Deformity of the breast and axilla observed in famous paintings is a fascinating field for the medico-artists. The attempt of a retrospective diagnosis of breast tumors is highly challenging. This paper deals with a Rubens painting portraying the heroine Judith with a visible but previously unreported left breast mass. Though speculative, the present medico-artistic diagnosis is of a tumor likely to be of benign nature. It is of interest that the present case is the sixth breast disease discovered in Rubens’s works.
TO THE EDITOR
I read with interest the letter by Klaus Rose et al. regarding the article about delayed diagnosis of severe medical conditions during the coronavirus disease 2019 (COVID-19) pandemic.1 The author stressed the importance of recognizing that delayed presentation of patients, during the COVID-19 pandemic, was not limited to the pediatric population. I agree with this important point, and the article does not claim otherwise. The presented cases are pediatric, given that they took place in a pediatric department, but it is reasonable to assume that adults have faced the same challenges.
We have carefully read and evaluated the letter writ¬ten by Drs Mungmunpuntipantip and Wiwanitkit regarding our article published in the July issue of Rambam Maimonides Medical Journal.
Background: Chronic respiratory diseases, such as chronic obstructive pulmonary disease (COPD), significantly impact patients’ quality of life by limiting physical function, mobility, and overall well-being. Pulmonary rehabilitation (PR), particularly home-based programs, has emerged as a vital non-pharmacological intervention to address these limitations. However, comprehensive assessments of the impact of home-based PR on both lung function and disability in COPD patients remain limited.
Objective: This study aimed to evaluate the effectiveness of a 12-week home-based PR program on pulmonary function and disability in COPD patients, using pulmonary function tests (PFTs) and the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) to assess outcomes across multiple domains.
Methods: A prospective, single-arm pre–post interventional study was conducted among 62 COPD patients at All India Institute of Medical Sciences, Jodhpur. Participants completed a 12-week home-based PR program, which included endurance exercises, breathing techniques, and self-management education. Pulmonary function tests were conducted, and disability levels were assessed using WHODAS 2.0 at baseline and after completing the program.
Results: Improvements were observed in pulmonary function, with forced vital capacity (FVC), and forced expiratory volume in one second (FEV1), showing substantial increases (FVC: 2.50±0.43 L to 2.85±0.59 L; FEV1 1.53±0.33 L to 1.63±0.34 L; P<0.001). The WHODAS 2.0 scores demonstrated notable reductions in disability, particularly in the life activities and participation domains (P<0.001). Cognitive and self-care scores remained stable, while improvements in mobility were observed but not significant. Regression analysis revealed a strong negative correlation between increases in FVC and reductions in WHODAS 2.0 total scores (r=-0.65), highlighting FVC as a key predictor of disability reduction.
Conclusion: The 12-week home-based PR program improved lung function and reduced disability in COPD patients. These findings support the role of home-based PR as a viable, patient-centered alternative to traditional rehabilitation, addressing both physical and social dimensions of health. Future research should focus on long-term outcomes, the potential for broader implementation, and expanding access to underserved populations.
The recently published paper “US Medical Schools’ 2024 Commencements and Antisemitism: Addressing Unprofessional Behavior” discusses antisemitism expressions and unprofessional behavior in US medical schools’ 2024 commencement ceremony. While we share the authors’ concerns regarding rising antisemitic, anti-Palestinian and anti-Muslim bias, alongside hateful behavior toward minorities and immigrants in the US in general and in medical schools in particular, we are also concerned about the significant bias informing this paper. The authors mistakenly conflate antisemitism with harsh criticism of Israeli government and the actions of its military, and legitimate acts of solidarity with people under oppression. This fallacy is further aggravated by serious concerns (mentioned by the authors themselves) involving the paper’s methodological and statistical shortcomings. Ultimately, the paper lacks scientific rigor and appears to be ideologically motivated rather than a contribution to objective research. Scholars worldwide, Jews and Israelis amongst them, have demonstrated that these are legitimate protests, and the interpretation of their messaging as antisemitic is just another way to silence Palestinian voices calling for freedom and liberation, and delegitimizing critique on the Israeli government. This paper aims to provide the reader with currently published evidence and scientific controversy regarding this issue, that the discussed paper failed to mention.
