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Biomedical subjects

M Sharf

Publications and source records attributed to M Sharf.

At least 37 records · Page 2Linked to original sources
PubMed1990

Fetal blood flow velocity waveforms in pregnancies complicated by intrauterine growth retardation.

Fifty-three pregnancies suspected for a small-for-gestational age fetus (SGA) by ultrasonographic weight estimation (below the 10th percentile of Brenner nomograms) were studied using pulsed Doppler (Duplex) for recording fetal blood flow velocity waveforms from the umbilical artery and fetal internal carotid artery. The pulsatility index (PI) for each artery was calculated as an index of vascular resistance. The gestational age ranged from 29 to 40 weeks. In 42 cases an SGA newborn was delivered (according to Brenner tables corrected for maternal parity and fetal sex), 34 newborns were SGA according to Usher and McLean (2 SD below the mean). Fetal structural and/or chromosomal defects were found in four cases, all of which showed symmetric intrauterine growth retardation and normal PI values in the fetal internal carotid artery. After excluding the infants with congenital abnormalities and using nomograms constructed for our own population, the ratio between the PI of the umbilical artery and the internal carotid artery was found to be the best predictor of SGA (sensitivity 84.2%, specificity 90.9%, positive predictive value 97.0%, negative predictive value 62.5%). Using the more demanding criteria for SGA according to Usher and McLean, sensitivity improved to 100%, specificity was 80.0%, positive predictive value 87.9%, and negative predictive value 100%.

Blood Flow Velocity↗
PubMed1989

Maternal echocardiography in hypertensive pregnancies.

Echocardiographic hemodynamic and left ventricular parameters were determined in 14 normotensive and 18 hypertensive women during the last trimester of pregnancy. The hypertensive patients had significantly higher mean values of total peripheral resistance (p less than 0.001), maximum velocity of posterior wall motion (p less than 0.05), mean velocity of circumferential fiber shortening (p less than 0.01) and percent fiber shortening of left ventricular diameter (p less than 0.05). The mean values for heart rate, stroke volume, cardiac output, cardiac index, left ventricular posterior wall thickness and septal thickness did not differ significantly in both groups. These results reflect increased cardiac contractility related to elevated peripheral vascular resistance in subjects with pregnancy-induced hypertension.

Adult↗
PubMed1989

Kallmann syndrome: a case of twin pregnancy and review of the literature.

In order to evaluate the possibilities for induction of ovulation, the functional competence of the pituitary gland of a woman with Kallmann syndrome was examined by two consecutive dynamic GnRH tests. The second test was conducted after 1 week's treatment by a GnRH pump. The results, which showed some rise of LH but no response of FSH, favored induction by hMG/hCG therapy. Three treatment cycles resulted in a twin pregnancy which was normal and was carried to term. Review of the literature shows only six previously reported pregnancies in women with Kallmann syndrome. Five of them were treated by hMG/hCG, and one by pulsatile GnRH. The two methods of induction are discussed in relation to the heterogeneity of the pituitary and ovarian function in Kallmann syndrome. We show that this heterogeneity dictates that the treatment for induction of ovulation should be individually adjusted according to the pituitary and ovarian competence.

Adult↗
PubMed1988

Paracentric inversion of Xq and ovarian dysfunction.

We report on a paracentric inversion X(q13 q24) in a 20-year-old woman with ovarian dysfunction. The findings add evidence on the role of breakpoints in Xq13 and Xq24 in causing ovarian dysfunction. A review of the published data on paracentric inversion of chromosome X is included.

Adult↗
PubMed1988

Decrease in pulsatile flow in the internal carotid artery in fetal hydrocephalus.

The effect of ventriculomegaly on pulsatile flow in the internal carotid arteries has been studied by Doppler ultrasound in four hydrocephalic fetuses. The pulsatility index showed progressive elevation proportional to the developing ventriculomegaly and thus may be a valuable index for the study of the mechanism of brain injury and for the determination of optimal timing of intervention.

