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N Mordel

Publications and source records attributed to N Mordel.

35 records · Page 2Linked to original sources
PubMed1992

Triplets are not so rare any more.

Triplet gestations present a considerable management challenge due to a high rate of antenatal, intrapartum and neonatal complications. The introduction of ovulation inducing agents resulted in a marked increase of these pregnancies. Consequently, triplet conceptions are not considered a rare phenomenon and have become almost routine high risk pregnancies. In our department the triplet gestation frequency increased 2-4 times in a 10 year period from a rate of 0.07-0.14% during 1978-84 to 0.28% of all deliveries in 1987. This high incidence of triplet deliveries results in a threefold increase in the frequency of triplet neonates and their associated complications. It is reasonable to assume that the wide application of various assisted reproductive techniques will result in continuous increase in the incidence of triplets which will in turn require coordinated management of a high risk pregnancy unit, delivery room and neonatal intensive care unit.

Clomiphene↗
PubMed1992

The value of an electronic microcomputerized basal body temperature measurement device (Bioself) in in vitro fertilization cycles.

The Bioself 110 electronic basal body temperature (BBT) measurement device was employed in 18 women undergoing in vitro fertilization (IVF). This microcomputer-operated device records, charts and accurately analyzes the mean temperature measurements. These temperature recordings were used in addition to transvaginal ovarian sonography and serum estradiol and progesterone levels. The BBT rise correlated significantly (p < 0.0002) with progesterone elevation following human chorionic gonadotropin (hCG) administration. It is suggested that this electronic device may be used as an additional tool in the detection of premature progesterone secretion in IVF cycles.

Body Temperature↗
PubMed1991

The effect of a prolonged artificial follicular phase on endometrial development in an oocyte donation program.

Stretching the duration of an artificial follicular phase in an oocyte donation program facilitates greatly the synchronization between the donor and the recipient. In order to investigate the limits of such a prolonged endometrial preparation, 18 patients with ovarian failure were studied during 20 treatment cycles. These patients were prospectively and randomly divided into three groups (A, B, and C in eight, six, and six cycles respectively). All groups were treated with oral estradiol and estriol (at a 2:1 ratio), 4 mg/day for 21, 28, and 35 days, respectively. At this stage 50 mg/day of intramuscular progesterone was added for additional 7 days. Endometrial adequacy was evaluated by late follicular and midluteal endometrial biopsies. During treatment no patient suffered from breakthrough bleeding. The mean estradiol and progesterone levels during the follicular and luteal phases did not differ significantly between groups. All late follicular biopsies showed a normal proliferative endometrium with no signs of glandular cystic hyperplasia. The midluteal biopsy showed a secretory endometrium adequate for 18.6 +/- 1.8, 21.8 +/- 1.8, and 18.6 +/- 1.5 days in groups A, B, and C, respectively, with no significant glandular-stromal disparity. We conclude that an artificial prolonged follicular phase does not seem to affect adversely the endometrial preparation in an oocyte donation program.

Adult↗
PubMed1991

The value of menotrophin treatment for unexplained infertility prior to an in-vitro fertilization attempt.

This work was undertaken in order to evaluate retrospectively the relative efficacy of ovulation induction by menotrophins and that of in-vitro fertilization and embryo transfer (IVF-ET) in the treatment of unexplained infertility. These two treatments were compared between two groups of patients: 87 couples undergoing 446 cycles of ovulation induction by menotrophins (group A) and 72 couples undergoing 108 cycles of IVF-ET (group B). A total of 30 and 20 pregnancies were achieved in groups A and B for a rate of 34 and 28% per patient, respectively. A similar cumulative pregnancy rate (CPR) was achieved for three cycles of ovulation induction (23%) and one cycle of IVF-ET (22%). The cumulative live birth rate (CLBR) in group A was 22% after three cycles and exceeded that of one IVF-ET cycle (17%). It is concluded that menotrophin treatment in unexplained infertility is highly beneficial and should precede an IVF attempt.

Adult↗
PubMed1991

Menotropins as a possible risk factor for premature deliveries in triplet pregnancies.

