1
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Boyle T, Kleinstern G, Bracci PM, Cerhan JR, Benavente Y, Casabonne D, Chiu BCH, Habermann TM, Holly EA, Liebow M, Norman A, Paltiel O, Robinson D, Rothman N, Abu Seir R, Slager SL, Villeneuve PJ, Wang SS, Weisenburger DD, Spinelli JJ. Physical activity and the risk of non-Hodgkin lymphoma subtypes: A pooled analysis. Int J Cancer 2023; 152:396-407. [PMID: 36054546 DOI: 10.1002/ijc.34266] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 03/03/2022] [Accepted: 03/21/2022] [Indexed: 02/01/2023]
Abstract
Non-Hodgkin lymphoma (NHL) is composed of a heterogeneous collection of subtypes with considerable differences in genetics, biology and aetiology. Studies to date on physical activity and NHL risk have not had sufficient sample size to evaluate whether associations differ by subtype. We pooled data from nine case-control studies to examine the association between moderate-to-vigorous intensity physical activity (MVPA) and risk of NHL overall and by subtype (diffuse large B-cell lymphoma, follicular lymphoma, chronic lymphocytic leukaemia/small lymphocytic lymphoma, marginal zone lymphoma and mature T-cell lymphoma). A total of 5653 cases and 9115 controls were included in the pooled analysis. Physical activity was harmonised across nine studies and modelled as study-specific tertiles. Multinomial logistic regression was used to estimate the association between physical activity and NHL, adjusting for confounders. The overall odds of NHL was 13% lower among participants in the most active tertile of MVPA compared to the least active tertile (adjusted odds ratio = 0.87, 95% CI = 0.80, 0.95). Similar decreases were observed across NHL subtypes. In summary, in this pooled analysis of case-control studies, physical activity was associated with a modest risk reduction for each NHL subtype examined and with overall NHL.
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Affiliation(s)
- Terry Boyle
- Australian Centre for Precision Health, Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia.,Cancer Control Research, BC Cancer Agency, Vancouver, British Columbia, Canada.,School of Public Health, Curtin University, Perth, Western Australia, Australia
| | | | - Paige M Bracci
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA
| | - James R Cerhan
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Yolanda Benavente
- Unit of Molecular and Genetic Epidemiology in Infections and Cancer (UNIC-Molecular), Cancer Epidemiology Research Programme, IDIBELL, Catalan Institute of Oncology, Hospitalet De Llobregat, Spain.,Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP, Madrid, Spain
| | - Delphine Casabonne
- Unit of Molecular and Genetic Epidemiology in Infections and Cancer (UNIC-Molecular), Cancer Epidemiology Research Programme, IDIBELL, Catalan Institute of Oncology, Hospitalet De Llobregat, Spain.,Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP, Madrid, Spain
| | - Brian C-H Chiu
- Department of Public Health Sciences, University of Chicago, Chicago, Illinois, USA
| | | | - Elizabeth A Holly
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA
| | - Mark Liebow
- Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Aaron Norman
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Ora Paltiel
- Braun School of Public Health and Community Medicine, Hadassah-Hebrew University, Jerusalem, Israel.,Department of Hematology, Hadassah-Hebrew University, Jerusalem, Israel
| | - Dennis Robinson
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Nathaniel Rothman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
| | - Rania Abu Seir
- Department of Medical Laboratory Sciences, Faculty of Health Professions, Al-Quds University, Palestine
| | - Susan L Slager
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Paul J Villeneuve
- School of Mathematics and Statistics and Department of Neuroscience, Carleton University, Ottawa, Ontario, Canada
| | - Sophia S Wang
- Department of Health Analytics, Division of Computational and Quantitative Medicine, Beckman Research Institute, City of Hope, Duarte, California, USA
| | - Dennis D Weisenburger
- Department of Pathology, City of Hope National Medical Center, Duarte, California, USA
| | - John J Spinelli
- Cancer Control Research, BC Cancer Agency, Vancouver, British Columbia, Canada
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2
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Tayyem R, Al-Bayyari N, Al-Awwad N, Abuhijleh H, Hoteit R, Qasrawi R, Badran E, Basha A, Allehdan S, Boukari K, Arrish J, Seir RA, Hoteit M. Dietary intake and lifestyle practices of eastern mediterranean postpartum women before and during COVID-19 pandemic: An internet-based cross-sectional survey. Front Nutr 2022; 9:932418. [PMID: 36034906 PMCID: PMC9400898 DOI: 10.3389/fnut.2022.932418] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 07/06/2022] [Indexed: 11/18/2022] Open
Abstract
Background During the lockdown period, a substantial group of these women reported lifestyle changes. Aim The aim of the study is to characterize the dietary patterns, intake and the adherence to the United States Department of Agriculture (USDA) pregnancy guidelines before and during the COVID-19 pandemic in Eastern Mediterranean postartum women. Methods An internet-based cross-sectional survey was used to collect the data. The survey was carried out among 1,939 postpartum women from five countries from the Eastern Mediterranean region. Change in dietary intake from the five food groups and the adherence to USDA's daily recommendations were assessed. Findings There was a significant increase in the mean (SD) consumption of all the food groups, including bread, rice, and other cereals, fruits, vegetables, milk and milk products, white and red meat, and nuts during the pandemic. Around 84% of participants reported no/low adherence (0–2) to USDA guidelines, whereas only 15% reported moderate or high adherence (3–5) to the guidelines before the pandemic. However, there was an increase in the proportion of subjects reporting moderate/high adherence (22%) during the pandemic. Discussion and conclusions A substantial proportion of our study participants reported a lower dietary intake than the recommended amounts, and low adherence to the five food groups. Reasonable and applicable actions should be taken to protect postpartum women and their children from the effects of low dietary intake, particularly during pandemics and lockdowns. More researches are needed to identify the modifiable factors which could improve the nutritional status of the postpartum women during the pandemic.
