bluuebunny/crossref_metadata_2025 huggingface dataset:
Ureteric injuries associated with gynecologic surgery
Authors: Onwudiegwu U. , Makinde O.O. , Badejo O.A. , Okonofua F.E. , Ogunniyi S.O.
Published: April 2004

We conducted a review of eight ureteric injuries associated with major gynecologic surgery in seven patients over an 11‐year period. Our low incidence of 0.36% is comparable with other reports. Diagnosis was made either intra‐operatively or postoperatively. Immediate ureteric repair is advocated for all injuries discovered intra‐operatively. Attention to preventive measures both before and during gynecological operations will reduce the incidence of ureteric injuries.
Repeat pregnancy associated with cardiac pacemaker
Authors: Matorras R. , Diez J. , Saez M. , Montoya F. , Aranguren G. , Rodriguez‐Escudero F.J.
Published: April 2004

Two pregnancies in a patient with a fixed‐rate pacemaker are reported. The first pregnancy was uneventful. The second had no maternal complications either. A moderate tachysystolia was detected during the second period. The newborn was delivered with forceps applied under spinal anesthesia. Newborn infant evolution presented no hazards, but umbilical cord analysis revealed a severe acidosis, in spite of a normal scalp analysis 45 min earlier. Epidural anesthesia is recommended for such patients.
No decline in preterm birth rate over three decades
Authors: Yan J.S. , Yin C.‐S.
Published: April 2004

Low socioeconomic status has been associated with risk of preterm delivery. During the past 30 years, Taiwan has had tremendous economic growth and people have attained higher levels of education and living. It is thus not unreasonable to presume that the rate of preterm delivery would decline in response to these changes. The birth registry of Tri‐Service General Hospital from 1957 to 1987 was reviewed. The rate of preterm delivery remained stable over the past 30 years, unaffected by these country‐wide social changes.
Vaginal hysterectomy for the management of menstruation in mentally retarded women
Authors: Sheth S. , Malpani A.
Published: April 2004

A personal series of 60 vaginal hysterectomies performed in nulliparous mentally retarded women is presented. This is the largest series published in the literature. The advantages of the vaginal route in performing hysterectomies in these patients is discussed and the technique is described.
Unexplained infertility: a review of diagnosis, prognosis, treatment efficacy and management
Authors: Collins J.A. , Crosignani P.G.
Published: April 2004

The dilemma of unexplained infertility posed by Southam in 1960 remains today: despite advances in the diagnostic assessment of infertility, many couples still have no explanation for their infertility. Even the most sophisticated evaluation of semen, ovulation and genital tract competence cannot reveal all of the possible defects in the complex process leading to conception. Because it arises from these shortcomings in our knowledge of fertilization and from our inability to utilize all of the current knowledge, unexplained infertility is a challenge for both biological and clinical research. This paper attempts to summarize some clinical issues in the management of unexplained infertility: the prevalence of the disorder, problems in the definition and possible explanations for the existence of this diagnostic category. It reviews outcome‐based clinical publications as a guide to decision‐making on what diagnostic tests to use, provides a summary of the untreated prognosis and evaluates study results that may serve as a basis for treatment decisions in this puzzling diagnostic category of infertility.
The feasibility of suppressing ovarian activity following the end of amenorrhoea by increasing the frequency of suckling
Authors: Gellén J.J.
Published: April 2004

OBJECTIVE: To determine the feasibility of suppressing ovarian activity by increasing the frequency of suckling episodes. METHOD: Prospective study was carried out with 19 exclusively breastfeeding volunteers. Ten subjects (experimental group) increased the suckling episodes by minimum 50% per day from the beginning of the first postpartum menses. Nine controls continued breastfeeding as before. Estradiol, progesterone, LH, FSH and prolactin were measured in blood samples, drawn twice a week up to the second postpartum menses or for 60 days, by RIA. Student's t‐test was employed. RESULT: The higher suckling frequency prevented ovulation in 7 of 10 cases examined according to the plasma progesterone concentration (<9.5 nmol/l). Significantly higher average prolactin value could also be found in the experimental group (1038 (527) munits/l vs. 518 (245) munits/l; P < 0.05). CONCLUSION: Results suggest that an earlier initiation of the increase in breastfeeding frequency may delay the resumption of ovulation. Frequent, full time lactation may reduce the risk of pregnancy.
Amoxycillin/clavulanic acid (augmentin) compared with triple drug therapy for pelvic inflammatory disease
Authors: Uri F.I. , Sartawi S.A. , Dajani Y.F. , Masoud A.A. , Barakat H.F.
Published: April 2004

Sixty Jordanian women with pelvic inflammatory disease (PID) were studied. Of these, 31 were given oral amoxycillin/clavulanic acid (augmentin) for a mean duration of 8.4 days and 29 were given a standard triple drug regimen of oral ampicillin, intramuscular gentamicin and metronidazole tablets/pessaries for a mean duration of 7.2 days. Bacterial culture (cervical and high vaginal swabs) was positive in every case, most often E. coli but sometimes more than one pathogen was isolated. No gonococci were isolated and tests for chlamydia in 16 patients (8 in each group) were negative, suggesting a dissociation between the etiology of PID and sexually transmitted disease in this Jordanian study. After 3 days of treatment, more patients in group I (augmentin) showed diminution of symptoms of pain and discharge (P ≤ 0.05) compared to group II. At the end of treatment, complete cure or satisfactory improvement was recorded in 93.1% and 92.9% of cases in the two groups, corresponding to in vitro bacterial efficacy of 90.4% and 96.5%, respectively. No serious side effects were noted in either regimen. The results of this comparative study suggest that oral amoxycillin/clavulanic acid (augmentin) may be a convenient alternative to the triple drug regimen usually administered for the treatment of pelvic inflammatory disease.
Cytokines in the peritoneal fluid of patients with endometriosis
Authors: Koyama N. , Matsuura K. , Okamura H.
Published: April 2004

