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Findler M, Perzon O, Almoznino G, Zini A, Sharav Y, Czerninski R, Aframian DJ, Haviv Y. Unveiling denture-induced oral lesions: A comprehensive study on classification and pain assessment. J Oral Rehabil 2024; 51:931-937. [PMID: 38356185 DOI: 10.1111/joor.13664] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 01/15/2024] [Accepted: 02/05/2024] [Indexed: 02/16/2024]
Abstract
BACKGROUND Denture-induced oral Lesions (DIOLs) often manifests shortly after the placement or adjustment of new or realigned dentures, frequently resulting in severe pain and discomfort. OBJECTIVES This study aimed to classify DIOLs placing a particular emphasis on assessing the associated pain. METHODS A prospective case study was conducted involving 126 patients who were fitted with a total of 193 dentures of various types at the Hadassah School of Dental Medicine. All patients underwent comprehensive intra-oral examinations within 1-8 weeks following denture delivery, completed symptom questionnaires and had their medical records reviewed. Key variables documented included age, gender, overall health status, denture type, and a detailed description of the DIOLs. The description encompassed factors such as lesion location, shape, colour, size, border characteristics, ulcerative appearance, membrane coverage, 3D morphology (elevated, immersed and flat) and patient-reported Verbal Pain Score (VPS) when touching the DIOLs, when wearing the denture, and when not wearing the denture. RESULTS Notably, 25.4% of denture wearers required no adjustments, while 14.4% necessitated more than three revisions. A majority (71.8%) of DIOLs cases were associated with mandibular complete dentures, primarily situated on the alveolar ridge. The mean VPS indicated a pain intensity of 7 ± 2.1, with temporary dentures in both jaws causing the most discomfort. Implant-supported overdentures were particularly painful when placed in the mandible. Additionally, VPS scores were higher among older individuals and those with prior prosthetic experiences. A significant correlation was observed between pain intensity and presence of chronic health condition (0.036). CONCLUSIONS This study revealed distinct characteristics of DIOLs and highlighted the multifactorial nature of pain experienced following the development of DIOLs. Insights into the influence of patient and denture characteristics on DIOLs and pain intensity can guide healthcare professionals in optimising patient comfort and satisfaction.
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Affiliation(s)
- M Findler
- Oral Medicine Unit, Sheba Medical Center, Tel HaShomer, Israel
| | - O Perzon
- In Partial Fulfillment of DMD Requirements, Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel
- Department of Endodontics, Hadassah Medical Center, Jerusalem, Israel
| | - G Almoznino
- Department of Endodontics, Hadassah Medical Center, Jerusalem, Israel
- Department of Oral Medicine, Sedation and Imaging, Faculty of Dental Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
- Big Biomedical Data Research Laboratory, Faculty of Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | - A Zini
- The Laboratory of Epidemiology and Clinical Studies in Oral Health, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Y Sharav
- Department of Oral Medicine, Sedation and Imaging, Faculty of Dental Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | - R Czerninski
- Department of Oral Medicine, Sedation and Imaging, Faculty of Dental Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | - D J Aframian
- Department of Oral Medicine, Sedation and Imaging, Faculty of Dental Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Y Haviv
- Department of Oral Medicine, Sedation and Imaging, Faculty of Dental Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
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Aharon A, Benedek G, Barhoum B, Parnasa E, Magadle N, Perzon O, Mevorach D. HLA binding-groove motifs are associated with myocarditis induction after Pfizer-BioNTech BNT162b2 vaccination. Eur J Clin Invest 2024; 54:e14142. [PMID: 38071404 DOI: 10.1111/eci.14142] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 11/16/2023] [Accepted: 11/25/2023] [Indexed: 03/13/2024]
Abstract
BACKGROUND AND AIMS We found a higher incidence of myocarditis in young males who had received at least two Pfizer-BioNTech BNT162b2 vaccinations. The human leukocyte antigens (HLA) are known to play an important role in infectious and autoinflammatory diseases. We hypothesized that certain HLA alleles might be associated with vaccination-induced myocarditis. METHODS HLA typing was performed using next-generation sequencing technology with the Illumina Iseq100 platform. HLA class I and II loci were genotyped in 29 patients with post-vaccination myocarditis and compared with HLA data from 300 healthy controls. RESULTS We demonstrate that the DRB1*14:01, DRB1*15:03 alleles and the motifs in HLA-A - Leu62 and Gln63, which are part of binding pocket B and HLA-DR Tyr47, His60, Arg70 and Glu74, which are part of binding pockets P4, P7 and P9, were significantly associated with disease susceptibility. CONCLUSIONS Our findings suggest that immunogenetic fingerprints in HLA peptide-binding grooves may affect the presentation of peptides derived from the Pfizer-BioNTech BNT162b2 vaccination to T cells and induce an inflammatory process that results in myocarditis.
