While individual Jewish plastic surgeons have been recognized in the literature for their groundbreaking achievements, a comprehensive review of their collective contributions to plastic surgery is lacking. The goal of this review is to document and highlight the major advancements made by Jewish physicians whose work significantly impacted plastic and reconstructive surgery from its inception as a discipline to the present day. A comprehensive literature search was conducted to identify key developments in the history of plastic surgery, which were then narrowed to those made by Jewish practitioners. The Jewish identity of these practitioners, along with the significance of their work, was verified through historical records, newspaper archives, and peer-reviewed publications. Contributions were then organized chronologically to construct a cohesive historical narrative. Beginning in the 1800s and accelerating through the 20th century, Jewish plastic surgeons have been instrumental in shaping the field. Their innovations include advancements in the treatment of facial deformities, the development of the lumpectomy with adjunctive radiation therapy as a less invasive alternative to radical mastectomy, and the founding of key institutions such as the American Society of Plastic Surgeons and the International College of Surgeons. Additional breakthroughs include the use of albumin in burn management, foundational work in angiogenesis physiology, and numerous innovations in cosmetic surgery. The history of plastic and reconstructive surgery is a rich tapestry of discovery and evolution. Fully understanding its development is not possible without acknowledging the enduring and transformative contributions of Jewish surgeons and researchers.

Polypharmacy carries the potential for increased risk and severity of adverse reactions. Deprescribing may reduce adverse events and possibly hospitalizations, although evidence on hard outcomes such as mortality is mixed. As the medication experts responsible for the close monitoring of their patient, doctors, nurses, and pharmacists play a crucial role in the process of medication deprescribing. They are involved in the therapeutic process and contribute to the appropriate use of medications and the proper discontinuation of those that no longer benefit the patient or are harmful. This role is particularly important for vulnerable groups, such as older people, who often take chronic medication. This study aims to review the literature on polypharmacy and the importance of suspending unnecessary or harmful medications in older people, emphasizing the role of healthcare professionals in the process. A narrative review of recent publications (articles from 2023 to 2025) in Web of Science, PubMed, and Scopus databases, addressing polypharmacy and deprescribing in older adults was conducted. A multidisciplinary team including doctors, nurses, and pharmacists plays a pivotal role in this process by reviewing patients' therapeutic regimens, identifying inappropriate medications, and monitoring the withdrawal process. Their intervention can support more appropriate medication use, may improve patients' quality of life, and has the potential to reduce healthcare costs.

This study explored the relationship between visual perceptual skills and participation performance in 4-6-year-old children diagnosed with autism spectrum disorder (ASD). A cross-sectional design was employed for children diagnosed with ASD. Visual perceptual abilities were assessed using the Motor-Free Visual Perception Test-Fourth Edition (MVPT-4), and participation levels were measured using the Children Participation Questionnaire (CPQ). Statistical analysis was done using SPSS version 26, employing one-sample t-tests and Pearson correlation analysis. A total of 48 participants were included in the study: mean age, 4.98±0.82 years; 66.7% were male; 79.2% attended regular schools. One-sample t-tests indicated significant deficits across all CPQ dimensions (P<0.001). Visual perception was negatively correlated with autism severity (r=-0.429, P=0.002) and positively correlated with participation diversity (r=0.404, P=0.004). In the activities of daily living (ADL) and instrumental ADL (IADL) occupations, visual perception was significantly associated with all CPQ elements. Conversely, play and leisure occupations showed mostly negative correlations with the CPQ occupations, while social participation and education showed mixed results. Visual perception was positively correlated with most elements but negatively associated with enjoyment (r=-0.428; P=0.002). Preschool children with ASD demonstrate significant participation restrictions. Visual perception emerged as a critical determinant of participation, particularly in ADL and educational contexts. Early interventions targeting visual perception skills may enhance independence and functional engagement, though interventions should also address the enjoyment and emotional experience occupations to ensure holistic participation outcomes.

To the Editor: We thank Dr Vijayasimha and colleagues for their thoughtful analysis of our work and their proposal for prospective validation of the Padua × D-dimer (PaDd) score. Their roadmap provides a rigorous framework that addresses critical gaps in our single-center retrospective design. We welcome this opportunity to clarify key methodological considerations and invite the global research community to collaborate on next-generation studies.