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Affiliation(s)
- Reema Tayyem
- Department of Human Nutrition, College of Health Sciences, QU-Health, Qatar University, Doha, Qatar.,School of Agriculture, The University of Jordan, Amman, Jordan
| | - Nahla Al-Bayyari
- Department of Nutrition and Food Technology, Faculty of Al-Huson University College, Al-Balqa Applied University, Al-Salt, Jordan
| | - Narmeen Al-Awwad
- Department of Clinical Nutrition and Dietetics, Faculty of Allied Health Sciences, The Hashemite University, Zarqa, Jordan
| | - Haya Abuhijleh
- Department of Human Nutrition, College of Health Sciences, QU-Health, Qatar University, Doha, Qatar
| | - Reem Hoteit
- Hariri School of Nursing, American University of Beirut, Beirut, Lebanon
| | - Radwan Qasrawi
- Department of Computer Science, Al-Quds University, Jerusalem, Palestine.,Department of Computer Engineering, Istinye University, Istanbul, Turkey
| | - Eman Badran
- School of Medicine, The University of Jordan, Amman, Jordan
| | - Asma Basha
- School of Medicine, The University of Jordan, Amman, Jordan
| | - Sabika Allehdan
- Department of Biology, College of Science, University of Bahrain, Bahrain
| | - Khlood Boukari
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, Taibah University, Medina, Saudi Arabia.,National Nutrition Committee (NNC), Saudi Food and Drug Authority (Saudi FDA), Riyadh, Saudi Arabia
| | - Jamila Arrish
- National Nutrition Committee (NNC), Saudi Food and Drug Authority (Saudi FDA), Riyadh, Saudi Arabia
| | - Rania Abu Seir
- Department of Biomedical Technology, Al-Quds University, Jerusalem, Palestine
| | - Maha Hoteit
- Faculty of Public Health, Lebanese University, Beirut, Lebanon.,PHENOL Research Group (Public Health Nutrition program-Lebanon), Faculty of Public Health, Lebanese University, Beirut, Lebanon
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3
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Qasrawi R, Amro M, VicunaPolo S, Abu Al-Halawa D, Agha H, Abu Seir R, Hoteit M, Hoteit R, Allehdan S, Behzad N, Bookari K, AlKhalaf M, Al-Sabbah H, Badran E, Tayyem R. Machine learning techniques for predicting depression and anxiety in pregnant and postpartum women during the COVID-19 pandemic: a cross-sectional regional study. F1000Res 2022; 11:390. [PMID: 36111217 PMCID: PMC9445566 DOI: 10.12688/f1000research.110090.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/16/2022] [Indexed: 02/02/2023] Open
Abstract
Background: Maternal depression and anxiety are significant public health concerns that play an important role in the health and well-being of mothers and children. The COVID-19 pandemic, the consequential lockdowns and related safety restrictions worldwide negatively affected the mental health of pregnant and postpartum women. Methods: This regional study aimed to develop a machine learning (ML) model for the prediction of maternal depression and anxiety. The study used a dataset collected from five Arab countries during the COVID-19 pandemic between July to December 2020. The population sample included 3569 women (1939 pregnant and 1630 postpartum) from five countries (Jordan, Palestine, Lebanon, Saudi Arabia, and Bahrain). The performance of seven machine learning algorithms was assessed for the prediction of depression and anxiety symptoms. Results: The Gradient Boosting (GB) and Random Forest (RF) models outperformed other studied ML algorithms with accuracy values of 83.3% and 83.2% for depression, respectively, and values of 82.9% and 81.3% for anxiety, respectively. The Mathew’s Correlation Coefficient was evaluated for the ML models; the Naïve Bayes (NB) and GB models presented the highest performance measures (0.63 and 0.59) for depression and (0.74 and 0.73) for anxiety, respectively. The features’ importance ranking was evaluated, the results showed that stress during pregnancy, family support, financial issues, income, and social support were the most significant values in predicting anxiety and depression. Conclusion: Overall, the study evidenced the power of ML models in predicting maternal depression and anxiety and proved to be an efficient tool for identifying and predicting the associated risk factors that influence maternal mental health. The deployment of machine learning models for screening and early detection of depression and anxiety among pregnant and postpartum women might facilitate the development of health prevention and intervention programs that will enhance maternal and child health in low- and middle-income countries.
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Affiliation(s)
- Radwan Qasrawi
- Department of Computer Science, Al- Quds University, Jerusalem, Palestinian Territory
- Dpertment of Computer Engineering, Istinye University, Istanbul, 34010, Turkey
| | - Malak Amro
- Department of Computer Science, Al- Quds University, Jerusalem, Palestinian Territory
| | - Stephanny VicunaPolo
- Department of Computer Science, Al- Quds University, Jerusalem, Palestinian Territory
| | - Diala Abu Al-Halawa
- Department of Faculty of Medicine, Al- Quds University, Jerusalem, Palestinian Territory
| | - Hazem Agha
- Department of Faculty of Medicine, Al- Quds University, Jerusalem, Palestinian Territory
| | - Rania Abu Seir
- Department of Medical Laboratory Sciences, Al-Quds University, Jerusalem, Palestinian Territory
| | - Maha Hoteit
- Faculty of Public Health, Lebanese University, Beirut, Lebanon
- PHENOL Research Group (Public Health Nutrition Program Lebanon), Faculty of Public Health, Lebanese University, Beirut, Lebanon
- Lebanese University Nutrition Surveillance Center (LUNSC), Lebanese Food Drugs and Chemical Administrations, Lebanese University, Beirut, Lebanon
| | - Reem Hoteit
- Clinical Research Institute, American University of Beirut, Bliss Street, Riad El Solh 1107 2020, Beirut, Lebanon
| | - Sabika Allehdan
- Department of Biology, College of Science, University of Bahrain, Zallaq, Bahrain
| | - Nouf Behzad
- Salmaniya Medical Complex, Ministry of Health, Manama, Bahrain
| | - Khlood Bookari
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, Taibah University, Medna, Saudi Arabia
- National Nutrition Committee (NNC), Saudi Food and Drug Authority (Saudi FDA), Riyadh, Saudi Arabia
| | - Majid AlKhalaf
- National Nutrition Committee (NNC), Saudi Food and Drug Authority (Saudi FDA), Riyadh, Saudi Arabia
| | - Haleama Al-Sabbah
- Department of Health Sciences, Zayed University, Dubai, United Arab Emirates
| | - Eman Badran
- Faculty of Medicine, University of Jordan, Amman, Jordan
| | - Reema Tayyem
- Department of Human Nutrition, College of Health Sciences, Qatar University, Doha, Qatar
- Department of Nutrition and Food Technology, Faculty of Agriculture, The University of Jordan, Amman, 11942, Jordan
