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Shraga S, Grinshpun A, Kadouri L, Zick A, Maimon O, Sella T, Adler-Levy Y, Zeltzer G, Granit A, Maly B, Carmon E, Meiner V, Hamburger T, Peretz T. Breast screening in BRCA1/2 carriers leads to earlier detection and superior therapy of breast cancers. Breast 2021. [DOI: 10.1016/s0960-9776(21)00130-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Portal D, Hofstetter L, Eshed I, Dan-Lantsman C, Sella T, Urban D, Onn A, Bar J, Segal G. L3 skeletal muscle index (L3SMI) is a surrogate marker of sarcopenia and frailty in non-small cell lung cancer patients. Cancer Manag Res 2019; 11:2579-2588. [PMID: 31114324 PMCID: PMC6497853 DOI: 10.2147/cmar.s195869] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [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: 11/24/2018] [Accepted: 02/23/2019] [Indexed: 12/20/2022] Open
Abstract
Background: Non-small cell lung cancer (NSCLC) is a common and highly lethal disease. As advanced treatment modalities are being developed, improved prognostication methods are sought. L3 skeletal muscle index (L3SMI) and alanine aminotransferase (ALT) levels are accepted surrogate markers of sarcopenia and related frailty. We aimed to evaluate the potential association of these markers with NSCLC patients’ survival. Methods: A retrospective, single-center study of an NSCLC patients’ cohort. L3SMI was calculated based on skeletal muscle area on computed tomography scans at the level of the L3 vertebra. Clinical data were extracted from clinical charts. Results: A total of 140 patients (56.4% males, median age 66 [range 37–86]) were included in this study, 32% were diagnosed at stage 3 and 45% at stage 4. During the follow-up duration (median of 1.9 years; range 1 month to 6.4 years), 102 patients (72.8%) died. Patients’ characteristics that were found to be associated with increased mortality were performance status, albumin and tumor stage at diagnosis. Sarcopenia, defined as low L3SMI (lower than 41 cm2/m2 for women and lower than 53 cm2/m2 for men) was significantly associated with higher risk of mortality compared with patients with normal L3SMI values (77.2%, vs 64.6%, p=0.013) in univariate analysis, but not in a multiple regression analysis. Conclusion: Low L3SMI could serve as a surrogate marker for sarcopenia and frailty and, as such, facilitate the prognostication process of NSCLC patients.
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Affiliation(s)
- D Portal
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - L Hofstetter
- Department of Internal Medicine 'T', Chaim Sheba Medical Center, affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - I Eshed
- Department of Diagnostic Imaging, Chaim Sheba Medical Center, affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - C Dan-Lantsman
- Department of Diagnostic Imaging, Chaim Sheba Medical Center, affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - T Sella
- The Dr. Pinchas Borenstein Talpiot Medical Leadership Program, Sheba Medical Center, Ramat Gan, Israel.,Institute of Oncology, Chaim Sheba Medical Center, affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - D Urban
- Institute of Oncology, Chaim Sheba Medical Center, affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - A Onn
- Institute of Oncology, Chaim Sheba Medical Center, affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel.,Institute of Pulmonary Medicine, Chaim Sheba Medical Center, affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - J Bar
- Institute of Oncology, Chaim Sheba Medical Center, affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - G Segal
- Department of Internal Medicine 'T', Chaim Sheba Medical Center, affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
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Sella T, Ackerstein A, Halperin S, Hout-Siloni G, Lieberman S, Barshack I, Nechushatan H, Berger R, Bar J, Onn A. P3.03-028 WINTHER – a Study of Cancer Therapy Based on Tumor and Normal-Matched Biopsies – the Sheba Medical Center Lung Cancer Experience. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Sella A, Kovel S, Sella T. PSA kinetics impact on CT-PET PSMA uptake in prostate cancer. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx370.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Sella T, Goren I, Shalev V, Shapira H, Zandbank J, Rosenblum J, Kimlin M, Chodick G. Incidence trends of keratinocytic skin cancers and melanoma in Israel 2006-11. Br J Dermatol 2014; 172:202-7. [DOI: 10.1111/bjd.13213] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2014] [Indexed: 11/28/2022]
Affiliation(s)
- T. Sella
- Medical Division; Maccabi Healthcare Services; Tel Aviv Israel
- Department of Oncology; Sheba Medical Center; Tel Hashomer Israel
| | - I. Goren
- Medical Division; Maccabi Healthcare Services; Tel Aviv Israel
| | - V. Shalev
- Medical Division; Maccabi Healthcare Services; Tel Aviv Israel
- Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
| | - H. Shapira
