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Biomedical subjects

B Caspi

Publications and source records attributed to B Caspi.

At least 37 records · Page 2Linked to original sources
PubMed1996

[Follow-up of intrauterine contraceptive devices].

The intrauterine contraceptive device (IUCD) is the most popular, reversible contraceptive method, worldwide. Leaving an IUCD in-utero even beyond the time recommended by the manufacturer has been found both safe, and effective in terms of contraceptive ability. In 1995 we screened the medical records of the gynecologic infirmaries of 4 agricultural settlements (kibbutzim) and found 78 women who had worn an IUCD continuously for more than 5 years. All had been regularly examined every 6 months. Most of the IUCDs (63, 80.7%) were copper-containing. Mean IUCD wear was 7.9+/- 2.6 years (range, 5-17 years). At the time of the study, 38 (48.7%) of the IUCDs were still in utero. Related complications were 3 cases of dysmenorrhea (3.8%) and 20 of metrorrhagia. No pregnancies or pelvic infections were recorded. This study also shows that wearing an IUCD beyond the time recommended by the manufacturer is not associated with loss of contraceptive effectiveness. Furthermore, the rate of IUCD-related complications after 5 years of wear was not higher than during the first 5 years. To support these findings further studies with larger samples are needed.

Female↗
PubMed1996

[Chorionic villus sampling in multiple pregnancies].

Prenatal genetic diagnosis is recommended in multiple pregnancies because of the increased prevalence of genetic abnormalities in such fetuses. It can be done early by chorionic villus sampling or later by amniocentesis. Several studies have demonstrated the efficacy and safety of chorionic villus sampling in multiple pregnancies. Our study describes the results of this method in a twin pregnancy and in 3 triplet pregnancies, which represent 3% of the chorionic villus samplings performed in our ultrasound unit during 1989-95. All genetically deformed fetuses in these pregnancies were identified by chorionic villus sampling and the method was not associated with fetal loss. Our results confirm the safety and efficacy of chorionic villus sampling as expressed in the world literature.

Chorionic Villi Sampling↗
PubMed1996

Sonographic evaluation of the uterus in postmenopausal women receiving tamoxifen: characterization of mid-uterine abnormalities.

BACKGROUND: Tamoxifen is known to exert agonist estrogenic effects on the uterus. Its use in postmenopausal women has also been associated with various endometrial and uterine abnormalities that can be detected by endovaginal sonography. OBJECTIVE: To study postmenopausal patients receiving tamoxifen who were referred for evaluation following the detection of abnormal uterine findings by endovaginal sonography. METHODS: Fifty-two women treated with tamoxifen for breast cancer who were found to have an abnormal uterine sonogram constituted the study population. Uterine sonograms were reviewed and clinical and sonographic data were correlated with the results of the histologic examinations. RESULTS: Forty-five women demonstrated a thickened mid-uterine structure. Of these, in thirty-nine patients (87%) either no tissue of scant fragments of normal endometrium were obtained on curettage, and six women (13%) had endometrial hyperplasia. Seven women had fluid loculation lined by thin endometrium. Their subsequent histologic examination was normal. The sonograms of the women who demonstrated an appearance of a thickened endometrium but no neoplasia, characteristically demonstrated hyperechogenic cystic area with no midline echo. CONCLUSIONS: Among 52 postmenopausal patients receiving tamoxifen presented with an abnormal uterine sonogram, 39 (75%) women were found to have a thick mid-uterine structure resembling a thickened endometrium without histologic evidence of neoplasia. This phenomenon can be characterized by typical sonographic features, and may be differentiated from other uterine abnormalities.

Adult↗
PubMed1996

Pathognomonic echo patterns of benign cystic teratomas of the ovary: classification, incidence and accuracy rate of sonographic diagnosis.

