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Article: Collateral damage: a case of pylephlebitis in the COVID-19 era.

Kupietzky, Amram / Lehmann, Hillel / Hiller, Nurith / Ariche, Arie

2021 Volume 10, Issue 3, Page(s) 418–420

Language	English
Publishing date	2021-04-27
Publishing country	China (Republic : 1949- )
Document type	Journal Article
ZDB-ID	2812398-0
ISSN	2304-389X ; 2304-3881
ISSN (online)	2304-389X
ISSN	2304-3881
DOI	10.21037/hbsn-20-705
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Article ; Online: Reversible 'Unstable' Abdominal Angina Caused by Ruptured Plaque of the Superior Mesenteric Artery: Clinical and Radiological Correlations.

Yaari, Shaul / Hiller, Nurith / Samet, Yacov / Heyman, Samuel N

European journal of case reports in internal medicine

2023 Volume 10, Issue 4, Page(s) 3766

Abstract: Unstable angina, characteristic of coronary artery disease, is caused by in-situ clot formation complicating ruptured atheromatous plaque. Abdominal angina, however, usually reflects chronic mesenteric ischaemia, caused by multi-vessel stable plaques ... ...

Abstract	Unstable angina, characteristic of coronary artery disease, is caused by in-situ clot formation complicating ruptured atheromatous plaque. Abdominal angina, however, usually reflects chronic mesenteric ischaemia, caused by multi-vessel stable plaques involving mesenteric arteries. Herein, we describe a patient with new-onset abdominal pain caused by a ruptured atheromatous plaque at the superior mesenteric root. The diagnosis was based on an evident reversible epigastric bruit and high-degree eccentric stenosis caused by a non-calcified atheroma. Symptoms and bruit resolved within 3 weeks on aspirin and statins with regression of the stenotic lesion. Although the condition is likely common, this is the first clear-cut report compatible with 'unstable' abdominal angina, resolved by conservative treatment. Learning points: Resembling unstable angina pectoris, ruptured atheromatous plaque in mesenteric vessels can develop, clinically manifested by new-onset abdominal angina.This condition may be reversible under treatment with antiplatelet medications and statins.Searching for abdominal bruit is invaluable in the assessment of unexplained abdominal pain.
Language	English
Publishing date	2023-03-30
Publishing country	Italy
Document type	Journal Article
ISSN	2284-2594
ISSN (online)	2284-2594
DOI	10.12890/2023_003766
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Article ; Online: Correction to: Parenchymal echotexture changes as a predictor of viability in testicular torsion.

Halevy, Dan / Simanovsky, Natalia / Lev-Cohain, Namma / Sosna, Jacob / Hiller, Nurith / Duvdevani, Mordechai / Gofrit, Ofer N / Hidas, Guy

Emergency radiology

2022 Volume 29, Issue 3, Page(s) 621

Language	English
Publishing date	2022-04-02
Publishing country	United States
Document type	Published Erratum
ZDB-ID	1425144-9
ISSN	1438-1435 ; 1070-3004
ISSN (online)	1438-1435
ISSN	1070-3004
DOI	10.1007/s10140-022-02043-3
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Article: OPPORTUNISTIC EVALUATION OF BONE MINERAL DENSITY BY PET-CT IN HODGKIN LYMPHOMA PATIENTS.

Cohen, Bar / Hiller, Nurith / Szalat, Auryan / Vainstein, Vladimir

Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists

2019 Volume 25, Issue 9, Page(s) 869–876

Abstract: Objective: ...

Abstract	Objective:
MeSH term(s)	Absorptiometry, Photon ; Bone Density ; Hodgkin Disease/diagnostic imaging ; Humans ; Lumbar Vertebrae ; Positron Emission Tomography Computed Tomography ; Retrospective Studies
Language	English
Publishing date	2019-06-06
Publishing country	United States
Document type	Journal Article
ZDB-ID	1473503-9
ISSN	1530-891X
ISSN	1530-891X
DOI	10.4158/EP-2019-0122
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Zs.A 5034: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
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Article: Lymphadenopathy Associated With the COVID-19 Vaccine.

