Jerusalem Center Research Articles

Philippine visas-for-Jews from the perspective of 1939 unanswered letters to president Quezon

More than twenty letters of European Jews to the President of the Philippines Manuel Quezon, sent to apply for entry visas for over four dozen people, were recently found in the Rare Books and Manuscripts Department of the National Library of the Philippines in Manila. The letters written in English, German, and Spanish are dated Spring-Summer 1939, when escape from Europe was still possible. Though several hundreds of Jewish refugees came to Manila via various ways during 1937–1941, the letters in question remained unanswered. All of them provide the exact time of the short-lived Mindanao plan, which proposed to establish an agricultural colony of European Jews in the Philippines, but got stuck in the very beginning. The databases of the Yad Vashem World Holocaust Remembrance Center in Jerusalem and the United States Holocaust Memorial Museum in Washington reveal the tragedy, which many Jews anticipated: all of the Philippine visa-seekers, except for one person, found their death in various concentration camps, ghettos, and labour battalions. The article is dedicated to the memory of Jewish refugees, who were seeking in vain an asylum from the Nazis and their collaborators in the Philippines and other parts of the world.

When a vehicle becomes a weapon: intentional vehicular assaults in Israel

BackgroundWe have recently witnessed an epidemic of intentional vehicular assaults (IVA) aimed at pedestrians. We hypothesized that IVA are associated with a specific injury pattern and severity.MethodsRetrospective analysis of prospectively acquired data of patients injured following IVA from October 2008 to May 2016 who were admitted to the Hadassah Level I trauma center in Jerusalem, Israel. Comparison of injury parameters and outcome caused by vehicular attacks to non-intentional pedestrian trauma (PT). Measured outcomes included ISS, AIS, injury pattern, ICU and blood requirements, participating teams, length of stay, and mortality.ResultsThere were 26 patients in the IVA group. Mean age in the IVA group was significantly younger and there were more males compared to the PT group (24.7 ± 13.3 years vs. 48.3 ± 21.3, and 81% vs. 52%, respectively, p < 0.01). Lower extremity (77% of patients), followed by head (58%) and facial (54%) injuries were most commonly injured in the IVA group, and this was significantly different from the pattern of injury in the PT group (54, 35, and 28%, respectively, p < 0.05). Mean ISS and median head AIS were significantly higher in the IVA group compared with the PT group (23.2 ± 12.8 vs. 15.4 ± 13.8, p = 0.012, and 4.5 vs. 3, p = 0.003, respectively). ICU admission and blood requirement were significantly higher in the IVA group (69% vs. 38%, and 50% vs. 19%, p < 0.01). Mortality was significantly higher in the IVA group (4 patients, 15%, vs. 3 patients, 4%, respectively, p = 0.036) and was caused by severe head trauma in all cases.DiscussionThe severity of injury and mortality rate following IVA are higher compared with pedestrian injury. The pattern of injury following IVA is significantly different from non-intentional pedestrian trauma.ConclusionsIVA results in higher mortality than conventional pedestrian trauma secondary to more severe head injury. More hospital resources are required following IVA than following conventional road traffic accidents.

Brucellosis Outbreak in Children and Adults in Two Areas in Israel.

Two parallel outbreaks of Brucella melitensis infection occurred in 2014 in two geographical areas in Israel. In two medical centers in northern Israel and one medical center in Jerusalem, 102 patients (58 children, 47 adults) were diagnosed with brucellosis. Most patients (N = 76, 72%) were Muslim Arabs, 28 (27%) were Druze, and one was Jewish. The source of infection was often traced to cheese from the Palestinian Authority. Biovar-1 was evident in 98% in northern Israel but only in 42% in Jerusalem. Most common manifestations were fever (82%) and osteoarticular symptoms (49%). The major differences between the geographic areas were ethnicity and duration until diagnosis. Compared with adults, children had higher rates of hospitalization (93% versus 64%, P = 0.001), osteoarticular symptoms (60% versus 36%, P = 0.05), elevated alanine aminotransferase (12% versus 0%, P = 0.01), and lower C-reactive protein (2.28 ± 2.08 versus 5.57 ± 6.3l mg/dL, P = 0.001). Two unrelated brucellosis outbreaks occurred in 2014 in two different geographic areas of Israel and were limited to sections of the Arab and Druze populations. Most of the demographic and clinical aspects of patients were not affected by geographic variability. Clinical and laboratory differences were found between children and adults emphasizing the nonuniformity of the disease in different age groups. Effective control of unpasteurized dairy foods, health education programs, and improved regional cooperation are required to control brucellosis in Israel.

