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עמוד בית
Sat, 26.07.25

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August 2019
Abdulla Watad MD, Nicola Luigi Bragazzi MD PhD MPH, Howard Amital MD MHA and Yehuda Shoenfeld MD FRCP MACR
Valerii G. Zolotykh MD, Anna Y. Kim MD, Yehuda Shoenfeld MD FRCP MACR and Leonid P. Churilov MD PhD
Richard Haber MB BS (Hons) FRACP and George M. Weisz MD FRACS BA MA
July 2019
Carlo Perricone MD PhD, Daphna Katz, Cinzia Ciccacci PhD, Fulvia Ceccarelli MD PhD, Guido Valesini MD, Yehuda Shoenfeld MD FRCP MaACR, Paola Borgiani PhD and Fabrizio Conti MD PhD

Recurrent pericarditis is a state of repetitive inflammation of the pericardium with intervals of remission. The etiology of recurrent pericarditis is still largely unknown, yet most causes are presumed to be immune mediated. Genetic factors, including human leukocyte antigen (HLA) haplotypes, can be involved in dysregulation of the immune system and as a predisposition to several autoimmune conditions, including recurrent pericarditis. Several diseases are frequently associated with such manifestations. They include systemic lupus erythematosus, familial Mediterranean fever, and tumor necrosis factor receptor-associated periodic syndrome. However, idiopathic recurrent pericarditis remains the most frequently observed clinical condition and the conundrum of this disease still needs to be solved.

June 2019
Margarita Makarov, Nir Peled MD PhD FCCP, Tzippy Shochat MD, Alona Zer MD, Ofer Rotem MD and Elizabeth Dudnik MD

Background: The main acquired resistance mechanism to first- and second-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) in EGFR mutant non-small cell lung cancer (NSCLC) is the propagation of T790M clones, which can be detected in circulating tumor DNA (ctDNA).

Objectives: To analyze osimertinib outcomes according to T790M testing method.

Methods: The study comprised 33 consecutive patients with advanced EGFR mutant NSCLC who were diagnosed with a T790M mutation after progression on first- or second-generation EGFR TKIs and treated with osimertinib. The patients were divided into groups A (diagnosed by tumor testing) and B (by ctDNA testing). Osimertinib outcomes were compared between the groups.

Results: Objective response rate with osimertinib comprised 54% and 62% in groups A and B, respectively (P = 0.58). Median progression-free survival (PFS) with osimertinib was 8.9 months (95% confidence interval [95%CI] 1.8–17.5) and 9.1 months (95%Cl 5.3–12.6) in groups A and B, respectively (log-rank test 0.12, P = 0.73). Median overall survival (OS) was 13.8 months (95%CI 4.9–25.5) and 13.8 months (95%Cl 7.7–27.7) in groups A and B, respectively (log-rank test 0.09, P = 0.75). T790M testing technique did not affect PFS (hazard ratio [HR] 1.16, 95%CI 0.50–2.69, P = 0.73) or OS (HR = 1.16, 95%CI 0.45–3.01, P = 0.76). The proportion of patients diagnosed by ctDNA grew from 56% in 2015 to 67% in 2016–2017.

Conclusions: Our study provides a ctDNA validation for the purpose of T790M testing in EGFR mutant NSCLC.

April 2019
Lazaros I. Sakkas MD PhD, Dimitrios P. Bogdanos MD PhD, Dimitrios Boumpas MD, Zisis Mamouris PhD, Athanasios Gkoutzourelas MD, Athanasios Mavropoulos PhD, Zisis Tsouris PhD, Stamatis-Nickοlaos Liossis MD, Dimitrios Daoussis MD, Dimitrios Vasilopoulos MD, Maria Tektonidou MD, Athanasios Tzioufas MD, George Efthymiou BSc, Efthymios Dardiotis MD, George Kitas MD PhD, Κassem Sharif MD, Miri Blank MD, Dimitrios Karussis MD, Doron Rimar MD, Gleb Slobodin MD, Bat-Sheva Porat-Katz MD, Zahava Vadasz MD PhD, Howard Amital MD MHA, Elias Toubi MD and Yehuda Shoenfeld MD FRCP MaACR
March 2019
February 2019
Sol Jaworowski MBBS FRANZCP, Jean-Louis Golmard MD PhD, Morag Engelberg MD, Sarah Prijs, Lital Twizer, Cornelius Gropp MD and Joseph Mergui MD

Background: A history of childhood sexual abuse (CSA) has been linked to a variety of physical and psychiatric illnesses, including ischemic heart disease and post-traumatic stress disorder (PTSD).