Hiller, Nurith / Goldberg, Shraga Nahum / Cohen-Cymberknoh, Malena / Vainstein, Vladimir / Simanovsky, Natalia

Cureus

2021 Volume 13, Issue 2, Page(s) e13524

Abstract: The coronavirus disease 2019 (COVID-19) pandemic has dominated nearly everyone's life since its initial outbreak in the Hubei province of China in December 2019. The disease had spread quickly throughout the world causing extensive, widespread morbidity, ...

Abstract	The coronavirus disease 2019 (COVID-19) pandemic has dominated nearly everyone's life since its initial outbreak in the Hubei province of China in December 2019. The disease had spread quickly throughout the world causing extensive, widespread morbidity, over two million deaths, and economical and social devastation over the entire world. Researchers and pharmaceutical companies around the globe have been racing to develop potent and safe vaccines for the disease. Pfizer-BioNTech COVID-19 vaccine followed by Moderna COVID-19 mRNA-1273 vaccine were the first to receive FDA approval. These vaccines are based on messenger RNA novel technology and considered efficient in preventing contagion ensuring safety. Known side effects for this vaccine have been reported as very similar to those known for other vaccines. Specifically, lymphadenopathy has not been considered a common manifestation of COVID-19 vaccination. Israel has been cited as leading in the introduction of these vaccines, which are available for every citizen older than 16 years. Here, we present the cases of three patients who developed lymphadenopathy after the first dose of Pfizer-BioNTech COVID-19 vaccine. Time elapsed from the injection until the appearance of the enlarged nodes, clinical symptoms, and sonographic features differed between the patients, but in all cases gradual regression was noted in the enlarged nodes until complete resolution. Accordingly, to our knowledge, this is the first report describing post-COVID-19 vaccine lymphadenopathy detailing the clinical aspects, sonographic features, and outcomes.
Language	English
Publishing date	2021-02-23
Publishing country	United States
Document type	Case Reports
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.13524
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Article ; Online: Existing Scores Fail to Predict Bowel Ischemia in Patients With Adhesive Small Bowel Obstruction.

Kupietzky, Amram / Dodi, Omri / Dover, Roi / Lourie, Nachum Emil Eliezer / Berrebi, Yehonatan / Lev-Cohain, Naama / Hiller, Nurith / Mazeh, Haggi / Mizrahi, Ido

The Journal of surgical research

2022 Volume 283, Page(s) 416–422

Abstract: Introduction: Early recognition of bowel ischemia is critical in patients suffering from acute adhesive small bowel obstruction (ASBO). Recent studies attempted to propose a score combining clinical and radiological factors to predict the risk of bowel ... ...

Abstract	Introduction: Early recognition of bowel ischemia is critical in patients suffering from acute adhesive small bowel obstruction (ASBO). Recent studies attempted to propose a score combining clinical and radiological factors to predict the risk of bowel ischemia in patients with ASBO. This study aimed to compare and validate the existing clinical scores with a cohort of surgical patients. Methods: We conducted a retrospective study including all ASBO cases admitted to our institution between January 1, 2005 and December 31, 2019. Based on three existing clinical scores, we calculated the risk of bowel ischemia for each patient. We then divided the cohort into groups based on the risk for bowel ischemia. For each risk-based category, the proportion of patients who underwent surgical resection and were found to have evidence of ischemic bowel was calculated. Results: A total of 160 patients presenting with 217 episodes of acute ASBO were included. One hundred seventy-one (78.8%) cases were managed nonoperatively while 46 cases (21.2%) required surgery. Sixteen patients (7.3%) were eventually found to have ischemic bowel while 13 required small bowel resection (5.9%). All three clinical scores showed correlation between the calculated risk of ischemia and the intraoperative finding of ischemia. However, all three scores overestimated ischemia rates in the high-risk groups, yielding a PPV of 8.3%-28.5% and a NPV of 93.3%-94.7%. Conclusions: Current clinical scores for predicting bowel ischemia in patients with ASBO are of high value in ruling out ischemia, yet are of extremely low sensitivity, warranting an overly aggressive and unnecessary surgical approach.
MeSH term(s)	Humans ; Tissue Adhesions/surgery ; Retrospective Studies ; Treatment Outcome ; Intestinal Obstruction/surgery ; Mesenteric Ischemia ; Ischemia
Language	English
Publishing date	2022-11-23
Publishing country	United States
Document type	Journal Article
ZDB-ID	80170-7
ISSN	1095-8673 ; 0022-4804
ISSN (online)	1095-8673
ISSN	0022-4804
DOI	10.1016/j.jss.2022.10.056
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Zs.A 178: Show issues