Prevalence of interdigital psoriasis of the feet ("psoriasis alba") in mild, moderate, and severe psoriasis.

Interdigital psoriasis of the feet ("psoriasis alba") is a rare form of inverse psoriasis. We conducted a cross-sectional study of the prevalence of interdigital psoriasis in mild, moderate, and severe psoriasis, compared to atopic dermatitis and normal controls. Data were collected during 2010-2013 from 232 psoriatic patients, 190 patients with atopic dermatitis, and 202 normal controls. The psoriatic and atopic dermatitis patients were from the dermatology department and outpatient clinic of the Hadassah-Hebrew University Medical Center in Jerusalem, Israel. The normal controls were healthy workers and volunteers from Hadassah Hospital who were not aware of any dermatological disease and had never consulted a general practitioner or dermatologist for skin problems of the feet. Our study revealed a prevalence of 2.6% of interdigital psoriasis of the feet in psoriatic patients, especially in men, and none in atopic dermatitis and normal controls. Three of the six affected patients with interdigital psoriasis of the feet complained of itching, both feet were involved in four patients, while two presented with additional palmoplantar psoriasis. The hematoxylin and eosin histopathological findings were in line with those found in inverse psoriasis. Dermatologists should be aware of this entity and treat it correctly. The diagnosis should be considered in psoriatic patients presenting with whitish plaque or patches in the toe-webs, in whom the fungal test is negative and are not responding to antimycotic treatment.

Glucose-6-Phosphate Dehydrogenase Screening in Israel-Arab and Palestinian-Arab Neonates

To evaluate the frequency of glucose-6-phosphate dehydrogenase (G-6-PD) deficiency, the incidence of clinically significant jaundice (any serum total bilirubin value >75th percentile on the hour-specific bilirubin nomogram), and the need for phototherapy in the pooled male Israeli-Arab and Palestinian-Arab population born at the Shaare Zedek Medical Center in Jerusalem, Israel. Quantitative G-6-PD enzyme testing of umbilical cord blood was performed during birth hospitalization. G-6-PD deficiency was defined as any G-6-PD value <7.0 U/gHb. Transcutaneous bilirubin was performed daily during birth hospitalization, with serum total bilirubin testing in those with a transcutaneous bilirubin value >75th percentile. Ten of 286 (3.5%) consecutively delivered male Arab newborns had G-6-PD deficiency. Clinically significant jaundice was higher in the population with G-6-PD deficiency compared with normal controls (relative risk, 3.45; 95% CI, 1.24-9.58). Thirty percent of the newborns with G-6-PD deficiency met American Academy of Pediatrics indications for phototherapy according to the high-risk (middle) curve on the phototherapy graph. The frequency of G-6-PD deficiency in the Arab neonatal population delivering at this medical center meets World Health Organization criteria for neonatal G-6-PD screening (3%-5%). As in other ethnic groups, clinically significant jaundice is more frequent in newborns of this ethnic group with G-6-PD deficiency compared with G-6-PD-normal controls. Neonatal G-6-PD screening for both males and females of this population subgroup, in conjunction with parental education regarding the dangers of the condition and its prophylaxis, has now been incorporated into our institution's routine G-6-PD screening program.