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Affiliation(s)
- Aviran Aharon
- Hebrew University-Hadassah Faculty of Medicine, Jerusalem, Israel
| | - Gil Benedek
- Hebrew University-Hadassah Faculty of Medicine, Jerusalem, Israel
- Tissue Typing and Immunogenetics Unit, Department of Genetics, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Barhoum Barhoum
- Institute of Rheumatology-Immunology-Allergology and the Wohl Institute for Translational Medicine, Department of Medicine, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Elchanan Parnasa
- Institute of Rheumatology-Immunology-Allergology and the Wohl Institute for Translational Medicine, Department of Medicine, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Nur Magadle
- Institute of Rheumatology-Immunology-Allergology and the Wohl Institute for Translational Medicine, Department of Medicine, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Ofer Perzon
- Institute of Rheumatology-Immunology-Allergology and the Wohl Institute for Translational Medicine, Department of Medicine, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Dror Mevorach
- Hebrew University-Hadassah Faculty of Medicine, Jerusalem, Israel
- Institute of Rheumatology-Immunology-Allergology and the Wohl Institute for Translational Medicine, Department of Medicine, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
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Maman O, Ahmad WA, Perzon O, Mahlab-Guri K, Elbirt D, Elinav H. The effect of a treatment switch to integrase Strand transfer inhibitor-based regimens on weight gain and other metabolic syndrome-related conditions. BMC Infect Dis 2024; 24:221. [PMID: 38373940 PMCID: PMC10877751 DOI: 10.1186/s12879-024-09120-7] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Accepted: 02/09/2024] [Indexed: 02/21/2024] Open
Abstract
OBJECTIVE This study aimed to assess weight gain associated with treatment switching to INSTI-based regimens in people living with HIV (PLWH) and to determine whether it is accompanied by worsening features of hypertension, dyslipidemia, or hyperglycemia. METHODS In this two-center retrospective observational study, we assessed weight gain and metabolic features in PLWH who switched to an INSTI-based regimen (study group) as compared to patients who remained on a non-INSTI regimen (control group) over a 24-month follow-up period. RESULTS One-hundred seventy-four PLWH were included in the study group, and 175 were included in the control group. The study group gained 2.51 kg ± 0.31 (mean ± standard deviation) over the 2 years of follow-up, while the control group gained 1.1 ± 0.31 kg over the same time course (p < 0.001). INSTI treatment, Caucasian origin, and lower BMI were risk factors associated with excessive weight gain during the 2 years of follow-up. Among metabolic parameters, only glucose levels increased after initiating INSTI-based regimens, although limited to males of African origin (p = 0.009). CONCLUSIONS We observed a mild weight gain after switching to INSTI-based regimens, with no major impact on metabolic parameters over 2 years of follow-up. Longer follow-up might be needed to observe the adverse metabolic effects of INSTI-based regimens. The impact on weight gain should be discussed with every patient before the treatment switch to ensure a balanced diet and physical activity to prevent excessive weight gain that might hamper compliance with ART.
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Affiliation(s)
- Omer Maman
- Medical School, Hebrew University, Jerusalem, Israel
- Imaging division, Radiology department, Sourasky medical center-Ichilov, Tel Aviv, Israel
| | - Wiessam Abu Ahmad
- Braun School of Public Health and Community Medicine, Hebrew University, Jerusalem, Israel
| | - Ofer Perzon
- Internal medicine ward B, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Keren Mahlab-Guri
- Department of Allergy, Immunology and HIV, Kaplan Medical Center, Rehovot, Israel
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Daniel Elbirt
- Department of Allergy, Immunology and HIV, Kaplan Medical Center, Rehovot, Israel
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Hila Elinav
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
- Hadassah AIDS Center, Department of Microbiology and Infectious Diseases, Hadassah Hebrew University Medical Center, Jerusalem, Israel.
