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Biomedical subjects

G S Berkowitz

Publications and source records attributed to G S Berkowitz.

At least 55 records · Page 3Linked to original sources
PubMed1989

Ultrasound detection of Down syndrome: is it really possible?

Several ultrasonographic signs have been described in second-trimester fetuses at high risk for Down syndrome. We examined these parameters in twin pregnancies in which one fetus was affected with Down syndrome and the other was normal. Biparietal diameter to femur length ratio was concordant (either normal or abnormal) in eight of nine sets of twins. Actual femur length to expected femur length ratio was concordant in seven of nine sets of twins. Nuchal fold thickening (6 mm or more) correctly identified five out of nine affected fetuses and was not present in any of the normal fetuses. In conclusion, neither ratio was helpful in differentiating the fetus with Down syndrome from its normal cotwin. A thickened nuchal fold was the most informative parameter examined.

Diseases in Twins↗
PubMed1988

Sonographic estimation of fetal weight and Doppler analysis of umbilical artery velocimetry in the prediction of intrauterine growth retardation: a prospective study.

A prospective study was undertaken to examine whether Doppler velocimetry studies of the umbilical artery give a better or an earlier prediction of intrauterine growth retardation (IUGR) than do sonographic estimation of fetal weight. A total of 385 examinations were performed between 30 and 42 weeks of gestation on 168 patients who were at risk for IUGR. Forty-two (25%) of the patients delivered an infant with a birth weight below the tenth percentile. Although sensitivity was lower for the systolic to diastolic ratio (55%) of the umbilical artery than for the sonographic estimation of fetal weight (76%), the umbilical artery studies had a higher specificity (92% versus 80%) and predictive value of a positive test (73% versus 58%) when the last study to delivery interval was within 2 weeks. Furthermore, among 21 IUGR pregnancies with serial studies, the umbilical systolic to diastolic ratio was abnormal at a significantly earlier gestational age than when the sonographic estimate of fetal weight identified growth retardation. These findings indicate that sonographic biometry is a more sensitive technique for identifying IUGR but that the umbilical artery waveforms are a valuable adjunct for improving the diagnostic accuracy for the prenatal detection of IUGR. These data also provide suggestive evidence that umbilical artery velocimetry may be predictive of IUGR at an earlier gestational age than sonographic estimation of fetal weight.

Adult↗
PubMed1988

Efficacy and side effects of magnesium sulfate and ritodrine as tocolytic agents.

Ritodrine as the first-line drug in the treatment of established preterm labor has been supplanted in some centers by magnesium sulfate. To assess the relative efficacy and rates of side effects of these two agents, 120 patients were randomly assigned to receive one of these two drugs. Patients were included if they had intact membranes and met strict criteria for the definition of labor. In both groups excellent outcome was achieved, with 96.3% and 92.3% of patients receiving ritodrine and magnesium sulfate, respectively, obtaining a delay in delivery of greater than 48 hours. Side effects were comparable in both groups, although they tended to be more serious in the patients receiving ritodrine. In patients receiving both drugs together, the rate of side effects was 77% without a demonstrable benefit over a single agent. We conclude that ritodrine and magnesium sulfate are tocolytics of comparable efficacy and when used aggressively are highly successful in delaying delivery.

Adult↗
PubMed1988

Fibroadenoma and the use of exogenous hormones. A case-control study.

The association between fibroadenoma and the use of exogenous hormones in women aged 18-74 years was examined in a case-control study conducted in Connecticut during 1979-1981. The study population included 251 women with biopsy-confirmed fibroadenoma and 1,081 control women drawn from inpatient and outpatient general surgical services of five Connecticut hospitals. Among women under age 45 years, oral contraceptive use was negatively associated with the occurrence of fibroadenoma (age-adjusted odds ratio (OR) = 0.57, 95% confidence interval (CI) = 0.42-0.79). The odds ratio for women over age 45 years who had ever used oral contraceptives was 1.65 (95% CI = 0.58-4.68). Women over age 45 years who had ever used replacement estrogens had an elevated odds ratio for fibroadenoma (OR = 2.83, 95% CI = 1.21-6.60). The data suggest either that the effects of exogenous hormones may differ by age, or that the changing composition of exogenous hormones has brought about different associations depending upon the cohort of women.

Adenofibroma↗
PubMed1988

Comparison of continuous-wave and pulsed Doppler S/D ratios of umbilical and uterine arteries.

