bluuebunny/crossref_metadata_2025 huggingface dataset:
A primary amelanotic melanoma of the vagina diagnosed by immunocytochemistry
Authors: Scambia G. , Benedetti Panici P. , Baiocchi G. , Coli A. , Ferrone S. , Natali P.G. , Mancuso S.
Published: April 2004

A case of primary malignant melanoma of the vagina is discussed. The lesion consisted of a nodule in the middle third of the vagina that was histologically suspected of being an unpigmented malignant melanoma. The melanocytic origin of the lesion was confirmed by the pattern of reactivity to a battery of human melanoma associated antigens and to class 1 and 2 histocompatibility antigens. No secondary lesions or alternative primary sites were found. The patient underwent radical hysterectomy with bilateral salpingo‐oophorectomy, total vaginectomy and vulvectomy, radical inguinal, pelvic and para‐aortic lymphadenectomy. The pathology report showed the presence of multiple neoplastic foci in the vagina. Although the removed lymph nodes were histologically free of metastases, microscopic foci of neoplastic cells were detected by immunohistochemistry in three lymph nodes. There is no evidence of recurrence at the twelfth postoperative month. Our results show that immunohistochemical techniques may usefully complement diagnostic histopathology in the diagnosis of female genital tract melanoma.
An immunohistochemical study of neuroendocrine cells in gynecologic tumors
Authors: Ueda G. , Shimizu C. , Saito J. , Inoue Y. , Tanaka Y. , Inoue M. , Tanizawa O.
Published: April 2004

Various gynecologic tumors with argyrophilia were studied immunohistochemically for chromogranin using two antibodies, antichromogranin and antineuroendocrine. Of seven small cell carcinomas of the cervix, four were immunoreactive with antichromogranin and seven with antineuorendocrine. Argyrophil cells of six cervical adenocarcinomas were all immunoractive with both antibodies. Type I argyrophil cells of 20 endometrial carcinomas were likewise stained positively. However, of the 30 endometrial carcinomas with type II argyrophil cells, 19 showed positive immunoreactivity for chromogranin and 22 for neuroendocrine. Of the ovarian tumors tested, argyrophil cells of 11 mucinous tumors, three carcinoid tumors, and the pancreatic tissue of a malignant mixed germ cell tumor were all chromogranin‐ and neuroendocrine‐immunoreactive. Type I argyrophil cells of five endometrioid carcinomas of the ovary were also immunoreactive with both antibodies. Of the 13 endometrioid carcinomas with type II argyrophil cells, only four showed positive immunoreactivity for chromogranin and only five for neuroendocrine. In conclusion, both antichromogranin and antineuroendocrine detect the specific neuroendocrine markers in close association with argyrophilia in gynecologic tumors, the latter being more sensitive for small cell carcinoma of the cervix, and for type II argyrophil cells in adenocarcinoma of the endometrium and endometrioid carcinoma of the ovary.
Breastfeeding and growth monitoring
Authors: Greaves J.P. , Hendrata L.
Published: April 2004

One of the main reasons women stop breastfeeding is they lack confidence in their ability to produce enough milk. Growth monitoring gives them the confidence by showing their baby's satisfactory growth. There are ten pitfalls to growth monitoring programs however: (1) the emphasis on a curative rather than a preventive approach; (2) monitoring starts too late; (3) programs emphasize nutritional status rather than growth status; (4) the chart is not used to prompt a dialogue with the mother on meaning; (5) health workers do not listen to find out why some babies are succeeding and others are not; (6) insufficient attention is paid to training and supervision, and programs should address the child's total environment; (7) growth monitoring is seen as isolated from other aspects of health care; (8) the community should become involved in addressing growth problems; (9) additional food is often seen as the only activity rather than separating the preventive strategy of growth monitoring from the curative activity; and (10) growth monitoring itself achieves little unless it leads to growth promotion.
Clinical efficacy of LH‐Color: A new home ovulation test
Authors: Gregoriou O. , Kassanos D. , Vitoratos N. , Papadias C. , Zourlas P.A.
Published: April 2004

In this study we evaluate the efficacy of a new home ovulation test to identify LH surge (LH‐Color, Organon). Fifty‐five spontaneously ovulating women were followed during their cycles with twice daily urinary LH testing as well as daily ultrasound and BBT charts. In 39 (70.91%) of the 55 patients, ovulation occurred within 24 h after the decoloration of the LH‐Color. Follicular collapse as visualized by ultrasonography, took place in all patients within 36 h after the decoloration of the LH‐Color. Thus a good correlation was found between urinary LH surge and ultrasound. We conclude that the rapid LH test was able to predict impending ovulation.
Endometrioid carcinoma of the fallopian tube: Pathology and clinical outcome
Authors: Rorat E. , Wallach R.C.
Published: April 2004

A case of endometrioid carcinoma of the fallopian tube is reported with histologic description and clinical follow‐up of four years. Only two other cases have been documented previously. This case is thought to be unique as the carcinoma arose in a benign endometrioid tumor. Inferences concerning Mullerian duct expression and neoplasia are reviewed.
Sequential Gn‐RH superagonist and medroxyprogesterone acetate treatment of uterine leiomyomata
Authors: Benagiano G. , Morini A. , Aleandri V. , Piccinno F. , Primiero F.M. , Abbondante G. , Elkind‐Hirsch K.
Published: April 2004

