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Biomedical subjects

M Neuman

Publications and source records attributed to M Neuman.

At least 19 recordsLinked to original sources

Ultrasonographic "endometrial three-layer" pattern: a unique finding in ectopic pregnancy.

Although diagnostic ultrasonography is playing an increasing role in the investigation of the patient with suspected ectopic pregnancy (EP), it has significant limitations in the very early stages of pregnancy. By sonographically exploring the intrauterine echoes in 45 cases of documented EP, we demonstrated a unique pattern in 28 cases (62.2%). A well-defined spheric structure forming an endometrial three-layer (ETL) pattern was seen, probably formed by a midline echo between the two adjacent edematous proliferative layers of the endometrium, the latter resembling the late proliferative endometrium. In 17 patients with a proved EP (37.8%), the ETL pattern was not demonstrated. However, the ETL was not demonstrated in all 40 cases of early intrauterine pregnancy and all 50 cases of miscarriage. These findings suggest a 100% specificity and a sensitivity of 62.2% for the ETL pattern in the diagnosis of EP.

Endometrium

The effect of feedback on anxiety levels during ultrasound scanning for ovarian cancer.

Women undergoing ultrasound scanning for the detection of ovarian cancer benefit psychologically from the examination, which has been shown to reduce levels of anxiety, depression, hostility and complaints about somatic symptoms. However, it is not completely clear what aspects of the ultrasound examination are responsible for these effects, and how these beneficial psychological effects vary under different circumstances. This study examined, in particular, the effect of various levels of feedback on patients' anxiety levels before and after ultrasound examination. Two hundred and seven women were randomly assigned to two different experimental conditions: high feedback and low feedback. The subjects' levels of anxiety (both trait and state anxiety) were measured immediately before and after the ultrasound examination. The women's individual risk factors for ovarian cancer were also recorded. This study showed a significant decrease in the level of trait anxiety following ultrasound scanning. The decrease in anxiety did not relate to the level of feedback provided to the patients, nor to the woman's degree of risk for ovarian cancer. The results are discussed in terms of possible implications for clinical care and the allocation of resources in the medical system.

Adolescent

Early uterine prolapse following colponeedle suspension.

The association of retropubic colposuspension for the treatment of urinary stress incontinence with genital prolapse has been reported previously. Described here is a case of an 83-year-old patient who had a colponeedle suspension and was readmitted because of genital prolapse 3 weeks after surgery. This case emphasizes the need for proper evaluation of the whole pelvic floor prior to any surgical treatment for urinary incontinence, and addition of appropriate surgical measures aimed to avoid later genital prolapse, if necessary.

Aged

Regression of hepatic tumors during transdermal estradiol replacement therapy.

A 39 year-old patient with long-standing diagnosis of pelvic endometriosis had been treated for over twenty years with oral contraceptives (OCs). A year prior to admission to the gynecological ward, an ultrasonographic examination revealed three hepatic lesions, which were not reported in previous liver sonography. These lesions progressed during OC use, over the next six months. Liver function tests were normal. Liver scan, CT and ultrasound imaging techniques supported the diagnosis of solid hepatic tumors. These lesions developed concomitantly to long-term use of OCs, therefore discontinuation of therapy was mandatory. Six months later, the patient was hospitalized due to pelvic pain. She underwent total abdominal hysterectomy and left salpingo-oophorectomy (the right adnexa had been removed years before). Due to the patient's young age, hormone replacement therapy was indicated. The preferred preparation was transdermal estradiol due to the fact that systemic absorption has no hepatic first-pass effect and therefore exerts minimal influence on liver enzymes and functions. Serial ultrasonographic examinations, performed while under treatment with transdermal estradiol, showed complete regression of the hepatic lesions over a period of two years. Our report demonstrates regression of multifocal hepatic tumors despite transdermal estradiol replacement therapy.

Administration, Cutaneous

Extra-pelvic metastasis of endometrioid carcinoma; resistance to chemo-radiation therapy--response to paclitaxel treatment. Case report.

We present a case report of a 56 year old female suffering from recurrence of simultaneous endometrial and ovarian carcinomas, confined to distant neck and axillary lymph nodes. Resistance of the tumor to conventional chemotherapy and radiotherapy was followed by experimental Paclitaxel treatment which led to complete regression of all metastatic foci.

Antineoplastic Agents, Phytogenic

[Emotional reactions of psychiatric staff to violent patients].

Approximately 10% of psychiatric patients are violent and their violence is often directed towards the treating staff. Up to half of all psychiatrists have been physically assaulted at some time during their careers. Emotional reactions of the psychiatric staff to assault by patients vary, and include fear, anger and helplessness. Psychological defense mechanisms employed include projection, denial and isolation. For the staff, these reactions are a source of distress and a cause of burn-out. Anger can lead to nontherapeutic interventions such as counter-aggression.

Defense Mechanisms

Decrease of serum iron in acutely psychotic schizophrenic patients.

Iron deficiency has been shown to effect the dopaminergic system. Iron deficient rats have low dopamine D2 receptor levels and modified dopamine-mediated behaviors, including reversal of circadian cycles of these behaviors. Abnormal iron deposits have been found in the brains of schizophrenics in CT and post mortum studies. We examined serum iron levels at 0800, 1700 and 2400 hours in 26 medication free schizophrenic patients in acute psychotic relapse and compared them to iron levels in a normal control group. The results show significant decreases in the iron levels at 1700 and 2400, and a non significant drop in the 0800 levels. A feedback mechanism involving iron and dopamine is proposed.

