bluuebunny/crossref_metadata_2025 huggingface dataset:
Management of vesico‐uterine fistulae: a report of six cases
Authors: Kumar A. , Vaidyanathan S. , Sharma S.K. , Sharma A.K. , Goswami A.K.
Published: April 2004

Six cases of vesico‐uterine fistulae caused by cesarean section in four and pelvic trauma in two cases were treated during the past 15 years. Both the cases of vesico‐uterine fistulae due to pelvic trauma and one case of vesico‐uterine fistula due to cesarean section in whom the fistula was detected in the early post‐operative period, could be managed successfully by suprapubic urinary diversion and control of infection. Two patients who were seen more than 1 year after the cesarean section, were cured by trans‐abdominal closure of the fistula with omental interposition. One patient who reported 3 months after the cesarean section was managed by estrogen and progesterone‐induced amenorrhea. The management protocol for vesico‐uterine fistula should thus be individualised taking into consideration the etiology, and time interval between its occurrence and institution of treatment regimen.
Interval insertion of an intrauterine contraceptive device following cesarean section
Authors: Holloway G.A. , Goldstuck N.D. , Bowen D.
Published: April 2004

Two previous studies of interval insertion of intrauterine contraceptive devices (IUCD) in women with previous cesarean delivery produced conflicting results. We studied the first and subsequent segment IUCD performance in 215 women with one or more cesarean deliveries. All the insertions were performed by doctors in the outpatient department of the hospital. The follow‐up rate at 6 months was over 80%. There was a higher than expected expulsion rate of 19 per 100 insertions in the first 12 months, in both the first and subsequent segments. Other IUCD related problems were in keeping with expectations. The IUCD nonetheless remains a useful contraceptive option for these women.
Pneumoperitoneum due to peritoneovaginal fistula following hysterectomy
Authors: Massad L.S. , Santoriello K. , Berchuck A.
Published: April 2004

A patient with pneumoperitoneum that developed due to peritoneovaginal fistula following hysterectomy is presented. In addition, we have reviewed the literature and formulated guidelines for the management of this problem. Most patients present following sexual intercourse and in many cases the fistula can be diagnosed radiographically. Laparotomy may be avoided if the cause of the fistula is suspected. Surgical closure of the fistula may be unnecessary since spontaneous closure occurs frequently.
Fertility after ectopic pregnancy in an African population
Authors: Ogunniyi S.O. , Faleyimu B.L.
Published: April 2004

Cases of ectopic pregnancy were studied retrospectively at the Obafemi Awolowo University Teaching Hospitals Complex, Ile‐Ife, Nigeria, for the period from January 1, 1977 to June 30, 1987. The records of 108 patients who had at least 1 year of follow‐up were reviewed to determine their subsequent reproductive performance. Thirty‐eight patients (35.9%) subsequently conceived, 15 (13.9%) had recurrent ectopic pregnancy, 21 (19.4%) delivered at term, and 40 (37%) remained secondarily infertile. Thirty patients were sterilized or using contraception.
Cost effectiveness of ambulatory uterine activity monitoring
Authors: Morrison J.C. , Martin J.N. , Martin R.W. , Hess L.W. , Gookin K.S. , Wiser W.L.
Published: April 2004

A cost analysis is presented comparing 34 patients who received uterine activity monitoring versus 33 patients who attempted to detect uterine activity by palpation. All patients were at high risk for preterm delivery and were given the same educational information and prenatal care regarding signs and symptoms of preterm labor. The results revealed an increase in newborn days (640) and cost to those patients who were in the self‐palpation group ($13,364) compared to monitored parturients (268 days and $8,633). The difference was attributed to neonatal morbidity from an increased number of preterm deliveries > 26 weeks but < 37 weeks (P = 0.04). The increase in NICU days was significant (P = 0.03). No difference in normal newborn costs for infants delivered after > 33 weeks could be detected between the two groups, but morbidity was increased among control infants delivering between 34 and 36 weeks. Uterine activity monitoring to prevent preterm birth appears to be medically effective and reduces cost.
Ogilvie's syndrome in the postcesarean section patient
Authors: Rodriguez‐Ballesteros R. , Torres‐Bautista A. , Torres‐Valadez F. , Ruiz‐Moreno J.A.
Published: April 2004

Two cases of colonic pseudo‐obstruction (the so‐called Ogilvie's syndrome) are reported. Both patients were in the immediate postcesarean section puerperium. The importance of early diagnosis in these cases is stressed, because this complication has a high mortality rate, frequently in relation to delayed diagnosis and treatment. One patient was successfully treated with conservative measures because diagnosis was made early. A plain X‐ray abdominal film which shows cecum dilatation, with or without ascending and transverse colon dilatation, and no distal air, makes the diagnosis. A cecum diameter of 9 cm or more is a surgical indication, because the possibility of wall perforation is high. Surgical techniques are: puncture decompression or cecostomy. When cecum diameter is less than 9 cm, non‐surgical measures (nasogastric suction, correction of any fluid and electrolytic imbalance, and maybe a flatus tube) are indicated. Observation through repeated X‐ray abdominal films shows when the surgical indication appears: (1) failure of the conservative treatment (cecal distension continues or increases); or (2) cecal perforation is documented.
Recurrent trophoblastic neoplasia
Authors: Nalini V. , Dasan J. , Mathura Vani K.
Published: April 2004

