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Biomedical subjects

I Beiran

Publications and source records attributed to I Beiran.

27 records · Page 2Linked to original sources
PubMedDate not supplied

A quality management project in Israeli navy primary care clinics.

The objective of this project was to establish a measurable process of continuous quality improvement of health care services in the Israeli naval primary care clinics. All navy clinics were surveyed at 6-month intervals. The quality of medical recording was evaluated, and instructive workshops were given on the matter. Real-time physician-patient interactions were evaluated, and immediate feedback was given to the examining physician. Complementary medical services were evaluated and steps toward improvement were taken. A total of 1043 medical records were examined. A general improvement in medical-record documentation (from a score of 6.0 +/- 2.5 to a score of 7.4 +/- 1.9, P < .001) was demonstrated during the first 3 years of the project. No significant change was noticed in the physician-patient interaction score. Complementary medical services improved from a score of 4.9 +/- 1.5 in 1994 to a score of 7.4 +/- 0.9 3 years later (P < .02). This project achieved a significant improvement in the quality of medical recording and of complementary medical services.

Health Services Research↗
PubMedDate not supplied

Early hyperbaric oxygen therapy for retinal artery occlusion.

PURPOSE: To assess whether early hyperbaric oxygenation (HBO) treatment has a beneficial effect on visual results after retinal artery occlusion (RAO). METHODS: A comparative retrospective study in which medical records of all HBO-treated RAO patients in our department were reviewed and compared with matched RAO patients not treated by HBO (from a different medical center). Mean visual acuity (VA) at completion of treatment, the presence or absence of improvement in VA between admission and discharge, and the mean change in VA between admission and discharge were noted. All patients treated by HBO had treatment no later than 8 hours after the beginning of visual symptoms. RESULTS: Mean VA at discharge was 0.2981 (6/20) in the treated group and 0.1308 (6/46) in the control group (p < 0.03). In the treated group, 82.9% had an improvement in VA between admission and discharge, compared with 29.7% of the control group (p < 0.00001). Mean improvement in VA was 0.1957 in the treated group and 0.0457 in the control group (p < 0.01). Differences in outcome measures between treatment and control groups were found to reflect the difference between treated and untreated hypertensive patients. No difference was found between treated and untreated non-hypertensive patients. CONCLUSIONS: Early HBO therapy appears to have a beneficial effect on visual outcome in patients with RAO. Further large-scale prospective controlled studies are needed to confirm this.

Aged↗
PubMedDate not supplied

Hyperbaric oxygenation combined with nifedipine treatment for recent-onset retinal artery occlusion.

We describe the results of early hyperbaric oxygenation combined with nifedipine treatment for central retinal artery occlusion, and explain the results pathophysiologically. We report four cases in which hyperbaric oxygenation therapy was applied in combination with nifedipine, eyeball massage, and glycerol for the treatment of central retinal artery occlusion. In two of the cases in which therapy was started less than 100 minutes after the acute onset of visual loss and one case in which therapy was started during the course of central arterial occlusion, considerable improvement in visual acuity was observed, while in the fourth case in which therapy was started six hours after the acute onset of visual loss, no improvement appeared. We conclude from these results that hyperbaric oxygenation therapy has a beneficial effect on the final visual outcome of central retinal artery occlusion, provided it is applied early enough. Further investigation is needed to fully define the nature and terms of this beneficial effect.

Adult↗
PubMedDate not supplied

A change in ocular involvement in a patient suffering from ankylosing spondylitis and Behçet's disease.

We report a case of a young man suffering from both ankylosing spondylitis and Behçet's disease in whom the character of the ocular involvement changed according to the predominant disease at a given time. When the clinical picture was one of ankylosing spondylitis, only anterior uveitis was observed, while the clinical picture of Behçet's disease occurred with panuveitis and retinal vasculitis. To the best of our knowledge, this is the first report in the English literature of two different patterns of ocular involvement in the same patient with two seronegative arthritides.

Adult↗
PubMedDate not supplied

Erythropoietin-induced iritis-like reaction.

The present report describes an iritis-like reaction found in 13 patients treated with recombinant human erythropoietin (Eprex), a drug given to hemodialysis patients for their chronic anemia. Among 120 patients being treated by hemodialysis in two centers affiliated with our medical center, ten out of 30 Eprex-treated patients but none of 90 not being treated with Eprex developed this reaction. The observations described support a causal relation between Eprex treatment and the iritis-like reaction. Further investigative effort is needed to establish the mechanism.

Adult↗
PubMedDate not supplied

Synthetic patch for scleral tissue loss.

We report a case in which traumatic scleral tissue loss was surgically treated by a synthetic patch used in neurosurgical procedures. In the present case the patch served as a permanent solution to scleral loss. The patch is available commercially and easily stored. In the light of our experience, we suggest that this patch material be considered for both urgent and semi-elective scleral patching procedures.

Adult↗
PubMedDate not supplied

Coexistence of optic nerve head drusen and pseudotumor cerebri: a clinical dilemma.

The coexistence of optic nerve head drusen and pseudotumor cerebri is a potential clinical problem since diagnosing only one of two clinical abnormalities in a patient may delay or prevent the appropriate treatment. To the best of our knowledge, only four cases of such coexistence have been described. We report three cases diagnosed as having both optic nerve head drusen and pseudotumor cerebri and propose possible explanations. The report draws attention to the need for awareness of this potential coexistence in order to assure proper treatment.

Adult↗
PubMedDate not supplied

"Silent" ocular toxocariasis.

We describe an unusual presentation of ocular Toxocara infection. On examination of a 52-year-old asymptomatic male with no previous relevant general or ocular history, a lesion suggestive of a scarred Toxocara worm was found in his right fundus, medical workup revealed normal blood count and blood chemistry. Serologic tests were negative for Toxoplasma and Echinococcus and in 1:4 dilution were positive for Toxocara. The patient appeared to have a subclinical Toxocara infection, resulting in the present picture.

Animals↗