Publications by authors named "Zohar Levi"
Background: Glucagon-like peptide-1 (GLP-1) receptor agonists delay gastric emptying and are used for the treatment of diabetes (DM) and obesity. Successful treatment of Helicobacter pylori (H. pylori) infection depends upon a precise dosing schedule.
View Article and Find Full Text PDFBackground: Development of novel colorectal cancer (CRC) screening tests is a dynamic field. Decision analytic modeling based on inputs derived from rigorous prospective studies informs CRC screening guidelines. Exploratory modeling may have a place in early phases of test development.
View Article and Find Full Text PDFDeciphering 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.
View Article and Find Full Text PDFBackground And Aim: Endoscopic ultrasound (EUS) is the most sensitive method for evaluation of pancreatic lesions but is limited by significant operator dependency. Artificial intelligence (AI), in the form of computer-aided detection (CADe) systems, has shown potential in increasing accuracy and bridging operator dependency in several endoscopic domains. However, the complexity of integrating AI into EUS is far more challenging.
View Article and Find Full Text PDFThe impact of glucagon-like peptide-1 receptor agonist on the gastric residue in upper endoscopy.
Diabetes Res Clin Pract
November 2024
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.
Background: Due to lower operational costs, health maintenance organizations (HMOs) may prioritize stool antigen testing (HpStAg) for the non-invasive diagnosis of infection over 13C-urea breath tests (13C-UBTs). The aim of our study was to compare the accuracy of the diagnostic tests for .
Methods: We performed histology, rapid urease test (RUT), 13C-UBT and HpStAg on consecutive patients referred for gastroscopy.
Background And Aims: Janus kinase [JAK] inhibitors are used for treating inflammatory bowel diseases [IBD]. We aimed to identify the molecular effects of JAK inhibition in human intestinal mucosa, considering IBD location and phenotype.
Methods: Colonic and ileal explants from patients with ulcerative colitis [UC], Crohn's disease [CD], and non-IBD controls [NC] were assessed for levels of phosphorylated signal transducers and activators of transcription [p-STAT] and expression of inflammatory genes in response to an ex vivo JAK inhibitor [tofacitinib].
Article Synopsis
- Early detection of colorectal cancer (CRC) is essential for improving survival rates, and risk prediction models can help spot individuals at higher risk using health records.
- The study analyzed EHR data from Clalit Health Services, involving over 1.1 million people aged 50-74, to develop a model predicting CRC diagnosis within two years, which considered around 20,000 clinical features.
- The results indicated that the model effectively identified high-risk individuals, with those in the top 1% risk scores showing significantly higher CRC incidence, making it a valuable tool for healthcare providers to target at-risk patients for further testing.
Article Synopsis
- POT1 is an important gene involved in protecting and regulating the length of telomeres, and mutations in this gene can increase cancer risk, particularly for melanoma and chronic lymphocytic leukemia (CLL).
- A specific mutation, p.(I78T), has been identified as a common pathogenic variant among Ashkenazi Jews, linked to a range of cancers and recurrent melanoma in individuals aged 25 to 67.
- Research suggests that this variant should be included in genetic testing for high-risk patients of Ashkenazi Jewish descent due to its association with early-onset severe cancers.
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.
View Article and Find Full Text PDFObjectives: Israel is regarded as a country with a developed economy and a moderate income inequality index. In this population-based study, we aimed to measure the inequalities in colorectal cancer screening within Clalit Health, an organization with universal insurance, before and during the coronavirus disease 2019 pandemic.
Setting: Retrospective analysis within Clalit Health Services, Israel.
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.
Background And Aims: Surveillance colonoscopies are crucial for high-risk patients with inflammatory bowel diseases (IBD) to detect colorectal carcinoma (CRC). However, there is no established quality metric for dysplasia detection rate (DDR) in IBD surveillance. This study assessed the DDR in a dedicated surveillance program at a tertiary referral center for IBD.
View Article and Find Full Text PDFArticle Synopsis
- 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.
Article Synopsis
- Barrett's esophagus (BE) can recur even after complete treatment through radiofrequency ablation (RFA), and this study looked into factors that influence such recurrences.
- Researchers analyzed 118 patients treated with RFA over several years, finding that 13.3% experienced a recurrence of BE during follow-up.
- Multifocal dysplasia was identified as a significant risk factor for recurrence, indicating that patients with this condition need closer monitoring post-treatment.
Background: Subjects with a positive Fecal Occult Blood Test (FOBT) that are non-compliant with colonoscopy are at increased risk for colorectal cancer (CRC). Yet, in clinical practice, many remain non-compliant.
Aims: To evaluate whether machine learning models (ML) can identify subjects with a positive FOBT predicted to be both non-compliant with colonoscopy within six months and harbor CRC (defined as the "target population").
Article Synopsis
- 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.
Article Synopsis
- * Common methods like ELISpot and flow cytometry (FCM) were assessed for measuring vaccine efficacy; however, they often showed significant background interference affecting results.
- * The study developed a refined FCM panel incorporating early activation markers (4-1BB and CD40L) to minimize background noise, achieving much lower background expression and improving the detection of rare, antigen-specific T-cell responses.
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.
(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.
View Article and Find Full Text PDFBackground: There is an increasing interest in inappropriate proton pump inhibitors prescription (InPPIp), as defined by the National Institute for Clinical Excellence (NICE) guidelines.
Aims: To evaluate the rate, trend over time and factors associated with InPPIp upon discharge from internal medicine departments.
Methods: We evaluated patients discharged from internal medicine departments with a PPI prescription in 2014 and 2017 at an academic referral center according to a developed algorithm.
Article Synopsis
- The study examined the levels of hTERT-mRNA in exosomes from the serum of colon cancer patients, Lynch syndrome carriers, and healthy controls to assess its potential as a diagnostic marker.
- Results showed that colon cancer patients had significantly higher hTERT-mRNA levels compared to healthy individuals, and those with metastatic disease had even higher levels that correlated with CEA levels.
- The findings also indicated that Lynch syndrome carriers had a higher occurrence of positive hTERT-mRNA in exosomes than controls, suggesting the need for further research to understand its role in cancer development.
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
Adenomatous Polyposis Phenotype in BMPR1A and SMAD4 Variant Carriers.
Clin Transl Gastroenterol
October 2022
Article Synopsis
- Variants in the SMAD4 or BMPR1A genes are linked to juvenile polyposis syndrome, which is marked by numerous gastrointestinal polyps, but some patients exhibit a rare form without hamartomatous polyps.
- * The study analyzed 8 individuals with these gene variants who had at least 10 colorectal adenomas or cancer, confirming a genetic basis for their conditions through multigene panel testing.
- * Findings showed a variety of genetic mutations among participants, with a significant incidence of colorectal cancer before age 50, suggesting the need for monitoring and screening in families with these hereditary variants.*