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Biomedical subjects

Ehud Assia

Publications and source records attributed to Ehud Assia.

10 recordsLinked to original sources
PubMed2005

Changing bacterial isolates and antibiotic sensitivities of purulent dacryocystitis.

OBJECTIVE: To examine the current spectrum of bacterial isolates in cases of chronic dacryocystitis and dacryoabcess and to determine their antibiotic sensitivities. MATERIALS AND METHODS: We carried out a prospective study in which 39 patients who presented to the outpatient clinic with chronic purulent dacryocystitis or acute dacryoabscess had cultures taken. All patients were antibiotic-free for at least one week prior to culturing. RESULTS: The 39 positive cultures grew 41 bacterial isolates, as two patients grew two species of bacteria; 16 isolates (39%) were Gram-positive and 25 (61%) were Gram-negative. The most common isolates were Pseudomonas (22%), Staphylococcus aureus (13%), Enterobacter (10%), Citrobacter (10%), Streptococcus pneumoniae, E. coli, and Enterococcus (7%). Uncommon Gram-negative bacteria were also cultured: Alcaligenes in two cases (5%), and one case of Stenotrophomonas maltophilia (2.5%). No anaerobic bacteria were isolated. Gram-negative isolates were sensitive to ceftazidime in 95%, ciproxin in 86%, and cefuroxime in 50% of cases, with sensitivity of less than 30% to cephalexin and ampicillin in those tested. All Pseudomonas isolates (100%) were sensitive to ceftazidine, 86% were sensitive to ciprofloxacin, with only 20% being sensitive to ampicillin and 14% to cephalexin. Alcaligenes was resistant to all antibiotics tested with the exception of ceftazidine. CONCLUSION: This study demonstrates a significant change in bacterial flora and antibiotic treatment requirements of purulent dacryocystitis from previously published data. A higher incidence of Gram-negative organisms, particularly Pseudomonas, with resistance to commonly used antibiotics was found. The emergence of rarer highly resistant Gram-negative microorganisms may also indicate a trend in lacrimal sac infections. These findings suggest that the antibiotic treatment protocol before and after lacrimal surgery should be reconsidered in this subgroup of patients.

Adolescent↗
PubMed2005

Headaches as the main presenting symptom of subacute angle closure glaucoma.

The diagnosis of subacute angle closure glaucoma is suspected in patients with narrow angles of the anterior chamber of the eye, presenting with periodic ocular, or periocular pain. However, some patients may present with headaches in the absence of significant ocular discomfort, which often leads to misdiagnosis and delay in specific therapy. The clinical features of 9 such patients are described. Subacute angle closure glaucoma should always be considered in the differential diagnosis of adult-onset headaches.

Adult↗
PubMed2005

[Cataract surgery and incidence of postoperative endophthalmitis in Israel].

BACKGROUND: Cataract surgery is the most common surgery in ophthalmology. Acute postoperative endophthalmitis is one of the most serious complications of cataract surgery and may result in severe visual impairment and even loss of the eye. In Israel there is no established and controlled registry on the number of operations or the rate of postoperative complications. AIM: To survey the total number of cataract operations performed annually in Israel, to investigate trends in surgical techniques and intraocular lenses used, and to study the rate of postoperative acute endophthalmitis. METHODS: Since the year 1990, a questionnaire regarding cataract surgery has been sent to all of the recognized inpatient and ambulatory surgical centers in the country. As of the year 2000, a questionnaire regarding postoperative endophthalmitis was added. RESULTS: The number of cataract operations performed annually demonstrates a constant increase in the last decade. In the last survey, conducted in 2004, there was a total estimated number of 39,000 operations. The incidence of post cataract endophthalmitis ranged between 0.13%-0.25%, with a downwards tendency in the past years. CONCLUSIONS: The constant increase in the number of cataract operations probably reflects both a true increase in the rate of operations, as well as better retrieval of data. The number of surgeries relative to the size of the population of Israel is within the lower limits of the range accepted in the industrialized world. The incidence of acute postoperative endophthalmitis is similar to that reported in controlled series. There is a need for an established controlled registry including information on the number of operations and the rate of complications.

Cataract Extraction↗
PubMed2005

[Optic disc drusen and acute vision loss].

Optic disc drusen (ODD) are calcified nodules within the optic nerve head. These are products of degenerated retinal ganglion cells axoplasmic transport, also known as hyaline or colloid bodies. They are mainly encountered as an incidental benign finding, or as a benign cause of swollen discs (in the differential diagnosis of papilledema). The majority of the patients are asymptomatic, and a slowly progressive sub-clinical visual field loss is found in about 80% of the patients. However, acute painless symptomatic visual field loss, occasionally massive, is rare. This is a case history of 4 patients who developed acute painless visual field loss which was attributed to optic disc drusen. The clinical features and proposed ischemic pathophysiology of acute vision loss and ODD are discussed.

Adolescent↗
PubMed2004

Frequency doubling technology threshold testing in the pediatric age group.

PURPOSE: To evaluate the feasibility of performing visual field with the Frequency Doubling Technology (FDT) in children aged 5 to 10 years. PATIENTS AND METHODS: Forty healthy children and fifteen healthy adults, all with no previous experience with visual field testing, underwent visual field testing with the C20 threshold test of the Carl Zeiss Meditec FDT analyzer in both eyes. The subjects were divided into three groups. Group A (age 5-7), group B (age 8-10), and group C (adults). RESULTS: The mean explanation time for the test was 83 +/- 43 seconds for group A, 68 +/- 31 seconds for group B, and 37 +/- 15 seconds for group C (P < 0.001 for the difference between group C and groups A and B). Test performance time for the right eye was 347 +/- 57 seconds, 301 +/- 21 seconds, and 298 +/- 35 seconds for groups A to C, respectively (P < 0.001 for the difference between group A and groups B and C). Forty percent of the children, but none of the adults required two demonstrations prior to initiation of the test. In children fixation losses for the right and left eye were 10% and 37% respectively. No fixation losses occurred in adults. In both eyes a mean deviation <0.5% occurred significantly more often in group A than in group C (P = 0.013). CONCLUSION: Visual field testing with FDT in the young age group is feasible. Test reliability was similar between children aged 5 to 7 and 8 to 10. Pre-selection of children is suggested to achieve reliable results.

