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J Shalev

Publications and source records attributed to J Shalev.

96 records · Page 6Linked to original sources
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Pharmacokinetics of the progesterone-containing vaginal tablet and its use in assisted reproduction.

Natural progesterone, which is devoid of androgenic activity, is widely used in assisted reproduction for luteal and pregnancy support. The vaginal route has become the most established way to deliver natural progesterone because it is easily administered, avoids liver first-pass metabolism, and has no systemic side-effects. The vagina has a large potential for absorption, and through the 'uterine first-pass effect' vaginal administration results in higher uterine progesterone concentrations. We have investigated the pharmacokinetics of natural progesterone in the form of a vaginal tablet. A single dose of 100 mg resulted in a mean C(max) of 31.53 +/- 9.15 nmol/l with a T(max) of 6.92 +/- 3.12 h. The terminal half-life was 16.39 +/- 5.25 h. The pharmacokinetic data are discussed in relation to dose, age, and estrogen priming. Single-dose pharmacokinetics of 100 mg of progesterone vaginal tablets and gelatin capsules were evaluated over 24 h. Results indicated a similar mean T(max) of 6.92 +/- 3.12 and 6.23 +/- 6.57 h, respectively. However, a significantly higher C(max) was achieved by the vaginal tablet (31.95 +/- 9.15 and 23.85 +/- 9.57 nmol/l, respectively, P < 0.05). Continuous use of vaginal progesterone did not influence the hormonal, liver, or lipid profiles evaluated. There was no case of endometrial hyperplasia. The vaginal tablet was found to be well-tolerated, safe, and easily administered. In conclusion, progesterone-containing vaginal tablets have good pharmacokinetic properties and should be used for progesterone supplementation in IVF.

Administration, Intravaginal↗
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Fallopian tube torsion: laparoscopic evaluation and treatment of a rare gynecological entity.

BACKGROUND: Fallopian tube torsion is a cause for acute low abdominal pain that is difficult to diagnose. The purpose of this article is to review the available data on and to update clinicians regarding its diagnosis and treatment in the era of laparoscopic surgery. METHODS: We searched in MEDLINE and EMBASE and reviewed the lists of references. The keywords used were "laparoscopy," "fallopian tube," and "torsion." RESULTS AND CONCLUSION: Fallopian tube torsion is an uncommon cause for acute low abdominal pain in women. Because it has no pathognomonic clinical symptoms or findings on imaging or laboratory studies, a history of current or past pelvic pathologic conditions or surgery, as well as pregnancy, should draw the attention of the attending physician to its occurrence. Early laparoscopy is the reference standard in the diagnosis and treatment.

Blood Flow Velocity↗