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Biomedical subjects

B Shalev

Publications and source records attributed to B Shalev.

9 recordsLinked to original sources
PubMed2004

[Immune enhancing diet].

Immunonutrition contains nutritional elements which generally carry a positive effect on the immune system when given in large amounts. The main nutrients included in immunonutrition are: L-arginine, L-glutamine, nucleotides, and polyunsaturated fatty acids. Patients fed with immunonutrition had less infectious complications, were mechanically ventilated for shorter periods of time, and their hospitalization period was shorter. Mortality rates were generally not improved. In 2001, the U.S. Summit on Immune-Enhancing Enteral Therapy listed groups of patients who would benefit from immunonutrition. The article includes these recommendations. In conclusion, physicians should familiarize themselves with the issue of immunonutrition and consider using it in specific groups of hospital patients.

Amino Acids, Essential↗
PubMed2002

[The current approach to hemangiomas and vascular malformations of the head and neck].

Though most hemangiomas do not need treatment, a significant minority are associated with complications and external deformities that demand intervention. Steroids play an important role in therapy, but not infrequently afford only partial and temporary benefit. Thanks to improvements in the surgical approach and equipment, hemostasis control devices and laser techniques, we can now treat patients who would otherwise go untreated. Moreover, in certain cases, we can now recommend earlier intervention, saving patients from years of living with deformities and the concomitant psychosocial problems. Vascular anomalies of the head and neck include venular, venous and arteriovenous malformations. These lesions are slow growing vascular ectasia that never involute spontaneously and almost always require intervention. Treatment includes laser therapy, injection of sclerosing agents, embolization through angiography and surgery, which in many cases is the only definitive treatment. We present the current treatment approach and describe our experience in the treatment of 16 patients.

Blood Vessels↗
PubMed2001

Randomized comparison of diode laser photocoagulation versus cryotherapy for threshold retinopathy of prematurity: seven-year outcome.

PURPOSE: To report the structural and functional outcomes at a minimum of 7 years postmenstrual age after randomized treatment of threshold retinopathy of prematurity with laser ablation or cryotherapy. METHODS: Nineteen patients were entered into a prospective, randomized protocol, in which one eye received cryotherapy, while the other eye received diode laser photocoagulation. Asymmetric eyes were randomly assigned. Two patients have died, and seven were no longer available for 7-year outcome examinations, leaving 10 children for analysis. RESULTS: Six males and four females with a mean birthweight of 631 g and a mean gestational age of 24.8 weeks were examined. Eight were symmetrical cases and treated in both eyes. Of these, there were six concordant and two discordant structural outcomes. The laser-treated eyes had the favorable outcome in each instance. The geometric mean visual acuity of the paired eyes after laser photocoagulation was 20/33, and after cryotherapy it was 20/133 (P =.03). The mean refractive error was -6.50 diopters after laser photocoagulation and -8.25 diopters after cryotherapy (P =.27), although one of the cryotherapy eyes could not be refracted because of phthisis. CONCLUSIONS: Laser photocoagulation appears to be associated with a structural and functional outcome at least as good as cryotherapy 7 years after therapy. Visual acuity and refractive error data suggest that laser photocoagulation may have an advantage over cryotherapy.

Cryotherapy↗
PubMed2000

Restoration of fusion in children with intracranial tumors and incomitant strabismus.

PURPOSE: Intracranial tumors may cause eye misalignment and interruption of sensory fusion. The ocular misalignment may be permanent or may be corrected after tumor treatment with or without specific strabismus treatment. This report analyzes the binocular vision outcome of children with misaligned eyes from brain tumors who regain orthotropia. DESIGN: A retrospective noncomparative case series. PARTICIPANTS: Twenty-three surviving children less than 18 years of age with a new heterotropia and absence of fusion associated with the development of a brain tumor. INTERVENTIONS: Tumor resection/radiation/chemotherapy and necessary strabismus management. MAIN OUTCOME MEASURE: Stereopsis (>/= 4 of 10 circles) measured with the Randot II stereo test at near fixation. RESULTS: Fourteen children regained orthotropia either after tumor therapy, strabismus treatment, or both. Ten of these 14 children with realigned vision regained high-grade stereovision. Nine patients did not regain orthotropia and were excluded. The mean age at tumor diagnosis of the fusing group was 9.9 years (range, 3-17 years) compared with 8.5 years (range, 6-12 years) in the four realigned nonfusing patients. The mean duration of misalignment was 12 months (range, 2-51 months) for the fusing group, and 45 months (range, 14-120 months) for the nonfusing group. CONCLUSIONS: Children and adolescents with brain tumor-associated eye misalignment may regain the ability to fuse if their misalignment can be corrected. An improved prognosis was noted for those patients when the misalignment had been present for a shorter duration. These data suggest that the outcome may be better for incomitant strabismus than that reported for acute comitant esotropia.

