Despite the established association between chronic idiopathic/spontaneous urticaria (CIU) and presence of antinuclear antibodies (ANAs), the prevalence of autoimmune comorbidities in this population has not been analyzed. Here, we aim to identify clinical and laboratory manifestations associated with ANA-positive CIU. ANA-positive patients were identified via electronic data capture from the electronic patient record database of Leumit Health care Services (LHS) of Israel. Patient characteristics, medical histories, and details of diagnostic workup, medical treatment, and follow-up were retrieved by performing a chart review of electronic patient records (EPRs). The prevalence of target diseases among ANA(+) CIU(+), ANA(+) CIU(-), and ANA(-) CIU(+) patients was calculated. A total of 91 ANA(+) CIU(+), 3131 ANA(+) CIU(-), and 478 ANA(-) CIU(+) patients were identified. The ANA(+) CIU(+) group was characterized by higher prevalence of Sjögren's syndrome (SS)-A 52 antibodies (Ab) (7.7% versus 2.4%; p = 0.008), SS-A 60 Ab (11% versus 2.8%; p = < 0.001), and SS-B Ab (14.3% versus 3.2%; p < 0.001), compared with ANA(-) CIU(+) group. Additionally, ANA(+) CIU(+) patients were more likely to be diagnosed with thyroid autoimmune diseases, higher C-reactive protein (6.4 ± 10.3 versus 4.1 ± 8.8 mg/L; p = 0.027), and more profound basopenia (0.04 ± 0.09 versus 0.15 ± 0.11 cell/mm(3); p < 0.001) than ANA(-) CIU patients. More ANA(+) CIU(+) patients were resistant to four-fold standard licensed doses of antihistamines than ANA(-) CIU(+) patients [11 (12.1%) versus 29 (6.1%); p = 0.046]. ANA-positive CIU is characterized by higher prevalence of SS-A 52, SS-A 60, and SS-B antibodies and poorer clinical response to antihistamine medications.

Since the emergence of the SARS-CoV-2 pandemic, various genetic variants have been described. The B.1.1.7 variant, which emerged in England during December 2020, is associated with increased infectivity. Therefore its pattern of spread is of great importance. The Israeli government established three national programs: massive RT-PCR testing, focused surveillance in nursing homes and robust prioritized vaccination with BNT162b2. To define the impact of the aforementioned programs, we analyze data from ∼300,000 RT-PCR samples collected from December 6 th 2020 to February 10 th 2021. We reveal that the B.1.1.7 is 45% (95% CI:20-60%) more transmissible than the wild-type strain, and become the dominant in Israel within 3.5 weeks. Despite the rapid increase in viral spread, focused RT-PCR testing and prioritized vaccination programs are capable of preventing the spread of the B.1.1.7 variant in the elderly. Therefore, proactive surveillance combined with prioritized vaccination are achievable, and reduce severe illness and subsequent death.

Cytomegalovirus (CMV) is a leading cause of physical and neurological abnormalities in newborns. Hence, the diagnosis of CMV infection in pregnant women is necessary in order to allow appropriate management of their pregnancy. New assays have been developed for the Roche Elecsys® immunoassay platform that detect CMV-specific immunoglobulin (Ig)M and IgG, with the IgM assay designed to target IgM produced at the start of infection rather than IgM persisting later in infection. This study aimed to evaluate the performance of the new assays compared with other commercial kits widely distributed in laboratories. The performance of the Elecsys and comparator CMV IgM and IgG assays was assessed using 967 preselected patient samples characterised by CMV infection status, as well as being compared using 1,668 unselected clinical samples. The Elecsys CMV IgM and IgG assays performed consistently with comparator assays using the preselected samples. The Elecsys CMV IgM assay showed improved sensitivity compared with the Enzygnost® assay in primary infection (91.2 % vs. 79.4 %) and improved specificity over the Architect® assay in potentially cross-reacting samples (94.1 % vs. 82.4 %). The Elecsys IgM assay reported fewer positive results in the later stages of CMV infection compared with ETI-CYTOK-M ELISA, while the Elecsys IgG assay reported slightly fewer negative results in the early stages of infection compared with ETI-CYTOK-G ELISA. There was good agreement between Elecsys and comparator assays using unselected clinical samples (range 90.4-99.4 %). The Elecsys CMV IgM and IgG assays compare well with routinely used assays and are suitable for clinical use.

Since the emergence of the SARS-CoV-2 pandemic various generic variants have been described. Of specific interest is a new variant, which was observed in England during December 2020 and is now termed B.1.1.7. This variant is now associated with increased infectivity and therefore its spread within the community is of great importance. The Israeli government established three noteworthy programs namely, mass PCR testing, focused protection of the elderly and more recently an unparalleled prioritized vaccination program. In this study we analyzed primary data of >300,000 RT-PCR samples collected throughout December 6th 2020 until February 10th 2021 in the general community and nursing homes. We identified that within a period of six weeks, the B.1.1.7 variant was capable of out competing the wildtype SARS-CoV-2 strain to become the main strain. Furthermore, we show that the transmission of B.1.1.7 in the 60+ population reached a near complete halt, due to an ongoing surveillance testing program in nursing homes and the vaccination program of Israel. Thus, proactive protection programs such as routine surveillance and monitoring of populations at risk combined with prioritized vaccination, is achievable and will result in a reduction of severe illness and subsequent death.

T3, covalently bound to red blood cells (RBCs), stimulated the uptake rate of 2-deoxy-D-glucose (2-DOG) in cultured chick embryo heart cells. The response, measured 6 h after exposure, was at least the same than that to free T3. An inhibitor of rhodamine-T3 internalization, bacitracin, did not affect the stimulation of sugar uptake by T3 regardless of whether T3 was covalently bound or free. Pretreatment of RBC-T3 with anti-T3 immunoglobulin G completely blocked the effect of T3, whereas normal rabbit immunoglobulin G failed to do so. Addition of 5% chick serum to the medium stimulated 2-DOG uptake to 144% of the control at 6 h. Adding T3 (10 nM) to the serum-containing medium increased 2-DOG uptake to 171% of the control. The effect of T3 alone or in the presence of serum was not inhibited by cycloheximide, puromycin, or actinomycin D. A T3 dose response curve, in medium containing 10% dehormonized serum, showed enhancement of the T3 effect when compared with the curve obtained in the serum-free medium. The minimal effective concentration of T3 was 10 pM in the presence of serum and 100 pM in its absence. The slope of the linear portion of the dose response curve was greatly increased and the maximal response markedly enhanced by serum. The ED50 was 0.33 nM vs. 0.43 nM in terms of total T3 concentration and 0.16 nM vs. 0.43 nM in terms of free T3 in the presence or absence of serum, respectively. These data suggest that T3, in physiological concentrations, activates sugar transport through an external contact with the cell surface.