An unusual case of recurrent benign trophoblastic growth occurring for the fourth time in a gravida 4, para 0, 30‐year‐old woman is reported. Prophylactic chemotherapy was instituted to avert the disaster again, without success. The question of her future obstetric outcome poses a formidable dilemma and no radical measures could be undertaken, as the patient hoped for a normal pregnancy.
Eclampsia and fetal sex
Authors: López‐Llera M.M.
Published: April 2004

The study of the possible importance of the sex of the fetus on the frequency and clinical characteristics of 777 singleton pregnancies complicated by antepartum eclampsia showed that; (1) the male to female ratio for the total group was 1.23/1, (2) this figure was 1.27/1 in first pregnancies and 1.32/1 in patients less than 20 years old, (3) the ratio increased to 1.44/1 in women more than 30 years of age, and (4) in contrast, 169 postpartum eclampsia cases had a male to female ratio of 1.07/1. There were no statistically significant differences in the obstetric profiles, the main eclamptic symptoms or the fetomaternal mortality figures attributable to the sex of the fetus. However, since eclampsia is more severe in older women, the clinician may see more complications and maternal deaths associated with male fetuses because of their significantly higher ratio. In addition, these findings suggest that the presence of a male fetus with a hormonal and genetic code more different from the mother than with female offspring may be an accessory to the fundamental causes of this disease.
Anamnestic pregnancy risk assessment
Authors: de Caunes F. , Alexander G.R. , Berchel C. , Guengant J.P. , Papiernik E.
Published: April 2004

Based on data obtained from the 1984–1985 Guadeloupean Perinatal Audit, a pregnancy risk scoring system was developed using maternal demographic, socioeconomic, obstetric history and risk characteristics recorded at the first prenatal visit. Various combinations of risk factors were identified for four distinct pregnancy outcomes (perinatal mortality, low birth weight, preterm delivery and intra‐uterine growth retardation). The findings emphasize the importance of developing risk assessments for discrete pregnancy outcomes within specific populations.
Comparative study of Filshie clip and Pomeroy method for postpartum sterilization
Authors: Yan J.‐S. , Hsu J. , Yin C.S.
Published: April 2004

A prospective randomized comparison of the peri‐operative complications and long‐term sequelae between the Filshie clip and Pomeroy methods was undertaken in 200 postpartum women at Tri‐Service General Hospital, Taipei, Taiwan. The peri‐operative complications in either group were mild and infrequent. One pregnancy in the Pomeroy group was reported after follow‐up for 24 months. No significant difference between the two groups was found in respect to long‐term sequelae.
The commitment to breastfeeding
Authors: Brady N.C.
Published: April 2004

The Agency for International Development (A.I.D.) is increasing its efforts to promote breastfeeding, as part of its child survival initiatives in child spacing, diarrheal disease control, and nutrition. Research suggests that promotion can increase breastfeeding rates. The Agency, for the first time, has set aside funds specifically for breastfeeding promotion and is working to identify places in its programs where such promotion can take place.
The effect of breastfeeding promotion on the infertile postpartum period
Authors: Perez A.
Published: April 2004

A new project is testing whether a breastfeeding promotion program will change breastfeeding behavior and the length of postpartum amenorrhea. The control group and 100 of the eventual 400 experimental subjects have been recruited. The program consists of workshops, prenatal care, maternity ward postpartum care, early home visits, and a breastfeeding outpatient clinic. Early results seem to indicate decreased use of pacifiers and foods and fluids other than breast milk by women in the study group.
Breastfeeding trends and the breastfeeding promotion program in the Philippines
Authors: Williamson N.E.
Published: April 2004

Breastfeeding duration and incidence have declined in the Philippines since 1973, particularly in urban, better‐educated, and higher income groups. As more and more women move into these modern groups breastfeeding may continue to decline, making attempts to decrease fertility more difficult. The National Movement for the Promotion of Breastfeeding seeks to overcome the declines by encouraging a wide range of breastfeeding promotion activities including improving hospital practices and implementing a 5‐year plan.
A midwife's view of the history of modern breastfeeding practices
Authors: Fisher C.
Published: April 2004

The author finds that three things make breastfeeding successful: the mother's desire; correct positioning of the baby; and the baby's control of time at the breast. Restrictions of feeding time originated early in this century. Combined with descriptions of babies sucking from the nipple instead of the breast, misinformation has spread about breastfeeding in spite of correct knowledge being available. A review of textbooks and articles should be undertaken.
Food supplementation programs and breastfeeding practices
Authors: Marchione T.J.
Published: April 2004

There has been insufficient evaluation of food supplementation programs and their effect on breastfeeding. On the one hand, they reach millions of childbearing women, often in rural areas with little or no other services, and act as a magnet for other health interventions to take place. On the other hand, the risks of substituting food assistance for breast milk and overburdening health personnel with feeding responsibilities, contradict breastfeeding promotion efforts. There is some evidence that focusing on pregnant women rather than infants will reduce these problems and will result in fewer low birth weight babies and better capacity for the mother to produce breast milk.
Technical working group D report: Government and donor support for breastfeeding in health and health‐related programs
Authors: Hogan Robert , Cravero Kathleen , Dabbs Carol
Published: April 2004