Continuous-wave and pulsed Doppler ultrasound measurements of blood flow velocity waveforms of both uterine and umbilical arteries were performed on 85 patients to assess the correlation between these two measurements techniques. Peak systolic to end-diastolic (S/D) ratios measured by continuous-wave devices were not statistically different (P greater than .05) from those measured by a pulsed Doppler device. The S/D ratios of the umbilical artery measured by each device showed a strong correlation, whether measured by one observer (r = 0.93) or two observers (r = 0.89). Uterine artery ratios showed a weaker, although still significant, correlation (r = 0.57). Pulsed Doppler is not routinely necessary for the identification and measurement of umbilical and uterine artery S/D ratios.

Blood Flow Velocity↗
PubMed1988

Doppler umbilical velocimetry in the prediction of adverse outcome in pregnancies at risk for intrauterine growth retardation.

Perinatal indicators of fetal compromise were assessed according to the results of continuous-wave Doppler umbilical velocimetry for 172 patients at risk for intrauterine growth retardation (IUGR). Forty-three (25%) of the patients delivered an infant with a birth weight below the tenth percentile for gestational age. The last Doppler study before delivery was abnormal in 48.8% of the growth-retarded infants but in only 13.2% of the infants without evidence of IUGR. Furthermore, in the growth-retarded group, early delivery, reduced birth weight, decreased amniotic fluid at birth, admission to the neonatal intensive care unit, neonatal complications associated with IUGR, and a prolonged hospital stay were observed more frequently in those who had an abnormal ratio than in those with a normal ratio. The sensitivity of the systolic/diastolic ratio for an adverse perinatal outcome (operative delivery for fetal distress, neonatal morbidity associated with IUGR, and/or perinatal death) was significantly better for the infants with IUGR (66.7%) than for the infants without IUGR (27.8%; P less than .05). The predictive value of an abnormal ratio was also higher for the pregnancies complicated with IUGR (57.1%) than for those without IUGR (29.4%), but not to a statistically significant degree. These data suggest that Doppler umbilical velocimetry studies are valuable in identifying those growth-retarded fetuses at increased risk for an adverse perinatal outcome.

Blood Flow Velocity↗
PubMed1987

Prenatal sonographic assessment of the fetal thorax: normal values.

Fetal thoracic circumference and thoracic length measurements were obtained by ultrasonographic examination on 576 women between 16 and 40 weeks gestation. Nomograms for thoracic circumference and thoracic length with respect to gestational age were developed. Growth of both thoracic parameters was observed to be linear throughout gestation. In normal pregnancy the ratios of thoracic circumference to abdominal circumference and thoracic length to humerus length remained virtually constant at 0.89 and 0.93, respectively.

Adolescent↗
PubMed1987

Epidemiology of premenstrual symptoms.

We examined the prevalence of selected premenstrual symptoms among 520 Connecticut women in relation to demographic, reproductive, contraceptive, and medical characteristics. The prevalence ranged from 39 per cent for breast swelling to 81 per cent for premenstrual weight gain. Socioeconomic status, race, history of benign breast disease, bra cup size, and history of abortions were some of the factors associated with premenstrual symptoms.

Adult↗
PubMed1986

Decreasing frequency of iatrogenic neonatal respiratory distress syndrome.

A retrospective study was undertaken to evaluate the obstetric events preceding delivery of infants who developed respiratory distress syndrome (RDS) at one New York City hospital between January 1970 and July 1973, and January 1980 and July 1983. Elective delivery without adequate documentation of fetal maturity occurred in 7 (11.1%) of 63 pregnancies resulting in RDS during 1970-1973 as compared to only 1 (1.4%) of 71 pregnancies resulting in RDS during 1980-1983 (P less than 0.05). This decline in "iatrogenic" RDS presumably reflects improved physician diligence in the prevention of unnecessary RDS, increased availability of ultrasound and fetal lung maturity studies, and advances in the application and interpretation of these diagnostic procedures.

Fetal Organ Maturity↗
PubMed1986

Crown-rump length and serum human chorionic gonadotropin as predictors of gestational age.

The accuracy of fetal crown-rump length measurement and maternal serum human chorionic gonadotropin (hCG) concentration in the prediction of obstetric gestational age was analyzed in a study population of 77 patients for whom time of ovulation was reliably determined. Published nomograms relating maternal serum hCG concentration to gestational age were not found to be valid predictors of gestational age for the study population. Fetal crown-rump length measurement using the uncorrected regression equation of Robinson was found to give the most accurate prediction of gestational age.

Chorionic Gonadotropin↗
PubMed1985

A comparison of sonographic estimation of fetal weight and obstetrically determined gestational age in the prediction of neonatal outcome for the very low-birth weight fetus.

A comparison of sonographic estimation of fetal weight and obstetrically determined gestational age in the prediction of neonatal outcome for the very low-birth weight fetus was conducted in a study population of 122 fetuses. With stepwise logistic regression, obstetric gestational age was found to be the best predictor of neonatal death, while sonographic estimated fetal weight did not add significantly to this prediction. However, both variables were important in the prediction of adverse neonatal outcome (neonatal death together with major neonatal complications of prematurity.