A group of 48 women with symptomatic leiomyomata were treated during 6 months with the short‐acting Gn‐RH superagonist analog buserelin. The first (group C) was followed up for an additional six months of no medication. The second (group M) was treated for 6 additional months with medroxyprogesterone acetate (MPA) at doses decreasing from 200 to 25 mg/day. Buserelin therapy significantly decreased uterine size (P < 0.001) in all patients, the average final volume being 48.5% of the original (from 262 ± 147 ml to 127 ± 85.4 ml). In group C there was a significant (P < 0.001) re‐growth during the post‐treatment observation period (from 120 ± 81.0 ml to 198 ± 77.2 ml); a significant (P < 0.01) re‐growth was also observed in group M during MPA medication (from 132 ± 77.2 ml to 170 ± 96.0 ml). The agonist had also a marked effect on fibroids: on average they decreased from 75.1 ± 74.3 ml to 24.7 ± 23.3 ml (P < 0.025). In group C during the post‐buserelin period of observation without treatment, there was a significant re‐growth from 23.7 ± 21.6 ml to 47.7 ± 27.5 ml (P < 0.001), whereas in group M treatment with MPA prevented any significant re‐growth (from 25.6 ± 24.8 to 30.6 ± 32.9 ml; P > 0.3).
The “kangaroo‐mother” method: Evaluation of an alternative model for the care of low birth weight newborns in developing countries
Authors: Colonna F. , Uxa F. , da Graca A.M. , de Vonderweld U.
Published: April 2004

The “kangaroo‐mother” method, that is nursing babies by continuously keeping them wrapped at the mother's breasts, has been proposed as an “appropriate technology” for the care of low birth weight (LBW) newborns in developing countries. We evaluated the effectiveness of this method as an alternative hospital care model in the Special Care nursery of the Central Hospital of Mapto, Mozambique. One hundred LBW newborns (mean birth weight 1329 g, SD ± 208 g) were consecutively admitted to the “kangaroo‐mother” section of the unit at the mean postnatal age of 11.6 days. Ninety‐five of them were discharged alive after a mean period of 16.3 days of “kangaroo” nursing. During this period they were exclusively breast fed and their mean weight gain was 12.8 g/day. Besides being very effective in improving survival, this method favored the development of early mother‐infant relations, which are certainly very important for the long term well‐being of the child.
Genital tuberculosis and subsequent fertility
Authors: Varma T.R.
Published: April 2004

A successful pregnancy ending in live birth at term is very rare following genital tuberculosis, in spite of effective medical treatment for tuberculosis. The medical, surgical or combined treatments all are associated with relatively poor fertility outcome. In vitro fertilization and embryo replacement have been found to be successful in a few patients.
The influence of demographic and phenotypic heterogeneity on the prevalence of gestational diabetes mellitus
Authors: Dooley S.L. , Metzger B.E. , Cho N. , Liu K.
Published: April 2004

In order to explore the influence of demographic and phenotypic characteristics on the prevalence of gestational diabetes mellitus (GDM), data were analyzed from 3744 consecutive patients who underwent universal screening with a 50 g glucose load at 24–28 weeks gestational age. Those with a 1‐h plasma glucose ≥130 mg/dl underwent a 3‐h, 100‐g oral glucose tolerance test following dietary preparation. The population was 39.1% White, 37.7% Black, 19.8% Hispanic and 3.4% Oriental/other. The overall prevalence of GDM was 3.5 cases/100. Significant inter‐racial differences in maternal age and prepregnant percent ideal body weight (PIBW) were observed, with White patients being older and leaner than Blacks and Hispanics. By multiple logistic regression, Black and Hispanic race, maternal age and PIBW were found to have significant independent effects on the prevalence of GDM. Controlling for age and PIBW, the adjusted relative risk of GDM was significantly higher in Black (1.81, 95% CI 1.13–2.89) and Hispanic (2.45, 95% CI 1.48–4.04) patients compared to White. We conclude that demographic and phenotypic characteristics of populations need to be taken into consideration in future studies of prevalence of GDM, perinatal implications and therapeutic approaches to the disease.
Maternal mortality in Jamaica: health care provision and causes of death
Authors: Keeling J.W. , McCaw‐Binns A.M. , Ashley D.E. , Golding J.
Published: April 2004

Details of 62 maternal deaths occurring in 1986/1987 were compared with a control population. The incidence was 11.5 per 10 000 livebirths. The major cause of maternal mortality was hypertension followed by hemorrhage and infection. There were trends with advanced maternal age and high parity. The risk of maternal death varied with hospital facilties available, being lowest in areas with access to a specialist hospital and highest in areas where there were no obstetricians available.
Illegal induced abortion — A continuing problem in Nigeria
Authors: Archibong E.I.
Published: April 2004

Illegal induced abortion is still a major contributing factor to maternal morbidity and mortality in Nigeria. It is very common among school girls who are still ignorant of contraception. A good percentage of the abortions are procured by nonmedically qualified personnel. The author has not only advocated the introduction of sex education into the school curriculum as a redeeming measure, but also the provision of contraception in schools and the liberalization of the abortion law.
Combined GnRH‐agonist and HMG therapy in patients with stimulation failure
Authors: Loutradis D. , Kallianidis K. , Siskos K. , Bletsa R. , Creatsas G. , Michalas S. , Aravantinos D.
Published: April 2004

