bluuebunny/crossref_metadata_2025 huggingface dataset:
Ovarian Function in Tubectomized Women Studied by Vaginal Cytology
Authors: Mehta P. V.
Published: January 2017

The present menstrual pattern of 450 tubectomized women was analysed in respect to flow, intensity and duration, 2 to 8 years after the operation. A control group, matched for age, parity and socio‐economic status, comprising of 100 women whose husbands had undergone vasectomy, was similarly analysed as to their menstrual pattern. The menstrual changes in both the groups were assessed by comparing them with the normal menstrual cycle. The ovarian function in a representative 250 tubectomized women of the original group of 450 women was studied by serial vaginal cytology. The smear pattern in 240 women was ovulatory and in the remaining 10 women, anovulatory with a mild estrogenic effect. In the present study, both the tubectomized and the control groups had mild menstrual changes. The changes in the tubectomized women were found statistically significant by χ2 test. The menstrual changes observed were decreased flow, shorter duration and shorter intervals.
Effect of Dexamethasone on Blood Levels of ACTH, Cortisol, Progesterone, Estradiol and Estriol during Late Pregnancy
Authors: Kauppila Antti , Jouppila Pentti , Karvonen Pentti , Tuimala Risto , Ylikorkala Olavi
Published: January 2017

Corticosteroids are used to prevent the respiratory distress syndrome of the premature newborn. In order to evaluate the effect of such treatment on maternal and fetal endocrine functions the circulation levels of ACTH, Cortisol, progesterone, estradiol and estriol were measured in 13 patients before, during and after three days of intramuscular dexamethasone treatment. ACTH was significantly lower in the first day of the treatment and Cortisol in all three days, indicating a significant suppression of the pituitary‐adrenal axis. The treatment did not effect placental steroid genesis, as seen in the unchanged level of progesterone. Estradiol and estriol levels decreased significantly during the days of the treatment. This was supposedly the result of a decrease in the production of C‐19 estrogen precursors, caused by the suppression of both maternal and fetal adrenals. Clinically, it is important to notice that during dexamethasone treatment estriol is not a reliable indicator of fetoplacental function and the blocking of the pituitary‐adrenal system ought to be borne in mind when planning operative delivery during such treatment.
The Relationship of Amniotic Fluid Insulin Levels and the Lecithin‐Sphingomyelin Ratio
Authors: Newman Robert L.
Published: January 2017

Amniotic fluid insulin levels and the lecithin‐sphingomyelin ratio were determined in 62 samples of 33 insulin‐dependent diabetic patients from the 29th to the 44th week of gestation inclusive and in 42 samples of 38 gestational diabetic patients from the 35th to the 43rd week of gestation inclusive. (Gestational age was measured by ultrasonography.) The level of insulin in the amniotic fluid did not appear to affect the lecithin‐sphingomyelin ratio.
IgG, IgA, and IgM in the Serum of Latin American (Chilean) Women in the Course of Normal Gestation
Authors: Lizana Jorge , Ludwig Hella
Published: January 2017

This paper reports the results of tests for the 3 major immunoglobulins (G, A, and M) in a homogeneous, low socioeconomic group of 81 pregnant women of different gestational ages and 20 postpartum and 20 nonpregnant women from a developing Latin American country (Chile). The serum total proteins and albumin values are also included. The single radial immunodiffusion assay used was standardized with the WHO Reference Immunoglobulin Preparation.

Total proteins and albumin decreased throughout pregnancy by 12.5% and 20.2%, respectively, in the third trimester. IgG decreased during gestation in the first trimester; the fall was 18.0% below the IgG of the reference group. IgA decreased in the first trimester, declined by 25.0% during the second trimester, and recovered to its normal values in the third trimester. There was no noteworthy change in IgM, but 19.7% of the cases showed elevated serum IgM concentrations.

In the postpartum sera, the total proteins, albumin, IgG, and IgM levels slowly returned to normal values, but the IgA level was elevated.

The mechanisms causing the variations observed are not clear; but dilutional effects, alteration of the regulation mechanisms, race, environmental conditions, and transport across the placenta should be considered in looking for an explanation.
Psychological Sequelae of Sterilization in Women in Singapore
Authors: Cheng Mark C. E. , Cheong J. , Khew K. S. , Ratnam S. S.
Published: January 2017

The Chinese in Singapore erroneously believe that there is an association between sterilization and castration. This belief has led to deep‐seated fears that sterilization may result in obesity, physical weakness, and impairment of sexual function. Beginning in 1969, Singapore authorities introduced increasingly stronger social policies to help reduce family size. Subsequently, there was a large increase in the number of tubal ligations. It was initially thought that this might result in a high incidence of psychological sequelae. A study of 150 women who had had culdoscopic ligations showed that 6.3% were dissatisfied at the end of 2 years. Women with fewer than 4 children and those with fewer than 2 sons tended to be more dissatisfied with sterilization.
Perspectives in Evaluating the Safety and Effectiveness of Steroidal Contraceptives in Different Parts of the World
Authors: Goldzieher Joseph W.
Published: January 2017