Acute Disease

Intrapartum bimanual tocolytic-assisted reversal of face presentation: preliminary report.

OBJECTIVE: To design and conduct a mode of vaginal delivery for mentoposterior-presenting fetuses when cesarean delivery is not possible. METHODS: Eleven orthodox Jewish parturients who refused cesarean delivery had intrapartum bimanual conversion of mentoposterior to occipitoanterior presentation, concomitant with ritodrine infusion in ten. RESULTS: Excluding the first case, in which ritodrine was not administered, the maneuver was successful and vaginal delivery was achieved. CONCLUSION: This maneuver, performed with intravenous ritodrine tocolysis, might be an alternative mode of delivery in the presence of mentoposterior presentation when cesarean delivery is not possible. More experience is needed with this technique before it is performed routinely.

Adult

Maternal serum creatine kinase: a possible predictor of tubal pregnancy.

Tubal pregnancy remains a clinical challenge in spite of improvements in diagnostic tests and procedures. In a prospective study we evaluated the role of the serum creatine kinase as a possible marker for tubal pregnancy. Three groups of 17 patients each were included in the study: group A, documented tubal pregnancy; group B, spontaneous abortion; and group C, normal pregnancy. Serum was tested for creatine kinase in all of the patients. Creatine kinase level was > 45 IU/L in all patients with tubal pregnancy, significantly higher than the level in patients in either of the two other groups (p < 0.0001). We conclude that a high serum creatine kinase level can be an important diagnostic test in the evaluation of a suspected tubal pregnancy.

Abortion, Spontaneous

Molecular epidemiology of type 1 polioviruses isolated in Israel and defined by restriction fragment length polymorphism assay.

The genomic variability of 27 type 1 polioviruses (PV-1) isolated in Israel during 1980-1991 was examined by restriction fragment length polymorphism (RFLP) analysis of a reverse-transcribed genomic fragment amplified by polymerase chain reaction. By using the restriction enzymes HaeIII, DdeI, and HpaII, strain-specific restriction profiles were generated for the PV-1/Mahoney and PV-1/Sabin strains and 27 wild-type isolates. The profile observed for PV-1 isolated during an outbreak in 1988 was also observed for PV-1 isolated from different places in Israel in 1982 and 1983, 1987, and 1991. This profile, characterized by the lack of the DdeI site, was different from the DdeI profile of PV-1 isolated in 1984 or in 1986 from sporadic cases of poliomyelitis. The diversity of circulating PV-1 in Israel was also confirmed by nucleotide sequence analysis. The epidemiologic information provided by the RFLP and sequence data establishes a clear epidemiologic link between epidemic and sporadic virus strains and demonstrates the power of this molecular approach to epidemiology.

Base Sequence

Prophylactic effect of the open vaginal vault method in reducing febrile morbidity in abdominal hysterectomy.

In a randomized study, we evaluated the efficacy of the "open vaginal vault" method of abdominal hysterectomy, when cefonicid is administrated preoperatively, in reducing postoperative febrile morbidity. The vaginal vault was left open in 72 patients and closed in 65 patients in control groups. No significant difference in postoperative febrile morbidity was noticed in the two groups.

Cefonicid

Serous papillary adenocarcinoma of the endometrium. A unique entity with a grave prognosis. Case report and review of the literature.

A case of Papillary Serous Adenocarcinoma of the endometrium is described. This unique variant of endometrial carcinoma was described initially only 10 years ago. The tumor has distinct pathological characteristics and a very grave prognosis. The importance of identifying this unique tumor type is related to appropriate treatment as well as to correct statistical analysis of endometrial carcinoma.

Antineoplastic Combined Chemotherapy Protocols

The effect of prenatal administration of dexamethasone and ritodrine on cord blood cortisol and glucose concentrations in premature infants with respiratory distress syndrome.

The influence of maternal dexamethasone and ritodrine administration during pregnancy on cord blood cortisol and capillary serum glucose concentrations and on the incidence of respiratory distress syndrome (RDS) was studied in 30 premature infants (gestational age 27-36 weeks), and compared with a matched control group of 37 premature infants where no such medications were administered. RDS occurred less often in the treated group of infants (13.3%) than in the controls (35.1%, p < 0.01). The healthy treated infants had a significantly lower mean umbilical cord plasma cortisol concentration (5.5 +/- 1.8 ug/dl, mean +/- SD) than that observed in the controls (11.2 +/- 3.9 ug/dl, p < 0.01). Mean cord plasma cortisol concentrations increased with duration of pregnancy. No significant difference in the capillary serum glucose at 30 minutes post-delivery was found between the healthy, RDS, treated and non-treated infants. No adverse effects of steroid and ritodrine therapy were observed.

Blood Glucose

Fetal hydrocephalus associated with maternal neurofibromatosis.

Neurofibromatosis (NF), an autosomal dominant inherited disorder affecting multiple organ systems, is rare among pregnant women. NF in pregnancy has been reported to be complicated by maternal hypertension, fetal intrauterine growth retardation and fetal wastage. A case of pregnancy associated with neurofibromatosis, complicated by pregnancy aggravated chronic hypertension, asymmetric intrauterine growth retardation and fetal hydrocephalus is described. Possible interrelations between those pathologies are discussed.

Female