The purpose of this working group was to design a general strategy for government and donor support for breastfeeding promotion in health‐related and other non‐maternity health programs. First, it is important to examine the reasons why governments and donor agencies accept or reject programs to support.
Twin gestations and prophylactic hospitalization
Authors: Younis J.S. , Sadovsky E. , Eldar‐Geva T. , Mildwidsky A. , Zeevi D. , Zajicek G.
Published: April 2004

The study evaluates the benefit of elective hospitalization in preventing premature deliveries of twin gestations. Three groups of women with twin gestations, having no other complications of pregnancy which could cause premature delivery, were evaluated. The study group was comprised of 43 women who were electively hospitalized between 30—32 and 36 weeks of gestation. Control group 1 was comprised of 55 women who were not hospitalized but were instructed to rest at home. Control group 2 was comprised of 53 women who were not hospitalized and were not instructed to rest at home. Our results showed that elective hospitalization did not significantly affect the gestational duration or the prematurity rate. However the mean birthweight difference between the study group and the two control groups were 143 ± 83 g and 205 ± 84 g, respectively. This result was more significant in multiparous women. The slight increase in birthweight of the hospitalized women compared to the controls, does not seem to justify the cost of hospitalization.
Gravid uterus in an anterior abdominal wall hernia of a Nigerian woman
Authors: Dare F.O. , Makinde O.O. , Lawal O.O.
Published: April 2004

A case of a gravid uterus in an incisional hernia in the anterior abdominal wall of a 27‐year‐old Nigerian woman is presented. The patient developed an ulceration of the anterior abdominal wall necessitating prolonged hospitalization. She was delivered by emergency lower segment cesarean section at 35 weeks gestational age because of premature labor. The patient unfortunately died from primary postpartum hemorrhage.
Post‐molar trophoblastic disease following coexisting molar pregnancy and living fetus subsequent to clomiphene citrate therapy
Authors: Grenman S.E. , Salmi T. , Meurman L.
Published: April 2004

A case of the cominbation of a complete hydatidiform mole and a coexisting, living fetus arising from a twin pregnancy, subsequent to clomiphene citrate therapy for ovulation induction, is presented. The diagnostic problems of this combination as well as the incidence of molar pregnancy following the use of ovulation inducers are discussed.
Early termination of pregnancy: medical induction with prostaglandins versus surgical aspiration under local anesthetic
Authors: Hill N.C.W. , MacKenzie I.Z.
Published: April 2004

Termination of pregnancy at 4–8 weeks gestation in 1085 patients using either local prostaglandin instillation (n = 820) or uterine aspiration under local anesthetic (n = 265) have been analyzed. Morbidity for both methods was similar although the incidence of side‐effects (0.4%) and the transfusion rate (0%) were lower after aspiration than the respective rates of 59% and 1.3% after prostaglandin treatment. However the rates of genital tract trauma (0.75%) and uterine sepsis (1.8%) after aspiration were higher than the respective rates of 0.3% and 0.9% after prostaglandin treatment. The major disadvantage of prostaglandin treatment was the rate of re‐admission for evacuation (8.5%) compared with (0.9%) after aspiration, although patient acceptability for both techniques was similar. In view of the advantages, more widespread use of both methods of termination is indicated.
Pre‐eclampsia, hypertension and the premenstrual tension syndrome
Authors: Andersch B. , Svensson A. , Hansson L.
Published: April 2004

A total of 261 of 17,000 pregnancies were complicated by pre‐eclampsia/hypertension in pregnancy. Seven to twelve years later 237 were available for follow‐up together with 33 women, who had a normotensive pregnancy in 1969–1973. The association between pre‐eclampsia/hypertension and the premenstrual tension syndrome has been studied. Women with present hypertension complained significantly (P < 0.05) more of premenstrual sadness than the normotensive women. However, women with previous pre‐eclampsia/hypertension in pregnancy did not have more premenstrual symptoms than women in general, on the contrary, women with a history of severe pre‐eclampsia had less symptoms.
C‐reactive protein is a marker for the diagnosis of adnexitis
Authors: Schmidt‐Rhode P. , Schulz K.‐D. , Sturm G. , Prinz H.
Published: April 2004

The study reports the C‐reactive protein (CRP) plasma concentrations in 115 women with a presumed diagnosis of acute adnexitis. In addition to CRP, blood sedimentation rate, white blood cell count and the body temperature were evaluated and compared with the clinical findings. Diagnosis was confirmed or excluded by laparoscopy (n = 69) or laparotomy (n = 9). Clinical examinations and conventional laboratory examinations were of limited value in the diagnosis of acute adnexitis. In contrast, CRP was a highly sensitive indicator of inflammatory pelvic disease. Furthermore, the CRP determination was superior in assessing the efficacy of an antibiotic treatment.
Urinary surge of human luteinizing hormone in infertile women
Authors: Okamura T. , Kigasawa K. , Takeuchi T. , Nishii O. , Yaginuma T.
Published: April 2004

An improved semiquantitative immunoassay method allows human luteinizing hormone (hLH) in urine to be detected from 2.5 to 640 mIU/ml has developed. With this method, the hLH surges in every 3 h urine samples while awake were measured in 8 normal and 12 infertile women. The result was that the urinary hLH surge in infertility was insufficient regardless of the high urinary E2 value. This result may play, at least in part, an etiologic role in infertility.
Determinants of low birthweight among the Mendi of Sierra Leone: implications for medical and socio‐economic strategies
Authors: Aitken I.W.
Published: April 2004

