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Reges O, Test T, Hoshen M, Cicurel A, Saliba W, Greenland P, Dicker D, Lavie G. Time-varying association of acute and post-acute COVID-19 with new-onset diabetes mellitus among hospitalized and non-hospitalized patients. BMJ Open Diabetes Res Care 2023; 11:e003052. [PMID: 36669793 PMCID: PMC9871869 DOI: 10.1136/bmjdrc-2022-003052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 12/12/2022] [Indexed: 01/22/2023] Open
Abstract
INTRODUCTION Previous studies have shown disruption of glycometabolic control and new diabetes mellitus (DM) diagnosis among patients with COVID-19. It is still unclear how the association of COVID-19 and new-onset DM may be modified by disease severity or vary over time, during acute and post-acute phases. RESEARCH DESIGN AND METHODS In this retrospective matched cohort study, 157 936 patients with COVID-19 (aged ≥25 years, diagnosis date between March 01, 2020 and August 31, 2021) were compared with individuals without COVID-19, separately for non-hospitalized, hospitalized, and severe hospitalized patients. Stratified Cox proportional hazards models, with changing baseline time (starting at the date of COVID-19 diagnosis, and at 1, 2, 3, and 4 months afterwards), were used to evaluate the occurrence of new DM in relation to COVID-19 infection in different time frames-from each landmark date until end of study. RESULTS During mean follow-up time of 10.9 months, there were 1145 (0.72%) new diagnoses of DM compared with 1013 (0.64%) in the individuals without COVID-19 (p=0.004). Non-hospitalized patients with COVID-19 were not at higher risk of new DM neither during the acute phase nor afterward. Hospitalized patients with COVID-19 had a higher risk of developing DM, with the highest risk among severe hospitalized patients. This risk among hospitalized patients was highest in the acute phase (HR 2.47 (95% CI 1.86 to 3.29)), attenuated over time, but remained significant at 4-month landmark analysis (HR 1.60 (95% CI 1.12 to 2.29)). CONCLUSIONS Acute and post-acute COVID-19 were associated with new DM only among hospitalized patients, with the highest risk among those hospitalized with severe disease. Those patients should be followed and monitored post-discharge for new DM. Patients who were not hospitalized did not have higher risk of new-onset DM.
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Affiliation(s)
- Orna Reges
- Department of Health System Management, Ariel University, Ariel, Israel
- Branch of Planning and Strategy, Clalit Health Services, Tel Aviv, Israel
| | - Tsafnat Test
- Department of Family Medicine, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- Clalit Health Services, Southern District, Beer-Sheva, Israel
| | - Moshe Hoshen
- Branch of Planning and Strategy, Clalit Health Services, Tel Aviv, Israel
- Bioinformatics Department, Jerusalem College of Technology, Tal Campus, Jerusalem, Israel
| | - Assi Cicurel
- Branch of Planning and Strategy, Clalit Health Services, Tel Aviv, Israel
- Department of Family Medicine, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- Clalit Health Services, Southern District, Beer-Sheva, Israel
| | - Walid Saliba
- Department of Community Medicine and Epidemiology, Carmel Medical Center, Haifa, Israel
- Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
| | - Philip Greenland
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Dror Dicker
- Internal Medicine D Department, Hasharon Hospital, Rabin Medical Center, Petah Tikva, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Gil Lavie
- Branch of Planning and Strategy, Clalit Health Services, Tel Aviv, Israel
- Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
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Solomon M, Gimple A, Fuchs I, Cicurel A, Meninger T, Avni D, Nasereddin A, Jaffe CL, Schwartz E. Failure to Detect Leishmania in the Blood of Patients with Old-World Cutaneous Leishmaniasis: Implications for Blood Donation. Am J Trop Med Hyg 2022; 107:996-998. [PMID: 36216319 PMCID: PMC9709017 DOI: 10.4269/ajtmh.21-1120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 05/02/2022] [Indexed: 11/07/2022] Open
Abstract