OBJECTIVE: To determine which of the various cytokines interleukin‐5 (IL‐5), interleukin‐6 (IL‐6) and interleukin‐1 (IL‐1) are important in endometriosis. METHODS: Peritoneal fluid (PF) samples were taken from 55 women at the time of either laparotomy or laparoscopy, and were examined for the levels of IL‐5, IL‐6 and IL‐1 using each cytokine specific sandwich enzyme‐linked immunosorbent assay. Thirty‐two patients had pelvic endometriosis, eight post‐pelvic inflammatory disease, four advanced cancer, three adenomyosis, three benign ovarian tumor, and other diseases. Statistical analysis was performed with the Mann Whitney test, chi‐square test or Fisher's test. RESULTS: Both IL‐5 and IL‐6 levels in PF specimens with endometriosis tended to be higher than normal, while the same specimens were mostly interleukin‐1β (IL‐1β) negative. Of great interest was the negative correlation between log (IL‐5) and IL‐6 (Fisher's test, P < 0.04). CONCLUSION: These findings support the concept that IL‐5 and IL‐6 but not IL‐1 are associated with endometriosis.
A comparison of manual vacuum aspiration (MVA) and sharp curettage in the management of incomplete abortion
Authors: Mahomed K. , Healy J. , Tandon S.
Published: April 2004

Objectives: A prospective longitudinal study was carried out in two Harare hospitals to determine whether manual vacuum aspiration (MVA) was as safe and as effective as sharp curettage for treatment of incomplete abortion. Methods: Demographic and clinical data were collected over a 3‐month period on 589 women treated with sharp curettage for incomplete abortion ≤ 12 weeks gestation. One year later, after faculty and staff at the two hospitals were trained to use MVA, data were similarly collected on 834 women treated with MVA for incomplete abortion. Results: Based on procedure‐related complications at the time of treatment, MVA was found to be as safe as sharp curettage in treating incomplete abortion ≤ 12 weeks gestation. MVA was more effective than sharp curettage in achieving complete uterine evacuation (0% incomplete evacuations vs. 0.7%, P < 0.05). Conclusions: Given the safety and effectiveness of the MVA procedure and the potential for reducing health care costs and improving patient management, this technology should be considered by health care systems in developing countries for improving treatment of abortion complications.
Transvaginal ultrasound in threatened abortions with empty gestational sacs
Authors: Tongsong T. , Wanapirak C. , Srisomboon J. , Sirichotiyakul S. , Polsrisuthikul T. , Pongsatha S.
Published: April 2004

Objective: To determine whether transvaginal ultrasound criteria alone can distinguish viable from non‐viable gestational sacs at a single examination. Method: A prospective descriptive study was undertaken and analysis performed on 211 pregnancies complicated by threatened abortion and empty gestation sacs diagnosed by transvaginal ultrasound. The main outcome measure was the final diagnosis of viable or non‐viable gestation on subsequent transvaginal sonography. Results: The study shows that a single transvaginal ultrasound examination is useful in differentiating viable from non‐viable gestation sacs. The mean sac diameter (MSD) was found to be the most useful criterion for determining non‐viability. An MSD of ≥ 17 mm that lacked an embryo and an MSD of ≥ 13 mm without visible yolk sac were reliable predictors of non‐viable gestation sacs at a single examination with 100% specificity and 100% positive predictive value. An MSD ≥ 13 mm without visible yolk sac was the most sensitive criterion. Using MSD criteria, 73% of non‐viable gestations could be reliably identified without any false‐positive diagnoses. Deformed shape, low position and thin decidual reaction are strong indicators of non‐viable gestations but are not 100% accurate. There is still a significant proportion of empty sacs, where no accurate distinction between viable and non‐viable can be made according to one criterion at a single examination and in these cases serial examinations should be carried out before any active management is advocated. Conclusion: In most cases, transvaginal sonographic criteria alone can distinguish viable from non‐viable empty gestational sacs at a single examination.
Type‐IV collagenase and tissue inhibitor of metalloproteinase in ovarian cancer tissues
Authors: Takemura M. , Azuma C. , Kimura T. , Kanai T. , Saji F. , Tanizawa O.
Published: April 2004

Objective: We examined the specific expression of gelatinase/type‐IV collagenase and tissue inhibitor of metalloproteinase (TIMP) in clinical ovarian cancer tissue. Methods: Molecular weight‐specific gelatinase/type‐IV collagenase activity was examined by sodium dodecyl sulfate (SDS)‐polyacrylamide gel electrophoresis in which substrate was included (zymography). The expression of TIMP mRNA was examined by Northern blot analysis. Results: Zymography revealed that in ovarian cancer the activity of a 92‐kDa gelatinase/type‐IV collagenase was always greater than that of a 64‐kDa gelatinase/type‐IV collagenase in contrast to the situation in the normal ovary. Northern blot analysis revealed no remarkable difference of TIMP mRNA expression between cancer and normal ovarian tissues. Conclusions: These results indicate that the higher activity of the 92‐kDa gelatinase/type‐IV collagenase enzyme, relative to that of the 64‐kDa enzyme, is involved in the malignant phenotype of ovarian cancer, while the inhibitor of these enzymes, TIMP, is distributed in a widespread fashion in the tissue, and its levels are not correlated with the malignancy.
The immediate surgical management of fresh obstetric fistulas with catheter and/or early closure
Authors: Waaldijk K.
Published: April 2004

