Background: Understanding migraine epidemiology and its burden is crucial for planning health policies and interventions at the local level as well as at the global level. National policies in Israel rely on global estimations and not on local data since local epidemiologic studies had not previously been performed. In this study, we evaluated the epidemiology of migraine in the southern district of Israel using the electronic medical records database of the largest Israeli health maintenance organization (HMO). Methods: In this population-based, retrospective, observational cohort study, adult migraine patients were identified in the computerized database of the southern district of the Clalit Health Services HMO (total population, 0.75 million). Patients were identified based on recorded diagnosis (International Classification of Diseases, Ninth Revision) and/or claims for specific anti-migraine medication (triptans) between 2000 and 2018. A 1:2 age-, gender-, and primary care clinic–matched control group was used for evaluation of comorbidities. Results: In 2018, a total of 29,938 patients with migraine were identified out of 391,528 adult HMO members. Most of the patients were women (75.8%), and the mean ± standard deviation age at diagnosis was 36.94 ± 13.61 years. The overall prevalence of migraine (per 10,000) was 764.64 (7.65%), 1143.34 (11.43%) for women and 374.97 (3.75%) for men. The highest prevalence was observed in patients aged 50 to 60 years and 40 to 50 years (1143.98 [11.44%] and 1019.36 [10.19%], respectively), and the lowest prevalence was among patients aged 18 to 30 years and > 70 years (433.45 [4.33%] and 398.49 [3.98%], respectively). Conclusions: This is the first large-scale epidemiologic study of migraine prevalence in Israel. Compared to international estimations, migraine appears to be underdiagnosed in the southern district of Israel.

Purpose: Vernal keratoconjunctivitis (VKC) is a severe chronic allergic inflammation of the ocular surface with episodes of acute exacerbations, that primarily affects children and young adults. Although the etiology and pathogenesis of VKC remain unclear, studies have suggested that environmental factors may be involved. This study aims to investigate the association between exposure to meteorological and environmental factors and the incidence of VKC exacerbations. Methods: This study was conducted in southern Israel, which is a semi-arid, hot, and dry climate with frequent dust storms. Patients diagnosed with VKC were recruited for the study. VKC exacerbations were identified as the need for medical intervention. Pollutants measured included nitrogen dioxide (NO₂), ozone (O₃), particulate matter (PM₁₀ and PM_2.5), sulfur dioxide (SO₂), relative humidity (RH), temperature, and solar radiation (SR). To assess the association between VKC exacerbations and exposure to different pollutants, a case-crossover analysis was conducted. We also stratified the analysis by sex, age, ethnicity, immigration status, and social state score. Results: Our results demonstrated that the pollutants NO₂, O₃, and PM₁₀ were associated with VKC exacerbations with odds ratio (OR) = 2.17 (95% confidence interval [CI] =1.40 to 3.04), OR = 2.28 (95% CI = 1.30 to 3.39), and OR = 1.89 (95% CI = 1.06 to 2.74). Other pollutants PM_2.5, temperature, and solar radiation were also independently associated with incidence of exacerbations with OR = 1.15 (95% CI = 0.87 to 1.50), OR = 1.75 (95% CI = 1.16 to 2.65), and OR = 1.37 (95% CI = 1.01 to 1.63) and had varying effects in different demographic strata. Conclusions: The environmental parameters, NO₂, O₃, PM₁₀, PM_2.5, temperature, and solar radiation were found to be significantly associated with VKC exacerbations, with NO₂, O₃, and PM₁₀ showing the strongest associations. Our findings suggest that environmental factors should be considered when developing strategies to prevent and manage VKC exacerbations.