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Canavati C, Siam A, Labes S, Trabelsi N, Regev E, Parnasa E, Barhoum B, Magadle N, Perzon O, Braun M, Mor-Shaked H, Schueler-Furman O, Tabach Y, Mevorach D. Pathogenic Variants of Scavenger Receptor CD36 Lead to Decreased Efferocytosis and Predispose to Myocarditis Following Vaccination With Pfizer-BioNTech BNT162b2 Against Coronavirus Infection (COVID-19). Circulation 2024; 149:270-273. [PMID: 38227712 DOI: 10.1161/circulationaha.123.064884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Affiliation(s)
- Christina Canavati
- Department of Developmental Biology and Cancer Research, Institute for Medical Research Israel-Canada (C.C., S.L., M.B., Y.T.), Jerusalem, Israel
- Hebrew University-Hadassah Faculty of Medicine (C.C., S.L., H.M.-S., Y.T., D.M.), Jerusalem, Israel
| | - Ahmad Siam
- The Wohl Institute for Translational Medicine (A.S., E.R., E.P., B.B., N.M., O.P., D.M.)., Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Sapir Labes
- Department of Developmental Biology and Cancer Research, Institute for Medical Research Israel-Canada (C.C., S.L., M.B., Y.T.), Jerusalem, Israel
- Hebrew University-Hadassah Faculty of Medicine (C.C., S.L., H.M.-S., Y.T., D.M.), Jerusalem, Israel
| | - Nirit Trabelsi
- Department of Microbiology and Molecular Genetics, IMRIC (N.T., O.S.F.), Jerusalem, Israel
| | - Eshcar Regev
- The Wohl Institute for Translational Medicine (A.S., E.R., E.P., B.B., N.M., O.P., D.M.)., Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Elchanan Parnasa
- The Wohl Institute for Translational Medicine (A.S., E.R., E.P., B.B., N.M., O.P., D.M.)., Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Barhoum Barhoum
- The Wohl Institute for Translational Medicine (A.S., E.R., E.P., B.B., N.M., O.P., D.M.)., Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Nur Magadle
- The Wohl Institute for Translational Medicine (A.S., E.R., E.P., B.B., N.M., O.P., D.M.)., Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Ofer Perzon
- The Wohl Institute for Translational Medicine (A.S., E.R., E.P., B.B., N.M., O.P., D.M.)., Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Maya Braun
- Department of Developmental Biology and Cancer Research, Institute for Medical Research Israel-Canada (C.C., S.L., M.B., Y.T.), Jerusalem, Israel
| | - Hagar Mor-Shaked
- Hebrew University-Hadassah Faculty of Medicine (C.C., S.L., H.M.-S., Y.T., D.M.), Jerusalem, Israel
- Department of Genetics, Hadassah Medical Center, Jerusalem, Israel (H.M.-S.)
| | - Ora Schueler-Furman
- Department of Microbiology and Molecular Genetics, IMRIC (N.T., O.S.F.), Jerusalem, Israel
| | - Yuval Tabach
- Department of Developmental Biology and Cancer Research, Institute for Medical Research Israel-Canada (C.C., S.L., M.B., Y.T.), Jerusalem, Israel
- Hebrew University-Hadassah Faculty of Medicine (C.C., S.L., H.M.-S., Y.T., D.M.), Jerusalem, Israel
| | - Dror Mevorach
- Hebrew University-Hadassah Faculty of Medicine (C.C., S.L., H.M.-S., Y.T., D.M.), Jerusalem, Israel
- The Wohl Institute for Translational Medicine (A.S., E.R., E.P., B.B., N.M., O.P., D.M.)., Hadassah-Hebrew University Medical Center, Jerusalem, Israel
- Institute of Rheumatology-Immunology-Allergology and Department of Medicine (D.M.), Hadassah-Hebrew University Medical Center, Jerusalem, Israel
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Perzon O, Cahn A, Gellman YN, Leibovitch M, Peled S, Elishoov O, Haze A, Olshtain-Pops K, Elinav H. Enterococci in Diabetic Foot Infections: Prevalence, Clinical Characteristics, and Outcomes. Open Forum Infect Dis 2023; 10:ofad238. [PMID: 37234514 PMCID: PMC10205551 DOI: 10.1093/ofid/ofad238] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 04/28/2023] [Indexed: 05/28/2023] Open
Abstract