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4
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Hoteit M, Hoteit R, Al-Jawaldeh A, Abou Nasr M, Obeid S, Fakih C, El Hajj M, Qasrawi R, Abu Seir R, Allehdan S, Ismail MS, Bookari K, Arrish J, Al-Bayyari N, Tayyem R. Adherence to the United States Department of Agriculture Dietary Recommendations Pre- and During the Coronavirus Disease-19 Pandemic Among Pregnant Women in Arab Countries. Front Nutr 2022; 9:824305. [PMID: 35369076 PMCID: PMC8970272 DOI: 10.3389/fnut.2022.824305] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 02/17/2022] [Indexed: 01/09/2023] Open
Abstract
During pregnancy, woman’s diet is one of the most preeminent factors affecting mother and child’s health. Prior to the coronavirus disease-19 (COVID-19) pandemic, inadequate maternal diet and low adherence to dietary guidelines was reported among pregnant women in the Arab countries. Nowadays, COVID-19 infection during pregnancy is widely discussed among literature. However, there is limited data on the health impacts of the COVID-19 pandemic on non-infected pregnant women. This substantially larger group also suffered significant lifestyle changes during the lockdown period. The aim of the study is to characterize dietary patterns, intake and adherence to the United States Department of Agriculture (USDA) pregnancy guidelines before and during the COVID-19 pandemic in Arab pregnant women. Using a specially designed questionnaire and using the snowball sampling method, the survey was carried out among a convenient sample of 1,939 pregnant women from five Arab countries. Our study found an increment in the consumption of cereals, fruits, vegetables, dairy products, meats, and nuts that occurred during the pandemic compared to the preceding period. Despite this noticeable increase during the pandemic, the Arab pregnant women in this study had significantly lower adherence to the USDA pregnancy guidelines. The daily consumption of almost all food groups was lower than the USDA’s daily recommendations, except for fruits intake, which was higher than the daily standard. Demonstrated poor adherence to prenatal USDA dietary guidelines by Arab pregnant women can lead to numerous deficiencies and health risks among their offspring. In conclusion, our study showed that before and during the COVID-19 pandemic, poor adherence to dietary recommendations occurred in a considerable number of Arab pregnant women. The findings emphasize the need for nutritional education and intervention during prenatal visits.
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Affiliation(s)
- Maha Hoteit
- Faculty of Public Health, Lebanese University, Beirut, Lebanon
- PHENOL Research Group Public Health Nutrition Program-Lebanon, Faculty of Public Health, Lebanese University, Beirut, Lebanon
- Lebanese University Nutrition Surveillance Center (LUNSC), Lebanese Food Drugs and Chemical Administrations, Lebanese University, Beirut, Lebanon
- *Correspondence: Maha Hoteit,
| | - Reem Hoteit
- Hariri School of Nursing, American University of Beirut, Beirut, Lebanon
| | - Ayoub Al-Jawaldeh
- World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | | | - Sara Obeid
- Faculty of Public Health, Lebanese University, Beirut, Lebanon
| | - Chadi Fakih
- Al Hadi Laboratory and IVF Center, Beirut, Lebanon
| | - Mohamad El Hajj
- Faculty of Public Health, Lebanese University, Beirut, Lebanon
| | - Radwan Qasrawi
- Department of Computer Science, Al-Quds University, Jerusalem, Palestine
- Department of Computer Engineering, Istinye University, Istanbul, Turkey
| | - Rania Abu Seir
- Department of Medical Laboratory Sciences, Al-Quds University, Jerusalem, Palestine
| | - Sabika Allehdan
- Department of Biology, College of Science, University of Bahrain, Zallaq, Bahrain
| | - Mahmoud Samy Ismail
- Department of Obstetrics and Gynecology, King Hamad University Hospital, Busaiteen, Bahrain
- Department of Obstetrics and Gynecology, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Khlood Bookari
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, Taibah University, Madinah, Saudi Arabia
| | - Jamila Arrish
- National Nutrition Committee (NNC), Saudi Food and Drug Authority (Saudi FDA), Riyadh, Saudi Arabia
| | - Nahla Al-Bayyari
- Department of Nutrition and Food Technology, Al-Huson University College, Al-Balqa Applied University, As-Salt, Jordan
| | - Reema Tayyem
- Department of Human Nutrition, College of Health Sciences, Qatar University, Doha, Qatar
- Reema Tayyem,
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5
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Hoteit M, Mortada H, Al-Jawaldeh A, Mansour R, Yazbeck B, AlKhalaf M, Bookari K, Tayyem R, Al-Awwad NJ, Al Sabbah H, Cheikh Ismail L, Qasrawi R, Abu Seir R, Kamel I, Dashti S, Allehdan S, Al-Mannai M, Bawadi H, Waly M. Dietary Diversity in the Eastern Mediterranean Region Before and During the COVID-19 Pandemic: Disparities, Challenges, and Mitigation Measures. Front Nutr 2022; 9:813154. [PMID: 35252299 PMCID: PMC8893198 DOI: 10.3389/fnut.2022.813154] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 01/04/2022] [Indexed: 12/25/2022] Open
Abstract
The COVID-19 pandemic has revealed the Eastern Mediterranean Region's food system's fragility posing severe challenges to maintaining healthy sustainable lifestyle. The aim of this cross-sectional study (N = 13,527 household's family members, mean age: 30.3 ±11.6, 80% women) is to examine the impact of the COVID-19 pandemic on food consumption patterns and household's dietary diversity in 10 Eastern Mediterranean countries. A food frequency questionnaire was used to investigate the consumption patterns along with the calculation of the Food Consumption Score (FCS), a proxy indicator of dietary diversity. Data collected on cooking attitudes, shopping and food stock explore the community mitigation measures. In the overall population, before and during the pandemic, most food groups were consumed less or equal to 4 times per week. As evident from our findings and considering that the pandemic may be better, but it's not over, small to moderate changes in food consumption patterns in relatively short time periods can become permanent and lead to substantial poor dietary diversity over time. While it is a priority to mitigate the immediate impact, one area of great concern is the long-term effects of this pandemic on dietary patterns and dietary diversity in Eastern Mediterranean households. To conclude, the COVID-19 crisis revealed the region's unpreparedness to deal with a pandemic. While the aggressive containment strategy was essential for most countries to help prevent the spread, it came at a high nutritional cost, driving poor dietary diversity.