IntroductionPulp stones (PS) are incidental, mostly asymptomatic, radiographic findings that may hinder endodontic therapy. They are observed as radiopaque aggregates within coronal or radicular pulp tissue on intraoral periapical, bite-wing, panoramic radiographs and cone-beam computed tomography images. This study aimed to evaluate PS prevalence in patients with cardiovascular disease (CVD), diabetes mellitus (DM), and chronic periodontitis (CP) as compared with controls, as a function of age and sex.Material and MethodsThis cross-sectional study included 200 subjects: 50 healthy controls, and 50 patients each with CVD, DM, and CP. All participants underwent digital panoramic radiograph (orthopantomogram) (OPG) evaluation for the presence/absence, number, and location of PS.ResultsSignificant differences in PS prevalence were observed among the groups (P<0.01), with CVD patients showing the highest prevalence. Older individuals (>50 years) and first molars were most frequently affected. The maxillary arch showed a significantly higher prevalence than the mandible (odds ratio [OR]=1.45; 95% CI 1.22–1.72). The strongest risk factor was CVD (OR=7.38; 95% CI 5.20–10.47), followed by DM (OR=4.18; 95% CI 2.91–5.99) and CP (OR=4.16; 95% CI 2.88–6.00). Age was significantly associated with PS, while sex showed no association.ConclusionThe presence of PS, even among healthy controls, may serve as an adjunctive radiographic marker and could also alert dental practitioners to the possibility of underlying systemic disease.

[Letter to the Editor] Home-based pulmonary rehabilitation (PR) represents a practical, patient-centered approach to managing chronic obstructive pulmonary disease (COPD), particularly in settings with limited access to conventional center-based programs. In their study, Kasim et al. demonstrated that a structured 12-week home-based PR program improved pulmonary function and disability outcomes, with particular gains in activities of daily living and social participation, as measured by the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0). This letter highlights the significance of these findings, emphasizing the multidimensional benefits of PR beyond pharmacological therapy, including physiological, psychosocial, and functional improvements. We also discuss potential limitations, such as the lack of a control group, reliance on self-reported adherence, and the need for long-term and personalized interventions. The integration of tele-rehabilitation, cognitive and mobility-focused exercises, and family involvement may further enhance outcomes. Home-based PR has important implications for low- and middle-income countries, offering a cost-effective strategy to reduce disease burden, improve quality of life, and support sustainable, comprehensive COPD management.

Dear Editor, ... The recommendation by Roth and Wald to enforce stricter regalia policies and uphold professionalism at commencements is crucial. However, such measures should be complemented by proactive educational interventions. ...

Background and ObjectiveChronic low back pain disability (CLBPD) is a syndrome that includes pain, disability, emotional impairments, and social problems. The study was conducted to examine the effect of an inpatient rehabilitation program on the performance of everyday life tasks (daily activities), and report on pain in CLBPD patients with primary activities of daily living (ADL) deficits.MethodsIn a retrospective cohort study, demographic and clinical data were retrieved from records of inpatients admitted consecutively to the program. Scores of the Spinal Pain Independence Measure (SPIM) and of changes in reported pain levels were used to assess improvement in the performance of daily activities and pain reduction. T-tests were used to assess the significance of score changes. Spearman’s correlations and analysis of variance were used to assess relationships of SPIM gain and affecting factors.ResultsNinety-nine patients were included. Daily task performance improved in 71 patients (71.7%). The SPIM score increased from 48.7 (SD 16.3) at admission to the rehabilitation program to 57.8 (SD 12.5) at discharge (P<0.001). The SPIM score at admission negatively affected SPIM gain (P<0.001). The SPIM gain was significant for admission SPIM scores of 50 or lower (P<0.05), but differences in SPIM scores were not as noticeable for patients with admission SPIM scores above 50. Relief in pain was reported in 59 patients (59.6%) and was not associated with function.ConclusionsThe multidisciplinary rehabilitation program, which improved function and provided limited pain relief in inpatients with CLBPD primary ADL deficits, can be effective for the most severe CLBPD cases.

Bite mark analysis plays a pivotal role in forensic investigations, by helping to identify suspects and establish links between individuals and crime scenes. However, traditional bite mark methodologies face significant challenges due to issues with reliability and subjectivity. Recent advances in microbiome analysis, which involves identifying and characterizing the microbial communities found in bite marks, have led to the emergence of a promising tool for forensic investigations. The integration of microbiome analysis with conventional DNA profiling enables more accurate interpretation of bite mark evidence in forensic investigations. This review provides an in-depth look at the integration of bite mark microbiome analysis with forensic DNA profiling. It also addresses the challenges and strategies involved in microbiome-based bite mark analysis for forensic purposes.

There is a long history of starvation, including reports dated back to antiquity. Despite exceptional scientific developments, starvation still exists today. The medical aspects of starvation were well established in the twentieth century, particularly following studies related to the 1943-1944 Bengal famine in India and starved prisoners of war and survivors of World War 2. The refeeding of the starved victims provided disappointing results. Nevertheless, those studies eventually led to the development of a new branch of research in medicine and to the definition of what is now known as refeeding syndrome. This paper briefly reviews the history and groundwork that led to today's understanding of starvation and refeeding, with a particular emphasis on the observations from studies on starved Holocaust survivors and prisoners of war after World War 2. The relevance of these studies for modern times is briefly discussed.