Background Diabetic foot infections (DFIs) are frequently polymicrobial, yet the relevance of each isolated pathogen, remains ill-defined. Specifically, the prevalence and pathogenicity of enterococcal DFIs and the impact of targeted antienterococcal treatment remain elusive. Methods We collected demographic, clinical, and outcome-related data on patients admitted with DFIs to the Hadassah Medical Center diabetic foot unit between 2014 and 2019. The primary outcome was a composite of in-hospital death or major amputation. Secondary outcomes included any amputation, major amputation, length of stay (LOS), and 1-year major amputation or mortality rate. Results Enterococci were isolated in 35% of 537 eligible DFI case patients, who were notable for a higher prevalence of peripheral vascular disease, increased levels of C-reactive protein, and higher Wagner scores. Infection in enterococci-positive individuals was mostly polymicrobial (96.8% vs 61.0% in non-enterococci-infected patients; P < .001). Enterococci-infected patients were more likely to undergo amputation (72.3% vs 50.1%; P < .001) and had longer hospital stays (median LOS, 22.5 vs 17 days; P < .001), but the primary end point of major amputation or in-hospital death did not differ between groups (25.5% vs 21.0%; P = .26). Appropriate antienterococcal antibiotics were used in 78.1% of enterococci-infected patients and, compared with results in untreated patients, were associated with a trend toward a lower rate of major amputations (20.4% vs 34.1%; P = .06) but longer hospitalization (median LOS, 24 vs 18 days; P = .07). Conclusions Enterococci are common in DFIs and associated with higher rates of amputation and longer hospitalization. A reduction in major amputation rates with appropriate enterococci treatment is suggested retrospectively, meriting validation by future prospective studies.
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Affiliation(s)
- Ofer Perzon
- Correspondence: Ofer Perzon, MD, Internal Medicine B Department, Hadassah Hebrew University Medical Center and Hebrew University of Jerusalem, PO Box 12271, Ein Kerem, Jerusalem 9112102, Israel ()
| | | | - Yechiel N Gellman
- Diabetic Foot Unit, Department of Orthopedics, Hadassah Hebrew University Medical Center, Ein Kerem, Jerusalem, Israel
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Michal Leibovitch
- Department of Military Medicine and “Tzameret,” Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
- Medical Corps, Israel Defense Forces, Israel
| | - Shahar Peled
- Department of Military Medicine and “Tzameret,” Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
- Medical Corps, Israel Defense Forces, Israel
| | - Ofer Elishoov
- Diabetic Foot Unit, Department of Orthopedics, Hadassah Hebrew University Medical Center, Ein Kerem, Jerusalem, Israel
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Amir Haze
- Diabetic Foot Unit, Department of Orthopedics, Hadassah Hebrew University Medical Center, Ein Kerem, Jerusalem, Israel
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
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Parnasa E, Perzon O, Klinger A, Ezkoria T, Fischer M. Glucose-6-Phosphate Dehydrogenase Deficiency and COVID-19 Mortality, ICU Admission, and Length of Hospitalization. Isr Med Assoc J 2023; 25:88-90. [PMID: 36841974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has severe consequences in terms of mortality and morbidity. Knowledge of factors that impact COVID-19 may be useful in the search for treatments. OBJECTIVES To determine the effect of glucose-6-phosphate dehydrogenase (G6PD) deficiency on morbidly and mortality associated with COVID-19. METHODS All patients admitted to Hadassah Hebrew University Medical Center between 01 March 2020 and 03 May 2021 with a diagnosis of COVID-19 were included. We retrospectively retrieved demographic, clinical, and laboratory data from the hospital's electronic medical records. The main outcomes were mortality, intensive care unit (ICU) admission, and severity of COVID-19. RESULTS The presence of G6PD deficiency emerged as an independent protective predictor for ICU admission (odds ratio [OR] 0.258, 95% confidence interval [95%CI] 0.077-0.619, P = 0.003) and the development of critical illness (OR 0.121, 95%CI 0.005-0.545, P = 0.006). Moreover, patients with G6PD deficiency had a trend toward lower mortality rates that did not reach statistical significance (OR 0.541, 95%CI 0.225-1.088, P = 0.10). CONCLUSIONS Patients with G6PD deficiency were less likely to have a severe disease, had lower rates of ICU admission, and trended toward lower mortality rates.
