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Biomedical subjects

Y Yogev

Publications and source records attributed to Y Yogev.

35 records · Page 2Linked to original sources
PubMed2003

Routine hemoglobin testing following an elective Cesarean section: is it necessary?

OBJECTIVE: To determine the clinical relevance of routine hemoglobin testing following an elective Cesarean section. METHODS: The charts of all women who underwent elective Cesarean section at a public teaching hospital during 2001 were reviewed for pre- and postoperative hemoglobin values, demographic data, indication for surgery and need for blood transfusion. RESULTS: The study group included 383 patients. Mean (+/- SD) hemoglobin level was 12.24 +/- 1.09 g/dl prior to surgery and 10.87 +/- 1.2 g/dl after, a mean loss of 1.37 +/- 0.87 g/dl (p < 0.001). There was no significant difference in blood loss by indication for surgery. None of the patients needed an intraoperative or postoperative blood transfusion. CONCLUSION: Routine postoperative hemoglobin measurement after an uncomplicated elective Cesarean section in asymptomatic low-risk women is not necessary and should be eliminated.

Adolescent↗
PubMed2003

Continuous glucose monitoring for the evaluation and improved control of gestational diabetes mellitus.

OBJECTIVES: To compare the daily glycemic profile reflected by continuous versus self-monitoring of blood glucose in women with gestational diabetes mellitus (GDM), and to evaluate possible differences in treatment strategy based on the two monitoring methods. MATERIALS AND METHODS: The study sample consisted of 57 women with gestational diabetes, 47 in Israel and ten in California. Gestational age ranged from 24 to 32 weeks in the Israeli women, and 32 to 36 weeks in the American women. Data derived from the Continuous Glucose Monitoring (CGM) System (MiniMed) for 72 h were compared to fingerstick glucose measurements (6-8 times a day). During continuous monitoring, patients documented the timing of food intake, insulin injections and hypoglycemic events. RESULTS: In the Israeli group, 23 women were treated by diet alone, and 24 by diet plus insulin. An average of 763 +/- 62 glucose measurements was recorded for each patient with continuous glucose monitoring. The mean total time of hyperglycemia (glucose level > 140 mg/dl) undetected by the fingerstick method was 132 +/- 31 min/day in the insulin-treated group and 94 +/- 23 min/day in the diet-treated group. Nocturnal hypoglycemic events (glucose levels < 50 mg/dl) were recorded in 14 patients, all insulin-treated. On the basis of the additional information provided by continuous monitoring, the therapeutic regimen (insulin therapy, diet adjustment, or both) was changed in 36 of the 47 patients. All ten American women were treated with insulin. The mean time of undetected hyperglycemia for a total group monitoring time of 30 days was 78 +/- 13 min/day. Eight women had nocturnal hypoglycemia on at least one of the three nights of monitoring for a total of 12 nights. A change in insulin dosage was made in all women on the basis of the data provided by continuous glucose monitoring. CONCLUSION: Continuous glucose monitoring is helpful for monitoring women with GDM and for adjusting diabetes therapy. It can accurately detect high postprandial blood glucose levels and nocturnal hypoglycemic events that may go unrecognized by intermittent blood glucose monitoring. A large prospective study on maternal and neonatal outcome is needed to determine the clinical implications of this new monitoring technique.

Adult↗
PubMed2003

Knowledge and attitude towards personal health care and menopause among women with ischemic heart disease undergoing coronary angiography.

The aim of this study was to assess the knowledge, perception, and attitude towards personal health care and menopause among women with ischemic heart disease. The study population consisted of 100 menopausal women attending the cardiac unit for coronary angiography. All women completed a 20-item questionnaire, covering information on health-care habits, life style and attitude towards menopause. About half of the study population had ever smoked, were overweight, had never tried to lose weight and did not exercise regularly. The majority regularly underwent screening mammography, Pap smear and lipid profile measurement. There was a positive statistically significant correlation between years of education and having annual mammography, Pap smear and lipid profile, performing breast self-examinations and taking an annual vacation. Sixty eight per cent of the study population had never used hormone replacement therapy (HRT), 13.2% had used HRT in the past and 18.8% were currently using HRT. There was a negative statistically significant correlation between use of HRT and age and number of children, and a positive statistically significant correlation between use of HRT and having an annual Pap smear and mammography scan. Only a relatively small percentage of the study population safeguarded their health care or used HRT. We believe that stronger efforts are needed to promote good health-related behaviors for these women.

Aged↗
PubMed2003

Uterine cervical elongation and prolapse during pregnancy: an old unsolved problem.

