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Biomedical subjects

E Weiner

Publications and source records attributed to E Weiner.

At least 37 records · Page 2Linked to original sources
PubMed1994

Comparison of first-trimester transvaginal amniocentesis with chorionic villus sampling and mid-trimester amniocentesis.

Between August 1989 and December 1991, 356 patients underwent first-trimester transvaginal amniocentesis (10-12 weeks). The same number of patients referred in the same period for mid-trimester amniocentesis (14-21 weeks) was matched also for maternal age and indication. A third group consisted of the first 356 cases in which chorionic villus sampling (CVS) was attempted. The overall success rate was 99.7 and 100 per cent for early and mid-trimester amniocentesis, respectively, and 97.2 per cent for CVS. The mean harvesting time was 12.8, 11, and 7.9 days, respectively. The percentage of patients rescheduled was 3.4 per cent in first-trimester amniocentesis, 1.7 per cent in mid-trimester amniocentesis, and 6.2 per cent in the CVS group. The early (less than 2 weeks) pregnancy loss was 1.7 and 0.6 per cent in early and mid-trimester amniocentesis, respectively, and 1.7 per cent in CVS. The total pregnancy loss was 3.2, 0.9, and 2.9 per cent, respectively. The rate of preterm birth was 6.0, 5.2 and 6.9 per cent, respectively. The results indicate that CVS has the shortest procedure-result interval, but the highest rescheduling rate. First-trimester amniocentesis has a higher procedure and laboratory success rate but, until otherwise proved, mid-trimester amniocentesis is the most efficient and safest procedure.

Abortion, Spontaneous↗
PubMed1994

Cognitive functions and aging in the dog: acquisition of nonspatial visual tasks.

Old, middle-aged, and young dogs were compared on discrimination and reversal learning and on acquisition of a delayed-nonmatching-to-sample (DNMS) test of recognition memory. DNMS acquisition was acquired more rapidly by young dogs. Reversal deficits were found between aged mixed-breed dogs and young beagles, but not between old and young beagles. Aged beagles also showed unexpected deficits in reward approach and object approach learning. Aged mixed-breed dogs did not show deficits in reward approach and object approach learning, but they learned the discrimination task more slowly than the age-matched beagles. A detailed analysis of response patterns indicated that once present, the development of side preferences contributed to deficits of old dogs in discrimination learning. In the discrimination reversal, old dogs were more persistent in responding to the previously rewarded stimulus object. Findings suggest that the dog, like other species, shows age-dependent deterioration in cognitive function, the extent of deterioration is a function of both task and previous experience, and at least part of the deterioration is a result of increased behavioral rigidity. Results also indicate that it is important to control for breed differences and previous experience.

Aging↗
PubMed1994

Clinical and echographic features of in utero cardiac dysfunction in the recipient twin in twin-twin transfusion syndrome.

OBJECTIVE: Fetal twin-twin transfusion syndrome (TTTS) presenting in the second trimester has been associated with almost no perinatal survival until recently, when serial drainage of amniotic fluid has improved the prognosis to 70%-80%. Most recipient twins now survive but develop cardiac dysfunction. The study was undertaken to evaluate the abnormal echocardiographic features and clinical complications of cardiac disease in the recipient twin of TTTS. DESIGN: Antenatal and postnatal echocardiographic and clinical observational study. SETTING: Antenatal studies in a tertiary referral centre. Postnatal management and follow up were performed by the same paediatric cardiologist, either at the obstetric hospital or at the regional referral centre. PATIENTS: Twin pregnancies complicated by TTTS with severe polyhydramnios diagnosed earlier than 25 weeks that proceeded until viability (n = 5). INTERVENTION: Serial fetal echocardiography with colour Doppler. Postnatal echocardiography in the first week and between two and seven months. Serial amnioreduction was performed in all pregnancies. Digoxin treatment, pericardiocentesis, paracentesis, or laser ablation of placental anastomoses was undertaken when there was hydrops. RESULTS: Increased cardiothoracic ratio and tricuspid regurgitation were seen in all recipient twins. High pulmonary artery velocities developed in three. One recipient twin died a week after delivery of endocardial fibroelastosis and infundibular pulmonary stenosis. Two other had balloon dilatation for pulmonary stenosis, one shortly after birth and one at four months. A further twin has apical thickening of the right ventricle at six months. The remaining recipient twin had normal echocardiographic findings at follow up. CONCLUSION: This report characterises for the first time a cardiac disease acquired in utero in the recipient twin in pregnancies complicated by TTTS. Clinical manifestations in utero range from mild to critical pulmonary stenosis or lethal cardiomyopathy. Although perinatal prognosis seems to be related to the severity of dysfunction when first diagnosed in utero, follow up in infancy is recommended in view of the possibility of progressive pulmonary stenosis.