Cutaneous leishmaniasis (CL) is endemic in Israel, caused mainly by Leishmania major (L. major) and L. tropica. In addition, returning travelers import another leishmanial species such as L. braziliensis. Although we are dealing with a skin disease, the blood bank in Israel does not accept blood donations from people infected with CL in cases of multiple lesions due to the possibility of transfusion. Our purpose was to investigate the prevalence of Leishmania in the blood of patients with active or previous CL. This pilot study screened patients with active or previous CL for parasites in their blood. All patients were infected in Israel or were returning travelers with leishmaniasis acquired in Latin America. Patients were seen at the Sheba Medical Center. In addition, patients were seen at their homes in L. tropica and L. major endemic regions in Israel. Blood samples were taken from each patient for culture and polymerase chain reaction (PCR). Altogether 62 blood samples were examined (L. tropica = 26, L. major = 33, and L. braziliensis = 3). Twenty-seven patients had an active disease and 35 were recovered. All blood cultures and PCR were negative for parasites except one blood sample that was PCR positive for L. braziliensis. The findings of our study, although a small sample, suggest that people with active or recent CL caused by L. major and L. tropica, do not harbor parasites in their blood. Thus, their exclusion from blood donation should be revisited. Further studies are needed with larger sample size and highly sensitive tests.
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Affiliation(s)
- Michal Solomon
- Department of Dermatology, Chaim Sheba Medical Center, Tel Hashomer, Israel
- The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ariel Gimple
- Department of Dermatology, Chaim Sheba Medical Center, Tel Hashomer, Israel
- The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Inbal Fuchs
- Faculty of Health Sciences, Department of Family Medicine, Ben Gurion University, Clalit Health Services, Southern District, Beersheba, Israel
| | - Assi Cicurel
- Faculty of Health Sciences, Department of Family Medicine, Ben Gurion University, Clalit Health Services, Southern District, Beersheba, Israel
| | - Tal Meninger
- The Institute of Geographic Medicine and Tropical Diseases and the Laboratory for Tropical Diseases Research, Sheba Medical Center, Tel Hashomer, Israel
| | - Dror Avni
- The Institute of Geographic Medicine and Tropical Diseases and the Laboratory for Tropical Diseases Research, Sheba Medical Center, Tel Hashomer, Israel
| | - Abed Nasereddin
- Department Microbiology and Molecular Genetics, Kuvin Center, The Hebrew University - Hadassah Medical Center, Jerusalem, Israel
| | - Charles L. Jaffe
- Department Microbiology and Molecular Genetics, Kuvin Center, The Hebrew University - Hadassah Medical Center, Jerusalem, Israel
| | - Eli Schwartz
- The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- The Institute of Geographic Medicine and Tropical Diseases and the Laboratory for Tropical Diseases Research, Sheba Medical Center, Tel Hashomer, Israel
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Sagy YW, Cicurel A, Battat E, Saliba W, Lavie G. The impact of COVID-19 pandemic on emergency department visits and associated mortality during 14 months of the pandemic in Israel. Intern Emerg Med 2022; 17:1699-1710. [PMID: 35576046 PMCID: PMC9108137 DOI: 10.1007/s11739-022-02991-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 04/10/2022] [Indexed: 02/06/2023]
Abstract
BACKGROUND A substantial drop in emergency department (ED) visit volume was previously demonstrated at the onset of the COVID-19 pandemic. OBJECTIVE To examine changes in the number of non-COVID adult ED visits and their associated 30-day mortality during 14 months of the pandemic in Israel. METHODS This is a retrospective cohort study including 1,285,270 adult ED visits between 1st March, 2018 and 30th April, 2021 to the internal and surgical EDS in eight general hospitals of the largest healthcare organization in Israel. The 14 months of the pandemic period (March 2020-April 2021) were divided into seven periods according to dates of the three lockdowns. Exposure to each of these periods was compared to the parallel period during the two previous years. March 2020-April 2021 was compared to the parallel periods in 2018 and 2019. RESULTS During the pandemic period, the largest decline in ED visits (44.6% and 50.9% for internal and surgical EDs, respectively) and the highest excess 30-day mortality following an ED visit (internal EDs Adjusted OR (ORadj), 1.49; 95% CI, 1.34-1.66 and surgical EDs: ORadj 1.50; CI, 1.16-1.94) were 95%, observed during the first lockdown. Both gradually levelled-off subsequently until near-normalization was reached in March-April 2021 for both parameters. CONCLUSIONS A substantial decline in non-COVID ED visits and excess mortality at the beginning of the pandemic, are probably the results of social distancing restrictions alongside patients' fear of exposure to COVID-19, which gradually moderated thereafter, until near normalization was reached after 14 months. Gradual return to pre-pandemic ED utilization patterns were noticed as the population and the healthcare system acclimatize to life alongside COVID.
