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Biomedical subjects

M Glezerman

Publications and source records attributed to M Glezerman.

At least 19 recordsLinked to original sources
PubMed1992

[Limulus amebocyte lysate assay for diagnosing intraamniotic infection].

The value of the Limulus amebocyte lysate assay (LAL) in the diagnosis of intraamniotic infection was determined in amniotic fluid from transabdominal amniocenteses in 51 women in preterm labor with intact membranes. The prevalence of positive amniotic fluid cultures was 21.5% (11/51) in detecting intraamniotic infection. The LAL was positive in 19.6% (10/51), its sensitivity 81.8% (9/11), specificity 97.5% (39/40), positive predictive value 90.0% (9/10), and negative predictive value 95.1% (39/41). Similarly, in detecting women who would fail tocolysis and deliver prematurely, its sensitivity was 27.6% (8/29), specificity 90.9% (20/22), positive predictive value 80% (8/10), and negative predictive value 48.8% (20/41). We conclude that LAL is a simple, rapid and sensitive test for detecting intraamniotic infection in women in preterm labor.

Amniotic Fluid↗
PubMed1992

[HIV infection in pregnancy].

The epidemic of human immunodeficiency virus (HIV) is now affecting populations that were less susceptible in the early 1980s. It is estimated that 8% of patients with AIDS in the US are women in the reproductive age, and 1% are children. In Israel up to 1992, 134 women and 14 children of infected parents were reported as carrying antibodies against the virus. A pregnant women who was a carrier prompted us to formulate various questions as to how the infection affects pregnancy and vice versa, proper management at delivery, rate and modes of perinatal transmission, risk to health care workers, and legal aspects of HIV infection in Israel.

Delivery, Obstetric↗
PubMed1992

[Resistance in uterine arcuate arteries of pregnant hypertensive patients].

Hypertensive pregnant women were examined by continuous Doppler-ultrasound to measure resistance to blood flow in the uterine arcuate arteries. 20/26 had increased resistance. Those with bilateral increased resistance delivered after a mean of 33.2 weeks of pregnancy, 46.1% of them by cesarean section, and the mean birthweight was 1743 g. Those with unilateral increased resistance delivered after a mean of 38.0 weeks, 28.5% by cesarean section, and the mean birthweight was 2813 g. Measurement of blood flow by the Doppler method seems to be useful in the management of hypertensive disorders in pregnancy, as it helps to assess deficiency of the uterine circulation.

Arteries↗
PubMed1992

Culdocentesis is an obsolete diagnostic tool in suspected ectopic pregnancy.

We studied 332 patients with proven pregnancies. Prediction of hemoperitoneum by assessment of the Douglas pouch during bimanual examination had a false negative rate of 42.1%. The false negative rate for culdocentesis was 14.8%. It is therefore concluded that culdocentesis is not a useful tool in the diagnosis of suspected ectopic pregnancies.

Culdoscopes↗
PubMed1992

Listeria monocytogenes. The role of transabdominal amniocentesis in febrile patients with preterm labor.

Two women with preterm labor and intraamniotic infection with Listeria Monocytogenes are presented. In both patients, the prenatal diagnosis of Listeriosis was made by transabdominal amniocentesis. The immediate prominent observation was meconium staining of the amniotic fluid. We propose that an amniocentesis should be performed in women with premature labor and fever. If the amniotic fluid is meconium stained and the Gram stain examination reveals Gram positive rods, Listeria Monocytogenes should be suspected and the patient should be treated accordingly until the culture results are obtained.

Adult↗
PubMed1992

Prenatal ultrasonographic diagnosis of fetal scrotal inguinal hernia.

Fetal scrotal inguinal hernia was diagnosed at 33 weeks of pregnancy by ultrasonographic examination. Moving, echo-free, cystlike structures representing peristalsis within trapped loops of bowel in an abnormally enlarged scrotum were the main ultrasonographic finding. The diagnosis was confirmed post partum, and surgery was successfully carried out 4 days after delivery.

Female↗
PubMed1992

The relationship between endogenous oestradiol and vitamin D3 metabolites in serum and follicular fluid during ovarian stimulation for in-vitro fertilization and embryo transfer.

