103 results match your criteria: "From the Leumit Research Institute & Department of Family Medicine[Affiliation]"

The Diabetes in Pregnancy Program Project Grant (PPG) was a 15-year program focused on enhancing the care for women with insulin-dependent diabetes mellitus (IDDM) during pregnancy and improving the well-being of their offspring. Launched in July 1978 at the University of Cincinnati, the PPG pursued a multifaceted research agenda encompassing basic science, animal and placental studies, and maternal and neonatal clinical trials to understand the physiological and pathophysiological aspects of IDDM during pregnancy. A total of 402 singleton pregnancies in 259 women with IDDM were enrolled prior to 10 weeks gestation over the 15-year period.

View Article and Find Full Text PDF

Is Pregnancy a Risk Factor for Progression of Diabetic Retinopathy and Nephropathy in Type 1 Diabetes? A Matched Cohort Study.

Am J Perinatol

December 2024

Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Inova Medical Campus, Falls Church, Virginia.

Objective:  This study aimed to test the hypothesis that the development or deterioration of nephropathy and retinopathy over time is not affected by pregnancy in women with pregestational type 1 diabetes mellitus (T1DM).

Study Design:  Prospective, observational study of nephropathy and retinopathy follow-up during pregnancy and in a subsequent period of 2 years in a group of pregnant women with T1DM (study group) that we compared with pair-matched non-pregnant women with T1DM (control group) who underwent similar intensive follow-up.

Results:  The rate of renal microvascular complications was similar at entry, 17.

View Article and Find Full Text PDF

Health disparities in diabetes treatment: The challenge of G6PD deficiency.

Diabetes Res Clin Pract

December 2024

Leumit Research Institute, Leumit Health Services, Tel-Aviv, Israel; Adelson School of Medicine, Ariel University, Ariel, Israel.

Aims: To assess the impact of Glucose-6-phosphate dehydrogenase (G6PD) deficiency, an enzymatic deficiency prevalent in individuals of African or Asian descent, on Hemoglobin A1c (HbA1c) levels, diabetes medication purchases, and the cumulative incidence of diabetes related complications.

Methods: A large cohort study was conducted within a national health organization, comparing 3,913 G6PD-deficient patients to a matched control group without G6PD deficiency over two decades. The main measures and outcomes were the HbA1c levels, patterns of diabetes medication purchases, and the incidence of severe diabetes-related complications.

View Article and Find Full Text PDF

Hypoglycemia in Pregnant Women with Type 1 Diabetes: Is It Inevitable?

Am J Perinatol

November 2024

Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Inova Health System, Fairfax, Virginia.

The human body has abundant mechanisms to counteract hypoglycemia and prevent neuroglycopenia primarily involving the secretion of glucagon and adrenalin. Within several years from the onset of diabetes, people with type 1 diabetes lose their ability to mount a counterregulatory response to hypoglycemia and develop hypoglycemia unawareness, thus being at risk for deteriorating to a state of severe hypoglycemia and neuroglycopenia. Pregnant individuals with type 1 diabetes are particularly prone to experience severe hypoglycemia during the first half of pregnancy.

View Article and Find Full Text PDF

Pediatric pain significantly affects children's lives, leading to school absenteeism, impaired social interactions, and psychological distress. The perception of sensory signals as pain is influenced by the brain's noradrenergic system, and recent evidence suggests that chronic pain may impact cognitive functioning and emotional regulation. Attention-Deficit/Hyperactivity Disorder (ADHD) is associated with alterations in the dopaminergic/noradrenergic systems, which could affect pain perception.

View Article and Find Full Text PDF

Delphi definition of general practice/family medicine specialty for a post-COVID world: in-person and remote care delivery.

Fam Pract

November 2024

General Practice and Primary Care, School of Health and Wellbeing, University of Glasgow, Clarice Pears Building, 90 Byres Road, Glasgow G12 8TB, United Kingdom.

Introduction: The evolving landscape of general practice (GP)/family medicine (FM) in the post-COVID-19 era, focussing on integrating telemedicine and remote consultations requires a new definition for this specialty. Hence, a broader consensus-based definition of post-COVID-19 GP/FM is warranted.

Methods: This study involved a modified electronic Delphi technique involving 27 specialists working in primary care recruited via convenient and snowball sampling.

View Article and Find Full Text PDF

Background: Inflammatory bowel disease (IBD) encompasses chronic gastrointestinal disorders characterized by recurrent inflammation. Achieving mucosal healing and preventing disease progression are primary treatment goals.

Objectives: This study aimed to compare disease characteristics, medication utilization, procedures performed, and hospitalizations between IBD patients treated in hospital and community settings using the Leumit Health Service database.

View Article and Find Full Text PDF
Article Synopsis
  • The study investigates the effects of GLP-1 analogs, commonly used for diabetes and obesity, on patients with inflammatory bowel diseases (IBD).
  • Data was collected from over 3,700 patients with both IBD and diabetes, revealing that those treated with GLP-1 analogs had better health outcomes, reducing the risk of complications.
  • The findings highlight a stronger protective effect in obese patients compared to non-obese patients, suggesting a need for further research on mechanisms and broader applicability of GLP-1 analogs.
View Article and Find Full Text PDF

Objective: This study examines the way healthcare staff describe challenging patients and perceive responsibility for follow-up of patients with chronic conditions.