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Affiliation(s)
- Yael Wolff Sagy
- Branch of Planning and Strategy, Clalit Health Services, Tel Aviv, Israel
| | - Assi Cicurel
- Branch of Planning and Strategy, Clalit Health Services, Tel Aviv, Israel
- Southern District and Faculty of Health Sciences, Clalit Health Services, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Erez Battat
- Branch of Planning and Strategy, Clalit Health Services, Tel Aviv, Israel
| | - Walid Saliba
- Department of Community Medicine and Epidemiology, Lady Davis Carmel Medical Center, Haifa, Israel
- Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Gil Lavie
- Branch of Planning and Strategy, Clalit Health Services, Tel Aviv, Israel
- Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
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Israel A, Cicurel A, Feldhamer I, Stern F, Dror Y, Giveon SM, Gillis D, Strich D, Lavie G. Vitamin D deficiency is associated with higher risks for SARS-CoV-2 infection and COVID-19 severity: a retrospective case-control study. Intern Emerg Med 2022; 17:1053-1063. [PMID: 35000118 PMCID: PMC8742718 DOI: 10.1007/s11739-021-02902-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 11/20/2021] [Indexed: 12/30/2022]
Abstract
Robust evidence of whether vitamin D deficiency is associated with COVID-19 infection and its severity is still lacking. The aim of the study was to evaluate the association between vitamin D levels and the risks of SARS-CoV-2 infection and severe disease in those infected. A retrospective study was carried out among members of Clalit Health Services (CHS), the largest healthcare organization in Israel, between March 1 and October 31, 2020. We created two matched case-control groups of individuals for which vitamin D levels and body mass index (BMI) were available before the pandemic: group (A), in which 41,757 individuals with positive SARS-CoV-2 PCR tests were matched with 417,570 control individuals without evidence of infection, and group (B), in which 2533 patients hospitalized in severe condition for COVID-19 were matched with 2533 patients who were tested positive for SARS-CoV-2, but were not hospitalized. Conditional logistic models were fitted in each of the groups to assess the association between vitamin D levels and outcome. An inverse correlation was demonstrated between the level of vitamin D and the risks of SARS-CoV-2 infection and of severe disease in those infected. Patients with very low vitamin D levels (< 30 nmol/L) had the highest risks for SARS-CoV-2 infection and also for severe COVID-19 when infected-OR 1.246 [95% CI 1.210-1.304] and 1.513 [95% CI 1.230-1.861], respectively. In this large observational population study, we show a significant association between vitamin D deficiency and the risks of SARS-CoV-2 infection and of severe disease in those infected.
