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Biomedical subjects

E Hornstein

Publications and source records attributed to E Hornstein.

10 recordsLinked to original sources
PubMed1994

Ureteric jet examination by color Doppler ultrasound versus IVP for the assessment of ureteric patency following pelvic surgery--a pilot study.

During the study period 228 women underwent major gynecological surgery in our department. Of these, 25 were selected for the study because of suspected post-operative ureteric obstruction. Post-operatively, both intravenous pyelography (IVP) and ureteric jet examination by the means of color Doppler ultrasound were performed in the study group. The aims were to exclude iatrogenic ureteric occlusion and to test the reliability of ureteric jet examination with ultrasound, as compared with IVP, as a diagnostic test for ureteric obstruction. In 19 patients both IVP and jet examination were normal. In the remaining six patients, jet was negative either uni- or bi-laterally. Of these six, only two obstructions were diagnosed using IVP. This test was associated with a positive predictive value of 33.3%, negative predictive value of 100%, sensitivity of 100%, specificity of 88.6%, false negative of 0% and a false positive of 17.4%. It is concluded that the results suggest that color Doppler ultrasound may be a good screening test for ureteric occlusion following pelvic surgery. Whenever a jet test is negative, further evaluation by IVP is required.

Adult↗
PubMed1990

The effect of disopyramide on uterine contractions during pregnancy.

To evaluate the effect of disopyramide on uterine contractions during pregnancy, the drug was given for 48 hours to 10 women with indications for labor induction. Placebo was given to 10 other women with the same indications for induction. During the study period, regular uterine contractions occurred in 10 women in the study group, as compared with none in the control group (p less than 0.0001). Eight women in the study group were delivered of infants within 48 hours, as compared with none in the control group (p less than 0.0001). The mean time until the appearance of regular uterine contractions in the study group (4.15 +/- 1.76 hours) was significantly shorter (p less than 0.001) than that in the control group (56.13 +/- 5.28 hours). Patients who were not delivered of infants within 48 hours received other medications (prostaglandin E2, oxytocin). The mean maternal blood level of disopyramide at the time of appearance of uterine contractions was 1.52 +/- 0.9 mg/ml. The mean maternal level at delivery was 0.93 +/- 0.43 mg/ml and the cord blood level at the time of delivery was 0.33 mg/ml (cord blood/maternal level ratio = 0.36, r = 0.73, p less than 0.05). These results indicate that disopyramide should not be used in pregnancy for antiarrhythmic purposes because it may induce uterine contractions and delivery.

Adult↗
PubMed1990

Cocaine: maternal use during pregnancy and its effect on the mother, the fetus, and the infant.

Cocaine was previously regarded as a soft drug causing only mild damage. Its use during pregnancy, however, creates a variety of grave medical problems which necessitate immediate attention not only on the part of internists and psychiatrists but also, and more particularly, by obstetricians and pediatricians. The pregnancy of a cocaine-using woman must be carefully managed and regarded as a high-risk one. This in view of the numerous obstetric risks caused by the drug, notably premature separation of the placenta, increased incidence of stillbirths, congenital malformations, premature births, and intrauterine growth retardation. The neonatal monitoring must be focused on prevention of complications resulting from the withdrawal syndrome and associated conditions such as pneumonia, severe weight loss, and contagion from the mother. Moreover, efforts must be made to ensure a strict observation of the infant outside the hospital in view of the far greater incidence of idiopathic infant death in such cases. Owing to the sharp rise of the regular and occasional use of the drug and since pregnant women tend on anamnesis to deny any drug taking, we recommend a test of maternal urine for cocaine and other drugs whenever a suspicion to this effect arises. It is also advisable to test for the presence of such drugs in the urine of the neonate in cases of reasonable suspicion of maternal use during pregnancy, though a negative outcome of the urine test naturally does not rule out a possible use. Strict monitoring of positive cases, accompanied by preventive treatment, may contribute a great deal toward a reduction of perinatal morbidity and mortality associated with cocaine use use.

Cocaine↗
PubMed1982

The management of breast carcinoma in pregnancy and lactation.

Until recent years, the prognosis for breast cancer in pregnancy and lactation was regarded as grave. The current new data suggest that pregnant women with early breast carcinoma may be treated in the same way as nonpregnant women without affecting pregnancy. However, women with breast cancer in their first trimester of pregnancy and in whom axillary lymph nodes are involved, should receive chemotherapy and have their pregnancy terminated. Toward the end of pregnancy, adjuvant therapy, when needed, can be delayed until after delivery. In patients with advanced disease pregnancy should be terminated and subsequent treatment initiated. During lactation, diagnosis of breast carcinoma requires suppression of lactation by means other than estrogens. The carcinoma will be treated by standard methods. After radical mastectomy for breast cancer, subsequent pregnancies are allowed but should be delayed until the period of greatest risk has passed.

Abortion, Therapeutic↗
PubMed1981

[Rectus sheath hematoma].

Rectus sheath hematoma is rarely diagnosed preoperatively. It can mimic acute intra-abdominal disease and other familiar disorders. It is more frequent during pregnancy and debilitating diseases. Blunt trauma to the abdomen, straining, coughing and anticoagulant therapy are also common contributing factors. The presenting symptom is onset of acute, localized, abdominal pain soon after the precipitating event. A tender abdominal mass is palpated in one of the rectus muscles. There are no specific diagnostic laboratory tests. Ultrasonography is the procedure of choice for correct diagnosis. Most of these patients can be successfully managed conservatively. During a period of two years, five cases were treated. Three of the patients suffered from acute cough associated with upper respiratory infections. Two had had multiple childbirths, one had had an abdominal operation and another had Cushing's disease and morbid obesity. Three were misdiagnosed and operated on. The hematoma was evacuated but the peritoneum was not opened. In two patients the correct diagnosis was made by ultrasonography and they were successfully treated conservatively.

Abdomen, Acute↗
PubMed1980

Selective versus routine intrapartum monitoring: comparison of effects on perinatal outcome.

This study compares perinatal results of 7,604 deliveries in two successive years (1976--1977) in which no policy changes occurred other than a four-fold increase in electronic intrapartum monitoring. In the first year 15.4 per cent of births were monitored selectively. In the second year all births were monitored, with the exception of patients admitted at an advanced stage of labor and elective cesarean section. The results show no significant improvement either in intrapartum or in early neonatal mortality rates. The same results obtained in cesarean section rate and in instrumental deliveries. The only positive result is a significant reduction of low Apgar scores in the unselected monitoring group (1977). The low morbidity is considered to be a result not only of increased monitoring, but also of active management of labor, of a short duration of labor and of intensive neonatal care.

Apgar Score↗