Recent Publications

Isolated sphenoidal sinusitis (ISS) is a rare disease with non-specific symptoms and a potential for complications. Diagnosis is made clinically, endoscopically, and with imaging like CT scans or MRIs. This study aimed to evaluate if ISS meets the EPOS 2020 criteria for diagnosing acute rhinosinusitis and if new diagnostic criteria are needed.

(Raed Farhat, Ashraf Khater, Nidal El Khatib, Majd Asakly, Alaa Safia, Marwan Karam, Saqr Massoud, Yaniv Avraham, Shlomo Merchavy)

Choanal atresia occurs in about 1 in 5000 births and is associated with other structural and genetic abnormalities. Choanal atresia is usually diagnosed postnatally due to respiratory distress, and rarely diagnosed antenatally. Here, a woman with severe polyhydramnios is described, whose fetus was diagnosed antenatally with isolated bilateral choanal atresia, as evident by persistent absence of flow through the nostrils on ultrasound. A literature review is presented of the antenatal findings of choanal atresia, using ultrasound and other imaging modalities.

Pancreatic adenocarcinoma (PAC) is one of the most lethal types of cancer. Most cases of PAC occur in the head of the pancreas. Given the proximity of the pancreatic head to the bile duct, most patients present clinically during early stages of the disease, while distally located PAC could have delayed clinical presentation.  Aims: To assess predictors of non-head PAC. 

Multiple sclerosis (MS) is a multifactorial disease of uncertain etiology damaging myelin sheaths around axons of the central nervous system. Myelin protects the axon from potentially harmful exogenous factors. The aetiological role of environmental exposure metals and organophosphates is unclear. Objective: Identify whether urinary levels of metals and organophosphates differed in MS patients and controls.

Acute graft-versus-host disease (aGvHD) is a serious complication of allogeneic hematopoietic stem-cell transplantation with limited treatment options. The gut microbiome plays a critical role in aGvHD pathogenesis. Fecal microbiota transplantation (FMT) has emerged as a potential therapeutic approach to restore gut microbial diversity. In this prospective pilot study, 21 patients with steroid-resistant or steroid-dependent lower gastrointestinal aGvHD received FMT in capsule form.

Patients with atrial fibrillation (AF) are at increased risk of thromboembolic events originating mainly from left atrial appendage thrombus (LAAT). Patients with atrial flutter (AFL) are treated with anticoagulation based on the same criteria as patients with AF. However, whether patients with AFL have similar thromboembolic risk as AF is unclear. In the current study we aimed to estimate the prevalence of LAAT in patients with AFL undergoing trans-esophageal echocardiography (TEE).

Child vaccinations are among the most effective public health interventions. However, wide gaps in child vaccination remain among different groups with uptake in most minorities or ethnic communities in Europe substantially lower compared to the general population. A systematic review was conducted to understand health system barriers and enablers to measles, mumps and rubella (MMR) and human papilloma virus (HPV) child vaccination among disadvantaged, minority populations in middle- and high-income countries.

(Jumanah Essa-Hadad, Yanay Gorelik, Michael Edelstein)

We recently reported in Gut that the microbiome is unequivocally implicated in early gestational diabetes mellitus (GDM) aetiology, starting in the first trimester (T1), and other groups have shown continued microbiota dysbiosis in women with GDM in second trimester (T2) and third trimester (T3). In continuation of our T1 research, we now have data showing that dietary interventions, the preferred and primary treatment of GDM, are effective in part by altering the gut microbiota. 

Atrial fibrillation (AF) is associated with increased morbidity and mortality because of stroke and in some cases may promote heart failure. According to several studies, catheter ablation is superior to antiarrhythmic therapy in preventing AF recurrence.

Data on the effect of catheter ablation within different racial and ethnic groups are scarce. Because of genetic diversity and varying environmental milieus between different ethnic groups, ethnic differences might influence the effectiveness and safety of the catheter ablation procedure.

The Israeli Catheter Ablation Registry provides an excellent opportunity to explore the effectiveness and safety of AF catheter ablation for patients within 2 ethnic groups that utilize the same national healthcare system and constitute most of the Israeli population: patients of Arab and patients of Jewish ethnicities.

The cause of death for Pharaoh Tutankhamun (ca. 1330–1324 BCE) is still unknown despite the advancement in modern paleopathology and the introduction of computed tomography mummy examination and modern molecular pathology, including PCR-based gene analysis. Many speculations regarding his unexpected death have been published, including crush injury, infectious diseases such as malaria, and hereditary disease. We discuss for the first time all these events that could have ultimately caused Tutankhamun's sudden death, particularly sickle cell disease, which can cause osteonecrosis and lead to walking disability, bone deformities, and fragility. 

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Laryngopharyngeal reflux (LPR) refers to the backflow of acidic stomach content into the larynx, pharynx, and upper aerodigestive tract. The diagnosis of LPR is based on the patient's history and findings of the laryngoscopy associated with LPR. Other possible manifestations consistent with LPR symptoms include laryngeal cancer, vocal fold granulomas, Reinke's space edema, and vocal polyps. In this study, we compared the characteristics of patients with LPR symptoms and incidental laryngeal findings (ILF) in the laryngoscopic evaluation to those without ILF (WILF).

Macrosomia is associated with increased risk of fetal and maternal complications such as trauma during birth, cesarean delivery, postpartum hemorrhage, and shoulder dystocia. Sonographic estimation of fetal weight is imprecise particularly in excessively large fetuses, prompting the need for additional measures to assess the feasibility of vaginal delivery of a macrosomic newborn and thus improve prenatal consultation.

Dapagliflozin or Saxagliptin in Pediatric Type 2 DiabetesDapagliflozin (a sodium-glucose co-transporter-2 inhibitor) and saxagliptin (a dipeptidyl peptidase-4 inhibitor) have both been approved by the U.S. Food and Drug Administration for the treatment of type 2 diabetes in adults but not in children. In this randomized trial of 245 pediatric patients (10 to 17 years of age) with uncontrolled type 2 diabetes, dapagliflozin but not saxagliptin significantly reduced A1C compared with placebo.

Sarcoidosis is a chronic granulomatous disease of unknown cause characterized by the presence of non-caseating granulomas. The disease can affect any organ including the nervous system. Neurosarcoidosis occurs in about 5% patients with sarcoidosis. The clinical presentation of neurosarcoidosis is varied, and it can involve the brain, spinal cord and peripheral nervous system, separately or in different combinations. The diagnosis of neurosarcoidosis is challenging, as biopsies from the nervous system are not readily available. Anti-TNFα agents are becoming one of the cornerstone treatments for neurosarcoidosis. In this case-based review, we discuss two cases of neurosarcoidosis with different clinical presentations.