Background: Migraine, a neurovascular disorder evident by recurrent headaches, is associated with increased risk of ischemic vascular events, including ischemic stroke and myocardial infarction. Triptans, acute migraine‐specific treatment, cause vasoconstriction, complicating treatment decisions, especially for patients with migraine with cardiovascular risk factors. This study examined associations between triptan usage and cardiovascular (CV) events in patients with migraine. Methods: This retrospective, population‐based cohort study conducted in southern Israel utilized data from Clalit Health Services. Electronic medical records from January 2000 to January 2022 were analyzed to assess triptan usage and CV events within 90 days post‐purchase among patients aged ≥18 years with a diagnosis of migraine based on International Classification of Diseases, Ninth Revision codes or triptan claims. Sensitivity analyses accounted for varying timeframes and usage patterns. Results: Among 26,054 patients with migraine, 12,560 (48.2%) initiated triptan therapy. The prevalence of CV risk factors including dyslipidemia, diabetes mellitus, hypertension, smoking, atrial fibrillation, and obesity was higher in the non‐triptan group (standardized mean difference [SMD] = 0.028–0.289). The mean (standard deviation) number of triptan pills used per month was 1.9 (1.5), with most patients (89.5%) using 1–4 pills/month. CV events within 90 days occurred slightly more in the triptan group (5.1%) compared to the non‐triptan group (4.1%, SMD = 0.047). Multivariable analysis revealed no significant association between triptan use and increased CV events (adjusted hazard ratio 0.96, 95% confidence interval 0.77–1.23), controlling for demographic variables and CV risk factors. Sensitivity analyses also showed no significant risk with triptan use across different timeframes and usage patterns, reinforcing these findings. In the triptan group, patients with CV events were more likely to use triptans frequently, with a higher average number of pills per month. Conclusions: This retrospective, population‐based study found that triptan usage did not increase CV risk among patients with migraine, even in those with existing CV risk factors, where no formal contraindication exists. The study highlights the importance of considering individual risk factors when prescribing triptans, as certain subgroups may still be at higher risk.

Background: Migraine, a condition affecting 12% of the population, is a prevalent cause of disability, significantly impacts individuals during their most productive working years. Several studies have established that a migraine patient's job performance is often limited by absenteeism and presenteeism. The present study aimed to investigate the impact of migraines on occupational burnout, which affects up to 40% of workers. Methods: A subset of participants from the Negev Migraine Cohort, including both migraine patients and non-migraine controls, were asked to complete the study questionnaire. The main exposures of interest were migraine diagnosis and severity. The primary outcome was occupational burnout. Migraine severity and associated disability were evaluated using the Migraine Disability Assessment (MIDAS) score, psychiatric comorbidities using the Depression, Anxiety and Stress Scale – 21 Items (DASS-21) scale and occupational burnout using the Maslach Burnout Inventory (MBI-GS version) scale. Statistical analyses included multivariable quantile regression models to identify associations and adjust for potential confounders. Results: In total, 675 migraine patients and 232 non-migraine participants participated in the study. Migraine patients exhibited higher rates of depression (mean DASS-21: 0.864 vs. 0.664, standardized mean difference (SMD) = 0.262), tended to work longer hours (median weekly hours: 40.0 vs. 36.0, SMD = 0.148) and expressed a preference for remote work (20.3% vs. 10.3%, SMD = 0.097). Migraine patients reported significantly higher levels of occupational burnout (mean burnout score: 3.46 vs. 2.82, SMD = 0.469). Controlling for depression, anxiety and stress, migraine diagnosis (25th percentile estimate = 0.67, p = 0.002, 75th percentile estimate = 0.92, p = 0.032) and migraine severity (estimates: 2.2–5.3, p < 0.001 for all) were associated with higher levels of occupational burnout. Conclusions: Migraine diagnosis and severity is associated with an occupational burnout, after controlling for various psychological and work-related factors. The findings underscore the need for workplace adjustments to support migraine patients’ participation in the work market.

Background/Objectives: Weaning failure remains a major challenge in patients requiring prolonged mechanical ventilation. This study aimed to describe outcomes in patients ventilated for >14 days and identify specific predictors of weaning success. Methods: A retrospective analysis of 88 patients from the Soroka University Medical Center database was conducted. Outcomes in the successful weaning (SW) group were compared to those in the failed weaning (FW) group. Predictors of weaning success were analyzed using multivariate logistic regression. Results: Forty patients (45%) were successfully weaned and discharged to rehabilitation or home. In-hospital mortality was 28%, with deaths occurring exclusively in the FW group (p < 0.001). One-month and one-year post-discharge all-cause mortality rates were 11% and 28%, respectively, with no group differences. Hypoalbuminemia and the Sequential Organ Failure Assessment (SOFA) score at admission significantly predicted weaning failure (odds ratio: 5.71 and 0.54, respectively). Demographics, comorbidities, ventilation indications, admission data, and diuretic use were not predictive. Conclusions: Hypoalbuminemia and the SOFA score at admission were key predictors of weaning success in patients ventilated for more than 2 weeks. Age and comorbidities were not significant. Prospective studies on albumin supplementation and high-protein diets are warranted to assess their impact on weaning outcomes.