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Article ; Online: Ultrasonographic features can predict outcome of conservative management of acute appendicitis in children.

Levy, Shiran / Hiller, Nurith / Lev-Cohain, Naama / Goldberg, S Nahum / Mizrahi, Ido / Simanovsky, Natalia

Emergency radiology

2021 Volume 29, Issue 1, Page(s) 59–65

Abstract: Purpose: To determine whether specific ultrasonographic features can predict failure of conservative treatment of acute appendicitis.: Methods: A 2-year retrospective study was conducted on children admitted with acute appendicitis. Those with ... ...

Abstract	Purpose: To determine whether specific ultrasonographic features can predict failure of conservative treatment of acute appendicitis. Methods: A 2-year retrospective study was conducted on children admitted with acute appendicitis. Those with uncomplicated appendicitis diagnosed solely by ultrasound, and treated conservatively, were followed 18-24 m to assess treatment outcome. Management was considered successful if recurrent acute appendicitis was not observed during follow-up. Appendix diameter, wall thickness, presence of mucosal ulceration, hyperechogenic fat, free fluid, and lymph nodes were evaluated as potential discriminatory ultrasonographic predictors. T-tests, chi-square, sensitivity, specificity, and odds ratios were calculated. Results: Out of 556 consecutive patients that were admitted with acute appendicitis, 180 (32%) managed conservatively. One hundred eleven (62%) imaged by US only. Ninety-two out of 111 (83%) were followed 18-24 m to assess treatment outcome, and 19/111 (17%) were lost to follow-up. Conservative management was successful in 72/92 (78.2%), with treatment failure in 20/92 (21.8%) (5/92 (5.4%) with recurrent acute appendicitis and 15/92 (16.3%) underwent appendectomy). Of the ultrasonographic features studied, mucosal ulceration demonstrated statistically significant predictive value. Fifteen out of 20 (75%) treatment failures had mucosal ulceration, compared to 21/72 (29.2%) of the patients with successful treatment (p < 0.001). This yielded a positive odds ratio of 7.3 (2.3-22.6, 95% CI), 70.8% (58.9-80.9, 95% CI) specificity, and 75% (50.9-91.3, 95% CI) sensitivity. Positive predictive value was 41.6% (31.5-52.5, 95% CI) while intact mucosa had negative predictive value of 91% (82.4-95.6, 95% CI) for conservative management success. Conclusion: The presence or absence of appendiceal mucosal ulceration at ultrasound can predict conservative management outcome in the setting of acute appendicitis, potentially improving pediatric patient selection for conservative management.
MeSH term(s)	Acute Disease ; Appendectomy ; Appendicitis/diagnostic imaging ; Appendicitis/therapy ; Appendix ; Child ; Conservative Treatment ; Humans ; Retrospective Studies
Language	English
Publishing date	2021-09-17
Publishing country	United States
Document type	Journal Article
ZDB-ID	1425144-9
ISSN	1438-1435 ; 1070-3004
ISSN (online)	1438-1435
ISSN	1070-3004
DOI	10.1007/s10140-021-01984-5
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Article ; Online: Opportunistic screening for osteoporosis and osteopenia by routine computed tomography scan: A heterogeneous, multiethnic, middle-eastern population validation study.

Cohen, Adiel / Foldes, A Joseph / Hiller, Nurith / Simanovsky, Natalia / Szalat, Auryan

European journal of radiology

2021 Volume 136, Page(s) 109568

Abstract: Purpose: We aimed define thresholds for HU values observed on opportunistic CT scans that suggest abnormal bone mineral density (BMD) in a heterogeneous Middle Eastern population.: Methods: Consecutive patients who had undergone CT and dual-energy X- ... ...