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Affiliation(s)
- Ariel Israel
- Branch of Planning and Strategy, Clalit Health Services, Tel Aviv, Israel
| | - Assi Cicurel
- Branch of Planning and Strategy, Clalit Health Services, Tel Aviv, Israel
- Southern District and Faculty of Health Sciences, Clalit Health Services, Ben-Gurion University of the Negev, Beersheba, Israel
| | - Ilan Feldhamer
- Branch of Planning and Strategy, Clalit Health Services, Tel Aviv, Israel
| | - Felicia Stern
- School of Nutrition, Faculty of Agriculture, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Yosef Dror
- School of Nutrition, Faculty of Agriculture, The Hebrew University of Jerusalem, Rehovot, Israel
| | | | - David Gillis
- Department of Pediatrics, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - David Strich
- Pediatric Specialist Clinic, Clalit Health Services, Jerusalem District, Israel
| | - Gil Lavie
- Branch of Planning and Strategy, Clalit Health Services, Tel Aviv, Israel.
- Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
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Israel A, Schäffer AA, Cicurel A, Cheng K, Sinha S, Schiff E, Feldhamer I, Tal A, Lavie G, Ruppin E. Identification of drugs associated with reduced severity of COVID-19 - a case-control study in a large population. eLife 2021; 10:e68165. [PMID: 34313216 PMCID: PMC8321549 DOI: 10.7554/elife.68165] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 07/07/2021] [Indexed: 12/21/2022] Open
Abstract
Background Until coronavirus disease 2019 (COVID-19) drugs specifically developed to treat COVID-19 become more widely accessible, it is crucial to identify whether existing medications have a protective effect against severe disease. Toward this objective, we conducted a large population study in Clalit Health Services (CHS), the largest healthcare provider in Israel, insuring over 4.7 million members. Methods Two case-control matched cohorts were assembled to assess which medications, acquired in the last month, decreased the risk of COVID-19 hospitalization. Case patients were adults aged 18 to 95 hospitalized for COVID-19. In the first cohort, five control patients, from the general population, were matched to each case (n=6202); in the second cohort, two non-hospitalized SARS-CoV-2 positive control patients were matched to each case (n=6919). The outcome measures for a medication were: odds ratio (OR) for hospitalization, 95% confidence interval (CI), and the p-value, using Fisher's exact test. False discovery rate was used to adjust for multiple testing. Results Medications associated with most significantly reduced odds for COVID-19 hospitalization include: ubiquinone (OR=0.185, 95% CI [0.058 to 0.458], p<0.001), ezetimibe (OR=0.488, 95% CI [0.377 to 0.622], p<0.001), rosuvastatin (OR=0.673, 95% CI [0.596 to 0.758], p<0.001), flecainide (OR=0.301, 95% CI [0.118 to 0.641], p<0.001), and vitamin D (OR=0.869, 95% CI [0.792 to 0.954], p<0.003). Remarkably, acquisition of artificial tears, eye care wipes, and several ophthalmological products were also associated with decreased risk for hospitalization. Conclusions Ubiquinone, ezetimibe, and rosuvastatin, all related to the cholesterol synthesis pathway were associated with reduced hospitalization risk. These findings point to a promising protective effect which should be further investigated in controlled, prospective studies. Funding This research was supported in part by the Intramural Research Program of the National Institutes of Health, NCI.
