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Biomedical subjects

M Gelber

Publications and source records attributed to M Gelber.

13 recordsLinked to original sources
PubMed1996

[Percutaneous feeding gastrostomy].

In the past 3 years 71 procedures for insertion of a percutaneous gastrostomy for enteral feeding were performed under X-ray control. The indication for gastrostomy was inability or refusal of the patient to swallow food, in the absence of mechanical obstruction of the gastrointestinal tract. The age range was 66-93 years (mean 82). Most patients had suffered strokes and some had dementia or Parkinson's disease. The procedure was successful in 69/71 patients (97%). 9 (12.6%) died within 30 days of causes related to their underlying condition, rather than to the procedure; 1 developed peritonitis and 6 (8.4%) developed minor infections at the site of entry of the gastrostomy tube. This is the first account of this technique to appear in the Hebrew medical literature. In our opinion the technique should be adopted as the preferred method for forming a gastrostomy, as it is quicker, safer and cheaper than the operative method, and even easier to perform than endoscopic percutaneous gastrostomy.

Aged↗
PubMed1996

[Strongyloides stercoralis hyperinfection].

Strongyloides stercoralis (SS) is an intestinal nematode which infects a large proportion of tropical and subtropical populations. The endemic areas are southeast Asia, South America and sub-Saharan Africa. Infection is acquired when the worms penetrate the skin, pass via the blood stream to the lungs, ascend the respiratory tract, are swallowed and grow into adult worms in the mucosa of the small intestine. The eggs laid by the female release larvae which pass down the lumen and reach the soil via the feces. While passing down the intestinal tract, a few of the rhabditiform larvae may be transformed into infective filariform larvae which can penetrate the distal intestinal and anal mucosa, returning to the blood stream. This "autoinfection" cycle is unique to SS, and explains why the infection can be perpetuated without further exposure to exogenous, infective larvae and can persist decades after departure from endemic areas. A substantial proportion of those affected are asymptomatic, but overwhelming infection may occur in immunosuppressed patients. This "hyperinfection" state is characterized by severe gastrointestinal and respiratory tract involvement, along with skin rash, Gram-negative bacteremia and cerebral signs. While frequently fatal, it is curable when diagnosed and treated promptly. We present a 79-year-old woman with idiopathic polymyositis, who was immunosuppressed by prolonged corticosteroid treatment. Her illness was complicated by SS hyperinfection. Diagnosis was made from stool and bronchial smears. Treatment with thiabendazole was started early and within a week there was complete cure. This is the fourth reported case of SS hyperinfection treated in Israel.

Aged↗
PubMed1995

[Polymyalgia rheumatica as the presenting symptom of multiple myeloma].

Polymyalgia rheumatica is a clinical syndrome which appears after the age of 50 and is characterized by pain and stiffness of proximal muscles, rapid sedimentation rate and a dramatic response to small doses of corticosteroids. The linkage between polymyalgia rheumatica and temporal arteritis is well-known, but the connection with monoclonal gammopathy and lympho-proliferative disorders has rarely been reported. We present a 74-year-old man admitted with the typical clinical picture of polymyalgia rheumatica, which was the presenting symptom of monoclonal gammopathy and subsequently-diagnosed multiple myeloma.

Aged↗
PubMed1988

Theophylline prolongs survival and decreases renal damage in female NZB/W F-1 mice.

Theophylline (Th) augments suppressor T cell activity (STCA). We attempted to test this immunoregulatory effect of TH on survival, renal disease and several immunologic parameters in NZB/W F-1 female mice. The median survival was 274 +/- 50 days for the mice receiving Th and 235 +/- 39 days for the controls (p less than 0.01). Assessment of the extent of renal damage by light microscopy revealed activity scores of 1.86 +/- 2 and 4.71 +/- 2.7 for the Th and control groups, respectively (p less than 0.001). T cell activity of NZB/W F-1 lymphocytes was assessed by the local xenogeneic GVH reaction. The mean GVH reaction volume of the Th group was significantly lower (9.3 +/- 8.8 mm3) as compared to controls (31 +/- 9 mm3) (p less than 0.001). The proportion of Lyt-1 versus Lyt-2 spleen lymphocytes did not change significantly. It is concluded that Th prolongs survival and decreases the extent of renal damage in female NZB/W F-1 mice.

Animals↗
PubMed1987

Hereditary complement deficiency in survivors of meningococcal disease: high prevalence of C7/C8 deficiency in Sephardic (Moroccan) Jews.

The prevalence of complement deficiency was studied among 111 survivors of sporadic meningococcal disease located through the medical records of 10 Israeli hospitals. There were 11 patients with CH50 = 0: one with systemic lupus erythematosus and 10 with hereditary terminal complement deficiency (four with homozygous C7 and six with C8 deficiency). There was no hereditary complement deficiency among 39 Ashkenazi subjects as against 18 per cent among 38 Sephardi subjects and 40 per cent among 15 of Moroccan ancestry (p less than 0.05). The age at first presentation of meningococcal disease in complement deficient patients was 14.7 +/- 7.6, years compared with 8.1 +/- 10.9 in the non-deficient patients (p less than 0.025). None of the complement deficient patients had meningitis below the age of 5 years vs. 49 per cent of non-deficient subjects. Recurrent meningitis was observed in 40 vs. 4 per cent (p less than 0.01) and meningitis in siblings in 40 vs. 2 per cent respectively (p less than 0.001). In addition to the 10 propositi, 11 non-propositus siblings were identified with severe complement deficiency (six with homozygous C7 and five with C8 deficiency). Seven of the non-propositi had no history at all of meningitis or any other serious systemic disease, underlining the relatively favourable prognosis of terminal complement deficiency. With increasing familiarity with the clinical features of this hereditary disease, it is possible now to identify on clinical grounds patients with meningococcal disease with a high likelihood of terminal complement deficiency.

Adolescent↗
PubMed1985

Hemophagocytosis simulating malignant histiocytosis: a terminal event of the myelodysplastic syndrome.

We describe a patient with hemophagocytic syndrome resembling malignant histiocytosis which was complicating myelodysplastic disease of 3 years duration. Detailed morphological and ultrastructural studies indicate that the histiocytic component did not demonstrate features of malignancy. A review of other known malignancies ending up in the hemophagocytic syndrome is given, and the significance of this syndrome is discussed.

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