Showing papers by "Arnon D. Cohen published in 2016"
TL;DR: Patients with SLE have a greater proportion of hypothyroidism than matched controls, and physicians treating patients with Sle should be aware of the possibility of thyroid dysfunction.
55 citations
TL;DR: To quantify the association between RA and IHD according to certain demographics as well as traditional cardiovascular risk factors in order to determine their roles in the development of coronary artery disease among patients with RA, data from the largest HMO in Israel was selected.
50 citations
38 citations
TL;DR: Doctors treating patients with rather IBD or SLE should consider this potential association between IBD and SLE, as patients with SLE have a greater prevalence of CD than matched controls.
38 citations
TL;DR: Patients with SLE have a higher proportion of aortic aneurysms as compared with matched controls, and physicians treating patients with Sle should be aware of this life threatening association.
Abstract: ObjectivesAortic aneurysm is a life threatening cardiovascular complication in patients with systemic lupus erythematosus (SLE).The purpose of this study was to investigate the association between SLE and occurrence of aortic aneurysms.MethodsPatients with SLE were compared with age- and sex-matched controls regarding the proportion of aortic aneurysm in a case–control study. Chi-square and t-tests were used for univariate analysis and a logistic regression model was used for multivariate analysis. The study was performed utilizing the medical database of Clalit Health Services.ResultsThe study included 5018 patients with SLE and 25,090 age- and sex-matched controls. The proportion of aortic aneurysm in patients with SLE was increased compared with the proportion in controls (0.6% and 0.1%, respectively, p < 0.001). In a multivariate analysis SLE was associated with the coexistence of aortic aneurysms (odds ratio 2.06, 95% confidence interval 1.21–3.51).ConclusionsPatients with SLE have a higher proportio...
37 citations
TL;DR: In this article, the incidence of pemphigus in the Jewish population was threefold higher than that in Arabs (9.6 vs 3.2 cases per million per year, respectively; P P P ǫ = 0.068).
Abstract: Background The epidemiology of pemphigus in different ethnic populations exposed to similar environments is unknown. Trends in the incidence of pemphigus based on an immunopathologically validated cohort have not been investigated. Objectives We sought to estimate the incidence of pemphigus in Israel and to investigate differences between the 2 major ethnic populations. Methods Pemphigus incidence was retrospectively estimated from January 2000 to December 2015 in 2 Israeli regions with a total population of 1.56 million inhabitants. Results One hundred eighty patients with pemphigus (mean age, 54.70 ± 16 years) were identified. The overall estimated incidence was 7.2 per million inhabitants per year (95% confidence interval, 6.2-8.3). The incidence in the Jewish population was threefold higher than that in Arabs (9.6 vs 3.2 cases per million per year, respectively; P P P = .068). Limitations This study was limited by the retrospective design and the small population. Conclusions The incidence of pemphigus in Israel is among the highest reported worldwide and is significantly more frequent among Jews.
37 citations
TL;DR: Patients with SLE had a greater prevalence of CD than matched controls in a large case-control study, and a complex combination of genetic, immunological and novel environmental factors may explain this positive association.
36 citations
TL;DR: In the current study PsA was associated with gastrointestinal morbidities including Crohn’s disease, ulcerative colitis, PUD and IBS and Physicians treating patients with PsA should be aware of these associations.
Abstract: Comorbidities associated with psoriatic arthritis (PsA) include cardiovascular diseases, diabetes mellitus, and obesity. This study evaluated the association between PsA and common gastrointestinal (GI) diseases. A retrospective study was performed in Israel’s largest health care provider database between 2002 and 2013. 3161 PsA patients were matched for age and sex with 31610 randomly selected patients. We searched these patients’ records for the presence of peptic ulcer disease (PUD), reflux esophagitis, Crohn’s disease, ulcerative colitis, irritable bowel syndrome (IBS) and celiac disease. T-test was used to compare continuous variables and a Chi-square test was used for categorical variables. Multivariate logistic regression models were used to assess the association between PsA and GI comorbidities. PsA was associated with Crohn’s disease (OR 2.4, 95 %CI: 1.75–3.32, p < 0.0001), ulcerative colitis (OR 2.1, 95 %CI: 1.33–3.26, p = 0.001), reflux esophagitis (OR 1.6, 95 %CI: 1.44–1.78, p < 0.0001), PUD (OR 1.5, 95 %CI: 1.31–1.63, p < 0.0001) and IBS (OR 1.4, 95 %CI: 1.01–1.86, p = 0.045). After controlling for known risk factors, the association remained significant between PsA and Crohn’s disease (OR 2.2, 95 %CI: 1.59–3.03, p < 0.0001), ulcerative colitis (OR 1.9, 95 %CI: 1.21–3.00, p = 0.005), reflux esophagitis (OR 1.5, 95 %CI: 1.31–1.63, p < 0.0001), and PUD (OR 1.3, 95 %CI: 1.12–1.47, p < 0.0001). No significant association was found between PsA and celiac disease. In the current study PsA was associated with gastrointestinal morbidities including Crohn’s disease, ulcerative colitis, PUD and IBS. Physicians treating patients with PsA should be aware of these associations.