While differences in acceptability of steroidal contraceptives from nation to nation are generally recognized, variations in safety and effectiveness have been given little attention. Cardiovascular hazards such as thromboembolic disease, myocardial infarction, and stroke, which create such concern in developed countries, may be insignificant problems in other parts of the world where these diseases are rare in women of reproductive age. On the other hand, the influence of nutritional deficiencies, anemia, intestinal parasitism, malaria, and other widespread health problems on the effects and/or metabolism of steroids, which may be of major concern in developing countries, is just coming under study. Side effects also vary greatly among religiously and ethnically different populations, and significant differences in pregnancy protection and bleeding patterns among different populations have been reported—even with injectables. It is, therefore, important to examine and define intergroup differences and especially to recognize that safety concerns in one geographic setting cannot be automatically assumed to apply equally in other areas.
An Overview of IUD Research and Implications for the Future
Authors: Zipper J. , Edelman D. A. , Goldsmith A.
Published: January 2017

The limitations of nonmedicated intrauterine devices (IUDs) and the potential for improving IUD performance through the addition of pharmacologic agents are discussed. The mechanisms of action of IUDs, particularly of the copper and the progesterone‐releasing devices, are reviewed. The development of improved intrauterine contraceptive devices will depend on an understanding of these mechanisms of action. In order to determine the optimal design of intrauterine contraceptives, the effects of the pharmacologic agents will also have to be evaluated, both separately and in combination with the carrier (vector).
IUD Insertions by Midwives: Five Years' Experience in Santiago, Chile
Authors: Pastene Laura , Rivera Mirtha , Zipper Jaime , Medel Mario , Thomas Michael
Published: January 2017

This report includes data on insertions of Lippes Loop D, Copper‐7, and Copper‐T intrauterine devices (IUDs) performed by certified nurse‐midwives and physicians with comparable levels of training and experience in inserting IUDs. Net 1‐year pregnancy, expulsion, and removal rates were used to compare the experiences of the 2 groups. There were no significant differences between the groups in most of the event rates or in the overall method discontinuation rates. The authors conclude that, with adequate training and experience, nurse‐midwives can provide this family planning service with no additional risk to patients.
Alternatives to Female Sterilization
Authors: Ratnam S. S. , Rauff Mary , Chew S. C.
Published: January 2017

With national policies aimed at reaching zero population growth in the shortest possible time, many countries have introduced restrictive legislation and disincentive programs in an attempt to decrease family size norms to 2 or 3 children. As a result, younger women of lower parity are being sterilized, with consequences that will be seen in the years to come. Although female sterilization is usually associated with minimal complications and side effects and is highly effective without continuing motivation or promotion, it has the disadvantage of causing permanent, essentially irreversible sterility. Therefore, it will not be readily acceptable to a large portion of the population. For many women, alternatives must be sought. Reversible methods of female or male sterilization, longacting systemic contraceptives, longacting implants, and immunization against implantation or sperm antigens are potential alternatives, but all are still in experimental stages of development. Intrauterine devices and injectables are the 2 most effective alternatives now available. The use of intrauterine devices with abortion as a backup in case of contraceptive failure ranks high as an alternative to female sterilization.
Induction of Abortion with 15(S)‐15‐MethylPGF2α (Tham) Vaginal Suppositories
Authors: Vengadasalam D. , Lean T. H. , Edelman D. A.
Published: January 2017

The repeated administration of vaginal suppositories containing 1 mg 15(S)‐15‐methyl PGF2α (Tham) successfully induced abortions in 60 of 62 patients. Among patients who successfully aborted, the mean abortion time was 19.0 hours. The mean abortion time was not related to gestational age or parity. Sixty (96.8%) aborted within 48 hours, and 53 (85.5%) aborted within 24 hours. Gastrointestinal side effects occurred for 33.9% of the patients. Diarrhea was the most frequent side effect. The abortion was complete for 40.3% of the patients.
Mortality and Fertility Control
Authors: Tietze Christopher , Lewit Sarah
Published: January 2017

The authors present a continuation of the thesis suggesting that the most rational procedure for regulating fertility is a perfectly safe, even though not completely effective, contraceptive method combined with safe methods for terminating pregnancy when the contraceptive fails. This analysis demonstrates that, compared with the risk of death from pregnancy and childbirth, major reversible methods of fertility control—the pill, IUDs, condoms, and diaphragms—and abortion are associated with very low levels of mortality. The exception to this statement is pill use after age 40 by women who smoke. This analysis also confirms the very low mortality associated with using the condom and diaphragm with early induced abortion as a backup to terminate pregnancies resulting from contraceptive failures.
Postcoital Hormonal Contraception: Uses, Risks, and Abuses
Authors: Yuzpe A. Albert
Published: January 2017

The author reviews the present state of use, risks, and side effects associated with postcoital hormonal contraceptives. Data pertaining to various regimens of postcoital hormonal contraception are presented.
Toxoplasma Antibodies and Spontaneous Abortion
Authors: Lolis D. , Tzigounis V. , Michalas S. , Koumentakou E. , Kaskarelis D.
Published: January 2017

One hundred and fifty‐two women with spontaneous abortion were investigated by hemagglutination (HA) and immunofluorescence antibody (IFA) tests for toxoplasmosis. In 48 cases, quantitive immunoglobulin (Ig) studies and mouse inoculation with gestational material were performed. Positive toxoplasma antibody titers were observed in 62 cases (40.8%) using HA and in 52 cases (38.2%) using IFA. This prevalence was significantly higher than that observed in 80 normal women who served as controls. Toxoplasma gondii was isolated in two cases. No correlation was found between antibody titers and IgG, IgM or IgA levels. We conclude that toxoplasmosis should be considered as the cause of abortion when a patient's antibody titer exceeds 1:256.
Advances in Sterilization Equipment
Authors: McCann Margaret F. , Morrow Margaret M. , Goldsmith Alfredo
Published: January 2017

