Rappaport Faculty of Medicine

About: Rappaport Faculty of Medicine is a based out in . It is known for research contribution in the topics: Population & Heparanase. The organization has 3205 authors who have published 3915 publications receiving 114533 citations.

Pregnancy in women with hypertrophic cardiomyopathy: Data from the European Society of Cardiology initiated Registry of Pregnancy and Cardiac disease (ROPAC)

Abstract: textWe report the maternal and foetal outcomes at birth and after 6 months in a cohort of pregnant women with hypertrophic cardiomyopathy (HCM). Although most women with HCM tolerate pregnancy well, there is an increased risk of obstetric and cardiovascular complications. Methods and results All pregnant women with HCM entered into the prospective worldwide Registry of Pregnancy and Cardiac disease (ROPAC) were included in this analysis. The primary endpoint was a major adverse cardiovascular event (MACE), which included death, heart failure (HF), thrombo-embolic event, and arrhythmia. Baseline and outcome data were analysed and compared for patients with MACE vs. without MACE and for patients with obstructive HCM vs. nonobstructive HCM. Sixty pregnant women (mean age 30.4 ± 6.0 years) with HCM (41.7% obstructive) were included. No maternal mortality occurred in this cohort. In 14 (23%) patients at least one MACE occurred: 9 (15.0%) HF and 7 (12%) an arrhythmia (6 ventricular and 1 atrial fibrillation). MACE occurred most commonly during the 3rd trimester and postpartum period. In total, 3 (5.0%) women experienced foetal loss. Women with MACE had a higher rate of emergency Caesarean delivery for cardiac reasons (21.4% vs. 0%, P = 0.01). No significant differences in pregnancy outcome were found between women with obstructive and non-obstructive HCM. NYHA functional class of >-II and signs of HF before pregnancy, were associated with MACE. Conclusion Although most women with HCM tolerated pregnancy well, cardiovascular complications were not uncommon and predicted by pre-pregnancy status facilitating pre-pregnancy counselling and targeted antenatal care.

Vitamin D and COVID-19 susceptibility and severity in the COVID-19 Host Genetics Initiative: A Mendelian randomization study

Abstract: Background Increased vitamin D levels, as reflected by 25-hydroxy vitamin D (25OHD) measurements, have been proposed to protect against COVID-19 based on in vitro, observational, and ecological studies. However, vitamin D levels are associated with many confounding variables, and thus associations described to date may not be causal. Vitamin D Mendelian randomization (MR) studies have provided results that are concordant with large-scale vitamin D randomized trials. Here, we used 2-sample MR to assess evidence supporting a causal effect of circulating 25OHD levels on COVID-19 susceptibility and severity. Methods and findings Genetic variants strongly associated with 25OHD levels in a genome-wide association study (GWAS) of 443,734 participants of European ancestry (including 401,460 from the UK Biobank) were used as instrumental variables. GWASs of COVID-19 susceptibility, hospitalization, and severe disease from the COVID-19 Host Genetics Initiative were used as outcome GWASs. These included up to 14,134 individuals with COVID-19, and up to 1,284,876 without COVID-19, from up to 11 countries. SARS-CoV-2 positivity was determined by laboratory testing or medical chart review. Population controls without COVID-19 were also included in the control groups for all outcomes, including hospitalization and severe disease. Analyses were restricted to individuals of European descent when possible. Using inverse-weighted MR, genetically increased 25OHD levels by 1 standard deviation on the logarithmic scale had no significant association with COVID-19 susceptibility (odds ratio [OR] = 0.95; 95% CI 0.84, 1.08; p = 0.44), hospitalization (OR = 1.09; 95% CI: 0.89, 1.33; p = 0.41), and severe disease (OR = 0.97; 95% CI: 0.77, 1.22; p = 0.77). We used an additional 6 meta-analytic methods, as well as conducting sensitivity analyses after removal of variants at risk of horizontal pleiotropy, and obtained similar results. These results may be limited by weak instrument bias in some analyses. Further, our results do not apply to individuals with vitamin D deficiency. Conclusions In this 2-sample MR study, we did not observe evidence to support an association between 25OHD levels and COVID-19 susceptibility, severity, or hospitalization. Hence, vitamin D supplementation as a means of protecting against worsened COVID-19 outcomes is not supported by genetic evidence. Other therapeutic or preventative avenues should be given higher priority for COVID-19 randomized controlled trials.

Inhibin B in men with severe obesity and after weight reduction following gastroplasty.

Abstract: Although the effect of obesity on some gonadal functions in men is known, its effect on Sertoli cell function has not been reported. We tested the hypothesis that the serum inhibin B level is decreased in men with severe obesity, and that this change persists after significant weight loss. We measured gonadal hormones in 17 obese men before (baseline) and after weight reduction following silastic ring vertical gastroplasty (SRVG). Their baseline body mass index (BMI) was 44.3 +/- 1.7 kg/ m2, mean +/- standard error of the mean (SEM). Seven of 16 obese men (44%), compared to 8 of 69 reference men (12%), had a baseline inhibin B level below 100 pg/ml (p < 0.01). A weak inverse association was found between inhibin B and BMI before weight reduction (r = -0.494, p = 0.072). Furthermore, FSH levels, which were weakly inversely associated with inhibin B levels (r = -0.482, p = 0.059), were inappropriately unelevated in 5 of the 7 obese men with low (below 100 pg/ml) inhibin B. After a weight reduction of 40 +/- 2.6 kg, mean +/- SEM, following surgery, the obese men's BMI was 31.6 +/- 1.5 kg/m2, mean +/- SEM, and inhibin B normalized in 3 of the 7 patients with low inhibin B. Despite weight reduction, FSH remained inappropriately unelevated in 2 of the 4 patients whose inhibin B remained low. This study also confirmed previously published findings that obese men have low serum total and free testosterone and relative hypogonadotropic (low LH) hypogonadism that may persist after weight reduction. In conclusion, Serum inhibin B levels in obese men may be low. This may be due to relative hypogonadotropic (also low FSH) hypogonadism.