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Biomedical subjects

E Schiff

Publications and source records attributed to E Schiff.

At least 109 records · Page 6Linked to original sources
PubMed1992

Characteristics of second labor occurring 10 or more years after the first.

Labor characteristics in 89 women undergoing a second vaginal delivery 10-18 years after the first were compared retrospectively with those of 136 women with an interval of 1-4 years between their first and second vaginal deliveries and with those of 128 nulliparous women. The pelvic findings on admission, average length of stages 1 and 2 of labor, average cervical dilation per hour and rates of surgical intervention in relation to arrest disorders were similar in the two multiparous groups and significantly different from these parameters in the nulliparous group. Women with long intervals between their first and second vaginal deliveries should be managed in the same way as are other multiparas and not like nulliparas with respect to such issues as indications for oxytocin treatment, surgical intervention and use of conduction anesthesia.

Adult↗
PubMed1991

Cystotomy--for facilitation of optimal resection of adherent pelvic tumors.

Optimal resection of pelvic tumor was facilitated by cystotomy in one patient with a benign and five patients with malignant adherent pelvic tumors. Four of the five patients with malignant tumors had recurrent or persistent carcinoma of the ovary. Blood loss and surgical duration were acceptable and there were no postoperative complications. Cystotomy is a relatively easy and safe procedure and is recommended when optimal resection of adherent pelvic tumor is attempted.

Female↗
PubMed1991

Failure of oocyte retrieval during in vitro fertilization: a sporadic event rather than a syndrome.

Failure to retrieve oocytes during in vitro fertilization (IVF) treatment was recently referred to as the "empty follicle syndrome." Data on the possible repetitiveness of this during previous or subsequent IVF attempts is lacking, which limits the understanding of its significance to the involved patients. Of 26 patients who had cycles during which no oocytes were retrieved, 10 were pregnant in the past and 20 had at least one other IVF cycle that yielded oocytes. There was no difference in the frequency of any stimulation protocol among the failure cycles compared with the successful ones. Hormonal response pattern and the number of large follicles observed sonographically did not differ between the two occasions. Fertilization occurred in 70% of the successful cycles and two biochemical pregnancies were recorded. In 13 patients, at least one cycle was canceled because of poor ovarian response, but 9 of these 13 had at least one other successful cycle. We conclude that the so-called empty follicle syndrome cannot be predicted by the pattern of ovarian response and does not predict a reduced fertility potential in future cycles.

Clomiphene↗
PubMed1991

Factors affecting inappropriate hospital stay.

Fifty-four per cent of hospital stay days on the medical wards in a large teaching hospital, 40% on surgery and 26% on pediatrics, were found to be unjustified, using an assessment method based on explicit criteria. Despite the observed differences between the various specialties, the frequency distribution of the reasons for unjustified hospital stay days was essentially similar. Most of the unjustified hospital stay days were attributed to diagnostic evaluation, non-emergency treatment and immediate follow-up, which were carried out within the hospital rather than on an ambulatory basis. The major factors for unjustified hospital stay days were age, ethnic group, ward of admission and diagnostic category. These findings may contribute to the implementation of hospital utilization management programs aimed at cost containment.

Evaluation Studies as Topic↗
PubMed1991

[Prevalence of antibodies against hepatitis C virus (anti HCV) in different populations with chronic liver disease using the first generation test].

