11 results on '"Ginsburg RN"'
Search Results
2. Successful Treatment of Central Retinal Artery Occlusion With Tissue Plasminogen Activator Followed by Recurrent Retinal Ischemia.
- Author
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Hsu J, Brown J, Mallick A, Fara M, De Leacy R, Rosen RB, Ginsburg RN, and Lema GMC
- Abstract
Purpose: To describe the use of intra-arterial tissue plasminogen activator (tPA) to treat central retinal artery occlusion (CRAO). Methods: A case and its findings were analyzed. Results: A 45-year-old man diagnosed with a CRAO and had cerebral angiography and treatment with intra-arterial tPA. After treatment, follow-up included optical coherence tomography (OCT), fundus photography, fluorescein angiography, and OCT angiography. The visual acuity (VA) improved from hand motions to 20/30 immediately after fibrinolysis. A vascular occlusion event the next day resulted in a decrease in VA to 20/400. After initiation of dual antiplatelet therapy, the patient's VA improved to 20/20. As the retina recovered, the evolution of retinal ischemic changes to a finding similar to paracentral acute middle maculopathy was seen on imaging. Conclusions: This is the first report describing a patient safely started on dual antiplatelet therapy that led to vision improvement after initial treatment with intra-arterial tPA for a CRAO resulted in recurrent vision loss., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of the article., (© The Author(s) 2024.)
- Published
- 2024
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3. A Remote Consult Retinal Artery Occlusion Diagnostic Protocol.
- Author
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Lema GMC, De Leacy R, Fara MG, Ginsburg RN, Barash A, Banashefski B, Tsai JC, and Rosen RB
- Subjects
- Humans, Retrospective Studies, Male, Female, Aged, Middle Aged, Aged, 80 and over, Fibrinolytic Agents therapeutic use, Clinical Protocols, Adult, Point-of-Care Systems, Retinal Artery Occlusion diagnosis, Retinal Artery Occlusion physiopathology, Tomography, Optical Coherence, Visual Acuity physiology, Remote Consultation, Tissue Plasminogen Activator therapeutic use, Tissue Plasminogen Activator administration & dosage
- Abstract
Purpose: To report a novel protocol for diagnosis of retinal artery occlusions at the point of care using OCT and a remote consult model., Design: Retrospective case series and evaluation of a diagnostic test or technology., Participants: Adult patients who presented with painless monocular vision loss and were diagnosed with a nonarteritic retinal artery occlusion., Methods: OCT machines were placed in the stroke center or emergency department at 3 hospitals within our health system. Patients who presented with painless monocular vision loss were evaluated by the stroke neurology service and an OCT was acquired. The images were interpreted remotely by the retina service. An in-house ophthalmology consult was not required to make the final treatment decision. Eligible patients were treated with intra-arterial tissue plasminogen activator (IA-tPA). Patients were followed by ophthalmology during their admission when an in-house consultation service was available or otherwise evaluated immediately after discharge., Main Outcome Measures: Visual acuity (VA) before and after treatment with IA-tPA; time from last known well (LKW) to treatment; and time from presentation to treatment., Results: In the first 18 months since the protocol went live, 59 patients were evaluated. Twenty-five patients (42%) had a confirmed retinal artery occlusion based on OCT and follow-up examination. Ten patients were eligible for treatment, and 9 patients received treatment with IA-tPA. There was a statistically significant improvement in mean VA from logarithm of the minimum angle of resolution (logMAR) 2.14 to logMAR 0.7 within 24 hours after treatment (P = 0.0001) and logMAR 1.04 after 4 weeks (P = 0.01). Clinically significant improvement was noted in 66% of patients within 24 hours and maintained through 1 month in 56% of all treated patients. The mean time to treatment from LKW was 543 minutes and from presentation at the stroke center was 146 minutes., Conclusions: We report the successful implementation of a remote consult protocol using point-of-care automated OCT. This novel paradigm demonstrates the potential utility of remote consult services for the diagnosis of time-sensitive ophthalmic emergencies., Financial Disclosure(s): Proprietary or commercial disclosure may be found after the references., (Published by Elsevier Inc.)
