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Biomedical subjects

M Sharf

Publications and source records attributed to M Sharf.

At least 55 records · Page 3Linked to original sources
PubMed1985

Ultrasonographic and clinical correlates of menotropin versus sequential clomiphene citrate: menotropin therapy for induction of ovulation.

Forty-six women remaining infertile with clomiphene citrate (CC) with or without human chorionic gonadotropin (hCG) were treated by either human menopausal gonadotropin (hMG, 44 cycles) or CC + hMG (33 cycles) and monitored by serum estradiol (E2) and ultrasonography. Ovarian hyperstimulation syndrome (OHS) and pregnancy outcome were compared in both regimens. In the presence of dominant follicles (greater than or equal to 18 mm) alone or with a single secondary follicle (14 to 16 mm) at hCG administration, OHS did not develop. A significant increase in OHS was noted when three or more secondary follicles were observed. Overall pregnancy rates were similar in both regimens but significantly higher when hCG was injected before rather than after the E2 peak. The results suggest secondary follicles rather than dominant follicles are a valuable sign of possible OHS development; and CC + hMG should be considered in CC-failure patients.

Chorionic Gonadotropin↗
PubMed1985

Lipid and lipoprotein levels following pure estradiol implantation in post-menopausal women.

8 post-menopausal, post-oophrectomy and hysterectomy women had a 100-mg pure 17 beta-estradiol pellet installed in their subcutaneous abdominal tissue. The pellet caused a marked systemic hormonal effect in these patients causing an up to 30-fold increase in plasma estradiol and a marked decrease in follicle-stimulating hormone levels. It showed a significant increase in plasma high density lipoprotein (HDL) and HDL to total cholesterol ratio levels, no change in plasma triglycerides and very low density lipoprotein levels and some decrease in total cholesterol and low density lipoprotein cholesterol concentrations. These results differ from the previously reported influence of synthetic hormonal preparations on the same plasma lipids and lipoproteins.

Adult↗
PubMed1985

Isometric exercise test for predicting gestational hypertension.

One hundred normotensive young primigravidas underwent an isometric handgrip exercise test between 28 and 32 weeks of gestation. The same individual performed the tests and the results were withheld from the physician taking care of the patient. The study demonstrates a sensitivity of 81% and a specificity of 96.5%. These results demonstrate a reliable predictive ability of this simple exercise test for gestational hypertension.

Exercise Test↗
PubMed1984

Is serum free estriol measurement essential in the management of hypertensive disorders during pregnancy?

A prospective study of antepartum fetal evaluation of 306 randomized hypertensive pregnancies was carried out. One hundred and fifty-four patients (group 1) were managed in accordance with a protocol (protocol A) which included non-stress test (NST), oxytocin challenge test (OCT), serum unconjugated (free) estriol measurements (E3), and ultrasound measurement of the fetal head-to-abdomen circumference ratio (H/A c.r.). A second group (group 2), composed of 152 patients, was managed using another protocol (protocol B) which included the NST, OCT and ultrasound measurement of the fetal head-to-abdomen circumference ratio (H/A). We found a good correlation between the serial normal tests and the outcome of pregnancies. We obtained good results in patients with abnormal NST-OCT and meconium-stained amniotic fluid and in patients with repeated abnormal NST-OCT with clear amniotic fluid due to active management by early deliveries ignoring fetal lung maturity. This management increased the rate of cesarean section and prematurity. There was a low correlation between patients with abnormal serum free estriol as the only antepartum pathological test and the appearance of intrapartum fetal distress, low birth weight and perinatal morbidity and mortality. The contribution of serum free estriol (E3) measurements in such patients was only of value in cases of intra-uterine fetal growth retardation, but its prediction rate was less than that of ultrasound measurement of head-to-abdomen circumference ratio. Our results indicate that hypertensive pregnancy management without serum free estriol measurement may be valuable and safe.

Estriol↗
PubMed1984

Hormonal profile of endometrial cancer.

Out of all the risk factors of endometrial carcinoma, the 'Oestrone Theory' is especially fascinating. This theory assumes that prolonged uninterrupted stimulation of the endometrial cell by oestrone, without the competition of oestradiol and oestriol, brings about neoplasia. There is also some evidence of a protective effect of androgens and progesterone. In order to verify this theory in vivo, oestrone (E1), oestradiol (E2), testosterone (T) and progestogen levels were examined from the serum of 36 post-menopausal women suffering from endometrial carcinoma, and compared with a healthy group of women. Oestrone levels were found to be significantly higher in patients with endometrial carcinoma. A correlation was also found between oestrone levels and previous infertility. With the intention of tracking the origin of oestrone in those suffering from endometrial cancer, hormone levels were checked before and after total hysterectomy and oophorectomy. The high oestrone values dropped to normal after the operation, except in those who had previously suffered from infertility. In those patients, high oestrone values were found a year after the operation. No significant differences of testosterone or progesterone were found between the cancer patients and the healthy women. The operation did not have any influence on these values.

Adult↗
PubMed1983

Prenatal echocardiographic diagnosis of Ebstein's anomaly with pulmonary atresia.

Ebstein's anomaly with pulmonary atresia was diagnosed in utero for the first time by fetal echocardiography. The fetus, examined at 35 weeks' gestation, had no extracardiac sonographic evidence of heart failure, but the heart filled the anterior portion of the chest. Two-dimensional echocardiography revealed a huge right atrium. The tricuspid valve, instead of originating from the anulus, was demonstrated as originating from the wall of the right ventricle, thus dividing the ventricle into two parts: the true ventricle and the "atrialized portion" of the right ventricle. These features corresponded with Ebstein's anomaly. Short episodes of supraventricular tachycardia (250 bpm) corresponded with the tachyarrhythmias frequently associated with Ebstein's anomaly. Pulmonary atresia was suspected, as movement of the pulmonary valve could not be demonstrated. The baby was delivered at 40 weeks' gestation and died 3 days later. Postnatal cardiac catheterization and angiocardiography and postmortem examination confirmed the prenatal diagnosis.