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Affiliation(s)
- Maha Hoteit
- Faculty of Public Health, Lebanese University, Beirut, Lebanon.,PHENOL Research Group (Public HEalth Nutrition prOgram Lebanon), Faculty of Public Health, Lebanese University, Beirut, Lebanon.,Lebanese University Nutrition Surveillance Center (LUNSC), Lebanese Food Drugs and Chemical Administrations, Lebanese University, Beirut, Lebanon
| | - Hussein Mortada
- PHENOL Research Group (Public HEalth Nutrition prOgram Lebanon), Faculty of Public Health, Lebanese University, Beirut, Lebanon.,Faculty of Science IV, Lebanese University, Beirut, Lebanon
| | - Ayoub Al-Jawaldeh
- World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - Rania Mansour
- Faculty of Public Health, Lebanese University, Beirut, Lebanon
| | - Batoul Yazbeck
- Faculty of Public Health, Lebanese University, Beirut, Lebanon
| | - Majid AlKhalaf
- National Nutrition Committee, Saudi Food and Drug Authority, Riyadh, Saudi Arabia
| | - Khlood Bookari
- National Nutrition Committee, Saudi Food and Drug Authority, Riyadh, Saudi Arabia.,Department of Clinical Nutrition, Faculty of Applied Medical Sciences, Taibah University, Madinah, Saudi Arabia
| | - Reema Tayyem
- Department of Human Nutrition, College of Health Sciences, Qatar University, Doha, Qatar
| | - Narmeen J Al-Awwad
- Department of Clinical Nutrition and Dietetics, Faculty of Applied Health Sciences, The Hashemite University, Zarqa, Jordan
| | - Haleama Al Sabbah
- Department of Health Sciences, College of Natural and Health Sciences, Zayed University, Dubai, United Arab Emirates
| | - Leila Cheikh Ismail
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.,Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, United Kingdom
| | - Radwan Qasrawi
- Department of Computer Science, Al-Quds University, Jerusalem, Palestine.,Department of Computer Engineering, Istinye University, Istanbul, Turkey
| | | | | | - Somaia Dashti
- Public Authority for Applied Education and Training, Kuwait City, Kuwait
| | - Sabika Allehdan
- Department of Biology, College of Science, University of Bahrain, Zallaq, Bahrain
| | - Mariam Al-Mannai
- Department of Mathematics, College of Science, University of Bahrain, Zallaq, Bahrain
| | - Hiba Bawadi
- Human Nutrition Department, College of Health Sciences, QU-Health, Qatar University, Doha, Qatar
| | - Mostafa Waly
- Food Science and Nutrition Department, College of Agricultural and Marine Sciences, Sultan Qaboos University, Muscat, Oman
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6
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Aldwaik R, Abu Mohor T, Idyabi I, Warasna S, Abdeen S, Karmi B, Abu Seir R. Health Status of Patients With β-Thalassemia in the West Bank: A Retrospective-Cohort Study. Front Med (Lausanne) 2021; 8:788758. [PMID: 34988098 PMCID: PMC8720844 DOI: 10.3389/fmed.2021.788758] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 10/03/2021] [Accepted: 11/22/2021] [Indexed: 11/20/2022] Open
Abstract
Management of β-thalassemia in developing countries is demanding in the absence of available therapies rather than recurrent transfusions. This study describes the characteristics and evaluates the hematological, biochemical, and hormonal findings of patients with β-thalassemia in the West Bank. We conducted a retrospective cohort study between January 2017 and December 2018. Data were collected through medical files of the patients with β-thalassemia from eight primary healthcare clinics, nine emergency departments, and 11 governmental hospitals across the West Bank. Results of the hematological, biochemical, and hormonal evaluations, in addition to demographic data and the use of iron chelation were included in the study and analyzed. A total of 309 patients with β-thalassemia were included with a male-to-female ratio of 1:1 and an average age of 23.4 ± 10.4 years. The anemic presentation was reported in 78.6% of the patients as indicated by hemoglobin level (mean ± SD = 8.4 ± 1.4 g/dl), and 73.1% had iron overload with serum ferritin (SF) levels ≥ 1,000 μg/L (mean ± SD = 317.8 ± 3,378.8 μg/L). Evaluation of the liver function tests showed that alanine transaminase (ALT) and aspartate transaminase (AST) levels were high among 38.1 and 61.2% of the patients, respectively. ALT and AST showed significant positive correlations with SF levels, while the kidney tests did not. As for iron chelation medications, patients receiving deferoxamine (26.5%) showed significantly higher SF levels compared with patients receiving deferasirox (73.5%). This study highlights the importance of establishing patient-tailored comprehensive assessment and follow-up protocols for the management of β-thalassemia with an emphasis on blood transfusion and iron chelation practices.
