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Biomedical subjects

M Moshkowitz

Publications and source records attributed to M Moshkowitz.

31 records · Page 2Linked to original sources

Extracorporeal shock wave lithotripsy of gallstones: early experience in an Israeli population.

Fifty-four patients with symptomatic gallbladder stones were treated by extra-corporeal shock wave lithotripsy (ESWL) and oral bile acids on an outpatient basis. In 49 patients (90%), the stones were successfully fragmented to fragments < 5 mm on follow-up ultrasonography. Patients underwent 1-3 lithotripsy sessions with 7,500-9,750 shock waves per session. The gallbladder clearance rate of fragments was dependent mainly on the number of stones and reached 59% for patients with one or two stones, compared to 34% for patients with more than two stones after 9 months follow-up. The only side effects noted were mild abdominal pain, transient microscopic hematuria and minimal impairment in liver function tests. There were no serious complications such as cholecystitis, bile duct obstruction, or pancreatitis. These results, which are comparable with those of other groups using the same shock wave lithotriptor, indicate that this therapy may become an alternative treatment for selected patients with symptomatic gallbladder stones, especially those who are at high risk for surgical treatment.

Administration, Oral

Gastric polypoid lesions--an eight-year study.

We have reviewed the eight years of experience with gastric polypoid lesions of a university hospital serving the Tel Aviv area, and analyzed 188 polyps. No clinical or endoscopic findings were able to distinguish the polyp variants prior to histological examination. The most frequent type of polyp was the hyperplastic polyp (45.2%), followed by the inflammatory type (29.3%). There were six cases of adenoma and ten cases of gastric carcinoma. The polyps were distributed equally within the body (44.7%) and antrum (48.9%), while the fundus was rarely involved (6.3%). Our findings are compatible with the statement that in general there is no distinction between the histological types classified by sex, age, location, symptoms or endoscopic appearance. Nevertheless, this is the first report of a higher incidence of gastric polyps among Ashkenazi Jews than non-Ashkenazi Jews with identical sex distribution.

Adult

A prospective analysis of liver biopsies in rheumatoid arthritis patients receiving long term methotrexate therapy.

Baseline and sequential liver biopsies were performed in ten patients with rheumatoid arthritis (RA) treated with methotrexate (MTX) for more than 4 years. Liver biopsies were performed in all patients before the initiation of MTX therapy and were repeated after reaching a cumulative dose of 1500 mg or more. In four patients a third biopsy was performed 3 years after the first one. No significant worsening of hepatic architecture was found in any of our patients after 4 to 7 1/2 years of MTX therapy. No correlations between histologic findings and various clinical or pharmacological variables could be found. Our results suggested that prolonged MTX administration in RA patients did not cause severe hepatic abnormalities.

Adult

Halitosis and Helicobacter pylori. A possible link?

The exact pathophysiological mechanism of halitosis is not clear, and in many patients the etiology is an enigma. We followed three couples in which one member or both had halitosis. All the subjects had evidence of Helicobacter pylori infection. All received a treatment course of colloidal bismuth subcitrate four times a day and 250 mg metronidazole three times a day. There was impressive improvement in their symptoms, the halitosis disappearing along with eradication of the organism. We call the attention of physicians to the possible connection between halitosis, H. pylori infection, and familial occurrence. Further studies to confirm this surprising association are in order.

Antacids

Streptococcus bovis endocarditis as a presenting manifestation of idiopathic ulcerative colitis.

Streptococcus bovis bacteraemia and endocarditis have been associated with several gastrointestinal diseases, mainly malignant or potentially malignant tumours, and less commonly non-malignant gastrointestinal disorders. We describe a 73 year old man in whom Streptococcus bovis endocarditis developed, and was the presenting manifestation of undiagnosed quiescent ulcerative colitis. Such an association has not been described previously.

Aged

The effects of hormone replacement therapy in normal postmenopausal women: measurements of Doppler-derived parameters of aortic flow.

In this study the effects of hormone replacement therapy on cardiac function in healthy postmenopausal women were evaluated by Doppler echocardiography that was performed before (T1) and 2.5 months after the initiation of hormone replacement therapy (T2) in the peak estrogenic phase. The following parameters of aortic flow were measured: peak flow velocity, acceleration time, and ejection time. Additional parameters were calculated: flow velocity integral and mean acceleration. The study group included 24 postmenopausal women aged 43 to 60 years (mean 51.6 years). The control group consisted of 19 postmenopausal women aged 46 to 60 years (mean 53.5 years) who were not receiving hormone replacement therapy and who underwent the same evaluation. There were no changes in all Doppler parameters between T1 and T2 in the control group. However, in the study group there were significant increases in peak flow velocity (108.3 +/- 16.7 cm/sec at T1 vs 123 +/- 20.7 cm/sec at T2; p = 0.002), flow velocity integral (17.7 +/- 3.9 vs 21.5 +/- 4.7 cm; p = 0.0003), mean acceleration (11.5 +/- 1.9 vs 13.1 +/- 2.6 m/sec/sec; p = 0.001), and ejection time (324 +/- 37.6 vs 348.8 +/- 40.7 msec; p = 0.002). There was no change in acceleration time (94.8 +/- 6.6 vs 95 +/- 10.9 msec). These results demonstrate that estrogens increase both stroke volume and flow acceleration. The latter probably reflects a combination of enhanced inotropism and vasodilatation. We assume that the cardioprotective effect of hormone replacement therapy in postmenopausal women may be due not only to changes in lipid profile but also to direct effects of estrogens on central and peripheral hemodynamic parameters.

Adult

Skin blisters as a manifestation of oxazepam toxicity.

A 75 year-old comatous patient was admitted after ingestion of 200 mg oxazepam. Skin blisters, attributed to oxazepam toxicity, appeared on the left forearm the following day and regressed spontaneously nine days later.

Aged

[Pentamidine inhalation for Pneumocystis carinii pneumonia in AIDS].

Pneumocystis carinii pneumonia (PCP) is the major cause of death in AIDS. The use of standard drugs for PCP is associated with a remarkably high rate of adverse reactions in AIDS patients. We treated a 35-year-old homosexual with a first episode of PCP with intravenous trimethoprim, 20 mg/kg, and sulfamethoxazole, 100 mg/kg and later with pentamidine injections. However medication had to be stopped because of severe side effects. A new method of therapy using aerosolized pentamidine (300 mg per inhalation, daily) was then applied successfully. The patient recovered and has been having prophylactic inhalations and getting azothymidine for the past 8 months. In studies on relatively small numbers of patients this treatment has been reported to give good results with only minor side effects. However, further data are needed, especially on the optimal characteristics of the generated aerosol and the best delivery system.

Acquired Immunodeficiency Syndrome

Autoantibodies to epithelial cells (intercellular substance) and their correlation with clinical activity of pemphigus vulgaris.

The presence of autoantibodies to intercellular substance of squamous epithelium was studied in the sera of 46 patients suffering from pemphigus vulgaris. This study suggests that in the majority of patients suffering from the severe form of the disease the autoantibody titer can be used as a guide to prednisone therapy. However, in patients with a mild or moderate form, no such correlation is established.

Adult