In order to identify the most appropriate interventions to reduce the amount of low birthweight among the Mendi people of Sierra Leone, the seasonal pattern of birthweights has been studied in three hospitals and compared with the incidence of known risk factors. Malaria and pregnancy‐induced hypertension are shown to contribute to the excess low birthweight during the rainy season, particularly in primiparous women. There are no significant seasonal food shortages in this population and the best correlate for the bimodal seasonal excesses of low birthweight is the amount of agricultural work performed by the women during planting and harvesting. The significance of this for the choice of strategies to increase agricultural productivity is discussed.
A study of the menstrual patterns of adolescents in Ile‐Ife, Nigeria
Authors: Thomas K.D. , Okonofua F.E. , Chiboka O.
Published: April 2004

Questionnaires and interviews with 768 female students in residence at the Obafemi Awolowo University, Ile‐Ife, Nigeria revealed that the mean and median ages of menarche were respectively 13.4 ± 1.4 and 13.5 years and 80.8% had menstrual cycles between 25 and 35 days. The duration of menstrual bleeding was 4.5 ± 0.8 days; 72.3% had dysmenorrhea and 17.8% complained of nausea and vomiting during menstruation.
Carcinoma of the cervix and pregnancy
Authors: Baltzer J. , Regenbrecht M.E. , Kopcke W. , Zander J.
Published: April 2004

A simultaneous occurrence of carcinoma of the cervix and pregnancy is uncommon. In a cooperative study a total of 1092 patients treated for cervical cancer were examined. Forty of these women were either pregnant at the time of surgery or were operated on postpartum. The course of the disease for these patients was compared to that of 426 non‐pregnant women with cervical cancer. The analysis of tumor grading and tumor growth revealed no remarkable differences. Remarkable, however, was the increased frequency of blood vessel invasion observed in pregnant patients, particularly in puerperal patients. Also the percentage of macrometastases was higher in puerperal and/or postpartum patients. These findings might explain the worse prognosis for these women.
Amniotic fluid and maternal plasma prostaglandins in hypertonic saline‐induced abortion
Authors: Ivanisevic M. , Djelmis J.
Published: April 2004

Intraamniotic instillation of 20% sodium chloride solution was carried out in 12 women within the 16th to 18th weeks of pregnancy. PgE2 and PgF2α levels were monitored both in amniotic fluid 5 and 11 h following NaCl instillation as well as in the maternal plasma within the 5‐h interval up to 36 h after instillation had been performed. A significant increase was observed of both PGE2 and PGF2α concentrations in the amniotic fluid of all women who underwent induction of abortion. PgF2α in amniotic fluid was increasing abruptly during the time of abortion, reaching the value of 249.7 ± 19.6 ng/l (n = 12; P < 0.001). Maternal plasma PgF2α showed a continuous mild increase from 20.4 ± 5.5 ng/l before to the maximum level, recorded 36 h after instillation, ranging within 205 ± 1.0 ng/l (n = 4; P < 0.001). A statistically significant increase in the levels of PgE2 and PgF2α in both amniotic fluid and maternal plasma suggests that the release of primary PGs is a pathognomonic event for initiating labor pains, maturation of the cervix in abortions induced via intra‐amniotic instillation of hypertonic NaCl solution.
Evaluation of the roll over test as predictor of gestational hypertension in African women
Authors: Okonofua F.E. , Odunsi A.O. , Hussain S. , O'Brien P.M.S.
Published: April 2004

Fifty‐six primigravid women at 28–32 weeks gestation were studied prospectively to assess the roll over test (ROT) as a predictor of gestational hypertension in African women. Blood pressures were measured continuously in the supine and left lateral positions using an automated accutor machine. ROT was positive in only two women (3.6%). These two women later developed gestational hypertension but so did 18 others who had negative ROT. Measures that may be useful in increasing the predictive value of the ROT in these women are suggested.
Carbohydrate metabolic studies in women using a levonorgestrel/ethinyl estradiol containing triphasic oral contraceptive for eighteen months
Authors: Spellacy W.N. , Tsibris J.C.M. , Ellingson A.B.
Published: April 2004

Carbohydrate metabolism was evaluated in 17 women before and after 18 months of triphasic oral contraceptive use. The triphasic oral contraceptive contained levonorgestrel and ethinyl estradiol. An oral glucose tolerance test was utilized and both plasma glucose and insulin levels were measured. There were no significant changes in the glucose levels. The fasting insulin level was raised at the 18‐month test, whereas the other insulin values were similar. These results demonstrate that the new triphasic oral contraceptive preparations produce minimal carbohydrate metabolic changes.
Prevention of postcesarean infectious morbidity with a single dose of intravenous metronidazole
Authors: Ruiz‐Moreno J.A. , Garcia‐Rojas J.M. , Lozada‐Leon J.D.
Published: April 2004

The efficacy of intravenous metronidazole for the prevention of postcesarean section infectious morbidity was studied in 100 healthy women, randomly given either the drug or a placebo. The metronidazole group received 1.0 g intravenously, immediately after cord clamping. Among the 50 patients who received metronidazole, endometritis developed in 7 (14%) as it did in 15 (30%) of the placebo group (P < 0.01); wound infection was found in 1 (2%) and 4 (8%), respectively (P < 0.01). If both infectious complications are compared together, the difference (16% versus 38%) is more significant (P < 0.001). Metronidazole was well tolerated by the mother and with this type of administration regimen, the fetus is not exposed to the drug. It is concluded that metronidazole, used as here reported, is effective in reducing the frequency of postcesarean section endometritis and wound infection with the consequent clinical and economic impacts.
Extremely large number of twists of the umbilical cord causing torsion and intrauterine fetal death
Authors: Herman A. , Zabow P. , Segal M. , Ron‐El R. , Bukovsky Y. , Caspi E.
Published: April 2004

