Biomedical subjects

R Maymon

Publications and source records attributed to R Maymon.

112 records · Page 7Linked to original sources

PubMedDate not supplied

Three-dimensional vaginal sonography in obstetrics and gynaecology.

Great strides have recently been made in obstetrics and gynaecology secondary to the development of high-performance transvaginal ultrasound (TVS) instruments. However, even this advanced technology can provide only two-dimensional (2D) views of three-dimensional (3D) structures. Although an experienced examiner can easily piece together sequential 2D planes for creating a mental 3D image, individual sectional planes cannot be achieved in a 2D image because of various difficulties. Today, 3D TVS can portray not only individual image planes, it can also store complex tissue volumes which can be digitally manipulated to display a multiplanar view, allowing a systematic tomographic survey of any particular field of interest. The same technology can also display surface rendering and transparency views to provide a more realistic 3D portrayal of various structures and anomalies. The current review provides examples and discussions of the various applications in obstetrics, gynaecology and assisted reproduction in which 3D TVS is a useful supplement to image modality.

Congenital Abnormalities↗

PubMedDate not supplied

Utilization of the nuchal translucency image-scoring method during training of new examiners.

Training of new examiners, utilizing 1st-trimester nuchal translucency ultrasound screening, is mandatory for obtaining reproducible measurements. This study examined the contribution of the nuchal translucency image-scoring method to the process of training and its utilization as an objective tool of image evaluation and a tool for approving qualification. The study included an evaluation of the performance of two new examiners (examiners A and B) before and after intervention, using the image-scoring method. The preintervention period included 75 images evaluated by two reviewers using general evaluation and the scoring method. The report of the scoring method was submitted to the examiners and was applied to 55 images performed afterwards. The agreement between two reviewers in classifying the first 75 images as 'accepted' or 'rejected' was tested using general evaluation versus the scoring method. The effect of the intervention was examined by comparing the quality of the images between the two time periods. A chart indicating final scores of 80 successive images analyzed by examiner A was used to set criteria for assessing qualification. Using general evaluation, the reviewers disagreed on 19 (25%) of the images, whereas using the scoring method they disagreed on only 5 (7%, p < 0.01). Comparison before and after application of the intervention demonstrated significant improvement expressed by the increased rate of better quality groups (p < 0.001) and improved mean scores from 4.31 +/- 0.31 to 6.15 +/- 0.32 (p < 0. 001). Enhanced improvement of examiner's A performance could be attributed to the intervention rather than to his learning curve. Improvement was demonstrated in all the criteria examined; however, it was significant only for images size (from 33 to 98%), amnion demonstration (from 13 to 42%), and caliper placement (from 49 to 71%). Examiner's A chart enabled us to set standards for assessing competence, based on the scoring method. These included a minimum of 40 scans, followed by more than ten sequential images of acceptable quality. The scoring method contributed to the process of training, as it made possible to objectively evaluate the images, pointed out specific errors, served as an efficient tool of intervention, and might be used for ascertaining competence. We recommend to consider its utilization in centers running 1st-trimester ultrasound screening during training new examiners.

Education, Medical, Continuing↗

PubMedDate not supplied

Ectopic pregnancy, the new gynecological epidemic disease: review of the modern work-up and the nonsurgical treatment option.

Over the past few decades, the incidence of ectopic pregnancy has increased almost to the extent of an "epidemic disease." Early diagnosis of tubal pregnancy, with the aid of serum human chorionic gonadotropin, high-resolution ultrasound, and the more liberal use of laparoscopy, has dramatically reduced both maternal mortality and the need for radical surgery. Despite this, women with previous ectopic pregnancies still have reduced fertility potential. We report on some current aspects of the epidemiology, etiology, and work-up of ectopic pregnancy. In a review of 328 patients, gleaned from the literature, who were treated with various nonsurgical options, 283 (86%) were able to avoid surgery. The benefits, safety, and efficacy of the various treatment options are discussed, with appropriate recommendations for their use.

Female↗

PubMedDate not supplied

Growth hormone--non multum sed multa (quality, not quantity).

In view of the recent availability of recombinant human growth hormone (GH) and reports of its ability to augment ovulation induction by exogenous gonadotropins, we have surveyed the reproductive physiological role of GH and the family of polypeptides that mediate its action. The clinical studies using GH to improve ovulation induction, although achieving a significant reduction in exogenous gonadotropin administration, show only minor benefits in terms of attainment of pregnancy. An explanation for this phenomenon is suggested, and we provide guidelines for whom GH should be recommended.

Animals↗