From the array of sterilization procedures that are safe, simple and effective, the service provider must select procedures that fit his or her logistical criteria, which include the cost and maintenance of equipment, availability of supplies, and training of the requisite personnel. In this paper, these criteria are discussed for each of the various sterilization procedures. Information about female sterilization equipment for conventional postpartum laparotomy, minilaparotomy, colpotomy, laparoscopy, and culdoscopy is presented, together with facts about the related tubal occlusion techniques. The standard ligation techniques for male sterilization are compared with the newer electrocoagulation and thermocoagulation methods. A variety of methods for both female and male sterilization that are in the research stage are also mentioned. It is concluded that, from a programmatic point of view, vasectomy and postpartum ligation via laparotomy are the optimal sterilization procedures. For women who have not recently been pregnant, minilaparotomy with a standard tubal ligation technique is recommended, except in large teaching hospitals where laparoscopy can be performed efficiently.
Endometriosis Presenting as Acute Appendicitis
Authors: Rubio Pedro A. , Farrell Edward M. , Alvarez B. Antonio , Rowe Guillermo
Published: January 2017

A rare case of endometriosis presenting as acute appendicitis is reported. Appendectomy was performed with excellent results.
Fetal‐Maternal Hemorrhage after Amniocentesis: Incidence, Degree and Ramifications
Authors: Goldstein Arthur I. , Pezzlo Frank
Published: January 2017

A review of the literature indicates a small but significant incidence of fetal‐maternal hemorrhage following amniocentesis. In these studies, consideration has not been given to the frequency with which erythrocytes containing hemoglobin F are to be found in the maternal circulation in the absence of amniocentesis. In this investigation, Kleihauer‐Betke analysis was carried out before and after amniocentesis. This study confirms previous reports that spontaneous fetal‐maternal hemorrhage is not uncommon during normal intrauterine gestation and that amniocentesis is probably only an occasional cause of fetal‐maternal hemorrhage. This impression is based on the findings that most Kleihauer‐positive maternal blood samples after amniocentesis were also positive before amniocentesis. In spite of these findings, and since Rh‐immune serum globulin is apparently harmless to the fetus and mother, its use is still advocated in nonsensitized Rh‐negative mothers after amniocentesis.
Aerobic and Anaerobic Cervical Flora of Healthy Thai Women
Authors: Jayanetra Panida , Kongmuang Urirat , Vorachit Malai , Benchakan Vilai
Published: January 2017

The bacteriologic study of the cervical flora in 50 healthy women revealed that 70% harbored mixed aerobic and anaerobic organisms. Aerobic organisms alone were recovered in 15 women (30%). Polymicrobial organisms were found in all but five women (in these only one aerobe was isolated per patient). The majority of patients had 1–2 anaerobes, with more than two aerobes. The common aerobes were α‐hemolytic streptococci, Staphylococcus epidermidis and lactobacilli. The most common anaerobes were Peptococcus asaccharolyticus isolated in 21 women (42%), P prevotii in 13 (26%) and Bacteroides in 10 (20%). These organisms are frequently found in pelvic infection, suggesting the pathogenic potential of the normal flora of the cervix.
Rheumatic Heart Disease Diagnosed During Pregnancy: A 30‐Year Follow‐up
Authors: Gleicher Norbert , Knutzen Victor K. , Elkayam Uri , Loew Saul , Kerenyi Thomas D.
Published: January 2017

One hundred one patients originally diagnosed as having rheumatic heart disease (RHD) during the years 1945–1948 were reevaluated in 1975 to determine the natural history of the disease. Twenty patients (19.8%) showed no sign of RHD. Of the patients with confirmed RHD, 56 (70.0%) had their original lesion confirmed, while 23 (28.8%) had developed additional valvular involvement. Pure mitral stenosis resulted in significantly lower mortality than all other valvular lesions, and congestive heart failure was the leading cause of death. Nineteen patients underwent cardiac surgery; the mortality in this group (52.6%) was not significantly higher than that in the overall RHD group (38.8%). False diagnosis of RHD during pregnancy is common. A more thorough evaluation of the “cardiac murmur of pregnancy” is advocated.
Viral Hepatitis Complicating Pregnancy: Mortality Trends in Saudi Arabia
Authors: Gelpi A. P.
Published: January 2017

The striking mortality in viral hepatitis associated with pregnancy, regularly observed in developing countries, has shown a significant decrease in Saudi Arabia during a period of unprecedented economic growth. However, the risk of fatal hepatitis in the pregnant Saudi woman remains approximately four times that for the nonpregnant woman. The explanation for the observed mortality trend is not apparent, but is unlikely to be the result of improved nutritional status of the population alone, or because of treatment of severe hepatitis with adrenal corticosteroids. Disseminated intravascular coagulation may be one factor that decisively influences the outcome of hepatitis in the pregnant woman.
The Significance of Adrenal and Ovarian Catheterization in Patients with Polycystic Ovary Syndrome
Authors: Tzingounis Vassilios A. , Aksu M. Feridun , Natrajan Puthugramam K. , Greenblatt Robert B.
Published: January 2017

