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Is It Possible to Predict the Outcome of IVF Treatment in Poor Response Patients?  [PDF]
Adi Uretzky, Avraham Harlev, Limor Man, Eitan Lunenfeld, Iris Har-Vardi, Michael Friger, Eliahu Levitas
Open Journal of Obstetrics and Gynecology (OJOG) , 2014, DOI: 10.4236/ojog.2014.412098
Abstract:

Poor ovarian response (POR)—retrieval of 3 or fewer eggs, is a challenging issue in IVF. A retrospective study included POR women who underwent 386 IVF cycles. The data were classified in four groups according to women’s age (years) during the treatment cycle: 1) 20 - 34 (n = 133), 2) 35 - 39 (n = 133), 3) 40 - 42 (n = 78), 4) 43 - 47 y (n = 42), and correlated with the characteristics of the population. The clinical pregnancy rates for groups 1, 2, 3, and 4 were: 23.3%, 12%, 2.6%, 4.8%, respectively. It was found to be significantly higher (p < 0.001) comparing group 1 with group 3 patients. The “take home baby” rate was much lower (p < 0.001) in group 3; there were no deliveries in group 4. Delivery rates for groups 1, 2, 3, and 4 were: 19.5%, 10.5%, 1.3% and 0%, respectively. Intraabdominal adhesions were more common (p = 0.005) as the cause of infertility in group 3 women compared to groups 2 and 1: 24.4% compared with 9% and 9.8%, respectively. According to multivariate regression analysis, the parameters that negatively reflect on the pregnancy rate in POR women are intraabdominal adhesions, POR in the past, and increased age. We suggest encouraging young POR patients to pursue IVF treatments since the “take home baby” rates are reasonably good.

First Trimester Pregnancy Loss May Temporary Reduce the Ovarian Response during the Subsequent IVF Cycle  [PDF]
Dina Levitas, Avi Harlev, Michael Friger, Iris Har-Vardi, Atif Zeadna, Eliahu Levitas
Open Journal of Obstetrics and Gynecology (OJOG) , 2018, DOI: 10.4236/ojog.2018.84038
Abstract: The aim of this study was to compare the in vitro fertilization (IVF) cycles ended by miscarriage with subsequent IVF cycles in relation to various IVF cycle parameters and pregnancy termination modalities. Comparison of pre-miscarriage to post-miscarriage IVF cycles parameters demonstrated that lower peak E2 levels (1087 ± 593 versus 1237 ± 676 pg/ml, respectively; p < 0.05) were achieved in the post miscarriage cycles despite higher total gonadotropin consumption (2341 ± 1488 versus 2115 ± 1101 IU; p <0.05). A greater endometrial thickness (10.4 ± 2.16 versus 9.98 ± 1.74 mm, respectively; p < 0.05) and a higher number of embryos (4.62 ± 2.63 versus 3.78 ± 2.54, respectively; p < 0.05) were observed in the pre-miscarriage cycles. A comparison of IVF parameters between the first and second IVF cycles following miscarriage showed an increase in peak estradiol level (954 ± 800 and 1257 ± 838 pg/ml, respectively; p < 0.05), an increased number of retrieved oocytes (7.38 ± 4.2 and 10.49 ± 4.99, respectively; p < 0.05), more fertilized embryos (3.87 ± 2.38 and 5.66 ± 3.64, respectively; p < 0.05), and an increase in the conception rate (34.7% versus 42.2%, respectively) at the second post-miscarriage IVF cycle.
The Effect of Acupuncture on Blood Pressure in Hypertensive Patients Treated in a Complementary Medicine Clinic
Nirit Weil,Michael Friger,Yan Press,Dror Tal
Integrative Medicine Insights , 2007,
Abstract: Background: Hypertension is a major health problem with serious medical and financial consequences. Experimental studies in animals and clinical studies in humans have demonstrated that acupuncture can reduce blood pressure significantly in hypertensive patients. The objective was to assess the effect of acupuncture on blood pressure in hypertensive patients treated at a complementary medicine clinic.Methods: Blood pressure values measured before and following acupuncture were recorded from the charts of hypertensive patients who came to the clinic for treatment of other problems. The therapy used was the Kiiko Matsumoto technique for blood pressure imbalance.Results: Twenty-nine patients were studied (18 [62%] women). The mean age was 58.5 ± 16.3 years. Systolic blood pressure dropped significantly as a result of the treatment and there was a non-significant trend to reduced diastolic pressure. Weekly acupuncture therapy led to a continuous reduction in systolic blood pressure.Conclusions: Acupuncture has a beneficial effect on hypertension, particularly on systolic pressure. Further studies with larger study groups for longer periods of time can confirm this observation and contribute to our understanding of combination therapy with acupuncture and conventional medications for hypertension.