Prolapse with elongation of the cervix is a rare complication of pregnancy. Prolapse that existed before onset of pregnancy will usually resolve spontaneously by the end of the second trimester, without further complications. A pessary can be used to protect the cervix. Prolapse that develops during pregnancy is usually first noted in the third trimester, and management consists of bed rest in a slight Trendelenburg position. In these cases, pessaries will probably not remain in place or prevent preterm labor. Patient discomfort, urinary tract infection, acute urinary retention, premature labor, and prenatal loss are still major complications, and prolapse usually persists or recurs after labor. Treatment depends on the severity of the condition and the patient's preference.

Female↗
PubMed2002

Attitude towards health and hormone replacement therapy among female obstetrician-gynecologists in Israel.

OBJECTIVE: To assess Israeli women gynecologists toward their own health, their health related behaviors and to assess attitude towards and the use of hormone replacement therapy (HRT). METHODS: Ninety five actively employed hospital and community women gynecologist completed a questionnaire on attitude towards self-health, way of life, smoking habits, and regular breast, blood, pap smear examinations and HRT. RESULTS: Mean BMI was 25.3 Kg/m(2)+/-4.2, 61% considered themselves above average weight, and only 39% estimated their weight as appropriate. Fifty six percent were on active weight-loss diets, and 35% were current smokers. Blood tests, pap smears and breast evaluations were regularly done by 73.4, 91.5, and 64.1%, respectively. Overall, 74% of the gynecologists had a positive opinion about HRT; 70% of the menopausal subgroup had ever used HRT, and 93.3% of the perimenopausal subgroup intended to use it. The main reason for starting HRT was climacteric symptoms, and for stopping or avoiding HRT were equally bleeding, fear of cancer and adverse reactions towards HRT. By far the oral HRT mode was the most popular and 90% of users expressed satisfaction with treatment. CONCLUSIONS: Israeli women gynecologists are aware and maintain carefully their health, excluding cigarette smoking. The high rate of use and awareness of HRT among this group is encouraging considering that gynecologist serves as role model for the public and maintains the main source of HRT in the community.

Attitude of Health Personnel↗
PubMed2002

Attitudes of mothers toward their daughters' use of contraceptives in Israel.

The objective of the study was to examine mothers' knowledge about contraception, their attitudes to their daughters' use of contraception, and their communication with their daughters on the subject. A 20-item questionnaire was distributed in gynecological clinics throughout Israel for completion by women who had daughters over the age of 14 years. The questionnaire covered the mothers' demographic data, use of contraception, knowledge of contraception, attitude to their daughters' contraceptive use and sexual relationships, and communication with their daughters about contraception. Only 36% of the women received contraceptive information from physicians. Almost half felt their daughter should begin sexual relations when she felt she was ready; over two-thirds felt she should begin using contraception before or at the time of beginning sexual relations. Over three-quarters spoke with their daughters about contraception. Higher educational level of the mother was associated with high rate use of contraception by the mother, her support of earlier use of contraception by her daughter, a greater likelihood of her discussing contraception with her daughter, and a lesser likelihood to view contraceptives as dangerous to one's health. It is concluded that mothers of teenage daughters in Israel are involved in their daughters' decisions to begin sexual relations and the use of contraceptives. Their knowledge of contraception is adequate, although some gaps are still apparent. Clear correlation is found between higher educational level of the mothers and a more liberal attitude toward their daughters' sex life.

Adolescent↗
PubMed2002

Changing attitudes toward mode of delivery and external cephalic version in breech presentations.

OBJECTIVES: To compare the attitude of gravid women in breech presentation towards external cephalic version (ECV) and mode of delivery between 1995 and 2001. METHODS: A questionnaire on ECV and mode of delivery was distributed to women in the third trimester of pregnancy with breech presentation, attending our departmental clinic for a routine check-up once in 1995 and again in 2001 in order to analyze changing attitudes. RESULTS: One hundred fifty-four women completed the questionnaire in 1995 and 127 in 2001. There were no statistically significant differences between the groups in age, gestational age, gravidity, parity, or level of education. In 1995, more than half the women (52.7%) had heard of ECV and 53.8% were willing to consider it, whereas in 2001, 73.2% had heard of it but only 23.9% were willing to consider it. In both groups, the women who were familiar with ECV were more likely to work outside of the home, have a higher level of educated than the women who were not. The women who were willing to try ECV were more likely not to work outside of the home, to consider their pregnancy low risk, and to opt for vaginal delivery (vs. cesarean section) if ECV did not succeed. The percentage of women who would choose planned cesarean section if the presentation remained breech was significantly higher in 2001 (97%) than in 1995 (64.7%). CONCLUSIONS: Attitudes toward breech delivery have changed since 1995. More women are aware of the option of ECV but are less inclined to consider it. Planned cesarean section for breech presentation is the overwhelming choice of women in general, with a significant increase in 2001 compared with 1995.

Adult↗
PubMed2002

A survey of physicians' attitude and approach to hormone replacement therapy during menopuase.