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Affiliation(s)
- Reem Aldwaik
- Department of Medical Laboratory Sciences, Al-Quds University, Jerusalem, Palestine
| | - Tamara Abu Mohor
- Department of Medical Laboratory Sciences, Al-Quds University, Jerusalem, Palestine
| | - Israa Idyabi
- Department of Medical Laboratory Sciences, Al-Quds University, Jerusalem, Palestine
| | - Salam Warasna
- Department of Medical Laboratory Sciences, Al-Quds University, Jerusalem, Palestine
| | - Shatha Abdeen
- Department of Medical Laboratory Sciences, Al-Quds University, Jerusalem, Palestine
| | - Bashar Karmi
- Thalassemia Patients' Friends Society, Ramallah, Palestine
| | - Rania Abu Seir
- Department of Medical Laboratory Sciences, Al-Quds University, Jerusalem, Palestine
- *Correspondence: Rania Abu Seir
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7
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Sina M, Ghorbanoghli Z, Abedrabbo A, Al-Mulla F, Sghaier RB, Buisine MP, Cortas G, Goshayeshi L, Hadjisavvas A, Hammoudeh W, Hamoudi W, Jabari C, Loizidou MA, Majidzadeh-A K, Marafie MJ, Muslumov G, Rifai L, Seir RA, Talaat SM, Tunca B, Ziada-Bouchaar H, Velthuizen ME, Sharara AI, Ahadova A, Georgiou D, Vasen HFA. Identification and management of Lynch syndrome in the Middle East and North African countries: outcome of a survey in 12 countries. Fam Cancer 2020; 20:215-221. [PMID: 33098072 PMCID: PMC8214581 DOI: 10.1007/s10689-020-00211-3] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 10/06/2020] [Indexed: 12/01/2022]
Abstract
BACKGROUND Lynch syndrome (LS), the most common inherited form of colorectal cancer (CRC), is responsible for 3% of all cases of CRC. LS is caused by a mismatch repair gene defect and is characterized by a high risk for CRC, endometrial cancer and several other cancers. Identification of LS is of utmost importance because colonoscopic surveillance substantially improves a patient's prognosis. Recently, a network of physicians in Middle Eastern and North African (ME/NA) countries was established to improve the identification and management of LS families. The aim of the present survey was to evaluate current healthcare for families with LS in this region. METHODS A questionnaire was developed that addressed the following issues: availability of clinical management guidelines for LS; attention paid to family history of cancer; availability of genetic services for identification and diagnosis of LS; and assessment of knowledge of LS surveillance. Members of the network and authors of recent papers on LS from ME/NA and neighbouring countries were invited to participate in the survey and complete the online questionnaire. RESULTS A total of 55 individuals were invited and 19 respondents from twelve countries including Algeria, Azerbaijan, Cyprus, Egypt, Iran, Jordan, Kuwait, Lebanon, Morocco, Palestine, Tunisia, and Turkey completed the questionnaire. The results showed that family history of CRC is considered in less than half of the surveyed countries. Guidelines for the management of LS are available in three out of twelve countries. The identification and selection of families for genetic testing were based on clinical criteria (Amsterdam criteria II or Revised Bethesda criteria) in most countries, and only one country performed universal screening. In most of the surveyed countries genetic services were available in few hospitals or only in a research setting. However, surveillance of LS families was offered in the majority of countries and most frequently consisted of regular colonoscopy. CONCLUSION The identification and management of LS in ME/NA countries are suboptimal and as a result most LS families in the region remain undetected. Future efforts should focus on increasing awareness of LS amongst both the general population and doctors, and on the improvement of the infrastructure in these countries.
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Affiliation(s)
- Mohammad Sina
- Genetics Department, Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran, Iran.,A. Nocivelli Institute for Molecular Medicine, Department of Molecular and Translational Medicine, University of Brescia, 25123, Brescia, Italy
| | - Zeinab Ghorbanoghli
- Department of Gastroenterology and Hepatology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands. .,Dutch Hereditary Cancer Registry, Leiden, The Netherlands.
| | - Amal Abedrabbo
- Department of Pediatrics, Makassed Islamic Charitable Hospital, Jerusalem, Palestine
| | - Fahd Al-Mulla
- Department of Genetics and Bioinformatics, Dasman Diabetes Institute, P.O. Box 1180, 15462, Dasman, Kuwait
| | - Rihab Ben Sghaier
- Cytogenetic, Molecular Genetics and Human Reproduction Biology - Farhat, HACHED Hospital, Sousse, Tunisia
| | - Marie-Pierre Buisine
- Unit of Molecular Oncology and Genetics, Institute of Biochemistry and Molecular Biology, Lille University Hospital, Lille, France
| | - George Cortas
- Department of Gastroenterology, St. George Hospital Medical Center, University of Balamand Medical School, Beirut, Lebanon
| | - Ladan Goshayeshi
- Department of Gastroenterology and Hepatology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Andreas Hadjisavvas
- Department of Electron Microscopy/Molecular Pathology, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
| | - Wail Hammoudeh
- Department of Internal Medicine, Arabcare Hospital, Ramallah, Palestine
| | - Waseem Hamoudi
- Department of Gastroenterology, The Royal Hospital, Amman, Jordan
| | - Carol Jabari
- Patient's Friends Society, Jerusalem, Palestine.,Hebron University, Hebron, Palestine
| | - Maria A Loizidou
- Department of Electron Microscopy/Molecular Pathology, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
| | - Keivan Majidzadeh-A
- Genetics Department, Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran, Iran
| | - Makia J Marafie
- Kuwait Medical Genetics Centre, Maternity Hospital, 13059, Safat, Kuwait
| | - Gurbankhan Muslumov
- Colorectal Surgery Department, Scientific Center of Surgery, Baku, Azerbaijan
| | - Laila Rifai
- Centre Hospitalier Universitaire IBN SINA, Rabat Instituts, Institut National D'Oncologie Sidi Mohamed Ben Abdellah, BP 6213, Rabat, Maroc
| | | | | | - Berrin Tunca
- Department of Medical Biology, Medical Faculty, Uludag University, Bursa, Turkey
| | - Hadia Ziada-Bouchaar
- Laboratory of Biology and Molecular Genetics, Faculty of Medicine, University 3, Rabah Bitat, Constantine, Algeria
| | - Mary E Velthuizen
- Department of Genetics, University Medical Center Utrecht (Location WKZ), Utrecht, the Netherlands
| | - Ala I Sharara
- Division of Gastroenterology, American University of Beirut Medical Centre, Beirut, Lebanon
| | - Aysel Ahadova
- Department of Applied Tumour Biology, Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany.,Cooperation Unit Applied Tumour Biology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Demetra Georgiou
- Department of Clinical Genetics, London North West University Healthcare, London, UK
| | - Hans F A Vasen
- Department of Gastroenterology and Hepatology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands.,Dutch Hereditary Cancer Registry, Leiden, The Netherlands
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8
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Abu Seir R, Kharroubi A, Ghannam I. Prevalence of tobacco use among young adults in Palestine. East Mediterr Health J 2020; 26:75-84. [PMID: 32043549 DOI: 10.26719/2020.26.1.75] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 10/28/2019] [Indexed: 11/09/2022]
Abstract
Background Smoking tobacco is a worldwide public health issue. Over the last few decades, smoking patterns have been changing, reflected by increasing rates among young people and females in particular. Aims This study aimed to determine the prevalence and modalities of smoking and to assess the factors, habits and beliefs that might encourage or discourage smoking among young adults in Palestine. Methods A cross-sectional study was conducted in the West Bank in 2014 among Palestinians aged 18-25 years old. Subjects were recruited from six Palestinian universities (n=1997). Participants were asked to complete a questionnaire focusing on sociodemographics, knowledge and beliefs towards tobacco smoking, and the reasons that motivate or hinder smokers to quit. Results The prevalence of tobacco smoking was found to be 47.7%. Males had higher smoking rates, consumption levels, and initiated smoking at younger ages (74.4% started at ≤18 years old). Smoking cigarettes and waterpipe were the most common forms among both sexes. Smokers were also found to consume higher amounts of caffeinated drinks and fast food, showed lower scores towards anti-smoking beliefs, and reported significantly higher prevalence of smoking-related symptoms and diseases, primarily shortness of breath (20.5%) and cough (16.6%). The majority of smokers reported attempting and willingness to quit smoking. Health and financial costs were the strongest factors encouraging quitting while mood changes and lack of self-control were the most reported discouraging factors. Moreover, smoking among family members and peers increased the odds of smoking. Conclusions Increasing rates of smoking among young Palestinians and a growing popularity of waterpipe use should alert stakeholders to the necessity for the implementation of smoking prevention and awareness policies and programmes.