Carotid Artery, Internal↗
PubMed1988

Patterns of growth of uterine leiomyomas during pregnancy. A prospective longitudinal study.

In a prospective study 32 leiomyomas (fibroids) in 29 pregnant women were examined with ultrasound every 3-8 weeks. Each patient had between 3 and 6 scans (mean 4.4) during the course of pregnancy, and 13 patients had a final scan at 6 weeks postpartum. An individual growth curve was established for each tumour and the patterns of growth were analysed. No increase in size during the pregnancy was observed in 25 fibroids (78%). Only 7 (22%) increased in size but by no more than 25% of the initial volume. At 6 weeks postpartum the size of the fibroids did not differ significantly from the size during pregnancy.

Female↗
PubMed1988

Fetal internal carotid artery flow velocity time waveforms in twin pregnancies.

The fetal internal carotid artery and umbilical artery flow velocity time waveforms were studied in 17 consecutive twin pregnancies. The pulsatility index was calculated for each fetus in each artery as an index of vascular resistance. All studies were done within 14 days before delivery. In 8 pregnancies both fetuses were of birthweight appropriate for gestational age; whereas, in 9 patients one or both of the infants were small for gestational age (SGA). From ultrasound criteria and Doppler studies of the umbilical and fetal internal carotid arteries, decreased fetal internal carotid artery pulsatility index (cut off value less than or equal to 1.2) was found to be the best predictor of SGA (sensitivity 83%, specificity 95%, positive predictive value 91%, negative predictive value 91%).

Birth Weight↗
PubMed1988

Fetal arrhythmia associated with sinus node dysfunction--a case report.

Real time and M-mode echocardiography were used for evaluation of fetal bradycardia. Sinus bradycardia was revealed without structural abnormalities. An abdominal wall derived fetal electrocardiogram and the failure of the sinus rate to increase in response to maternal exercise or I.V. atropine suggested sinus node dysfunction. Postnatal evaluation revealed sinus bradycardia with blunted response to I.V. atropine and an abnormal sinus node recovery time. A gradual increase in heart rate was demonstrated in the neonatal period, possibly due to decrease in vagal tone.

Adult↗
PubMed1987

Magnetic resonance imaging of gynecologic masses.

The pelvis of 21 women with various gynecological masses were imaged with magnetic resonance (MR) imagers at 2.0 and 0.5 T. Fifteen normal individuals were used for studying the normal appearance of the female genitalia using spin echo pulse sequences with various pulse repetition (TR) and spin echo (TE) time values. Images were compared with those of the ultrasonic images, intraoperative findings, and the histopathologic examinations. The masses included simple ovarian cyst, cystadenoma, serous cystadenocarcinoma, ovarian teratoma, dysgerminoma, and uterine myoma. MR imaging was useful in demonstrating the anatomy and pathology of the cases examined in this study. It detected the internal structure of some tumors which were sonographically homogeneous. The potential of MR in staging of malignancies was demonstrated.

Adolescent↗
PubMed1987

The usefulness of Doppler echocardiography in the management of rhabdomyoma diagnosed prenatally.

Cardiac rhabdomyoma diagnosed prenatally by cross-sectional echocardiography was confirmed after birth by Doppler echocardiography and cardiac catheterization in a baby with tuberous sclerosis. Doppler echocardiographic follow-up after 2 years revealed regression of tumour masses and concomitant disappearance of pulmonary regurgitation which was caused by the large tumour mass in the right ventricular outflow tract. In spite of a sizeable mass protruding into the left ventricular outflow tract, repeated Doppler examination failed to demonstrate any significant obstruction, thus avoiding repeated catheterizations and unnecessary surgery. Doppler examination of ventricular inflow revealed normal filling characteristics. Doppler and cross-sectional echocardiography was of great value in the management of this patient.