The great variability in the sonographic appearance of ovarian cystic teratomas poses difficulties for their diagnosis and classification. To overcome such difficulties, we have proposed a simplified classification of the pathognomonic echo patterns of ovarian cystic teratomas based on three basic types of echo pattern. In a prospective study of 118 echogenic adnexal masses, with postoperative histological confirmation, this classification enabled the correct diagnosis to be made in 115 cases (accuracy rate, 97.45%). In the three cases misdiagnosed preoperatively as ovarian cystic teratoma, the tumors proved to be benign and included a serous cyst adenoma, a serous cyst adenofibroma and a Brenner tumor. We suggest that, with our proposed classification of the echo patterns of ovarian cystic teratomas, sonography can become a quick and accurate tool in the recognition of this condition.

Adolescent↗
PubMed1996

Acute appendicitis: diagnosis by transvaginal sonography.

We present a case of a female patient with right lower quadrant abdominal pain, in whom transvaginal ultrasound facilitated the diagnosis of acute appendicitis. The insertion of the appendix into the cecum was demonstrated with direct continuity between the cecal lumen and the appendix. The inflamed appendix was in close proximity to the right ovary and was distinguished by a thick edematous wall and fluid in the lumen. This combination of findings may comprise a new sonographic sign for the diagnosis of acute appendicitis, particularly when performed by transvaginal sonography.

Abdominal Pain↗
PubMed1996

Sonographically guided aspiration: an alternative therapy for tubo-ovarian abscess.

Our objective was to evaluate the role of single-step ultrasound-guided aspiration in conjunction with intracavitary antibiotic instillation for the treatment of tubo-ovarian abscess. Ten women with the clinical and sonographic diagnosis of tubo-ovarian abscess, who failed to respond to systemic antibiotic therapy, were treated by ultrasound-guided aspiration of the abscess followed by intracavitary instillation of a combination of antibiotics. All ten women improved clinically and none required surgery. The mean time from aspiration to hospital discharge was 3.1 days with mean duration of hospitalization 7.8 days. No major complications were observed. The average time interval between aspiration of the lesion and resolution on sonographic follow-up was 9.5 weeks. In three cases, pelvic inflammatory disease recurred, but none needed surgical intervention. The average follow-up period of the patients was 12 months. One-step sonographically guided aspiration of tubo-ovarian abscess followed by intracavitary antibiotic instillation may serve as an easy and safe alternative therapy in patients in whom treatment with systemic antibiotics has failed.

Abscess↗
PubMed1996

Penetration of the bladder by a perforating intrauterine contraceptive device: a sonographic diagnosis.

We describe a case of penetration of the urinary bladder by an intrauterine contraceptive device with perforation of the uterine wall. This finding was discovered incidentally during an ultrasound examination for an earlier nonspecific mild abdominal pain of short duration. No abnormality had been noted on pelvic examination, during which the device's strings were found to protrude through the patient's cervix; a short laboratory workup including urinalysis, urine culture, blood count and blood sedimentation rate was also negative. The sonographic diagnosis was confirmed by cystoscopy. The device was retrieved transcervically. No complications were observed on follow-up. Bladder perforation by an intrauterine contraceptive device is very rare, and only a handful of such cases have been described. In all previous cases, the diagnosis followed a rather prominent clinical presentation, whereas, in this case, the patient complained of intermittent low abdominal pain of short duration. We therefore suggest that pelvic ultrasound examination be performed in every patient with unexplained low abdominal pain who is known to carry an intrauterine contraceptive device.

Adult↗
PubMed1996

Sonographically guided aspiration of ovarian cyst with simple appearance.

The objective of this study was to evaluate the role of sonographically guided aspiration of simple ovarian cysts. During the period from 1985 through 1992, 107 ultrasonographically guided punctures of apparently simple ovarian cysts were performed. The group included 76 premenopausal and 31 postmenopausal women who were followed for 1 to 6 years (mean, 2.7 years) after initial cyst puncture. In 42 cases, cyst aspiration constituted the definitive therapy. In 65 cases the cyst recurred and in this group, 38 women (with complete recurrence) were operated on whereas 27 women with a cyst less than 5 cm (incomplete recurrence) were allocated to a follow-up group. Overall, in 69 cases (65%) surgery was avoided. No major complications were encountered. In our experience, aspiration of simple ovarian cysts is a suitable alternative in the management of this problem. Close follow-up is necessary to detect recurrence and perform surgical intervention when indicated.