OBJECTIVES: To determine prospectively if the immediate surgical management of obstetric fistulas within the first 3 months by catheter and/or early closure is effective. METHODS: During a 10‐month period (August 1992 through May 1993), a total of 170 patients with an obstetric fistula of less than 3 months' duration were treated. A catheter was inserted if the fistula was necrotic, and as soon as the fistula edge was clean an early closure was performed unless the fistula had healed already. RESULTS: The fistula was closed in 156 (91.8%) of the 170 consecutive patients: with continence in 146 (93.6%), minimal/mild incontinence in 7 (4.5%) and severe incontinence in 3 (1.9%) of the closed fistulas. In 14 patients (8.2%) the fistula was not closed at first intention; however, 12 were closed at the second attempt. CONCLUSION: The immediate surgical management proved highly effective in terms of closure and continence.
The relationship between family structure and process variables and adolescent decision making
Authors: Brown Jacob E. , Mann Leon
Published: April 2004

This study examined the relationship between family structural and process variables and adolescent participation in family decisions and vigilant decision making. Data were obtained from a survey sample of 585 adolescents aged 12–18 years living in Adelaide, South Australia. Adolescents from one‐parent families participated in a greater number of family decisions than those from two‐parent families. Adolescents from families adaptable in allocating roles and setting rules participated in more family decisions than those from low adaptable families. Family socio‐economic status was significantly linked to the adolescent's self reported vigilance. High family cohesion, good parent‐adolescent communication and sound parental conflict resolution skills were also significantly related to adolescents' vigilant decision making, testifying to the importance of family environment in the socialization of adolescents for decision making
A study of the relationship between life events and disturbed self image in adolescents
Authors: Palazzi Stefano , De Vito Enrico , Luzzati Donata , Guerrini Antonio , Torre Eugenio
Published: April 2004

The occurrence and subjective importance of a list of life events were determined in 1296 adolescents and compared with the risk of a disturbed self image, as assessed on the basis of Offer's (1981) questionnaire. A disturbed self image was shown by 24·2 per cent of the sample, and it was significantly associated with a reported excess of events (one standard deviation above the mean), and with the reporting of specific classes of events. These included serious disagreement between parents, sudden decrease in family income, serious abuse either within the family or outside the family, and having had an abortion. The events were sorted and ranked by the observed values of their sample frequency, subjective importance, and assessed risk of a disturbed self image. The rarest and subjectively most important events were often associated with a higher risk of a disturbed self image, and the role of reporting such “exceptional” experiences is discussed.
AIDS knowledge and beliefs, and sexual behavior of sexually delinquent and non‐delinquent (runaway) adolescents
Authors: Rotheram‐Borus Mary Jane , Becker Judith V. , Koopman Cheryl , Kaplan Meg
Published: April 2004

This study assessed general knowledge of AIDS, beliefs about preventing AIDS, and sexual behavior among two groups of male adolescents at high risk of HIV/AIDS: 60 sexually delinquent males and 57 non‐delinquent runaway males.

Significantly fewer sexually delinquent than non‐delinquent (runaway) males had experienced sexual intercourse with a consenting female partner (45 vs. 89 per cent). Sexually delinquent youths scored significantly lower than non‐delinquent youths in general knowledge of AIDS (65 vs. 73 per cent) and were not able to discriminate safer behaviors from those which were less safe (42 vs. 71 per cent). Both groups reported moderate support for beliefs about preventing AIDS. These results suggest HIV/AIDS prevention programs that attempt to increase knowledge are needed by these youths, particularly for sexually delinquent youths.
Interpersonal needs in middle adolescents: companionship, leadership and intimacy
Authors: Bakken Linda , Romig Charles
Published: April 2004

Recent research suggests that, along with identity, intimacy is an important developmental construct during adolescence. Are there gender differences in current society regarding intimacy development? Two hundred and seven middle adolescents (70 males and 137 females) were measured using Schutz's (1958) Fundamental Interpersonal Relationship Inventory (FIRO). The FIRO is a self‐report survey which assesses the subject's perceived expressions and perceived desires in three categories of interpersonal relationships: Inclusion (companionship), control (leadership), and affection (intimacy). Results indicated that there were differences in expression of inclusion, control, and affection, and desire for inclusion and affection. A second analysis addressed the perceived ranking in importance of the three interpersonal categories measured. Males ranked control expressed highest and affection desired lowest; females ranked affection desired as highest and control expressed lowest. Both groups ranked inclusion desired and expressed as moderate. The current research suggests that gender differences in the development of intimacy may occur as early as middle adolescence.
Glue sniffing: a comparison study of sniffers and non‐sniffers
Authors: Jansen P. , Richter L.M. , Griesel R.D.
Published: April 2004