Adolescent↗
PubMed1999

Slanted lateral rectus recession for exotropia with convergence weakness.

OBJECTIVE: To evaluate the efficacy of slanted recession of the lateral rectus (LR) muscle for exotropia (XT) with convergence weakness. DESIGN: Predesigned, nonrandomized, comparative trial. PARTICIPANTS: Twelve study patients and six control subjects with XT greater at near than at distance by > or =10 prism diopters (PD). INTERVENTION: Twelve consecutive patients underwent slanted LR recession, and six consecutive control subjects underwent standard LR recession. MAIN OUTCOME MEASURES: Between-groups comparison of the postoperative ocular alignment at distance and near, and the difference between them, as well as the stereopsis. RESULTS: Slanted LR recession reduced the XT to <8 PD in all patients at distance and in 11/12 patients at near. Additionally, the mean difference between the distance and near exodeviation was reduced from 14+/-4.5 PD preoperatively to 2.9+/-2.4 PD postoperatively. All patients in the control group demonstrated postoperative deviations of <8 PD at distance, but all had residual exodeviations >8 PD at near. Three of the study patients gained gross stereopsis postoperatively. CONCLUSIONS: Slanted recession of the LR is superior to standard recession in reducing both distance and near XT and in collapsing the difference between them. This technique may also have a positive impact on gross stereopsis.

Accommodation, Ocular↗
PubMed1999

Intraocular pressure fluctuations during strabismus operations and the postoperative period.

PURPOSE: To evaluate the intraocular pressure (IOP) variations which occur during and after strabismus surgery. METHOD: We measured the IOP in 34 eyes of 20 pediatric patients undergoing primary strabismus surgery under general anesthesia. Measurements were performed by the Tono-Pen (Mentor O&Q Inc. Norwell, MA) prior to surgery, immediately after suturing of the conjunctive, and 1 week and 4 weeks after surgery. All patients received the same local antibiotics and steroid solutions postoperatively. RESULTS: IOP decreased from baseline to the end of surgery by a mean of 8.26 +/- 1.8 mmHg and increased from baseline to 4 weeks after surgery by a mean of 3.6 +/- 1.8 mmHg. Thirty-eight percent of the eyes had an IOP of 21 mmHg or more during the postoperative period. CONCLUSION: IOP variations are prevalent during and after strabismus surgery. Careful postoperative measurements are recommended in order to identify individuals who may be prone to iatrogenically increased IOP.

Adolescent↗
PubMedDate not supplied

Mitomycin C and 5-fluorouracil antimetabolite therapy for pediatric glaucoma filtration surgery.

PURPOSE: To evaluate the efficacy and safety of augmented trabeculectomy with 5-fluorouracil (5-FU) and mitomycin C (MMC) compared to 5-FU only for the treatment of pediatric glaucoma. PATIENTS AND METHODS: In a prospective randomized clinical trial, 8 children (12 eyes) with pediatric glaucoma, either congenital or secondary to: lens aspiration, Sturge-Weber syndrome, or steroids underwent augmented trabeculectomy. Six patients (8 eyes) underwent augmented trabeculectomy with 5-FU plus MMC and 2 patients (4 eyes) underwent augmented trabeculectomy with 5-FU only. MAIN OUTCOME MEASURES: Between-group comparison of postoperative parameters: change in intraocular pressure (IOP), dependence on antiglaucoma medication, number of 5-FU injections, cup-disc ratio, corneal diameter, drug-induced complications. RESULTS: In the 5-FU/MMC group, 7/8 eyes showed good control of postoperative IOP (9-16 mm Hg), which was independent of antiglaucoma therapy; only 2 injections of 5-FU were needed. By contrast, in the 5-FU group, no control of the postoperative IOP (21-23 mm Hg) was achieved in 4/4 eyes, and these patients remained dependent on antiglaucoma medication; up to 6 injections of 5-FU were used. There was no deterioration in the cup-disc ratio or the corneal diameter in either group. Results were maintained on follow-up (23-27 months). No significant drug-induced complications were noted. CONCLUSION: Augmented trabeculectomy with adjunctive 5-FU/MMC may be an option for the control of pediatric glaucoma in patients with a poor surgical prognosis.

Alkylating Agents↗