Echocardiography↗
PubMed1986

Broad spectrum antibiotics as short term prophylaxis for elective abdominal hysterectomy: comparison of mezlocillin, cefazolin and placebo.

A prospective randomized placebo controlled double-blind study was conducted in order to evaluate the effect of short term perioperative antibiotic prophylaxis on patients undergoing elective abdominal hysterectomy. Fifty-two patients received 3 doses of 0.5 g cefazolin, 54 patients received 3 doses of 1 g mezlocillin and 53 patients received placebo. Postoperative infectious morbidity and the rate of pelvic cellulitis were significantly lower in either antibiotic group in comparison to the placebo group, but neither drug proved to be superior in this respect. The fever index was significantly lower in the mezlocillin group in comparison to both cefazolin and placebo groups. It was thus concluded that antibiotic prophylaxis has a beneficial effect on patients undergoing abdominal hysterectomy and both drugs--cefazolin and mezlocillin--seem to be equally effective.

Cefazolin↗
PubMed1986

Effect of irrigation or intravenous antibiotic prophylaxis on infectious morbidity at cesarean section.

The efficacy of intraoperative irrigation with cefamandole nafate at cesarean section was evaluated in a prospective, randomized double-blind study. Two hundred and eight patients were treated with antibiotic irrigation and intravenous placebo or with perioperative intravenous cefamandole and irrigated with normal saline. The rate of endometritis was 10.9% in the irrigation group and 14% in the intravenous group, but the difference was not statistically significant. The rate of any infection, the number of days with fever, additional hospitalization days, and number of antibiotics used for treatment were similar in the two groups. It thus was concluded that irrigation with antibiotic is equal but not superior to perioperative intravenous antibiotics.

Adult↗
PubMed1985

The value of laparoscopy in women with chronic pelvic pain and a "normal pelvis".

During the period January 1976--December 1982 laparoscopy was performed on 186 women complaining of pelvic pain of at least 6 months' duration. In all these cases, the routine pelvic examination and other medical and laboratory tests were negative. Laparoscopy revealed pelvic pathology in only 8.2%: in the vast majority (91.8%) entirely normal pelvic organs were seen. Evidence from the literature is compiling as to the psychogenic origin of most cases of chronic pelvic pain. Recently, it has been shown that laparoscopically negative pelvic pain can be relieved or abolished by psychological intervention. Since pathological findings on laparoscopy are of very low percentage and since the pain is psychogenic in most cases, the value of routine laparoscopy in chronic pelvic pain is very low. We propose that all women with chronic pelvic pain and normal pelvic examination should undergo psychological assessment and treatment if necessary. Laparoscopy should then be reserved for only those cases who show no amelioration on psychological intervention. Our estimation is that this approach would reduce the rate of laparoscopies performed for chronic pelvic pain by about 90%.

Adult↗
PubMed1985

Short-term prophylactic antibiotic for elective abdominal hysterectomy: how short?

A prospective double-blind study was conducted in order to evaluate the effect of antibiotic prophylaxis on patients undergoing elective abdominal hysterectomy. In the first stage of the study, 116 patients received, on call to the operating room and subsequently 8 and 16 h post-operatively, cefazolin sodium or placebo. In the second stage of the study, 90 patients received the same antibiotics, but treatment was extended to 6 doses, 8 h apart. Of the 53 women who received placebo, 27 (50.9%) became morbid, while only 15 of the 63 (23.8%) who received 24 h prophylaxis were classified as morbid (p less than 0.005). By extending the prophylactic treatment to 48 h further reduction of the morbidity was achieved. Of the 90 patients only 11 (12.2%) became morbid (P less than 0.005). When morbidity rates were compared between different ethnic groups, over-weight and normal weight patients, pre- and post-menopausal women, it was not possible to define a group which is at a higher risk for post-operative morbidity. It was thus concluded that prophylactic antibiotics should be administered routinely to all patients undergoing abdominal hysterectomy, preferably for 48 h.

Adult↗