A study of 22 glue sniffers and 22 non‐sniffers was carried out with individuals from the same reference group. The subjects were all street children living in supervised shelters. No statistically significant differences were found between the sniffers and non‐sniffers on cognitive measures or biographical features (e.g. time spent at school, years on the street). When rated by shelter staff on a modified version of the Christiansen Rating Scale (1967) the sniffers were perceived to be significantly more disturbed in their relationships with others, however, methodological issues do not permit conclusive evidence of behavioural differences to be drawn. The authors conclude that the findings lend support for the view that the effects of volatile substance abuse on cognitive and personality functioning cannot be clearly demonstrated.
Adolescent coping behavior when confronted with a friend with AIDS
Authors: Brown Larry K. , Spirito Anthony , Reynolds Lyn Ann , Hemstreet Alyce
Published: April 2004

The coping strategies employed by adolescents (n = 871) when presented with a hypothetical situation of a friend with AIDS were examined. Adolescents reported a wide range of imagined responses that were generally adaptive. Girls more than boys and distressed students more than nondistressed students were likely to endorse adaptive coping items. Comparison of the students with a separate sample (n = 472) that responded to a hypothetical situation of a suicidal peer revealed more distress in girls for the AIDS problem and more distress in boys for the suicide problem, contrary to expectations. Adolescents were more distressed and endorsed a wider variety of coping strategies in response to the AIDS scenario than to the suicide problem. Implications for care of adolescents dealing with these significant issues are discussed.
Regulation of the yeast phospholipid hydroperoxide glutathione peroxidase GPX2 by oxidative stress is mediated by Yap1 and Skn7
Authors: Tsuzi Daisuke , Maeta Kazuhiro , Takatsume Yoshifumi , Izawa Shingo , Inoue Yoshiharu
Published: April 2004

The GPX2 gene encodes a homologue of phospholipid hydroperoxide glutathione peroxidase in Saccharomyces cerevisiae. The GPX2 promoter contains three elements the sequence of which is completely consistent with the optimal sequence for the Yap1 response element (YRE). Here, we identify the intrinsic YRE that functions in the oxidative stress response of GPX2. In addition, we discovered a cis‐acting element (5′‐GGCCGGC‐3′) within the GPX2 promoter proximal to the functional YRE that is necessary for H2O2‐induced expression of GPX2. We present evidence showing that Skn7 is necessary for the oxidative stress response of GPX2 and is able to bind to this sequence. We determine the optimal sequence for Skn7 to regulate GPX2 under conditions of oxidative stress to be 5′‐GGC(C/T)GGC‐3′, and we designate this sequence the oxidative stress‐responsive Skn7 response element.
Flat semimodules
Authors: Al-Thani Huda Mohammed J.
Published: April 2004

We introduce and investigate flat semimodules and k‐flat semimodules .We hope these concepts will have the same importance in semimodule theory as in the theory of rings and modules.
Antenatal evaluation of FHR accelerations associated with fetal movements
Authors: Sadovsky Eliahu , Navot Daniel , Yaffe Haim
Published: April 2004

A retrospective comparative study of two definitions of the non‐stress testing employing two and four accelerations associated with fetal movements in 20‐min observation in 304 high risk pregnant women was evaluated. It was shown that four accelerations or more are no more predictive of good outcome than two accelerations during the same period. On the other hand a non‐reactive test is significantly more predictive of poor outcome when two acceleration definition was employed. It was shown in cases with good outcome that the reactivity of the non‐stress test increases with gestational age and that this test is invalid prior to the 33rd week of gestation.
Oral contraception during lactation: A global survey of physician practice
Authors: Strauss Lilo T. , Speckhard Mark , Rochat Roger W. , Senanayake Pramilla
Published: April 2004

The use of combined estrogen‐progestogen oral contraceptives (EP‐OC) by lactating women has been associated with suppression of lactation. To determine the extent to which physicians prescribe combined EP‐OC for lactating women, the International Planned Parenthood Federation (IPPF) and the United States Centers for Disease Control (CDC) collaborated in a global mail survey of 3697 physicians affiliated with Family Planning Associations (FPA) in 72 countries. Usable responses were received from 831 physicians (22%) in 65 countries. The percent of clinicians who provide EP‐OC to lactating women was higher in developing regions (63% or more) than in developed regions (40% or less). Patient preference was rated important more often than any other factor in the decision to prescribe EP‐OC for lactating women. The percentage of clinicians who reported complaints of decreased milk production from women using EP‐OC was higher (32% or more) in developing regions where breast milk is often essential to infant nutrition.
Pelvic abscess in gynecologic patients
Authors: Gini P.C. , Chukudebelu W.O.
Published: April 2004

A survey of an 8‐year period in which 37 cases of pelvic abscess occurred in a Nigerian hospital department of obstetrics and gynecology is presented. All 37 women were surgically treated; one death occurred post‐operatively. A regimen of 400 mg of metroni‐dazole three times daily combined with appropriate antibiotics is recommended as the treatment of choice, even where laboratory confirmation of anaerobic involvement is unavailable.
Familial benign cystic teratomata
Authors: Brenner Steven H. , Wallach Robert C.
Published: April 2004

A family with benign cystic teratomata in three successive generations is described. Other familial occurrences of these tumors have been reported; but not in three generations. Familial occurrence suggests an inherited characteristic for parthenogenic development and the occurrence of teratomata in twins and triplets supports the theory of a parthenogenic etiology. Benign cystic teratomata may, therefore, be tumors whose origin is genetically controlled.
Menstrual pattern and ovarian function in women with hyperprolactinemia
Authors: Bahamondes Luis , Faúndes Anibal , Tambascia Marcos , Trevisan Miriam , Dachs J. Norberto , Pinotti JoséA.
Published: April 2004