The present study was undertaken to examine the effect of circulating oestradiol on serum levels of 25-hydroxyvitamin D3 (25-OHD3), 24,25-dihydroxyvitamin D3[24,25-(OH)2D3], and 1,25-dihydroxyvitamin D3 [1,25-(OH)2D3] during gonadotrophin-induced ovarian stimulation in 10 healthy women undergoing in-vitro fertilization and embryo transfer (IVF). The presence of these metabolites in the follicular fluid was also investigated. Plasma oestradiol increased from 25 +/- 3.2 (mean +/- SE) pg/ml before initiation of treatment to 2563 +/- 328 pg/ml on the day of injection of human chorionic gonadotrophin (HCG) and 1641 +/- 299 pg/ml on the day of ovum retrieval (P < 0.01). Serum levels of 1,25-(OH)2D3 increased from 32.0 +/- 1.9 (mean +/- SE) pg/ml to 46.6 +/- 8.1 and 48.5 +/- 7.7 pg/ml (P < 0.05) on the day of HCG and ovum retrieval, respectively. No changes in blood levels of 25-OHD3 and 24,25-(OH)2D3 were found. The presence of vitamin D metabolites in follicular fluid is documented herein for the first time. All three metabolites were present in the follicular fluid but were significantly lower than in the concurrent serum (P < 0.01). A highly significant correlation was found between serum and follicular fluid levels: r = 0.787, P < 0.001 for 1,25-(OH)2D3; r = 0.738, P < 0.01 for 25-OHD3; and r = 0.751, P < 0.01 for 24,25-(OH)2D3. Our results suggest that raised levels of circulating oestradiol during gonadotrophin-induced ovarian stimulation are associated with a significant increase of serum 1,25-(OH)2D3.

24,25-Dihydroxyvitamin D 3↗
PubMed1992

Cordocentesis in the evaluation of the growth-retarded fetus.

The direct access to the fetal circulation provided by cordocentesis enables a better understanding of physiologic changes and more efficient diagnosis and treatment of many pathologic conditions. Because the procedure of direct fetal blood sampling is relatively safe, it has great potential in both antepartum surveillance and treatment of the severely growth-retarded fetus. Ultrasonography and Doppler instruments are the basis for urgently needed therapeutic trials which most probably will provide the obstetrician with new tools to treat the IUGR fetus early enough to prevent fetal compromise. Intrauterine infusion of nutrient supplements and methods to improve fetal acid-base balance may eventually be incorporated into the management protocols of the jeopardized growth-retarded fetus.

Blood Specimen Collection↗
PubMed1991

[Complications of third stage labor and the puerperium in preterm and term deliveries].

Preterm delivery is the leading cause of perinatal morbidity and mortality worldwide. The purpose of the present study was to determine whether preterm delivery is associated with complications of the third stage of labor and of the puerperium. Retained placentas occurred more frequently in 99 women with preterm vaginal delivery than in 97 with term vaginal delivery (13.1% vs 1%, p = 0.003). There was a higher rate of endometritis in women delivering before term than in those delivering at term (10.1% vs 0%, p = 0.004). This study indicated that preterm labor and delivery is associated with higher rates of perinatal morbidity and mortality and with an increased risk of maternal complications.

Female↗
PubMed1991

[Fetal heart rate monitoring in ambulatory and resting mothers].

The nonstress test (NST) to assess fetal wellbeing is done over the course of 30 minutes with the patient lying in the semi-Fowler position. The test relates changes in fetal heart rate to fetal movement, and uterine contractions are also recorded. The purpose of this study was to determine whether the NST is affected by maternal ambulation, so that the patient must be lying down when it is performed. We did the NST during ambulation as well as with the patient reclining. There were no differences in fetal heart rate and/or uterine activity between the 2 tests. 50% of the women preferred the ambulatory method while 25% preferred reclining and 25% expressed no preference. We conclude, that the ambulatory NST is an acceptable alternative to the conventional test with the patient reclining.

Female↗
PubMed1991

Fetal ovarian cysts: prenatal ultrasonographic detection and postnatal evaluation and treatment.

Ovarian cysts were diagnosed by antenatal ultrasonographic examination in 15 fetuses between 19 and 37 weeks' gestation. In six cases there was ultrasonographic evidence of torsion. Intracystic flocculation, which typically was deposited on the sloping part of the cyst, gave a characteristic liquid interface that was regarded as ultrasonographic evidence of torsion. All cases with evidence of torsion were managed surgically post partum, and in all patients this complication was confirmed. The remaining nine cases were followed up by repeated ultrasonograms, and in all patients disappearance of the cyst was documented within the first 6 months of life. The mean size of cysts with evidence of torsion was 5.41 +/- 0.25 cm, and the mean size of those without torsion was 4.33 +/- 0.3 cm (p less than 0.01). Histologic examination of the surgical specimen in the cases with evidence of torsion revealed follicular cysts in three cases and necrotic ovarian cysts with no specific epithelial findings in the remaining three. We recommend continuous ultrasonographic assessment of antenatally diagnosed cysts and believe that the choice of treatment depends on the appearance of the cyst and its evolution throughout pregnancy.

