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עמוד בית
Sun, 23.06.24

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July 2017
Amir Dagan, Naim Mahroum, Gad Segal, Shmuel Tiosano, Abdulla Watad, Doron Comaneshter, Arnon D. Cohen and Howard Amital

Background: Patients with giant cell arteritis (GCA) suffer from inflammatory diseases often treated by large amounts of corticosteroids. Whether this inflammatory burden also carries an increased risk for cardiovascular morbidity, and especially ischemic heart disease, is not clearly established.

Objectives: To clarify the linkage between GCA and ischemic heart disease. 

Methods: In a cross-sectional study, we assessed the association between GCA and ischemic heart disease, adjusting for cardiovascular risk factors, among GCA patients and matched controls using the database of the largest healthcare provider in Israel.

Results: The study group was comprised of 5659 GCA patients and 28,261 age and gender matched controls. The proportion of ischemic heart disease was higher in the GCA group (27.5% vs. 12.5% among controls, odds ratio 2.65). Diabetes mellitus, hypertension, hyperlipidemia and smoking were also found to have higher concurrency in GCA. After stratifying for those cardiovascular co-morbidities using logistic regression, GCA remained independently associated with ischemic heart disease with an odds ratio of 1.247 (1.146–1.357 P < 0.001).

Conclusions: GCA is associated with both cardiovascular risk factors and ischemic heart disease. Healthcare professionals should not overlook this aspect of the disease when managing GCA patients. 

 

Abdulla Watad MD, Nicola Luigi Bragazzi MD PhD MPH, Kassem Sharif MD, Ora Shovman MD, Boris Gilburd MD, Howard Amital MD and Yehuda Shoenfeld MD FRCP MACR

Background: Anti-glomerular basement membrane (GBM) antibody disease, or Goodpasture’s disease, is the clinical manifestation of the production of anti-GBM antibodies, which causes rapidly progressive glomerulonephritis with or without pulmonary hemorrhage. Anti-GBM antibody detection is mandatory for the diagnosis of Goodpasture’s disease either from the serum or kidney biopsy. Renal biopsy is necessary for disease confirmation; however, in cases in which renal biopsy is not possible or is delayed, serum detection of anti-GBM antibody is the only way for diagnosis.

Objectives: To assess the predictive value of positive anti-GBM antibodies in a clinical setting. 

Methods: Data from anti-GBM antibody tests performed at one medical center between 2006 and 2016 were systematically and retrospectively retrieved. We recruited 1914 patients for the study. Continuous variables were computed as mean ± standard deviation, while categorical variables were recorded as percentages where appropriate. Sensitivity and specificity of anti-GBM titers were calculated. Kaplan–Meyer analysis was performed, stratifying survival according to the anti-GBM antibody titers.

Results: Of the 1914 anti-GBM test results detected, 42 were positive, 23 were borderline, 142 were excluded, and 1707 results were negative. Male-to-female ratio was 1:1.2. Sensitivity of anti-GBM test was 41.2% while specificity was 85.4%. Concerning the Kaplan–Meyer analysis, overall survival was 1163.36 ± 180.32 days (median 1058 days). 

Conclusions: Our study highlights the lack of sensitivity of serological testing of anti-GBM titers. Comparing survival curves, the survival correlated with anti-GBM titer only in a borderline way. Because highly sensitive bioassays are not routinely used in clinics, renal biopsy is still pivotal for Goodpasture’s disease diagnosis.

 

June 2017
Nicola Luigi Bragazzi MD PhD MPH and Abdulla Watad
Abdulla Watad MD, Nicola Luigi Bragazzi MD, Noam Grysman MS, Hussein Mahagna MD and Howard Amital MD MHA

Taxanes are often used in the treatment of many types of cancers. Side effects of docetaxel are not as well documented as paclitaxel, but both can cause pulmonary injury. We present a dramatic case of a patient being treated for prostatic adenocarcinoma with docetaxel who presented with interstitial pneumonitis and responded dramatically to the early treatment with corticosteroids. This case is important as it reveals the side effects of docetaxel administration without administration of other chemotherapeutic agents, and it illustrates the importance of early diagnosis and treatment of docetaxel-induced interstitial pneumonitis. Further research into the mechanism of the side effects of docetaxel is warranted.

September 2016
Abdulla Watad MD, Howard Amital MD MHA, Gali Aljadeff BA, Gisele Zandman-Goddard MD, Hedi Orbach MD and Yehuda Shoenfeld MD FRCP MaCR
June 2016
Noam H. Grysman BA, Abdulla Watad MD, Efrat Ofek MD, Boaz Tzur MD and Howard Amital MD MHA
May 2016
Netanel Elkabetz MD, Danielle Bracco BA, Galit Zlotnik MD, Abdulla Watad MD, Stefan Mausbach MD and Howard Amital MD MHA
April 2016
Abdulla Watad MD, Shana G. Neumann BA, Alessandra Soriano MD, Howard Amital MD and Yehuda Shoenfeld MD FRCP MaCR

There is growing interest in the contribution of vitamin D deficiency to autoimmunity. Several studies have shown an association between low levels of vitamin D and autoimmune disorders, including multiple sclerosis, rheumatoid arthritis, type 1 diabetes, autoimmune thyroid diseases, celiac disease, and systemic lupus erythematosus (SLE). Vitamin D receptor ligands can mediate immunosuppressive effects. It has been suggested that low levels of this hormone contribute to the immune activation in lupus and other autoimmune diseases. This review updates and summarizes the literature on the association between vitamin D and SLE, and discusses the various correlations between vitamin D and SLE activity, clinical expressions, serology, and gene polymorphisms of vitamin D receptors.

January 2016
Abdulla Watad MD, Meytal Ben-Yosef , Victor Belsky MD and Howard Amital MD MHA
December 2015
Abdulla Watad MD, Qasim Odeh MD, Nora Balint Lahat MD and Howard Amital MD MHA
June 2015
Abdulla Watad MD, Victor Belsky MD, Yehuda Shoenfeld MD FRCP MaACR and Howard Amital MD MHA
February 2015
Abdulla Watad MD, Alessandra Soriano MD, Hananya Vaknine MD, Yehuda Shoenfeld MD FRCP MaACR and Howard Amital MD MHA
Abdulla Watad MD, Marina Perelman MD, Ribhi Mansour MD, Yehuda Shoenfeld MD FRCP MaACR and Howard Amital MD MHA
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