This study deals with the combined therapy of GnRH‐agonist (GnRH‐a) and HMG for stimulation in 15 patients who failed two prior in vitro fertilization attempts. Fifty‐three patients who received HMG without GnRH‐agonist suppresion served as controls. Comparing the HMG group with GnRH‐a/HMG cycles, the cancellation rate dropped from 35.5% to 13.2%. Oocyte recovery was similar in both groups, as were the fertilization rates, 88.4% in GnRH‐a and 82% in HMG cycles, respectively. The number of embryos available for transfer was virtually identical in both groups (3.7 vs. 3.6). Embryo cleavage speed was higher in GnRH‐a than in HMG regimens. The E2 rise was smooth in the GnRH‐a group compared to the sharp rise observed in the HMG group. The pregnancy rate per transfer was 30.5% in the GnRH‐a group versus 20.5% in the HMG group. GnRH‐a seems to offer a clear improvement to a number of stimulation failures.
The daytime glucose profile as a standardized model for metabolic management of diabetes mellitus in pregnancy
Authors: Thurnau G.R. , Payne G.G.
Published: April 2004

On the basis of normative data from non‐diabetic gravidae, the daytime glucose profile (DGP) is introduced as a model for insulin management of diabetes mellitus in pregnancy. The DGP employs four preprandial (target level = 70 mg/dl) and three 1‐h post‐prandial glucose determinations (target level = 140 mg/dl). Insulin changes are based on a simple equation applied to individual glucose value difference between the patient (P) and target (T) levels (P − T/20). With the aid of this model, the average (± SD) of the daytime mean plasma glucose (DMG) levels of 22 pregnant women requiring insulin treatment (183 ± 36 mg/dl) approached normalization (114 ± 15 mg/dl) after 2–7 profile determinations (median = 3.5).
Fructosamine as a screening‐test for gestational diabetes mellitus: a reappraisal
Authors: Nasrat H.A. , Ajabnoor M.A. , Ardawi M.S.M.
Published: April 2004

Fructosamine, glycosylated hemoglobin (HbAIc) and serum total proteins were measured in normal nondiabetic pregnant women (n = 170) at three stages of pregnancy (14–18, 24–28, and 32–40 weeks of gestation). No significant correlation was found between fructosamine and either HbAIc or total plasma proteins. Only early in pregnancy (< 20 weeks of gestation) was a correlation found between fructosamine and fasting blood glucose (r = 0.40, P < 0.05). There was also no correlation between either tests (i.e. fructosamine and HbAIc) and fetal birthweight. The value of fructosamine measurement in the detection of diabetes in pregnancy was further tested in a group of high‐risk patients (n = 98) for developing carbohydrate intolerance. It is concluded that fructosamine has limited value as a screening test for gestational diabetes mellitus, particularly for the mild form of the glucose intolerance.
Preterm premature rupture of fetal membranes in a low socioeconomic population: results of conservative management
Authors: Okonofua F.E. , Onwudiegwu U. , Odunsi O.A.
Published: April 2004

A retrospective review of pregnancies complicated by preterm premature rupture of membranes (PPROM) in 149 women of low socioeconomic status in Nigeria was undertaken. Delivery occurred within 24 h of onset of symptoms in 51 of these women (immediate delivery group), whereas 98 patients were managed conservatively. The mean length of gestation was higher in the conservatively managed group and the perinatal mortality was correspondingly lower. In contrast, there was a slightly increased incidence of puerperal febrile morbidity in the conservative group. These data suggest that conservative management can be selectively employed in PPROM occurring in women of low socioeconomic status.
Comparison between renal ultrasonography and excretory urography in cervical cancer
Authors: Frohlich E.P. , Bex P. , Nissenbaum M.M. , Epstein B.M. , Sonnendecker E.W.W.
Published: April 2004

Renal ultrasonography was compared with intravenous pyelography in order to establish the suitability and accuracy of the former investigation as a screening method for uretic obstruction in patients with carcinoma of the uterine cervix. With a sensitivity of 96.30%, specificity of 96.75%, a positive predictive value of 87.64% and a negative predictive value of 99.09% calculated on a large sample of 420 kidneys, it is recommended that renal ultrasonography is the method of choice in screening for ureteric obstruction in patients with cervical cancer. At the very least it is a suitable and equivalent alternative to intravenous pyelography in such patients.
Pituitary apoplexy in an acromegalic woman operated on during pregnancy by transphenoidal approach
Authors: Lunardi P. , Rizzo A. , Missori P. , Fraioli B.
Published: April 2004

We report a rare case of pituitary apoplexy in a woman, acromegalic at the sixth month of pregnancy, who suddenly complained of visual acuity disturbances.
Low dose acetyl salicylic acid in severe preeclampsia
Authors: Toppozada M. , Darwish E.A. , Osman Y.F. , Abd‐Rabbo M.S.
Published: April 2004

Twenty pregnant patients in the third trimester with severe preeclampsia were allocated at random into two equal groups. The first group was treated for 10 days with a low dose (75 mg/day) of acetyl salicylic acid (ASA) then with conventional therapy for another 10 days. The second group received the same regimen but conventional therapy in the first 10 days and ASA in the second 10 days. Changes in systolic and diastolic blood pressure, albuminuria, lower limb edema and urinary output were closely monitored and recorded. This comparative crossover study indicated that both the low dose ASA and conventional therapy significantly reduced systolic and diastolic blood pressure which was more pronounced with ASA and in group I. Crossover from one treatment to the other maintained the response but was more beneficial when ASA was given first.
Midwives: key rural health workers in maternity care
Authors: Kwast B.E.
Published: April 2004

