Arnon D. Cohen

Bio: Arnon D. Cohen is an academic researcher from Clalit Health Services. The author has contributed to research in topics: Population & Odds ratio. The author has an hindex of 41, co-authored 374 publications receiving 7913 citations. Previous affiliations of Arnon D. Cohen include University of Milan & University of Connecticut.

Pemphigus and hematologic malignancies: A population-based study of 11,859 patients.

Abstract: Background The association of nonparaneoplastic pemphigus with comorbid hematologic malignancies has yet to be established. Objective To estimate the association between pemphigus and the common types of hematologic malignancies. Methods A cross-sectional study was conducted comparing pemphigus patients with age-, sex- and ethnicity-matched control subjects regarding the prevalence of 6 comorbid hematologic malignancies. The study was performed using the computerized database of Clalit Health Services ensuring the availability of 4.5 million patients. Results The study included 1985 pemphigus patients and 9874 control subjects. The prevalence of chronic leukemia (0.9% vs 0.4%, odds ratio [OR] 2.1, 95% confidence interval [CI] 1.2-3.6), multiple myeloma (0.8% vs 0.4%, OR 2.2, 95% CI 1.2-3.9), and non-Hodgkin lymphoma (1.8% vs 1.2%, OR 1.5, 95% CI 1.0-2.2) was greater in patients with pemphigus than in controls. The association with chronic leukemia remained significant following the adjustment for immunosuppressive therapy (adjusted OR 2.0, 95% CI 1.1-3.7). No significant associations were observed between pemphigus and acute leukemia, Hodgkin lymphoma, myelodysplastic syndrome, and polycythemia vera. Limitations Lack of immunopathologic validation of the diagnosis of pemphigus. Conclusion A significant association was observed between pemphigus and chronic leukemia, multiple myeloma, and non-Hodgkin lymphoma. Further research is warranted to establish this observation in other cohorts.

Tumor necrosis factor inhibitors are associated with a decreased risk of COVID-19-associated hospitalization in patients with psoriasis- A population-based cohort study.

Abstract: The risk of coronavirus disease 2019 (COVID-19) and its complications among patients with psoriasis treated by tumor necrosis factor inhibitors (TNFis) remains to be decisively delineated We aimed to assess the risk of COVID-19 infection, COVID-19-associated hospitalization, and mortality among Israeli patients with psoriasis treated by TNFi relative to other systemic agents A population-based cohort study was conducted to compare psoriasis patients treated by TNFi (n=1,943), with those treated by methotrexate (n=1,929), ustekinumab (n=348), and acitretin (n=1,892) regarding COVID-19 outcomes Risk of investigated outcomes was assessed using uni- and multi-variate Cox regression analyses The incidence rate of COVID-19, COVID-19-associated hospitalization, and mortality in the TNFi group was 358 (95% CI, 261-479), 08 (95% CI, 00-42), and 00 per 1,000 person-years, respectively Exposure to TNFi was associated with a comparable risk of COVID-19 infection [adjusted hazard ration (HR) for TNFi vs methotrexate: 107 (95% CI, 067-171); TNFi vs ustekinumab: 107 (95% CI, 048-240); TNFi vs acitretin: 098 (95% CI, 061-157)] TNFi was associated with a decreased risk of COVID-19-associated hospitalization relative to methotrexate (adjusted HR, 010; 95% CI, 001-082) and ustekinumab (adjusted HR, 004; 95% CI, 000-064), but not to acitretin (adjusted HR, 100; 95% CI, 016-616) No significant difference in COVID-19-associated mortality was found between the four different groups TNFi was associated with a decreased risk of admissions due to COVID-19 Our findings substantiate the continuation of TNFi treatment during the pandemic TNFi may be positively considered in patients with moderate-to-severe psoriasis warranting systemic treatment during the pandemic This article is protected by copyright All rights reserved

Diabetes control in the Bedouin population in Southern Israel

Abstract: Background: The Bedouins in the Negev are a population in transition from traditional nomadic to a western sedentary lifestyle, characterized by changes in dietary habits and reduction in physical activity, with substantial changes in morbidity patterns. To describe the current state of diabetes prevalence and control among the Bedouin population in the Negev and to compare it to the non-Bedouin population. Material/Methods: A cross-sectional study was performed utilizing the database of Clalit Health Services. In patients with a confirmed diagnosis of diabetes, the following variables were extracted from the laboratory records: hemoglobinAlc (HgA1C) level, urine microalbumin level and low density lipoprotein (LDL) level. Chi-square test was used to compare categorical parameters between the groups. Results: Age-adjusted prevalence of diabetes was 5.1% in the Bedouin population as compared to 3.7% in the non-Bedouin population (p<0.001). Diabetes was more prevalent in urban as compared to rural settlements (5.5% vs. 3.9%, respectively, p<0.001). The proportion of Bedouins patients with controlled diabetes (HgAlC<7) was significantly lower in Bedouin patients (29.3%) as compare to Non-Bedouin patients (46.7%) (p<0.001). Conclusions: Age-adjusted prevalence of diabetes is increased in the Bedouin population as compared to the Non-Bedouin population in southern Israel. Despite similar performance status of laboratory tests and similar treatment regimens, the overall control of diabetes is poorer in the Bedouin population as compared to the Non-Bedouin population. These findings support previous observations that diabetes has become a major public health problem among Bedouins.

