Publications by authors named "Jeffrey Gelfand"

We developed a translational prototype antimicrobial blue light (ABL) device for treating skin wounds with ABL. Partial-thickness surgical wounds were created in live swine, an animal whose skin is considered the most like human skin, then heavily contaminated and left untreated for 24 hours with methicillin-resistant Staphylococcus aureus (MRSA). ABL treatment stabilized and reduced MRSA infection by greater than four orders of magnitude (>99.

View Article and Find Full Text PDF

Ataxia with anti-regulator of G-protein signaling 8 autoantibodies (RGS8-Abs) is an autoimmune disease recently described in four patients. The present study aimed to identify other patients with RGS8-Abs, describe their clinical features, including the link between RGS8-related autoimmune cerebellar ataxia (ACA) and cancer. Patients with RGS8-Abs were identified retrospectively in the biological collections of the French Reference Center for Paraneoplastic Neurological Syndrome and the University of California San Francisco Center for Encephalitis and Meningitis.

View Article and Find Full Text PDF
Article Synopsis
  • - Autoimmune encephalitis (AIE) is a rare neurological disorder characterized by brain inflammation, often linked to specific autoantibodies; currently, there are no approved treatments for AIE despite the involvement of interleukin-6 (IL-6) signaling in its pathology.
  • - The CIELO study aims to test the efficacy and safety of satralizumab, an IL-6 receptor-targeting monoclonal antibody, in patients with specific types of AIE, using a randomized, double-blind design with 152 participants.
  • - The study will follow a 52-week treatment period with possible extensions, enabling participants to receive either the study drug, placebo, or additional treatment options depending on the
View Article and Find Full Text PDF
Article Synopsis
  • Vitamin B12 is essential for blood cell formation and nerve insulation, and its deficiency can lead to neurological issues despite normal blood levels, as seen in a patient with symptoms like tremor and cognitive decline.
  • Researchers discovered an autoantibody against the transcobalamin receptor (CD320) that hinders vitamin B12 uptake in the brain, resulting in low levels found in cerebrospinal fluid even when blood levels appear normal.
  • The study suggests this autoimmune condition can be treated with immunosuppressive therapy and high-dose vitamin B12, and highlights the importance of recognizing how B12 transport differs in various tissues, which could improve diagnosis and treatment strategies for similar neurological disorders.
View Article and Find Full Text PDF
Article Synopsis
  • Scientists studied a group of people with multiple sclerosis (MS) to find a special antibody that could help diagnose the disease.
  • They found that about 10% of these patients had a unique pattern of antibodies that could appear years before they showed any symptoms of MS.
  • This discovery might help doctors identify people at high risk for MS earlier, even before the disease fully develops.
View Article and Find Full Text PDF
Article Synopsis
  • The study focuses on adult-onset leukoencephalopathy with axonal spheroids and pigmented glia (ALSP), a rare and severe neurodegenerative disease, emphasizing the importance of prompt and precise diagnosis due to its progressive nature.
  • A review of 291 ALSP cases revealed that only 24.7% received an accurate initial diagnosis, with common misdiagnoses including frontotemporal dementia and multiple sclerosis.
  • The analysis also identified demographic and clinical variations that influenced initial misdiagnosis, highlighting a strong family history in 59.1% of patients and a significant portion presenting with cognitive or psychiatric symptoms.
View Article and Find Full Text PDF

Importance: Biomarkers distinguishing nonrelapsing progressive disease biology from relapsing biology in multiple sclerosis (MS) are lacking. Cerebrospinal fluid (CSF) is an accessible fluid that most closely reflects central nervous system biology.

Objective: To identify CSF biological measures associated with progressive MS pathobiology.

View Article and Find Full Text PDF
Article Synopsis
  • Falls are a major concern for people with multiple sclerosis (MS), leading to injuries and decreased independence, and interventions like physical therapy are often underutilized.
  • The study introduces the Multiple Sclerosis Falls InsightTrack (MS-FIT), an app designed to enhance falls reporting, evaluation, and prevention tailored to individual patient needs.
  • The design process involved feedback from patients and clinicians using human-centered design principles, resulting in a user-friendly biweekly survey for falls reporting.
View Article and Find Full Text PDF
Article Synopsis
  • * A new high-throughput liquid chromatography method was developed to measure 14 species of sphingolipids in cerebrospinal fluid (CSF), which may serve as potential biomarkers for MS disease activity.
  • * Results showed higher sphingolipid levels in MS patients compared to healthy controls and a decrease in certain sphingolipids in RMS patients after ocrelizumab treatment, suggesting sphingolipid levels change with disease state and treatment response.
View Article and Find Full Text PDF

Objective: Upper extremity function reflects disease progression in multiple sclerosis (MS). This study evaluated the feasibility, validity, and sensitivity to change of remote dexterity assessments applying human pose estimation to patient-uploaded videos.

Methods: A discovery cohort of 50 adults with MS recorded "selfie" videos of self-care tasks at home: buttoning, brushing teeth, and eating.

View Article and Find Full Text PDF

Purpose Of Review: Falls occur in more than half of all people with multiple sclerosis (MS) but tend to be underdiagnosed and underreported in clinical encounters. This narrative review aims to summarize evidence-based approaches for evaluating fall risk and proven treatment strategies to reduce falling in people with MS to improve care for people with MS and to enhance interprofessional care coordination between treating neurologic and physical therapy (PT) teams.