- Pathology Laboratory; Maccabi Healthcare Services; Tel Aviv Israel
| | - J. Zandbank
- Pathology Laboratory; Maccabi Healthcare Services; Tel Aviv Israel
| | - J. Rosenblum
- Medical Division; Maccabi Healthcare Services; Tel Aviv Israel
| | - M.G. Kimlin
- AusSun Research Laboratory; Institute of Health and Biomedical Innovation,Queensland University of Technology; Brisbane Qld Australia
| | - G. Chodick
- Medical Division; Maccabi Healthcare Services; Tel Aviv Israel
- Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
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Sella A, Sella T, Kovel S. The Effect of Neutrophil to Lymphocyte Ratio (NLR) Prior to Taxotere-Based Chemotherapy in Patients (PT'S) with Metastatic Castration Resistant Prostate Cancer (MCRPC). Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)33511-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Sella T, Chodick G, Lunenfeld E, Shalev V. Further evidence on the high prevalence of male factor infertility diagnosis in Israel. Isr Med Assoc J 2011; 13:386. [PMID: 21809743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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Sella T, Chodick G, Barchana M, Heymann AD, Porath A, Kokia E, Shalev V. Gestational diabetes and risk of incident primary cancer: A large population-based cohort study in Israel. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.1538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Sella T, Shoshan A, Goren I, Shalev V, Blumenfeld O, Laron Z, Chodick G. A retrospective study of the incidence of diagnosed Type 1 diabetes among children and adolescents in a large health organization in Israel, 2000-2008. Diabet Med 2011; 28:48-53. [PMID: 21166845 DOI: 10.1111/j.1464-5491.2010.03174.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
AIMS To determine the incidence and examine temporal trends of Type 1 diabetes among children aged < 18 years, in a large Israeli health organization. METHODS All incident Type 1 diabetes cases diagnosed between 2000 and 2008 were ascertained from an automated diabetes registry based on members' electronic records and validated by comparison with the Israel Juvenile Diabetes Register. RESULTS During the study period, a total of 648 incident cases of Type 1 diabetes were identified. The average annual age-and-sex-standardized incidence was 11.09 per 100,000 person-years. There was an annual 5.82% (95% CI 1.80-9.98%) rise in incidence, with a greater relative increase in toddlers under 5 years of age. Incidence increased with age and demonstrated seasonal variation. Mean age at onset of diabetes significantly (P = 0.07) decreased from 10.21 years (SD = 4.48) in 2000-2002 to 9.25 years (SD = 4.54) in 2006-2008. Among very young patients (< 5 years), average blood glucose values at diagnosis dropped from 32.4 mmol/l (SD = 9.5) to 19.5 mmol/l (SD = 11.0) over the study period, with little change in average glucose for older children. CONCLUSIONS Incidence of diagnosed Type 1 diabetes continues to increase in Israel at a rate that is high compared with similar American and European populations. At the same time, the clinical presentation of children is changing.
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Affiliation(s)
- T Sella
- Medical Division, Maccabi Healthcare Services Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Abstract
AIMS To determine the incidence of postpartum diabetes mellitus in the years following a diagnosis of gestational diabetes mellitus (GDM) and to determine whether the severity of GDM, represented by the magnitude of the deviation of diagnostic tests from the normal values or requirement for medications, is associated with the development of diabetes. METHODS A retrospective cohort study was performed among 185 416 pregnant women who had glucose challenge test or 3 h oral glucose tolerance test (OGTT) in a large health maintenance organization in Israel. Subsequent diagnosis of diabetes was ascertained by using an automated patient registry. RESULTS A total of 11 270 subjects were diagnosed with GDM, comprising 6.07% of the cohort. During a total follow-up period of 1 049 334 person-years there were 1067 (16.9 per 1000 person-years) and 1125 (1.1 per 1000 person-years) diagnoses of postpartum diabetes among GDM and non-GDM women, respectively. The cumulative risk of incident diabetes in GDM patients with up to 10 years of follow-up was 15.7%, compared with 1% among the non-GDM population. Gestational diabetes mellitus was associated with nearly an eightfold higher risk of postpartum diabetes after adjusting for important confounders, such as socioeconomic status and body mass index. Among women with a history of GDM, the number of abnormal OGTT values and use of insulin were associated with a substantially higher risk for developing diabetes. CONCLUSIONS Three or four abnormal OGTT values and GDM requiring insulin or oral hypoglycaemic medications are important predictors of postpartum diabetes risk in women with a history of GDM.