FMF Is Associated With a Wide Spectrum of MHC Class I- and Allied SpA Disorders but Not With Classical MHC Class II-Associated Autoimmune Disease: Insights From a Large Cohort Study

Abstract: Objectives: To test the hypothesis that familial Mediterranean fever (FMF)-associated autoinflammation may exaggerate the tendency toward adaptive immunopathology or spondyloarthritis (SpA)-associated disorders including major histocompatibility complex (MHC) class I associated disorders but not classical MHC class II-associated disorders that exhibit transplacental autoimmunity including myasthenia gravis and pemphigus. Methods: Seven thousand seven hundred forty-seven FMF patients and 10,080 age- and sex-matched controls in the Clalit Health Services medical database were identified and compared in terms of prevalence of SpA-associated disorders. We also evaluated four classical and strong MHC class II-associated disorders, namely, pemphigus vulgaris, myasthenia gravis, sarcoidosis, and pernicious anemia, to ascertain whether such associations with SpA-spectrum disease were specific or merely reflected the non-specific consequences of innate immune system activation on driving divergent types of immunity. The diagnosis of FMF was based on the medical records and not genetically proven. Results: FMF showed a strong association with MHC class I-related diseases: odds ratio (OR) of 28.58 [95% confidence interval (95% CI), 6.93-117.87; p < 0.0001] for Behcet's disease, OR of 10.33 (95% CI, 4.09-26.09; p < 0.0001) for ankylosing spondylitis, and OR of 1.67 (95% CI, 1.19-2.33; p = 0.0029) for psoriasis. For weakly MHC class I-linked diseases, an OR of 3.76 (95% CI, 2.48-5.69; p < 0.0001) for Crohn's disease and OR of 2.64 (95% CI, 1.52-4.56; p = 0.0005) for ulcerative colitis were found. No association was found between FMF and the four MHC class II-associated autoimmune disorders. Conclusion: FMF patients are associated with increased risk of SpA-related disease diagnosis including MHC-I-opathies but not MHC-II-associated autoimmune diseases, suggesting that tissue-specific dysregulation of innate immunity share between FMF and SpA spectrum disorders may drive adaptive immune MHC class I-associated conditions.

Harrison's Principles of Internal Medicine

Abstract: The 11th edition of Harrison's Principles of Internal Medicine welcomes Anthony Fauci to its editorial staff, in addition to more than 85 new contributors. While the organization of the book is similar to previous editions, major emphasis has been placed on disorders that affect multiple organ systems. Important advances in genetics, immunology, and oncology are emphasized. Many chapters of the book have been rewritten and describe major advances in internal medicine. Subjects that received only a paragraph or two of attention in previous editions are now covered in entire chapters. Among the chapters that have been extensively revised are the chapters on infections in the compromised host, on skin rashes in infections, on many of the viral infections, including cytomegalovirus and Epstein-Barr virus, on sexually transmitted diseases, on diabetes mellitus, on disorders of bone and mineral metabolism, and on lymphadenopathy and splenomegaly. The major revisions in these chapters and many

The Self-Organizing Map

Abstract: An overview of the self-organizing map algorithm, on which the papers in this issue are based, is presented in this article.

The Geometry of Algorithms with Orthogonality Constraints

Abstract: In this paper we develop new Newton and conjugate gradient algorithms on the Grassmann and Stiefel manifolds. These manifolds represent the constraints that arise in such areas as the symmetric eigenvalue problem, nonlinear eigenvalue problems, electronic structures computations, and signal processing. In addition to the new algorithms, we show how the geometrical framework gives penetrating new insights allowing us to create, understand, and compare algorithms. The theory proposed here provides a taxonomy for numerical linear algebra algorithms that provide a top level mathematical view of previously unrelated algorithms. It is our hope that developers of new algorithms and perturbation theories will benefit from the theory, methods, and examples in this paper.

Sarcoidosis

Abstract: 结节病易误诊,据王洪武等~([1])收集国内18篇关于此病误诊的文献,误诊率高达63.2%,当然有误诊就会有误治,如孙永昌等~([2])报道26例结节病在影像学检查诊断的第一印象中拟诊结核5例,其中就有2例完成规范的抗结核治疗,为此应引起临床对本病诊治的重视。

Type 2 diabetes mellitus.

Abstract: Type 2 diabetes mellitus (T2DM) is an expanding global health problem, closely linked to the epidemic of obesity. Individuals with T2DM are at high risk for both microvascular complications (including retinopathy, nephropathy and neuropathy) and macrovascular complications (such as cardiovascular comorbidities), owing to hyperglycaemia and individual components of the insulin resistance (metabolic) syndrome. Environmental factors (for example, obesity, an unhealthy diet and physical inactivity) and genetic factors contribute to the multiple pathophysiological disturbances that are responsible for impaired glucose homeostasis in T2DM. Insulin resistance and impaired insulin secretion remain the core defects in T2DM, but at least six other pathophysiological abnormalities contribute to the dysregulation of glucose metabolism. The multiple pathogenetic disturbances present in T2DM dictate that multiple antidiabetic agents, used in combination, will be required to maintain normoglycaemia. The treatment must not only be effective and safe but also improve the quality of life. Several novel medications are in development, but the greatest need is for agents that enhance insulin sensitivity, halt the progressive pancreatic β-cell failure that is characteristic of T2DM and prevent or reverse the microvascular complications. For an illustrated summary of this Primer, visit: http://go.nature.com/V2eGfN.