34 citations
TL;DR: By univariate analysis the data implied that patients with RA have a greater prevalence of bipolar disorder than matched controls, however, the analysis suggests that this association may have been confounded by smoking status.
34 citations
TL;DR: This study has demonstrated that AA is more prevalent in patients with RA in comparison with general population, and it is important to identify cardiovascular- and disease-related risk factors for AA formation in RA patients.
Abstract: There is substantial evidence that aortic aneurysm (AA) may be a manifestation of several systemic rheumatic disorders. However, only several studies have assessed the association between rheumatoid arthritis (RA) and AA. The aim of this study was to evaluate the incidence of AA in RA patients in a case-control study. A retrospective case-control study was performed utilizing the database of Clalit Health Services (CHS), a large healthcare provider organization in Israel. Data available from the CHS database included age, sex, socioeconomic status (SES), and diagnoses of chronic diseases, including AA. Patients over the age of 20 years who were diagnosed with RA (“cases”) were compared with a sample of age- and gender-matched enrollees without RA (“controls”) regarding the prevalence of AA. Chi-square and t tests were used for univariate analysis, and a logistic regression model was used for multivariate analysis. The study included 11,782 RA patients and 57,973 age- and gender-matched controls. The proportion of AA was significantly higher in RA patients (0.72 %) compared to the control group 0.49 % (odds ratio (OR) 1.48, 95 %; confidence interval (CI) 1.15–1.88; p = 0.002). A multivariate analysis that evaluated covariates associated with AA revealed an independent association of AA and RA after adjustment for different factors including age, gender, SES, and smoking status (OR 1.406, 95 %; CI 1.094–1.789; p = 0.006). Our study has demonstrated that AA is more prevalent in patients with RA in comparison with general population. Future large randomized studies are important to identify cardiovascular- and disease-related risk factors for AA formation in RA patients.
31 citations
Journal Article•
TL;DR: Calcium levels may play a significant role in the SLE disease process, more than originally thought, since SLE patients are at a higher risk for hypocalcaemic events.
Abstract: OBJECTIVES Several reports have indicated an association between systemic lupus erythematosus (SLE) and low levels of vitamin D. We examined several blood work parameters in SLE patients and controls and performed an extensive data analysis in order to investigate the links between blood levels of calcium, vitamin D, and SLE disease. METHODS 4,278 SLE patients and 16,443 age and sex-matched controls were selected from a national health insurer database in Israel. Patients with no blood work results or having renal disease were excluded. Retrospective data from five consecutive years of routine blood work results were then analysed for mean serum calcium, albumin, albumin-corrected calcium, vitamin D levels, and the presence of a hypocalcaemic episode (Corrected Ca <8.5 mg/dL). RESULTS The mean levels of corrected serum calcium levels were slightly higher among SLE patients than controls (9.23±0.34 vs. 9.19±0.36 mg/dL p≤.001 respectively). In contrast to results of published studies, SLE patients had slightly higher levels of 25(OH)-vitamin D (SLE patients: 22.2±9.06 ng/ml, controls: 20.0±8.76 ng/ml, p≤.001). The most impressive finding entailing SLE patients was that they were twice as likely to experience episodes of hypocalcaemia in comparison to controls (SLE patients: 13.8%, controls: 6.4%, OR 2.34; 95% CI 2.33-2.83). CONCLUSIONS Calcium levels may play a significant role in the SLE disease process, more than originally thought, since SLE patients are at a higher risk for hypocalcaemic events. Specific changes in vitamin D and calcium homeostasis in SLE patients may be responsible for the severity of symptoms. Further research is required to determine the role of calcium supplementation.
TL;DR: Patients with SLE have a greater prevalence of hyperthyroidism than matched controls, and physicians treating patients with Sle should be aware of this possibility of this thyroid dysfunction.
Abstract: Background: Despite the frequently encountered association between thyroid disease and systemic lupus erythematosus (SLE) is well known, it is of surprise that only several reports compromised of small population size support this observation. Objectives: To investigate the association of comorbid SLE and hyperthyroidism. Methods: Using the database of the largest health maintenance organization (HMO) in Israel, the Clalit Health Services, we searched for the co-existence of SLE and hyperthyroidism. Patients with SLE were compared with age- and sex-matched controls regarding the prevalence of hyperthyroidism in a case–control study. Chi-square and t-tests were used for univariate analysis and a logistic regression model was used for multivariate analysis. Results: The study included 5018 patients with SLE and 25 090 age- and sex- matched controls. The prevalence of hyperthyroidism in patients with SLE was increased compared with the prevalence in controls (2.59% and 0.91%, respectively, p < 0.001)...