A previously unreported series of 15 anovulatory hirsute women with polycystic ovaries made up this study. Each underwent left adrenal and left ovarian vein catherization. Blood samples were obtained from the ovarian, adrenal and peripheral veins to test the levels of testosterone, Δ4 androstenedione (Δ4A), dehydroepiandrosterone (DHEA), estradiol and/or total estrogens, before and after administration of human chorionic gonadotropin (ten cases) and adrenocorticotropic hormone (ACTH) (five cases). Following intravenous human chorionic gonadotropin administration, the only response seen was a slight rise in ovarian levels of Δ4A and DHEA; after intravenous adrenocorticotropic hormone stimulation, the adrenal levels of Δ4A, testosterone and DHEA rose significantly. Peripheral concentrations of testosterone and Δ4A were in the high normal range and DHEA levels were high normal or slightly above normal range.
Ultrasound Diagnosis of Hematocervix Following Gynatresia in a Case of Uterus Bicornis Bicollis
Authors: Szöke Bela , Kiss Dezsö
Published: January 2017

The authors describe the ultrasound findings of a hematocervix associated with cervical atresia. They emphasize the diagnostic difficulties and the important role of ultrasound in such cases.
Recognition and Regulation of Midwives
Authors: Fenney Roger J.
Published: January 2017

There is an urgent need for international standards for the recognition, training and licensure of midwives. It is important for obstetricians to use their influence constructively to help meet the need.
Current Status of Immunologic Pregnancy Tests
Authors: Derman Richard , Edelman David A. , Berger Gary S.
Published: January 2017

Information about the mechanism of various pregnancy tests is summarized. The sensitivity of these tests as well as their advantages and limitations in a clinical setting are presented and evaluated in an effort to maximize their usefulness in a clinical setting.
A Survey of Sterilization Acceptors in a Family Planning Program in Rural Bangladesh
Authors: Bhatia Shushum , Osteria Trinidad , Chakraborty J. , Faruque A. S. G.
Published: January 2017

The results of a survey of 275 Bangladeshi women who were sterilized at a rural family planning clinic are presented. The survey comprised two interviews of each woman: one conducted immediately prior to the sterilization procedure and the second conducted one month after each woman was sterilized. Sociodemographic data were gathered for the survey from the patients' clinic records. Reasons for the choice of sterilization and sociodemographic impact of the procedure are discussed, as are implications of the results on other rural family planning programs.
α‐Fetoprotein: A Marker for Threatened Abortion
Authors: Sande H. A. , Fagerhol M. , Molnar O. , Foss O. P. , Torjesen P.
Published: January 2017

The role of α‐fetoprotein (AFP) as a marker for threatened abortion was investigated in 50 patients and compared with the roles of serum human chorionic somatomammotropin (HCS) or human placental lactogen (HPL) and human chorionic gonadotropin (HCG). Of the 50 patients admitted to the hospital with threatened abortion, 30 patients aborted and 20 gave birth to live‐born babies. Twenty women aborted within seven days of admission. Eighty‐two percent (82%) of the 20 had abnormal AFP values: one third were above the 97.5 percentile and two thirds were below the 2.5 percentile. The AFP values were normal in almost all cases in the group who aborted after seven days. The HCG level in serum was found to be the best indicator of threatened abortion. The AFP and HCS levels were equal indicators of threatened abortion, but were not as reliable as the HCG levels. The AFP values are of more diagnostic use than the HCS values, however, because both abnormally low and high AFP levels can indicate an unfavorable course in pregnancy.
Postponement of Preterm Birth with Salbutamol
Authors: TambyRaja R. L. , Prasad R. N. V. , Ratnam S. S.
Published: January 2017

Salbutamol was administered intravenously and orally to 58 patients who were admitted to the hospital because of premature labor. Pregnancy was postponed until at least 36 weeks' gestation in 34 of these patients. The success of this therapy was measured by a parameter of the prolongation index which was inversely related to the Bishop's score. This measurement was highest among patients in whom pregnancy was successfully prolonged.
Serum Estrone, Estradiol and Estriol Concentrations During Oral Hormone Therapy After Oophorectomy
Authors: Rauramo Lauri , Punnonen Reijo , Grönroos Matti
Published: January 2017

Serum estrone, estradiol and estriol concentrations during estradiolvalerate‐norgestrel therapy for women who have undergone oophorectomy were studied. The patients in one group received 1 mg of estradiolvalerate in the morning and 2 mg of estriolsuccinate in the evening. The estrone and estradiol concentrations of the first and fifth day were at roughly the same level and the treatment caused no estrogen cumulation. The estriol concentrations on the fifth day were distinctly higher than on the first, owing to the conversion of estrone and estradiol into estriol. The other group of women were placed on a regimen of 2 mg of estradiolvalerate plus 0.5 mg of norgestrel in the morning and 2 mg of estriolsuccinate in the evening. Here again, the estrone and estradiol concentrations on the first and fifth days were similar.
Cytohormonal Assessment of Ovarian Function Following Tubal Ligation
Authors: Khanna Sushila , Parthasaruthi Laxmi , Dube Shail , Gupta Saroj
Published: January 2017

One hundred fifty postligation and 54 random cases matched for age and parity were studied. Vaginal cytologic samples and endometrial histologic samples were used for cytohormonal assessment of ovarian function. There was no indication of ovarian insufficiency following tubal ligation. The menstrual cycles were ovulatory. Menstrual disturbances were seen in 40.6% of the cases following tubal ligation. Cytohormonal comparison of these cases with that of dysfunctional uterine bleeding cases (who did not undergo tubal ligation) showed either similar or high maturation value. This may be due either to psychological stimulation or to low‐grade infection following tubal ligation. There was complete cytomorphologic correlation.
Gonadal Dysgenesis Variants in Sisters: a Hitherto Undescribed Combination
Authors: Purandare V. N. , Sathe A. V.
Published: January 2017

