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  1. Article ; Online: The link between vitamin D deficiency and Covid-19 in a large population

    Israel, A. / Cicurel, A. A. / Feldhamer, I. / Dror, Y. / Giveon, S. M. / Gillis, D. / Strich, D. / Lavie, G.

    Abstract: BACKGROUND Recent studies suggest a link between vitamin D deficiency and Covid-19 infection. In our population we observe major differences in Covid-19 incidence in ethnic groups and genders in each group. METHODS We carried out a population-based study ...

    Abstract BACKGROUND Recent studies suggest a link between vitamin D deficiency and Covid-19 infection. In our population we observe major differences in Covid-19 incidence in ethnic groups and genders in each group. METHODS We carried out a population-based study among 4.6 million members of Clalit Health Services (CHS). We collected results from vitamin D tests performed between 2010 and 2019 and used weighted linear regression to assess the relationship between prevalence of vitamin D deficiency and Covid-19 incidence in 200 localities. Additionally, we matched 52,405 infected patients with 524,050 control individuals of the same sex, age, geographical region and used conditional logistic regression to assess the relationship between baseline vitamin D levels, acquisition of vitamin D supplements in the last 4 months, and positive Covid-19. RESULTS We observe a highly significant correlation between prevalence of vitamin D deficiency and Covid-19 incidence, and between female-to-male ratio for severe vitamin D deficiency and female-to-male ratio for Covid-19 incidence in localities (P<0.001). In the matched cohort, we found a significant association between low vitamin D levels and the risk of Covid-19, with the highest risk observed for severe vitamin D deficiency. A significant protective effect was observed for members who acquired liquid vitamin D formulations (drops) in the last 4 months. CONCLUSION In this large observational population study, we show a strong association between vitamin D deficiency and Covid-19 occurrence. After adjustment for baseline characteristics and prior vitamin D levels, acquisition of liquid vitamin D formulations is associated with decreased risk for Covid-19 infection.
    Keywords covid19
    Publisher MedRxiv; WHO
    Document type Article ; Online
    DOI 10.1101/2020.09.04.20188268
    Database COVID19

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  2. Article: A survey of primary care physicians' perceptions of their patients' use of complementary medicine.

    Giveon, S M / Liberman, N / Klang, S / Kahan, E

    Complementary therapies in medicine

    2004  Volume 11, Issue 4, Page(s) 254–260

    Abstract: Purpose: To study the perceptions and attitudes of primary care physicians concerning their patients' use of complementary medicine.: Methods: A questionnaire was distributed to all 165 primary care physicians attending a routine continuing-medicine ... ...

    Abstract Purpose: To study the perceptions and attitudes of primary care physicians concerning their patients' use of complementary medicine.
    Methods: A questionnaire was distributed to all 165 primary care physicians attending a routine continuing-medicine education program. Items included physicians' estimated rates of patient utilization of complementary medicine or herbal remedies and of patient reportage of such use; physicians' knowledge about side effects and interactions of herbal remedies; and frequency with which physicians questioned their patients on the use of complementary medicine and herbal remedies.
    Results: The compliance rate was 90.0% (n=150). Sixty-eight percent of physicians estimated that up to 15% of their patients use complementary medicine; 58% always or often asked their patients about it; 50% estimated that 10% of patients report use of complementary medicine, and 60% estimated the same rate for herbal remedies; 51% believed that herbal remedies have no or only mild side effects; more than 70% claimed that they had little or no knowledge about what herbal remedies are; 24% never referred patients for complementary medicine, and 69% did so occasionally. Twenty-five percent had some training in complementary medicine, and 31% practiced some kind of complementary medicine. Most of the physicians believed that people turn to alternative methods when they are dissatisfied with conventional medicine.
    Conclusions: Physicians underestimate the rate of complementary medicine use by patients, suggesting that many patients do not report such use to their physician. Since alternative treatments are potentially harmful and may interact with conventional medications, physicians should be encouraged to communicate with patients about complementary medicine in general and herbal remedies in particular, and they should regularly include questions about their use when taking histories. They should also inform themselves about risks of alternative treatments particularly with herbal remedies, and have access to appropriate information systems.
    MeSH term(s) Attitude of Health Personnel ; Complementary Therapies/adverse effects ; Complementary Therapies/statistics & numerical data ; Family Practice ; Female ; Herb-Drug Interactions ; Humans ; Male ; Medical History Taking ; Middle Aged ; Physician-Patient Relations ; Self Medication/adverse effects
    Language English
    Publishing date 2004-03-10
    Publishing country Scotland
    Document type Journal Article
    ZDB-ID 1155895-7
    ISSN 0965-2299
    ISSN 0965-2299
    DOI 10.1016/s0965-2299(03)00114-6
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Behavior of patients with flu-like symptoms: consultation with physician versus self-treatment.

    Kahan, E / Giveon, S M / Zalevsky, S / Imber-Shachar, Z / Kitai, E

    The Israel Medical Association journal : IMAJ

    2000  Volume 2, Issue 6, Page(s) 421–425

    Abstract: Background: The reasons that patients consult the clinic physician for common minor symptoms are not clearly defined. For seasonal epidemic events such as flu-like symptoms this characterization is relevant.: Objectives: To identify the factors that ... ...

    Abstract Background: The reasons that patients consult the clinic physician for common minor symptoms are not clearly defined. For seasonal epidemic events such as flu-like symptoms this characterization is relevant.
    Objectives: To identify the factors that prompt patients to seek medical attention, and correlate patient behavior with different demographic and disease variables.
    Methods: A random sample of 2,000 enrolled people aged 18-65 years and registered with eight primary care clinics located throughout Israel were asked to report whether they had had flu-like symptoms within the previous 3 months. Those who responded affirmatively (n = 346) were requested to complete an ad hoc questionnaire evaluating their treatment-seeking behavior.
    Results: A total of 318 patients completed the questionnaire (92% response rate), of whom 271 (85%) consulted a physician and 47 (15%) did not. Those who sought medical assistance had more serious symptoms as perceived by them (cough, headache and arthralgia) (P < 0.05), and their main reason for visiting the doctor was "to rule out serious disease." Self-employed patients were more likely than salaried workers to visit the clinic to rule out serious disease (rather than to obtain a prescription or sick note or to reassure family). They also delayed longer before seeking treatment (P = 0.01).
    Conclusion: In our study the majority of individuals with flu symptoms tended to consult a physician, though there were significant variations in the reasons for doing so, based on a combination of sociodemographic variables. We believe these findings will help primary care physicians to characterize their practices and to program the expected demand of flu-like symptoms.
    MeSH term(s) Adolescent ; Adult ; Aged ; Employment ; Female ; Health Behavior ; Humans ; Influenza, Human ; Israel ; Male ; Middle Aged ; Patients/psychology ; Physicians/utilization ; Self Medication ; Socioeconomic Factors
    Language English
    Publishing date 2000-06
    Publishing country Israel
    Document type Clinical Trial ; Comparative Study ; Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
    ZDB-ID 2008291-5
    ISSN 1565-1088 ; 0021-2180
    ISSN 1565-1088 ; 0021-2180
    Database MEDical Literature Analysis and Retrieval System OnLINE

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