UNLABELLED: In order to evaluate the prevalence of antibodies IgG against the virus of hepatitis C (anti HCV) in different forms of chronic liver disease negative for virus B markers of alcoholism, we studied 148 patients (pts) divided into several groups. Group I: Composed of 35 pts. with chronic active hepatitis (CAH) with definite evidence of parenteral exposure to blood. Group II: included 39 pts. with CAH without immune markers or evidence of possible parenteral transmission. Group III: Included 37 pts. with the diagnosis of CAH of autoimmune type with positivity of antinuclear, anti smooth muscle or both antibodies with range of positivity of 1:80 or higher. Group IV: was composed of 31 pts. with the diagnosis of primary biliary cirrhosis (PBC). Finally group V included 6 pts. with an overlap syndrome between CAH and PBC. The prevalence of anti HCV in the different groups was as follows: [table: see text] Two of the pts. positive for anti HCV in group III and 1 in group IV revealed parenteral exposure to blood or blood product. CONCLUSIONS: The determinations of anti HCV in order to characterize the posttransfusional NANB chronic hepatitis is of value. Positivity of anti HCV is high in cryptogenic chronic hepatitis and rare in PBC. In CAH of autoimmune type and in the overlap syndrome the prevalence was higher than expected. The question if we are dealing with false positivity or an uncertain diagnosis of autoimmunity is raised.

Biopsy↗
PubMed1991

Curettage vs. nonsurgical management in women with early spontaneous abortions. The effect on fertility.

Among 114 women with early spontaneous abortions, low beta-human chorionic gonadotropin levels and no ultrasonographically demonstrable residual tissue in the uterine cavity, 68 underwent uterine curettage, and 46 were managed conservatively. No complications, such as bleeding or infection, were observed in either group, and the probability of conception, outcome of subsequent pregnancies and rate of subsequent abortions were similar. Curettage offers no advantage over conservative management in selected patients with early abortions.

Abortion, Spontaneous↗
PubMed1991

Pelvic malignancy presenting as a pelvic inflammatory process in pre and postmenopausal women.

Among two hundred and twenty-one patients admitted with the diagnosis of pelvic inflammatory disease (PID), 6 had an underlying malignancy. The rate of underlying malignancy was 1.4% in premenopausal patients and 42.8% in postmenopausal patients. This difference was statistically significant, p less than 0.001. In postmenopausal patients presenting with a pelvic inflammatory process pelvic malignancy should be highly suspected and thorough examination made.

Adult↗
PubMed1991

Prediction of pregnancy-induced hypertension by a combination of rollover test and Doppler flow velocity measurement.

Following a rollover test performed in 306 nulliparous women in the 28th gestational week, Doppler flow velocity studies were conducted in all 34 women with positive rollover findings and in 67 women selected at random from those with negative findings. The mean systolic diastolic ratios in both the uterine and the umbilical arteries were significantly higher in women with positive rollover findings than in the control group. A review of the patients' medical records after delivery, indicated that this combined two-stage screening approach--a rollover test followed by a Doppler flow study--improved the predictive value and the sensitivity of the screening procedure from 35% and 39% respectively for the rollover test alone, to 56% and 50% with no decline in specificity. The sensitivity of the Doppler flow test as a single one among the 101 flow-studied women was higher--61%. However, broader studies are needed in order to establish its superiority as a single test for early prediction of pregnancy-induced hypertension.

Adult↗
PubMed1991

Midtrimester abortion induction with intraamniotic prostaglandin F2 alpha in women with previous uterine surgery.

Of 207 women who underwent midtrimester induced abortion with intraamniotic prostaglandin F 2 alpha instillation, 30 (14.5%) had had one or more previous uterine operations. Multivariate analysis showed no correlation between a previous uterine operation and the hospitalization length, procedure complication rate or length of the injection-delivery interval (IDI). The IDI was similar in patients with and without a previous uterine operation. No case of uterine rupture occurred. Intraamniotic prostaglandin instillation for midtrimester abortion induction seems to be an effective procedure without severe complications in women with previous uterine operations.

Abortion, Induced↗
PubMed1990

Prediction of residual trophoblastic tissue in first-trimester abortions and low levels of human chorionic gonadotropin beta-subunit.