Echocardiography, Doppler↗
PubMed1994

Exogenous estrogen therapy concurrent with clomiphene citrate--lack of effect on serum sex hormone levels and endometrial thickness.

The antiestrogenic action of clomiphene citrate (CC) is claimed to have an adverse effect on the development of the secretory endometrium. This effect can be assessed: (1) sonographically by measuring endometrial thickness, and (2) by serum hormone levels. The aim of this study was to evaluate whether administering ethinyl estradiol (EE) during CC treatment has any effect on endometrial thickness and/or hormone levels. Seventeen patients were treated with CC for one cycle and with CC plus EE in an adjacent cycle either before or after. The patients were followed by daily assessment of endometrial thickness, follicular growth and serum estradiol levels as well as midluteal prolactin and progesterone levels. We did not find any significant difference in either endometrial thickness, estradiol level, midluteal prolactin or progesterone levels between the two treatment protocols. We conclude that exogenous EE, in the dosage used in this study, does not overcome CC-induced alterations in endometrial thickness.

Anovulation↗
PubMed1994

Predictive value of psychiatric history, genital pain and menstrual symptoms for sexuality after hysterectomy.

OBJECTIVE: To study the predictive value of the history of genital pain, psychiatric complaints and menstrual symptoms on a woman's sexual life before and after subtotal hysterectomy. MATERIAL AND METHOD: One hundred and four premenopausal women were interviewed one month before and one year after surgery. A latent variable for pre- and postoperative sexuality was constructed from the intercorrelation between the measured parameters of frequency of desire for sex, coital frequency, cyclicity of desire and existence of multiple orgasm, and other variables for genital pain, psychiatric morbidity and menstrual symptoms were compared to the latent factors for sexuality. RESULTS: No difference was seen in postoperative sexuality in women with and without a history of psychiatric complaints. The regular use of analgetics, a need to stay home from work because of menstruation, and the occurrence of dyspareunia were positively correlated to the latent factors for sexuality before and after the operation. A history of the need to use psychopharmaceuticals, such as sedatives or antidepressants, had a negative influence on preoperative, but not on postoperative sexuality. Dysmenorrhea had a positive influence on postoperative, but not on preoperative, sexuality. CONCLUSION: Among variables studied, dysmenorrhea was the best predictor for postoperative sexuality. That is: women with dysmenorrhea do not only invariably experience relief from the pain, but also have a chance to improve their sexual lives after removal of their malfunctioning uterus. Presence of psychiatric problems had, in general, little influence on sexuality.

Adult↗
PubMed1994

Endothelin-1,2 levels in umbilical vein serum of intra-uterine growth retarded fetuses as detected by cordocentesis.

INTRODUCTION: The objective of this study was to determine whether the circulatory levels of endothelins, potent vasoconstrictor polypeptides produced mainly by endothelial cells, are increased in growth-retarded fetuses. STUDY DESIGN: Fetal venous serum samples, withdrawn by ultrasound-guided cordocentesis from 11 growth-retarded fetuses and 10 normally-growing fetuses who underwent the procedure because of other unrelated indications, were examined for immunoreactive endothelin-1,2 by radioimmunoassay. RESULTS: Higher mean endothelin-1,2 levels were found in the sera of growth-retarded fetuses than in controls (16.8 +/- 4.2 versus 10.9 +/- 4.3 fmol/ml, p = 0.008). Within the growth-retarded group, there were no differences in endothelin-1,2 levels in the presence of either abnormal umbilical Doppler, asymmetry of growth-retardation, maternal signs of preeclampsia, or fetal acidosis. CONCLUSION: High levels of endothelin-1,2 in the fetoplacental circulation may be pathophysiologically important in fetal growth retardation. However, the clinical significance of these elevated levels is yet to be determined.

Cordocentesis↗
PubMed1994

The role of cordocentesis in assessment of mosaicism found in amniotic fluid cell culture.