Abstract	Purpose: We aimed define thresholds for HU values observed on opportunistic CT scans that suggest abnormal bone mineral density (BMD) in a heterogeneous Middle Eastern population. Methods: Consecutive patients who had undergone CT and dual-energy X-ray absorptiometry (DXA) test of the lumbar spine within 6 months were included in this retrospective study. Hounsfield units (HU) on lateral lumbar spine CT and BMD at the spine and hip on DXA were compared. Potential HU thresholds suggestive of abnormal BMD were established using receiver operating characteristic (ROC) analysis. Results: 246 patients (mean age of 64 ± 11.6 years; 83 % female) were included. On DXA, 27 % had osteoporosis, 56 % had osteopenia, and 17 % had normal BMD. To distinguish osteoporosis from non-osteoporosis (osteopenia, normal BMD), a threshold of HU160 had sensitivity 95 % and the balanced threshold was HU121 (sensitivity 74 %, specificity 61 %). To distinguish normal from abnormal BMD (osteoporosis, osteopenia), a threshold of HU110 had specificity 93 % and the balanced threshold was HU149 (sensitivity 76 %, specificity 74 %). Conclusions: In a heterogeneous Middle-Eastern population, our study supports the reported correlation between HU values on lumbar spine CT and BMD on DXA. In this population, HU > 160 correlates with low probability of osteoporosis on DXA, and screening examination is not warranted unless a vertebral fracture is detected; for HU ≤ 110 there is high probability of abnormal (osteoporosis or osteopenia) BMD, DXA examination is warranted; Finally, for HU 110-160, there is an intermediate chance of abnormal BMD, DXA examination may be warranted in specific patients with other risk factors.
MeSH term(s)	Absorptiometry, Photon ; Aged ; Bone Density ; Bone Diseases, Metabolic/diagnostic imaging ; Bone Diseases, Metabolic/epidemiology ; Female ; Humans ; Lumbar Vertebrae/diagnostic imaging ; Male ; Middle Aged ; Osteoporosis/diagnostic imaging ; Osteoporosis/epidemiology ; Retrospective Studies ; Tomography, X-Ray Computed
Language	English
Publishing date	2021-01-27
Publishing country	Ireland
Document type	Journal Article
ZDB-ID	138815-0
ISSN	1872-7727 ; 0720-048X
ISSN (online)	1872-7727
ISSN	0720-048X
DOI	10.1016/j.ejrad.2021.109568
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Article ; Online: Parenchymal echotexture changes as a predictor of viability in testicular torsion.

Halevy, Dan / Simanovsky, Natalia / Lev-Cohain, Namma / Sosna, Jacob / Hiller, Nurith / Duvdevani, Mordechai / Gofrit, Ofer N / Hidas, Guy

Emergency radiology

2022 Volume 29, Issue 2, Page(s) 359–363

Abstract: Introduction: Preoperative test that can predict the salvageability of the torsed testis may add essential information to the surgeon managing testicular torsion (TT), this can assist with patients' and parents' expectations, particularly with nonviable ...