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Affiliation(s)
- Elchanan Parnasa
- Department of Internal Medicine, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Israel
| | - Ofer Perzon
- Department of Internal Medicine, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Israel
| | - Aviad Klinger
- Unit of Data Analysis, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Israel
| | - Tehila Ezkoria
- Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Israel
| | - Matan Fischer
- Department of Internal Medicine, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Israel
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Perzon O, Kenig A, Fellig Y, Mevorach D. Use of Colchicine for Pericardial Inflammation: Risks and Toxicities-A Cautionary Tale. JACC Case Rep 2022; 4:1449-1452. [PMID: 36388708 PMCID: PMC9663985 DOI: 10.1016/j.jaccas.2022.08.027] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 08/11/2022] [Accepted: 08/17/2022] [Indexed: 06/16/2023]
Abstract
Colchicine is commonly used as part of the treatment of acute and recurrent pericarditis. Neuromyopathy is a well-known, but probably underreported, side effect of colchicine. Here we present a unique case of a 56-year-old woman with recurrent episodes of colchicine-induced neuromyopathy over many years. (Level of Difficulty: Beginner.).
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Affiliation(s)
- Ofer Perzon
- Department of Internal Medicine, Hadassah Hebrew University Medical Center, Jerusalem, Israel
- Faculty of Medicine, Hebrew University, Jerusalem, Israel
| | - Ariel Kenig
- Department of Internal Medicine, Hadassah Hebrew University Medical Center, Jerusalem, Israel
- Faculty of Medicine, Hebrew University, Jerusalem, Israel
| | - Yakov Fellig
- Faculty of Medicine, Hebrew University, Jerusalem, Israel
- Department of Pathology, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Dror Mevorach
- Faculty of Medicine, Hebrew University, Jerusalem, Israel
- Institute of Rheumatology-Immunology-Allergology and the Wohl Institute for Translational Medicine, Department of Medicine, Hadassah Medical Center, Jerusalem, Israel
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Gorin K, Cahn A, Leibovitch M, Peled S, Perzon O, Tzukert K, Haze A, Elishoov O, Olshtain‐Pops K, Gelman YN. Acute diabetic foot in post kidney transplantation patients receiving chronic immunosuppression-clinical presentation and outcomes. Diabetes Metab Res Rev 2022; 38:e3575. [PMID: 36036940 PMCID: PMC9788065 DOI: 10.1002/dmrr.3575] [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: 03/21/2022] [Revised: 06/22/2022] [Accepted: 07/27/2022] [Indexed: 12/30/2022]
Abstract
AIMS Data regarding diabetic foot ulcers in patients after solid organ transplantation, particularly kidney transplantation, are limited. Chronic immunosuppression may be associated with impaired wound healing and a higher risk of amputations. In this study, we characterised the clinical presentation and outcomes of patients after kidney transplantation admitted to the diabetic foot unit, compared to non-kidney-transplant patients. MATERIALS AND METHODS Data on the baseline characteristics, clinical presentation, and outcomes of all patients admitted to the diabetic foot unit of a large tertiary centre between the years 2014 and 2019 were collected. The most recent admission of each patient was considered. Primary outcomes were major amputations and 1 year mortality rate. RESULTS During the study period, 537 patients were hospitalised, 18 of them were receiving immunosuppressive therapy due to kidney transplantation. Baseline characteristics of the patients were broadly similar, except that smoking was reported by 22.0% of the non-transplant patients and by none of the post-transplant patients (p = 0.01). Post-transplant patients tended to be younger (59.4 ± 11.1 vs. 65.3 ± 12.2; p = 0.07), were more likely to have type-1 diabetes (16.7% vs. 5.2%; p = 0.07) and had lower glucose levels upon admission (9.4 ± 4.3 vs. 12.0 ± 6.4 mmol/L; p = 0.07). Overall, 30% of the patients underwent major amputation, in-patient mortality rate was 9.3%, and 1 year mortality rate was 27.2%. Rates were similar in the post-transplant versus the non-post-transplant patients (p = 0.83, 1.00, 0.59, respectively). CONCLUSIONS Post-transplant patients did not incur worse outcomes in spite of immunosuppressive therapy. Limb salvage efforts should be pursued in these patients similar to the overall population.
