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Z Hagay

Publications and source records attributed to Z Hagay.

70 records · Page 4Linked to original sources
PubMed1992

Appearance of excessive lipids in amniotic fluid as a sign of fetal hyperlipidaemia.

The appearance of excessive lipids in amniotic fluid during Caesarean section raised the suspicion of a hyperlipidaemic fetus. The amniotic fluid had elevated cholesterol (53 mg/dl) and triglycerides (81 mg/dl). At the age of 2 months, the infant was hyperlipidaemic (cholesterol of 161 mg/dl and triglycerides of 84 mg/dl). The case suggests the possibility of prenatal diagnosis of hyperlipidaemia, a major risk factor for atherosclerosis.

Adult↗
PubMed1992

A controlled trial of self-nonstress test versus assisted nonstress test in the evaluation of fetal well-being.

OBJECTIVE: New portable devices have become available for home monitoring of fetal heart rates; these devices have the potential to immediately transmit these tracings to a medical facility. The null hypothesis of this study is the inability of mothers to perform their own nonstress tests (self-nonstress tests) and that such tests are not comparable to those performed by professional medical personnel (assisted nonstress tests). STUDY DESIGN: The feasibility of maternal self-testing was established in 50 high-risk patients followed by a controlled clinical trial conducted in 60 patients. The latter study represents the first controlled trial in which patients performed self-nonstress tests at their homes and transmitted the tracings via telecommunication to our perinatal unit. In all cases these patients came to our hospital within 60 minutes after the self-nonstress tests to have a perinatal nurse perform a second nonstress test. The pairs of self and assisted fetal heart rate tracings were independently reviewed by two investigators. RESULTS: The self and assisted tracing pairs were judged satisfactory for interpretation in 100% and 90%, respectively; self and assisted were interpreted by each examiner to be nonreactive in 20% and 14%, respectively. However, both examiners were unable to distinguish between tracings generated by assisted nonstress and self-nonstress tests. Furthermore, cost analysis revealed an estimated twofold savings with self-nonstress testing compared with the assisted nonstress test. CONCLUSION: Self-nonstress testing is a reliable and accurate method of antepartum fetal heart rate testing. This method of fetal assessment not only introduces a new approach to fetal surveillance with added convenience to patients, but may also significantly reduce medical cost without compromising the results of fetal testing.

Costs and Cost Analysis↗
PubMed1992

Eradication of Ureaplasma urealyticum from the amniotic fluid with transplacental antibiotic treatment.

Ureaplasma urealyticum was isolated from the amniotic fluid of a patient with preterm premature rupture of membranes at 24 weeks. A second amniocentesis performed 48 hours later indicated an increase in the number of neutrophils in the amniotic fluid. Treatment with erythromycin, ampicillin, gentamicin, and clindamycin was instituted for a period of 6 days. Amniotic fluid analysis from a third amniocentesis performed 24 hours after discontinuation of antibiotic treatment revealed only a few white blood cells and was negative for microorganisms. The pregnancy continued for 22 days after admission, at which time spontaneous labor began. The neonate survived with no sequelae and had negative blood cultures. Antibiotic treatment was associated with eradication of Ureaplasma urealyticum from the amniotic cavity, pregnancy prolongation, and neonatal survival.

Adult↗
PubMed1992

Diabetes mellitus in pregnancy and periconceptional genetic counseling.

Gestational diabetes constitutes 90% of all pregnant diabetic patients, whereas insulin-dependent diabetes mellitus (IDDM) and non-insulin-dependent diabetes mellitus (NIDDM) together account for the remaining 10%. Diabetes is considered a heterogeneous disease with a continuous spectrum between IDDM and NIDDM. It is believed that gestational diabetes is also a heterogeneous disorder representing, at least in part, patients who are destined to develop in later life either IDDM or NIDDM. Studies in identical twins have shown clear-cut differences in the genetic inheritance of IDDM and NIDDM. Nearly 100% of identical twins were found to be concordant for NIDDM; whereas in IDDM the concordance rate ranges between 20 and 50%. This concordant pattern indicates a higher genetic contribution in NIDDM than IDDM. Furthermore, IDDM is an HLA-linked disorder, and NIDDM is not. The exact mechanism of inheritance of IDDM and NIDDM is not known; therefore the information used in genetic counseling is based on empirical risk estimates. Recent information demonstrates that IDDM is transmitted less frequently to the offspring of diabetic mothers than diabetic fathers (1.3% versus 6%). The estimated risk of recurrence of IDDM to offsprings with one already affected sibling and unaffected parents is 5 to 6%. Additionally, the empirical risk of NIDDM first-degree relatives developing diabetes is much higher than the observed in IDDM relatives, 15% for first-degree relatives and 60 to 75% when both parents have NIDDM.(ABSTRACT TRUNCATED AT 250 WORDS)