Framing Spatial‐Religious Conflicts: The Case of Mormon Development in Jerusalem

AbstractThe paper's aims are twofold: first to present framing methodology as an approach which provides insights into conflicts stemming from the construction of new religious sites. Second, to analyse the Brigham Young University Jerusalem Center, using framing in order to understand the spatial‐religious conflicts involved in its establishment. The findings fall within three frame categories (‘super‐frames’) identified in the research: ‘process’, ‘values’, and ‘issues’. The findings reveal that the discord surrounding the BYU Center had to do primarily with process and the values, and not around the issues themselves. The methodology provides a typology for understanding and analysing the different stories told by stakeholders involved in spatial‐religious conflicts where the decision adopted might be perceived as endangering identity and ‘sense of place’. The typology may be helpful in the analysis of similar disputes elsewhere, and shed light on ways to reframe conflicts over sacred place

Turkey and the Muslim Brotherhood: Crossing Roads in Syria

Relations between Turkey and the Syrian Muslim Brotherhood (SMB) have gained momentum in the light of post-Arab revolt developments. This study aims to present the historical background of the relationship between SMB and AKP and effects of this relationship on foreign policy. For the analytical discussion on the relationship between AKP and SMB integration to particular recent foreign policies of Turkey, first of all, it will be examined how the SMB is perceived in Turkey in social and political arenas. Thus, the socio-political dimensions of the process in which the SMB came to the fore and began to be known in Turkey will be explored along with its position in foreign policy during the Justice and Development Party (JDP) government and the Syrian crisis. This study aims to analyze transformation of the relationship between Turkey and the Syrian Muslim Brotherhood. In many points Turkey has moved away from traditional Turkish foreign policy in its attitude toward the Arab revolts. In this respect, Turkey began to support civil unrest as distinct from the idea that are the main actors in international relations. It was a significant shift from the dominant principle of maintaining the status quo in traditional Turkish foreign policy. The traditional foreign policy rule non-interference in the internal affairs of states was abandoned by Tukey, with the expectation of the Syrian regime would soon change. With the Syrian crisis and the Arab revolts in particular, Turkey for the first time embraced its position as a model country for the Middle East countries and applied this perception in its foreign policy. The visible signs in this major shift in foreign policy are Turkeys moving away from its secular foreign policy as one of the interested parties of the problem as a result of its systematic and explicit intervention and its policy of supporting refugees with many pre- established camps in the immediate vicinity of the border. In terms of foreign policy, Turkey began for the first time to be known for its relations with a non-governmental opposition party, namely the SMB and SMB-Turkey relations also attracted much attention from the foreign press. For example, in the analysis published by the New York Times in February (Thomas Jr., 2011), it is mentioned that Erdogans party has already established ties with the Muslim Brotherhood — a result of Mr. Erdogans long and successful campaign to present himself as a dominant and increasingly anti-Israeli voice in the Middle East. And according to research by Dore Gold at the Jerusalem Center for Public Affairs, three members of the Muslim Brotherhood — two of whom serve in the Egyptian Parliament — were on the Turkish-sponsored ship that was attacked by Israeli forces on its way to deliver aid to the Gaza Strip in May. There is a great deal of ideological compatibility between the A.K.P. and the Muslim Brotherhood, said Mr.

Obituary: Cyril Jacob Kaplan, MD, MBChB(Cape), MChOrth(Liv), FRCS(Eng), FACS (1917–2012)