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Affiliation(s)
- G Chodick
- Medical Division, Maccabi Healthcare Services, 27 Ha'Mered Street, Tel Aviv, Israel.
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Tsirigotis P, Sella T, Shapira MY, Bitan M, Bloom A, Kiselgoff D, Levin M, Libster D, Abdul Hai A, Gesundheit B, Or R, Slavin S, Resnick I. Peliosis hepatis following treatment with androgen-steroids in patients with bone marrow failure syndromes. Haematologica 2007; 92:e106-10. [PMID: 18024386 DOI: 10.3324/haematol.11343] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Androgens widely used in the treatment of bone marrow failure syndromes can in rare cases cause hepatic peliosis, a pathological entity characterized by multiple blood-filled cavities in the liver parenchyma. Bone marrow failure syndromes per se are associated with a low coagulation status, which is further magnified by bone marrow transplantation for aplastic anaemia due to deep thrombocytopenia. Both these conditions can cause bleeding; their combination is especially dangerous. We describe two cases of aplastic anaemia due to paroxysmal nocturnal hemoglobinuria and Fanconi syndrome, in which patients developed peliosis hepatis after prolonged treatment with androgens. One patient developed severe subcapsular bleeding, successfully treated with catheterization of the right hepatic artery and embolization of the bleeding site. The second patient bridged over deep post-transplant aplasia with high frequency platelet transfusions, and demonstrated an uncomplicated post-BMT course. We suggest avoiding or interrupting treatment with androgens in patients preparing for BMT.
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Affiliation(s)
- P Tsirigotis
- Department of Bone Marrow Transplantation & Cancer Immunotherapy, Hadassah University Hospital, Jerusalem, Israel
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Abstract
This review focuses on the detection of extracolonic findings at CT colonography (CTC). Since its introduction, it has been regarded as a promising alternative to conventional colonoscopy for the detection of colorectal polyps and cancers. Unlike conventional colonoscopy and barium enema, CTC allows evaluation not only of the colon but also visualization of the lung bases, the abdomen, and the pelvis. CTC is performed with thin sections (1-5 mm) and small intervals (0.5-2 mm), enabling superb image reconstruction. The ability to evaluate the extracolonic structures can present a clinical dilemma. On the one hand, CTC may incidentally demonstrate asymptomatic malignant diseases or other clinically important conditions, thus possibly reducing morbidity or mortality. On the other hand, CTC may reveal numerous findings of no clinical relevance; this could result in costly additional diagnostic examinations with an increase in morbidity and overall negative impact on patients' health. In this article, extracolonic findings at CTC will be reviewed and the potential benefits and disadvantages will be presented.
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Affiliation(s)
- J Sosna
- Department of Radiology, Hadassah Hebrew University Medical Center, Jerusalem, Israel.
