Liraz Olmer

Background: Eosinophilia, defined as peripheral blood eosinophil counts > 0.5 K/μL, is associated with various clinical conditions, including allergic, infectious, and malignant diseases. Emerging evidence suggests that eosinophils may contribute to thrombo-inflammatory processes, but their association with thromboembolic events and mortality remains insufficiently characterized. This study aimed to evaluate whether eosinophilia is independently associated with increased risk of thromboembolic events and mortality in hospitalized patients. Methods: We conducted a retrospective cohort study using electronic medical records from Sheba Medical Center (2011–2020). Eosinophilia was classified as mild (0.5–1.5 K/μL) or hypereosinophilia (HE, >1.5 K/μL). Patients with eosinophilia were matched 1:1 to controls with normal eosinophil counts based on age, sex, and follow-up duration. Results: Among 93,320 patients (46,660 with eosinophilia and 46,660 controls), thromboembolic events occurred in 20.9% of eosinophilic patients vs. 9.8% of controls. Eosinophilia was independently associated with thrombosis (OR = 1.33; 95% CI, 1.28–1.38; p < 0.0001), with increased risk from counts ≥ 0.7 K/μL. Mortality was also higher among eosinophilic patients (HR = 1.17; 95% CI, 1.13–1.20; p < 0.0001). Conclusions: Eosinophilia is associated with increased thromboembolic and mortality risk, highlighting the importance of eosinophil monitoring in clinical practice.

Marginalized racial/ethnic minorities have disproportionately high rates of type 2 diabetes prevalence, complications and mortality. Researchers and policymakers have typically addressed these disparities using a deficit-based discourse focused on individual/cultural deficiencies or failure. A mixed-methods study was used to compare the deficit discourse to the perspectives of adults with diabetes in the Arab minority in Israel, using data from 10 focus groups (5 men’s, 5 women’s) and 296 quantitative in-person surveys. Both qualitative and quantitative data were triangulated. In addition, multivariable regression models tested associations between diabetes management perspectives and participant characteristics. Contrary to the deficit-based characterizations of patients as fatalistic and unknowledgeable, participants viewed diabetes as a chronic disease with serious complications. They expressed more support for patient responsibility in diabetes management than for passive fatalism, and were less fatalistic as educational level and adequacy of diabetes self-care training increased. The impact of social/environmental barriers and changing cultural norms on lifestyle behaviors was highlighted. Over 95% used prescription medications for diabetes management, although 35% reported economic barriers. The deficit discourse is not well-aligned with Arab patients’ evolving perceptions and needs, and has deflected attention from the socioeconomic/structural determinants of health, and the healthcare system’s responsibility to provide effective, culturally-relevant diabetes services.

Objectives: The BNT162b2 mRNA COVID-19 vaccine has been found to be highly effective in preventing COVID-19 but is associated with increased reactogenicity. We aimed to examine the correlation between immunogenicity and reactogenicity of the BNT162b2 vaccine. Methods: Subjects without prior SARS-CoV-2 infection that participated in active surveillance after being vaccinated with the BNT162b2 vaccine were included. Study participants reported adverse drug reactions (ADRs) through questionnaires administered by text message after receiving each dose of the vaccine. A reactogenicity score was developed based on the type and duration of ADRs. In addition, anti-receptor binding domain (RBD) levels and neutralization assays were performed 7–21 and 7–38 days after the first and second vaccine doses, respectively. Associations between ADRs and antibody levels were assessed by Spearman correlations. Multivariable logistic regression analyses were used to identify factors associated with ADRs. Results: A total of 831 health care workers were included. The mean age was 46.5 years (SD = 11.8) and 75.5% were females. 83.4% and 83.3% had at least one local ADR after the first and second doses, respectively. 33% and 83.2% had at least one systemic ADR after the first and second doses, respectively. Multivariate logistic regression analysis found a significant correlation between ADR score and anti-RBD-IgG titers (r = 0.366; p < 0.0001) after adjustment for age, gender, and days after the second vaccination. High anti-RBD-IgG levels, being younger than 55 and being female, were all correlated with increased rates of ADRs. Conclusion: BNT162b2 mRNA COVID-19 vaccine reactogenicity appears to be correlated with higher post-vaccination antibody levels and is independently associated with younger age and female gender.