The term “gonadal dysgenesis” covers a wide spectrum. This case report concerns two sisters with secondary amenorrhea who underwent systematic investigations, including karyotype analysis, tests for serum gonadotropins and laparoscopic gonadal biopsy. The diagnosis in each revealed a combination hitherto undescribed.
Changes in Thyroid Function Tests During Phenobarbital Treatment in Late Pregnancy
Authors: Luoma P. V. , Heikkinen J. E. , Ylöstalo P. R.
Published: January 2017

The effect of phenobarbital treatment in late pregnancy on thyroid function tests was investigated in 16 women. Ten women in late pregnancy served as controls. Phenobarbital treatment for two weeks was associated with a significant decrease in serum thyroxine (T4) level and in the free thyroxine index (T3U × T4) of 18% and 16%, respectively. These changes were associated with a significant increase in serum thyrotropin concentration of 15%. γ‐Glutamyl transpeptidase activity increased, and serum bilirubin concentration decreased during phenobarbital treatment. The changes in the thyroid function test might reflect the effect of phenobarbital on thyroid hormone metabolism. The changes may have diagnostic importance in borderline cases of thyroid disease.
Umbilical Blood Gas Analysis: II. Effect of Sodium Fluoride on Changes During Storage
Authors: Nhan Vu Quy , de Bruyn H. W. A. , Huisjes H. J.
Published: January 2017

Even when umbilical blood samples are kept on ice, their pH and blood gas values change during storage. The present study analyzes the effects of heparin and sodium fluoride (NaF) on these changes. At a concentration of 10 mg/ml, heparin significantly decreased all values; at a concentration of 5 mg/ml, it significantly decreased the pH and base excess values. Thus, the concentration of heparin used in microanalysis of blood should not exceed 2.5 mg/ml. NaF concentrations of 0.2 and 0.5 mg/ml reduced the decrease in pH after six hours (but not significantly) without causing changes themselves; but their effects on blood gas values were variable. A NaF concentration of 0.1–0.2 mg/ml is adequate to limit changes in most values during the storage of umbilical blood samples on ice for at least six hours.
Immunoreactive Plasma Estrogens and Vaginal Hormone Cytology in Postmenopausal Women
Authors: Benjamin Fred , Deutsch Stanley
Published: January 2017

The vaginal hormone cytology and the serum estrogen levels (as determined by radioimmunoassay) of 39 postmenopausal patients were compared. All cytologic parameters showed high statistical correlations with radioimmunoassay values, but these general associations could not be applied to individual patients. A more detailed analysis showed that an atrophic smear (eg, karyopyknotic index [KI], <10%; parabasal level, >20%; maturation value [MV], <40%) indicate estrogen deficiency in the postmenopause. When the KI is 20%‐40%, the parabasal cells less than 20% or the MV 40%‐60%, the evaluation of estrogen status, on the basis of hormone cytology alone, is indeterminate. The three cytologic indices studied seem much more useful for detecting estrogen deficiency than estrogen excess in the postmenopause. The fact that immunochemical characteristics are not always related to biologic behavior must also be considered when interpreting these findings.
Pedicled Omental Graft in Repair of Large, Difficult Vesicovaginal Fistulae
Authors: Sharma S. K. , Bapna B. C. , Gupta C. L. , Rao K. M. K. , Reddy M. J. , Subudhi C. L. , Shrikhande V. V. , Rao M. S. , Vaidyanathan S.
Published: January 2017

Large vesicovaginal fistulae, particularly those associated with urethral loss, present formidable repair problems. Omentum, recognized for its role in resolving abdominal infection, is successfully used for pedicle grafts in these complex situations. The authors present their experience in 25 cases, describing modifications of an earlier procedure.
Culdoscopy—Useful or Useless?
Authors: Lane Eduardo
Published: January 2017

With the increased use of laparoscopy as a diagnostic method in gynecologic practice, the continued usefulness of culdoscopy has been questioned. The author presents his experience with 402 culdoscopies, listing indications, anesthesia used, results and complications. There was a 4.7% failure rate and a 1.7% complication rate. No permanent damage or death occurred.
Teratogenic Potential of Some Psychopharmacologic Drugs: A Brief Review
Authors: VanBlerk G. A. , Majerus T. C. , Myers R. A. M.
Published: January 2017

The placenta has been considered a protective barrier between the mother and fetus. Because many drugs pass relatively freely between mother and fetus, the possible causal relationship between drug ingestion and the incidence of birth defects in humans demands critical examination. A brief review of background information about this interaction and an overview of the effects of commonly used drugs are presented.
Uterine Malignant Degeneration After Low‐Dose Endometrial Irradiation
Authors: Nikkanen Vesa , Salmi Tuula , Grönroos Matti
Published: January 2017