Adult↗
PubMed2002

A missense mutation in the LIM2 gene is associated with autosomal recessive presenile cataract in an inbred Iraqi Jewish family.

In an inbred Iraqi Jewish family, we have studied three siblings with presenile cataract first noticed between the ages of 20 and 51 years and segregating in an autosomal recessive mode. Using microsatellite repeat markers in close proximity to 25 genes and loci previously associated with congenital cataracts in humans and mice, we identified five markers on chromosome 19q that cosegregated with the disease. Sequencing of LIM2, one of two candidate genes in this region, revealed a homozygous T-->G change resulting in a phenylalanine-to-valine substitution at position 105 of the protein. To our knowledge, this constitutes the first report, in humans, of cataract formation associated with a mutation in LIM2. Studies of late-onset single-gene cataracts may provide insight into the pathogenesis of the more common age-related cataracts.

Adult↗
PubMed2002

Acoustic cavitation in phacoemulsification: chemical effects, modes of action and cavitation index.

High-intensity ultrasound (US) energy (HIUE) has been extensively used in the last 3 decades in a wide range of surgical procedures, including phacoemulsification. The generation of radicals and sonoluminescence (SL) by application of continuous-wave (CW) HIUE to an aqueous medium under conditions simulating cataract phacoemulsification surgery is demonstrated by electron paramagnetic resonance (EPR) spectroscopy and a sensitive photon-detecting system. The findings provide direct evidence for the generation of acoustic cavitation in the simulated intraocular environment, pointing out that generation of acoustic cavitation in clinical phacoemulsification and other surgical applications of US is possible. The findings imply that the effects of acoustic cavitation in aqueous medium may contribute to the endothelial damage observed clinically following phacoemulsification cataract surgery. Saturation of the irrigating solution with various gases modifies the acoustic cavitation. Saturation of the irrigating solution with CO2 practically eliminates acoustic cavitation, with the concomitant elimination of radicals and SonL. CO2 may be utilized clinically to suppress acoustic cavitation in phacoemulsification and other medical applications. A cavitation index (CI) is introduced for the purpose of standardizing phacoemulsification instrumentation and other medical US devices that employ HIUE.

Acoustics↗
PubMed2002

[Bilateral acute angle closure glaucoma following topiramate treatment].

We describe a case of bilateral acute angle closure glaucoma associated with oral topiramate therapy. A 64 year old woman developed bilateral acute angle closure glaucoma two weeks after beginning topiramate therapy for peripheral diabetic neuropathy. A topical and systemic anti-glaucomatous treatment were given and laser peripheral iridotomies were performed and, the intraocular pressure were stabilized. However, the anterior chambers remained very shallow and peripheral ciliochoroidal detachment was observed and confirmed echographically. Assuming that the mechanism of acute bilateral simultaneous angle closure glaucoma differs from the common pupillary block, and is related to external cause, the topiramate therapy was discontinued, and the patient was treated with cycloplegic agent and steroids. A gradual deepening of the anterior chamber and resolution of the choroidal edema were accompanied by improvement of visual acuity and corneal clarity. The presumed mechanism of drug related acute bilateral angle closure glaucoma is choroidal effusion and detachment associated with forward budging of the iris-lens diaphragm. This, in turn, causes a shallow anterior chamber and blockage of the ocular draining system.

Cornea↗
PubMedDate not supplied

Comparison of intraocular pressure profiles during cataract surgery by phacoemulsification and extracapsular cataract extraction.

BACKGROUND AND OBJECTIVE: In view of reports of fluctuations in intraocular pressure (IOP) during phacoemulsification, real-time IOP during small-incision, manual extracapsular cataract extraction (ECCE) and phacoemulsification was measured to determine the effect of anterior chamber maintainer infusion on intraoperative IOP dynamics. PATIENTS AND METHODS: A comparative study of IOP during cataract surgery was conducted by these two methods in 29 patients. An anterior chamber maintainer infused balanced salt solution continuously into the eye throughout ECCE. The anterior chamber maintainer was open in 7 cases throughout phacoemulsification and switched off during phacoemulsification in 7 cases. RESULTS: IOP measurements during small-incision ECCE were physiologic (range, 5 to 20 mm Hg) during most of the operation and coincided with the value of hydrostatic pressure established by the height of the anterior chamber maintainer infusion bottle. During phacoemulsification without concomitant anterior chamber maintainer, IOP was positive (> 2 to 3 mm Hg) as long as the phacoemulsification infusion line was activated (position 1). Moving to position 0 caused hypotony. Occlusion breaks occasionally caused wide fluctuations in IOP. Concomitant anterior chamber maintainer and phacoemulsification infusion did not prevent surges, but may account for the lower range of fluctuation. The anterior chamber maintainer also maintained a positive IOP at position 0 during phacoemulsification. CONCLUSIONS: An anterior chamber maintainer in conjunction with a self-sealing incision can maintain stable physiologic IOP during small-incision ECCE. The IOP fluctuations during phacoemulsification, especially during occlusion breaks, can be attenuated by an anterior chamber maintainer.

Aged↗