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Article ; Online: Preoperative body-related emotional distress and culture as predictors of outcomes of bariatric surgery.

Geller, Shulamit / Levy, Sigal / Hyman, Ofra / Jenkins, Paul L / Abu-Abeid, Subhi / Goldzweig, Gil

2021 Volume 26, Issue 7, Page(s) 2361–2369

Abstract: Purpose: Findings concerning the impact of bariatric surgical intervention on both psychological variables and weight loss are often controversial and misconstrued the world over. The aim of this study was to classify bariatric surgery patients ... ...

Abstract	Purpose: Findings concerning the impact of bariatric surgical intervention on both psychological variables and weight loss are often controversial and misconstrued the world over. The aim of this study was to classify bariatric surgery patients according to patterns of preoperative measures that may predict postoperative psychological and physiological outcomes and to compare these patterns between two distinct cultures. Methods: Of 169 consecutive bariatric surgery candidates from Israel and 81 candidates from the United States, 73 and 35 patients, respectively consented to be included in a follow-up phase. Body image dissatisfaction, emotional eating behaviors, risk of suicide, depressive symptoms, anxious symptoms, and percent excess weight loss were measured. K-means clustering procedure was used to classify bariatric surgery patients according to their preoperative body-related emotional distress, which was composed of body image dissatisfaction and emotional eating. The joint effect of culture and body-related emotional distress cluster on psychological distress was tested. Results: The cluster analysis revealed two preoperative body-related emotional distress patterns: high body-related emotional distress and low body-related emotional distress. Following surgery, US patients showed a higher risk of suicide and lower excess weight loss than Israeli patients within only the high body-related emotional distress cluster (a significant interaction effect). Conclusion: Preoperative assessment of body-related emotional distress patterns among bariatric surgery candidates may enable professionals to identify potential postoperative risks of suicide, anxiety, and decreased weight loss. The relationship between the body-related emotional distress cluster and outcome measures is culture dependent. Level iii: Case-control analytic study.
MeSH term(s)	Anxiety ; Bariatric Surgery ; Emotions ; Humans ; Obesity, Morbid/surgery ; Psychological Distress ; Weight Loss
Language	English
Publishing date	2021-01-03
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2038625-4
ISSN	1590-1262 ; 1124-4909
ISSN (online)	1590-1262
ISSN	1124-4909
DOI	10.1007/s40519-020-01085-1
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Article ; Online: Infantile Takayasu: clinical features and long-term outcome.

Miller-Barmak, Adi / Sztajnbok, Flavio / Balik, Zeynep / Borzutzky, Arturo / Fogel, Leslie A / Goldzweig, Ofra / Ozen, Seza / Butbul Aviel, Yonatan

Rheumatology (Oxford, England)

2022 Volume 62, Issue 9, Page(s) 3126–3132

Abstract: Objectives: Takayasu arteritis (TAK) is a large-vessel vasculitis rarely reported in children and infants. Most articles on paediatric TAK have not focused on infants. We present the largest case series of infantile TAK, aiming to identify its ... ...

