Biomedical subjects

Yoram Wolf

Publications and source records attributed to Yoram Wolf.

4 recordsLinked to original sources

PubMed2004

Early postpartum voiding dysfunction: incidence and correlation with obstetric parameters.

OBJECTIVE: To investigate the incidence and obstetric risk factors in early postpartum voiding dysfunction. STUDY DESIGN: Two hundred seventy-seven consecutive women in the early postpartum period were prospectively enrolled. Evaluation included history, physical examination, urinary questionnaire and non-invasive uroflowmetry measurements. Patients were interviewed regarding the presence and severity of voiding symptoms and were categorized into symptomatic versus asymptomatic subgroups. Obstetric parameters were compared in symptomatic versus asymptomatic patients as well as in cases of decreased (< 15 mL/sec) versus normal maximum urinary flow rates. RESULTS: One hundred twenty-five women (45% of the study population) hadearly postpartum voiding difficulties. Symptoms were significantly more common after vacuum extraction (38%) than spontaneous vaginal delivery (27%) or cesarean section (15%). The second stage of labor was significantly prolonged in symptomatic versus asymptomatic patients (62+/-52 versus 47+/-48 minutes). Voided volume, maximum and average flow rates and continuous flow pattern were significantly decreased in symptomatic versus asymptomatic patients. Twenty-eight patients (10%) demonstrated decreased (<15 mL/sec) maximum flow rates. The first stage of labor was significantly prolonged in these patients (9.7+/-5.8 versus 6.4+/-3.9 hours). Twenty-five patients (13%) gave birth to a neonate weighing > or =3,800 g. Maximum flow rates among these women were significantly decreased as compared to women with smaller infants (25.6+/-11 versus 32.9+/-19.2 mL/sec, respectively). CONCLUSION: Approximately 50% of patients complained of voiding difficulties in the immediate postpartum period. Main risk factors were prolonged first and second stages of labor, vacuum extraction and birth weight > or = 3,800 g. Long-term follow-up is needed to determine the significance of this clinically common entity.

Adult↗

PubMed2003

Divalent cation levels in serum and preovulatory follicular fluid of women undergoing in vitro fertilization embryo transfer.

In this controlled clinical study, we determined the serum and follicular fluid concentrations of the biologically active fractions of magnesium (Mg) and calcium (Ca) in 39 women undergoing controlled ovarian stimulation (COH) for in vitro fertilization (IVF) embryo transfer (ET). Serum levels of ionized Ca (Ca2+) and ionized Mg (Mg2+) were measured during day 3 of the IVF cycle, on the day of ovum pickup and 12 days following ET. Follicular fluid levels were measured on the day of ovum pickup. Serum levels of Mg2+ decreased and Ca2+ levels increased during the IVF cycle. Mg levels were significantly higher in follicular fluid than in serum. Ca2+ and Mg2+ may play a role in the preovulatory follicle, a possibility that warrants further study.

Adult↗

PubMed2003

Intensive care in a field hospital in an urban disaster area: lessons from the August 1999 earthquake in Turkey.

OBJECTIVE: To describe our experience with the implementation of intensive care in the setting of a field hospital, deployed to the site of a major urban disaster. DESIGN: Description of our experience during mission to Turkey; conclusions regarding implementation of intensive care at disaster sites. SETTING: Military Field Hospital at Adapazari in Turkey. PATIENTS: Civilian patients admitted for care at the field hospital. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: On August 17, 1999 a major earthquake occurred in western Turkey, causing approximately 16,000 fatalities and leaving >44,000 injured. Approximately 66,000 buildings were severely damaged or destroyed. A medical unit of the Israeli Defense Forces Medical Corps, consisting of 23 physicians, 13 nurses, nine paramedics, 13 medics, laboratory and roentgen technicians, pharmacists, and associated support personnel, were sent to Adapazari in Turkey. The field hospital treated approximately 1,200 patients over a period of 2 wks, 70 surgical operations were performed, 20 babies were delivered, and a variety of medical, surgical, orthopedic, and pediatric/neonatal care was provided. The 12-bed intensive care unit operated by the unit, was staffed by three physicians and eight nursing/paramedic personnel. Patient mix was: a total of 63 patients, among them five with major trauma, 20 with acute cardiac disease, 15 patients with various acute medical conditions, and 11 surgical and postoperative patients. Three patients were intubated and mechanically ventilated (one cardiogenic pulmonary edema and two major trauma). The intensive care unit provided the following functions to the field hospital: care of the critically ill and injured, preparation for and implementation of transportation of such patients, pre- and postoperative care for major surgical procedures, expertise, and equipment for the care of very ill patients throughout the field hospital. CONCLUSIONS: In suitable circumstances, an intensive care capability should be an integral part of medical expeditions to major disasters.

Disaster Planning↗

PubMed2002

Nitric oxide levels in peripheral blood as an indicator of microvascular anastomotic patency.

Nitric oxide (NO) was first recognized as the endothelial-derived relaxing factor in 1987, and since then has been extensively studied. It was found to be involved in almost every physiologic or pathophysiologic process in human biology. This study examined the correlation between peripheral blood levels of NO and the microvascular anastomotic patency of an infrarenal aortic anastomosis in a rat model. Four groups of six Sprague-Dawley rats each were studied. Three groups underwent microsurgical manipulation which included: anastomosis followed by ligation of the aorta in one group; anastomosis of the aorta in another; and dissection of the infrarenal aorta in the third group. A fourth group served as controls. Peripheral blood samples for NO levels were taken at different times before and during the first 24 hr after surgery. Results demonstrated a transient rise of NO levels in all operated groups. The ligated group exhibited the most prominent rise in NO blood levels. This rise was statistically significant, compared to the rise in other groups during the first 6 hr postoperatively. The anastomosed group levels were only mildly higher than the dissected group, showing no statistically significant difference postoperatively. NO blood levels in all of the groups returned to baseline at 24 hr postoperatively. The study shows that changes in NO levels in peripheral blood are detectable after microsurgical manipulation of the infrarenal aorta in a rat model. Furthermore, in rats undergoing ligation of the anastomosed aorta, mimicking anastomotic occlusion, NO peripheral blood levels are significantly higher than when the anastomosis remains patent.

Anastomosis, Surgical↗