The most acceptable and attainable rural health worker for maternity care is frequently the traditional birth attendant or other personnel lacking clinical skills to treat life‐threatening emergencies. When first referral level facilities are also poorly staffed and illequipped to deal with these emergencies, this again points to the need for training of and delegation to the trained midwife in rural areas. Unfortunately, their number is declining in rural areas of some countries most in need, e.g., Tanzania. Elsewhere, midwifery skills and knowledge have been integrated into basic nursing education, but practical skills are only developed postbasically when midwife educators are expert clinicians. The graduates of such training could be delegated responsibility for many lifesaving procedures in obstetric care. Successful clinical experience in use of these responsibilities will earn the midwife's needed community reputation as a trusted health worker.
Trends in postabortal mortality and morbidity in Ibadan, Nigeria
Authors: Adewole I.F.
Published: April 2004

Illegally induced abortion at the University College Hospital, Ibadan increased steadily over a 10‐year period (1980–1989) despite increasing availability of family planning services. Abortion was the commonest cause of death in the gynecology service during the period of the study and constituted 36.6% of fatalities. The majority of patients (76.2%) did not accept contraceptives. Almost one‐third of the illegal terminations were performed by physicians. Although the percentage of deaths decreased, the contribution of physicians to these fatalities increased, and accounted for 6/9 (66.7%) of fatalities in 1989. This circumstance probably signifies a defect in physician training and ability to perform abortion after‐care. Physicians should be trained in abortion care and laws changed in conjunction with greater drive to improve contraceptive utilization and reduce the incidence of unsafely induced abortion.
Use of low molecular weight heparin for prophylaxis and treatment of thromboembolism in pregnancy
Authors: Gillis S. , Shushan A. , Eldor A.
Published: April 2004

Low molecular weight heparin (LMWH) preserves the antithrombotic action but not the anticoagulant activity of heparin. LMWH is safe, does not cross the placenta and is administered as a single daily injection. We report our experience with 6 pregnant women given LMWH for treatment or prophylaxis of thromboembolism. The drug was successfully given to 5 women for periods of 6 weeks–6 months and no thromboembolic complications occurred during pregnancy or pueperium. There were no hemorrhagic complications and no excessive bleeding was observed during delivery. The sixth patient relapsed after 6 weeks of therapy. This patient also showed resistance to standard heparin administered intravenously at a very high dose. LMWH should be considered an alternative to standard heparin in pregnant women requiring antithrombotic prophylaxis and therapy.
Level and causes of maternal mortality in Guinea (West Africa)
Authors: Toure B. , Thonneau P. , Cantrelle P. , Barry T.M. , Ngo‐Khac T. , Papiernik E.
Published: April 2004

In order to evaluate the level of maternal mortality at Conakry, capital of Guinea (West Africa), a descriptive epidemiological study was made of all maternal deaths occurring between July 1st, 1989 and June 30th, 1990. To ensure that cases of maternal death were recorded as exhaustively as possible, we conducted this study over 1 year in municipal and hospital maternity units, and 3 months in the urban community. One hundred thirty‐nine maternal deaths were registered, representing an annual maternal mortality rate of 559/100 000 live births. The main causes of maternal death were abortion, complications linked with hypertension, and postpartum bleeding.
Small for gestational age twins: A retrospective analysis of clinical and acid‐base status immediately after delivery
Authors: Bartnicki Janusz , Meyenburg Michael , Saling Erich
Published: April 2004

In a retrospective study on 86 twins born between 1971 and 1990, the clinical and acidity status of small for gestational age twins in cases of uncomplicated labor was analysed and compared with the status of appropriate for gestational age twins. No difference was observed in Apgar score and umbilical blood pH between growth retarded and normal twins. The single fact of growth retardation without other factors of risk during labor has no influence on clinical status of small for gestational age twins.
Pelvic tuberculosis
Authors: Saracoglu Ö.F. , Mungan T. , Tanzer F.
Published: April 2004

Pelvic tuberculosis was diagnosed in 72 patients analyzed during the years 1979–1989. Twenty‐nine percent of the patients were over 40 years of age. The most common complaints were infertility (47.2%), abdominal or pelvic pain (32%) and abnormal uterine bleeding (11%). Only 2 patients had past or family history of pulmonary tuberculosis. The physical examination was normal in 31.6% of the patients. The chest X‐ray was normal in 81% of the patients. Blocked tubes were present in 32 of 34 patients who had hysterosalpingograms. Even if the diagnosis can be made from a histopathologic examination, hysterosalpingography is also a very useful aid in establishing a diagnosis. The most common site of infection was the tubes. Reconstructive surgery was performed in nine patients. Only one pregnancy was found in the present study without any medical or surgical treatment of pelvic tuberculosis. In one patient with habitual abortion as a cause endometrial tuberculosis was also found.
Strangulation of the umbilical cord due to combined amniotic band and true knot
Authors: Elchalal U. , Ashkenazy M. , Weissman A. , Rosenman D. , Blickstein I.
Published: April 2004

A case of fetal death due to an amniotic band and an umbilical cord true knot is presented. To the best of our knowledge the simultaneous occurrence of true knot of cord and amniotic band has never been previously reported and may shed light on the possible time of true knot formation in this case.
Haptoglobin as a sensitive marker of hemolysis in hellp‐syndrome
Authors: Wilke G. , Rath W. , Schutz E. , Armstrong V.W. , Kuhn W.
Published: April 2004