Diabetes Mellitus, Type 1↗
PubMed1991

Amniotic fluid white blood cell count: a rapid and simple test to diagnose microbial invasion of the amniotic cavity and predict preterm delivery.

The purpose of this study was to determine the value of amniotic fluid white blood cell count in the diagnosis of microbial invasion of the amniotic cavity. Amniotic fluid was retrieved by amniocentesis from 195 patients with preterm labor and intact membranes. Fluid was cultured for aerobic and anaerobic bacteria, as well as for mycoplasmas. The prevalence of a positive amniotic fluid culture was 12.8% (25/195). Patients with a positive amniotic fluid culture had a significantly higher median amniotic fluid white blood cell count than did patients with a negative amniotic fluid culture (median, 6 cells/mm3; range, 0 to 11,000 cells/mm3 vs median, 320 cells/mm3; range, 1 to 4480 cells/mm3; p less than 0.0001). An amniotic fluid white blood cell count greater than or equal to 50 cells/mm3 had a sensitivity of 80% (20/25), a specificity of 87.64% (149/170), a positive predictive value of 48.78% (20/41), and a negative predictive value of 96.75% (149/154) in the detection of a positive amniotic fluid culture for microorganisms. Although the sensitivity of an amniotic fluid white blood cell count (greater than or equal to 50 cells/mm3) in the detection of microbial invasion of the amniotic cavity was greater than that of the Gram stain of amniotic fluid (80% [20/25] vs 48% [12/25]; p less than 0.05), the specificity was lower (87.64% [149/170] vs 98.8% [168/170]; p less than 0.05). However, 88% (15/17) of all patients with an amniotic fluid white blood cell count greater than or equal to 50 cells/mm3 and a negative amniotic fluid culture had a spontaneous preterm delivery. We conclude that the amniotic fluid white blood cell count is a sensitive, simple, and inexpensive test for the detection of microbial invasion of the amniotic cavity. An elevated amniotic fluid white blood cell count is a risk factor for preterm delivery.

Adult↗
PubMed1991

Assessment of carbohydrate tolerance in pregnancy.

A review is given of the various methods of assessing carbohydrate tolerance in pregnancy. Oral glucose tolerance screening and diagnostic tests have been in use for more than 25 years. They are easily administered, relatively inexpensive, and present reasonable sensitivity; therefore, they continue to be used quite extensively. However, lack of reproducibility of the results and side effects such as nausea, vomiting, and headache have led to the use of alternate methods including glucose polymer (Polycose) and standard breakfast meals. These methods have been reported to present satisfactory results in clinical practice. Glycosylated hemoglobin (HbA1c) and fructosamine assays are also alternate forms of testing carbohydrate metabolism HbA1c measurement have been proven insensitive as a screening test for gestational diabetes, while their use as an index of overall glucose control remains valuable. The role of fructosamine in the assessment of carbohydrate intolerance remains controversial with conflicting claims made by various investigators regarding its sensitivity in detecting gestational diabetes and its response to alterations in glycemic control. In this review, the relative advantages and disadvantages of each glucose tolerance test are discussed and recommendations are given regarding their utility in pregnancy.

Dietary Carbohydrates↗
PubMed1991

Insulin-dependent diabetes mellitus and immunogenetics: maternal and fetal considerations.