Extremely large number of twists of the umbilical cord causing torsion of the entire length of the umbilical cord was found in two cases of intrauterine fetal death. It was twistd in one case 35 times and in the other 20 times. No additional pathology, such as stricture or abnormality of the Wharton's jelly, was found. The two mothers complained of decreased fetal movements and both newborns were found later to be growth retarded. A long cord of 120 cm was present in one case and normal length of 70 cm in the other. Close antenatal care in cases with growth retarded fetuses or decreased fetal movements may help in avoiding fetal demise in such rare cases.
Amniotic fluid turbidity: a useful adjunct for assessing fetal pulmonary maturity status
Authors: Strong T.H. , Hayes A.S. , Sawyer A.T. , Folkestad B. , Mills S. , Sugden P.
Published: April 2004

A rapid, very simple technique for establishing fetal pulmonary maturity status is presented. Among 100 receiving amniocenteses, aspiration of turbid amniotic fluid that would not permit the reading of newsprint through it was associated with a lecithin/sphyngomyelin (LS) ratio of ≥2.0, or the presence of phosphatidyl glycerol (PG) in 97% (specificity 98%, positive predictive value 97%). The authors conclude that when turbid fluid is aspirated, delay until LS and PG results are known may not be necessary.
A trial of labor after cesarean section in patients with or without a prior vaginal delivery
Authors: Bedoya C. , Bartha J.L. , Rodriguez I. , Fontan I. , Bedoya J.M. , Sanchez‐Ramos J.
Published: April 2004

OBJECTIVE: To determine the outcome of labor in women with a previous cesarean section, with or without prior vaginal delivery. METHOD: Records were reviewed for 1065 women with a previous cesarean section at ‘Virgen Macarena’ Hospital who were attended for a subsequent labor. RESULTS: Chisquared tests demonstrated that women with previous vaginal delivery (n = 346) had a significantly higher rate of vaginal delivery after a trial of labor (95.24%) than those without previous vaginal delivery (n = 719) (82.95%). All the ruptures of uterine scar (n = 4) were found in women without previous vaginal delivery. CONCLUSION: It appears that a cesarean section in a multiparous woman is not a determinant fact in her reproductive history and the risk of rupture of uterine scar did not appear to be present.
Maternal alpha‐2‐macroglobulin levels and fetal growth in Guatemala
Authors: Neel N.R. , Goldenberg R.L. , Tamura T. , Cliver S.P. , Avent K. , Hoffman H.J.
Published: April 2004

Maternal serum alpha‐2‐macroglobulin (α2M) levels were measured at the time of delivery in 244 women in the central highlands of Guatemala. Significantly higher α2M levels were found in thin women and in poor women. In multiple regression analysis controlling for gestational age, race, sex, maternal triceps skinfold thickness and socioeconomic status, high α2M levels were significantly associated with decreased birthweight. These findings agree with those in a predominantly black population in the United States and extend the relationship between α2M and decreased birth‐weight to a developing country.
Endometrial ablation for dysfunctional uterine bleeding: Role of GnRH agonists
Authors: Valle R.F.
Published: April 2004

OBJECTIVE: To discuss a new alternative to treat patients with dysfunctional uterine bleeding who fail to respond to hormonal treatments, and to outline the role of GnRH analogs in the presurgical preparation of these patients. METHOD: The causes and various hormonal treatments of dysfunctional uterine bleeding are outlined, and various methods of endometrial ablation, with hormonal and non‐hormonal preparations, are reviewed. RESULT: In endometrial ablation, while hormonal preoperative treatments are more advantagous than no endometrial suppression, GnRH analogs prepare the endometrium better by reducing thickness uniformly, decreasing edema, and avoiding pseudodecidual reaction usually present with other hormonal treatments. CONCLUSION: Because success of endometrial ablation seems to correlate with uniform destruction of endometrium and superficial portion of myometrium, thinning of the endometrium hormonally simplifies the procedure, adds in the overall success of endometrial ablation, and reduces additional blood loss by controlling the bleeding preoperatively.
Family planning and desire for additional children after cesarean section
Authors: Maier K. , Wacker J. , Bastert G.
Published: April 2004

OBJECTIVE: To determine the acceptance of contraceptives among cesarean section patients in a West African traditional environment. METHOD: Eighty‐three cesarean section patients of a regional hospital in Burkina Faso were interviewed at their homes as to their attitudes towards family planning. RESULT: In collaboration with local midwives, contraception for 2 years had been recommended to the patients. Only one woman had been using contraceptives before. After cesarean, 46 women used contraceptives and 13 had undergone tubal ligature. Contraceptive users had their next pregnancy on average 10 months later than women not practicing contraception. Patients showed a strong interest to limit their family size. None of the woman desired more than 5 children. CONCLUSION: Correct promotion provided, cesarean section patients in a traditional environment accept contraceptives and are interested in family planning.
Pregnancy after liver transplantation
Authors: Baruch Y. , Weiner Z. , Enat R. , Ronen N. , Blumenfeld Z.
Published: April 2004