The effectiveness of low‐dose intrauterine irradiation for benign diseases and its possible carcinogenic effect on the uterus was studied in 190 patients who were treated during the years 1952‐1974. The indications for irradiation were premenopausal functional bleeding, leukemia, hemophilia, fibroids, endometriosis or other benign reason. Radiation was also performed on patients with severe neurologic diseases that contraindicated surgery and on some mentally retarded patients whose restlessness and epileptic seizures were aggravated premenstrually and during menstruation. The mean follow‐up period was 15 years. Uterine bleeding recurred in 21% of the patients. No cases of uterine malignant degeneration were found.
The Use of the Laparoscope in Rural Thailand
Authors: Chaturachinda Kamheang
Published: January 2017

A survey of the use of laparoscopy in rural Thailand was undertaken between June 1974 and December 1977. All the physicians were trained at either Ramathibodi Hospital, Bangkok, or The Johns Hopkins Program for International Education in Gynecology and Obstetrics in the USA; about 30% and 46% of the physicians, respectively, were endoscopically inactive. The complication rate of rural laparoscopy was high and was inversely proportional to the degree of utilization. It is concluded that for a developing country with limited resources, laparoscopic sterilization in rural areas is not cost‐effective; a technique using simpler and hardier equipment should be chosen.
Responses of Bachman's sparrows and prairie warblers to fragmentation
Authors: Jones Clark D. , Stodola Kirk W. , Coombs Jason , Ward Michael P. , Cooper Robert J.
Published: January 2017

Fragmentation of a species’ habitat and the loss of habitat‐patch connectivity have been a major factor in the decline of many species. Increased risks (e.g., predation, parasitism) that threaten population persistence are associated with the loss and fragmentation of large blocks of contiguous habitat for a species. Longleaf pine (Pinus palustris) savannas of the southeastern United States have experienced high rates of fragmentation and loss of connectivity. Consequently, they are home to many federally endangered and declining species across a wide variety of taxa. We examined the effects of fragmentation of pine savannas in southern Georgia for Bachman's sparrows (Peucaea aestivalis) and prairie warblers (Setophaga discolor) using translocation experiments and radio‐telemetry (Bachman's sparrows only). Bachman's sparrows, a pine savanna specialist, showed lower probability of return within 48 hours when confronted with pine savannas fragmented by open fields, whereas prairie warblers were less sensitive to this type of landscape. Results from radio‐telemetry indicated that Bachman's sparrows avoided open agricultural fields on their return paths and primarily used pine savanna edges instead. Efforts to reduce fragmentation of existing pine savannas in the Southeast will likely benefit vegetation specialists such as Bachman's sparrow but be of lesser benefit to vegetation generalists such as prairie warbler. © 2017 The Wildlife Society.
A study on a two‐wave mode Kadomtsev–Petviashvili equation: conditions for multiple soliton solutions to exist
Authors: Wazwaz Abdul‐Majid
Published: January 2017

We establish a two‐wave mode equation for the integrable Kadomtsev–Petviashvili equation, which describes the propagation of two different wave modes in the same direction simultaneously. We determine the necessary conditions that make multiple soliton solutions exist for this new equation. The simplified Hirota's method will be used to conduct this work. We also use other techniques to obtain other set of periodic and singular solutions for the two‐mode Kadomtsev‐Petviashvili equation. Copyright © 2017 John Wiley & Sons, Ltd.
Efficacy of a long‐lasting bifenthrin‐treated net against horticultural pests and its compatibility with the predatory mite Amblyseius swirskii and the parasitic wasp Eretmocerus mundus
Authors: Fernández Maria del Mar , Colomer Ignacio , Medina Pilar , Fereres Alberto , Del Estal Pedro , Viñuela Elisa
Published: January 2017

BACKGROUND

Insecticide‐treated nets (ITNs) have been investigated recently for their use in agriculture. Depending on the insecticide, the hole size and the way they are produced, these nets can target different pests and therefore they could be interesting options for use in integrated pest management (IPM). As the information on their compatibility with beneficial fauna is practically negligible, in this work we have tested the compatibility of an experimental bifenthrin long‐lasting insecticide‐treated net (LLITN) with Amblyseius swirskii and Eretmocerus mundus, important natural enemies of whiteflies and thrips, under laboratory, semi‐field and commercial greenhouse conditions.

RESULTS

In the laboratory, the treated net was very deleterious to adults of both natural enemies, after 72 h exposure. However, in choice tests with Y‐tubes, both natural enemies were neither attracted nor repelled by the treated net and no short‐term mortality was detected in individuals that had crossed it. No deleterious effects on the E. mundus beneficial capacity were detected in semi‐field trials. In field trials, the LLITN proved to be compatible with A. swirskii while decreasing pest densities.

CONCLUSIONS

Bifenthrin LLITN studied could be a valuable method for reducing pest population infestations in IPM programmes while being compatible with biocontrol agents. © 2017 Society of Chemical Industry
Long-Term Outcomes in the Management of Painful Diabetic Neuropathy
Authors: Mai Lauren M. , Clark A. John , Gordon Allan S. , Lynch Mary E. , Morley-Forster Pat K. , Nathan Howard , Smyth Catherine , Stitt Larry W. , Toth Cory , Ware Mark A. , Moulin Dwight E.
Published: January 2017