Prolactine (PRL) and progesterone were systematically measured in all women presenting with amenorrhea, oligomenorrhea or galactorrhea at the Infertility Clinic of the Department of Obstetrics and Gynecology, State University of Campinas, Brazil, during a period of 34 months. The same hormonal assays were done to all infertile patients presenting for the first time during the last 6 months of the same period, for a total of 190 subjects. Fifty‐five patients with amenorrhea, 38 with oligomenorrhea and 97 with normal cycles, 20 of whom had galactorrhea, were included in the study. Fifty‐five percent of amenorrheic patients, 37% of oligomenorrheic and 9% of those with normal menses had elevated PRL. The mean PRL was higher the greater the menstrual disturbance but was not influenced by presence or absence of galactorrhea. Short luteal phase was the ovarian function condition most frequently associated with high PRL among women with normal menses.
The demography of maternal mortality‐seven Swedish parishes in the 19th century
Authors: Högberg Ulf , Broström Göran
Published: April 2004

Complications of childbirth is a leading death cause for women of reproductive ages in the developing countries today. The unique Swedish population statistics from the 19th century permit comparable historical studies. In seven Swedish parishes 170 maternal deaths were observed — 595 per 100,000 live births. Eclampsia, obstructed labor and hemorrhage were responsible for 92 deaths, and puerperal sepsis for only 15 deaths. Indirect obstetrical deaths, like pneumonia, tuberculosis, dynsentery and heart diseases, accounted for 30.8% (41/133) of the specified death causes. With a time limit of 1 year instead of 42 days following delivery, maternal mortality was increased by 17%. Out of 14 married women 1 died from childbirth. Maternal deaths accounted for 40–50% of all deaths in the central ages of reproduction, leaving the motherless children with a highly increased death risk. Of the live born, 3% survived 5 years after the mothers' death. Of children aged 1–5 only 13% survived 5 years after the mothers death.
Oral contraceptives and stroke: A preliminary report on an epidemiologic study in Taiwan, China
Authors: Chang K.K. , Chow L.P. , Rider R.V.
Published: April 2004

To investigate risk of stroke following use of oral contraceptives (OC) in less developed countries, a case‐control study was conducted in Taiwan involving 323 cases hospitalized in 1978–1980, 250 hospital controls, and 646 neighborhood controls matched with cases on several variables. All were alive at interview. For the total sample, no increased risk was found. However, when comparison is with hospital controls, the risk for the recent OC users was increased (OR = 3.93, 95% C.L. 1.21, 5.46). This latter finding is consistent with studies in developed countries.
Observations on some patients of high parity delivering in a general hospital in Saudi Arabia
Authors: Opaneye A.A.
Published: April 2004

In a prospective study 100 consecutive Saudi patients having their tenth or subsequent deliveries in a general hospital were observed. Unlike in some other reports [1,8] fetal malpresentations, maternal anaemia or hypertension were few. However there was a high incidence of uterine inertia and primary cesarean sections. Early perinatal mortality rate was 50 per 1000. High parity is still a hazard to both mother and baby. Health education and family planning should be improved.
Procidentia in the newborn
Authors: Carpenter S.E. , Rock J.A.
Published: April 2004

Complete uterine prolapse was noted shortly after birth in a female infant with a meningomyelocele at the level of the iliac crest with a palpable dimpled defect caudal to the primary lesion. The vagina and uterus were restored to their normal position with a rubber nipple placed into the vagina. The prolapse resolved on the sixth day of life after a repair of the meningomyelocele. Thus, conservative therapy with temporary support provides a satisfactory solution for newborn procidentia.
Endocrine and metabolic effects of simple hysterectomy
Authors: Menon R.K. , Okonofua F.E. , Agnew J.E. , Thomas M. , Bell J. , O'Brien P.M.S. , Dandona P.
Published: April 2004

A survey of 60 women who had undergone simple hysterectomy with preservation of ovaries revealed a high prevalence of menopausal flushes. Only 5 (8%) had menopausal concentrations of gonadotropins and estradiol. This is similar to the prevalence of natural menopause in population of comparable age. Of the remaining 55 women, 28 (47% of the total) had normal gonadotrophins and estradiol concentrations although they complained of hot flushes; these levels were not significantly different from those in 27 women who did not flush. The “flushers” did, however, have significantly diminished bone mineral index and higher serum uric acid concentrations than the “non‐flushers”. Flushes disappeared in those women who took estrogen replacement therapy. These data show that although full‐blown menopause does not increase in frequency following simple hysterectomy, a subtle diminution in estrogenisation is frequent. This hypo‐estrogenisation is sufficient to cause: (a) hot flushes; (b) demineralisation of the skeleton and (c) an elevation in serum uric acid concentrations. There may be a case for estrogen therapy in all women who develop hot flushes following simple hysterectomy.
Characteristics of changes in blood circulation induced by cold stimulation in pre‐eclamptic women
Authors: Miyamoto S. , Shimokawa H. , Touno A. , Kurokawa T. , Nakano H.
Published: April 2004