Elderly patients undergoing mechanical ventilation in and out of intensive care units: a comparative, prospective study of 579 ventilations
David Lieberman, Liat Nachshon, Oleg Miloslavsky, Valery Dvorkin, Avi Shimoni, Julian Zelinger, Michael Friger, Devora Lieberman
Critical Care , 2010, DOI: 10.1186/cc8935
Abstract: All mechanically invasive ventilated elderly (65+) medical patients in the hospital were included in a prospective, non-interventional, observational study.Of the 579 ventilations, 283 (48.9%) were done in ICUs compared with 296 (51.1%) in non-ICU wards. The percentage of ICU ventilations in the 65 to 74, 75 to 84, and 85+ age groups was 62%, 45%, and 23%, respectively. The decision to ventilate in ICUs was significantly and independently influenced by age (Odds Ratio (OR) = 0.945, P < 0.001), and pre-hospitalization functional status by functional independence measure (FIM) scale (OR = 1.054, P < 0.001). In-hospital mortality was 53.0% in ICUs compared with 68.2% in non-ICU wards (P < 0.001), but the rate was not independently and significantly affected by hospitalization in ICUs.In Israel, most elderly patients are ventilated outside ICUs and the percentage of ICU ventilations decreases as age increases. In our study groups, the lower mortality among elderly patients ventilated in ICUs is related to patient characteristics and not to their treatment in ICUs per se. Although the milieu in which this study was conducted is uncommon today in the western world, its findings point to possible means of managing future situations in which the demand for mechanical ventilation of elderly patients exceeds the supply of intensive care beds. Moreover, the findings of this study can contribute to the search for ways to reduce costs without having a negative effect on outcome in ventilated elderly patients.Mechanical ventilation is the highest priority indication for admission to ICUs according to accepted guidelines [1]. In Israel the shortage of ICU beds, taken together with the growing number of patients who need them, has led to a state in which the threshold for ICU-refusal for ventilated elderly patients is much lower than might be expected in accordance with the consensus statement [2]. As a result, a significant percentage of ventilated elderly patients are treated out
The Effect of Acupuncture on Blood Pressure in Hypertensive Patients Treated in a Complementary Medicine Clinic
Nirit Weil, Michael Friger, Yan Press, Dror Tal, Tammy Soffer and Roni Peleg
Integrative Medicine Insights , 2012,
Abstract: Background: Hypertension is a major health problem with serious medical and financial consequences. Experimental studies in animals and clinical studies in humans have demonstrated that acupuncture can reduce blood pressure significantly in hypertensive patients. The objective was to assess the effect of acupuncture on blood pressure in hypertensive patients treated at a complementary medicine clinic. Methods: Blood pressure values measured before and following acupuncture were recorded from the charts of hypertensive patients who came to the clinic for treatment of other problems. The therapy used was the Kiiko Matsumoto technique for blood pressure imbalance. Results: Twenty-nine patients were studied (18 [62%] women). The mean age was 58.5 ± 16.3 years. Systolic blood pressure dropped significantly as a result of the treatment and there was a non-significant trend to reduced diastolic pressure. Weekly acupuncture therapy led to a continuous reduction in systolic blood pressure. Conclusions: Acupuncture has a beneficial effect on hypertension, particularly on systolic pressure. Further studies with larger study groups for longer periods of time can confirm this observation and contribute to our understanding of combination therapy with acupuncture and conventional medications for hypertension.
Exploratory Spatial Data Analysis of Congenital Malformations (CM) in Israel, 2000–2006
Keren Agay-Shay,Yona Amitai,Chava Peretz,Shai Linn,Michael Friger,Ammatzia Peled
ISPRS International Journal of Geo-Information , 2013, DOI: 10.3390/ijgi2010237
Abstract: Congenital Malformations (CM) impose a heavy burden on families and society. Identification of spatial patterns of CM is useful for understanding the epidemiology of this public health issue. In Israel, about 1,000,000 births and 25,000 CM cases at 37 groups were geocoded during 2000–2006. These were geo-analyzed using global-Moran’s-I statistics. Eight groups demonstrated geospatial heterogeneity and were further analyzed at both the census tract (Local Indicator of Spatial Association (LISA) and hot spot analyses) and street levels (spatial scan statistics with two population threshold sizes). The positional definition of results is further discussed in relevance to possible exposure to teratogenic sources in the region. Limitations of data and methods used are presented as well.