Female↗
PubMed1985

Twin pregnancy: routine use of ultrasound examinations in the prenatal diagnosis of intrauterine growth retardation and discordant growth.

A prospective study was undertaken in 42 normal twin pregnancies to determine the value of routine ultrasound evaluation in the prenatal diagnosis of intrauterine growth retardation (IUGR) and intra-pair growth discordancy in twin gestations. Use of multiple sonographic parameters significantly improved diagnostic accuracy when compared with the use of single parameters, such as biparietal diameter (BPD) alone in the prepartum diagnosis of these two entities.

Adolescent↗
PubMed1985

Estrogen replacement therapy and fibrocystic breast disease in postmenopausal women.

The association between estrogen replacement therapy and fibrocystic breast disease was assessed in a hospital-based case-control study undertaken in Connecticut from 1979 to 1981. The cases were 143 postmenopausal women with biopsy-confirmed fibrocystic breast disease, and the controls were 355 postmenopausal women with other surgical conditions. Use of estrogen replacement therapy was positively associated with fibrocystic breast disease; the odds of disease increased with duration of use, reaching an approximately fivefold excess odds for those who had taken menopausal estrogens for 10 or more years. There was no evidence that the positive association between estrogen replacement therapy and the occurrence of fibrocystic breast disease could be explained by differential medical care utilization or other possible risk factors of biopsied fibrocystic breast disease.

Adult↗
PubMed1985

Cigarette smoking and benign breast disease.

The association between cigarette smoking and the occurrence of benign breast disease was assessed in a hospital-based case-control study conducted in Connecticut during 1979-81. Current smokers, but not former smokers, were at reduced risk for all benign breast diseases. The odds ratios associated with current smoking were 0.7 (95% confidence intervals = 0.6, 0.9) for fibrocystic breast disease, 0.6 (95% confidence intervals = 0.5, 0.9) for fibroadenoma, 0.6 (95% confidence intervals = 0.4, 1.0) for fibrocystic breast disease concomitant with fibroadenoma, and 0.6 (95% confidence intervals = 0.5, 0.9) for other benign breast disease. Adjustments for potentially confounding variables, including indices of medical care utilisation, affected these odds ratios only slightly. There was no convincing evidence of an association, either negative or positive, between current cigarette smoking and the degree of epithelial atypia of the fibrocystic lesions. However, the negative association between fibrocystic disease and current cigarette smoking was strongest for atypical lobular hyperplasia, which in turn has been associated with a particularly elevated risk of subsequent breast cancer.

Adenofibroma↗
PubMed1985

Risk factors for fibrocystic breast disease and its histopathologic components.

The relationship between various sociodemographic, reproductive, and other factors to the occurrence of fibrocystic breast disease was evaluated in a case-control study undertaken at five Connecticut hospitals from 1979 to 1981. The study groups comprised 590 women with biopsy-proven fibrocystic breast disease and 1,018 women with other surgical conditions. Among the premenopausal women, multivariate analysis suggested that high socioeconomic status, Jewish religion, low parity, a history of benign breast disease, a history of breast cancer in the mother or a sister, and low Quetelet index were associated with increased odds ratios (OR) for fibrocystic breast disease. Similar analysis for the postmenopausal women revealed increased OR for women with high socioeconomic status, a late age at menopause, and a history of benign breast disease. Current smokers as well as those who had had a tubal sterilization had significantly reduced odds of fibrocystic disease. There was no convincing evidence of linear trends according to degree of epithelial atypia for any of the variables considered. Although some variation in the OR emerged in the analysis according to selected histologic components, the results provided little evidence that women with biopsy specimens exhibiting gross cysts, sclerosing adenosis, papillary hyperplasia, or papillomatosis showed epidemiologic similarities with breast cancer patients.

Adult↗
PubMed1984

Exogenous hormone use and fibrocystic breast disease by histopathologic component.

In a hospital-based case-control study of 590 women with biopsy-proven fibrocystic breast disease and 1,018 control women with other surgical conditions, no linear relationship was evident between the use of oral contraceptives or of estrogen replacement therapy and the degree of epithelial atypia of the fibrocystic lesions. Case-control and intracase comparisons suggested that oral contraceptive use might be associated with an increased occurrence of sclerosing adenosis among the premenopausal women and of gross cysts among the postmenopausal women. Estrogen replacement therapy, which was positively associated with fibrocystic breast disease as a whole among the post-menopausal women, was most frequently used among the cases whose biopsy specimens exhibited gross cysts, papillomatosis or papillary hyperplasia.

Adult↗