Two patients who became pregnant after liver transplantation for end‐stage liver disease were carefully monitored using pulsed Doppler waveform measurements. One patient with Wilson's disease, on triple immunosuppressive therapy including prednisone, azathioprine and low‐dose cyclosporin A, delivered a healthy girl weighing 2650 g after 38 weeks' gestation. The other patient, with HBV‐related postnecrotic cirrhosis, became pregnant less than 3 months postoperatively, under triple therapy, after being amenorrheic for 6 years. Episodes of elevation in liver enzymes were noted, and severe osteoporosis with low back pain developed. A healthy boy weighing 2975 g was born at 35 weeks' gestation. Our cases add to previous reports of successful pregnancies under cyclosporin A immunosuppression.
Topical testosterone in the treatment of vulvar lichen sclerosus
Authors: Sideri M. , Origoni M. , Spinaci L. , Ferrari A.
Published: April 2004

Objectives: Comparison between 2% testosterone propionate and petrolatum ointment in the treatment of vulvar lichen sclerosus in a randomized, double‐blind, controlled clinical study. Methods: Fifty‐eight consecutive patients with histologically confirmed vulvar lichen sclerosus were enrolled. They underwent a 1‐year period of topical treatment with either medication, with clinical evaluations of symptoms and gross appearance at 2‐month intervals, followed by histological evaluation at the end of the treatment period. Statistical analysis was performed according to the chisquared test and the Student‐Newman‐Keuls test. Results: A substantial improvement in symptoms was achieved in 20 (66.6%) patients in the testosterone group and in 21 (75%) patients in the placebo group. No statistical differences were observed between the two groups. Gross changes were observed in a few cases and no case demonstrated histologic modifications. Conclusions: Petrolatum ointment is as effective as 2% testosterone in the treatment of vulvar lichen sclerosus.
Changing trends in maternal mortality over a decade
Authors: Juneja Y. , Goel U. , Sood M.
Published: April 2004

Objectives: To study the change in trend in maternal mortality over the last decade and to find out specific causes of death. Method: A retrospective study was carried out at Lady Harding Medical College, New Delhi, to analyze the causes of maternal deaths. The admission ledgers of patients admitted over two 3‐year periods (1979–1981 and 1989–1991) were studied to ascertain the total number of maternal deaths and the specific causes of death. Results: One hundred fifty‐eight deaths occurred during 1979–1981 and 149 deaths during 1989–1991. During the same period therè were 23 098 and 37 763 total births, respectively, the overall maternal mortality rate thus significantly declining from 684/100 000 total births in 1979–1981 to 394/100 000 total births in 1989–1991. Sepsis followed by hemorrhage and hepatitis were the leading causes of maternal deaths over the decade. Conclusion: Health education and availability of health services, largely at a community level, would contribute to reducing the incidence of preventable causes of maternal deaths such as sepsis and hemorrhage.
Diagnosing unruptured ectopic pregnancy
Authors: Obed S.A. , Wilson J.B. , Elkins T.E.
Published: April 2004

OBJECTIVE: A retrospective analysis of the management of ectopic pregnancy at Korle Bu Teaching Hospital in Accra, Ghana, to assess the impact of the introduction of ultrasonography as a diagnostic tool. METHODS: All charts of patients with ectopic pregnancies from 1 January 1986 to 31 December 1990 were analyzed. The management of those patients who had transabdominal ultrasonography was compared with those who had not. RESULTS: The use of ultrasonography increased the number of unruptured ectopic pregnancies from 0.3% to 8.5% (P < 0.001). This also reflected a reduction in misdiagnoses, blood transfusions, and maternal deaths. CONCLUSIONS: The reasonable use of modern technology can be of great assistance even in developing countries, as shown by the positive impact of the use of ultrasonography to aid in the diagnosis of ectopic pregnancy in Ghana, West Africa.
Herpes gestationis
Authors: Tanzi P. , Lojacono A. , Tarantini M. , Faden D.
Published: April 2004

Herpes gestationis is a rare autoimmune disease of pregnancy characterized by itching and skin lesions. The disease causes prominently maternal discomfort, but fetal and neonatal complications have been reported; however the frequency and severity of fetal illness are still debated. We describe three cases of herpes gestationis diagnosed and managed at our institution in the last 3 years.
The individuality of teenage mothers and its implication for intervention strategies
Authors: Landy Sarah , Cleland John , Schubert Josef
Published: April 2004

An exploratory longitudinal research project of teenage mothers and their infants was carried out, involving intensive study of a small number of cases. Four case studies from the research are presented which illustrate the tremendous differences between teenage mothers, their support systems and the need for and success of intervention. The cases also show the need to individualize support to teenage mothers and suggest that routine structured classes on child development and parenting skills are not always necessary or sufficient. The cases also suggest that there are at least three types of teenage mother‐infant pairs each of which will require a different level of intervention, ranging from Level I to Level IV. A plea is made for the individualization of services to teenage mothers depending on the strengths, emotional capacities and needs of the mother and her infant.
The status of identity: reflections on the need for intervention
Authors: Archer Sally L.
Published: April 2004