Abstract	Objectives: Takayasu arteritis (TAK) is a large-vessel vasculitis rarely reported in children and infants. Most articles on paediatric TAK have not focused on infants. We present the largest case series of infantile TAK, aiming to identify its demographic and clinical characteristics and compare them with existing data on older children. Methods: We conducted an international multicentre retrospective cohort study. Epidemiological and clinical data were collected from patients' charts from six rheumatology centres. All patients met both the EULAR/PReS 2008 criteria and the 1990 ACR/EULAR criteria and were diagnosed with TAK at age <5 years. Results: Twelve patients were included (50% female). Median age of symptom onset was 11 months, with a diagnostic delay of 4 months. The most common symptoms at presentation were hypertension, blood pressure differences between limbs, and fever. The most commonly involved arteries were the abdominal aorta and renal artery. Medications included steroids, conventional and biologic DMARDs, and other immunosuppressive therapies. Half of the patients received biologic agents, of which infliximab had the highest complete remission rate (40%). Other medications resulting in complete remission were CYC (40%) and MTX (38%). Invasive procedures were required for 58% of patients. The most common complications were cardiac (50%), stroke (42%), and serious infections (33%). No patients died. Conclusion: This study presents the largest series of infantile TAK. Compared with other reported series on older children, infants with TAK have more severe disease and were more likely to receive biologic agents, develop complications, and require invasive interventions.
MeSH term(s)	Infant ; Humans ; Child ; Female ; Adolescent ; Child, Preschool ; Male ; Retrospective Studies ; Delayed Diagnosis ; Antirheumatic Agents/therapeutic use ; Infliximab/therapeutic use ; Takayasu Arteritis/complications ; Takayasu Arteritis/diagnosis ; Takayasu Arteritis/drug therapy ; Biological Factors/therapeutic use
Chemical Substances	Antirheumatic Agents ; Infliximab (B72HH48FLU) ; Biological Factors
Language	English
Publishing date	2022-12-27
Publishing country	England
Document type	Journal Article
ZDB-ID	1464822-2
ISSN	1462-0332 ; 1462-0324
ISSN (online)	1462-0332
ISSN	1462-0324
DOI	10.1093/rheumatology/keac691
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Article: Juvenile Dermatomyositis (JDM) Complicated by Thrombotic Thrombocytopenic Purpura (TTP) and Purtscher's Retinopathy Responsive to Rituximab: Case Report and Literature Review.

Gullapalli, Keerthi / Goldzweig, Ofra / Nanda, Kabita / Chekka, Ravi / Berry, Shanail / Bukulmez, Hulya

Frontiers in pediatrics

2020 Volume 8, Page(s) 436

Abstract: Juvenile dermatomyositis (JDM) is a multisystem vasculopathy that infrequently presents with acute complications (1). We report here the case of a 12-year-old girl with JDM who developed Thrombotic Thrombocytopenic purpura (TTP) and Purtscher's ... ...

Abstract	Juvenile dermatomyositis (JDM) is a multisystem vasculopathy that infrequently presents with acute complications (1). We report here the case of a 12-year-old girl with JDM who developed Thrombotic Thrombocytopenic purpura (TTP) and Purtscher's retinopathy. This is the second pediatric case of JDM with TTP and Purtscher's retinopathy in the literature. The diagnosis of JDM was based on her clinical presentation (fever, myalgia, proximal muscle weakness, characteristic skin rash and elevated muscle enzymes) (2). Despite improvement of rash, fever and weakness with corticosteroids and intravenous Immunoglobulins (IVIG), the patient developed retinopathy, thrombocytopenia, hemolytic anemia, renal failure, and pulmonary edema within 1 week of initial treatment. A clinical diagnosis of TTP and Purtscher's retinopathy was made and her ADAMTS13 activity was found to be low. Regardless of aggressive treatment with pulse steroid therapy, IVIG, plasmapheresis along with multiple infusions of Fresh Frozen plasma (FFP), her condition deteriorated. In view of her worsening condition, she received one dose of Rituximab and within 48 h, her hematological and retinal involvements improved. Rituximab was given at the same dose once weekly thereafter for 4 total doses. Her disease process was halted, and retinopathy improved significantly in 48 h and continued to gradually improve over 3 weeks of maintenance therapy with cyclosporine, methotrexate, and IVIG and then stabilized. This report documents the association of TTP and Purtscher's retinopathy with JDM, emphasizing that early recognition and prompt treatment with rituximab along with the current standard of care treatment i.e., Vincristine, corticosteroids and plasmapheresis could be of potential benefit in controlling disease activity.
Language	English
Publishing date	2020-08-04
Publishing country	Switzerland
Document type	Case Reports
ZDB-ID	2711999-3
ISSN	2296-2360
ISSN	2296-2360
DOI	10.3389/fped.2020.00436
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Article ; Online: Body Image, Emotional Eating and Psychological Distress among Bariatric Surgery Candidates in Israel and the United States.

Geller, Shulamit / Levy, Sigal / Hyman, Ofra / Jenkins, Paul L / Abu-Abeid, Subhi / Goldzweig, Gil

Nutrients

2020 Volume 12, Issue 2

Abstract: Background: The present study aimed to examine the relations between body image dissatisfaction (BID) and psychological distress variables among bariatric surgery candidates from two distinct cultures in Israel and in the United States.: Methods: A ... ...