Objectives: To determine the prevalence of past CSA and re-traumatization among hospital psychiatric consultations and to determine whether a CSA group in a hospital setting shared characteristics with community samples described in the literature.

Methods: We divided 228 consecutive psychiatric consultations into two groups. One group comprised patients with a past history of CSA while the other group had no such history. Both groups were further divided into a subgroup that presented with features of re-traumatization.

Results: In the cohort, 38% described a history of CSA. Twenty patients were identified as presenting with features of re-traumatization. There were significant differences between the two groups. The patients with a history of CSA were more likely to have arrived at the emergency department (ED) during the preceding 12 months with a diagnosis of PTSD, personality disorder, and substance use disorder. There was a greater proportion of patients in the CSA group who had grown up in an ultra-Orthodox Jewish household and who currently identified as being secular.

Conclusions: The characteristics of the patients with past CSA in this study are similar to community-based samples, except for a significant gender difference. To the best of our knowledge, this study is the first to investigate CSA history during hospital ED psychiatric consultations. A history of CSA should be considered during psychiatric consultations in a general hospital ED admission.

Ana R. Nogueira MD, Sumit Chatterji MD, Tiberiu Shulimzon MD, Yehuda Shoenfeld MD FRCP (Hon) MaACR
December 2018
Daphna Katz-Talmor B Med Sc, Shaye Kivity MD, Miri Blank PhD, Itai Katz B Med Sc, Ori Perry BS, Alexander Volkov MD, Iris Barshack MD, Howard Amital MD MHA, Yehuda Shoenfeld MD FRCP MaACR
Dvir Shalem, Asaf Shemer, Ora Shovman MD, Yehuda Shoenfeld MD FRCP MACR and Shaye Kivity MD

Background: Guillain-Barré syndrome (GBS) is an autoimmune disease of the peripheral nervous system with a typical presentation of acute paralysis and hyporeflexia. Intravenous immunoglobulin (IVIG) and plasma exchange (PLEX) are treatments that have proven to expedite recuperation and recovery of motor function.

Objectives: To describe our experience at one tertiary medical center treating GBS with IVIG and to compare the efficacy of IVIG as the sole treatment versus combined therapy of IVIG and plasma exchange.

Methods: We reviewed the records of all patients diagnosed with GBS and treated with IVIG at the Sheba Medical Center from 2007 to 2015 and collected data on patient demographics, disease onset and presentation, and treatments delivered. The motor disability grading scale (MDGS) was used to evaluate the motor function of each patient through the various stages of the disease and following therapy.

Results: MDGS improvement from admission until discharge was statistically significant (P < 0.001), as was the regainment of motor functions at 3 and 12 months follow-up compared to the status during the nadir of the disease. The effectiveness of second-line treatment with IVIG following PLEX failure and vice versa was not statistically significant (P > 0.15).

Conclusions: The majority of patients included in this study experienced a significant and rapid improvement of GBS following treatment with IVIG. Combined therapy of PLEX and IVIG was not proven to be effective in patients who encountered a failure of the first-line treatment.

September 2018
Joseph Mergui MD, David Raveh-Brawer MD, Meydan Ben-Ishai MD, Sarah Prijs MD, Cornelius Gropp MD, Igor Barash MD MHA, Jean-Louis Golmard MD PhD, Sol Jaworowski MBBS FRANZCP

Background: There is scant research on the psychopathology of Israeli soldiers who present to a general hospital emergency department (ED).

Objectives: To assess the psychopathology among a cohort of Israeli soldiers who presented to a general hospital ED for mental health assessment.

Methods: The demographic and clinical characteristics of 124 consecutive soldiers who presented to the ED for psychiatric assessment between January 2008 and September 2012 were reviewed. Twenty-seven soldiers from the cohort were contacted for follow-up by telephone on average 52 months later.

Results: The reasons for presentation to the ED, usually during the early stages of military service, included self-harming behavior, suicidal ideation, somatoform complaints, and dissatisfaction with their military service. Psychiatric diagnoses included adjustment disorder and personality disorder. Self-harming behavior/suicidal ideation was significantly correlated with unspecified adjustment disorder (P = 0.02) and personality disorder (P = 0.001). At follow-up, there was a lack of substantial psychopathology: none of the subjects engaged in self-harming behavior/suicidal ideation and a consistent trend was observed toward clinical improvement.

Conclusions: Psychiatric intervention of soldiers who present to a general hospital ED because of emotional difficulties may provide the opportunity for crisis intervention and validation of the soldier's distress. To the best of our knowledge this is the first Israeli study of psychopathology among soldiers who presented to an ED.

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