This study was undertaken in order to evaluate pregnancy outcome in three groups of triplet conceptions. Of 36 delivered triplet gestations, seven were spontaneous, 12 achieved using clomiphene citrate and 17 induced by menotropins. The mean gestational age (weeks) at delivery was 36.5 +/- 1.0 SD, for spontaneous and clomiphene citrate pregnancies it was 35.9 +/- 1.9 SD which differed significantly from that in pregnancies induced by menotropins which was 32.9 +/- 3.7 SD. Similarly, triplets born following menotropin treatment had a significantly lower gestational weight (g) of 1656 +/- 516 SD vs. 2015 +/- 198 SD and 2176 +/- 315 SD for spontaneous and clomiphene citrate gestations, respectively. It is concluded that triplets following menotropins are at an increased risk for premature delivery and low birth weight.

Adult↗
PubMed1989

Successful pregnancies of two patients with relapsing thrombotic thrombocytopenic purpura.

Thrombotic thrombocytopenic purpura is a severe multisystemic disorder of unknown origin. The association of relapsing TTP with pregnancy is rare but well documented and high mortality rates of mothers and fetuses have been reported so far. Since the introduction of plasma therapy for treating the acute exacerbations of the disease, overall mortality rates have decreased significantly. It is now evident that the manifestations of the disease may reappear even after long disease-free intervals and as many as a third of the recovering patients may develop a relapse. Presented are two TTP patients with relapsing TTP complicating their pregnancies. Prophylactic treatment with aspirin and dipyridamole during their last three successful pregnancies prevented or minimized the severity of TTP relapses. The course of these pregnancies and the management of such patients is discussed.

Adult↗
PubMed1989

Malignant melanoma of the uterine cervix: case report and review of the literature.

Malignant melanoma of the uterine cervix is an extremely rare manifestation, and neither retrospective nor prospective studies on this disease entity have been published. A patient with this disease entity is described. In addition, the data contained in 25 published case reports were collated in an attempt to clarify the origin, presenting symptoms, macroscopic appearance, and staging of the tumor. Although there is no consensus as to comprehensive treatment, radical hysterectomy is generally advocated. The prognosis in these patients is poor.

Adult↗
PubMed1989

Direct demonstration of iron in a term placenta in a case of beta-thalassemia major.

Successful term pregnancy in homozygous beta-thalassemia is rare. A pregnant patient with thalassemia usually is found to have chronic anemia concurrent with tissue and circulatory iron overload. We have demonstrated and localized iron deposits in a term placenta of a patient with homozygous beta-thalassemia with the use of routine histochemical staining.

Adult↗
PubMed1989

The long-term predictive value of the zona-free hamster ova sperm penetration assay.

Three hundred sixty-nine infertile couples were followed for 2 to 5 years in a study designed to determine the clinical long-term predictive value of the zona-free hamster ova sperm penetration assay (SPA). Semen analysis (SA), SPA, and a full infertility workup were done in all cases, and only couples in whom the female had no evident cause of infertility were included in the study. During the follow-up period, 106 couples (29%) achieved a pregnancy. Sixteen percent of 131 men who had an SPA of 0%, 23% of 120 men with 1% to 19%, and 48% of 118 men who had a penetration of greater than 19% impregnated their wives 2 to 5 years after the assays. Significant difference in fertility prognosis was found between those who had an SPA greater than 19% and those with an SPA less than 20% (48% versus 20%). Sperm penetration assay greater than 19% was predictive of higher pregnancy rates in both oligospermic (41% versus 17%) and unexplained infertile couples (52% versus 24%). The specificity and positive predictive values of the SPA were higher than those of the SA (77% versus 57% and 48% versus 37%). These findings emphasize the value and importance of the SPA in determining the long-term fertility potential of men.

Animals↗
PubMed1989

Successful full-term pregnancy in homozygous beta-thalassemia major: case report and review of the literature.

Patients afflicted by homozygous beta-thalassemia suffer from severe anemia and hypersplenism and are dependent on blood transfusions. The consequent hypoxia and massive tissue iron deposition lead to concomitant cardiac, hepatic, and endocrine system failure. Hemodynamic changes related to gestation may aggravate the underlying multiorgan damage of the pregnant mother and lead to high fetal wastage. These entanglements may be prevented by performing thorough maternal and fetal surveillance and by maintaining the hemoglobin concentration above 10 g/dL. We describe a successful full-term pregnancy in a patient with transfusion-dependent homozygous beta-thalassemia major.

Adult↗
PubMed1988

Papillomaviruses in lesions of the lower genital tract in Israeli patients.

