Background: Previous studies described a higher prevalence of cardiovascular comorbidities during the winter season. Data regarding seasonal association of atrioventricular (AV) block are scarce. Methods: A retrospective cohort analysis of all patients admitted to a tertiary medical center with AV block requiring a permanent pacemaker (PPM) implantation between 2006-2017 was performed. In a time-series analysis, the seasonal incidence of PPM implementations due to AV block was assessed and adjusted for meteorological factors. The association between the weekly incidence of PPM implantations and the weekly rates of influenza as reported by the Israel Center of Disease Control (ICDC) were also assessed. Result: The study population included 759 patients. Mean age was 76.1 years and 55% were males. Most of the patients (34.1%) were admitted in the winter season. In multivariate analysis, there was a significantly higher incidence of PPM implantations among men during the winter season as compared to the fall season (Adjusted IRR [Incidence Rate-Ratio] 1.40, 95% CI 1.05;1.88; p<0.05), and a significant increase of 24% in the incidence of PPM implantations during the influenza season as compared to the rest of the year (Unadjusted IRR 1.24, 95% CI 0.99;1.53; p<0.05). Conclusion: In the present analysis the incidence of PPM implantations due to AV block was higher among men during the winter season and correlated with high influenza illness rates. Further prospective and larger studies are required to assess these findings.

Introduction: Although the association between necrotizing otitis externa (NOE) and diabetes mellitus (DM) is well known, there is little knowledge in regards to the effects of DM and glycemic control (preadmission and during hospitalization) on the outcome of NOE. The aim of the study was to determine the effects of DM duration and preadmission glycemic control, and in-hospital glycemic control on NOE severity. Methods: A retrospective case series analysis, including all patients between the years 1990-2018 hospitalized due to NOE were included in the study. Data collected included NOE disease characteristics, duration of DM, DM associated comorbidities, glycated hemoglobin (HbA1c), urine micro-albumin and in-hospital blood glucose measurements. Disease severity was defined based on duration of hospitalization (above or below 20 days) and need for surgery. Results: Eighty nine patients were included in the study. Eighty three patients (94.3%) had DM. Preadmission HbA1c was 8.13% (5.8%-12.6%). Forty nine patients (65.5%) had mean blood glucose of ≥140mg\dL and 26 patients (34.5%) had ≤ 140mg/dL. DM duration was 157.88 months among NOE patients who required surgery, and 127.6 months among patients who were treated conservatively (p-value 0.25). HbA1c in patients hospitalized < 20 days was 7.6%, and 8.7% among NOE hospitalized ≥ 20 days (p-value 0.027). Seven patients with mean blood glucose of ≤140mg\dL had Pseudomonas Aeruginosa (PA-NOE) (26.7%), in comparison to 25 patients (51.0%) with mean blood glucose measurement of ≥140mg\dL (p=0.045). Conclusions: HbA1c levels at admission are associated with longer hospitalization duration among NOE patients. High mean blood glucose during hospitalization was associated with a higher likelihood for a PA infection, however it had no effect on disease outcome.