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Affiliation(s)
- Kobi Gorin
- Internal Medicine DivisionHadassah‐Hebrew University Medical CenterJerusalemIsrael
- The Faculty of MedicineHebrew UniversityJerusalemIsrael
| | - Avivit Cahn
- The Faculty of MedicineHebrew UniversityJerusalemIsrael
- Department of Endocrinology and MetabolismDiabetes UnitHadassah‐Hebrew University Medical CenterJerusalemIsrael
| | - Michal Leibovitch
- The Faculty of MedicineHebrew UniversityJerusalemIsrael
- Department of Military Medicine and ‘Tzameret’Medical CorpsIsrael Defense ForcesJerusalemIsrael
| | - Shachar Peled
- The Faculty of MedicineHebrew UniversityJerusalemIsrael
| | - Ofer Perzon
- Internal Medicine DivisionHadassah‐Hebrew University Medical CenterJerusalemIsrael
- The Faculty of MedicineHebrew UniversityJerusalemIsrael
| | - Keren Tzukert
- The Faculty of MedicineHebrew UniversityJerusalemIsrael
- Department of Nephrology and HypertensionHadassah‐Hebrew University Medical CenterJerusalemIsrael
| | - Amir Haze
- The Faculty of MedicineHebrew UniversityJerusalemIsrael
- Orthopedic DivisionFoot and Ankle UnitHadassah‐Hebrew University Medical CenterJerusalemIsrael
| | - Ofer Elishoov
- Orthopedic DivisionFoot and Ankle UnitHadassah‐Hebrew University Medical CenterJerusalemIsrael
| | - Karen Olshtain‐Pops
- The Faculty of MedicineHebrew UniversityJerusalemIsrael
- Division of Microbiology and Infectious DiseasesHadassah‐Hebrew University Medical CenterJerusalemIsrael
| | - Yechiel Nisan Gelman
- The Faculty of MedicineHebrew UniversityJerusalemIsrael
- Orthopedic DivisionFoot and Ankle UnitHadassah‐Hebrew University Medical CenterJerusalemIsrael
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9
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Mevorach D, Anis E, Cedar N, Hasin T, Bromberg M, Goldberg L, Levi N, Perzon O, Magadle N, Barhoum B, Parnassa E, Dichtiar R, Hershkovitz Y, Green MS, Ash N, Keinan-Boker L, Alroy-Preis S. Myocarditis After BNT162b2 COVID-19 Third Booster Vaccine in Israel. Circulation 2022; 146:802-804. [PMID: 36067275 PMCID: PMC9439627 DOI: 10.1161/circulationaha.122.060961] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
- Dror Mevorach
- Pnimit B & Division of Rheumatology-Immunology-Allergology and the Wohl Institute for Translational Medicine, Department of Medicine, Hadassah Medical Center, Jerusalem, Israel (D.M., O.P., N.M., B.B., E.P.).,Faculty of Medicine, Hebrew University, Jerusalem, Israel (D.M., E.A., T.H.)
| | - Emilia Anis
- Faculty of Medicine, Hebrew University, Jerusalem, Israel (D.M., E.A., T.H.).,Division of Epidemiology, Israeli Ministry of Health, Jerusalem (E.A., N.C., L.G.).,Braun School of Public Health, Jerusalem, Israel (E.A., N.C., L.G.)
| | - Noa Cedar
- Division of Epidemiology, Israeli Ministry of Health, Jerusalem (E.A., N.C., L.G.).,Braun School of Public Health, Jerusalem, Israel (E.A., N.C., L.G.)
| | - Tal Hasin
- Faculty of Medicine, Hebrew University, Jerusalem, Israel (D.M., E.A., T.H.).,Jesselson Integrated Heart Center, Shaare Zedek Medical Center, Jerusalem, Israel (T.H., N.L.)
| | - Michal Bromberg
- Israel Center for Disease Control, Ministry of Health, Ramat Gan, Israel (M.B., R.D., Y.H., L.K.-B.).,Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Israel (M.B.)
| | - Lital Goldberg
- Division of Epidemiology, Israeli Ministry of Health, Jerusalem (E.A., N.C., L.G.).,Braun School of Public Health, Jerusalem, Israel (E.A., N.C., L.G.).,Clalit Health Services, Tel Aviv, Israel (L.G.)
