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Biomedical subjects

Y Romem

Publications and source records attributed to Y Romem.

At least 19 recordsLinked to original sources
PubMed1995

Amniocentesis rate and the detection of Down syndrome and other chromosomal anomalies in Israel.

We investigated the contribution of different screening criteria to the prenatal detection of Down syndrome (DS) as well as other chromosomal anomalies in the Jewish population in Israel during 1990 and 1992. There was a significant decrease (P < 0.03) in the incidence of DS live-births during 1992 (40:78 442) compared with 1990 (69:73 751) which paralleled a marked increase in total prenatal testing and in DS cases detected prenatally. Private laboratories, which perform amniocenteses mostly for women with a low risk of DS and without genetic counselling, had a significantly lower detection rate (1:917) compared with that of the genetic institutes, which following genetic counselling test both women > or = 37 years of age (1:91) and women younger than 37 years (1:113). The detection of chromosomal anomalies other than DS was less affected by the reason for amniocentesis. Amniocentesis indicated by maternal serum marker screening of women younger than 37 years identified a greater number of chromosomal anomalies other than DS than amniocentesis based on age (> or = 37 years) alone (111:9604 versus 94:9810; P < 0.06). Prenatal detection of DS is most effective when the indication for amniocentesis follows genetic counselling. The increasing use of maternal serum marker screening leads to a significant improvement in the positive detection rate of chromosomal anomalies other than DS in young women.

Adult↗
PubMed1995

Down syndrome prevention program in a population with an older maternal age.

OBJECTIVE: To investigate the effect of a relatively high proportion of pregnant women 35 years and older on the efficacy of prenatal screening for Down syndrome. METHODS: We obtained information on normal and abnormal cytogenetic and maternal serum marker studies for 1990 and 1992 from all 11 public and two private cytogenetic laboratories operating in Israel. RESULTS: In the Jewish Israeli population, 16.2-17.1% of all pregnant women are at least 35 years old. Thus, prenatal testing of all pregnant women at least 35 years old could have identified 62.8-66.5% of all Down syndrome cases. Screening by maternal serum markers would classify 9.28% of pregnancies as being at high risk for Down syndrome (greater than 1:386 at birth). The percentage of Down syndrome cases detected prenatally increased from 78 of 147 (53%) to 123 of 163 (75%) as a result of the increased use of prenatal testing from 11.3% to 19.4% of all pregnancies in 1990 and 1992, respectively. CONCLUSIONS: In a population with a high proportion of mothers at least 35 years old, as in the Jewish population in Israel, screening by maternal serum markers instead of by maternal age alone would leave the Down syndrome detection rate unchanged, but would lower the amniocentesis rate from 16.2-17.1% to 9.28%. In addition to the reduction in the expected fetal loss as a result of post-amniocentesis spontaneous abortion, this policy would also pay the cost of maternal serum marker testing of the entire pregnant population.

Adult↗
PubMed1995

Human chromosome classification using multilayer perceptron neural network.

A multilayer perceptron (MLP) neural network (NN) has been studied for human chromosome classification. Only 10-20 examples were required for the MLP NN to reach its ultimate performance classifying chromosomes of 5 types. The empirical dependence of the entropic error on the number of examples was found to be highly comparable to the 1/t function. The principal component analysis (PCA) was used, both for network initialization and for feature reduction purposes. The PCA demonstrated the importance of retaining most of the image information whenever small training sets are used. The MLP NN classifier outperformed the Bayes piecewise classifier for all the cases tested. The MLP classifier was found to be almost unsusceptible to the ratio of the number of training vectors to the number of features, whereas the piecewise classifier was highly dependent on this ratio.

Algorithms↗
PubMed1995

Induction of labor.

Several mechanical and biochemical methods have been used to induce labor throughout modern obstetrics. We review and compare mechanical and medical methods of labor induction, along with several new uterotonic agents such as mifepristone (RU 486) and misoprostol, which can be conveniently administered orally and managed in the outpatient clinic.

Female↗
PubMed1994

Prenatal testing for Down syndrome in the Jewish and non-Jewish populations in Israel.