- Published
- 2024
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- View/download PDF
4. Reply: To PMID 24582994.
- Author
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Pierce LM, Raab EL, Holzman IR, Ginsburg RN, Brodie SE, and Stroustrup A
- Subjects
- Female, Humans, Male, Birth Weight, Gestational Age, Infant, Very Low Birth Weight, Retinopathy of Prematurity diagnosis
- Published
- 2014
- Full Text
- View/download PDF
5. Importance of birth weight as a risk factor for severe retinopathy of prematurity when gestational age is 30 or more weeks.
- Author
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Pierce LM, Raab EL, Holzman IR, Ginsburg RN, Brodie SE, and Stroustrup A
- Subjects
- Female, Humans, Infant, Newborn, Intensive Care Units, Neonatal, Male, Neonatal Screening, Practice Guidelines as Topic, Retinopathy of Prematurity surgery, Retrospective Studies, Risk Factors, Birth Weight, Gestational Age, Infant, Very Low Birth Weight, Retinopathy of Prematurity diagnosis
- Abstract
Purpose: To determine whether birth weight less than 1500 g is a relevant guideline indicating the need for examination for retinopathy of prematurity (ROP) when gestational age at birth is 30 or more completed weeks., Design: A retrospective observational cohort study., Methods: A total of 266 infants in a single institutional neonatal intensive care unit (NICU), whose gestational age at birth was 30 or more weeks but whose birth weight was less than 1500 g, were examined according to published guidelines. Infants with lethal congenital anomalies or major ocular abnormalities were excluded. Outcomes were vascularization in retinal zone III without a prior need for treatment, or ROP warranting treatment., Results: A study outcome was reached by 212 infants. Two hundred and eleven (99.5%) became vascularized through zone III without needing treatment. Only 1 (0.5%) required treatment for ROP. The 95% confidence interval for the occurrence rate of ROP requiring treatment in this cohort was 0.01%-2.60%., Conclusion: Our results suggest that the occurrence rates of ROP requiring treatment in infants with gestational age 30 or more weeks and birth weight less than 1500 g is very low, and could indicate the need to revise examination guidelines for this subgroup of infants., (Copyright © 2014 Elsevier Inc. All rights reserved.)
- Published
- 2014
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6. Caribbean corals in crisis: record thermal stress, bleaching, and mortality in 2005.
- Author
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Eakin CM, Morgan JA, Heron SF, Smith TB, Liu G, Alvarez-Filip L, Baca B, Bartels E, Bastidas C, Bouchon C, Brandt M, Bruckner AW, Bunkley-Williams L, Cameron A, Causey BD, Chiappone M, Christensen TR, Crabbe MJ, Day O, de la Guardia E, Díaz-Pulido G, DiResta D, Gil-Agudelo DL, Gilliam DS, Ginsburg RN, Gore S, Guzmán HM, Hendee JC, Hernández-Delgado EA, Husain E, Jeffrey CF, Jones RJ, Jordán-Dahlgren E, Kaufman LS, Kline DI, Kramer PA, Lang JC, Lirman D, Mallela J, Manfrino C, Maréchal JP, Marks K, Mihaly J, Miller WJ, Mueller EM, Muller EM, Orozco Toro CA, Oxenford HA, Ponce-Taylor D, Quinn N, Ritchie KB, Rodríguez S, Ramírez AR, Romano S, Samhouri JF, Sánchez JA, Schmahl GP, Shank BV, Skirving WJ, Steiner SC, Villamizar E, Walsh SM, Walter C, Weil E, Williams EH, Roberson KW, and Yusuf Y
- Subjects
- Animals, Caribbean Region, Climate, Ecosystem, Environmental Monitoring, Geography, Oceans and Seas, Survival Analysis, Water Movements, Anthozoa growth & development, Coral Reefs, Stress, Physiological physiology, Temperature
- Abstract
