PubMed Health⌕ Search

Biomedical subjects

B Mozes

Publications and source records attributed to B Mozes.

47 records · Page 3Linked to original sources
PubMed1987

Reduction of redundant hospital stay through controlled intervention.

With the aim of reducing redundant hospital stay through controlled intervention, preset criteria for inpatient care were applied on a medical ward. The proportion of unjustified hospital stay days fell by 52.6% and the average length of stay on the experimental ward declined from 6.3 days to 4.6 days. On a control medical ward there was practically no change. At one-month follow-up, patients from the two wards did not differ in death rate, readmission rate, or subjective evaluation of health status.

Age Factors↗
PubMed1987

Neutrophilic dermatosis and myelodysplastic syndrome.

Acute febrile neutrophilic dermatosis (AFND) is sometimes associated with leukemia. We present a patient with myelodysplastic syndrome who subsequently developed AFND, and we briefly review the association of AFND and myeloproliferative disorders.

Fever↗
PubMed1986

Thiazide-induced hyponatremia: an unusual neurologic course.

We have presented a case of thiazide-induced hyponatremia that followed an unusual course after the patient, suffering from extreme lethargy, was admitted with a serum sodium concentration of 104 mEq/L. Although the electrolyte imbalance was essentially corrected within 20 hours and there was clinical improvement, three days later the patient suddenly lost consciousness. She was comatose for more than a month, apparently from extrapontine myelinolysis. After a dramatic improvement, the patient was discharged with almost no neurologic deficit.

Acute Disease↗
PubMed1985

Pericardial effusion as the sole manifestation of infectious mononucleosis.

A 56-year-old patient presented with fever, dyspnoea and large pericardial effusion, which were the only features of infectious mononucleosis. Atypical cases or infectious mononucleosis are common in older patients. Such a well documented case of effusive pericarditis, however, has not been previously recorded.

Dyspnea↗
PubMed1985

Positive serological tests for infectious mononucleosis in a patient with Mediterranean spotted fever.

The Monospot test is an accurate and reliable test for infectious mononucleosis. False positive reactions have been seldom recorded. We report the conversion of the Monospot test from negative to positive during the course of Mediterranean spotted fever. Changes in the titre of the Paul-Bunnell test were observed also. The importance of measuring IgM antibodies as part of the routine investigation of infectious diseases is emphasised.

Adult↗
PubMed1984

Guillain-Barré syndrome associated with acute cytomegalovirus mononucleosis syndrome.

A case of Guillain-Barré syndrome (GBS) in a young patient who suffered from an acute cytomegalovirus (CMV) infection is presented. The diagnosis was reached following the isolation of the virus from the urine and the demonstration of high titers of both IgM and IgG antibodies in the serum. In contrast to previous cases in which GBS was merely associated with positive serology for CMV, but with almost no clinical manifestations of CMV mononucleosis syndrome, our patient had a full blown picture of acute CMV mononucleosis, including peripheral lymphocytosis, splenomegaly, hepatic involvement and hemolysis. Severe transient hypocomplementemia was also noted.

Adult↗
PubMedDate not supplied

Evaluation of the appropriateness of blood and blood product transfusion using preset criteria.

The use of 1930 units of blood or blood products during 765 transfusion episodes in 560 patients was reviewed. This represented one-half of all transfusions in a large medical center over a 2-month period. By clearly defined, present criteria, 42.3 percent of the episodes were found not to be appropriate. Whole blood and platelet transfusions were used more appropriately than those of red cells, cryoprecipitate, and fresh-frozen plasma. Blood transfusions were used more appropriately in the management of acute bleeding or anemia associated with cardiovascular problems. Three groups of patients were especially prone to inappropriate transfusions: those with end-stage renal disease or terminal cancer and cancer patients on chemotherapy. Age, sex, and specific hospital wards were not associated with inappropriate use. Most unjustified episodes occurred as a result of the overestimation of the immediate risk incurred by withholding transfusion.

Acute Disease↗
PubMedDate not supplied

Comparing medical centers treating hip fractures in the elderly: the importance of multi-outcome measurements.