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Affiliation(s)
- Rania Abu Seir
- Department of Medical Laboratory Sciences, Al-Quds University, Abu Dis, Palestine
| | - Akram Kharroubi
- Faculty of Health Professions, Al-Quds University, Abu Dis, Palestine
| | - Ibrahim Ghannam
- Department of Medical Laboratory Sciences, Al-Quds University, Abu Dis, Palestine
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9
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Hadyeh E, Azmi K, Seir RA, Abdellatief I, Abdeen Z. Molecular Characterization of Methicillin Resistant Staphylococcus aureus in West Bank-Palestine. Front Public Health 2019; 7:130. [PMID: 31192182 PMCID: PMC6549579 DOI: 10.3389/fpubh.2019.00130] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 05/08/2019] [Indexed: 11/16/2022] Open
Abstract
Background: Methicillin-resistant Staphylococcus aureus (MRSA) is a public health threat and a major cause of hospital-acquired and community-acquired infections. This study aimed to investigate the genetic diversity of MRSA isolates from 2015 to 2017 and to characterize the major MRSA clones and anti-biogram trends in Palestine. Methodology: Isolates were obtained from 112 patients admitted to different hospitals of West Bank and East Jerusalem, originating from different clinical sources. Antibiotic susceptibility patterns, staphylococcal chromosomal cassette mec (SCCmec) typing, and Staphylococcus aureus protein A (spa) typing were determined. Also, a panel of toxin genes and virulence factors was studied, including: Panton-Valentine Leukocidin (PVL), ACME-arcA, Toxic Shock Syndrome Toxin-1 (TSST-1), and Exfoliative Toxin A (ETA). Results: Of the 112 confirmed MRSA isolates, 100% were resistant to all β-lactam antibiotics. Resistance rates to other non- β-lactam classes were as the following: 18.8% were resistant to trimethoprim-sulfamethoxazole, 23.2% were resistant to gentamicin, 34.8% to clindamycin, 39.3% to ciprofloxacin, and 63.4% to erythromycin. All MRSA isolates were susceptible to vancomycin (100%). Of all isolates, 32 isolates (28.6%) were multidrug- resistant (MDR). The majority of the isolates were identified as SCCmec type IV (86.6%). The molecular typing identified 29 spa types representing 12 MLST-clonal complexes (CC). The most prevalent spa types were: spa type t386 (CC1)/(12.5%), spa type t044 (CC80)/(10.7%), spa type t008 (CC8)/(10.7%), and spa type t223 (CC22)/(9.8%). PVL toxin gene was detected in (29.5%) of all isolates, while ACME-arcA gene was present in 18.8% of all isolates and 23.2% had the TSST-1 gene. The two most common spa types among the TSST-1positive isolates were the spa type t223 (CC22)/(Gaza clone) and the spa type t021 (CC30)/(South West Pacific clone). All isolates with the spa type t991 were ETA positive (5.4%). USA-300 clone (spa type t008, positive for PVL toxin gene and ACME-arcA genes) was found in nine isolates (8.0%). Conclusions: Our results provide insights into the epidemiology of MRSA strains in Palestine. We report a high diversity of MRSA strains among hospitals in Palestine, with frequent SCCmec type IV carriage. The four prominent clones detected were: t386-IV/ CC1, the European clone (t044/CC80), Gaza clone (t223/CC22), and the USA-300 clone (t008/CC8).
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Affiliation(s)
- Etaf Hadyeh
- Al-Quds Public Health Society, Jerusalem, Palestine.,Department of Medical Lab Sciences, Faculty of Health Professions, Jerusalem, Palestine
| | - Kifaya Azmi
- Al-Quds Public Health Society, Jerusalem, Palestine.,Faculty of Medicine, Al-Quds Nutrition and Health Research Institute, Al-Quds University, Jerusalem, Palestine.,Biochemistry and Molecular Biology Department, Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Rania Abu Seir
- Department of Medical Lab Sciences, Faculty of Health Professions, Jerusalem, Palestine
| | - Inas Abdellatief
- Laboratory Department of Al-Makassed Charitable Hospital, Jerusalem, Palestine
| | - Ziad Abdeen
- Al-Quds Public Health Society, Jerusalem, Palestine.,Faculty of Medicine, Al-Quds Nutrition and Health Research Institute, Al-Quds University, Jerusalem, Palestine
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10
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Klil-Drori AJ, Kleinstern G, Seir RA, Choshen-Cohen L, Abdeen Z, Hussein E, Aqel M, Göen T, Perlman R, Ben-Yehuda D, Paltiel O. Serum organochlorines and non-Hodgkin lymphoma: A case-control study in Israeli Jews and Palestinians. Chemosphere 2018; 213:395-402. [PMID: 30241084 DOI: 10.1016/j.chemosphere.2018.09.069] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 09/11/2018] [Accepted: 09/12/2018] [Indexed: 06/08/2023]
Abstract
Associations of organochlorine (OC) pesticides and polychlorinated biphenyls (PCBs) with non-Hodgkin lymphoma are controversial. We compared serum levels of 6 OC pesticides and 38 PCBs in Israeli Jews (IJ) and Palestinian Arabs (PA) and assessed possible associations with B-cell non-Hodgkin lymphoma (B-NHL). Ninety B-NHL cases (50 IJ and 40 PA) and 120 controls (65 IJ and 55 PA) were included. Median concentrations of analytes in controls were compared across ethnic groups using quantile regression, adjusting for age and sex. We used logistic regression to derive odds ratios (OR) and 95% confidence intervals (CI) for detectable analytes and B-NHL, adjusting for age, ethnic group, faming and body mass index. Median values of PCBs and dichlorodiphenyldichloroethylene (DDE) were higher in IJ vs PA controls (P = 0.0007), as were several PCBs (74, 99, 118, 138, 146, 153, 156, 163, 170, and 180). Overall, OC pesticide and PCB exposures were comparable with reports from high-income countries. B-NHL was associated with PCB 146 (OR 1.70, 95% CI: 1.02, 2.83), PCB 156 (OR 1.75, 95% CI: 1.06, 2.89), and high-chlorinated PCBs (OR 1.55, 95% CI: 1.00, 2.40) in all study subjects. These associations were robust in quantile as well as sensitivity analyses. An association of DDE with B-NHL was noted in PA (OR 1.72, 95% CI: 1.07, 2.77), but not in IJ (OR 0.87, 95% CI: 0.59, 1.27). Although high-chlorinated PCB concentrations did not indicate high exposure levels, our findings indicate that B-NHL may be associated with this exposure.