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Affiliation(s)
- Ariel Israel
- Division of Planning and Strategy, Clalit Health ServicesTel AvivIsrael
| | - Alejandro A Schäffer
- Cancer Data Science Laboratory, National Cancer Institute, National Institutes of HealthBethesdaUnited States
| | - Assi Cicurel
- Division of Planning and Strategy, Clalit Health ServicesTel AvivIsrael
- Clalit Health Services, Southern District and Faculty of Health Sciences, Ben-Gurion University of the NegevBeer-ShevaIsrael
| | - Kuoyuan Cheng
- Cancer Data Science Laboratory, National Cancer Institute, National Institutes of HealthBethesdaUnited States
| | - Sanju Sinha
- Cancer Data Science Laboratory, National Cancer Institute, National Institutes of HealthBethesdaUnited States
| | - Eyal Schiff
- Sheba Medical Center, Tel-Aviv UniversityRamat GanIsrael
| | - Ilan Feldhamer
- Division of Planning and Strategy, Clalit Health ServicesTel AvivIsrael
| | - Ameer Tal
- Division of Planning and Strategy, Clalit Health ServicesTel AvivIsrael
| | - Gil Lavie
- Division of Planning and Strategy, Clalit Health ServicesTel AvivIsrael
- Ruth and Bruce Rappaport Faculty of Medicine, Technion – Israel Institute of TechnologyHaifaIsrael
| | - Eytan Ruppin
- Cancer Data Science Laboratory, National Cancer Institute, National Institutes of HealthBethesdaUnited States
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Israel A, Schäffer AA, Cicurel A, Feldhamer I, Tal A, Cheng K, Sinha S, Schiff E, Lavie G, Ruppin E. Identification of drugs associated with reduced severity of COVID-19: A case-control study in a large population. medRxiv 2021:2020.10.13.20211953. [PMID: 33083810 PMCID: PMC7574266 DOI: 10.1101/2020.10.13.20211953] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Until COVID-19 drugs specifically developed to treat COVID-19 become more widely accessible, it is crucial to identify whether existing medications have a protective effect against severe disease. Towards this objective, we conducted a large population study in Clalit Health Services (CHS), the largest healthcare provider in Israel, insuring over 4.7 million members. METHODS Two case-control matched cohorts were assembled to assess which medications, acquired in the last month, decreased the risk of COVID-19 hospitalization. Case patients were adults aged 18-95 hospitalized for COVID-19. In the first cohort, five control patients, from the general population, were matched to each case (n=6202); in the second cohort, two non-hospitalized SARS-CoV-2 positive control patients were matched to each case (n=6919). The outcome measures for a medication were: odds ratio (OR) for hospitalization, 95% confidence interval (CI), and the p-value, using Fisher's exact test. False discovery rate was used to adjust for multiple testing. RESULTS Medications associated with most significantly reduced odds for COVID-19 hospitalization include: ubiquinone (OR=0.185, 95% CI (0.058 to 0.458), p<0.001), ezetimibe (OR=0.488, 95% CI ((0.377 to 0.622)), p<0.001), rosuvastatin (OR=0.673, 95% CI (0.596 to 0.758), p<0.001), flecainide (OR=0.301, 95% CI (0.118 to 0.641), p<0.001), and vitamin D (OR=0.869, 95% CI (0.792 to 0.954), p<0.003). Remarkably, acquisition of artificial tears, eye care wipes, and several ophthalmological products were also associated with decreased risk for hospitalization. CONCLUSIONS Ubiquinone, ezetimibe and rosuvastatin, all related to the cholesterol synthesis pathway were associated with reduced hospitalization risk. These findings point to a promising protective effect which should be further investigated in controlled, prospective studies. FUNDING This research was supported in part by the Intramural Research Program of the National Institutes of Health, NCI.
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Affiliation(s)
- Ariel Israel
- Division of Planning and Strategy, Clalit Health Services, Tel Aviv 62098, Israel
| | - Alejandro A. Schäffer
- Cancer Data Science Laboratory, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA 20892
| | - Assi Cicurel
- Division of Planning and Strategy, Clalit Health Services, Tel Aviv 62098, Israel
- Clalit Health Services, Southern District and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel
| | - Ilan Feldhamer
- Division of Planning and Strategy, Clalit Health Services, Tel Aviv 62098, Israel
| | - Ameer Tal
- Division of Planning and Strategy, Clalit Health Services, Tel Aviv 62098, Israel
| | - Kuoyuan Cheng
- Cancer Data Science Laboratory, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA 20892
| | - Sanju Sinha
- Cancer Data Science Laboratory, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA 20892
| | - Eyal Schiff
- Sheba Medical Center, Tel-Aviv University, Ramat Gan 52621, Israel
| | - Gil Lavie
- Division of Planning and Strategy, Clalit Health Services, Tel Aviv 62098, Israel