The objective of this study was to assess the merit of multi-outcome measurements on the evaluation of quality of care, comparing different health care providers. We performed a cross-sectional study in 3 medical centers. Three hundred three patients undergoing surgical repair of traumatic femoral neck fracture were included. Trained nurses gathered data by patient and proxy interview and by chart abstraction. Multivariate analysis was performed to obtain an explanatory model for each outcome. Then, the additional contribution of each of the centers to the explanatory power of the model was examined. The outcomes were mortality, functional capacity, post-operative complications, and length of stay. Explanatory variables included were sociodemographic details, comorbidity indices, preoperative functional capacity, depression, and cognition. The results demonstrated that center A was a "good" outlier for mortality rate but, in contrast, was a "bad" outlier for complication rate and length of stay. Center B was a "bad" outlier for functional capacity but a "good" outlier for length of stay. We conclude that outcome studies for quality assurance programs should include all relevant outcomes, as the assumption that one major outcome may be representative for quality of care assessment may be misleading.

Activities of Daily Living↗
PubMedDate not supplied

Factors associated with nonprescription of evolving modes of therapy--a model for drug use evaluation in hospitalized medical patients.

OBJECTIVE: To measure the rate of inappropriate underuse of drug therapy among hospitalized patients and to identify factors associated with nonprescription of two effective modes of therapy. DESIGN: A survey was conducted by retrospective chart extraction to measure the rates of nonprescription of two therapeutic modalities--aspirin and angiotensin converting enzyme inhibitors. Stepwise logistic regression was used to determine which factors were significantly associated with nonprescription of either drug. SETTING: Two internal medicine departments in a major community and referral hospital in Israel. PATIENTS: Those who were hospitalized through 1990 with a diagnosis on their discharge sheet of angina pectoris or congestive heart failure. A random sample selection was made to define the study population. RESULTS: The rates of nonprescription among patients in whom there are no drug contraindications were 54% (95% CI 47-62) for aspirin and 34% (95% CI 27-41) for angiotensin converting enzyme inhibitors. Three variables correlated independently with nonprescription of both drugs: hospitalization in ward B, nonuse of the drug prior to hospitalization, and secondary priority of the diagnosis angina pectoris or congestive heart failure on discharge sheet. CONCLUSIONS: Nonprescription of essential drugs is a common phenomenon that varies significantly among physicians. Inconsistency in application of knowledge to clinical practice, as well as a diversity of approaches toward interpretations of clinical study results, significantly influences the prescription rates of evolving modes of therapy.

Angina Pectoris↗
PubMedDate not supplied

Variation in mortality among seven hemodialysis centers as a quality indicator.

OBJECTIVES: To identify patient attributes that were associated with increased mortality; variables that were associated with process of care that were correlated with mortality; and outlier centers after adjustment for patient attributes. DESIGN: Standard interviews were conducted by trained nurses with all patients. Detailed information regarding primary renal diagnosis, comorbidity, and results of laboratory tests were obtained from the medical charts. The vital status of the patients was obtained from the records of each of the centers. We used the Cox hazard method to identify variables that correlated with a 1-year mortality. Centers with observed mortality exceeding the 95% confidence interval (CI95) of the expected probability of death were marked as outliers. SETTING: Seven dialysis centers located in large teaching hospitals in Israel. PATIENTS: The current study included patients > 16 years of age who had undergone hemodialysis > 4 weeks prior to the day of data collection. RESULTS: The study included 564 patients. Significant differences were found in patient demographics and process variables among the centers. The following variables correlated with mortality; diabetes (odds ratio [OR], 2.03; CI95, 1.28-3.21); ischemic heart disease (OR, 2.2; CI95, 1.39-3.49); each year of age (OR, 1.04; CI95, 1.02-1.06); each 1 g% of albumin (OR, 0.51; CI95, 0.30-0.86). The average observed mortality in all centers was 17.4%. After adjustment for casemix, one center showed excess mortality (24% observed compared to 15% expected after adjustment for patient attributes; CI95, 6.2-23.7). CONCLUSIONS: The ability to compare mortality rates among dialysis centers to detect possible quality outliers depends on thorough consideration of patient attributes and random variation.

Adolescent↗