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Affiliation(s)
- Adi J Klil-Drori
- Center for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, Quebec, Canada.
| | - Geffen Kleinstern
- Braun School of Public Health, Hadassah-Hebrew University, Jerusalem, Israel; Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Rania Abu Seir
- Department of Hematology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel; Faculty of Health Professions, Dept. of Medical Laboratory Sciences, Al-Quds University, Abu Deis, West Bank, Israel
| | - Lotan Choshen-Cohen
- Braun School of Public Health, Hadassah-Hebrew University, Jerusalem, Israel
| | - Ziad Abdeen
- Al-Quds Nutrition and Health Research Institute, Al-Quds University, Abu Deis, West Bank, Israel
| | - Elyan Hussein
- Department of Hematology, Beit Jala Hospital, West Bank, Israel
| | - Mohammad Aqel
- Augusta Victoria Hospital, Jerusalem, West Bank, Israel
| | - Thomas Göen
- Institute and Outpatient Clinic of Occupational, Social and Environmental Medicine, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Riki Perlman
- Department of Hematology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Dina Ben-Yehuda
- Department of Hematology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Ora Paltiel
- Braun School of Public Health, Hadassah-Hebrew University, Jerusalem, Israel; Department of Hematology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
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11
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Abu Seir R, Azmi K, Hamdan A, Namouz H, Jaar F, Jaber H, Rubin C, Doron D, Rahav G, Abdeen Z, Regev-Yochay G. Comparison of early effects of pneumococcal conjugate vaccines: PCV7, PCV10 and PCV13 on Streptococcus pneumoniae nasopharyngeal carriage in a population based study; The Palestinian-Israeli Collaborative Research (PICR). PLoS One 2018; 13:e0206927. [PMID: 30418989 PMCID: PMC6231627 DOI: 10.1371/journal.pone.0206927] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Accepted: 10/21/2018] [Indexed: 01/15/2023] Open
Abstract
Background Pneumococcal conjugate vaccines (PCVs), PCV10 and PCV13, are currently used in different countries. We have previously reported the effectiveness of PCV7, following its introduction in Israel and before PCVs were introduced in Palestine. Here, we extended the study and compared the initial impact of PCV10 to that of PCV7/13. Methods Four cross-sectional surveys of S. pneumoniae carriage among children <5y through 2009–2014 were preformed among two proximate populations, living under two distinct health authorities, with different vaccination policies. In East-Jerusalem (EJ), PCV7 was implemented in 2009 and replaced by PCV13 in late 2010, while in Palestine (PA), PCV10 was implemented in 2011. Results A total of 1267 and 2414 children from EJ and PA were screened. In 2014, S. pneumoniae was detected in 30.7% and 28.6% of the children in EJ and PA respectively Implementation of both PCV7 (in EJ) and PCV10 (in PA) did not affect overall S. pneumoniae carriage, but resulted in a significant decrease in the prevalence of vaccine-type strains. In the pre-vaccine era, VT7/VT13 strains consisted 47.0%/62.0% and 41.2%/54.8% of pneumococci in EJ and PA, respectively. A 48.6% and 53.9% decrease in VT7 strains was observed within 3 years of PCV7 implementation in EJ (p = 0.001) and PCV10 in PA (p<0.0001), respectively. These vaccination policies also resulted in ~50% reduction in VT13-added serotypes especially 6A (from 11.0% to 0.0% (EJ) and 9.5% to 4.9% (PA)). Three years after PCV13 implementation in EJ, an additional 67% decrease in VT13 strains was observed, yet an increase in serotype 3 was observed (0.0% to 3.4%, p = 0.056). While the prevalence of VT13 strains decreased significantly during the study period, the overall carriage rate didn’t change significantly due to replacement with non-VT13 strains which comprised 89.8% and 70.7% of all pneumococci, in EJ and in PA respectively in the last study year. Conclusions Within the first three years following PCV implementation, we observed similar reductions in carriage of VT10 and VT13 strains with either vaccination policies, with no effect on overall carriage. Further follow-up is needed to compare the long-term effects.