- Ruth and Bruce Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, Haifa 3109601, Israel
| | - Eytan Ruppin
- Cancer Data Science Laboratory, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA 20892
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Tejman-Yarden S, Ben-Zeev B, Goldshmit Y, Sarquella-Brugada G, Cicurel A, Katz U, Mishali D, Glikson M. The Utilization of an Insertable Cardiac Monitor in a Child With Pallid Breath-Holding Spells. Pediatr Neurol 2016; 64:80-82. [PMID: 27751664 DOI: 10.1016/j.pediatrneurol.2016.06.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Revised: 06/15/2016] [Accepted: 06/18/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Pacing can be a successful treatment for pallid breath-holding spells, primarily in individuals with severe bradycardia. PATIENT DESCRIPTION We describe an 18-month-old girl experiencing severe pallid breath-holding spells in whom repeated electrocardiographic, Holter, and electroencephalographic monitoring tests were all normal. RESULTS Using a subcutaneous insertable cardiac monitor, severe bradycardia was detected during one of this girl's episodes. This finding led to a pacemaker implantation. Subsequently, her breath-holding spells completely resolved. CONCLUSION This child illustrates the ability of the insertable cardiac monitor to help and diagnose arrhythmias in children with unresolved clinical findings. The ability to implant it with a minimal scar makes it ideal for uncooperative individuals with relative few and unexpected episodes that are hard to diagnose.
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Affiliation(s)
- Shai Tejman-Yarden
- The Edmond J. Safra International Congenital Heart Center, Sheba Medical Center, Ramat Gan, Israel.
| | - Bruria Ben-Zeev
- The Edmond J. Safra International Congenital Heart Center, Sheba Medical Center, Ramat Gan, Israel
| | | | - Georgia Sarquella-Brugada
- Servicio de Cardiología Pediátrica, Hospital Clínic-Sant Joan de Déu, University of Barcelona, Esplugues de Llobregat, Spain
| | - Assi Cicurel
- Clalit Health Services, and The Department of Family Medicine, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Uriel Katz
- The Edmond J. Safra International Congenital Heart Center, Sheba Medical Center, Ramat Gan, Israel
| | - David Mishali
- The Edmond J. Safra International Congenital Heart Center, Sheba Medical Center, Ramat Gan, Israel
| | - Michael Glikson
- Davidai Arrhythmia Center, The Heart Center, Sheba Medical Center, Ramat Gan, Israel
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Kalchiem-Dekel O, Shai I, Biderman A, Orenstein A, Cicurel A, Reuven Y, Henkin Y. Metabolic changes in immigrants from Africa to a Western country: time-lag effects of 20 years since immigration. J Diabetes 2015; 7:531-9. [PMID: 25223990 DOI: 10.1111/1753-0407.12215] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Revised: 08/29/2014] [Accepted: 08/29/2014] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND An increase in the prevalence of type 2 diabetes mellitus occurs in immigrants from developing regions to Western countries. However, the dynamics of these transitions in relation to the duration of residence in the new environment are not clearly defined. METHODS Data concerning cardiovascular risk factors were retrospectively extracted from medical charts of 736 Ethiopian immigrants and 575 randomly-chosen, age and sex matched non-Ethiopian subjects ("reference group"). Ethiopian immigrants were designated "established" (≥ 20 years of residence), "intermediate" (10-15 years of residence), or "recent" (<10 years of residence). RESULTS Compared to non-Ethiopians, the age- and sex-adjusted odds ratio (OR) for diabetes was 1.00 (95%CI: 0.66-1.49) for established, 0.55 (95%CI: 0.29-1.03) for intermediate, and 0.15 (95%CI: 0.04-0.50) for recent immigrants (P < 0.001). The corresponding OR for hypertension was 0.94 (95%CI: 0.68-1.31), 0.42 (95%CI: 0.26-0.69), and 0.14 (95%CI: 0.06-0.30) for the established, intermediate, and recent immigrants respectively (P < 0.001). In contrast to the gradual increase in prevalence of diabetes and hypertension, the Ethiopian immigrants maintained their lower body mass index (BMI) (28.7 ± 5 vs 25.5 ± 5 kg/m(2) respectively, P < 0.001) and serum low-density-lipoprotein cholesterol (129 ± 36 vs 118 ± 34 mg/dL, P < 0.001) compared to the non-Ethiopians even after 20 years of residence in Israel. CONCLUSIONS The prevalence of diabetes and hypertension among the immigrants increased to about half that of the local population within 15 years and became equal to that of the local population after a time-lag of 20 years. These metabolic derangements occurred despite maintaining desirable BMI levels, reinforcing the need for re-defining optimal BMI ranges in relation to the ethnic origin.