Abstract	Background: The present study aimed to examine the relations between body image dissatisfaction (BID) and psychological distress variables among bariatric surgery candidates from two distinct cultures in Israel and in the United States. Methods: A sample of consecutive pre-surgical bariatric candidates was recruited from a Bariatric Center in Israel ( Results: BID was positively correlated with suicidality, depression, and anxiety in both samples. The relations between BID depression and anxiety were mediated by emotional eating in both cultures. However, the relation between BID and suicidality that was mediated by emotional eating in the Israeli sample, was reflected in a direct link between BID and suicidality in the US sample. Conclusion: Our findings confirm the adverse effect of BID on psychological distress among surgery candidates in both cultures, emphasizing the intercultural similarities related to emotional eating behavior. Physicians and other health professionals are encouraged to be more attentive to this specific behavior.
MeSH term(s)	Adolescent ; Adult ; Aged ; Bariatric Surgery/psychology ; Body Dissatisfaction ; Body Image ; Cultural Diversity ; Eating/psychology ; Emotions ; Female ; Humans ; Israel ; Male ; Middle Aged ; Psychological Distress ; United States ; Young Adult
Language	English
Publishing date	2020-02-14
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2518386-2
ISSN	2072-6643 ; 2072-6643
ISSN (online)	2072-6643
ISSN	2072-6643
DOI	10.3390/nu12020490
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Article ; Online: Characterizing the differences between multisystem inflammatory syndrome in children and Kawasaki disease.

Bar-Meir, Maskit / Guri, Alex / Godfrey, Max E / Shack, Avram R / Hashkes, Philip J / Goldzweig, Ofra / Megged, Orli

Scientific reports

2021 Volume 11, Issue 1, Page(s) 13840

Abstract: To characterize the new SARS-Co-V-2 related multisystem inflammatory syndrome in children (MIS-C) among Israeli children and to compare it with Kawasaki disease (KD). We compared, in two medical centers, the clinical and laboratory characteristics of MIS- ...

Abstract	To characterize the new SARS-Co-V-2 related multisystem inflammatory syndrome in children (MIS-C) among Israeli children and to compare it with Kawasaki disease (KD). We compared, in two medical centers, the clinical and laboratory characteristics of MIS-C, KD and an intermediate group, which met the case definitions of both conditions. MIS-C patients were older, were more likely to be hypotensive, to have significant gastrointestinal symptoms, lymphopenia and thrombocytopenia and to have non-coronary abnormal findings in their echocardiogram. Lymphopenia was an independent predictor of MIS-C. Most of our MIS-C patients responded promptly to corticosteroid therapy. KD incidence in both centers was similar in 2019 and 2020. Although there is clinical overlap between KD and MIS-C, these are separate entities. Lymphopenia clearly differentiates between these entities. MIS-C patients may benefit from corticosteroids as first-line therapy.
MeSH term(s)	Adolescent ; Adrenal Cortex Hormones/therapeutic use ; Adult ; COVID-19/complications ; COVID-19/diagnosis ; COVID-19/drug therapy ; COVID-19/pathology ; COVID-19/virology ; Child ; Child, Preschool ; Diagnosis, Differential ; Female ; Humans ; Lymphopenia/diagnosis ; Lymphopenia/pathology ; Male ; Mucocutaneous Lymph Node Syndrome/diagnosis ; Mucocutaneous Lymph Node Syndrome/drug therapy ; Mucocutaneous Lymph Node Syndrome/pathology ; Mucocutaneous Lymph Node Syndrome/virology ; Risk Factors ; SARS-CoV-2/pathogenicity ; Systemic Inflammatory Response Syndrome/diagnosis ; Systemic Inflammatory Response Syndrome/drug therapy ; Systemic Inflammatory Response Syndrome/pathology ; Systemic Inflammatory Response Syndrome/virology ; Young Adult
Chemical Substances	Adrenal Cortex Hormones
Language	English
Publishing date	2021-07-05
Publishing country	England
Document type	Journal Article
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-021-93389-0
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Article ; Online: Characterizing the differences between multisystem inflammatory syndrome in children and Kawasaki disease

Maskit Bar-Meir / Alex Guri / Max E. Godfrey / Avram R. Shack / Philip J. Hashkes / Ofra Goldzweig / Orli Megged

Scientific Reports, Vol 11, Iss 1, Pp 1-

2021 Volume 5

Abstract: Abstract To characterize the new SARS-Co-V-2 related multisystem inflammatory syndrome in children (MIS-C) among Israeli children and to compare it with Kawasaki disease (KD). We compared, in two medical centers, the clinical and laboratory ... ...