Dr. Cyril Kaplan died July 11, 2012 at the age 95 from pneumonia. Born in Durban, South Africa in 1917, while a medical student at the University of Cape Town, Cyril Kaplan joined the Cape Garrison Artillery as a volunteer gunner on the outbreak of World War II in 1939. Following graduation, he enlisted in the South African Medical Corps in 1942, where he was exposed to war injuries and became interested in orthopaedics (Fig. 1). Fig. 1 In 1942, Dr. Kaplan enlisted in the South African Medical Corps, where he was exposed to war injuries and became interested in orthopaedics. Following his discharge from the Army in 1946, Dr. Kaplan worked in Liverpool and Guy’s Hospital in London. With the newly proclaimed State of Israel at war in 1948, Dr. Kaplan joined the military in Israel, leading an orthopaedic department in Haifa. There, he met Sylvia, his future wife. He returned to Durban, South Africa following 14 months of service. In Durban, Dr. Kaplan started an orthopaedic practice and worked in leprosy and tuberculosis hospitals. In 1976, Dr. Kaplan (Fig. 2) accepted an invitation to work in the department of orthopaedic surgery at Montefiore Medical Center, a teaching hospital affiliated with Albert Einstein College of Medicine in the Bronx, New York. One of his close colleagues at Montefiore Medical Center was Dr. Edward T. Habermann, an Association of Bone and Joint Surgeons member, who died in 2009. Kaplan previously worked with Dr. Haberman at the Hadassah Medical Center in Jerusalem during the Yom Kippur War in 1973. Fig. 2 Colleagues often consulted with Dr. Kaplan on bone tuberculosis management, a significant pathology among the immigrant population in the Bronx. Dr. Kaplan’s interests included hip and extremity surgery, and colleagues would often consult with him regarding bone tuberculosis management, a significant pathology among the immigrant population in the Bronx. Kaplan remained in New York until 1980, when he returned to South Africa. He practiced there until 1989, then moved back to New York to work at Montefiore Medical Center once again before retiring in 2002. In 2008, Dr. Kaplan published his memoir, In Three Wars: a Personal and Orthopaedic Prospective [1] at the age of 91. His nonmedical interests included European and African history. Dr. Kaplan also collected old maps and Persian miniature paintings, and after retirement, sculpted in bronze. Cyril Kaplan is survived by his wife, three sons, a daughter, and two grandchildren.

The Mormon University on the Mount of Olives: A Case Study in LDS Public Relations

This article explores the use of media by small anti-missionary organizations in Israel to block construction of Brigham Young University's Jerusalem Center for Near Eastern Studies on the Mount of Olives in the mid-1980s. These groups defined Mormons in the public square as aggressive proselytizers with no regard for law or Jewish sensibilities. They felt that Mormons were enemies to Judaism because of their purported interest to convert Jews. The anti-missionary groups were highly organized and effectively employed communitarian arguments couched in spiritual and concrete conceptions of Judaism. To counter these attacks, Mormons hired an Israeli public relations firm to redefine public perceptions of Mormons among Israelis. They created a campaign that focused on public reasons (the appeal to arguments that resonate across sectarian lines) over faith-based justifications for the Mormon construction project. The campaign was based in historicity, political expediency, and legalism. In this way, Mormons successfully argued their position and completed construction of the Jerusalem Center. This high-profile media campaign continues to inform Mormon public affairs efforts today.

The Sum of all Fears: Israel's Perception of a Nuclear-Armed Iran

Thucydides’ ancient logic still governs: uncertainty (over Iran’s nuclear intentions) and the fear this inspires (in Israel) increases the risk of another war (in the Middle East). Even if Israel’s response to the Iranian nuclear program does not lead the region into a war, Israel’s fears will be crucial in shaping Middle Eastern politics and will help to determine the stability of the region in the years ahead. The U.S. public has been hearing about Israeli fears of a nuclear Iran for several years. It is understandable if most Americans discount this drama as

Spatial transgression of new religious sites in Israel

Religion and the expansion of religious sites throughout the built environment have a long and conflict-ridden history. This paper examines the development of three controversial religious sites in Israel that have developed in recent decades in an effort to better understand the kinds of political, social, and locational circumstances that cause some new sites to be regarded as spatially transgressive. The three sites examined here are the Mormon Center in Jerusalem, the Baha'i Gardens in Haifa, and the Church/Mosque in Nazareth. The study is based primarily on 75 structured, open interviews with stakeholders and decision-makers.The broader aim of the paper is to generate a better understanding of the concept of spatial transgression through systematic investigation based on the methodology of “framing.” This methodology provides a comprehensive vocabulary for perceptions, referred to as “frames,” and offers a detailed and systematic typology of frames based on the literature and the empirical data (grounded research) of the case studies.The main findings fall within the three aggregated super-frames identified in the research: “Process,” “Values,” and “Issues.” Of these, the Process super-frame was found to be dominant in all three cases. Comparing the different frames in the three cases enabled us to identify the factors that influenced the transgression process. It also facilitated a better understanding of the different “stories” involved and the concept of spatial transgression, which was found to exist on a scale ranging from low to high intensity. This paper also proposes a framing typology that may prove useful for understanding and mapping similar cases elsewhere.