The clinical data and the histologic report of curettage specimens of 174 patients with first-trimester abortion and human chorionic gonadotropin beta-subunit less than 500 mIU/ml were reviewed. In only 22 (12.6%) were chorionic villi histologically reported. A multivariate analysis showed that increased log human chorionic gonadotropin beta-subunit levels within the range of 20 to 500 mIU/ml, intrauterine tissue demonstrated by ultrasonography, higher gestational age, and active bleeding were significant predictive variables for the presence of villi in curettage specimens. A mathematical formula and a clinical scoring system for the prediction of residual villi in these cases were devised and were applied to the data of our study group. The sensitivity, false-negative rate, and specificity of the scoring system were 90.9%, 2.2%, and 59.2%, respectively; however, the false-positive rate was 75.6%. By use of this scoring system in patients with first-trimester abortion and low human chorionic gonadotropin beta-subunit level, the presence of villi in curettage specimens can thus be predicted with a high sensitivity and as many as 60% of curettage procedures might be prevented.

Abortion, Induced↗
PubMed1990

Recurrence and clearance of hepatitis B surface antigenemia in a dialysis patient infected with the human immunodeficiency virus.

Hepatitis B vaccination programs have prevented infection in many dialysis patients, although the antibody response to vaccination is still insufficient in approximately 50%. Reinfection or reactivation of latent hepatitis B infection (HBV) has been reported in certain groups of immunosuppressed patients, including those infected with the human immunodeficiency virus (HIV-1). We report the reactivation or reinfection of HBV with resurgence of hepatitis B surface antigen in a dialysis patient coinfected with HIV-1. Thus, in dialysis patients with latent HBV infection, with undetectable hepatitis B surface antigen (HBsAg) levels, the potential exists to reactivate during immunosuppression associated with HIV-1 infection and/or end-stage renal disease. Reinfection with a different subtype is also possible. The development of hepatitis B surface antigenemia in this patient population creates a potential for transmission in the dialysis setting. This is of special concern since the number of patients infected with HIV-1 and with evidence of prior hepatitis B infection is increasing in urban units.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Low-dose aspirin does not influence the clinical course of women with mild pregnancy-induced hypertension.

The effect of low doses of aspirin on women with mild pregnancy-induced hypertension was investigated by means of a prospective, randomized, double-blind trial. Forty-seven women hospitalized at 30-36 weeks' gestation because of mild pregnancy-induced hypertension were treated by a daily dose of either 100 mg aspirin or placebo. The mean blood pressure values, rates of development of severe preeclampsia, gestational ages at delivery, newborn weights, and 5-minute Apgar scores were similar in the aspirin-treated and the placebo-treated groups. We conclude that low-dose aspirin is not curative but is essentially a preventive treatment which, in order to be effective, should be started weeks before clinical signs of preeclampsia are present.

Adult↗
PubMed1990

Comparison of persistence of seven bovine viruses on bovine embryos following in vitro exposure.

The ability of seven cytopathic strains of bovine viruses to adhere to the zona pellucida of six-to-eight day-old bovine embryos were compared. Embryos were exposed to virus by placing them either in virus suspensions or by culturing them on infected bovine turbinate cultures for 18-24 h. After exposure to bovine virus diarrhea virus (BVDV), infectious bovine rhinotracheitis virus (IBV), bluetongue virus (BTV), pseudorabies virus (PRV), vesicular stomatitis virus (VSV), parainfluenza 3 virus (PI3), or bovine enterovirus virus (BEV), the embryos were tested for virus by culture in bovine turbinate cells and by morphological examination using electron microscopy (EM). A special technique to minimize loss of embryos processed for EM was developed. More embryos had viral particles on the surface of the zona pellucida after exposure to 18-24 hour infected cell cultures than did embryos exposed to viral culture suspensions. The most dramatic finding was that BTV adhered in large numbers to the surface of the zona pellucida of exposed embryos. IBRV, PRV, and VSV comprised an intermediate group, with virions occasionally detected on the surface of exposed embryos after 5 washes. Therefore, extensive washing is required. The PI3 and BEV were easily removed from embryo-exposed virus by washing. BVD was difficult to identify morphologically, making assessment by EM unreliable. There was no evidence that any one of the seven viruses penetrated the intact zona pellucida. Using a micromanipulator, 42 embryos were also directly inoculated through the zona pellucida with +/- 50 picoliters of virus inoculum or medium.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