In a prospective study we measured laboratory variables of hemolysis in 25 patients with HELLP‐syndrome. Reduced haptoglobin levels were observed in all 25 patients at diagnosis. Elevated bilirubin and plasma hemoglobin levels were observed in 5/25 patients while an abnormal peripheral blood smear was found in 11/25 patients. Our results suggest that haptoglobin is a sensitive parameter for early detection of moderate hemolysis in HELLP‐syndrome and should be included in laboratory screening to aid diagnosis.
Sex differences in serum hormone levels in umbilical vein blood
Authors: Herruzo A.J. , Mozas J. , Alarcón J.L. , López J.M. , Molina R. , Molto L. , Martos J.
Published: April 2004

OBJECTIVE: To determine the serum levels of FSH, LH, PRL, estradiol, progesterone and testosterone in umbilical vein blood in a group of normal neonates. METHOD: Umbilical vein blood was obtained for serum analyses from 52 newborns (25 females and 27 males) in the Maternity of the Hospital Regional Virgen de las Nieves, Granada (Spain) and means were compared with Student's t‐test. RESULT: Mean values of prolactin, estradiol and progesterone were similar in both sexes. The levels of gonadotropins in umbilical vein blood found were significantly higher in newborn males than in females (P < 0.001 for LH, P < 0.007 for FSH). Testosterone levels were higher in male neonates than in females (P < 0.004). CONCLUSION: Our data reflect the dynamic state of male fetal endocrinological status in comparison to female fetuses, and strongly suggest that the mechanisms of hormonal regulation differ in the two sexes.
Norplant® use by women with sickle cell disease
Authors: Ladipo O.A. , Falusi A.G. , Feldblum P.J. , Osotimehin B.O. , Otolorin E.O. , Ojengbede O.A.
Published: April 2004

OBJECTIVE: To assess the safety of Norplant® contraceptive implant use by women with mild‐moderate homozygous sickle cell disease (HbSS). METHOD: Prospective observation of women pre‐ and post‐insertion of Norplant®, with each woman serving as her own control. Participants: 25 women 18–40 years of age who attended a hospital sickle cell clinic; post‐insertion data were available for 23 women. Outcome measures: Changes in hematologic parameters including PCV, MCV, reticulocytes, ISCs, HbF and bilirubin; changes in biochemical parameters including HDL cholesterol, aspartate transaminase, alkaline phosphate, serum creatinine and serum albumin. RESULT: With a mean follow‐up of 12.4 months (range 1–29 months), there were no clinically or statistically significant group or individual changes in the hematologic or biochemical parameters after Norplant® insertion. CONCLUSION: Norplant® appears to be a safe and appropriate contraceptive for women with mild‐moderate HbSS disease.
Hemostatic variables in patients with intrauterine fetal death
Authors: Duchinski T. , Pisarek‐Miedzinska D. , Szczepanski M.
Published: April 2004

OBJECTIVE: To assess the occurrence of hemostatic disturbances in patients with intrauterine fetal death (IFD). METHOD: The occurrence of abnormal results of hemostatic variables and of bleeding complications was noted from the medical records of 41 patients with IFD, 6 of whom had a multiple pregnancy. RESULT: Apart from the increased platelet count, results of blood coagulation tests in all except one patient with IFD did not differ from normal values. This patient, who had a twin pregnancy with one dead fetus, had an increase in fibrin degradation products and fibrin monomers 4 weeks after IFD and fibrinogenopenia and thrombocytopenia 2 weeks later. CONCLUSION: The deterioration of systemic hemostasis in women with IFD is rare and only occurs after 4 weeks of dead fetus retention; the main signs of this deterioration are fibrinogenopenia and thrombocytopenia.
Effect of hormone replacement therapy on spinal bone mineral density and T lymphocyte subsets in premature ovarian failure and Turner's syndrome
Authors: Kurabayashi T. , Yasuda M. , Fujimaki T. , Yamamoto Y. , Oda K. , Tanaka K.
Published: April 2004

OBJECTIVE: Our purpose was to evaluate the effect of hormone replacement therapy (HRT) on bone metabolism and the immunological change in premature ovarian failure (POF) and Turner's syndrome. METHOD: The study was conducted on 17 POF patients, 10 Turner's syndrome patients and 35 control subjects aged 20–40 years. Bone mineral density (BMD) of lumbar vertebra by dual energy X‐ray absorptiometry, serum bone metabolic parameters and T lymphocyte subsets in the peripheral blood were investigated. RESULT: The untreated and treated patients of POF (0.829 ± 0.077, 0.918 ± 0.094 g/cm2) and the untreated and treated patients of Turner's syndrome (0.647 ± 0.037, 0.885 ± 0.148 g/cm2) showed spinal osteopenia compared with the control group (1.039 ± 0.107 g/cm2). They showed a significantly lower percentage of CD4 and a ratio of CD4/CD8 in T lymphocytes as compared with the control group before HRT. CONCLUSION: POF and Turner's syndrome patients showed marked spinal osteopenia and abnormal T lymphocytes subsets. HRT slightly improved their BMD and immunological status.
Polymerase chain reaction analysis of human papillomavirus in adenocarcinoma and adenosquamous carcinoma of the uterine cervix
Authors: Matsuo N. , Iwasaka T. , Hayashi Y. , Hara K. , Mvula M. , Sugimori H.
Published: April 2004