Changes in peripheral deep body temperature (p‐DBT) after cooling were examined in normal, chronically hypertensive pregnant and pre‐eclamptic subjects. The recovery of p‐DBT after cooling was delayed significantly in the pre‐eclamptic subjects, as compared to findings in the other two groups. The delay in the recovery process of blood flow in the tissue after cooling, probably due to disturbance of the vasodilating process, is a characteristic of microcirculation in pre‐eclamptic subjects.
Analysis of sterilization failure in Brazil
Authors: Lassner K.J. , Chen C.H.C. , Oberle M.W. , da Trindade T.C.S.M. , Aguinaga H.
Published: April 2004

A study of 13,423 female sterilization procedures performed from 1981 to 1984 in Rio de Janeiro, Brazil, was conducted to determine the level of sterilization failure. The lifetable cumulative failure rate was 0.54 at 12 months per 100 initial sterilizations, increasing to 1.04 at 48 months. Results of a multivariate analysis indicated that the differential in the rate of sterilization failure by woman's age at sterilization at 12 and 24 months was statistically highly significant. However, the differential rate of failure by the other variables such as whether sterilized during a training period, number of sterilizations per surgeon per day, and year of sterilization were not statistically significant.
Breech births in twin pregnancy: An analysis of Apgar score and perinatal mortality from a Nigerian sample
Authors: Fakeye O.
Published: April 2004

Perinatal mortality (PNM) rates are reported for 146 twin‐1 and 192 twin‐2 breech births among 622 consecutive twin pairs delivered at the University of Ilorin Teaching Hospital, Ilorin, Nigeria. Stillbirths and infants with severe asphyxia (Apgar score 1–3) were recorded in significant proportions of both first and second twin breech infants. PNM rates were 13.7% twin‐1, 18.8% twin‐2; corrected PNM for infants weighing 2.0 kg or more, were 9.3% and 12.4% for twin‐1 and twin‐2, respectively. Twin specific breech PNM decreased with increasing birthweight of first and second twin to a low optimum in the weight group 2.5–2.9 kg, and thereafter rose for both first and second twin with birthweight 3.0 kg and above. Factors such as low birthweight, breech/breech presentation, breech extraction and retained second twin breech contributed significantly to the high PNM rates. More favorable PNM rates were recorded among a limited number of breech infants delivered by primary cesarean section for breech/breech or first twin breech presentations. A liberal approach to cesarean section delivery for breech twin births, and particularly for paired breech/breech presentation is strongly advocated.
Plasma antithrombin III levels in pre‐eclampsia and chronic hypertension
Authors: Leiberman J.R. , Hagay Z.J. , Mazor M. , Wiznitzer A. , Aharon M. , Nathan I. , Dvilansky A.
Published: April 2004

Plasma levels of antithrombin III were tested during pregnancy in a control group of normal patients and in a study group that included patients with moderate and severe pre‐eclampsia and chronic hypertension. The control group showed mean antithrombin III activity of 97.9 ± 20.9%, the severe pre‐eclamptic patients 22.33 ± 18.22%, the moderate pre‐eclamptic patients 56.0 ± 7.56%, and the chronic hypertensive patients 77.5 ± 6.69%. The difference between normal pregnancy and moderate pre‐eclampsia was significant at P < 0.002, normal pregnancy and severe pre‐eclampsia P < 0.002, moderate and severe pre‐eclampsia P < 0.002, chronic hypertension and normal pregnancy P < 0.1, and chronic hypertension and severe pre‐eclampsia P < 0.002. All the severe pre‐eclamptic patients and 2 out of 6 of the moderate pre‐eclamptic women were below 55.7% (x – 2S.D.) of normal antithrombin III activity. Patients with heavy proteinuria had depressed antithrombin III activity. However, chronic hypertensive pregnancies, although rather a small group, had almost normal values of plasma antithrombin III activity. The plasma antithrombin III value may thus help to distinguish between chronic hypertension and severe pre‐eclamptic disease.
The effect of maternal age on primary cesarean section rate
Authors: Witter F.R. , Repke J.T. , Niebyl J.R.
Published: April 2004

A retrospective analysis of computerized data from 11,815 patients with no history of previous cesarean section revealed an increasing primary cesarean section rate with increasing maternal age. This increase occurred over the entire reproductive age span. Fetal distress as an indication for primary cesarean section may account for this increase.
Resurfacing the vulva and vagina
Authors: Cronjé H.S. , Van Zyl J.S.
Published: April 2004

Thirteen patients are described where split thickness skin grafts, cutaneous or myocutaneous flaps were used to cover large defects on the vulva and vagina. For defects over the pubic groin areas, the tensor fascia lata flaps are most suitable. Defects of the vulva are best covered by split thickness skin grafts or gracilis flaps, and vaginal defects by split thickness skin grafts or vulvar flaps.
Clinical experiences with the Spring Coil intrauterine device: a ten‐year follow‐up study
Authors: Batár István
Published: April 2004

In a ten‐year follow‐up study analysing 1080 cases and 29 138 cumulative woman‐months of use, the clinical experiences of the Spring Coil IUD are evaluated using the life table technique, the net cumulative pertinent termination rates calculated for 100 women at the end of the 10th year, were as follows: pregnancy 1.2; expulsion 32.5; bleeding/pain removal 31.6; removal for other medical reasons 6.2. The results support the concept that in problem‐ and symptom‐free cases, routine IUD removal is not necessary.
Cervico‐vaginal fistula and spontaneous mid‐trimester abortion
Authors: Barzilai M. , Fejgin M. , Gruber A. , Ben‐Aderet N.
Published: April 2004