Human papillomaviruses (HPVs) have been strongly associated with benign lesions of the genital tract (condylomata) and with genital cancer of the vulva and cervix. Since the incidence of these lesions in Israel is considered to be low, we have studied the presence of HPV 6, 11, 16 and 18 DNAs in benign, premalignant and malignant tissue samples or gynecological swabs of the lower genital tract. HPV sequences were detected in 48 out of 66 condylomatous lesions (72%), 5/11 grades I-II intraepithelial neoplasia (45%), 4/6 grade III intraepithelial neoplasia (carcinoma in situ) (66.6%) and 8/22 invasive carcinoma (36%). The latter included six cases of vulvar carcinoma which were all negative for HPV sequences. No additional HPV types could be detected in any of the tissue biopsies examined. HPV 18 DNA has been found in one vulvar condyloma where it persisted as an episomal molecule, this being the first report of that specific viral DNA in a condylomatous lesion. In all the benign and premalignant lesions containing HPV, the viral sequences were maintained in an episomal state. In two cases of invasive carcinoma, the HPV 16/18 related sequences were integrated in the cellular genome, but in five cases (three containing HPV 16/18 related DNAs and two containing HPV 6/11 related DNAs) the viral sequences were episomal. HPV 16/18 related sequences detected in one out of three cases of vaginal carcinoma were also found to be episomal. This data indicates that human papillomavirus sequences are indeed found in genital lesions of Israeli patients, although to a lesser extent than in other countries, especially for benign lesions and invasive carcinomas. Although HPVs may have a causative role in the development of genital lesions, also in this low tumor incidence area, other factors should be also considered in the etiology of these lesions.

Condylomata Acuminata↗
PubMed1988

Concurrence of ovarian cancer and dermatomyositis. A report of two cases and literature review.

The concurrence of dermatomyositis and ovarian carcinoma deserves special attention owing to the gravity of its prognosis. Until now, only scattered case reports on women suffering from this disease combination had been published. In this paper the information available in the literature on 28 women afflicted with these diseases is collated. In addition, two such patients treated in our hospital are described in detail. The review highlights the various aspects of this disease combination, emphasizing the quadrupled incidence, advanced stage and uniform epithelial origin of the malignancy as compared with that in the general female population with ovarian carcinoma. The value of a meticulous gynecologic evaluation was proven in one of our patients with dermatomyositis; in her, ovarian carcinoma was detected in its early phase.

Adult↗
PubMedDate not supplied

Successful full-term pregnancy in familial Mediterranean fever complicated with amyloidosis: case report and review of the literature.

Pregnancy during familial Mediterranean fever complicated with amyloidosis and severe nephrotic syndrome is rare and may cause several maternal and fetal complications. Asymmetrical intrauterine growth retardation, superimposed preeclampsia, thromboembolic phenomena, resistant anemia and renal failure only partially represent the possible complications. A successful outcome of a full-term pregnancy is presented and the efficiency of colchicine, a high protein diet, acetylsalicylic acid and dipyridamole is discussed.

Adult↗
PubMedDate not supplied

The human sperm hypoosmotic swelling test: its practical application and suggestions for improvement.

Semen samples of 209 males of infertile couples were evaluated by the sperm hypoosmotic swelling (HS) test, the in vitro human sperm zona-free hamster ovum penetration assay (SPA), and by the three main parameters of the spermatogram (concentration, motility, and morphology). Whereas the HS test and SPA were poorly correlated with one another, the former showed a correlation with motility, particularly in oligo-, astheno-, and teratospermic semen samples. The simple and inexpensive HS test may prove a worthwhile tool in the diagnosis of male infertility.

Humans↗
PubMedDate not supplied

The pattern of serum melatonin levels during ovarian stimulation for in vitro fertilization.

OBJECTIVE: To characterize the relationship between the pineal gland hormone, melatonin, and gonadal hormones. METHODS: We studied the pattern of serum melatonin at the time of ovarian stimulation for in vitro fertilization. Blood samples were obtained every morning, from 20 healthy women during the in vitro fertilization cycle. RESULTS: A progressive rise in serum estradiol and prolactin was noted in all IVF cycles, while serum melatonin levels remained unchanged throughout the cycles. In two of the subjects the circadian rhythm of serum melatonin was assessed at 4-hour intervals for 24 hours. In both subjects the melatonin rhythm was remarkably consistent in terms of phase, amplitude, and total melatonin secreted during the treatment cycles. CONCLUSIONS: These results indicate that endogenous estradiol, progesterone, and prolactin do not affect the levels or circadian phase of melatonin secretion in humans.

Adult↗