Managing congenital heart disease requires precise assessment of cardiac volume. However, traditional methods, such as Simpson’s rule, are often inaccurate when the shape of the heart is complex. Although cardiac magnetic resonance imaging, computed tomography, and echocardiogram are considered the current gold standards, other technologies are emerging to respond to the need for precision. In this study, we assessed the performance of a new method based on virtual reality for ventricular volume measurement in adult congenital heart disease patients who had undergone surgery in childhood and had structural anomalies.
The objective of this study was to examine the accuracy of a virtual reality-based approach for evaluating heart chamber and stroke volume in patients with congenital heart disease and validate its potential as a complementary measure in daily clinical routines as an alternative approach to assessing heart chamber volume.
In this retrospective single-center study, we reviewed the cardiac computed tomography scan records of 20 patients from Sheba Medical Center for the period from January 2022 to December 2023. We derived the ventricular volumetric calculations from conventional assessment methods based on computed tomography imaging, which we then compared to a novel segmentation approach utilizing virtual reality and computed tomography. The main goal was to determine the correlations between the computed tomography measurements and the virtual reality segmentation in terms of accuracy, especially in patients with complex profiles such as a tetralogy of Fallot or a systemic right ventricle.
Throughout the cardiac cycle, the left and right chamber virtual reality measurements showed significant positive correlation with the computed tomography-based measurements. By contrast, the stroke volume measurements correlations failed to reach significance. In the tetralogy of Fallot patients, the right ventricle measurements were more strongly correlated than the left ventricle measurements. There were no significant differences between methods for the left ventricle volumes, the right ventricle volumes, or the stroke volume.
Virtual reality-based volumetric analysis yielded a precise assessment of cardiac volumes even in patients with complex right ventricular geometry such as tetralogy of Fallot, thus validating its potential. This method can thus be usefully applied to congenital heart disease in general and may serve as an alternative to classical approaches to evaluating volumetric measurements.
Asaph Cohen BPT , David Hochstein MD, Yisrael Parmet PhD, Esther Berger BA, Yishay Salem MD, Eitan Keizman MD, Efrat Mazor MD, Jonathan Grossman MD, Orli Goitein PhD MD, Uriel Katz MD, Netanel Nagar B.Des, Oliana Vazhgovski RN, MA, Shai Tejman-Yarden MD, MSc
5 – 12
Maternal satisfaction with childbirth influences postpartum emotional health, mother-infant bonding, and future reproductive decisions. Delivery mode, especially in complicated second-stage labors, plays a key role in shaping this experience.
To evaluate maternal birth satisfaction and postpartum quality of life following instrumental vaginal delivery compared to second stage cesarean section (SSCS).
This cross-sectional study included women who delivered via instrumental vaginal delivery or SSCS at a tertiary medical center between January 2021 and April 2024. Primary outcomes were birth satisfaction, assessed by the Birth Satisfaction Scale-Revised (BSS-R), and postpartum quality of life, measured using the PROMIS-10 questionnaire. Questionnaires were completed during hospitalization or within one week postpartum. Maternal, pregnancy, and delivery data were extracted from electronic medical records. Group differences were analyzed using univariate tests, and effect sizes with 95% confidence intervals were reported for significant findings.
A total of 688 women were included (316 instrumental deliveries, 372 SSCS). The SSCS group had a higher median BMI (29 [IQR: 26–33] vs. 28 [25–31], p < 0.001) and more multiple pregnancies (48% vs. 39%, p = 0.015). Instrumental delivery was associated with greater overall birth satisfaction (median BSS-R 27 vs. 24, p < 0.001; r=0.22, 95% CI 0.14–0.30), higher quality of care perception (13.5 vs. 12.9, p = 0.012), and better physical health scores (median PROMIS-10 42 vs. 37, p = 0.001; r=0.18, 95% CI 0.09–0.26). The SSCS group reported higher stress during labor (median 7 vs. 8, p < 0.001) and higher rates of postpartum pain (39.8% vs. 29.7%, p = 0.023).
Instrumental delivery was associated with higher maternal satisfaction and better early postpartum physical health compared to SSCS. These findings highlight the importance of addressing maternal expectations and providing clear explanations about delivery options, even in emergency scenarios, to improve birth experience.
Shani Meysharim, Alex Galper RN, Dr. Varda Shtanger PhD, Dr. Tal Cahan MD
14 – 24
Low-birth-weight percentile has been shown to be associated with impaired pulmonary function at adulthood. However, its impact on pulmonary function early in life remains less well established.
To assess the impact of small-for-gestational-age (SGA) status on pulmonary function in infants 3 months to 2 years of age.
