Publications by authors named "Naim Abu Freha"

Background: The lifestyle of the Arab population in Israel has changed in the last few decades, and modernization and urbanization have impacted the prevalence of chronic diseases.

Objectives: To investigate the prevalence of chronic diseases in the Arab population compared to the Jewish population in Israel.

Methods: This retrospective study included Arab and Jewish people insured by Israel's largest health maintenance organization.

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Deciphering the spectrum and founder disease-causing variants (DCVs) in specific populations can shape and facilitate the diagnostic process of Lynch Syndrome (LS). The aim of this report was to comprehensively update on the genetic landscape of LS in the ethnically diverse Israeli-Jewish population. The cohort included 1080 carriers from 588 families; some from underrepresented, understudied Israeli ethnic groups recruited from 8 genetic institutes and high-risk clinics throughout the country.

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  • A study investigated sex-based differences in colonoscopy indications and findings by analyzing data from 287,930 colonoscopy procedures performed between 2016 and 2021.
  • Results showed that women were more likely to undergo colonoscopies due to abdominal pain, constipation, diarrhea, and anemia, while men had more procedures related to positive FOBT, rectal bleeding, and surveillance.
  • In terms of findings, men had higher rates of colorectal cancer and polyps, while women had better bowel preparation, underscoring the need for tailored approaches in diagnosing and managing gastrointestinal diseases based on sex.
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Aim: We aimed to investigate the association between Glucagon-like-peptide-1 receptors agonists (GLP1-RA) use and gastric residue on esophagogastroduodenoscopy (EGD).

Methods: A multicenter, retrospective study included all EGDs conducted across seven gastroenterology departments. EGDs with the diagnosis of "poor preparation" or described as a poor preparation in the endoscopist's report were considered as gastric residue.

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  • The study focused on the rising trend of early onset colorectal cancer (EO-CRC) in patients diagnosed between 1999 and 2021, analyzing risk factors compared to late onset colorectal cancer (LO-CRC).
  • Out of 61,679 colorectal cancer patients surveyed, 5,561 were classified as EO-CRC, revealing a significant increase in EO-CRC cases over the past decades and identifying key risk factors such as gender, family history, ethnicity, and smoking status.
  • EO-CRC patients showed lower rates of common comorbidities and had a significantly lower all-cause mortality rate compared to their LO-CRC counterparts, highlighting the need for targeted screening in high-risk groups, including young people with family histories
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  • GLP-1 receptor agonists (GLP-1RAs) slow down gastric emptying and may affect bowel preparation for colonoscopy, but their impact on bowel preparation adequacy was under-studied.
  • A multicenter study compared 4,876 patients using GLP-1RAs with 4,876 matched controls, finding that 10% of GLP-1RA users had inadequate bowel preparation (IBP), compared to just 4% of controls.
  • Results indicated that both diabetes and GLP-1RA usage independently increased the risk of IBP, suggesting that special attention is needed for these patients.
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Background: Hiatal hernia (HH) is a common finding in gastroscopy. The aim of the present study was to investigate the frequency rate of HH among patients who underwent esophagogastroduodenoscopy (EGD) according to their age, gender, and procedural indication.

Methods: A multicenter, retrospective study including all EGDs was conducted across seven endoscopy departments between 2016 and 2021.

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: Terminal ileitis (TI) is often identified on CT scans in emergency settings. Diagnosing Crohn's disease (CD) as a cause of TI is crucial due to its significant long-term implications. This study aimed to differentiate CD from other causes of acute TI and develop a predictive model for CD diagnosis.

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  • Gastrointestinal angiodysplasia (GIAD) is a rare condition, with an overall prevalence of 0.092%, primarily affecting older adults, particularly those aged 71-80, where the prevalence peaks at 0.37%.
  • A study identified significant risk factors for GIAD, including liver cirrhosis, hypertension, and aortic stenosis, along with demographic factors like female gender, and noted that GIADs are less common in patients with malignancies.
  • Understanding the associated clinical conditions and demographics of GIAD can aid in better recognizing its causes and developing effective treatment strategies for this rare gastrointestinal issue.
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The study aimed to explore patients' experiences and perceptions throughout the various stages of endoscopic procedures and examine the association between patient-centered communication and the patient's experience. A total of 191 patients responded to pre- and post-procedure surveys that inquired about fear and pain, patients' satisfaction regarding the information provided to them, perceptions and experience. Pain was associated with post-procedure fear (r = 0.

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  • Non-alcoholic fatty liver disease (NAFLD) is the most prevalent liver disease, and a study compared its impact between Arab and Jewish patients in Israel, analyzing data from over 200,000 individuals.
  • Arab patients with NAFLD were diagnosed at a younger age and presented with higher rates of obesity, diabetes, and severe complications, such as cirrhosis and portal hypertension-related issues, compared to Jewish patients.
  • Despite the higher complication rates, Arab patients demonstrated lower all-cause mortality and slightly higher liver transplantation rates, indicating the need for tailored prevention and treatment strategies based on ethnicity.
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Background: Colorectal cancer (CRC) incidence at ages <50 years is increasing worldwide. Screening initiation was lowered to 45 years in the United States. The cost-effectiveness of initiating CRC screening at 45 years in Israel was assessed with the aim of informing national policy and addressing internationally relevant questions.