Adolescent↗
PubMed1995

Preoperative sonography in detecting small benign cystic teratomas.

Identification of small ovarian benign cystic teratomas (dermoid cysts) is difficult and sometimes impossible by clinical findings alone. They may be missed even on direct inspection during laparotomy or laparoscopy. There are several typical ovarian sonographic signs which are known to occur frequently in women with benign ovarian cystic teratomas. High-resolution sonography can identify the cysts based on their typical sonographic signs. Since these very small dermoid cysts are sometimes undetected by the naked eye during the operation, ultrasonography with particular attention to the signs is very important. We present three cases reports that illustrate the problem and stress the contribution of preoperative sonography in the diagnosis and treatment of such cases.

Abdominal Pain↗
PubMed1995

Smiling and fussing in seven-month-old preterm and full-term black infants in the still-face situation.

We investigated emotional responses to the still-face paradigm in 7-month-old preterm and full-term black infants. Baby FACS criteria were used to code the duration and intensity of infant smiles and the presence or absence of cry faces and fussy vocalizations within each episode. Infants in both groups showed the still-face effect: a significant reduction in smiling from episode 1 (baseline) to episode 2 (maternal still-face) and partial return to baseline in episode 3 (recovery). A multivariate analysis of covariance (MANCOVA) for big smiles yielded significant main effects for group and episode and a significant group x episode interaction. Preterm infants spent less time than full-term infants displaying big smiles in episode 1 and a less pronounced decrease in big smiles in episode 2. Maternal depressive symptoms did not differ significantly between groups. Counter to our expectations, depressive symptoms were positively associated with small-to-medium smiles in the baseline episode but not with big smiles in any episode. These findings confirm the robustness of the still-face paradigm and its potential usefulness for research on individual as well as group differences in affective communication in infants.

Affect↗
PubMed1995

The role of sonography in the detection of vaginal foreign bodies in young girls: the bladder indentation sign.

The cases of four young girls with vaginal foreign bodies, successfully diagnosed by ultrasound, are presented. The sonographic signs include varying echogenicity and acoustic shadowing, but always an indentation of the posterior bladder wall was clearly observed. Sonography should be considered as the first step in the evaluation of suspected vaginal foreign bodies in young girls.

Child↗
PubMed1994

Expectant management of interstitial pregnancy.

A case of interstitial pregnancy is described. Transvaginal ultrasound examination, performed at 8 weeks' gestation, revealed an empty endometrial cavity with an eccentric gestational sac in the left uterine corner, with a clear separation between the uterine cavity (endometrium) and the gestational sac. Expectant management, consisting of repeated sonographic examinations and assessment of serum beta-human chorionic gonadotropin, resulted in a favorable outcome.

Journal Article↗
PubMed1994

Successful resolution of persistent trophoblastic disease after partial mole with the EMA-CO regimen.

A 29-year-old nullipara with partial hydatidiform mole at 8 weeks had pre-evacuation hCG levels of 275,000 mIU/ml. Free beta-hCG levels were measured as 3% (normal value below 4%). The patient developed persistent gestational trophoblastic disease, failed to respond to methotrexate and actinomycin D, but has responded to combination chemotherapy with EMA-CO. Such a response to EMA-CO was not reported previously.

Adult↗
PubMed1994

Prenatal diagnosis of twin zygosity by DNA 'fingerprint' analysis.

A twin pregnancy with one hydrocephalic fetus with oligohydramnios is presented. Sonographic evaluation could not exclude monochorionicity. Before considering selective feticide, blood samples from both fetuses were examined for DNA 'fingerprint' analysis. The different banding patterns of the blood samples established dizygosity. This procedure is suggested in cases where sonography fails to determine chorionicity.

Abortion, Therapeutic↗