7 years for re-hospitalization or death. Multivariate analyses assessed sociodemographic and clinical risk factors predicting rehospitalization or death in patients with one hospitalization and did not fill prescriptions for antipsychotics; results from Sweden and Israel were then meta-analyzed., Study Results: The main analysis of this paper included 1611 patients from Sweden and 1607 from Israel. Male gender (adjusted hazard ratio [aHR], 1.57; 95% confidence interval [CI], 1.16-2.13) and a diagnosis of narrowly defined schizophrenia (F20.0-F20.9; aHR, 1.85; 95% CI, 1.55-2.2) were associated with increased risk of a second hospitalization or death among those who did not use antipsychotics. No sociodemographic or clinical characteristics were associated with a decreased risk of a second hospitalization or death., Conclusions: Based on registry data, it was not possible to characterize, in a clinically meaningful way, those patients who can safely discontinue anti-psychotic medications and not be re-hospitalized or die. Male gender and a diagnosis of narrowly defined schizophrenia were associated with an increased risk of later relapse., (© The Author(s) 2025. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center.)

Introduction: Post-orgasmic Illness Syndrome (POIS) is an uncommon condition characterized by the emergence of flu-like and allergy-like symptoms following ejaculation, lasting for a period of 2 to 7 days. The syndrome presents in two primary age-related onset patterns: one during puberty and another initiating later in adult life. Although the condition leads to significant emotional distress and a decline in quality of life, its true prevalence remains elusive due to underreporting and underdiagnosis. The leading etiological hypothesis suggests an immunological mechanism, specifically an allergic reaction to the patient's own sperm. A handful of studies support this hypothesis, providing compelling evidence that hyposensitization treatment using autologous sperm effectively alleviates the symptoms of POIS. This suggests that an immune response against sperm components may be the primary underlying cause. However, a definitive understanding of the syndrome's pathophysiology requires further investigation.

Background: The massive terrorist attack on a mixed population of civilians, soldiers, and foreigners on October 7, 2023, resulted in 1200 casualties and led to many major personal identification issues. At the Israel National Center for Forensic Medicine (INCFM), addressing the mass casualty incidents required precision that included technical, ethical, and humanitarian dimensions. Many obstacles arose that were attributable to the vast number and diversity of victims and the heavy workload in the setting of a small forensic team., Objectives: To define the various methods utilized for victim identification., Methods: The different types of identification were visual, primary, and circumstantial. Primary methods compared unique and stable characters of the human body, including fingerprints, comparisons of dental data, X-rays, and medical databases. We implemented other methods (anthropology, genetics) and novel creative strategies (digital photography taken by random individuals using mobile phones) and computed tomography (CT) scan at another designated site other than at the INCFM., Results: Often, visual recognition and extraction of DNA were impossible because of burnt human remains. Hence, a comparison method of antemortem and postmortem CT findings became imperative for many unidentified victims. The more complex cases included the finding of body parts of more than one individual in different body bags (comingled remains). In such situations, we matched the body parts by utilizing DNA methods. We present seven case challenges., Conclusions: We utilized various known and novel methods for victim identification in the aftermath of the events of 7 October 2023 while addressing ethical issues in a case series.

Introduction: The immune system could be affected by a mixture of factors. It is customary to classify factors that affect the immune system into three main groups: hereditary, environmental and hormonal factors. When those factors deviate from their normal physiological effect, in the genetically pre-dispositioned, an autoimmune disease may erupt and a lymphoma may develop as a result. Viruses are a significant part of the environmental factors that affect the immune system. Recent evidence demonstrates the ability of the COVID-19 virus to induce hyper-stimulation of the immune system, thus leading to the formation of autoantibodies in patients. This effect of the COVID-19 virus is caused by two main courses of action: firstly, its ability to induce hyper-stimulation of the immune system; secondly, its molecular similarity to humans. Numerous records demonstrate the tendency of severely ill COVID-19 patients to develop multiple autoantibodies known to be found in common autoimmune diseases, such as antinuclear antibodies, antiphospholipid antibodies, and many more. Additionally, many case reports have been published on COVID-19 infected patients who developed autoimmune diseases. It is extremely important to recognize the autoimmune effects of the COVID-19 virus when dealing with the ongoing pandemic.