OBJECTIVE: A major problem with postmenopausal hormone replacement therapy (HRT) is its relatively low long-term continuation rate. The aim of the present study was to assess the contribution of physicians to the low long-term continuation rate by surveying their attitude and approach to the use of HRT in postmenopausal women. PATIENTS AND METHODS: A questionnaire was sent to registered members of the North American Menopause Society. Data were collected on demographics, medical education and affiliation, attitude to the use of HRT and its contraindications, and follow-up, strategies. RESULTS: The response rate was 21% (n = 218). Sixty-six percent of the physicians recommended HRT for every postmenopausal woman with no contraindications. and 11% also took age and/or time since menopause into consideration. Eighty-six percent claimed they would try to persuade symptom-free women not interested in HRT into changing their minds. There was no correlation between the time since completion of residency or affiliation with a medical school and physicians' attitude to prescribing HRT or contraindication to HRT, or management strategy. However, type of specialty was significantly correlated with physicians' tendency to recommend HRT. Specialists in menopause showed a lower tendency to unconditionally recommend HRT (in the absence of contraindications) (67%) than specialists in reproductive endocrinology (90%), infertility (90%). gynecology (83%), and perinatology (84%) (p < 0.006, C-measure = 0.25). CONCLUSIONS: The attitude toward HRT and the management strategies of members of the North American Menopause Society correlate with contemporary recommendations in the literature, indicating good training of young physicians and adequate updating of older ones. Thus, to increase the continuation rate of HRT, educational efforts should be directed primarily to the public rather than to medical professionals.

Adult↗
PubMed2002

Self-health attitudes and practices of obstetrics and gynecology nurses in Israel.

OBJECTIVE: To assess the attitude of obstetrics and gynecology nurses towards their own health and their health-related behaviors. METHODS: Two hundred and ninety community obstetrics and gynecology nurses in Israel were asked to complete a questionnaire on attitude to self-health, way of life, smoking habits, and regular breast, blood and PAP smear examinations. RESULTS: The average body mass index of the responders was 25.2 kg/m2. However, more than half the nurses (163/287, 56.8%) considered themselves as being above-average in weight, and only 41.1% as being appropriate in weight; 55% were on weight-loss diets. Smoking was reported by 44.8%. Blood tests, PAP smears and breast evaluations were regularly done by 72.5%, 83.0% and 55.7%, respectively. CONCLUSION: Obstetrics and Gynecology nurses in Israel are aware of the importance of their own health and have good health habits, except for cigarette smoking, which remains a problem among this group.

Attitude of Health Personnel↗
PubMed2002

Ethnicity and attitude toward menopause and hormone replacement therapy in Northern Israel.

PURPOSE: The aim of the study was to assess the knowledge, perception and attitude towards menopause and hormone replacement therapy (HRT) among women of different ethnic groups in Israel. METHODS: 292 postmenopausal women attending primary health-care centers in northern Israel were recruited. All women completed a questionnaire, which included information on demographics, health status, menopausal symptoms, attitude toward menopause, adequacy of counseling and experience with HRT. RESULTS: Thirty-five percent of women were Arabic women. Most of the population categorized menopause as a positive and natural event, only 26% of the Arabic women thought of menopause as an illness-oriented event compared to 7.7% of the Jewish women. Half the Arabic women had never received information or been counseled about menopause and HRT, compared to 18% of the Jewish women. Menopausal symptoms showed a statistically significant improvement with HRT. However, only 40% of the Jewish women and 24% of the Arabic women used HRT. CONCLUSIONS: Only a relatively small percentage of Arabic women know about menopause and HRT use, probably because of the relatively low rate of counseling and information provided about menopause and HRT, and their lack of knowledge. Greater efforts are needed to promote a positive attitude to aging and menopause, increase awareness and knowledge. Providing greater access to information and support are essential steps in improving the women's health of the Arabic population in Israel during menopausal years.

Arabs↗
PubMed2002

The health-promoting behaviors and attitude towards menopause and hormone replacement therapy among women on dialysis.

The aim of this study was to assess the health-related behaviors, knowledge and attitude towards menopause and hormone replacement therapy (HRT) among women receiving dialysis treatment. The study population consisted of 44 women aged 55-75 years attending the dialysis unit. All women completed a 20-item questionnaire, which covered information on personal health-care habits, life style and attitude regarding menopause and HRT. The majority of participants were of desirable weight (body mass index < 25 kg/m2) and had a positive body image. About 80% had never smoked, and did not engage in regular physical activity. Over half underwent annual Pap smear, mammography, breast examination by a physician, and only a small minority performed breast self-examination. Surprisingly, 45% had used HRT in the past, but only 5% were current users. Although we expected postmenopausal women with a life-threatening disease to be more aware of personal health care than the general population, only a relatively small percentage of the study population safeguarded their health care, and used HRT. Stronger educational efforts may be needed to promote health-related behaviors and a positive attitude to health care, aging and menopause in this subgroup of patients.

Aged↗