Abdulrahman Elsalti MD, Abdulkarim Alwani MD, Isa Seida MD, Mahmoud Alrais MD, Ravend Seida MD, Sevval Nil Esirgun MD, Tunahan Abali MD, Zeynep Kiyak MD, and Naim Mahroum MD
Avi Ohry MD and Esteban González-López MD PhD
Dr. Joseph Weill was a French Jewish doctor who made significant contributions to the knowledge of hunger disease in the refugee camps in southern France during World War II. He was involved with the clandestine network of escape routes for Jewish children from Nazi-occupied France to Switzerland
Carla Caffarelli MD PhD, Paolo Cameli MD, Miriana D’Alessandro MD, Elena Bargagli MD, Bruno Fredian MD, and Stefano Gonnelli MD
Background: Some studies have shown that patients who are hospitalized with severe COVID-19 also have low levels of vitamin D. It is known that vitamin D can reduce the risk of infections and down regulate the immune/inflammatory reaction.
Objectives: To investigate the association between vitamin D status and lymphocyte subpopulations in hospitalized pneumonia COVID-19 patients.
Methods: In 33 positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) patients with radiologic evidence of interstitial pneumonia and in 16 healthy control subjects matched for age, sex, and seasonality lymphocyte subpopulations and vitamin D levels were evaluated.
Results: The majority of patients with COVID-19 pneumonia (70.8%) presented vitamin D deficiency. The percentages of neutrophils presented a negative correlation (r = -0.74; P < 0.001), whereas the percentages of lymphocytes presented a positive correlation (r = 0.43; P < 0.01) with 25(OH)D. Moreover, vitamin D levels were positively correlated with CD3+ (r = 0.37, P < 0.05), CD4+ (r = 0.41, P < 0.05), CD8+ (r = 0.32, P < 0.07), and CD19+ (r = 0.38, P < 0.05).
Conclusions: This preliminary study confirms the high prevalence of vitamin D deficiency in patients with COVID-19 pneumonia and that vitamin D deficiency is associated with a reduction of lymphocyte subsets and altered T-lymphocyte activation. This finding may contribute to clarify the mechanisms by which vitamin D influences the course and outcome of COVID-19 pneumonia.
Vânia Borba MD and Yehuda Shoenfeld MD FRCP MaACR
Ori Wand MD, David Dahan MD, Naveh Tov PhD, Gali Epstein Shochet PhD, Daniel A. King MD, and David Shitrit MD
João Gouveia MD, Carolina Barros MD, Mónica Caldeira MD, Caldeira Ferreira MD, and Rafael Freitas MD
Magdi Zoubi MD, Ashraf Hejly MD, Howard Amital MD MHA, and Naim Mahroum MD
Adnan Zaina MD, Ilan Shimon MD, Ali Abid MD,Eldad Arad MD,Elzbieta Baron MD, Elena Golden MD, Michal Gershinsky MD, Nariman Saba Khazen MD, Mohammed Abu Saleh MD, Noga Roguin Maor MD, Orit Bardicef MD, Yulia Pauker MD and Sameer Kassem MD
Background: National registries for acromegaly and population-based data make an important contribution to disease understanding and management. Data concerning the epidemiology of acromegaly in Israel is scanty.
Objectives: To evaluate the epidemiology of acromegaly in different industrial areas in northern Israel.
Methods: Data from adult patients diagnosed with acromegaly from 2000 to 2020, living in Haifa and the western Galilee District were collected using the electronic database and medical records from Clalit Health Services. The prevalence of acromegaly in three distinct areas and overall were reported. In addition, other epidemiological data including associated co-morbidities, pituitary tumor size, and treatment modalities were collected.
Results: We identified 77 patients with a confirmed diagnosis of acromegaly. The overall prevalence was 155 cases/106 inhabitants without statistically significant differences between the three areas. The mean age at diagnosis was 50 ± 1.8 years and the male to female ratio was 1.1. Macroadenoma and microadenoma were identified in 44 (57%) and 25 (33%), respectively. The frequency rate of acromegaly-associated co-morbidities such as diabetes, hypertension, carpal tunnel syndrome, and osteoporosis was similar to previously reported studies. The mean body mass index (BMI) was 29 ± 5.6 kg/m2 .Obesity, with a BMI ≥ of 30 kg/m2, was found in 29 patients (38%). The majority of patients underwent transsphenoidal surgery 67 (87%). Normalized insulin-like growth factor 1 was reported in 64 (83%).
Conclusions: A high prevalence of acromegaly was found in northern Israel. The pituitary microadenoma frequency rate is the highest reported.
Amit Frenkel MD MHA, Victor Novack MD PhD, Yoav Bichovsky MD, Moti Klein MD MPH, and Jacob Dreiher MD PhD MPH
Background: Low serum albumin is known to be associated with mortality in sepsis, as it reflects effects of nutrition, catabolism, and edema.
Objectives: To examine the association of albumin levels with in-hospital mortality in adults with sepsis, stratified by age groups.
Methods: This nationwide retrospective cohort study comprised patients admitted with sepsis to intensive care units in seven tertiary hospitals during 2003–2011. Only patients with available serum albumin levels at hospital admission and one week after were included. Patients with an intra-abdominal source of sepsis were excluded. The association between sepsis and mortality was analyzed using multivariate logistic regression models.
Results: The study included 3967 patients (58.7% male, median age 69 years). Mean serum albumin levels were 3.1 ± 0.7 g/dl at admission and 2.4 ± 0.6 g/dl one week later. In a multivariate logistic regression model, serum albumin one week after admission was inversely associated with in-hospital mortality (odds ratio [OR] 0.64, 95% confidence interval 0.55–0.73 per 1 g/dl). In an age-stratified analysis, the association was stronger with younger age (OR 0.44 for patients aged < 45 years, 0.60 for patients aged 45–65 years, and 0.67 for patients aged > 65 years). Serum albumin on admission was not associated with in-hospital mortality.
Conclusions: The decline in serum albumin one week after admission is a stronger predictor of mortality in younger patients. Older patients might have other reasons for low serum albumin, which reflect chronic co-morbidity rather than acuity of disease.