It has now become clear that certain HLA antigens are associated with disease susceptibility more than any other genetic markers. Insulin-dependent diabetes mellitus (IDDM or type I) is an HLA-associated condition. Moreover, there is evidence to show that IDDM is a genetically programmed autoimmune disease. Studies of the HLA-DR region have shown a strong association with IDDM, with over 90 per cent of IDDM patients possessing DR3 and/or DR4. Although the HLA-DR region is a major component in the inherited disease susceptibility, it is not the only gene region involved. Recent studies demonstrated that HLA-DQ may be more closely linked to the disease locus than HLA-DR. Sequence analysis of the HLA-DQ3 gene products suggest that a single amino acid (aspartic acid) at position 57 is uniquely important for determining susceptibility or resistance to IDDM. Although there is a strong association of certain HLA loci with IDDM, it may not explain nor account for all the genetic susceptibility to the disease. It seems that 60 per cent of the genetic basis of IDDM is related to the HLA gene (chromosome 6) and another 40 per cent is non-HLA-associated (i.e., chromosomes 2, 7, 11, and 14). Even though great progress has been made in the understanding of the genetics of IDDM, the mode of inheritance of the disease remains controversial. The present review discusses various aspects of the autoimmune process believed to be involved in pancreatic beta cell destruction in individuals genetically susceptible to IDDM. The possible modes of inheritance and new data regarding estimated risks of transmitting the disease are presented.

Chromosome Mapping↗
PubMed1990

Preterm delivery: a risk factor for retained placenta.

The purpose of this study was to determine whether preterm delivery, with and without intraamniotic infection, is a risk factor for retained placenta. This complication occurred more frequently in women with preterm vaginal delivery than in women with term vaginal delivery (9.1% [21/231] vs 1.1% [6/561]; p less than 0.00001; odds ratio = 9.25). There was no significant difference in the prevalence of retained placenta between women with preterm labor and intact membranes and those with preterm premature rupture of membranes (8% [10/125] vs 10.4% [11/106]; p greater than or equal to 0.05). A positive amniotic fluid culture or clinical chorioamnionitis was not associated with a higher incidence of retained placenta. This study indicates that preterm delivery is associated with an increased risk of complications of the third stage of labor.

Adult↗
PubMed1990

The safety of obstetric ultrasonography: concern for the fetus.

It has been estimated that more than half of all pregnant women in the United States undergo diagnostic ultrasound during their pregnancies. In light of this, the question of safety is of fundamental importance. Nondiagnostic ultrasound has been shown to produce biologic effects by thermal and cavitational activities. However, diagnostic ultrasound uses much lower intensities, and no evidence exists to suggest that it is associated with adverse effects. Numerous studies have examined the biologic effects of diagnostic ultrasound in insects, plants, cell suspensions, and even small mammals. The data from these experiments are confusing when attempting to relate these findings to the human. Epidemiologic data in humans, used to evaluate the potential adverse effects of exposure to diagnostic ultrasound, have revealed no ill effects from such exposure. Current data indicate that there are no confirmed biologic effects on patients and their fetuses from the use of diagnostic ultrasound and that the benefits to patients exposed to prudent use of diagnostic ultrasound outweigh the risks, if any. This review discusses the available information on the safety of obstetric ultrasonography.

Animals↗
PubMed1986

Spectrophotometric determination of meconium concentration in amniotic fluid.

When a fetus is acutely distressed, for example as a result of strangulation by the umbilical cord, the bowel content, meconium, may be passed into the amniotic fluid. Assessment of meconial contamination of the amniotic fluid is important in the management of late pregnancy. Fresh or increasing meconium content is an indication for urgent delivery. 'Old' meconium is usually distinguished from 'new' by visual inspection of the stained amniotic fluid; a more objective method could have advantages. We consider the effects of meconium staining of amniotic fluid on the spectrophotometric properties of the liquor. The absorption spectra of meconial amniotic fluids reveal an excess absorption band, centred around 410 nm. Quantification of the band height is proposed and it is shown that the height is linearly related to meconium concentration, with a proportionality factor, or sensitivity, of 0.046 +/- 0.009 (mean +/- s.d.) proportionality factor, or sensitivity, of 0.046 +/- 0.009 (mean +/- s.d.) optical density (OD) units per g l-1. This sensitivity factor may be used to estimate meconium concentration in samples of amniotic fluid.