Adult↗
PubMed1983

Congenital cardiac fibroma associated with fetal arrhythmia.

A congenital cardiac fibroma presented itself, antenatally by bursts of extrasystoles which were detected by the cardiotocograph during labor. Congenital cardiac tumors are extremely rare. The symptomatology of such tumors consists mainly of hemodynamic disturbances and various arrhythmias. Most of the reported cases were diagnosed in neonates or infants, usually in autopsies, none were diagnosed in utero. It seems logical to assume that some of the arrhythmias may have been present but not diagnosed antepartum. To the best of our knowledge the association of congenital cardiac tumor and fetal arrhythmia (FA) has not been reported yet.

Adult↗
PubMed1983

Ovarian pregnancy in association with an intrauterine device.

Within a 1-year period, two cases of primary ovarian pregnancy associated with an intrauterine device (IUD) occurred in our institution. The clinical signs and symptoms were similar to those in any other ectopic pregnancy. Both cases satisfied the criteria of Spiegelberg. The final diagnosis was based on the histopathological findings. A review of the literature is presented summarizing the 53 cases reported until now. The association between IUD, ectopic pregnancy in general, and ovarian pregnancy in particular is discussed.

Adult↗
PubMed1983

Experience with combined individualized method of hMG/hCG therapy.

The introduction of powerful ovulation induction agents, such as gonadotropins, has made an important contribution to the temporary elimination of the anovulation syndrome. Since the treatment is expensive and not without significant medical complication, it is vitally important to conduct therapy according to a well-defined monitoring system. In the past, clinicians have tended to monitor gonadotropin therapy by biophysical signs, but they were found to be insufficient monitors if used alone. Estrogen secretion from the ovaries does reflect the follicular maturation process. In this study a combined individualized method for hMG/hCG therapy is presented. Fifty-one infertile anovulatory women were treated for a total of 124 treatment cycles. All courses of therapy were judged to have induced ovulation. There was a good clinical correlation between cervical score and increasing estrogen levels. The pregnancy rate was 62.7%, with 60% of patients becoming pregnant within the first three cycles of treatment. In spite of the complications of less than 1% of severe hyperstimulation, 15.5% multiple gestation, and 28% of abortion rate, gonadotropin therapy is a most efficient tool in the treatment of infertility due to anovulation.

Adult↗
PubMed1983

Continuous subcutaneous insulin infusion. Improved blood glucose in pregnant diabetics.

The effect of continuous subcutaneous insulin infusion (c.s.i.i.) on the control of blood-glucose concentration and outcome of pregnancy was assessed in two pregnant diabetics (class B and class C White classification) who were poorly controlled with conventional insulin therapy. The insulin pump was carried in a holster and enabled the patients to ambulate freely. The patients were able to refill the syringe, to augment the infusion rate at mealtime and to change the implantation site of the needle weekly, and thus, were able to leave the hospital. Daily glucose profiles were assessed 1-3 times a week, and the infusion rate was readjusted accordingly. Twenty-four hours glucose profiles were obtained from both patients during inpatient conventional insulin regimens, and then, during c.s.i.i. which was maintained for 41 and 145 days, respectively. Mean 24 hours glucose concentrations were reduced from 156 to 113 mg/100 ml, mean fasting glucose from 152 to 106 mg/100 ml, and mean diurnal variation (maximal excursion) from 75 to 65 mg/100 ml. The favourable results achieved with the c.s.i.i. enabled both patients to reach the 18th week of gestation and to deliver healthy non-macrosomic infants, who had uneventful and morbid-free neonatal periods. Since the c.s.i.i. supplies insulin in a more physiological manner than twice daily regimens, better control of blood sugar and body fuel metabolism may be achieved. By extending the therapy to the early stages of pregnancy, or if possible to pre-conceptional period, reduced perinatal mortality and morbidity may be anticipated.

Adult↗
PubMed1982

The effect of intraperitoneal colchicine on the formation of peritoneal adhesions in the rat.

A double blind study was carried out to determine the effect of colchicine on the formation of intraperitoneal adhesions in the rat. Adhesions were produced by a standard method in 92 rats. The animals were than divided at random into two groups. One group (47 rats) was treated with intraperitoneal colchicine, whilst the other, the control group (45 rats) was treated with intraperitoneal normal saline in the same volume, frequency and duration. Four weeks later the animals were killed for assessment and measurement of adhesions. Two kinds of adhesions were found. 1. "Surface adhesion" - consisting of two serosal surfaces attached together; their area was significantly smaller (p less than 0.00003), and their number was lower (p less than 0.03) in the colchicine group than in the control group. 2. "Filamentous adhesions" - thin, elastic cords connecting omentum or pelvic fat bodies to other viscera; there was no significant difference in their number between the colchicine and the control group. We concluded that post-operative treatment with colchicine reduces the formation of intraperitoneal adhesions in the rat.

Animals↗
PubMed1982

Hypertensive crisis associated with ritodrine infusion and betamethasone administration in premature labor.

A case is reported of hypertensive crisis associated with treatment of premature labor with intravenous ritodrine hydrochloride and betamethasone. Ritodrine has been in clinical use for over 10 yr in Europe, and recently also in the U.S.A. The drug has proved to be efficient and relatively safe. Yet, a few cases of severe side effects, all related to its effect on the cardiovascular system, have already been reported. The pathophysiology of this episode is unclear, but it is most likely related to the treatment, and should be added to the list of reported side effects of treatment with ritodrine and betamethasone.

Adult↗