In 10 patients with chronic renal failure (CRF), undergoing hemodialysis, we studied respiratory muscle strength and endurance. The data obtained was compared with those acquired from 10 age-, sex-, weight- and height-matched normal volunteers. Maximal static inspiratory pressures (PI_max) measured at residual volume and maximal static expiratory pressures (PE_max) measured at total lung capacity were significantly lower in the CRF group, 58.2 ± (SD)24.9 and 50.8 ± (SD)24.2% of predicted, respectively (p < 0.005, p < 0.01). There was a significant correlation between PI_max and PE_max (r = 0.827, p < 0.001), indicating similar involvement of both inspiratory and expiratory muscle groups. Maximal voluntary ventilation (MVV), although 84.4% of the predicted value in the CRF group, was significantly lower than in the control group, where it was 114% of predicted (p < 0.001). MVV also correlated significantly with PI_max and PE_max (r = 0.764, p < 0.001 and r = 0.807, p < 0.001, respectively). All but one CRF patient had elevated serum inorganic phosphorus levels, and a significant correlation was found between the serum inorganic phosphorus levels and PI_max and PE_max (r = 0.718, p < 0.001). These data indicate that there is an impairment of respiratory muscle strength and endurance in patients with CRF which may predispose the patient to respiratory muscle fatigue

The aim of this study was to develop and validate a rapid and sensitive real-time PCR method for detection of all known species of dermatophytes, including identification of Trichophyton rubrum and Trichophyton interdigitale. Fungal DNA was extracted directly from clinical samples by using a pre-lysis step, followed by automated DNA extraction on the MagNA Pure Compact. In total, 202 clinical samples were examined by both conventional culture and by the new PCR method. In 103 (51%) of the samples fungal nucleic acid was detected by PCR, while only 79 (39%) were found to be positive by culture. Out of 103 PCR-positive clinical samples, 94 (91%) were identified as T. rubrum and eight (8%) as T. interdigitale. This real-time PCR is far more sensitive and 2-4 weeks faster than conventional culture for detection of dermatophytes present in clinical samples.

Asthma in pregnancy has been associated with maternal and fetal morbidity and mortality. This study examines the relations of asthma in pregnancy, its severity and its treatment to the labor process, maternal and fetal parameters. Hundred and one consecutive asthmatic women, who gave birth to single babies between November 1993 and November 1994 at the Soroka Medical Center were studied. A group of 77 nonasthmatic women, matched for age and ethnic origin, who gave birth to single babies during the same period served as controls. A larger percentage of asthmatic women suffered from respiratory and urinary tract infections than in the control group (p < 0.001). Severe asthma was associated with a higher rate of infections than milder asthma (p = 0.01). The incidence of smoking was higher among asthmatic women than among controls (p = 0.037). No association was found between socioeconomic status and smoking or infections. No association was found between maternal asthma or maternal use of corticosteroids and the following: maternal hypertension, maternal diabetes, low birth weight (<2,500 g), preterm delivery (<37 weeks), adequacy of weight to gestational age and Apgar scores. Three infants with congenital heart defects were born to asthmatic mothers. When the presentation of the fetus was not cephalic, all the asthmatic women were delivered by cesarean section, versus only 60% in the control group (p = 0.08). Labor was induced with oxytocin more often in the asthma group than in the control group (p = 0.07). We conclude that the labor and neonatal outcome in pregnant asthmatic women treated medically is good, even when asthma is severe and when the patient is treated with corticosteroids. There is, however, a relation between asthma in pregnancy, especially if severe, and predisposition to infections.

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