Survey: Nations failing to address cancer pain

Hundreds of millions of cancer patients are suffering needlessly because governments have failed to ensure access to pain-relieving drugs, according to an international survey released last fall during the 2012 European Society for Medical Oncology (ESMO) Congress held in Vienna, Austria. Unrelieved pain is causing worldwide suffering, not because physicians do not have the ability to treat it but because most patients do not have access to the medication, said the lead author of the report, Nathan Cherny, MD, of the Shaare Zedek Medical Center in Jerusalem, Israel and chair of the ESMO Palliative Care Working Group. ESMO initiated the International Collaborative Project to Evaluate the Availability and Accessibility of Opioids for the Management of Cancer Pain and coordinated with the European Association for Palliative Care, the Pain and Policy Study Group at the University of Wisconsin Carbone Cancer Center, the Union for International Cancer Control, and the World Health Organization. The data were gathered between December 2010 and July 2012 and included 156 reports submitted by experts in 76 countries and 19 Indian states. The survey found that very few countries provided all 7 of the opioid medications that are considered to be essential for the relief of cancer pain. In many countries, fewer than 3 of the 7 medications are available and, if they are available, they are either unsubsidized or weakly subsidized by many governments. In addition, availability is often limited. Researchers also learned that many countries have highly restrictive regulations, including those that limit patients' ability to receive prescriptions, limit prescriber privileges, impose limits on the duration of the prescription, restrict dispensing, and increase bureaucracy for the prescribing and dispensing process. The restrictions are particularly severe in Africa, Asia, the Middle East, and Latin and Central America, and researchers note that there is an urgent need to examine drug control policies that impede pain treatment. Studies have shown that pain can affect as many as 64% of patients with metastatic, advanced, or terminal disease and 59% of patients receiving anticancer treatment, says Carla Ripamonti, MD, head of supportive care in the cancer unit of the IRCCS Foundation National Cancer Institute in Milan, Italy. Dr. Cherny says the ESMO study has provided key information that will be useful in developing national efforts for treating cancer pain. Not only do researchers now know which countries have suboptimal formularies of medication to relieve pain, they also know how much patients pay out-ofpocket for such medications as well as which countries have excessive regulations that limit patients' ability to access vital medications. The presentation of the study at ESMO Congress is the beginning of an organized effort to tackle the challenge, says Dr. Cherny.

The Relegitimization of Israel and the Battle for the Mainstream Consensus

Joel Fishman is a historian and a fellow of the Jerusalem Center for Public Affairs. He is also a member of the board of Scholars for Peace in the Middle East and served as Chairman of the Foundation for the Research of Dutch Jewry at the Hebrew University of Jerusalem. Dr. Fishman is co-author (with Efraim Karsh) of La Guerre d’Oslo and is presently carrying out research on political warfare, particularly media warfare and incitement.