We conducted an observational study evaluating infant pulmonary function tests (iPFTs) performed at Hadassah Medical Center between 2008 and 2023. iPFTs results in infants born SGA were compared with infants born appropriate and large for gestational age (AGA/LGA). Excluded from the study were infants diagnosed with chronic diseases other than prematurity.
iPFT data from 161 SGA infants were compared with 545 infants born AGA/LGA. No consistent significant differences were found in iPFT results between infants born SGA and infants born AGA/LGA (mean (SD); FEV0.5 = 80.11 (18.40) %predicted vs. 81.55 (18.03) %predicted, P=0.39; FVC = 84.24 (20.30) %predicted vs. 85.61 (20.22) %predicted, P=0.46). Infants born SGA were not more likely to suffer from a restrictive (8.3% vs. 4.7%, P=0.09) or an obstructive phenotype (53.7% vs. 49.7%, P=0.39). This remained true when evaluating subgroups of early premature and term born infants.
Our findings challenge the hypothesis that SGA is associated with impaired pulmonary function in infancy. While subtle differences were observed, they were not statistically or clinically significant. Further research is needed to better understand the respiratory outcomes of intrauterine growth restriction.
Avigdor Hevroni MD, Nadav Juven Wetzler BMSc, Alex Gileles-Hillel MD, Malena Cohen-Cymberknoh MD, Laurice S. Boursheh BSc, Oded Breuer MD
23 – 28
About one-third of ischemic events in the brain occur in the vertebrobasilar arteries. Arterial calcification is a significant risk factor for stroke. We investigated whether a calcium component in the vessel wall is also a measurable risk factor that can predict ischemic events, in a study similar to those conducted on coronary arteries.
To determine whether measuring calcium score (CS) can predict vertebrobasilar disease. This study aims to examine the relationship between CS in the vertebrobasilar arteries and ischemic events in patients with vertebrobasilar disease.
This study is a retrospective observational-analytical study conducted at the Galilee Medical Center designed to evaluate the change in vertebrobasilar CS before and after ischemic stroke events. The statistical method used was the Wilcoxon signed test, with a significance level of 5%.
In a group of 24 patients, a statistically significant difference (P=0.009) was found in the CS when scans before and after the event were compared.
Our findings indicate that there is a significance difference in the CS of CT scans before and after ischemic events in the vertebrobasilar arteries and that CS may serve as a measure for predicting occlusive events in these arteries. This study is limited by its small sample size, retrospective design, and absence of a control group, which may affect the generalizability and introduce bias. The association between CS and stroke remains unclear and could be confounded by underlying inflammation. Future multicenter studies with larger cohorts and direct patient-reported data are needed to validate these findings. We propose that a calcium component in the vessel wall is a measurable risk factor that can predict ischemic events, as seen in similar studies conducted on coronary arteries.
Rhegmatogenous retinal detachment (RRD) is a sight-threatening condition requiring surgical intervention. Various tamponade agents (air, gas, silicone oil) facilitate retinal reattachment, yet the comparative effectiveness and long-term outcomes of these methods remain uncertain.
To systematically review and compare anatomical and functional outcomes and complication rates associated with air, gas, and silicone oil tamponades in primary vitrectomy for RRD.
A systematic search of PubMed, Embase, Web of Science, and the Cochrane Library was conducted (January 2010 – February 2025) following PRISMA guidelines. Randomized controlled trials (RCTs) and comparative observational studies with ≥6 months’ follow-up were included. Risk of bias was assessed using RoB 2.0 and the Newcastle-Ottawa Scale. Only four studies (one RCT, three observational) met the criteria, which limits the generalizability of findings.
All tamponade agents achieved >90% final anatomical success. Air provided faster early visual recovery and fewer complications (e.g., lower intraocular pressure elevation than gas), whereas silicone oil yielded poorer visual outcomes and higher complication rates.
Although air, gas, and silicone oil can all effectively reattach the retina, tamponade selection should be tailored to the complexity of the RRD and individual patient factors. Larger, high-quality RCTs are needed to validate these findings and clarify optimal tamponade strategies.
Hexakapron (tranexamic acid, TXA) is a widely used antifibrinolytic agent for controlling bleeding in surgical and clinical settings. It effectively reduces blood loss, especially in patients with bleeding disorders such as haemophilia. Although generally safe, severe hypersensitivity reactions to TXA are rare, with only a few reported cases of anaphylaxis or allergic responses.
This case report describes a 34-year-old man with von Willebrand disease and factor XI deficiency who developed throat swelling, pain, and shortness of breath after receiving TXA for post-surgical epistaxis; allergy testing confirmed hypersensitivity. The patient’s allergic reaction was managed symptomatically, with symptoms resolving successfully. The allergy was documented to avoid future exposure.
This case adds to the limited data on TXA hypersensitivity and highlights the need to recognize potential allergic reactions, even to drugs with a low rate of adverse effects. Clinicians should stay alert for hypersensitivity in at-risk patients, as early detection and reporting are key to preventing severe reactions to TXA.