Amniotic Fluid↗
PubMedDate not supplied

Non-Hodgkin's lymphoma presenting as advanced ovarian cancer--a case report and review of literature.

Non-Hodgkin's lymphoma involving the ovaries is unusual and may cause confusion for the clinician since its presentation might resemble other, much more frequent tumors. Malignant lymphoid cells may occur in the ovary either as a primary neoplasm or as a secondary manifestation of a disseminated occult or known disease. The most common presenting signs or symptoms of malignant lymphomas involving the ovaries are abdominal or pelvic pain or mass. We present here a unique case of non-Hodgkin's lymphoma involving the ovaries presenting as advanced ovarian cancer with a pelvic mass, pleural effusion, and marked elevation of CA-125.

Aged↗
PubMedDate not supplied

Management of chloroquine-resistant Plasmodium falciparum malaria in a pregnant Ethiopian immigrant--a case report.

Plasmodium falciparum malaria is infrequently recognized in Israel as a cause of infection during pregnancy. We expect that with increasing frequency physicians in Israel will confront patients with malaria. Special concern should be given to malaria in pregnancy because of its serious complications. Thus, prompt diagnosis and treatment are essential. While chloroquine is safe for use in pregnancy, drug resistance is common, especially with Plasmodium falciparum. There is concern about the safety of other antimalarial agents during pregnancy. We recently observed a case of chloroquine-resistant Plasmodium falciparum malaria during pregnancy in a new immigrant primigravida from Ethiopia. Malaria in patients from endemic regions is less severe than in nonimmune hosts. Therefore, we elected to follow the patient's parasitemia periodically without additional antimalarial treatment until after delivery.

Adolescent↗
PubMedDate not supplied

Tumor-preventive effects of the soluble p53 antigen on chemically-induced skin cancer in mice.

BACKGROUND: The tumor-suppressive effects of the rat soluble p53 antigen on chemically induced skin cancer in mice and the role of the spleen in the immune response to a carcinogen and vaccination were studied. METHODS: Skin cancer was induced by 9,10-dimethyl-1,2-benzanthracene (DMBA). Vaccination was initiated by injection of liposomes with the soluble p53 antigen (10-12 micrograms/mouse) while boosters were with the p53 mixed with Freund's incomplete adjuvant (two injections). Four months later, the spleen and tumors were removed and examined morphometrically (determination of areas of different spleen's zones) and immunohistochemically (determination of number of B lymphocytes and macrophages, apoptotic index). The following groups of mice were studied: A) control non treated mice; Bl) tumor-free mice treated with a carcinogen; B2) tumor-bearing mice; Cl) tumor-free vaccinated mice exposed to a carcinogen; C2) tumor-bearing vaccinated mice. RESULTS: Mice exposed to a carcinogen, which were tumor-free, displayed high proliferative activity of the spleenic lymphoid constitutes such as B lymphocytes and macrophages. This was reflected in the remarkable transformation of B lymphocytes in lymphoblasts (blast transformation) and an increase in the area of germinal centers, compared to untreated controls. In tumor-bearing non vaccinated mice, significantly more spleenic apoptotic cells were found than in their tumor-free counterparts. Shrinkage of the mantle layer and a decrease in cellular density of follicles were seen in all carcinogen-treated mice, reflecting the reduced total production of lymphoid cells, and thus the insufficiency of the immune reaction of animals to a carcinogen. A sharp decrease in the apoptotic index in the spleen of tumor-free mice may reflect an inhibition of apoptotic activity of the spleen by a carcinogen. Vaccination with the soluble p53 protein decreased the incidence of tumors and their size, significantly increased the apoptotic index within tumors, and reversed the splenic parameters of immune insufficiency. CONCLUSIONS: The immune system is active during tumorigenesis. Vaccination with the soluble p53 antigen had positive tumor-suppressive effects. The findings may facilitate the development of vaccines for the prevention of recurrent cancers in humans.

9,10-Dimethyl-1,2-benzanthracene↗