Recent Findings: Screening not just for but for as well because can improve fall assessment and identify patients who may benefit from fall prevention interventions.

View Article and Find Full Text PDF

Background In the setting of the COVID-19 pandemic, the development of care processes that reduce the need for in-person clinic visits while maintaining low complication rates is needed. The purpose of this study is to assess the outcomes of patients undergoing trigger finger release with various suture and follow-up visit types to assess the feasibility of shifting towards telemedicine-based follow-up protocols. Methods A retrospective review of 329 patients undergoing trigger finger release was performed.

View Article and Find Full Text PDF
Article Synopsis
  • The study focuses on the detection of anti-TRIM9 and TRIM67 autoantibodies (TRIM9/67-IgG) in patients with paraneoplastic cerebellar syndrome, aiming to determine their diagnostic value and the most effective detection methods.
  • A retrospective analysis across multiple centers found that cell-based assays (CBA) were the most sensitive method for confirming the presence of TRIM9/67-IgG, identifying it in all tested cases (100%).
  • The findings indicate that a significant majority of patients with TRIM9/67-IgG had subacute cerebellar syndrome and were often associated with underlying cancers, reinforcing the idea of these auto
View Article and Find Full Text PDF

Background The purpose of our study is to investigate disparities in the patient populations and outcomes of carpal tunnel release (CTR) and trigger finger release (TFR).  Methods A retrospective review of 777 CTR and 395 TFR patients from May 2021 to August 2022 was completed. The shortened form of the Disabilities of the Arm, Shoulder, and Hand (DASH) scores (QuickDASH) was recorded to evaluate physical function preoperatively and at one and three months postoperatively.

View Article and Find Full Text PDF

Although B cells are implicated in multiple sclerosis (MS) pathophysiology, a predictive or diagnostic autoantibody remains elusive. Here, the Department of Defense Serum Repository (DoDSR), a cohort of over 10 million individuals, was used to generate whole-proteome autoantibody profiles of hundreds of patients with MS (PwMS) years before and subsequently after MS onset. This analysis defines a unique cluster of PwMS that share an autoantibody signature against a common motif that has similarity with many human pathogens.

View Article and Find Full Text PDF

Cutaneous bacterial wound infections typically involve gram-positive cocci such as Staphylococcus aureus (SA) and usually become biofilm infections. Bacteria in biofilms may be 100-1000-fold more resistant to an antibiotic than the clinical laboratory minimal inhibitory concentration (MIC) for that antibiotic, contributing to antimicrobial resistance (AMR). AMR is a growing global threat to humanity.

View Article and Find Full Text PDF

Importance: Progressive multifocal leukoencephalopathy can occur in the context of systemic sarcoidosis (S-PML) in the absence of therapeutic immune suppression and can initially be mistaken for neurosarcoidosis or other complications of sarcoidosis. Earlier recognition of S-PML could lead to more effective treatment of the disease.

Objective: To describe characteristics of patients with S-PML.

View Article and Find Full Text PDF

Neuroinvasive infection is the most common cause of meningoencephalitis in people living with human immunodeficiency virus (HIV), but autoimmune etiologies have been reported. We present the case of a 51-year-old man living with HIV infection with steroid-responsive meningoencephalitis whose comprehensive pathogen testing was non-diagnostic. Subsequent tissue-based immunofluorescence with acute-phase cerebrospinal fluid revealed anti-neural antibodies localizing to the axon initial segment (AIS), the node of Ranvier (NoR), and the subpial space.

View Article and Find Full Text PDF

A small proportion of multiple sclerosis (MS) patients develop new disease activity soon after starting anti-CD20 therapy. This activity does not recur with further dosing, possibly reflecting deeper depletion of CD20-expressing cells with repeat infusions. We assessed cellular immune profiles and their association with transient disease activity following anti-CD20 initiation as a window into relapsing disease biology.

View Article and Find Full Text PDF
Article Synopsis
  • The study investigates the impact of remote evaluations on engagement and costs for participants with chronic neurological conditions like multiple sclerosis (MS), especially due to restrictions from the COVID-19 pandemic.
  • Participants engaged in both in-clinic and virtual visits, with a focus on comparing costs and disability assessments between methods.
  • Results show that remote evaluations are not only more cost-effective but also yield comparable disability scores to traditional in-clinic assessments, suggesting a shift towards remote monitoring could be beneficial for ongoing research.
View Article and Find Full Text PDF

Background: Remote activity monitoring has the potential to evaluate real-world, motor function, and disability at home. The relationships of daily physical activity with spinal cord white matter and gray matter (GM) areas, multiple sclerosis (MS) disability and leg function, are unknown.

Objective: Evaluate the association of structural central nervous system pathology with ambulatory disability.

View Article and Find Full Text PDF

Introduction: Coronavirus disease 2019 (COVID-19) has resulted in a global pandemic with several hundred million infections worldwide. COVID-19 causes systemic complications that last beyond the initial infection. It is not known whether patients who undergo elective orthopaedic surgeries after COVID-19 are at increased risk of complications.

View Article and Find Full Text PDF