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Biomedical subjects

E Confino

Publications and source records attributed to E Confino.

At least 55 records · Page 3Linked to original sources

Effect of ejaculation frequency on sperm quality.

Sixty-four normozoospermic and 19 oligozoospermic males underwent sperm analyses of two successive specimens obtained at 1-, 2-, and 3-day intervals. The first specimen was produced after 3 days of abstinence. Sperm volume of normozoospermic males declined from 2.3 +/- 1.0 to 1.6 +/- 1.0 ml, 2.6 +/- 1.0 to 2.0 +/- 0.9 ml, and 2.1 +/- 0.9 to 1.9 +/- 1.0 ml at 1-, 2-, and 3-day intervals, respectively. Similarly, oligozoospermic males showed declines from 2.3 +/- 1.2 to 1.7 +/- 1.5 and 2.3 +/- 1.1 to 1.8 +/- 1.2 and an increase from 1.2 +/- 1.2 to 1.5 +/- 0.7 ml, respectively. Sperm counts of normozoospermic males declined from 65 +/- 54 to 55 +/- 34, 83 +/- 57 to 69 +/- 47, and 97 +/- 51 to 81 +/- 46 million spermatozoa/ml at 1-, 2-, and 3-day intervals, respectively. Oligozoospermic males showed declines from 5.1 +/- 5.4 to 3.8 +/- 4.1 and 8.2 +/- 8.6 to 7.2 +/- 5.2 and an increase from 3.8 +/- 0.6 to 5.7 +/- 2.1 million spermatozoal/ml at 1-, 2-, and 3-day intervals, respectively. Sperm motility of normozoospermic males varied from 41 +/- 20 to 38 +/- 18, 55 +/- 14 to 56 1/3 pm 14, and 52 +/- 15 to 52 +/- 20% at 1-, 2-, and 3-day intervals, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Ejaculation↗

Prenatal sonographic diagnosis of Hirschsprung's disease.

The prenatal sonographic presentation of Hirschsprung's disease is described. This report strongly suggests that bowel distention in Hirschsprung's disease may begin in the late third trimester of intrauterine life. The importance of early diagnosis and treatment cannot be overemphasized. Sonography may greatly contribute to the early diagnosis of Hirschsprung's disease.

Adult↗

The predictive value of hCG beta subunit levels in pregnancies achieved by in vitro fertilization and embryo transfer: an international collaborative study.

Serial human chorionic gonadotropin (hCG) beta subunit measurements of 300 pregnancies achieved by in vitro fertilization (IVF) were obtained by 15 IVF centers worldwide. Hormonal curves were established for 164 normal singleton pregnancies, 25 normal multiple gestations, 60 chemical pregnancies, 41 first-trimester spontaneous abortions, and 10 ectopic pregnancies. In comparison to the normal singleton pregnancy curve, chemical pregnancies and spontaneous abortions showed statistically lower hCG levels. hCG levels of ectopic pregnancies, compared with normal singleton gestations, were lower from days 7 to 14. It is concluded that beta-hCG determinations of in vitro fertilized pregnancies allow pregnancy diagnosis as early as 7 to 9 days after embryo transfer (ET) and will permit early discrimination between normal and abnormal IVF pregnancies. A single beta-hCG determination on day 9 after ET may discriminate chemical, ectopic pregnancy or impending miscarriage from a normal gestation. An hCG determination on day 17 will predict early normal development of an IVF pregnancy.

Abortion, Spontaneous↗

Does cyclic human chorionic gonadotropin secretion indicate embryo loss in in vitro fertilization?

The human chorionic gonadotropin (hCG) beta subunit curve of normal singleton in vitro fertilization (IVF) pregnancies shows cyclic peaks during the first 56 days after embryo transfer (ET). This phenomenon is not demonstrable in normal spontaneous conceptions. The hCG curves of 151 singleton IVF pregnancies achieved by transfer of two, three, and four embryos therefore were compared statistically with the hCG curves of singleton IVF pregnancies achieved by transfer of only one embryo. The hCG levels of singleton IVF pregnancies achieved by transfer of more than one embryo had statistically higher hCG levels at 7 and 8, 19 and 20, and 37 and 38 days after ET. In a separate evaluation it was observed that declines in hCG levels of normal singleton IVF pregnancies preceded four of five first-trimester abortion incidence peaks of singleton IVF pregnancies. The observed cyclic hCG secretion may be indicative of early embryo deaths. This observation supports the contention that multiple ET results in significantly more multiple implantations than previously appreciated. Thus embryo survival in utero may represent another major contributory factor to success or failure of IVF.