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Affiliation(s)
| | | | | | | | - Fuad Jaar
- Independent Researcher, Bethlehem, Palestine
| | | | | | - Dafna Doron
- Macabbi Healthcare Services, Jerusalem, Israel
| | - Galia Rahav
- Sheba Medical Center, Ramat-Gan, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Gili Regev-Yochay
- Sheba Medical Center, Ramat-Gan, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- * E-mail:
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12
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Kleinstern G, Averbuch M, Abu Seir R, Perlman R, Ben Yehuda D, Paltiel O. Presence of autoimmune disease affects not only risk but also survival in patients with B-cell non-Hodgkin lymphoma. Hematol Oncol 2018; 36:457-462. [PMID: 29469175 DOI: 10.1002/hon.2498] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2017] [Revised: 12/21/2017] [Accepted: 01/10/2018] [Indexed: 12/26/2022]
Abstract
Although autoimmune diseases (AIDs) are known to predispose to non-Hodgkin lymphoma (NHL), their association with NHL prognosis has rarely been investigated. We examined associations between autoimmunity and B-cell NHL onset by comparing AID history (determined by self-report and medication review and supplemented by chart review where possible) among 435 adult B-NHL patients in Hadassah-Hebrew University Medical Center, diagnosed 2009-2014, and 414 age-and-sex frequency-matched controls. We examined AIDs as a whole, B- and T-cell-mediated AIDs, and autoimmune thyroid diseases. Among cases, we used Kaplan-Meier and Cox regression models to assess the association of AID with overall survival and relapse-free survival, adjusting for prognostically important patient and disease characteristics such as Ki67% staining, International Prognostic Index, rituximab treatment, and histological subgroup. Autoimmune diseases were associated with B-NHL (odds ratio [OR] = 1.95; 95% confidence interval (CI), 1.31-2.92), especially AIDs mediated by B-cell activation (OR = 5.20; CI, 1.90-14.3), which were particularly associated with marginal zone lymphoma (OR = 19.3; CI, 4.59-80.9). We found that time to relapse for all B-NHL patients with AIDs was significantly shorter (mean of 49.21 mo [±3.22]) than among patients without AID (mean of 59.74 mo [±1.62]), adjusted hazard ratio [HRadj ] = 1.69 (CI, 1.03-2.79). Specifically, in patients with diffuse large B-cell lymphoma, of whom 91.8% had received rituximab, a history of B-cell-mediated AIDs was associated with shorter relapse-free survival and overall survival, HRadj = 8.34 (CI, 3.01-23.1) and HRadj = 3.83 (CI, 1.20-12.3), respectively. Beyond confirming the well-known association between AIDs and B-NHL, we found that AID is an adverse prognostic factor in B-cell lymphoma, associated with a shortened time to relapse, suggesting that there are specific therapeutic challenges in the subgroup of patients suffering from both these diseases. Further work is required to address mechanisms of resistance to standard treatment in the setting of AID-associated B-NHL. In the era of immunotherapy, these findings have particular relevance.
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Affiliation(s)
- Geffen Kleinstern
- School of Public Health, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.,Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Mor Averbuch
- School of Public Health, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Rania Abu Seir
- Department of Hematology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.,Department of Medical Laboratory Sciences, Al Quds University, Abu Deis, Jerusalem
| | - Riki Perlman
- Department of Hematology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Dina Ben Yehuda
- Department of Hematology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Ora Paltiel
- School of Public Health, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.,Department of Hematology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
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13
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14
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Kleinstern G, Seir RA, Perlman R, Abdeen Z, Khatib A, Elyan H, Dann EJ, Kedmi M, Ellis M, Nagler A, Amir G, Ben Yehuda D, Safadi R, Paltiel O. Associations between B-cell non-Hodgkin lymphoma and exposure, persistence and immune response to hepatitis B. Haematologica 2016; 101:e303-5. [PMID: 27102500 DOI: 10.3324/haematol.2016.144840] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Affiliation(s)
- Geffen Kleinstern
- School of Public Health, Hadassah-Hebrew University Medical Organization, Jerusalem, Israel
| | - Rania Abu Seir
- Dept of Hematology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel Faculty of Health Professions, Dept of Medical Laboratory Sciences, Al Quds University, Abu Deis, West Bank, PA
| | - Riki Perlman
- Dept of Hematology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Ziad Abdeen
- School Faculty of Medicine, Dept of Community Medicine, Al Quds University, Abu Deis, West Bank, PA
| | - Areej Khatib
- Cancer Care Center, Augusta Victoria Hospital, East Jerusalem
| | | | - Eldad J Dann
- Rambam Medical Center and Rappaport Faculty of Medicine, Technion, Haifa, Israel
| | - Meirav Kedmi
- Chaim Sheba Medical Center, Tel Hashomer and Tel Aviv University, Israel
| | | | - Arnon Nagler
- Chaim Sheba Medical Center, Tel Hashomer and Tel Aviv University, Israel
| | - Gail Amir
- Dept of Pathology, Hadassah Medical Center, Jerusalem, Israel
| | - Dina Ben Yehuda
- Dept of Hematology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Rifaat Safadi
- Liver and Gastroenterology Units, Division of Medicine, Hadassah University Medical Center, Jerusalem, Israel
| | - Ora Paltiel
- School of Public Health, Hadassah-Hebrew University Medical Organization, Jerusalem, Israel Dept of Hematology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
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15
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Abdeen Z, Berman T, Azmi K, Abu Seir R, Agha H, Ein-Mor E, Göen T, Stein Y, Richter E, Calderon-Margalit R. Urinary organophosphate metabolite levels in Palestinian pregnant women: results of the Middle East Regional Cooperation Project. Int J Environ Health Res 2015; 26:254-266. [PMID: 26578062 DOI: 10.1080/09603123.2015.1109067] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The purpose of the study was to measure urinary organophosphate (OP) metabolites in Palestinian pregnant women, and to compare levels with those in pregnant women in Jerusalem and women from the general population in Israel. We measured six dialkyl phosphates in urine samples collected from 148 pregnant women from the West Bank area. Median total dimethyl phosphate (DM(total)) levels were significantly lower in Palestinian women compared to Jerusalem pregnant women and women in Israel (p = 0.041). In Palestinian women reporting that their place of residence was near an agricultural field, DM(total) levels were significantly higher (p = 0.037). Lower urinary excretion of dimethyl phosphate pesticide metabolites in Palestinian women compared to Israeli women may result from lower consumption of fruits and vegetables in the Palestinian population. Our findings highlight differences in OP pesticide exposure in populations with close geographical proximity but with differences in culture, diet, lifestyle, and regulatory oversight of pesticides.
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Affiliation(s)
- Ziad Abdeen
- a Al-Quds Nutrition and Health Research Institute , Al-Quds University , Jerusalem , Palestine
| | - Tamar Berman
- b Public Health Services , Ministry of Health , Jerusalem , Israel
| | - Kifaya Azmi
- a Al-Quds Nutrition and Health Research Institute , Al-Quds University , Jerusalem , Palestine
| | - Rania Abu Seir
- a Al-Quds Nutrition and Health Research Institute , Al-Quds University , Jerusalem , Palestine
| | - Hazem Agha
- a Al-Quds Nutrition and Health Research Institute , Al-Quds University , Jerusalem , Palestine
| | - Eliana Ein-Mor
- c The Hebrew University-Hadassah School of Public Health , Jerusalem , Israel
| | - Thomas Göen
- d Institute and Outpatient Clinic of Occupational, Social and Environmental Medicine , Friedrich-Alexander-Universität Erlangen-Nürnberg , Germany
| | - Yael Stein
- c The Hebrew University-Hadassah School of Public Health , Jerusalem , Israel
| | - Elihu Richter
- c The Hebrew University-Hadassah School of Public Health , Jerusalem , Israel
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