Female↗
PubMed1991

Fibrolamellar carcinoma of the liver in pregnancy. A case report.

Fibrolamellar carcinoma of the liver is a rare tumor that has not been previously reported to occur during pregnancy. A 22-year-old, pregnant Arab woman with documented fibrolamellar carcinoma of the liver was followed at our high-risk pregnancy unit. Despite the severity of the disease, the pregnancy and delivery were uneventful.

Adult↗
PubMed1991

[Leukocyte esterase in the rapid detection of intraamniotic infection].

Several lines of evidence support the view that premature rupture of the membranes and premature labor are associated with bacterial infection of the amniotic cavity. The standard method of diagnosing intraamniotic infection is amniotic fluid culture, but the results become available only after 72 hours. Methods for more rapid diagnosis of bacterial invasion are therefor needed. We examined leukocyte esterase activity for this purpose. Amniotic fluid obtained from 62 women in preterm labor was cultured for aerobic, anaerobic and mycoplasma species. Leukocyte esterase activity was measured with a Bio-dynamics test strip. The sensitivity of the test was 50.0% and its specificity 93.4%. It was found to be a simple and rapid method for the detection of intraamniotic infection.

Amniotic Fluid↗
PubMed1990

Experience in the treatment of epithelial ovarian carcinoma with cisplatinum-containing combination chemotherapy and dose intensity calculation.

Twenty-six patients with epithelial ovarian carcinoma, were treated by cisplatinum--containing combination chemotherapy following initial laparotomy. The mean number of treatment cycles was 7.8 (median: 9). The mean dose intensity (DI) and mean relative dose intensity (RDI) respectively were for cyclophosphamide: 108 mg/m2/week and 0.65, for doxorubicin: 8.6 mg/m2/week and 0.51, and for cisplatinum: 9.8 mg/m2 week and 0.59. The mean average relative dose intensity (ARDI) was 0.53. The three-year survival for all patients was 43%. No statistically significant difference in the three-year survival between patients receiving RDI's and ARDI of less than median dose and those receiving RDI's and ARDI of more than median dose could be demonstrated. Larger series are needed to test whether, and to what extent, dose intensity contributes to outcome, independently of the total amount of drug given.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1989

[Beta-interferon for labial and genital herpes virus infection].

19 women and 9 men, aged 15-59 (mean, 35.1), who had had recurrent lip or genital infections with herpes virus (HSV) for from 1-38 years, were treated with beta-interferon gel (100,000 IU/g), self-administered 4 times daily to the affected areas. In half the patients the drug and a placebo were given in a double-blind, cross-over study. The trial lasted 30 months. Frequency of attacks, length of each attack and its severity, and the presence of itching were noted. If there was improvement in at least 2 parameters treatment was considered successful. This was the case in about 75% of the patients. The mean number of attacks per year before and during treatment with interferon was 6.8 and 3.0, respectively (p less than 0.003) and the mean length of attacks 8.2 and 4.7 days, respectively (p less than 0.001). Results of the double-blind, cross-over test were also significant, and were similar to those for the total group. These results clearly indicate that local interferon is effective treatment for genital and labial HSV infections.

Administration, Topical↗
PubMed1989

Optimal debulking following chemotherapy of advanced-stage epithelial ovarian carcinoma.

We reviewed the records of 110 consecutive patients with advanced-stage epithelial ovarian carcinoma treated at the Soroka Medical Center, Beer-Sheva, Israel, from 1961-1987. Twenty patients (18.1%) had optimal debulking at initial laparotomy, 30 patients (27.2%) had nonoptimal debulking at initial laparotomy, 20 patients (18.1%) had an "inoperable" disease at initial laparotomy, and 40 patients (36.3%) had such poorly written records that no information about the degree of resectability at initial laparotomy could be obtained. Four patients, in whom the residual tumor left at initial laparotomy had responded to chemotherapy, had a second laparotomy. In all four patients optimal debulking surgery at second laparotomy was easy to perform and was successful. The value of a second laparotomy after a few cycles of chemotherapy in order to optimally debulk the residual tumor left at initial laparotomy is discussed. It is concluded that a second attempt of debulking surgery after chemotherapy has a respectable place in the management of patients with advanced-state epithelial ovarian carcinoma, but further research is needed.

Antineoplastic Combined Chemotherapy Protocols↗