The present work evaluated the efficacy of a prenatal diagnosis program in which amniocentesis and chorionic villus sampling were offered free of charge to all pregnant women in Israel aged > or = 37 years. The number of Down syndrome (DS) live births that occurred during the period of the program (1978-92) was correlated to the prevalence of old maternal age (> 35 years) and the utilization of prenatal test in the Jewish and non-Jewish populations in 1990 and 1992. It was noted that in the Jewish population, there was a slight increase in the DS live birth rate, from 1.05 in 1978, to 1.37 DS cases/1,000 live births in 1987, which corresponded to an increase in the prevalence of older pregnant women, from 8.0% in 1978 to 14.8% in 1987. Thereafter, however, there was a continuous decline, to 0.71 DS cases/1,000 live births in 1992, as a result of increased acceptance of prenatal testing by women > or = 37 years (67%) and, recently, also by younger women (from 5.6% in 1990 to 14% in 1992). In the non-Jewish population, there has been a very low acceptance rate of prenatal testing (23.3-16.1% in women > or = 37 years and 0.36-0.63% in women < 37 years). As a result, a very low prenatal detection rate (8-16% of all DS cases) and a high prevalence of DS live births (1.4 cases/1,000 live births) were observed. We suggest that a unique genetic counseling approach is required in the non-Jewish population to improve prenatal DS prevention in Israel.

Adult↗
PubMed1993

The temporal relationship between maternal blood and amniotic fluid glucose levels.

OBJECTIVE: Our purpose was to examine the temporal relationship between maternal blood and amniotic fluid levels. STUDY DESIGN: Glucose levels were measured on 158 paired samples from maternal plasma and amniotic fluid obtained from healthy women undergoing genetic amniocentesis at 15 to 20 weeks of gestation. The samples of venous blood and amniotic fluid were drawn at different time intervals, randomly assigned from 0 to 200 minutes. Linear regression analysis was used to test the relationship. The significance was tested by two-tailed t test. RESULTS: A good significant correlation (r = 0.78, p < 0.01 and r = 0.67, p < 0.05) was found at 21- to 40- and 121- to 140-minute intervals, respectively. CONCLUSION: The amniotic fluid glucose level reflects the maternal blood glucose levels at specific lag times.

Adult↗
PubMed1993

Training immigrant doctors: issues and responses.

An unprecedented wave of immigration of doctors to Israel, mainly from the former Soviet Union, posed for Israeli health leaders the problem of bringing them to a common and accepted Western level of performance. Stemming from the deep commitment which Israel has towards the immigrants, the state offers them a training opportunity to enhance their chances of being licensed and finding jobs in their profession. A 6-month programme was launched by Ben-Gurion University, later adopted by other medical schools and supported by the Government of Israel. The programme was designed to provide effective responses to the specific problems of the immigrant population, which are: lack of knowledge of local language, both everyday and professional; overspecialization in too narrow specialties; possession of clinical specialties which do not exist in the new country; insufficient updating in medical sciences and technology; unawareness of economic implications of health care; difficulty in originating new solutions to clinical problems, and lack of skill in answering objective test items. The programme is characterized by a protective environment, problem-oriented learning, small-group activities and emphasis on learning languages. The clinical problems are designed to emphasize the general practitioner's point of view of both common and emergency situations. The programme has achieved its goals, as judged by the success rate of its graduates in the National Licensing Examination as compared with the success of immigrant doctors who chose not to participate in the training.(ABSTRACT TRUNCATED AT 250 WORDS)

Education, Medical, Graduate↗
PubMed1992

Copper metabolism--a factor in gestational diabetes?

The purpose of the present work was to investigate whether there is an involvement of copper metabolism in the mechanism of gestational diabetes mellitus. No statistically significant differences were found in serum copper and ceruloplasmin concentrations between healthy pregnant women and women with gestational diabetes mellitus. The activity of ceruloplasmin in women with gestational diabetes mellitus was slightly higher and its specific activity significantly raised. The CuZn superoxide dismutase activity was significantly increased (P < 0.05) in women with gestational diabetes mellitus, comparing the two groups by matched pairs according to age. The results indicate that oxidative stress may have a role in gestational diabetes mellitus and that reduced concentrations of copper are not the cause of this stress.

Adult↗
PubMed1989

Exercise prescription in pregnancy: weight-bearing versus non-weight-bearing exercise.

Bicycle ergometry (non-weight-bearing exercise) and treadmill (weight-bearing exercise) were compared to assess physiologic responses to similar work loads. A total of 22 subjects at 29.3 +/- 1.6 (+/- SEM) weeks' gestation who performed non-weight-bearing exercise were compared with 15 similarly fit subjects at 26.1 +/- 2.3 weeks' gestation who performed weight-bearing exercise at three submaximal levels. Measurements by indirect calorimetry indicate preferential carbohydrate use during non-weight-bearing exercise at submaximal levels.