Background: Painful diabetic neuropathy (PDN) is a frequent complication of diabetes mellitus. Current treatment recommendations are based on short-term trials, generally of ≤3 months’ duration. Limited data are available on the long-term outcomes of this chronic disease. The objective of this study was to determine the long-term clinical effectiveness of the management of chronic PDN at tertiary pain centres. Methods: From a prospective observational cohort study of patients with chronic neuropathic non-cancer pain recruited from seven Canadian tertiary pain centres, 60 patients diagnosed with PDN were identified for analysis. Data were collected according to Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials guidelines including the Brief Pain Inventory. Results: At 12-month follow-up, 37.2% (95% confidence interval [CI], 23.0-53.3) of 43 patients with complete data achieved pain reduction of ≥30%, 51.2% (95% CI, 35.5-66.7) achieved functional improvement with a reduction of ≥1 on the Pain Interference Scale (0-10, Brief Pain Inventory) and 30.2% (95% CI, 17.2-46.1) had achieved both these measures. Symptom management included at least two medication classes in 55.3% and three medication classes in 25.5% (opioids, antidepressants, anticonvulsants). Conclusions: Almost one-third of patients being managed for PDN in a tertiary care setting achieve meaningful improvements in pain and function in the long term. Polypharmacy including analgesic antidepressants and anticonvulsants were the mainstays of effective symptom management.
The AKP between populism and neoliberalism: lessons from pharmaceutical policy
Authors: Dorlach Tim
Published: January 2017

In September 2009, Turkey experienced a major reform of its pharmaceutical expenditure and price policy. By introducing a global budget, Turkey saved some 20 billion TL in public pharmaceutical expenditure in the 2010–2012 period. The lion’s share of this was achieved by introducing stricter price controls that reduced the profit margins of pharmaceutical producers and distributors (the populist policy solution), rather than by privatizing the cost of medicines through, for example, raising out-of-pocket payments (the neoliberal policy solution). This is a puzzle, given the Justice and Development Party (Adalet ve Kalkınma Partisi, AKP) government’s usual preference for lenient and business-friendly regulation. This article explains the policy reform with reference to (i) the pronounced electoral interests of the AKP’s political leadership in not substantially reducing access to public health services, (ii) the absence of powerful business interests in high medicine prices, and (iii) the absence of a developmentalist commitment to an industrial policy strategy for the pharmaceutical sector. This case study holds important lessons for scholars of Turkish politics. It suggests that externally the AKP’s economic and social policies are driven by the interests of its two major constituencies (namely, lower-class voters and “Anatolian capital”), while internally they are shaped by two camps of policy makers (namely, neoliberal-minded technocrats and election-focused party leaders).
Association between carbohydrate nutrition and prevalence of depressive symptoms in older adults
Authors: Gopinath Bamini , Flood Victoria M. , Burlutksy George , Louie Jimmy C. Y. , Mitchell Paul
Published: January 2017

We aimed to examine the relationship between dietary glycaemic index (GI) and glycaemic load of foods consumed, intakes of carbohydrates, sugars and fibre, and the prevalence of depressive symptoms in older adults. Data collected from 2334 participants aged 55+ years and 1952 participants aged 60+ years were analysed. Dietary information was collected using a semi-quantitative FFQ. Depressive symptoms were based on antidepressant use or either the 36-Item Short-Form Survey, which included the Mental Health Index (MHI), or the Center for Epidemiologic Studies Depression-10 Scale. Participants in the highestv. lowest tertile of dietary GI intake had increased odds of depressive symptoms (assessed by the MHI scale), multivariable-adjusted OR 1·55 (95 % CI 1·12, 2·14). Participants in the highest compared with lowest tertile of fruit consumption had reduced odds of prevalent depressive symptoms, multivariable-adjusted OR 0·66 (95 % CI 0·46, 0·95). Total fibre, vegetable fibre and breads/cereal fibre intakes were all inversely associated with the prevalence of depressive symptoms, with globalPvalues of 0·03, 0·01 and 0·03, respectively. Participants in the secondv. first tertile of vegetable consumption had 41 % reduced odds of prevalent depressive symptoms, multivariable-adjusted OR 0·59 (95 % CI 0·40, 0·88). We show that dietary GI and fibre intakes as well as consumption of fruits and vegetables are associated with the prevalence of depressive symptoms.
The Ethics of Atheism
Authors: RYRIE ALEC
Published: January 2017

The history of a sect can scarcely avoid dancing with sectarianism. Even if the sect has vanished from the earth, it is difficult not to become either a defender or a critic, and when there are controversies still living, history cannot help but feed them and feed off them. The only certain way to avoid this is to retreat inside the sect entirely, becoming part of a world where it is the only and obvious subject of interest. And so the histories of religious minorities easily become self-referential ghettoes, where formidable expertise is built up while basic questions about how the subject is framed are left unasked.
Tolstoy, Universalism and the World Religions
Authors: MOULIN DANIEL
Published: January 2017

Leo Tolstoy was one of the most prolific religious figures of his time. Yet his religious thought and its influence have seldom been explored by church historians. Drawing upon themes within his literature, non-fiction and previously unconsidered primary sources, this paper considers Tolstoy's religious position in relation to other similar nineteenth-century religious movements. It exposes Tolstoy's links with British Unitarians and also considers Tolstoy's influence upon the founder of Britain's first interfaith organisation, the World Congress of Faiths. It is argued that Tolstoy provides a paradigmatic example by which to examine the relationship between the legacy of the Enlightenment and changing attitudes towards non-Christian religions.
‘Have you entered the storehouses of the snow?’ China as a norm entrepreneur in the Arctic
Authors: Lanteigne Marc
Published: January 2017