| | - Nir Levi
- Jesselson Integrated Heart Center, Shaare Zedek Medical Center, Jerusalem, Israel (T.H., N.L.)
| | - Ofer Perzon
- Pnimit B & Division of Rheumatology-Immunology-Allergology and the Wohl Institute for Translational Medicine, Department of Medicine, Hadassah Medical Center, Jerusalem, Israel (D.M., O.P., N.M., B.B., E.P.)
| | - Nur Magadle
- Pnimit B & Division of Rheumatology-Immunology-Allergology and the Wohl Institute for Translational Medicine, Department of Medicine, Hadassah Medical Center, Jerusalem, Israel (D.M., O.P., N.M., B.B., E.P.)
| | - Barhoum Barhoum
- Pnimit B & Division of Rheumatology-Immunology-Allergology and the Wohl Institute for Translational Medicine, Department of Medicine, Hadassah Medical Center, Jerusalem, Israel (D.M., O.P., N.M., B.B., E.P.)
| | - Elchanan Parnassa
- Pnimit B & Division of Rheumatology-Immunology-Allergology and the Wohl Institute for Translational Medicine, Department of Medicine, Hadassah Medical Center, Jerusalem, Israel (D.M., O.P., N.M., B.B., E.P.)
| | - Rita Dichtiar
- Israel Center for Disease Control, Ministry of Health, Ramat Gan, Israel (M.B., R.D., Y.H., L.K.-B.)
| | - Yael Hershkovitz
- Israel Center for Disease Control, Ministry of Health, Ramat Gan, Israel (M.B., R.D., Y.H., L.K.-B.)
| | - Manfred S. Green
- School of Public Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Israel (M.S.G., L.K.-B.)
| | - Nachman Ash
- Department of Health Management, Ariel University, Jerusalem, Israel (N.A.).,Israeli Ministry of Health, Jerusalem (N.A., S.A.-P.)
| | - Lital Keinan-Boker
- Israel Center for Disease Control, Ministry of Health, Ramat Gan, Israel (M.B., R.D., Y.H., L.K.-B.).,School of Public Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Israel (M.S.G., L.K.-B.)
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Affiliation(s)
- Ofer Perzon
- Hadassah Hebrew University Medical Center, Jerusalem, Israel.
| | - Hila Elinav
- Hadassah Hebrew University Medical Center, Jerusalem, Israel
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11
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Kenig A, Perzon O, Tal Y, Sviri S, Abutbul A, Romain M, Orenbuch-Harroch E, Elefant N, Talmon A. An Adult with Recurrent Severe Pneumococcal Pneumonia Secondary to Prolidase Deficiency. Isr Med Assoc J 2021; 23:193-195. [PMID: 33734635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Affiliation(s)
- Ariel Kenig
- Department of Medicine, Hadassah-Hebrew University Medical Center, Ein Kerem Campus, Jerusalem, Israel
| | - Ofer Perzon
- Department of Medicine, Hadassah-Hebrew University Medical Center, Ein Kerem Campus, Jerusalem, Israel
| | - Yuval Tal
- Clinical Immunology and Allergy Unit, Hadassah-Hebrew University Medical Center, Ein Kerem Campus, Jerusalem, Israel
| | - Sigal Sviri
- Medical Intensive Care Unit, Hadassah-Hebrew University Medical Center, Ein Kerem Campus, Jerusalem, Israel
| | - Avi Abutbul
- Medical Intensive Care Unit, Hadassah-Hebrew University Medical Center, Ein Kerem Campus, Jerusalem, Israel
| | - Marc Romain
- Medical Intensive Care Unit, Hadassah-Hebrew University Medical Center, Ein Kerem Campus, Jerusalem, Israel
| | - Efrat Orenbuch-Harroch
- Medical Intensive Care Unit, Hadassah-Hebrew University Medical Center, Ein Kerem Campus, Jerusalem, Israel
| | - Naama Elefant
- Department of Genetics, Hadassah-Hebrew University Medical Center, Ein Kerem Campus, Jerusalem, Israel
| | - Aviv Talmon
- Clinical Immunology and Allergy Unit, Hadassah-Hebrew University Medical Center, Ein Kerem Campus, Jerusalem, Israel
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