Chorionic Gonadotropin↗

Intrauterine inseminations with washed human spermatozoa.

The success of intrauterine inseminations with washed human spermatozoa was evaluated in four groups of patients. The first two groups were couples in whom either the man or the woman had detectable circulating sperm-agglutinating antibodies. The third group included couples where the woman exhibited hostile or absent cervical mucus, whereas the fourth group represented couples with oligozoospermic males. The couples underwent 3.7 +/- 2.1 insemination cycles, with a 30% overall pregnancy rate for all four groups. Intrauterine inseminations of women with hostile cervical mucus yielded a 68% conception rate. Couples with either male or female serum sperm-agglutinating antibodies showed 25% and 40% pregnancy rates, respectively. However, none of the couples with oligozoospermic males achieved pregnancy. Intrauterine inseminations with washed human spermatozoa thus represent a satisfactory method of achieving pregnancy in women with hostile cervical mucus and in couples with circulating sperm agglutinating antibodies. Couples in whom oligozoospermia has been identified as the principal cause of infertility do not seem to benefit from this therapy.

Adult↗

Transcervical balloon tuboplasty.

TBT is a new technique that by use of a balloon catheter technique in a fashion similar to that of balloon angioplasty allows reestablishment of tubal patency in selected cases of tubal occlusion. The case presented here describes the first transcervical dilatation and recanalization of a proximally occluded fallopian tube in a patient with infertility.

Adult↗

A new stirrable catheter for gamete intrafallopian tube transfer (GIFT).

Cannulation of the fimbriated end of the fallopian tube during gamete intrafallopian tube transfer (GIFT) may be at times extremely difficult and even require minilaparotomy. An ideal laparoscopic GIFT catheter should be flexible and stirrable, have a small diameter, and yet be sturdy enough to enable its manipulation. Such a catheter was developed in collaboration with Cook Ob/Gyne, a Division of Cook Inc., Indiana, with primary emphasis on easy laparoscopic manipulation. Its use in eight attempts of GIFT resulted in three pregnancies (37%).

Catheterization↗

Vaginal versus cesarean section oriented approaches in the management of breech delivery.

In a 5-year retrospective study, 543 singleton breech presented infants weighing more than 1000 g were reviewed in two obstetric departments. Department "A" actively conducted the labor with lower cesarean section rate (26%). Department "B" attempted a trial of labor with less invasive procedures and performed more cesarean sections (38% P less than 0.05 S). The management of labor, fetal and maternal outcome were compared between the two departments. Both vaginal and abdominal routes of delivery in fetuses weighing more than 1500 g resulted in the same fetal and maternal outcome. For fetuses weighing 1000-1500 g cesarean section is probably the recommended delivery route.

Adolescent↗

Fetal heart rate in maternal hypoglycemic coma.

In pregnancies complicated by diabetes mellitus fetal heart rate (FHR) monitoring is widely utilized to detect early fetal compromise. Never, however, was the fetal heart rate monitored during a maternal hypoglycemic coma. Such a case is here presented.

Adult↗

The effect of epidural analgesia on maternal thermoregulation in labor.

Core and peripheral body temperatures were recorded in 24 parturients in labor with epidural analgesia and in 9 control parturients without analgesia. Shivering occurred in 11 (46%) of the women with epidural analgesia and in one parturient without analgesia. Twelve patients (50%) showed increase in leg and chest temperatures after injection of bupivacaine 0.35% into the epidural space. Lumbar epidural analgesia may produce shivering and temporary temperature changes in the periphery. Core temperature is not significantly altered.

Adult↗

Extradural analgesia in the management of singleton breech delivery.

Ninety-four singleton vaginal breech deliveries conducted under extradural analgesia were compared with 277 singleton vaginal breech deliveries conducted without extradural analgesia. Mean duration of the first stage of labour was similar in both groups. Mean duration of the second stage of labour was prolonged and mean 1-min Apgar scores were less in fetuses weighing more than 2500 g in the extradural group. Mean 5-min Apgar scores, perinatal morbidity and maternal complications were similar in both groups.

Anesthesia, Epidural↗

Sonographic imaging of intrauterine adhesions.

Hysterosalpingography and hysteroscopy are the diagnostic modalities most commonly used to evaluate and follow intrauterine adhesions (Asherman syndrome). Three patients with intrauterine adhesions are presented. These adhesions were visualized with sonography and appeared as dense intrauterine lines. These lines disappeared after hysteroscopic lysis of the adhesions. The present results indicate that sonography may alert the clinician to the presence of intrauterine adhesions.

Adult↗