An unusual complication of spontaneous second trimester abortion which was unaided by external agents is presented. We found no similar case in the literature.
Carcinoma of the uterine cervix and schistosomiasis
Authors: El Tabbakh G. , Hamza M.A.
Published: April 2004

The relation between cervical cancer and schistosomal infection is controversial. A case of well differentiated adenocarcinoma associated with schistosomiasis of the cervix is presented. A 45‐year‐old female complaining of intermenstrual bleeding had a polypoid ulcerated cervical mass. Biopsy revealed well differentiated adenocarcinoma and bilharzial ova with terminal spine embedded in the tumor tissue. The relation between cancer cervix and schistosomiasis is discussed.
Improved fetal survival with small volume plasmapheresis in Rhesus disease
Authors: Al‐Omari W.R.
Published: April 2004

Fifty pregnant multiparas with Rhesus isoimmunization were treated by small volume plasmapheresis initiated at the end of their first trimester. Forty mothers were successfully delivered at 31–38 weeks of babies that survived. There were ten fetal losses, six of these were stillborn, and there were three neonatal deaths, and one abortion. This fetal survival rate is acceptable, and plasmapheresis remains an alternative therapy in locations where immunoprophylaxis is not common.
Breech delivery in a Middle East Hospital
Authors: Vaclavinkova V.
Published: April 2004

This paper provides an analysis of the results of 206 deliveries in which the patient's preference influenced the mode of delivery.
Tubal ligation at cesarean delivery in five Asian centers: a comparison with tubal ligation soon after vaginal delivery
Authors: Chi I‐c. , Wilkens L.R. , Gates D. , Lamptey P. , Petrick T.
Published: April 2004

Increasingly more tubal sterilizations are being performed at the time of cesarean section in the United States and probably also in developing countries. This descriptive study provides us with hitherto unavailable information on the impact of this combined procedure on the women undergoing it. Five Asian centers were included for study. In these centers, 618 women had concurrent tubal ligation at cesarean section in 1973 and 1974. During this period, 3399 women had tubal ligation soon after term vaginal deliveries. The much higher morbidity and mortality in the former group were judged to be attributable to the indications leading to, or the complications of, cesarean section and not to the concurrent tubal ligation. Women undergoing the combined procedure of tubal ligation and cesarean section were more likely to have characteristics associated with later regretting the sterilization.
Combined pregnancy: how common is it?
Authors: Kivikoski A.I.
Published: April 2004

Three cases of combined intrauterine and ectopic pregnancy, treated in the same hospital over a 39‐day period, are presented. This condition has been acknowledged to be a rare phenomenon with delayed diagnosis and treatment. Two of the cases were diagnosed by ultrasound upon arrival at the hospital, and all three were treated within 24 h of arrival. These cases highlight the importance of ultrasound in diagnostics and indicate a possible higher incidence of this phenomenon than was previously estimated.
Intussusception: a rare complication following abdominal hysterectomy
Authors: Reddy N.S. , Rajaram P.
Published: April 2004

A 35‐year‐old parous woman was treated with abdominal hysterectomy for uterine myomata. The patient developed intussusception in the immediate postoperative period and was managed by laparotomy and manual reduction. The difficulties in diagnosis and management of this rare complication are discussed.
The outcome of pregnancies complicated by preterm rupture of the membranes with and without cerclage
Authors: Blickstein I. , Katz Z. , Lancet M. , Molgilner B.M.
Published: April 2004

Thirty‐two patients with cerclage were compared to 76 patients without cerclage. All pregnancies were complicated with preterm (<36 weeks) rupture of the membranes (PTROM). The management following removal of the cerclage was the same for the two groups and consisted of conservative treatment unless chorioamnionitis ensued. It was found that under similar conditions and treatment there was no significant difference between the outcomes of PTROM‐complicated gestations with and without a cerclage. The low added risk of cerclage to PTROM should not deter its use when indicated.
Pregnancy and primary biliary cirrhosis
Authors: Nir A. , Sorokin Y. , Abramovici H. , Theodor E.
Published: April 2004

Pregnancy is rarely encountered in patients with primary biliary cirrhosis. Ten pregnancies in nine patients have been reported in the literature. All five pregnancies that continued beyond the 31st week had increasing jaundice during late pregnancy. We describe a case of primary biliary cirrhosis with symptomatic onset at age 19, pregnancy a year later, with subsequent resolution of jaundice and pruritus. This course is different than most described by others.
One country's story: The PROALMA program in Honduras
Authors: Canahuati J.
Published: April 2004

The first phase of the PROALMA project in Honduras resulted in changed hospital breastfeeding practices within as little as 2 years. These changes affected the community, lengthening the duration of exclusive breastfeeding to 1–2 months and the duration of any breastfeeding to 12 months. The second phase of the project sought to extend the program nationwide. One of the original pilot hospitals in San Pedro Sula was well along in breastfeeding promotion but felt there were still problems in breastfeeding education and the integration with family planning services. Following retraining of staff and the opening of a Breastfeeding Clinic and a Temporary Methods Family Planning Clinic, there have been improvements in both areas.
The Brazilian national breastfeeding program: A success story
Authors: Ferreira Rea M.
Published: April 2004