The primary purpose of this article is to examine the need for intervention in the context of the information we have gathered to date about identity formation. The research evidence indicates that the identity achievement status is associated with the greatest effectiveness in psychological functioning while the identity diffusion status is related to poorer functioning. The moratorium and foreclosure statuses generally occupy intermediate positions in this regard. The identity activity of adolescents and youth is also reviewed. The complexity of the identity construct is discussed as it relates to domains, developmental patterns, gender, historical and social contexts. The author uses the findings from a longitudinal study to illustrate the need for, and purposes of, intervention while respecting the richness of the identity construct of the individual.
Adolescent ego development: relationship to family cohesion and adaptability
Authors: Bakken Linda , Romig Charles
Published: April 2004

Adolescence has been a focus of research for several decades. Recently, a portion of this body of research has addressed the relationship between adolescent development and family functioning. The intent of much of this research has been the attempt to determine how family dynamics influence the developmental processes of adolescents. Adolescents' perceptions of family cohesion and adaptability, as well as their levels of satisfaction with those perceptions, have been correlated with ego development within a sample of middle adolescents. Adaptability and cohesion were found to be significantly related to ego development, but interactions among the two variables, as well as with family structure were important.
Free condoms in youth clubs in Copenhagen
Authors: Segest Erling , Mygind Ole , Jørgensen Willy , Bechgaard Maj , Fallov Joel
Published: April 2004

As a step to limit the spread of AIDS, condoms were supplied free of charge in Copenhagen in youth clubs in connection with personal advice. A representative group of young people (N = 745) and of social workers in these clubs (N = 130) were asked to complete a structured questionnaire. The investigation revealed that the young were well informed about AIDS and its prevention, but despite this, they comprise a relative risk group with regard to the spread of AIDS due to high numbers of partners and poor habits with regard to the use of condoms. The campaign was well received by both the young and the youth club social workers. There was an obvious need for a continuation of such a campaign. It is concluded that youth clubs are a good forum for AIDS information.
Family relationship patterns: perceptions of teenage mothers and their non‐mother peers
Authors: Oz Sheri , Fine Marshall
Published: April 2004

Perceptions of self and family members were determined at two time periods for a sample of 30 teenage mothers and 30 non‐mothers using the Family Relations Inventory and a family map exercise. Both at present and from childhood reminiscences, teen mothers perceived their mothers and sisters more positively than did non‐mothers; fathers and brothers of the adolescent mothers were viewed more negatively than were those of the non‐mothers. Results are discussed in light of prior explanations of adolescent motherhood with respect to family dynamics. An approach to intervention is suggested.
Moratorium‐achievement (Mama) cycles in lifespan identity development: value orientations and reasoning system correlates
Authors: Stephen Joanne , Fraser Eugene , Marcia James E.
Published: April 2004

Three important questions emerging in identity research are: Why do only some persons with Foreclosed identities move on to Identity Achievement? Why do some Identity Achievement persons move “back” to Foreclosure? How can life‐span identity re‐formulation be accounted for? This study proposes that individual's positions on two variables, “instrumental vs. experiential orientation” and formistic vs. dialectrical thinking, may be important in answering these questions. Among 60 university students, 23 males and 37 females, those in an identity status characterized by formation and maintenance of structure (Foreclosure) were instrumentally‐oriented while those characterized by openness to change and revision (Moratorium) were experientially‐oriented. Similarly, more Moratoriums than other statuses were high in dialectic thinking. These results are discussed in terms of their theoretical implications for life‐span identity development.
Sexuality and AIDS: attitudes and behaviors of adolescents in East and West Berlin
Authors: Oswald Hans , Pforr Petra
Published: April 2004

The study which was conducted in 1990 in Berlin, Germany, compares two samples of 542 adolescents from West Berlin and 340 from East Berlin. The present investigation shows that the general trend toward sexual liberality among adolescents is continuing and that necessary processes of adolescent sexual development appear not to be influenced by the threat of AIDS. Though the level of knowledge about the threat of AIDS is, on the whole, satisfactory, this does not in itself guarantee determined and consistent AIDS‐preventive behavior. Fewer than one‐third of sexually‐active adolescents, and even fewer than one‐fourth of those in the most sexually‐active group, can be described as consistent users of condoms. The attitudes of adolescents in regard to contraceptive characteristics only partly suggest a preference for condoms. When adolescents are asked directly about condoms, they additionally emphasize their effect of reducing feeling and pleasure. Adolescents with experience of sexual intercourse rate condoms more negatively than do those without such experience. However, AIDS‐education efforts can make use of the fact that consistent condom‐users expressed clearly more positive attitudes to condoms than did others. Although the comparison between East and West Berlin adolescents yielded differences in certain details, these differences are not of significance to AIDS‐education programs which seek to increase AIDS‐preventive behavior.
Self‐control and ego identity development as predictors of unprotected sex in late adolescent males
Authors: Hernandez Jeanne T. , Diclemente Ralph J.
Published: April 2004

Male college students completed an anonymous self‐report questionnaire assessing HIV‐related knowledge, attitudes, moral development, personality factors and behaviors. Bivariate analyses were used to identify factors associated with high‐risk sexual intercourse. Significant demographic psychosocial and behavioral predictors were entered into a logistic regression analysis to evaluate the independent influence of each predictor on unprotected sexual intercourse. Behavioral factors were the most powerful predictors of unprotected sexual intercourse. Adolescents reporting multiple sex partners, drinking and picking‐up sex partners were significantly more likely to engage in sex without condoms. Examining psychosocial factors alone, it was found that adolescents who had low scores for ego‐development (goal‐directedness) and self‐control were significantly more likely to engage in sex without condoms. Identification of two personality constructs as underlying predictors of high‐risk behavior, while potentially important for the development of effective HIV prevention programs, needs corroboration to further define the interrelationships between these factors and other psychosocial constructs.
The effect of raft lipid depletion on microvilli formation in MDCK cells, visualized by atomic force microscopy
Authors: Poole Kate , Meder Doris , Simons Kai , Müller Daniel
Published: April 2004