Predictors of survival after emergency department thoracotomy in trauma patients with predominant thoracic injuries in Southern Israel: a retrospective survey
Evgeni Brotfain,Leonid Koyfman,Leonid Ruderman,Mahmud Abu Saleh,Michael Friger,Moti Klein,Yael Refaely
- , 2019, DOI: 10.2147/OAEM.S192358
Abstract:
Assessing access to paediatric trauma centres in Canada, and the impact of the golden hour on length of stay at the hospital: an observational study
Ian Pike,Michael Friger,Nadine Schuurman,Natalie L Yanchar,Ofer Amram
- , 2016, DOI: 10.1136/bmjopen-2015-010274
Abstract: Objectives In Canada injuries are a leading cause of death and morbidity among the paediatric population. Trauma systems have been established across North America to provide comprehensive injury care and to lead injury control efforts. However, not all populations have equal access to trauma care services. This is an observational study with the aim of assessing the impact of geographical access to paediatric trauma centres (PTCs) on patient outcomes, and to determine spatial access to PTCs across Canada. Setting To examine the relationship between access to PTC and injury outcome, length of stay at the PTC was determined for all injured patients who live within and outside of 60？min driving time of the PTC. To determine spatial access to PTCs across Canada, a list of level 1 and 2 PTCs was identified across Canada. A 1？h driving time catchment was created around each PTC in order to estimate spatial accessibility. Participants Hospital administration data sets from British Columbia (BC) and the Nova Scotia (NS) trauma registry were used to assess the impact of spatial access on paediatric injury (ages 0–15？years) outcomes. The data sets provided case-level data including the Injury Severity Score, postal code of place of residence, age and length of hospital stay. Results In NS and BC, average length of stay at the hospital is significantly lower inside 60？min driving time compared to outside of 60？min driving time from a PTC (p<0.05, using a non-parametric t test). In Canada, approximately 65% of the paediatric population resides within 1？h of a PTC. Conclusions This paper highlights differences in injury outcomes as a result of access. However, further investigation is needed as other considerations such as type of injury, age and/or gender may also affect injury outcomes
Quality of life at the dead sea region: the lower the better? an observational study
Avital Avriel, Lior Fuchs, Ygal Plakht, Assi Cicurel, Armando Apfelbaum, Robert Satran, Michael Friger, Dimitry Dartava, Shaul Sukenik
Health and Quality of Life Outcomes , 2011, DOI: 10.1186/1477-7525-9-38
Abstract: To assess the prevalence of chronic diseases and the quality of life of residents of the Dead Sea region compared with residents of the Ramat Negev region, which has a similar climate, but is situated 600 meters above sea level.An observational study based on a self-administered questionnaire. Data were collected from kibbutz (communal settlement) members in both regions. Residents of the Dead Sea were the study group and of Ramat Negev were the control group. We compared demographic characteristics, the prevalence of different chronic diseases and health-related quality of life (HRQOL) using the SF-36 questionnaire.There was a higher prevalence of skin nevi and non-inflammatory rheumatic diseases (NIRD) among Dead Sea residents, but they had significantly higher HRQOL mean scores in general health (68.7 ± 21 vs. 64.4 ± 22, p = 0.023) and vitality (64.7 ± 17.9 vs. 59.6 ± 17.3, p = 0.001), as well as significantly higher summary scores: physical component score (80.7 ± 18.2 vs. 78 ± 18.6, p = 0.042), and mental component score (79 ± 16.4 vs. 77.2 ± 15, p = 0.02). These results did not change after adjusting for social-demographic characteristics, health-related habits, and chronic diseases.No significant difference between the groups was found in the prevalence of most chronic diseases, except for higher rates of skin nevi and NIRD among Dead Sea residents. HRQOL was significantly higher among Dead Sea residents, both healthy or with chronic disease.The Dead Sea (DS) region has a unique climate. Its special therapeutic climatic advantages are recognized throughout the world. For many years this geographical area has served as a climatotherapy center for the treatment of various skin and rheumatic diseases [1-4], as well as pulmonary, cardiovascular, and gastrointestinal diseases [5-8].The DS is situated in the Syrian-African Rift Valley. At 410 meters below sea level it is the lowest place in the world. Its geographic and meteorological characteristics generate a rar
Antioxidants and Polyphenols: Concentrations and Relation to Male Infertility and Treatment Success
Avi Harlev,Batel Hamou,Eli Levitas,Iris Har-Vardi,Michael Friger,Oshra Saphier,Tali Silberstein,Tamar Barac
- , 2016, DOI: 10.1155/2016/9140925
Abstract:
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