A Guantanamo on the Sea: The Difficulty of Prosecuting Pirates and Terrorists

Copyright ? 2010 California Law Review, Inc. California Law Review, Inc. (CLR) is a California nonprofit corporation. CLR and the authors are solely responsible for the content of their publications. t Associate Professor, Northwestern University Law School. The author thanks Steven Art for his extraordinary assistance in researching this Essay, and the Global Law Forum at the Jerusalem Center for Public Affairs for its support for an earlier version of this project. Avi Bell, Evan Criddle, Gregory McNeal, and Bernard Oxman provided helpful comments. This Essay was selected for presentation at the National Security Law Junior Scholar's Workshop at the University of Texas, sponsored by the International Committee of the Red Cross, and at the American Association of Law Schools annual meeting. Special thanks go to the commentators and other participants. 1. See Germany Calls for International Court to Prosecute Pirates, FoxNews.com, Dec. 23, 2008, http://www.foxnews.corn/story/0,2933,471804,00.html (explaining why nations today are reluctant to act against pirates). 2. Jeffrey Gettleman, Pirates Outmaneuver Warships off Somalia, N.Y. Times, Dec. 15, 2008, at A6 (Even if foreign navies nab some members of his crew, Mr. Jama said, he is not worried. He said his men would probably get no more punishment than a free ride back to the beach.). 3. In 2008, the International Maritime Bureau of the International Chamber of Commerce reported an unprecedented wave of piracy in the Gulf of Aden, with 111 recorded attacks. See ICC Commercial Crime Services, 1MB Reports Unprecedented Rise in Maritime Hijackings, Jan. 16, 2009, http://www.icc-ccs.org/mdex.php7op reports-unprecedented-rise-in-maritime-hij ackings&catid=60 :ne ws&Itemid=51.

Increased Vitamin B12 levels are associated with mortality in critically ill medical patients

We describe an observational study in critically ill medical patients showing the association between serum Vitamin B12 levels measured on or near admission and the outcome in these patients. We used the database of patients admitted to the Medical Intensive Care Unit (MICU) at the Hadassah-Hebrew University Medical Center in Jerusalem, Israel, to analyze associations between patient demographics, background, diagnoses and serum Vitamin B12 levels with hospital and 90 day outcomes. Higher mean Vitamin B12 levels were found in patients who did not survive their hospital stay (1719pg/ml vs 1003pg/ml, p<0.01). Those who had died by 90 days after admission to the MICU also had higher Vitamin B12 levels than survivors (1593pg/ml vs 990pg/ml). Regression analysis showed that elevated Vitamin B12 levels were associated with increased 90 day mortality, even after controlling for other variables. Survival analysis also showed an increased mortality rate in patients with Vitamin B12 levels over 900pg/ml (p<0.0002). Our data show that high serum Vitamin B12 levels are associated with increased mortality in critically ill medical patients. We suggest that Vitamin B12 levels should be included in the work-up of all medical intensive care patients, particularly those with a chronic health history and increased severity of illness.

End-notes on Israel–Iran relations (unabridged)

End-notes on Israel–Iran relations (unabridged)

Institutional Control Measures to Curtail the Epidemic Spread of Carbapenem-Resistant Klebsiella pneumoniae: A 4-Year Perspective

To describe the implementation of an institution-wide, multiple-step intervention to curtail the epidemic spread of carbapenem-resistant Klebsiella pneumoniae (CRKP). Consecutive intervention analyses. All patients admitted to a 775-bed tertiary care medical center in Jerusalem, Israel, from 2006 through 2010. The effects of 4 interventions were assessed: (1) a policy of isolation for patients colonized or infected with CRKP in single rooms, which was started in March 2006; (2) cohorting of CRKP patients with dedicated nursing staff and screening of patients neighboring a patient newly identified as a carrier of CRKP, which was started in March 2007; (3) weekly active surveillance of intensive care unit patients, which was started during August 2008; and (4) selective surveillance of patients admitted to the emergency department, which was started in March 2009. Interrupted regression analysis and change-point analysis were used to assess the effect of each intervention on the CRKP epidemic. Patient isolation alone failed to control the spread of CRKP, with incidence increasing to a peak of 30 new cases per 1,000 hospital beds per month. Institution of patient cohorting led to a steep decline in the incidence of CRKP acquisition (P < .001). Introduction of active surveillance interventions was followed by a decrease in the incidence of CRKP-positive clinical cultures but an increase in the incidence of CRKP-positive screening cultures. The mean prevalence of CRKP positivity for the period after cohorting began showed a statistically significant change from the mean prevalence in the preceding period (P < .001). The cohorting of patients with dedicated staff, combined with implementation of focused active surveillance, effectively terminated the epidemic spread of CRKP. Cohorting reduced cross-infection within the hospital, and active surveillance allowed for earlier detection of carrier status. Both interventions should be considered in attempts to contain a hospital epidemic.

