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West Jerusalem, Israel

Zornitzki T.,Endocrinology Unit | Zornitzki T.,University Hadassah Medical School | Froimovici M.,Womens Health Center | Amster R.,Womens Health Center Noy Katovic | And 4 more authors.
Israel Medical Association Journal

Background: The prevalence of thyroid dysfunction in early pregnancy in Israel is not known.Objectives: To assess the rate of abnormal thyroid-stimulating hormone (TSH) tests in low risk pregnant women attending a community clinic in Israel.Methods: We conducted a retrospective analysis of the charts of low risk pregnant women (n=303) who had undergone a TSH screening during the first trimester of pregnancy at Clalit Health Services Women’s Health Centers in Ashkelon and Tel Aviv. TSH of 0.1–2.5 mIU/L during the first trimester was considered to be normal.Results: The TSH levels ranged from 0.04 to 13.3 mIU/L (median 1.73 mIU/L, mean 1.88 mIU/L). The rate of abnormal TSH was 25.6%, with low TSH 2.3% and high TSH 23.4%. The prevalence of abnormal TSH was not influenced by gravidity (primigravidas versus multigravidas) or place of residence (Ashkelon or Tel Aviv).Conclusions: In view of the high prevalence of abnormal TSH (25.6%) in pregnant women in Israel during the first trimester, a universal country-wide screening should be considered. © 2014, Israel Medical Association. All rights reserved. Source

Asher I.,University Hadassah Medical School | Guri K.M.,University Hadassah Medical School | Elbirt D.,University Hadassah Medical School | Bezalel S.R.,University Hadassah Medical School | And 5 more authors.
Medicine (United States)

To characterize the clinical, virological, and immunological status at presentation as well as the outcome of patients diagnosed with HIV above the age of 50. A retrospective study of 418 patients newly diagnosed with HIV in 1 Israeli center, between the years 2004 and 2013. Patients with new HIV diagnosis ≥50 years of age defined as "older" and <50 defined as "younger." Patients were evaluated every 1 to 3 months (mean follow-up 53 ± 33 months). Patients with <2 CD4/viral-load measurements or with <1 year of follow-up were excluded. Time of HIV infection was estimated by HIV sequence ambiguity assay. Ambiguity index ≤0.43 indicated recent (≤1 year) HIV infection. Eighty nine (21%) patients were diagnosed with HIV at an older age. Those older patients presented with significant lower CD4 cell counts and higher viral-load compared with the younger patients. At the end of the study, the older patients had higher mortality rate (21% vs 3.5%; P<0.001) and lower CD4 cell counts (381 ± 228 vs 483 ± 261cells/mL; P<0.001) compared with the younger patients. This difference was also observed between older and younger patients with similar CD4 cell counts and viral load at the time of HIV diagnosis and among patients with a recent (≤1 year) HIV infection. One-fifth ofHIVpatients are diagnosed at older age (≥50 years).Those older patients have less favorable outcome compared with the younger patients. This point to the need of educational and screening programs within older populations and for a closer follow-up of older HIV patients. © 2016 Wolters Kluwer Health, Inc. All rights reserved. Source

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