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Affiliation(s)
- Or Kalchiem-Dekel
- Department of Medicine B, Soroka University Medical Center, Be'er-Sheva, Israel
| | - Iris Shai
- The S. Daniel Abraham International Center for Health and Nutrition, Ben-Gurion University of the Negev, Be'er-Sheva, Israel
| | - Aya Biderman
- Department of Family Medicine, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er-Sheva, Israel
| | - Anna Orenstein
- Department of Family Medicine, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er-Sheva, Israel
| | - Assi Cicurel
- Department of Family Medicine, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er-Sheva, Israel
| | - Yonatan Reuven
- Department of Family Medicine, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er-Sheva, Israel
| | - Yaakov Henkin
- Department of Cardiology, Soroka University Medical Center, Be'er-Sheva, Israel
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Avriel A, Fuchs L, Plakht Y, Cicurel A, Apfelbaum A, Satran R, Friger M, Dartava D, Sukenik S. Quality of life at the Dead Sea region: the lower the better? An observational study. Health Qual Life Outcomes 2011; 9:38. [PMID: 21615969 PMCID: PMC3123541 DOI: 10.1186/1477-7525-9-38] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2011] [Accepted: 05/27/2011] [Indexed: 12/05/2022] Open
Abstract
Background The Dead Sea region, the lowest in the world at 410 meters below sea level, is considered a potent climatotherapy center for the treatment of different chronic diseases. Objective To assess the prevalence of chronic diseases and the quality of life of residents of the Dead Sea region compared with residents of the Ramat Negev region, which has a similar climate, but is situated 600 meters above sea level. Methods An observational study based on a self-administered questionnaire. Data were collected from kibbutz (communal settlement) members in both regions. Residents of the Dead Sea were the study group and of Ramat Negev were the control group. We compared demographic characteristics, the prevalence of different chronic diseases and health-related quality of life (HRQOL) using the SF-36 questionnaire. Results There was a higher prevalence of skin nevi and non-inflammatory rheumatic diseases (NIRD) among Dead Sea residents, but they had significantly higher HRQOL mean scores in general health (68.7 ± 21 vs. 64.4 ± 22, p = 0.023) and vitality (64.7 ± 17.9 vs. 59.6 ± 17.3, p = 0.001), as well as significantly higher summary scores: physical component score (80.7 ± 18.2 vs. 78 ± 18.6, p = 0.042), and mental component score (79 ± 16.4 vs. 77.2 ± 15, p = 0.02). These results did not change after adjusting for social-demographic characteristics, health-related habits, and chronic diseases. Conclusions No significant difference between the groups was found in the prevalence of most chronic diseases, except for higher rates of skin nevi and NIRD among Dead Sea residents. HRQOL was significantly higher among Dead Sea residents, both healthy or with chronic disease.
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Affiliation(s)
- Avital Avriel
- Pulmonary Unit, Soroka University Medical Center, Ben Gurion Avenue, Beer-Sheva, 84101, Israel.
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Dreiher J, Froimovici M, Bibi Y, Vardy DA, Cicurel A, Cohen AD. Nonattendance in Obstetrics and Gynecology Patients. Gynecol Obstet Invest 2008; 66:40-3. [DOI: 10.1159/000115844] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2007] [Accepted: 10/09/2007] [Indexed: 11/19/2022]
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