Abstract	Abstract To characterize the new SARS-Co-V-2 related multisystem inflammatory syndrome in children (MIS-C) among Israeli children and to compare it with Kawasaki disease (KD). We compared, in two medical centers, the clinical and laboratory characteristics of MIS-C, KD and an intermediate group, which met the case definitions of both conditions. MIS-C patients were older, were more likely to be hypotensive, to have significant gastrointestinal symptoms, lymphopenia and thrombocytopenia and to have non-coronary abnormal findings in their echocardiogram. Lymphopenia was an independent predictor of MIS-C. Most of our MIS-C patients responded promptly to corticosteroid therapy. KD incidence in both centers was similar in 2019 and 2020. Although there is clinical overlap between KD and MIS-C, these are separate entities. Lymphopenia clearly differentiates between these entities. MIS-C patients may benefit from corticosteroids as first-line therapy.
Keywords	Medicine ; R ; Science ; Q
Subject code	610
Language	English
Publishing date	2021-07-01T00:00:00Z
Publisher	Nature Portfolio
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Body Image, Emotional Eating and Psychological Distress among Bariatric Surgery Candidates in Israel and the United States

Geller, Shulamit / Levy, Sigal / Hyman, Ofra / L. Jenkins, Paul / Abu-Abeid, Subhi / Goldzweig, Gil

Nutrients. 2020 Feb. 14, v. 12, no. 2

2020

Abstract	Background: The present study aimed to examine the relations between body image dissatisfaction (BID) and psychological distress variables among bariatric surgery candidates from two distinct cultures in Israel and in the United States. Methods: A sample of consecutive pre-surgical bariatric candidates was recruited from a Bariatric Center in Israel (N = 114) and a Bariatric Center in the Unites States (N = 81). Body image dissatisfaction (BID-BSQ8), suicidal ideation (SBQ-R), depressive symptoms (PHQ-9), anxious symptoms (PHQ-7), and emotional eating behaviors (EES), were measured. Mediation models were assessed using path analysis. Results: BID was positively correlated with suicidality, depression, and anxiety in both samples. The relations between BID depression and anxiety were mediated by emotional eating in both cultures. However, the relation between BID and suicidality that was mediated by emotional eating in the Israeli sample, was reflected in a direct link between BID and suicidality in the US sample. Conclusion: Our findings confirm the adverse effect of BID on psychological distress among surgery candidates in both cultures, emphasizing the intercultural similarities related to emotional eating behavior. Physicians and other health professionals are encouraged to be more attentive to this specific behavior.
Keywords	adverse effects ; anxiety ; bariatric surgery ; body dissatisfaction ; correlation ; distress ; eating habits ; mental depression ; models ; nutrients ; path analysis ; physicians ; sampling ; Israel ; United States
Language	English
Dates of publication	2020-0214
Publishing place	Multidisciplinary Digital Publishing Institute
Document type	Article
Note	NAL-light
ZDB-ID	2518386-2
ISSN	2072-6643
ISSN	2072-6643
DOI	10.3390/nu12020490
Database	NAL-Catalogue (AGRICOLA)

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Article: Case Series of Myocarditis Following mRNA COVID Vaccine Compared to Pediatric Multisystem Inflammatory Syndrome: Multicenter Retrospective Study.

Butbul Aviel, Yonatan / Hashkes, Philip J / Dizitzer, Yotam / Inbar, Kanteman / Berkun, Yackov / Eisenstein, Eli M / Hamad Saied, Mohamad / Goldzweig, Ofra / Heshin-Bekenstein, Merav / Ling, Eduard / Feldon, Michal / Tal, Rotem / Pinchevski-Kadir, Shiran / Tirosh, Irit / Harel, Liora / Amarilyo, Gil / Kaidar, Kfir

Vaccines

2022 Volume 10, Issue 8

Abstract: Introduction: Since the development of COVID-19 vaccines, more than 4.8 billion people have been immunized worldwide. Soon after vaccinations were initiated, reports on cases of myocarditis following the second vaccine dose emerged. This study aimed to ... ...