Adult↗
PubMed1989

Effects of seminal ejaculate on the biomechanical properties of chorioamniotic membranes.

We investigated the effects of seminal ejaculate on the biomechanical properties of chorioamniotic membranes obtained and processed immediately after normal term vaginal deliveries. Study samples were exposed to seminal ejaculate and control samples to buffered normal saline. Both the samples and controls were incubated for periods of 1, 4 and 24 hours, after which a load-deformation curve was derived for each. Four biomechanical parameters were analyzed for each sample and control: modulus of elasticity, rupture tension, work to rupture and strain to rupture. Exposure to seminal ejaculate was associated with an increase in the modulus of elasticity, work to rupture and rupture tension, reflecting a change in the elastic component of the mechanical properties. No significant change was observed in the strain to rupture. We hypothesize that these changes may indicate an alteration in the ability of chorioamniotic membranes exposed to seminal ejaculate to dissipate mechanical stress, resulting in their predisposition to premature rupture.

Amnion↗
PubMed1986

Pulmonary responses to exercise in pregnancy.

The pulmonary responses of 88 pregnant women were compared to those of 39 nonpregnant control subjects during different exercise intensities. At rest the pregnant women had higher tidal volumes, oxygen consumption, carbon dioxide production, and respiratory exchange ratio. With increased work loads the pregnant volunteers have consistently lagged behind the nonpregnant control subjects for every parameter, which indicates a decrease in pulmonary reserve and inability to exercise anaerobically.

Adult↗
PubMed1986

Fetal heart rate responses to maternal exercise.

The fetal heart rate responses to mild, moderate, and strenuous maternal exercise were studied in 45 healthy subjects. In the majority of cases, the fetal heart rate increased during and after maternal exercise. Fetal bradycardia was recorded in five fetuses; this appears to be a sporadic event. There was no correlation between the individual fetal heart responses, gestational age, exercise intensity, and maternal circulating catecholamines.

Blood Glucose↗
PubMed1985

C-reactive protein in pregnancy and in the postpartum period.

Serum C-reactive protein levels were measured by means of the nephelometric immunoassay technique in 215 pregnant women at various gestational ages. The results indicate a positive correlation of serum C-reactive protein levels with gestational age. In addition, we studied serum C-reactive protein concentrations in 37 pregnant women in labor and during the postpartum period. Delivery was accomplished by either the vaginal or abdominal route and was associated with significant C-reactive protein production.

C-Reactive Protein↗
PubMed1985

Hormonal responses to exercise in diabetic and nondiabetic pregnant patients.

The hormonal responses to low-level exercise in pregnancy have been studied in 13 insulin-requiring diabetic patients and 42 control subjects. We found no significant changes in plasma glucose, epinephrine, glucagon, or FFA with this level of exercise in the study group and control subjects; but plasma norepinephrine showed a significant increase with exercise. This type of exercise appears to be safe and could serve as a model for exercise prescription for attaining improved glucose tolerance in pregnant diabetic women.

Adult↗
PubMed1984

C-reactive protein as a predictor for chorioamnionitis in cases of premature rupture of the membranes.

We evaluated C-reactive protein for its ability to predict the occurrence of clinical chorioamnionitis in 51 patients with spontaneous premature rupture of the membranes at less than or equal to 34 weeks of gestational age. All the patients had determinations of C-reactive protein on admission, and then 25 patients were tested daily. Of the total 51 patients, 14 developed clinical signs compatible with a diagnosis of chorioamnionitis. An analysis was conducted to compare the use of C-reactive protein to that of white blood cell count in predicting febrile disease. Our study indicates that C-reactive protein is an accurate and early marker for predicting clinical chorioamnionitis. White blood cell and differential counts are less accurate in such prediction, especially after steroid treatment.

Adult↗
PubMed1984

Fetal bradycardia induced by maternal exercise.

Fetal bradycardia that occurred during maternal exercise (a symptom-limited VO2 max treadmill test) in the fetuses of three healthy pregnant women is described. The mechanism of this bradycardia is believed to be mediated by catecholamines. The fetal bradycardia seems to be transitory and appears to be compensated for by an increase in fetal heart rate after the cessation of exercise.

Adult↗