Background: The rising temperature of the world's oceans has become a major threat to coral reefs globally as the severity and frequency of mass coral bleaching and mortality events increase. In 2005, high ocean temperatures in the tropical Atlantic and Caribbean resulted in the most severe bleaching event ever recorded in the basin., Methodology/principal Findings: Satellite-based tools provided warnings for coral reef managers and scientists, guiding both the timing and location of researchers' field observations as anomalously warm conditions developed and spread across the greater Caribbean region from June to October 2005. Field surveys of bleaching and mortality exceeded prior efforts in detail and extent, and provided a new standard for documenting the effects of bleaching and for testing nowcast and forecast products. Collaborators from 22 countries undertook the most comprehensive documentation of basin-scale bleaching to date and found that over 80% of corals bleached and over 40% died at many sites. The most severe bleaching coincided with waters nearest a western Atlantic warm pool that was centered off the northern end of the Lesser Antilles., Conclusions/significance: Thermal stress during the 2005 event exceeded any observed from the Caribbean in the prior 20 years, and regionally-averaged temperatures were the warmest in over 150 years. Comparison of satellite data against field surveys demonstrated a significant predictive relationship between accumulated heat stress (measured using NOAA Coral Reef Watch's Degree Heating Weeks) and bleaching intensity. This severe, widespread bleaching and mortality will undoubtedly have long-term consequences for reef ecosystems and suggests a troubled future for tropical marine ecosystems under a warming climate.
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- 2010
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7. Globe perforation associated with retrobulbar and peribulbar anesthesia.
- Author
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Ginsburg RN and Duker JS
- Subjects
- Adrenal Cortex Hormones, Aged, Anesthesia, Local methods, Cataract Extraction methods, Equipment Safety, Eye Injuries, Penetrating therapy, Female, Humans, Macula Lutea injuries, Needles adverse effects, Optic Nerve Injuries, Prognosis, Risk Factors, Anesthesia, Local adverse effects, Eye Injuries, Penetrating prevention & control
- Published
- 1993
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8. Oculocardiac reflex in the anophthalmic socket.
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Ginsburg RN, Cartwright MJ, Murad SS, and Nelson CC
- Subjects
- Aged, Anophthalmos surgery, Atropine therapeutic use, Blood Pressure, Electrocardiography, Eye Injuries complications, Eyelids surgery, Heart Rate, Humans, Intraoperative Complications, Male, Anophthalmos physiopathology, Reflex, Oculocardiac
- Abstract
The oculocardiac reflex occurred in a patient with an anophthalmic socket undergoing surgery for inferior fornix shortening and laxity of the lower lid. This reflex occurs only rarely in anophthalmia; it has not been previously reported during socket surgery.
- Published
- 1992
9. Tension pneumoorbitus.
- Author
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Cartwright MJ, Ginsburg RN, and Nelson CC
- Subjects
- Adult, Exophthalmos etiology, Humans, Ischemia etiology, Male, Optic Nerve blood supply, Orbital Fractures diagnostic imaging, Orbital Fractures etiology, Radiography, Retinal Artery Occlusion etiology, Emphysema etiology, Eye Injuries complications, Intraocular Pressure, Orbital Diseases etiology
- Abstract
Posttraumatic tension orbitus developed in a young man causing subconjunctival emphysema and proptosis. Intraocular pressures were monitored as a means of indirectly measuring intraorbital pressure. The patient was serially examined for evidence of compressive optic neuropathy. Because of the possibility of orbital pressure increasing several hours from the time of injury, we recommend monitoring of these patients through intraocular pressure measurement and evaluation of the optic nerve for evidence of compression. Our findings, however, do support previous documentation that the intraocular pressure rise following orbital trauma with orbital emphysema is usually not of sufficient severity or duration to result in visual compromise.
- Published
- 1992
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10. Peculiar structures.
- Author
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Ginsburg RN
- Published
- 1977
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11. Stromatolites.
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Ginsburg RN
- Published
- 1967
- Full Text
- View/download PDF
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