Abstract	Introduction: Since the development of COVID-19 vaccines, more than 4.8 billion people have been immunized worldwide. Soon after vaccinations were initiated, reports on cases of myocarditis following the second vaccine dose emerged. This study aimed to report our experience with adolescent and young adults who developed post-COVID-19 vaccine myocarditis and to compare these patients to a cohort of patients who acquired pediatric inflammatory multisystem syndrome (PIMS/PIMS-TS) post-COVID-19 infection. Methods: We collected reported cases of patients who developed myocarditis following COVID-19 vaccination (Pfizer mRNA BNT162b2) from all pediatric rheumatology centers in Israel and compared them to a cohort of patients with PIMS. Results: Nine patients with post-vaccination myocarditis were identified and compared to 78 patients diagnosed with PIMS. All patients with post-vaccination myocarditis were males who developed symptoms following their second dose of the vaccine. Patients with post-vaccination myocarditis had a shorter duration of stay in the hospital (mean 4.4 ± 1.9 vs. 8.7 ± 4.7 days) and less myocardial dysfunction (11.1% vs. 61.5%), and all had excellent outcomes as compared to the chronic changes among 9.2% of the patients with PIMS. Conclusion: The clinical course of vaccine-associated myocarditis appears favorable, with resolution of the symptoms in all the patients in our cohort.
Language	English
Publishing date	2022-07-29
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2703319-3
ISSN	2076-393X
ISSN	2076-393X
DOI	10.3390/vaccines10081207
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Article ; Online: Abatacept in the treatment of polyarticular JIA: development, clinical utility, and place in therapy.

Goldzweig, Ofra / Hashkes, Philip J

Drug design, development and therapy

2011 Volume 5, Page(s) 61–70

Abstract: Juvenile idiopathic arthritis (JIA) is a group of chronic arthritides affecting children. The polyarthritis category, affecting five or more joints in the first six months, tends to be more aggressive, leading to a destructive joint disease with ... ...

Abstract	Juvenile idiopathic arthritis (JIA) is a group of chronic arthritides affecting children. The polyarthritis category, affecting five or more joints in the first six months, tends to be more aggressive, leading to a destructive joint disease with significant morbidity, disability, and costs to society. The current treatment regimen, which primarily combines methotrexate and tumor necrosis factor alpha (TNF-α) blockade, still leaves a significant group of patients with an inadequate response. Therefore, the development of new medications that act via other mechanisms of pathogenesis is necessary. T cell lymphocytes are key components in the immune reaction in JIA. Cytotoxic lymphocyte-associated antigen-4 (CTLA-4) is a potent inhibitor of the costimulation pathway necessary to activate T cells. Abatacept is a recombinant fusion protein comprising the extracellular part of human CTLA-4 connected to a modified Fc part of IgG-1. In a randomized, multinational, blinded withdrawal study in children with polyarticular JIA, abatacept was found to be effective in about 70% of the patients, including 39% of TNF-α blockade failures, with significantly fewer flares occurring during the withdrawal phase than in patients receiving placebo. Abatacept continued to show good efficacy in a three-year open-label extension study, with a beneficial effect on health-related quality of life. The safety profile of abatacept is generally good. In 2008, the US Food and Drug Administration approved abatacept for use in children over six years of age with JIA and a polyarticular course. In 2010, the European Medicines Agency gave approval for abatacept to be used in combination with methotrexate for those who fail at least one disease-modifying medication and TNF-α blockade.
MeSH term(s)	Abatacept ; Antirheumatic Agents/adverse effects ; Antirheumatic Agents/pharmacology ; Antirheumatic Agents/therapeutic use ; Arthritis, Juvenile/drug therapy ; Arthritis, Juvenile/immunology ; Arthritis, Juvenile/physiopathology ; Child ; Drug Design ; Drug Therapy, Combination ; Humans ; Immunoconjugates/adverse effects ; Immunoconjugates/pharmacology ; Immunoconjugates/therapeutic use ; Methotrexate/therapeutic use ; Quality of Life ; T-Lymphocytes/immunology ; Tumor Necrosis Factor-alpha/antagonists & inhibitors
Chemical Substances	Antirheumatic Agents ; Immunoconjugates ; Tumor Necrosis Factor-alpha ; Abatacept (7D0YB67S97) ; Methotrexate (YL5FZ2Y5U1)
Language	English
Publishing date	2011-01-26
Publishing country	New Zealand
Document type	Journal Article ; Review
ZDB-ID	2451346-5
ISSN	1177-8881 ; 1177-8881
ISSN (online)	1177-8881
ISSN	1177-8881
DOI	10.2147/DDDT.S16489
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Article ; Online: Risk factors for haemodynamic compromise in multisystem inflammatory syndrome in children: a multicentre retrospective study.

