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Biomedical subjects

G Barkai

Publications and source records attributed to G Barkai.

At least 73 records · Page 4Linked to original sources
PubMed1993

Reduction of thromboxane A2 synthesis in pregnancy by polyunsaturated fatty acid supplements.

OBJECTIVE: High-dose supplements of fish oil reduce thromboxane synthesis in nonpregnant human subjects and were therefore proposed as a means of preventing various small-vessel disorders, including preeclampsia. The effect of fish oil on thromboxane metabolism in pregnancy was investigated in our study. STUDY DESIGN: Sixteen normal pregnant women in the third trimester of pregnancy were treated with a daily ingestion of 6 gm fish oil capsules containing 1.6 gm of n-3 fatty acid. In five patients the treatment was stopped because of severe-flavored reflux and hiccups. Eleven patients completed 3 weeks of treatment. Twenty-four-hour urinary 11-dehydro-thromboxane B2 was measured by means of radioimmunoassay before and after completion of the study protocol in these 11 patients and in seven control pregnant women who did not receive the oil treatment. RESULTS: A decrease ranging from 32% to 71%, in 24-hour urinary 11-dehydro-thromboxane B2 excretion (mean reduction from 1606 pg/mg creatinine to 779 pg/mg creatinine, p < 0.001) was found among the 11 fish oil-treated women. No change in excretion was found among the control women. No maternal, fetal, or neonatal bleeding disturbances occurred, and no laboratory changes in coagulation markers were observed. CONCLUSIONS: High-dose n-3 fatty acid intake in pregnancy significantly reduces maternal thromboxane A2 synthesis. These results may provide a basis for a possible role of fish oil in managing patients at risk for preeclampsia.

Adult↗
PubMed1993

X-linked recessive primary retinal dysplasia is linked to the Norrie disease locus.

X-linked primary retinal dysplasia (PRD) refers to an abnormal proliferation of retinal tissue causing either its neural elements or its glial tissue to form folds, giving rise to gliosis. A Jewish family of oriental origin was previously reported by Godel and Goodman, in which a total of five males suffer from different degrees of blindness. The authors postulated that the described findings are distinguished from Norrie disease, since in this case no clinical findings, other than those associated with the eyes, were noticed in the affected males. In addition, two of the carrier females exhibit minimal eye changes. We have performed linkage analysis of the family using the L1.28, p58-1 and m27 beta probes, and DXS426 and MAOB associated microsatellites. Our results map the gene responsible for the disorder between the MAOB and DXS426, m27 beta and p58-1 loci, on the short arm of the X chromosome at Xp11.3, which suggest the possibility that the same gene is responsible for both primary retinal dysplasia and Norrie disease.

Blindness↗
PubMed1992

Aplasia cutis congenita associated with epidermolysis bullosa and pyloric atresia: the diagnostic role of prenatal ultrasonography.

Aplasia cutis congenita associated with epidermolysis bullosa and pyloric atresia is a rare congenital disease in which localized or widespread areas of skin are absent at birth. Alphafetoprotein (AFP) and skin biopsy have been used for prenatal diagnosis of this condition. A patient in whom normal levels of amniotic AFP at 16 weeks' gestation presumably excluded the disease and who was at risk for aplasia cutis congenita associated with epidermolysis bullosa and pyloric atresia is described. However, 10 weeks later, ultrasonographic examination revealed hydramnios, a dilated stomach, a deformed external ear, and a contracted fisted hand. All signs were confirmed postnatally. The role of ultrasonography and the value of other diagnostic methods in this congenital disease are discussed.

Abnormalities, Multiple↗
PubMed1992

Successful pregnancy in a patient with polycystic kidney disease and advanced renal failure: the use of prophylactic dialysis.

Adult polycystic kidney disease is an inherited disease that is transmitted as an autosomal dominant trait. The clinical manifestations, which develop during the third or fourth decade of life, usually do not affect women during childbearing age and thus do not affect fertility or pregnancy outcome. The patient presented here had polycystic kidney disease and advanced renal failure, and was treated with meticulous fetal surveillance and prophylactic hemodialysis during pregnancy. The successful outcome strengthens the trend to perform prophylactic dialysis in pregnancies with advanced renal failure, despite the lack of controlled studies.

Adult↗
PubMed1992

Acoustic stimulation as a diagnostic test: comparison with oxytocin challenge test.

The usefulness of an acoustic stimulation test as a marker of fetal well-being was evaluated in a randomized controlled study of 121 pregnant women exhibiting a non-reactive fetal non-stress test at term. The women were randomly divided into two groups; those in the first group (n = 62) underwent an acoustic stimulation test immediately prior to an oxytocin challenge test, while those in the second (n = 59) underwent an oxytocin challenge test only. Fetal response to the acoustic stimulation was non-reactive in 22.5% of the women tested in the first group. The incidence of abnormal oxytocin challenge test among the women who were previously subjected to an acoustic stimulation was somewhat lower than among those who did not (14.5% vs. 23.7%), but the difference was not significant. In the prediction of an abnormal oxytocin challenge test, a non-reactive acoustic stimulation test had a sensitivity of 100%, a positive predictive value of 64% and a specificity of 91%. As a single test for the prediction of fetal distress in labor (n = 62), the acoustic stimulation test had a specificity and a positive predictive value similar to those of the oxytocin challenge test (n = 121), and its sensitivity was even higher (88% vs. 71%). We conclude that the acoustic stimulation test is at least as reliable as the oxytocin challenge test in the evaluation of fetal well-being in women exhibiting a non-reactive non-stress test at term.