Methods: Interviews were conducted with 46 healthcare staff (15 primary care physicians/12 nurses/15 administrative staff/4 pharmacists) at 12 clinics in Israel. They were audiotaped, transcribed, and thematically analyzed using Atlas qualitative data analysis software.

View Article and Find Full Text PDF

'Quantifying the long-term effects of measles infection': author's response.

Clin Microbiol Infect

September 2024

The Bio-statistical and Bio-mathematical Unit, The Gertner Institute for Epidemiology and Health Policy Research, Tel Hashomer, Israel; Department of Epidemiology and Preventive Medicine, School of Public Health, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

View Article and Find Full Text PDF

The concurrent presence of chronic hepatitis B virus (CHB) infection and metabolic dysfunction-associated steatotic liver disease (MASLD) presents a unique clinical scenario with implications that are not yet fully understood. This study aims to characterize the distinct clinical and virological features of CHB in the context of MASLD and evaluate its impact on disease progression and outcomes. Utilizing a comprehensive health maintenance organization database, this study included 1186 patients with CHB from 2000-2020.

View Article and Find Full Text PDF

Peripheral Blood Eosinophilia at Diagnosis of Inflammatory Bowel Disease Is Associated with Severe Disease Course; A Nationwide Study From the epi-IIRN Cohort.

J Crohns Colitis

August 2024

Pediatric Gastroenterology Institute, "Dana-Dwek" Children's Hospital, Tel Aviv Sourasky Medical Center and the Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Article Synopsis
  • A nationwide study assessed the link between high eosinophil counts (PBE) and long-term outcomes in patients with inflammatory bowel diseases (IBD).
  • The analysis included over 28,000 patients, revealing that PBE occurred more frequently in individuals with ulcerative colitis and in pediatric patients compared to adults.
  • Results indicated that PBE is a significant predictor of severe disease progression, increased hospitalization, and higher medication needs in IBD patients, highlighting its potential as a marker for adverse outcomes and target for therapies.
View Article and Find Full Text PDF

Quantifying the long-term effects of measles infection-a retrospective cohort study.

Clin Microbiol Infect

November 2024

The Bio-statistical and Bio-mathematical Unit, The Gertner Institute for Epidemiology and Health Policy, Tel Hashomer, Israel; Department of Epidemiology and Preventive Medicine, School of Public Health, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Objectives: To assess whether measles infection has an impact on the rate of non-measles infectious diseases over an extended period.

Methods: This retrospective matched cohort study included 532 measles-diagnosed patients who were exactly matched with 2128 individuals without a previous measles diagnosis. Adjusted OR for any all-cause infectious diagnosis and any viral infection diagnosis ≤2 years after measles diagnosis between the measles and control groups was obtained from a conditional logistic regression model.

View Article and Find Full Text PDF

This study aimed to review how the Cincinnati Diabetes in Pregnancy Program Project Grant (PPG) contributed to the understanding and treatment of neonatal complications in infants of diabetic mothers (IDMs). This is a retrospective review of all PPG work on glycemic control at different pregnancy time points and its association with embryonic, fetal, and neonatal complications, such as congenital malformations (CMs), intrauterine growth restriction, macrosomia, hypoglycemia, respiratory distress syndrome (RDS), asphyxia, and polycythemia. We found that maternal vasculopathy and poor glycemic control during embryogenesis, but not frequency of maternal hypoglycemic episodes or insulin therapy, are independent risk factors for major CMs.

View Article and Find Full Text PDF

This study aimed to review the Cincinnati PPG's contribution to the understanding and treatment of neonatal hypocalcemia (NHC) in infants of diabetic mothers. This study is a retrospective review of the NIH-funded Program Project Grant (PPG) works related to mineral metabolism in type 1 diabetic pregnant women. The PPG investigators first described the epidemiology and the additional risk factors for NHC, namely prematurity and neonatal asphyxia, but also recognized the independent effect of maternal diabetes mellitus.

View Article and Find Full Text PDF
Article Synopsis
  • Inflammatory Bowel Diseases (IBD) like Crohn's disease and ulcerative colitis have a higher prevalence of Familial Mediterranean Fever (FMF) compared to non-IBD individuals, with an odds ratio of 2.68.
  • The study analyzed data from a large cohort in Israel, showing that FMF is more common in patients with Crohn's disease than in those with ulcerative colitis, and often the FMF diagnosis comes before IBD.
  • FMF may lead to increased disease severity in patients with ulcerative colitis, while the disease outcomes are similar for Crohn's disease patients with or without FMF.
View Article and Find Full Text PDF

Predictors of Complicated Disease Course in Children and Adults With Ulcerative Colitis: A Nationwide Study From the epi-IIRN.

Inflamm Bowel Dis

May 2024

Juliet Keidan Institute of Pediatric Gastroenterology Hepatology and Nutrition, Shaare Zedek Medical Center, The Hebrew University of Jerusalem, Israel.