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Background: Surveillance of high-risk individuals for pancreatic ductal adenocarcinoma (PDAC) is recommended. This study aimed to determine the prevalence and outcomes of PDAC and its precursor lesions in BRCA1/2 pathogenic variants (PVs) carriers undergoing pancreatic surveillance.

Methods: A retrospective multicenter cohort study of pancreatic surveillance outcomes in Israeli BRCA1/2 carriers preferably with a family history of PDAC.

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  • Dominantly inherited micro-satellite instable (MSI) cancers, linked to mutations in mismatch repair (MMR) genes (MSH2, MLH1, MSH6, PMS2), challenge traditional views of cancer development and are associated with unique syndromes known as Lynch syndromes.
  • Each Lynch syndrome has distinct risks and expressions, and it’s crucial to consider factors like specific gene mutation and sex when studying these cancers.
  • Advances in colonoscopy surveillance, aspirin usage, and immunotherapy represent significant progress in personalized medicine for managing and preventing inherited MSI cancers.
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  • Treatment of chronic hepatitis C (HCV) with direct-acting antivirals (DAAs) can improve liver fibrosis, with 57% of patients showing improvement after at least three years post-treatment.
  • A study of 209 patients revealed that factors like age at treatment and advanced fibrosis stage were significantly linked to the regression of fibrosis.
  • While 71% of patients were treatment-naïve, 28% experienced significant improvement, moving from advanced fibrosis stages (F3/F4) to lower stages (F2 or less).
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Background: Colorectal cancer (CRC) is a feared complication of inflammatory bowel disease (IBD). We aimed to investigate the prevalence and risk factors of CRC among a large cohort of IBD patients.

Methods: Data on IBD patients free of CRC at baseline was extracted using the MDClone platform of the Clalit health maintenance organization in Israel.

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Hepatitis C Virus (HCV) infection is a leading etiology of liver cirrhosis and its associated complications, namely, decompensated cirrhosis. As such, hepatitis C potentially necessitates liver transplantation and may result in death. Recently, HCV treatment has evolved.

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Inflammatory bowel diseases are increasing among different ethnic groups. We aimed to compare the clinical characteristics, complications, and outcomes among Arab and Jewish people sharing the same healthcare system. All patients older than 18 years with a diagnosis of Crohn's disease (CD) or ulcerative colitis (UC) between the years 2000 and 2021 were included.

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(1) Background: Non-alcoholic fatty liver disease (NAFLD) is a common liver disease. Aims: We aimed to investigate the frequency of comorbidities and malignancies among NAFLD patients compared to the general population. (2) Methods: A retrospective study included adult patients with a NAFLD diagnosis.

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  • The Prospective Lynch Syndrome Database (PLSD) gathers data on individuals with MMR variants to study cancer diagnosis and treatment outcomes, focusing on a newly expanded cohort.
  • The study includes over 8,500 patients from 25 countries, analyzing cancer incidence, mortality rates up to age 75, and survival rates after diagnosis.
  • Findings reveal that while gynecological cancers have high incidence rates among carriers, non-colorectal cancers lead to more deaths, highlighting the need for improved care for these patients.
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Background: Autosomal recessive conditions are common in consanguineous populations. Since consanguinity is common in the Israeli Arab population, we evaluated the rate of MUTYH polyposis (MAP) among polyposis patients in this population and studied Pathogenic Variants (PVs) spectrum.

Methods: We reviewed health records of all Arab and Druze polyposis patients referred for counseling during 2013-2020 who fulfilled the Israeli Genetic Society criteria for MUTYH/APC testing, in a tertiary center in Northern Israel and four additional gastro-genetic clinics in Israel.

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(1) Background: Fecal occult blood test (FOBT) is the modality of choice in most countries for colorectal cancer (CRC) screening. We aimed to investigate the risk factors for CRC among patients with a positive FOBT in real life. (2) Methods: This was a retrospective study that included patients who tested positive for FOBT.

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Sex-based medicine is an important emerging discipline within medicine. We investigated the clinical characteristics, complications, and outcomes of Nonalcoholic Fatty Liver Disease (NAFLD) in females compared to males. Demographics, comorbidities, malignancy, complications, outcomes, and all-cause mortality of NAFLD patients older than 18 years were analyzed.

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Background: Since the outbreak of COVID-19, a significant decline in endoscopic procedures has been observed.

Aims: We investigated the change of incidence, clinical characteristics, disease stage and mortality of patients with gastric cancer (GC) or colorectal cancer (CRC) diagnosed in 2020 compared to the pre-pandemic year 2019.

Methods: Demographic, clinical and laboratory data on all patients diagnosed with GC or CRC at the Soroka University Medical Center were retrospectively collected and compared.

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Article Synopsis
  • - The study aims to compare colorectal cancer (CRC) incidences between two groups: one group receiving mandatory colonoscopy surveillance (PLSD) and another group with retrospective data (IMRC) that did not have the same follow-up.
  • - Results from the PLSD showed higher CRC rates in carriers of MMR gene variants, particularly for path_MLH1 and path_MSH2, compared to the IMRC cohort, challenging previous expectations about cancer rates in these groups.
  • - The study concludes that while colonoscopy did reduce CRC incidences in paths_MPS2 carriers prior to age 50, it did not have the same effect for path_MLH1 and path_MSH2, suggesting the need for reevaluation of
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