Acoustic Stimulation↗
PubMed1992

The effect of thyroxine and corticosteroids upon amniotic fluid fluorescence polarization: a randomized controlled study.

The efficacy of glucocorticoid and intra amniotic thyroxine therapy on fetal lung maturity were compared in a randomized prospective clinical trial. Eighty two patients received either intra amniotic thyroxine (n = 36), or intra muscular Dexamethasone (n = 46). The Fluorescence Polarization (FP) of amniotic fluid measured prior to and one week following treatment were similar in the two groups. The rate of decrease in FP value per unit of time (dFP/dt) was identical in the T4 and corticosteroid treated patients and the proportion of immature FP values obtained was similar in the two groups. The effect of thyroxine therapy was more pronounced in pregnancies above 33 weeks gestation. Intra amniotic thyroxine therapy appeared to be as effective as glucocorticoids for the enhancement of fetal lung maturity. This therapeutic modality may be of particular use on pregnant subjects in whom a relative contra indication for the administration of steroids exists.

Amniotic Fluid↗
PubMed1992

CT of pelvic infection after cesarean section.

The CT findings in 6 women with puerperal sepsis after Cesarean section were reviewed. In four patients a right-sided mass was palpated. CT scan confirmed the diagnosis of Tubo-ovarian abscess in two of the patients, puerperal ovarian vein thrombosis (POVT) in the third and an enlarged adnexa with no signs of abscess formation in the fourth patient. The last two patients had normal adnexae but a large amount of gas in the uterus. All patients recovered after appropriate treatment. In patients with severe puerperal sepsis who do not respond to antibiotic therapy, CT scanning of the abdomen and pelvis is useful. This study can demonstrate whether there is an abscess which requires surgical intervention or POVT which needs additional anticoagulant treatment.

Abscess↗
PubMed1992

Effect of intraumbilical prostaglandin F2 alpha injection on the third stage of labor.

The effect of an intraumbilical prostaglandin (PG) F2 alpha injection on the third stage of normal labor was studied in 54 normal, laboring women at term. Either 1 mg of PGF2 alpha diluted to 20 mL in normal saline (27 women) or 20 mL of normal saline alone (27 women) was injected into the umbilical vein immediately after delivery using a randomized, double-blind protocol. The mean (+/- SD) duration of the third stage was 7.31 +/- 6.37 minutes in the PGF2 alpha patients and 8.94 +/- 7.10 in the normal saline patients. Intraumbilical PGF2 alpha did not influence the third stage of normal labor.

Adult↗
PubMed1991

Concordance of auriculo-cardiovascular-skeletal malformations: a new malformation complex in an infant of a diabetic mother?

The incidence of malformations among infants of diabetic mothers (IDM) is known to be higher than in the general population. These malformations usually involve several organ systems and in the past few years there has been an attempt to group them into distinct "syndromes." The present report concerns a child with a specific constellation of findings not yet reported in the infant of a diabetic mother, and we urge our colleagues to look for other associations existing in these infants, rather than just listing series of individual malformations.

Abnormalities, Multiple↗
PubMed1991

Human chorionic gonadotrophin and trisomy 18.

Estimation of maternal serum beta-hCG is used in conjunction with alpha-fetoprotein (AFP) and estriol (E3) for estimating the risk of Down syndrome (DS) affected fetuses. However, low hCG levels have not been regarded as having clinical significance. We report on 2 patients with trisomy 18 fetuses in whom antenatal screening showed extremely low hCG levels (0.05 and 0.15 MOM). Low hCG levels might indicate increased risk for trisomy 18 despite low estimated risk for DS.

Adult↗
PubMed1991

Induction of fetal lung maturation with intra-amniotic thyroxine in multiple pregnancy.

Two premature triplet pregnancies underwent repeated treatment aimed at acceleration of individual fetal lung maturity while administering intravenous tocolytic treatment. From the early third trimester, repeated amniocenteses were used for intra-amniotic administration of thyroxine to each sac, while the individual fetal lung maturation rate was determined by surfactant microviscosity until lung maturity was achieved.

Adult↗
PubMed1991

Myocardial infarction during pregnancy: a case report.

Myocardial infarction during pregnancy is rare. This report presents a 28-year-old parturient with no risk factors for coronary heart disease, in whom an acute anterior myocardial infarction occurred in the 34th gestational week. A cesarean section was performed at term due to an obstetrical cause and under hemodynamic monitoring without complications. Coronary angiography performed 4 months after delivery revealed the presence of normal coronary arteries and mild regional left ventricular dysfunction.

Adult↗
PubMed1991

Intravenous pethidine and nalbuphine during labor: a prospective double-blind comparative study.

The perfect analgesic regimen is constantly sought, no matter how labor is conducted. The quest for an effective drug that will afford maximum relaxation and pain relief with minimum interruption of any natural homeostatic mechanism is a foremost subject in present obstetric analgesics research. Synthetic alternatives are being offered, promising perfect compatibility with the clinician's demands. Nalbuphine, a semisynthetic narcotic agonist-antagonist analgesic of the penanthren series, is supposed not to be liable to cause respiratory depression and is expected to have fewer side effects. A double-blind, randomised prospective study of 137 patients who received 10 mg nalbuphine or 50 mg pethidine i.v. during the active phase of labor in term was carried out. Maternal cardiovascular variables, pain intensity, progress of labor and fetal heart rate during labor were related to side effect and neonatal outcome (1- and 5-min Apgar scores and umbilical venous pH). Neither regimen showed an advantage over the other. Data analysis points to a possible transient depressive effect induced by nalbuphine on the fetal or neonatal central nervous system.

Analgesia, Obstetrical↗