Background: Data on predictors of complicated ulcerative colitis (UC) course from unselected populations cohorts are scarce. We aimed to utilize a nationwide cohort to explore predictors at diagnosis of disease course in children and adults with UC.

Methods: Data of patients diagnosed with UC since 2005 were retrieved from the nationwide epi-IIRN cohort.

View Article and Find Full Text PDF

Enteral nutrition compared with corticosteroids in children with Crohn's disease: A long-term nationwide study from the epi-IIRN.

Aliment Pharmacol Ther

July 2024

Juliet Keidan Institute of Pediatric Gastroenterology Hepatology and Nutrition, The Eisenberg R&D Authority, Shaare Zedek Medical Center, The Hebrew University of Jerusalem, Jerusalem, Israel.

Background: Both corticosteroids and exclusive enteral nutrition (EEN) have been used as induction therapy in children with Crohn's disease (CD).

Aim: To compare in a nationwide study the long-term outcomes of children with CD receiving either EEN or corticosteroids as induction therapy.

Methods: We retrieved data of all children diagnosed with CD (2005-2020) from the epi-IIRN cohort covering 98% of the Israeli population.

View Article and Find Full Text PDF

Introduction: The use of medicinal cannabis for managing pain expands, although its efficacy and safety have not been fully established through randomized controlled trials.

Objectives: This structured, prospective questionnaire-based cohort was aimed to assess long-term effectiveness and safety of cannabis oil extracts in patients with chronic pain.

Methods: Adult Israeli patients licensed to use cannabis oil extracts for chronic pain were followed prospectively for 6 months.

View Article and Find Full Text PDF

Durability of the First Biologic in Children and Adults With Ulcerative Colitis: A Nationwide Study from the epi-IIRN.

Inflamm Bowel Dis

April 2024

Juliet Keidan Institute of Pediatric Gastroenterology Hepatology and Nutrition, Shaare Zedek Medical Center, The Hebrew University of Jerusalem, Jerusalem, Israel.

Article Synopsis
  • This nationwide study analyzed the durability of first-line biologics in ulcerative colitis (UC) patients, focusing on monotherapy versus combotherapy with immunomodulators over a median follow-up of 7 years.
  • The results showed that the durability rates for pediatric and adult patients were similar, with 43% of patients maintaining their initial biologic treatment after 5 years.
  • Additionally, anti-TNF biologics demonstrated comparable durability to vedolizumab, but were more effective when used in combination with other therapies.
View Article and Find Full Text PDF

Chronic idiopathic eosinopenia, allergic, and autoimmune disorders.

J Allergy Clin Immunol Pract

July 2024

Leumit Research Institute, Leumit Health Services, Tel Aviv-Yafo, Israel; Department of Family Medicine, Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv-Yafo, Israel.

View Article and Find Full Text PDF

A Statistical Approach to the High Mortality Rate of Israeli Citizens Held Hostage in Gaza.

Isr Med Assoc J

March 2024

Leumit Health Services and Research Institute, Tel Aviv, Israel, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Background: According to Hamas sources, many Israeli hostages in Gaza were killed by indiscriminate Israeli airstrikes, together with a large number of Palestinian citizens.

Objectives: To verify whether the estimated death rate of Israeli hostages was similar to the estimated death rate of Gaza citizens from these acts of war.

Methods: We used two estimates of hostage death rates, one obtained from Israeli intelligence sources, and one published by a Hamas spokesperson.

View Article and Find Full Text PDF

Tramadol is primarily metabolized by the highly polymorphic enzyme, leading to a large spectrum of adverse events and clinical response. Ample evidence pointed a reduced CYPD26 activity score in individuals harboring the genotype, nevertheless, there is scarce studies on the impact of *10/*10 genetic polymorphism on long-term tramadol's adverse effects. To test the correlation between *10/*10 expression and the risk for tramadol-associated adverse effects.

View Article and Find Full Text PDF
Article Synopsis
  • - The study investigated how the COVID-19 pandemic impacted the incidence of inflammatory bowel diseases (IBD) in Israel and Sweden, two countries with different lockdown strategies.
  • - Findings revealed that IBD incidence in Israel significantly decreased during the pandemic, while Sweden experienced a slight decrease initially followed by an increase, particularly among elderly-onset patients.
  • - The research concluded that stricter lockdowns in Israel correlated with a greater reduction in IBD cases compared to Sweden, prompting a need for further research on the long-term effects of the pandemic on IBD.
View Article and Find Full Text PDF
Article Synopsis
  • A nationwide study in Israel examined how early use of biologic treatments affects outcomes in patients with Crohn's disease (CD) and ulcerative colitis (UC) from 2005 to 2020.
  • Among 34,375 patients, earlier initiation of biologics showed a small reduction in surgery rates and steroid dependency for CD, but no significant improvements were seen for UC or in the pediatric group.
  • The findings suggest that while early biologic treatment can lead to some benefits for CD patients, overall results for UC and in the pediatric population are less promising, indicating more research is needed.
View Article and Find Full Text PDF