Thirty‐two cervical adenocarcinomas and adenosquamous carcinomas were examined to search for human papillomaviruses (HPVs) using the polymerase chain reaction system. Human papillomavirus type 16 (HPV16) and type 18 (HPV18) deoxyribonucleic acid was detected in 22% and 16% of these carcinomas, respectively. HPV16 was the most common type in both adenocarcinoma and adenosquamous carcinoma, and the mean age of the HPV negative patients was significantly higher than that of HP V positive patients. There may be an association between HPVs and the development of certain adenocarcinomas and adenosquamous carcinomas of the cervix.
Total cholesterol, high density lipoprotein cholesterol and steroid hormone changes in normal weight women during the menstrual cycle
Authors: Nduka E.U. , Agbedana E.O.
Published: April 2004

OBJECTIVE: To study total cholesterol, high density lipoprotein cholesterol and steroid changes in normal weight women during the menstrual cycle. METHOD: Multiple point blood samples obtained at different phases of the menstrual cycle in 14 student nurses, consuming normal Nigerian diets (rich in vegetable based proteins and fiber), were analyzed for HDL cholesterol, total cholesterol and for the steroids progesterone, estradiol and testosterone by RIA. RESULTS: A multivariate repeated measures analysis was carried out according to Pillais, Hotelings Willes and Roys tests and the three phases of menstrual cycle were found to be significantly different with the significance level at 0.030. CONCLUSION: The fluctuations in plasma lipids that occur at different phases of the menstrual cycle have important implications in evaluating the factors of coronary heart disease in women of reproductive age. Also, the results suggest that multiple point measurements may give a better estimate of plasma lipid changes in blood in women of reproductive age.
Screening for consumptive coagulopathy in preeclampsia
Authors: Metz J. , Cincotta R. , Francis M. , Derosa L. , Balloch A.
Published: April 2004

Objective: To identify a practical and cost‐effective profile of tests to screen for consumptive coagulopathy in preeclampsia (PE). Methods: Retrospective analysis of the results of measurements of platelet count, prothrombin time (PT), activated partial thromboplastin time (APTT), plasma fibrinogen and D‐dimers in 100 patients presenting with PE uncomplicated by other disease or antepartum hemorrhage. Twenty‐four patients had pregnancy‐induced hypertension only, and 76 hypertension with proteinuria. Results: The incidence of abnormal tests on presentation was raised D‐dimers 34%, thrombocytopenia 14%, prolonged APTT 12%, prolonged PT 3%, and low fibrinogen 2%. Prolonged APTT without thrombocytopenia occurred in 8% of patients. In 19 patients with elevation of D‐dimers alone, only one showed evidence of consumption of coagulation factors on subsequent testing. Conclusions: A combination of platelet count and APTT is probably a practical and cost‐effective combination to screen for consumptive coagulopathy in PE.
A simple alternative to parenteral oxytocics for the third stage of labor
Authors: Irons D.W. , Sriskandabalan P. , Bullough C.H.W.
Published: April 2004

Objective: To determine the effect of nipple stimulation on uterine activity during the third stage of labor. Methods: Randomized controlled study comparing; (i) 15 min of nipple stimulation (n = 6), (ii) routine syntometrine injection (n = 3), (iii) no action/control (N = 5). Uterine activity was continuously measured using the placenta as an in‐situ hydrostatic bag connected to a pressure transducer. Results: Compared to controls uterine pressure was higher during nipple stimulation (103 mmHg vs. 70.8 mmHg, P = 0.04). The duration of the third stage and blood loss tended to be reduced with nipple stimulation compared to controls (20.3 vs. 12.3 min) and (257 vs. 166 ml) respectively but was not significant. Similar differences were observed between syntometrine and control groups. Conclusion: For women in developing countries where parenteral oxytocics are not available, nipple stimulation might reduce the incidence of postpartum hemorrhage. A larger trial now seems warranted.
Introduction of gynecologic endoscopic surgery in an African setting
Authors: Raiga J. , Kasia J.M. , Canis M. , Glowaczower E. , Doh A. , Bruhat M.A.
Published: April 2004

The new operative endoscopic techniques have been fully tried in the industrialized world and have spread to all surgical specialities. These new technologies present an obvious advantage for certain gynecologic pathologies which are particularly common in Africa. For pelvic inflammatory diseases, ectopic pregnancies and tubal sterility, laparoscopic surgery enables an initial assessment of disease, a less traumatic treatment and therefore a better long‐term prognosis for fertility and reduced postoperative morbidity. Recently, an operative endoscopic unit performing laparoscopic surgery and endoscopic resections was created at the Centre Hospitalo‐Universitaire de Yaoundé in Cameroon. This facility is the result of close collaboration between the University of Yaoundé and the University Hospital of Clermont‐Ferrand. This operative endoscopic unit has been functioning since April 1992. The authors discuss the difficulties involved in such projects, such as initial investment, maintenance of equipment and in particular training of the surgical team.
Estimating maternal mortality in rural areas of Mexico: the application of an indirect demographic method
Authors: Hernández B. , Chirinos J. , Romero M. , Langer A.
Published: April 2004