Kaidar, Kfir / Dizitzer, Yotam / Hashkes, Philip J / Wagner-Weiner, Linda / Tesher, Melissa / Butbul Aviel, Yonatan / Inbar, Kanteman / Berkun, Yackov / Eisenstein, Eli M / Saied, Mohamad Hamad / Goldzweig, Ofra / Heshin-Bekenstein, Merav / Ling, Eduard / Feldon, Michal / Levinsky, Yoel / Tal, Rotem / Harel, Liora / Amarilyo, Gil

Rheumatology (Oxford, England)

2022 Volume 62, Issue 8, Page(s) 2829–2837

Abstract: Objectives: To identify predictors of a severe clinical course of multisystem inflammatory syndrome in children (MIS-C), as defined by the need for inotropic support.: Methods: This retrospective study included patients diagnosed with MIS-C ( ... ...

Abstract	Objectives: To identify predictors of a severe clinical course of multisystem inflammatory syndrome in children (MIS-C), as defined by the need for inotropic support. Methods: This retrospective study included patients diagnosed with MIS-C (according to the CDC definition) in nine Israeli and one US medical centre between July 2020 and March 2021. Univariate and multivariate regression models assessed odds ratio (OR) of demographic, clinical, laboratory and imaging variables during admission and hospitalization for severe disease. Results: Of 100 patients, 61 (61%) were male; mean age 9.65 (4.48) years. Sixty-five patients were hypotensive, 44 required inotropic support. Eleven patients with MIS-C fulfilled Kawasaki disease diagnostic criteria; 87 had gastrointestinal symptoms on admission. Echocardiographic evaluation showed 10 patients with acute coronary ectasia or aneurysm, and 37 with left ventricular dysfunction. In a univariate model, left ventricular dysfunction was associated with severe disease [OR 4.178 (95% CI 1.760, 9.917)], while conjunctivitis [OR 0.403 (95% CI 0.173, 0.938)] and mucosal changes [OR 0.333 (95% CI 0.119, 0.931)] at admission were protective. Laboratory markers for a severe disease course were low values of haemoglobin, platelets, albumin and potassium; and high leukocytes, neutrophils, troponin and brain natriuretic peptide. In multivariate analysis, central nervous system involvement and fever >39.5°C were associated with severe disease. Mucosal involvement showed 6.2-fold lower risk for severe disease. Low haemoglobin and platelet count, and elevated C-reactive protein and troponin levels were identified as risk factors for severe disease. Conclusion: Key clinical and laboratory parameters of MIS-C were identified as risk factors for severe disease, predominantly during the disease course and not at the time of admission; and may prompt close monitoring, and earlier, more aggressive treatment decisions. Patients presenting with a Kawasaki-like phenotype were less likely to require inotropic support.
MeSH term(s)	Male ; Female ; Humans ; Retrospective Studies ; Risk Factors ; Connective Tissue Diseases ; Disease Progression ; Echocardiography ; Hemodynamics
Language	English
Publishing date	2022-12-28
Publishing country	England
Document type	Multicenter Study ; Journal Article
ZDB-ID	1464822-2
ISSN	1462-0332 ; 1462-0324
ISSN (online)	1462-0332
ISSN	1462-0324
DOI	10.1093/rheumatology/keac692
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