Nibley and the Environment

Research Article| January 01 2011 Nibley and the Environment Terry B. Ball Terry B. Ball Terry B. Ball is a professor of ancient scripture and dean of Religious Education at Brigham Young University. From BYU he received his BS in botany and education, his MA in ancient Near Eastern studies, and his PhD in archaeobotany with an emphasis in the ancient Near East. He has taught and traveled extensively in the Holy Land, including teaching at the BYU Jerusalem Center for Near Eastern Studies. Search for other works by this author on: This Site Google Journal of the Book of Mormon and Other Restoration Scripture (2011) 20 (2): 16–29. https://doi.org/10.5406/jbookmormotheres.20.2.0016 Cite Icon Cite Share Icon Share Facebook Twitter LinkedIn MailTo Permissions Search Site Citation Terry B. Ball; Nibley and the Environment. Journal of the Book of Mormon and Other Restoration Scripture 1 January 2011; 20 (2): 16–29. doi: https://doi.org/10.5406/jbookmormotheres.20.2.0016 Download citation file: Zotero Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu toolbar search search input Search input auto suggest filter your search All Scholarly Publishing CollectiveUniversity of Illinois PressJournal of Book of Mormon Studies Search Advanced Search The text of this article is only available as a PDF. Copyright 2011 by the Board of Trustees of the University of Illinois2011 Article PDF first page preview Close Modal You do not currently have access to this content.

Intrauterine balloon tamponade as a treatment for immune thrombocytopenic purpura–induced severe uterine bleeding

To report our experience of applying balloon tamponade in the treatment of intrauterine bleeding in two patients with immune thrombocytopenic purpura (ITP). Immune thrombocytopenic purpura is a well-known hematologic autoimmune disease. The uterus may be a major site of bleeding in patients with ITP. Halting bleeding is imperative to reduce blood loss and platelet consumption and to allow medical treatment to increase platelet count. Balloon tamponade has been described as an effective method to control bleeding in a variety of clinical situations; it is an effective and accessible modality, requiring no analgesia or anesthesia, and helps facilitate continuous monitoring of uterine bleeding. Report of two cases. Obstetrics and gynecology department in a tertiary care center in Jerusalem, Israel. Two patients with ITP with severe uterine bleeding refractory to treatment with estrogen and IV IgG. Intrauterine balloon tamponade. Cessation of uterine bleeding, appearance of complications. Insertion of balloon tamponade successfully controlled bleeding in both cases. The patient in case 1 subsequently had persistent hypomenorrhea. The patient in case 2 had abdominal pain and suspected pelvic inflammation. Our presented cases demonstrate that uterine bleeding can be controlled successfully in patients with ITP with an intrauterine balloon. This novel application raises many technical issues, such as the appropriate filling pressures and duration of treatment. Possible risks, such as endometrial injury, still remain to be resolved and mandate future clinical research.

Sex ratio is remarkably constant

To study whether the sex of the offspring is related to increasing parental age, gravidity, and parity, hypothesizing an altered male-to-female sex ratio with the advancing parental age. A large retrospective cohort study. The study analyzed birth records of Hadassah Hebrew University Medical Center in Jerusalem from June 2003 to December 2006. 35,837 birth records were analyzed including 941 multifetal deliveries, excluding foreign inhabitants (n = 744), missing data for the main study outcome (n = 2) and parturients over 50 years to control for egg donation (n = 26). None. Male-to-female sex ratio. The male-to-female sex ratio of all the newborns was 1.05. This ratio did not change significantly with either maternal or paternal age. Neither gravidity nor parity affected the male-to-female ratio. The only factor that affected the regression of sex ratio was the length of gestation. Sex ratio at birth is remarkably constant. No association was found between parental age or birth order and neonatal sex ratio.