Chromosomal mosaicism presents one of the most difficult problems in prenatal cytogenetic diagnosis, requiring the differentiation of true mosaicism from pseudomosaicism. To overcome associated problems and to prevent termination of normal pregnancies, we investigated 23 pregnancies in which true mosaicism has been found in amniotic fluid cell culture. A fetal blood sample was obtained by cordocentesis for rapid karyotyping, and meticulous sonographic examinations were carried out for detecting fetal abnormalities. The 23 cases in which mosaicisms were found in amniocytes involved five cases with sex chromosomal abnormalities, twelve with autosomal trisomy, four with autosomal structural defects, one with a supernumerary marker and one with tetraploidy. The karyotype from fetal leukocytes confirmed the diagnosis of mosaicism in only three out of 23 cases. These three included: two autosomal trisomies (47,XY + 13/47,XY + 21 and 46,XY/47,XY + 21) and one sex chromosome mosaicism (45,X/46,XY). These were all selected for elective termination of pregnancies by the parents' request. Post abortion karyotype re-confirmed previous karyotype. The other twenty lymphocyte karyotypes were normal, and of these, 19 patients gave birth at term, and one delivered prematurely due to premature rupture of membranes. All 20 born infants were found normal by both neonatal examination and re-karyotypes. We conclude that finding of mosaicism in amniotic fluid culture requires further investigation. Furthermore, in the presence of amniotic fluid cell true mosaicism and normal karyotype in fetal blood, continuation of the pregnancy is safe and to be recommended.

Abortion, Therapeutic↗
PubMed1993

[Congenital hypothyroidism in the Jezreel Valley].

39 patients in the Jezreel Valley area with congenital hypothyroidism were studied during the years 1978-1991. The incidence of the disease was 1:3.085 births. The most common subgroup was peroxidase deficiency which was found in 12 (30.7%) of them, as compared to the 6% reported in the literature. The average age at diagnosis was 30 days, and the average age at the start of 1-thyroxin replacement therapy 48 days. 80% had clinical signs of hypothyroidism at the time of diagnosis. Average height was at the 25th centile, as compared to midparental height at the 40th centile. 15 (38%) of the children had psychomotor delay. This study reveals that despite the national thyroid function screening program which shortens the time to diagnosis and improves the clinical course of congenital hypothyroidism, 38% of these children have irreversible damage.

Congenital Hypothyroidism↗
PubMed1993

A comparison of the nonstress test, oxytocin challenge test, Doppler velocimetry and biophysical profile in predicting umbilical vein pH in growth-retarded fetuses.

OBJECTIVE: To examine and compare the value of the nonstress test (NST), oxytocin challenge test (OCT), Doppler velocimetry (S/D ratio), and biophysical profile (BPP) in predicting fetal acidosis. METHOD: NST, OCT, S/D ratio and BPP were performed in 23 pregnancies with growth-retarded fetuses. The value of each parameter in predicting fetal acidosis (umbilical vein pH obtained by cordocentesis) was examined. RESULT: The NST, OCT and BPP were found to have the same positive predictive value of 57.1% in predicting fetal acidosis. The S/D ratio was found to have a very low positive predictive value (14.3%). The only combination of two parameters that showed improved positive predictive value, was that of OCT and NST (66.7%). CONCLUSION: (1) The best indirect method in assessing fetal well-being is the combination of NST and OCT. (2) Since the positive predictive value of the indirect methods is still low, direct assessment of the fetal metabolic status is recommended in premature growth-retarded fetuses with an abnormal test.

Acidosis↗
PubMed1992

First-trimester ultrasonic diagnosis of twin reversed arterial perfusion sequence.

Twin reversed arterial perfusion (TRAP) syndrome sequence is a rare specific anomaly of twin gestation with fused placentae and umbilical anastomosis. This syndrome occurs once in very 35,000-48,000 births and has been described in the second trimester (23-29 weeks of gestation). We report on early sonographic diagnosis (10 and 12 weeks' gestation) of two cases of TRAP sequence, together with their umbilical cord Doppler studies.

Adult↗
PubMed1992

High levels of maternal serum alpha-fetoprotein and human chorionic gonadotrophins leading to the diagnosis of combined neural tube defect and partial mole.

A case of combined partial mole and neural tube defect is presented. The detection of high levels of both maternal serum (MS) alpha-fetoprotein (AFP) and human chorionic gonadotrophin (hCG) during the second trimester led to the ultrasonic demonstration of anencephaly, omphalocele, and partial mole. This is the first report of combined elevation of MSAFP and MShCG.

Adult↗