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Biomedical subjects

M Shalit

Publications and source records attributed to M Shalit.

At least 127 records · Page 7Linked to original sources

Successful removal of an acute brain stem hematoma in a young child.

Several days after receiving a blow to the occipital region, a 5-year-old boy presented with acute symptoms and signs of a space-occupying-lesion in the posterior fossa. A CAT scan revealed a mass with increased density in the region of the fourth ventricle. A suboccipital craniectomy disclosed a subependymal hematoma bulging into the fourth ventricle. The hematoma was evacuated, and the child subsequently made a complete recovery. It is stressed that surgical intervention should be considered in all such cases and particularly in young patients who show progressive neurological deficits.

Brain Stem↗

Diencephalic syndrome due to a suprasellar epidermoid cyst. Case report.

A 5-year-old child with the unusual association of late-onset diencephalic cachexia and pituitary insufficiency is described. At operation a suprasellar epidermoid cyst was found and excised. This curable tumor should be added in the differential diagnosis of diencephalic syndrome.

Brain Diseases↗

Prolonged atypical illness associated with serological evidence of persistent Epstein-Barr virus infection.

Seven patients with prolonged atypical illness were followed up for more than a year. Sera taken during that period showed significantly increased titres of IgM antibodies against the viral capsid antigen (VCA) of Epstein-Barr virus (EBV). In four of the patients antibodies to the R component of the early antigen (EA) complex of EBV were clearly detectable. Only one of these seven patients had presented with symptoms of classic infectious mononucleosis. Serological and clinical observations in these patients suggest that the prolonged atypical illness was probably the result of persistent EBV infection.

Adult↗

Pneumococcal epiglottitis in systemic lupus erythematosus on high-dose corticosteroids.

A patient with systemic lupus erythematosus who developed pneumococcal epiglottitis is described and the literature reviewed. This infection is extremely rare in adults, and only 10 cases, none of them with SLE, have so far been reported. Epiglottitis is usually caused by Haemophilus influenzae. However, in immunocompromised hosts the probability of Streptococcus pneumoniae as the infecting agent is considerable. Penicillin should therefore be part of the antimicrobial regimen in such patients.

Adult↗

Non-A, non-B hepatitis not following transfusion: a study of hospital patients in Jerusalem.

An analysis of the etiology of acute viral hepatitis in 172 hospitalized patients showed that 70.9% suffered from hepatitis A (HA), 12.2% from hepatitis B (HB), 1.7% from infectious mononucleosis and 15.1% (26 cases) from non-A, non-B hepatitis. Patients who had received blood transfusions during the 6 mo preceding the onset of the disease were not included in the present survey. The male:female ratio in the patients with non-A, non-B hepatitis was 1:88; 73% were Ashkenazic and 27% non-Ashkenazic Jews. The ethnic distribution of patients with non-A, non-B hepatitis was similar to that of patients with HA but differed from that of HB patients (only 41% Ashkenazic). Thirty-eight percent of the non-A, non-B group had had contact with jaundiced patients during the 6 mo preceding the onset of the disease, and 46% were students or soldiers. The clinical course of the disease was, on the whole, milder than that of HB and similar to that of HA. Since many cases of non-A, non-B hepatitis are anicteric, it is concluded that the disease is a significant problem in Israel.

Adult↗

Cryoglobulinemia in acute type-A hepatitis.

Serum cryoglobulins were detected in 18 of 19 patients with type-A, and six of eight with type-B hepatitis. The predominant immunoglobulin in the cryoprecipitates was polyclonal IgM. Patients with type-A hepatitis had a significantly higher mean serum level of cryoglobulins when compared to those with type-B (106.9 vs. 20.5 micrograms/ml). IgM anti-hepatitis-A virus activity was detected in all cryoprecipitates obtained from hepatitis-A patients. Cryoglobulinemia in these patients was transient, associated with disease activity and accompanied by a marked increase in serum level of IgM. These findings are compatible with a recent hypothesis, which predicts the appearance of cryoglobulins under circumstances of enhanced stimulation of B cells in the presence of defective clearance of desialylated glycoproteins by their specific liver receptors.

Cryoglobulinemia↗

Serum amyloid P-component as a marker of liver disease.

The P-component of amyloid is a normal serum protein designated SAP. In view of recent in vivo experiments that suggested a possible role for the liver in the synthesis of SAP, we decided to evaluate the usefulness of its serum level as a marker of liver involvement. The study included 198 healthy adults, 154 patients with liver diseases, and 27 HBsAg carriers. Normal serum level of SAP was 66.12 micrograms/ml for males and 57.17 micrograms/ml for females. Patients with liver disease had a significantly decreased level of SAP. The mean serum level of SAP in cirrhosis was 30.15 in chronic active hepatitis--37.16 and in acute hepatitis--44.86 micrograms/ml. Asymptomatic HBsAg carriers had a normal SAP level (mean 65.48 micrograms/ml). Thirty-two patients with acute hepatitis were tested during the acute stage of the disease and after complete recovery. In all but three patients, a significant increase in SAP level, from a mean of 35.8 to 58.48 micrograms/ml, was observed. These results suggest a close correlation between serum levels of SAP and the degree of disease activity and hepatic impairment in patients with liver diseases, especially in those with acute hepatitis. Repeat determinations of SAP in patients with liver diseases could possibly help in their routine management.

Adult↗

Fever in multiple myeloma.

Tumor-associated fever is a rare manifestation of multiple myeloma (MM). Two patients with MM are described, in whom this disease was associated with a fulminant course and resistance to therapy. The patients had none of the currently recognized "poor prognostic factors" of MM. Thus it is suggested that tumor-associated fever should be considered to be an indicator of poor prognosis in MM.

Adult↗

A new sequential pneumatic device for the prevention of deep vein thrombosis.

A new sequential pneumatic instrument for the prevention of deep vein thrombosis (DVT), the Lympha Press, was investigated in neurosurgical patients. In the control group, 50% of patients developed DVT and in the treated group only 4.3% were affected. These results demonstrate the highly beneficial effect of this method of preventing DVT during and after surgery, especially when the use of other preventive methods is precluded.

Adult↗