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Abstract
OBJECTIVE The purpose of our study was to examine the role of chest CT scans in routine follow-up of patients who had been treated for ovarian carcinoma. MATERIALS AND METHODS The radiologic follow-up of 127 women with metatastic ovarian carcinoma who had undergone surgery and chemotherapy between 1985 and 1996 was reviewed. In reviewing each patient's medical record, we determined whether a chest CT scan had been obtained, and if so, how many had been obtained during the patient's follow-up period. For patients with a chest CT scan, an analysis of the presence of disease in the thorax and its relation to disease in the abdomen and pelvis, as revealed on CT images, was performed. RESULTS Of the patients whose cases were examined, 82 (65%) had had at least one chest CT scan obtained, with more than 50% having had three or more scans. Thirty-two (39%) patients had no radiologic evidence of disease. Twenty-eight (34%) showed disease in the abdomen or pelvis but no disease in the chest. Eighteen (22%) had both chest and abdominal or pelvic CT scans that indicated disease. In all of these patients, abdominal or pelvic disease had appeared on scans before spreading to the chest. Four (5%) of the patients had isolated chest disease. The rate of lung metastases from ovarian carcinoma in our series was 6%. In all of these patients, pulmonary metastases were preceded either by abdominal or pelvic disease or by a rise in tumor markers. CONCLUSION Pulmonary metastases in ovarian carcinoma are rare and usually preceded by recurrence of carcinoma in the abdomen or pelvis. We suggest that chest CT scanning could be eliminated in the routine follow-up of patients who have been treated for ovarian carcinoma; yet it should be performed for those patients with elevated serum tumor markers but without evidence of abdominal or pelvic disease.
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Affiliation(s)
- T Sella
- Department of Radiology, Hadassah University Hospital, P. O. Box 12227, Jerusalem, Israel, 91121
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Abstract
BACKGROUND The CT appearance of the normal and abnormal thymus and its age-related changes have been described. However, there is no information regarding the change in thymus CT attenuation values in children. OBJECTIVE The aim of the present study was to evaluate the normal CT attenuation of the thymus in infants and children and discover when the decline begins. MATERIALS AND METHODS CT attenuation values of the thymus were retrospectively evaluated in 152 children between ages of 1 day and up to 14 years. For each patient the mean value of the CT thymus attenuation was calculated and compared to CT attenuation of the chest wall and cardiac muscles. We also examined the correlation between thymic attenuation, gender, and disease. The statistical analysis used was multivariate linear regression. RESULTS CT attenuation of the thymus declines with age, beginning only after the 1st year of life. The thymus is more hyperdense than the chest wall and cardiac muscles in infants less than 1 year. The thymus is denser in males than females. In malignant conditions, in infants less than 1 year, thymus CT attenuation is decreased. In older children thymus attenuation was similar to that for the chest wall and cardiac muscles. CONCLUSION The decline in thymic CT attenuation with age is consistent with fatty infiltration of the gland. The measurements given in this report can serve as a basis for comparison to determine whether the thymus of a young child is normal or pathological.
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Affiliation(s)
- M Sklair-Levy
- Department of Radiology, Hadassah University Hospital, Jerusalem, Israel
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Gayer G, Apter S, Jonas T, Amitai M, Zissin R, Sella T, Weiss P, Hertz M. Polysplenia syndrome detected in adulthood: report of eight cases and review of the literature. Abdom Imaging 1999; 24:178-84. [PMID: 10024407 DOI: 10.1007/s002619900471] [Citation(s) in RCA: 70] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND To present the computed tomographic (CT) features of the abdominal anomalies consistent with polysplenia syndrome in adults. Awareness of these abnormalities may avoid misdiagnosing characteristic findings as separate pathological processes. METHODS Imaging studies, mainly abdominal CT scans, of eight patients were reviewed. Attention was directed to the location of the multiple spleens, stomach, and liver and to the possible presence of a short pancreas, malrotation of the intestine, and venous anomalies. We also reviewed the CT findings of 15 adult patients described in the literature. RESULTS Three men and five women underwent CT for various unrelated conditions. The most common findings were multiple spleens along the greater curvature of the stomach, which were located in the right upper quadrant in six patients. The inferior vena cava was seen on the left side in seven subjects, with azygos/hemiazygos continuation in six. A preduodenal portal vein was present in seven subjects. The liver was in the midline in four patients and on the left side in two. A short pancreas was seen in four patients, intestinal nonrotation in five, and dextrocardia in two. The prevalence of these anomalies was similar to that of the reviewed cases. CONCLUSIONS CT proved to be an excellent imaging modality in the diagnosis of the abdominal anomalies. Some of these (a short pancreas, multiple spleens, and azygos continuation) can simulate pathological processes. Hence the importance of recognizing these CT findings as part of a syndrome.
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Affiliation(s)
- G Gayer
- Department of Diagnostic Imaging, The Chaim Sheba Medical Center, Tel Hashomer, Israel
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