Shmuel Klang
Clalit Health Services
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Publication
Featured researches published by Shmuel Klang.
The American Journal of Gastroenterology | 2009
Zohar Levi; Paul Rozen; Rachel Hazazi; Alex Vilkin; Amal Waked; Eran Maoz; Shlomo Birkenfeld; Nicky Lieberman; Shmuel Klang; Yaron Niv
OBJECTIVES:We evaluated the effect of the use of aspirin, nonsteroidal anti-inflammatory drugs (NSAIDS), and anticoagulants on the performance of immunochemical fecal occult blood test (I-FOBT).METHODS:A prospective, cross-sectional study of 1,221 ambulatory patients having total colonoscopy after preparing three I-FOBTs. Information regarding the use of medications was collected from the health medical organization (HMO) database. I-FOBT was analyzed with the OC-MICRO instrument using both ≥75 and 100 ngHb/ml of buffer thresholds to determine positivity.RESULTS:Colorectal cancer (CRC) was found in 17 and advanced adenomatous polyp (AAP) in 97 patients. A total of 212 patients were using aspirin/NSAIDS at the time of I-FOBT testing. Qualitative analysis for the detection of AAP/CRC reveals a trend for an increased sensitivity with aspirin/NSAIDS use. At the threshold 75 ng/ml for positivity, the sensitivity for the detection of AAP/CRC was 66.7% for aspirin/NSAIDS use vs. 51.2% for nondrug takers (P=0.20), and at the threshold of 100 ng/ml, the sensitivity was 66.7 vs. 46.5% (P=0.09). The specificity, however, was not affected by the use of aspirin/NSAIDS. At the threshold of 75 ng/ml for positivity, the specificity for the detection of AAP/CRC was 89.5% for aspirin/NSAIDS use vs. 91.2% for nondrug takers (P=0.47), and at the threshold of 100 ng/ml, the specificity was 92.17 vs. 93.0% (P=0.69). A total of 33 patients were using antithrombotics/coagulants at the time of I-FOBT testing. This group was small; however, it appears that their use was also associated with a trend for increased sensitivity and no change in specificity.CONCLUSIONS:The use of aspirin/NSAIDS and anticoagulants was associated with a trend for increased sensitivity with no change in specificity for the detection of AAP/CRC. This study suggests that there is no need to stop these agents before I-FOBT testing.
Annals of Pharmacotherapy | 2008
Ariel Hammerman; Jacob Dreiher; Shmuel Klang; Hanan Munitz; Arnon D. Cohen; Margalit Goldfracht
Background Previous studies have reported an association between antipsychotic medications and diabetes. Objective To explore the association between antipsychotic medications and diabetes in patients of different ages. Methods A retrospective analysis of a large health maintenance organizations drug claim database (3.7 million members) was performed. All patients treated with antipsychotic drugs during 1998–2004 were identified. Patients with diabetes were defined by a record of antidiabetic drug uso during 2004. The prevalence of diabetes in different age groups treated with antipsychotics was compared with the prevalence of diabetes among enrollees in the same age groups not treated with antipsychotics. Results: Among 82,754 patients treated with antipsychotics, the association between diabetes and consumption of antipsychotics was strongest in the younger age groups and decreased with increasing age: for patients aged 0–24 years, OR 8.9 (95% CI 7.0 to 11.3); 25–44 years, OR 4.2 (95% CI 3,8 to 4.5); 45–54 years, OR 1.9 (95% CI 1.8 to 2.1); 55–64 years, OR 1.3 (95% CI 1.2 to 1.4); and 65 years or older, OR 0.93 (95% CI 0.9 to 1.0). However, the risk associated with atypical antipsychotics was lower than the risk associated with typical antipsychotics, with ORs ranging from 0.7 in patients 0–24 years old to 0.3 in those 65 years or older. Conclusions: Antipsychotic drug use was associated with diabetes mellitus. This association was stronger in younger patients. In older adults, the difference was much smaller and, in some cases, there was no association. A lowor risk was associated with atypical agents, as compared with typical antipsychotics. Clinicians should bo aware that young adults treated with antipsychotics are at increased risk for diabetes.
Value in Health | 2010
Shmuel Klang; Ariel Hammerman; Nicky Liebermann; Noa Efrat; Julie Doberne; John Hornberger
Breast Cancer Research and Treatment | 2013
Salomon M. Stemmer; Shmuel Klang; Noa Ben-Baruch; David B. Geffen; Mariana Steiner; Lior Soussan-Gutman; Shahar Merling; Christer Svedman; Shulamith Rizel; Nicky Lieberman
Journal of Clinical Oncology | 2010
Shmuel Klang; Nicky Liebermann; Shulamith Rizel; Noa Ben-Baruch; Shahar Merling; Lior Soussan-Gutman; R. Bugarini; C. Chao; Steven Shak
Value in Health | 2006
Ariel Hammerman; Shmuel Klang; Nicky Liebermann
Journal of Clinical Oncology | 2017
Salomon M. Stemmer; Mariana Steiner; Shulamith Rizel; Noa Ben Baruch; Lior Soussan-Gutman; Avital Bareket-Samish; Bella Nisenbaum; Kevin Isaacs; Georgeta Fried; Ora Rosengarten; Tamar Peretz; Christer Svedman; Debbie McCullough; Shmuel Klang; Jamal Zidan; Larisa Ryvo; Bella Kaufman; Steven Shak; Nicky Liebermann; David B. Geffen
Journal of Clinical Oncology | 2017
Salomon M. Stemmer; Mariana Steiner; Shulamith Rizel; Noa Ben Baruch; David B. Geffen; Lior Soussan-Gutman; Avital Bareket-Samish; Bella Nisenbaum; Kevin Isaacs; Georgeta Fried; Ora Rosengarten; Beatrice Uziely; Christer Svedman; Debbie McCullough; Shmuel Klang; Ella Evron; Natalya Karminsky; Hadassah Goldberg; Steven Shak; Nicky Liebermann
Journal of Clinical Oncology | 2017
Baruch Brenner; Ravit Geva; Alexander Beny; Ygael Dror; Mariana Steiner; Ayala Hubert; Efraim Idelevich; Alexander Gluzman; Ofer Purim; Einat Shacham-Shmueli; Katerina Shulman; Lior Soussan-Gutman; Shmuel Klang; Shahar Merling; Nicky Liebermann
Value in Health | 2009
Ariel Hammerman; Shmuel Klang; Nicky Liebermann