Objective: To measure maternal mortality levels in rural areas of Mexico. Methods: In a cross‐sectional study, a census of 13 378 households was carried out in the municipalities of Yecapixtla and Tlaltizapan, Morelos, Mexico. Information on 10443 subjects from 12 to 49 years old was included in the analysis. An indirect method of measuring maternal mortality — the sisterhood method — was used to estimate maternal mortality. Information about the number of sisters of the interviewees who died due to maternal causes was collected in the census. With this information, estimates of maternal mortality related to a period of 10–12 years before the application of the census were obtained. An innovation to the original method was the calculation of a confidence interval for the estimated maternal mortality rate (MMR). Results: The MMR in this region was 18.68/10 000 live births (95% CI 15.79–21.58/10 000 live births). The average risk of dying due to maternal causes was 1 in 87 for women between 12 and 49 years of age. Conclusions: The sisterhood method was effective for estimating maternal mortality in a small region, with no previous information about this indicator. The method proved to be useful for identifying a priority region for the implementation of maternal mortality reduction programs. Furthermore, the method was particularly convenient since it was applied as part of a multipurpose survey.
Idiopathic transient osteoporosis of the hip in pregnancy
Authors: Goldman G.A. , Friedman S. , Hod M. , Ovadia J.
Published: April 2004

Objective: To study the nature of a condition called transient osteoporosis of the hip (TOH) in pregnancy. Method: Fifty‐three cases of this syndrome of unknown etiology have been reviewed and an additional case has been added. Result and Conclusion: TOH is characterized by hip joint pain during the 3rd trimester of pregnancy and signs of demineralization of the femoral head. The course is benign with recovery shortly after birth. No specific therapy is required except bed rest.
Epidemiological correlates of preterm premature rupture of membranes
Authors: Spinillo A. , Nicola S. , Piazzi G. , Ghazal K. , Colonna L. , Baltaro F.
Published: April 2004

Objective: To study the clinical risk factors for preterm premature rupture of membranes (PROM). Method: We conducted a case‐control study of 138 patients with PROM between 24 and 35 weeks' gestation and 267 control subjects. Results: In stepwise multiple logistic regression models, the population of cases was more likely to be of low social class. Other risk factors for PROM were smoking in pregnancy, 1st or 2nd–3rd trimester hemorrhages, cervical incompetence and a documented cervico‐vaginal infection during index pregnancy. First trimester hemorrhage and a documented cervico‐vaginal infection during index pregnancy were associated with preterm PROM both in nulliparous and in multiparous women. Conclusion: Few potentially remediable risk factors are associated with the occurrence of preterm PROM.
External cephalic version after previous cesarean section—a clinical dilemma
Authors: Schachter M. , Kogan S. , Blickstein I.
Published: April 2004

OBJECTIVES: To describe our limited experience with external cephalic version from breech to vertex presentation at term, with the use of ritodrine tocolysis, in women who had undergone a previous cesarean delivery. METHODS: Eleven parturients after previous cesarean delivery underwent external version after 36 gestational weeks, utilizing tocolysis with ritodrine, after excluding cases of lowlying placenta, severe oligohydramnion or ruptured membranes. Patients were then followed until delivery and scar examination was carried out after vaginal delivery, or at re‐cesarean section, according to mode of delivery. RESULTS: All 11 attempted versions were successful. Six patients subsequently delivered vaginally and five by re‐cesarean section. None of the uterine scars showed any signs of dehiscence. Three of the five infants delivered by re‐cesarean section weighed over 4000 g, whereas all of the vaginally‐delivered infants weighed under 3500 g. CONCLUSIONS: External cephalic version to vertex presentation after previous cesarean section was successful in all 11 carefully selected patients. No untoward effects were noted, and no signs of scar dehiscence were found. The safety and efficacy of this procedure after previous cesarean delivery should be examined further.
Identity status research: implications for career counseling
Authors: Raskin Patricia M.
Published: April 2004

The purpose of this paper is to describe an empirical approach to the study of adolescence and to apply research findings to vocational counseling. The study of identity status has enriched and supported Erikson's theory of psychosocial development. Case histories of hypothetical clients in the four identity statuses are presented and different approaches for counseling with such clients are suggested.
Identity and intervention
Authors: Marcia James E.
Published: April 2004

The evidence, I thought, seemed clear enough. Frazier had claimed some innovations in behavioral techniques which I wanted to know more about, but I could imagine a potent technology composed of the principles already used by politicians, educators, priests, advertisers and psychologists. The techniques of controlling human behavior were obvious enough. The trouble was, they were in the hands of the wrong people—or of feeble repairmen. (B. F. Skinner, Walden Two, p. 308.)
The global world—a domain for development in adolescence?
Authors: Solantaus Tytti
Published: April 2004

Two case studies are presented for the purpose of providing material for theoretical discussion on the development of adolescents in the nuclear age.

The two cases originate from a study of 15 girls who were followed from the age of 15–16 to 17–18. Both cases showed an initial concern about nuclear war in earlier adolescence, but their subsequent development proceeded in opposite directions. The first case demonstrates how privatization and turning away from global issues might develop in one's mind and way of life. The second case demonstrates widening interests and activities in the global domain.