Abstract	Introduction: Preoperative test that can predict the salvageability of the torsed testis may add essential information to the surgeon managing testicular torsion (TT), this can assist with patients' and parents' expectations, particularly with nonviable testes. We aimed to examine if parenchymal echotexture changes in preoperative ultrasound can predict irreversible hemorrhagic necrosis. Materials and methods: Preoperative ultrasound studies of 154 patients with TT were reviewed by 3 raters (2 radiologists and 1 urologist). The raters were asked to categorize the affected testicular parenchymal echotexture into one of the following categories: (1) normal (identical to the contra-lateral testis), (2) homogenous hypoechoic, or (3) focal heterogeneous echotexture. Testis non-viability was defined macroscopically during surgical exploration and correlated with the US results. Sensitivity, specificity, and positive and negative predicting values of the proposed diagnostic test were calculated. Cohen's kappa coefficient was used to determine inter-rater agreement. Results: A total of 54/154 patients had a nonviable testis. Mean of 59.5% cases was classified as category 1, 27.3% cases as category 2, and 13.2% cases as category 3. Testicular necrosis was 12%, 34%, and 92% in each category, respectively. Category 3 classified non-viability with a mean specificity of 99.3% and with a high inter-rater agreement level (Cohen's kappa coefficient of 0.830). Mean positive predictive value of 97% and mean negative predictive value of 74.3%. The mean sensitivity of this test however was low 39.7%. Conclusion: Ultrasound finding of focal parenchymal echotexture heterogeneous changes is highly specific although not sensitive, for nonviable testis. The presence of this finding reassures non-viability in over 99%.
MeSH term(s)	Humans ; Male ; Predictive Value of Tests ; Retrospective Studies ; Spermatic Cord Torsion/diagnostic imaging ; Spermatic Cord Torsion/surgery ; Testis/diagnostic imaging ; Ultrasonography
Language	English
Publishing date	2022-01-07
Publishing country	United States
Document type	Journal Article
ZDB-ID	1425144-9
ISSN	1438-1435 ; 1070-3004
ISSN (online)	1438-1435
ISSN	1070-3004
DOI	10.1007/s10140-021-02014-0
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Article: Use of Unenhanced Abdominal Computed Tomography for Assessment of Acute Non-Traumatic Abdominal Pain in the Emergency Department.

Salameh, Shaden / Antopolsky, Meir / Simanovsky, Natalia / Arami, Eyal / Hiller, Nurith

The Israel Medical Association journal : IMAJ

2019 Volume 21, Issue 3, Page(s) 208–212

Abstract: Background: Acute non-traumatic abdominal pain is typically evaluated by abdomino-pelvic computed tomography (CT) with oral and venous contrast. The accuracy of unenhanced CT for diagnosis in this setting has not been widely studied.: Objectives: To ... ...

Abstract	Background: Acute non-traumatic abdominal pain is typically evaluated by abdomino-pelvic computed tomography (CT) with oral and venous contrast. The accuracy of unenhanced CT for diagnosis in this setting has not been widely studied. Objectives: To assess the accuracy of unenhanced CT in establishing the etiology of acute non-traumatic abdominal pain. Methods: We retrospectively reviewed the medical and imaging records of patients aged ≥ 18 years who presented to the emergency department (ED) during a 6-month period with acute non-traumatic abdominal pain of unknown etiology, and who were evaluated with non-contrast CT within 24 hours of ED admission. Clinical details were recorded. A presumptive clinical diagnosis and CT diagnosis were compared to the discharge diagnosis which was considered the reference standard. The requirement for informed consent was waived. Results: Altogether, 315 patients met the inclusion criteria - 138 males (44%) and 177 females (56%); their mean age was 45 years (range 18-90). Clinical diagnosis correlated with the CT findings in 162 of the cases (51%). CT was accurate in 296/315 cases (94%). The leading diagnosis in cases of a mismatch between CT diagnosis and discharge diagnosis was infection mostly in the urinary tract (12/18). Sensitivity, specificity, positive predictive value and negative predictive value were 91%, 99%, 91% and 85% respectively. The discharge diagnosis was unchanged in the patients who returned to the ED within 1 week of the first admission. Conclusions: In this study, unenhanced CT proved to be a feasible, convenient and legitimate examination for the evaluation of patients with acute non-traumatic abdominal pain presenting to the ED.
MeSH term(s)	Abdominal Pain/diagnostic imaging ; Aged, 80 and over ; Contrast Media ; Diagnosis, Differential ; Emergency Service, Hospital ; Female ; Humans ; Israel ; Male ; Retrospective Studies ; Tomography, X-Ray Computed/methods
Chemical Substances	Contrast Media
Language	English
Publishing date	2019-03-24
Publishing country	Israel
Document type	Journal Article
ZDB-ID	2008291-5
ISSN	1565-1088 ; 0021-2180
ISSN	1565-1088 ; 0021-2180
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