The admission of China as an observer in the Arctic Council in 2013 was a significant step in the ongoing evolution of the country's Arctic policy, but Beijing is still concerned about being accepted as a regional player given its geography and arguably lack of an Arctic history. As the Arctic becomes more open to scientific and economic engagement, China wishes to develop the idea of the Arctic as more of an international space as opposed to strictly a regional one, and to allow non-Arctic states, such as China itself, to become accepted as Arctic actors. However, in order to avoid a backlash from the Arctic states and potential exclusion from the region's development, Beijing cannot effectively be a unilateral ‘norm-maker’ in the Arctic. Instead, China has sought to develop the identity of a regional ‘norm entrepreneur’, engaging the Arctic on many levels to promote the norm of partnerships between Arctic and non-Arctic actors to promote positive sum outcomes. Through engagement via several areas and governmental levels, Beijing hopes to succeed in being widely viewed as a ‘near-Arctic state’ which can contribute to new norms, and possibly new regimes, in an Arctic which shows many signs of becoming further internationalised.
Functional outcomes of child and adolescent mental disorders. Current disorder most important but psychiatric history matters as well
Authors: Ormel J. , Oerlemans A. M. , Raven D. , Laceulle O. M. , Hartman C. A. , Veenstra R. , Verhulst F. C. , Vollebergh W. , Rosmalen J. G. M. , Reijneveld S. A. , Oldehinkel A. J.
Published: January 2017

Background

Various sources indicate that mental disorders are the leading contributor to the burden of disease among youth. An important determinant of functioning is current mental health status. This study investigated whether psychiatric history has additional predictive power when predicting individual differences in functional outcomes.

Method

We used data from the Dutch TRAILS study in which 1778 youths were followed from pre-adolescence into young adulthood (retention 80%). Of those, 1584 youths were successfully interviewed, at age 19, using the World Health Organization Composite International Diagnostic Interview (CIDI 3.0) to assess current and past CIDI-DSM-IV mental disorders. Four outcome domains were assessed at the same time: economic (e.g. academic achievement, social benefits, financial difficulties), social (early motherhood, interpersonal conflicts, antisocial behavior), psychological (e.g. suicidality, subjective well-being, loneliness), and health behavior (e.g. smoking, problematic alcohol, cannabis use).

Results

Out of the 19 outcomes, 14 were predicted by both current and past disorders, three only by past disorders (receiving social benefits, psychiatric hospitalization, adolescent motherhood), and two only by current disorder (absenteeism, obesity). Which type of disorders was most important depended on the outcome. Adjusted for current disorder, past internalizing disorders predicted in particular psychological outcomes while externalizing disorders predicted in particular health behavior outcomes. Economic and social outcomes were predicted by a history of co-morbidity of internalizing and externalizing disorder. The risk of problematic cannabis use and alcohol consumption dropped with a history of internalizing disorder.

Conclusion

To understand current functioning, it is necessary to examine both current and past psychiatric status.
William E. Connolly's Politics of Complexity: A Critique
Authors: Fear Christopher
Published: January 2017

In recent years, William E. Connolly has argued that the phenomenon of complexity in the physical sciences carries radical implications for political theory: namely, that political theorists should now be revising their concepts of agency, responsibility, and freedom. This very recent project of Connolly's has not (yet) attracted much opposition. Here I offer a critique of Connolly's argument which focuses on three key areas: (1) how he interprets and deploys “evidence” from physical science; (2) his theory of “creativefreedom”; and (3) the impact that his recent philosophy has on the idea of the intellect. I argue that Connolly's scientific evidence is not what he claims it is; that the theory of “creative freedom” he offers fails; and that his critique of the intellect fails in theory, and would be highly damaging in practice.
Risk factors for pertussis in adults and teenagers in England
Authors: WENSLEY A. , HUGHES G. J. , CAMPBELL H. , AMIRTHALINGAM G. , ANDREWS N. , YOUNG N. , COOLE L.
Published: January 2017

Pertussis is a vaccine-preventable respiratory infection caused by Bordetella pertussis which can be fatal in infants. Although high vaccine coverage led to prolonged disease control in England, a national outbreak of pertussis in 2011 led to the largest increase in over two decades, including a marked increase in cases aged ⩾15 years. A case-control study in four regions of England was undertaken to investigate risk factors for pertussis in adolescents and adults, specifically employment type and professional and household contact with children. Pertussis cases were laboratory-confirmed and aged ⩾15 years. Controls were recruited through general practitioner nomination. Demographic and risk factor information were collected using an online survey. Multivariable logistic regression was used to estimate independent associations with outcome. Two hundred and thirty-one cases and 190 controls were recruited. None of the four employment variables (social care, education, health sector, patient contact) were significantly associated with pertussis. Professional contact with children aged < 1 year was associated with a significantly reduced odds of pertussis [odds ratio (OR) 0·25, 95% confidence interval (CI) 0·08–0·78, P = 0·017]. Household contact with ⩾1 child aged 10–14 years was associated with significantly increased odds of pertussis (OR 2·61, 95% CI 1·47–4·64, P = 0·001). Occupational contact with very young children was associated with reduced odds of pertussis, probably due to immune boosting by low-level exposures to B. pertussis. Sharing a household with a young adolescent was a significant risk factor for pertussis in adults and older teenagers. The primary focus of the childhood pertussis vaccination programmes is to prevent infant disease. Although evidence is emerging that adolescent vaccination does not provide indirect protection to infants, our results highlight the importance of children aged 10–14 years in pertussis transmission to older adolescents and adults.