The cases are analysed using the Vygotskian concepts of internalization and the zone of proximal development. It is suggested that the development of mass media has created a new zone of proximal development in adolescence, the global domain. It is suggested further that an integrated world view is a developmental potential inherent in the global domain.
The adolescent as forgiver
Authors: Enright Robert D. , Santos Maria J.D. , Al‐Mabuk Radhi
Published: April 2004

A social cognitive developmental model of forgiveness is described and tested in two studies, the second being a replication of the first. In study 1, 59 subjects in grades 4, 7, 10, college and in adulthood were given a forgiveness interview that assessed six stages of forgiveness development, Rest's DIT measure of justice development, and a religiosity scale. As predicted, there were strong age trends for forgiveness and justice. Both forgiveness and justice were related but distinct constructs. The more one practiced one's faith, the higher one was in forgiveness stage. Study 2, with 60 subjects, replicated the above findings. The studies give strong evidence that people's understanding of forgiveness develops with age. Implications for adolescent development are drawn.
Ethnic identity in college students from four ethnic groups
Authors: Phinney Jean S. , Alipuria Linda Line
Published: April 2004

Research on adolescent identity development within Erikson's (1968) framework has not included ethnicity. This study examined ethnic identity search and commitment, the importance of ethnicity as an identity issue, and relationship of ethnic identity to self‐esteem among college students. Questionnaires were given to 196 male and female urban college students from three minority groups (Asian‐American, Black, and Mexican‐American) and a comparison White group. Exploration of ethnic identity issues was significantly higher among minority group, compared to majority group, college students. Ethnicity was considered to be as important as two other traditionally studied areas of identity and was rated as significantly more important by minorities than by Whites. Self‐esteem, especially for minority subjects was related to the extent that subjects had thought about and resolved issues involving their ethnicity.
Family economic stress, maternal and paternal support and adolescent distress
Authors: Lempers Jacques D. , Clark‐Lempers Dania
Published: April 2004

The present study investigated the effects of family economic stress on parental support and adolescent maladjustment in 622 9th through 12th graders in a Midwestern farm community. Economic stress had a direct effect on adolescent depressive symptoms, delinquency and drug use. The findings also indicated an indirect effect: increased stress was associated with lower paternal support for female, but not male adolescents, and lower paternal support for females was associated with higher female distress.
A metacognitive analysis of decision making in adolescence
Authors: Ormond Cheryl , Luszcz Mary A. , Mann Leon , Beswick Gery
Published: April 2004

Samples of 43 early (CA = 13 years) and 41 middle (CA = 15 years) adolescents were compared on three categories of metacognitive knowledge as they relate to decision making—person knowledge, task knowledge and strategy knowledge. Metacognitive knowledge was assessed using a 19‐item questionnaire. Consistent with our hypothesis, middle adolescents showed significantly greater metacognitive knowledge than early adolescents on all three scales. Self‐reported decision making style (using the Flinders Adolescent Decision Making Questionnaire) and decision making performance on a hypothetical scenario were also measured. Middle adolescents reported a more competent decision making style than early adolescents, while group differences on the scenario were not found. Adolescents completing the scenario scored significantly higher on all measures of decision making metacognition. Significant correlations were found between metacognitive knowledge of decision making, self‐reported decision making style and performance on the decision scenario task. By middle adolescence understanding of what is involved in the activity of decision making is well developed. This growth in understanding, accompanied by changes in social domains, plays a part in decision execution and style.
Ethnic differences in adolescent self‐poisoning: a comparison of Asian and Caucasian groups
Authors: Handy S. , Chithiramohan R.N. , Ballard C.G. , Silveira W.R.
Published: April 2004

A study of self‐poisoning in 25 Asian and 25 Caucasian adolescents is presented. Cultural conflicts were the most important factors in the parasuicidal behaviour of Asian children, whereas a variety of factors accounted for the parasuicidal behaviour of Caucasians with a predominance of a disrupted family background. There was little difference in the type of poisoning and the degree of pre‐planning between the two groups.
Male and female patterns in the discovery of sexuality during adolescence
Authors: Zani Bruna
Published: April 2004

The present paper attempts to analyse the various factors which influence adolescents strategies in their efforts to cope with the problems related to pubertal and sexual development: the physiological changes, the social pressures engendered by family and cultural environment, and the personal meanings young boys and girls attribute thereto.

The data came from 603 questionnaires and 60 interviews performed on Italian adolescents (both males and females, students and non‐students) on the following issues: the awareness of physical maturation in the same and opposite sex; the significance of heterosexual relationships; the motivation for early sexual experiences; and their effects on personal identity.

Significant differences concerning sex and level of schooling emerged with regard to the elaboration of the subject's psychosexual identity, motivation in the choice of partner and the precocity in the onset of sex life.
Relationship between physical attractiveness, physical effectiveness, and self‐esteem: a cross‐sectional analysis among adolescents
Authors: Thornton Bill , Ryckman Richard M.
Published: April 2004

In the present study, the relative contributions of physical attractiveness and physical effectiveness to the self‐esteem were examined among four different grade‐levels of adolescents (mean ages: 12·5, 14·6, 16·3, 18·3 years old). Overall, both attractiveness and effectiveness were significantly related to the self‐esteem of males and females. In contrast to previous research, attractiveness and effectiveness did not appear to be differentially important to the self‐esteem of males and females and consistent patterns were evident across the different grade‐levels. These results are believed to reflect changes occurring in sex‐role expectations and socialization.
Erotomania in an adolescent: clinical and theoretical considerations
Authors: Urbach John R. , Khalily Cyma , Mitchell Patricia P.
Published: April 2004

Erotomania is a relatively rare delusional syndrome, typically seen in heterosexual women of middle‐age or beyond. This is the first reported occurrence in an adolescent, and one of very few involving homosexual orientation. A detailed case report is discussed in the context of adolescent developmental phenomena, including “crushes”, identity formation, and the resolution of sexual orientation. The presentation of erotomania as alleged sexual abuse, and a possible etiologic role for childhood sexual trauma, are considered.