We have investigated whether raft lipids of Madin–Darby canine kidney (MDCK) cells play any role in microvilli maintenance using a combination of atomic force microscopy (AFM) and laser scanning confocal microscopy. MDCK cells were treated to reduce the amount of sphingolipids, cholesterol, or both and subsequently imaged, in buffer solution, using AFM. It was observed that inhibition of either sphingolipid or cholesterol biosynthesis led to a reduction in the number of microvilli on the surface of MDCK cells. However, this effect was not uniform across the monolayer, with some cells resembling those in untreated controls. The subsequent extraction of cholesterol from cells grown in the presence of inhibitors led to a further reduction in microvilli on the surface of the cells and, in some cases, resulted in monolayers devoid of full length microvilli. Significantly, smaller spikes were observed on the surface of the smoother cells.
SH3P2 in complex with Cbl and Src
Authors: Szymkiewicz Iwona , Destaing Olivier , Jurdic Pierre , Dikic Ivan
Published: April 2004

In this report, we describe SH3P2, an SH3‐domain containing protein, as a novel Cbl‐interacting molecule that is a substrate of tyrosine kinase Src. We identified a specific polyproline motif of Cbl responsible for binding of SH3P2 and Src, and observed mutual sequestration of Src and SH3P2 from monomer Cbl molecules. In adherent cells, SH3P2 associated with Cbl and fibrilar actin and was localized at focal contacts in fibroblasts as well as at the apical part of podosome rings in differentiated osteoclasts. Our data implicate that SH3P2, a novel component of adhesion sites, is involved in Cbl and Src‐mediated pathways.
Continuum limits of particles interacting via diffusion
Authors: Alikakos Nicholas D. , Fusco Giorgio , Karali Georgia
Published: April 2004

We consider a two‐phase system mainly in three dimensions and we
examine the coarsening of the spatial distribution, driven by the
reduction of interface energy and limited by diffusion as
described by the quasistatic Stefan free boundary problem. Under
the appropriate scaling we pass rigorously to the limit by taking
into account the motion of the centers and the deformation of the
spherical shape. We distinguish between two different cases and we
derive the classical mean‐field model and another continuum limit
corresponding to critical density which can be related to a
continuity equation obtained recently by Niethammer andOtto.
So, the theory of Lifshitz, Slyozov, and Wagner is improved by taking
into account the geometry of the spatial distribution.
Study Finds Hundreds of Reddit Posts on “Trip-Killers” for Psychedelic Drugs
Authors: Suran Melissa
Published: January 2024

This Medical News article discusses a recent study that examined the remedies most often recommended on Reddit for diluting psychedelic experiences.
Chlorosulfuric Acid
Authors: Bergen Elvira , Maas Joachim , Baunack Fritz
Published: January 2024

The article contains sections titled:1Introduction2Physical Properties3Chemical Properties4Production5Safety Precautions, Transportation6Uses and Economic Aspects7Toxicology and Occupational HygieneReferences
Biodegradable Ferric Phosphate Nanocarriers with Tumor‐Specific Activation and Glutathione Depletion for Tumor Self‐Enhanced Ferroptosis and Chemotherapy
Authors: Li Yan , Fan Wuzhe , Gu Xiang , Liu Shaopeng , He Tingting , Gou Shuangquan , Meng Weilin , Li Meng , Liu Xihong , Ren Yu , Qi Chao , Cai Kaiyong
Published: January 2024

Ferroptosis is a regulatory cell death that is dependent on iron‐mediated lipid peroxidation and cell membrane damage. The use of iron‐based nanocarriers to activate ferroptosis is of great significance in oncotherapy. However, the limited endogenous hydrogen peroxide (H2O2) and high expression of glutathione (GSH) in tumor cells restrict the efficiency of iron‐based nanocarriers in inducing ferroptosis. Herein, a ferric phosphate nanotherapeutic system (denoted as FeP@HCPT‐HA) is reported with H2O2‐supply and GSH‐elimination properties for tumor self‐enhanced ferroptosis and chemotherapy. FeP@HCPT‐HA is obtained by a coprecipitation method with the in situ loading of 10‐hydroxycamptothecin (HCPT), followed by the modification of hyaluronic acid (HA). FeP@HCPT‐HA actively targets CD44‐overexpressed tumor cells and degrades in acidic tumor microenvironment to release HCPT, Fe2+ and Fe3+. As a chemotherapy drug, HCPT not only induces tumor cell apoptosis but also supplies H2O2 for Fe2+‐mediated Fenton reaction to enhance ferroptosis. The released Fe3+ depletes GSH by the redox reaction between Fe3+ and GSH, which down‐regulates the expression of glutathione peroxidase 4 (GPX4) and enhances lipid peroxidation, resulting in enhanced ferroptosis. The integration of tumor targeting and tumor‐specific activation, as well as H2O2‐supply and GSH‐elimination, endow the FeP@HCPT‐HA with effective tumor growth inhibition by the enhanced ferroptosis and chemotherapy.