TL;DR: Psoriasis is a chronic inflammatory skin disorder that is associated with the metabolic syndrome and its components and an association between obstructive sleep apnea and the metabolic Syndrome was previously observed.
Abstract: Background
Psoriasis is a chronic inflammatory skin disorder that is associated with the metabolic syndrome and its components. An association between obstructive sleep apnea (OSA) and the metabolic syndrome was previously observed.
Objectives
To investigate the association between psoriasis and OSA in a comprehensive community-based database.
Materials and methods
The study was performed utilizing the medical database of Clalit Health Services. Patients with psoriasis were compared to controls regarding the prevalence of OSA in a case–control study. A logistic multivariate model was used to control for independent covariates.
Results
The study included 12,336 patients with psoriasis ≥21 years and 24,008 age- and sex-matched controls. The prevalence of OSA in patients with psoriasis was increased compared to the control group (2.7%, 1.5%, respectively, P < 0.001). Multivariate analysis adjusting for age, sex, ethnicity, body mass index, chronic obstructive pulmonary disease, hypothyroidism, hyperlipidemia, and peptic disease demonstrated a significant association between psoriasis and OSA (odds ratio = 1.27, 95% confidence interval 1.08–1.49, P < 0.001).
Conclusion
We found an association between psoriasis and OSA among a large cohort of patients with psoriasis. Clinicians should take into account that patients with psoriasis may have undiagnosed OSA.
Journal Article•
TL;DR: This is a novel project developing an objective system of measurement, directly assessing the quality of continuity of care for the individual patient in the Southern Region of Clalit Health Services and Soroka University Medical Center.
Abstract: INTRODUCTION The southern district of Clalit Health Services and Soroka University Medical Center are combined in an organizational configuration: the Southern Region. The Region has developed joint programs in order to advance the quality of medical care whilst optimizing the utilization of available resources. An objective continuous method of assessment was needed to evaluate the continuity of care between the community and the hospital. AIMS To produce objective tools for quantification based on pre-existing data systems, which enable ongoing assessment of the quality of continuity of care between the community and hospital, and the impact of the introduction of novel means of improvement. METHODS We defined a set of measurements that exemplify continuity of care in different areas of transition between community and hospital, all directly retrievable from existing computerized data sources. RESULTS About forty different measurements have been defined, in different clinical areas. Of these, a dozen have already been implemented by mapping the process and the main obstacles that the patient goes through, followed by implementation of appropriate solutions. CONCLUSIONS The application of an objective system of assessment of the results of continuity of care, utilizing pre-existing data sources, is essential for advancing the initiative, and is a breakthrough in the quantification of continuity of care. DISCUSSION Continuity of care between community and hospital has been applied in the Southern Region to dozens of quality measurements. This is a novel project developing an objective system of measurement, directly assessing the quality of continuity of care for the individual patient.
TL;DR: The data supports that SLE is an independent risk factor for IHD, and when evaluating by gender, the risk seems even more substantial in females.
Abstract: Background Ischemic heart disease (IHD) is a well identified cause of mortality in SLE patients due to accelerated premature atherosclerosis attributed to both traditional cardiovascular risk factors and to the inflammatory effect of SLE itself (1,2). Objectives To investigate the incidence and prevalence of IHD among Middle Eastern SLE patients derived from a large, national real-life database. Methods Using data from the largest HMO in Israel, the Clalit Health Services, we selected for patients with SLE. These patients were compared with age and sex matched controls with regards to the prevalence of IHD in a case-control study. Chi-square and t-tests were used for univariate analysis and a logistic regression model was used for multivariate analysis. Results The study included 5,018 patients with SLE and 25,090 age and sex-frequency matched controls. The prevalence of IHD in patients with SLE was increased compared to controls (11.3% and 3.1%, respectively, P Conclusions Our data supports that SLE is an independent risk factor for IHD. When evaluating by gender, the risk seems even more substantial in females. References Petri MA, Kiani AN, Post W, Christopher-Stine L, Magder LS. Lupus Atherosclerosis Prevention Study (LAPS).Ann Rheum Dis. 2011;70:760–5 Romero-Diaz J, Vargas-Vόrackova F, Kimura-Hayama E, Cortazar-Benitez LF,Gijόn-Mitre R, Criales S, Cabiedes-Contreras J, Iniguez-Rodriguez Mdel R,Lara-Garcia EA, Nunez-Alvarez C, Llorente L, Aguilar-Salinas C, Sanchez-Guerrero J. Systemic lupus erythematosus risk factors for coronary artery calcifications. Rheumatology (Oxford). 2012;51:110–9. Disclosure of Interest None declared