The Brazilian National Breastfeeding Program launched in 1981, is remarkable for its broad scope, including activities aimed at protecting (employment legislation, control of marketing of substitutes for mother's milk), promoting (use of the media, professional training), and supporting breastfeeding (mothers' groups, information material, and direct counseling). The program was preceded by an assessment in the metropolitan areas of Recife and São Paulo. Evaluation of the program carried out in 1987–1988 shows that it has had an impact; the average duration of breastfeeding increased from 89 to 127 days in São Paulo and from 66 to 104 days in Recife. Exclusive breastfeeding, which averaged 43 days in São Paulo, increased by 1.5 times; while in Recife the increase was 2.2 times, leading to 32 days.
The use of mass media to promote breastfeeding
Authors: Parlato M.B.
Published: April 2004

Breastfeeding promotion is currently hampered by four major problems: the decline in funding for campaigns; failure to use mass media; lack of program evaluation; and vague messages. Thorough social marketing research could determine why women are turning away from breastfeeding and what messages could be used to make breastfeeding a more attractive feeding option. Similar efforts should be made to include breastfeeding messages in other programs, such as family planning, growth monitoring, and oral rehydration therapy.
Perinatal morbidity and mortality in pregnancy hypertensive disorders: prognostic value of the clinical and laboratory findings
Authors: Acién P. , Lloret G. , Lloret M.
Published: April 2004

In 521 pregnancies complicated by hypertensive disorders (PHD) and in 200 control cases, we studied the incidence of intrauterine growth retardation (IUGR), depression in the newborns, general morbidity of live newborns requiring admission and perinatal mortality. We also analyzed the relationship between these conditions and the type and severity of hypertension, gestational age, presence of symptoms of the classic EPH triad and of abnormal uric acid values, hemoconcentration, and low urinary estriol values. Perinatal mortality (especially antepartum) was significantly increased in severe pre‐eclampsia, chronic hypertension and chronic hypertension with superimposed pregnancy‐induced hypertension (PIH); in all the cases with PHD it was three times higher than that of the control group (59‰ versus 20‰ and five times higher than the global perinatal mortality of the 25,763 deliveries attended during the same period (12‰ General morbidity reached 44% in severe pre‐eclampsia and 75% in antepartum eclampsia. But the preterminal deliveries were also more frequent in PHD, especially in severe pre‐eclampsia‐eclampsia. Nevertheless, the perinatal morbidity and mortality in general increased when proteinuria and edema plus proteinuria were associated with hypertension, and the incidence was significantly higher when proteinuria surpassed 100 mg/dl. Morbimortality also increased in the presence of hemoconcentration, hyperuricemia, and low estrioluria.
Laparoscopic observations of pelvic organs in pulmonary tuberculosis
Authors: Tripathy(Mrs) S.N. , Tripathy S.N.
Published: April 2004

Sixty‐two cases of bacteriologically positive pulmonary tuberculosis were studied in the Department of Tuberculosis and Chest Diseases at the V.S.S. Medical Collage Hospital, Burla, India. Apart from other investigations, all patients underwent laparoscopy to determine the incidence of genital involvement. Positive findings were observed in 37 women; tubercles were present in the tubes of 15 women. At dilatation and curettage, the endometrium was obtained in 37 women. Tuberculous endometritis was detected in 4 women.
The influence of lead ions on uterine activity in the rat
Authors: Modzelewski P. , Szamatowicz J. , Laudanski T. , Moniuszko‐Jakoniuk J. , Akerlund M.
Published: April 2004

Spontaneous uterine activity and reactivity to oxytocin, naproxen and PGF2α were studied in vitro in 80 rats, which for 2–8 weeks had been exposed to different concentrations and combinations of Pb2+, Zn2+ and Cu2+ in their water supply or had been given clean water for control. In rats given only Pb2+ in concentrations of 1000 and 500 ppm for 6 weeks the uterine activity was significantly increased, whereas in groups given the other ions alone, or Pb2+ for 6 weeks followed by 2 weeks of clean water or Zn2+ or Cu2+ no change was observed. The responses to the oxytocin, naproxen and PGF2α did not differ. These results suggest that contamination with lead ions might be one of the etiological factors involved in conditions with increased uterine activity.
Breech vaginal delivery after one cesarean section: a retrospective study
Authors: El Gammal N.A. El M. , Jallad K.B. , O'deh H.M.S.
Published: April 2004

This retrospective study evaluates the prospects of allowing a vaginal breech to follow a previous lower segment cesarean section by examining data from Farwania Hospital, Kuwait where 33 (38.4%) of 86 patients with a previous cesarean section with fetuses in breech presentation were given a chance for vaginal delivery. The remaining 53 patients were deliverd by lower segment cesarean section. Out of 53 patients, 34 patients were sectioned because of the presence of uterine scar. The other 19 patients were sectioned because of the additional presence of other obstetric complications such as diabetes, pre‐eclamptic toxemia or large fetus. This group of patients was excluded from comparison.
Noninsulin dependent diabetes mellitus and pregnancy in Mexico
Authors: Contreras‐Soto J. , Forsbach G. , Vazquez‐Rosales J. , Alvarez‐Garcia C. , Garcia G.
Published: April 2004

We analyzed 215 consecutive patients with diabetes mellitus and pregnancy, 118 (54.83%) with noninsulin dependent diabetes mellitus (NIDDM), 90 (41.86%) with gestational diabetes mellitus (GDM) and 7 (3.26%) with insulin dependent diabetes mellitus (IDDM). NIDDM and GDM patients had no significant difference in age and body mass index. There were no maternal deaths, nor episodes of ketoacidosis. Maternal and neonatal complications occurred with a similar frequency in NIDDM and GDM. We concluded that in our population, diabetes associated with insulin‐resistance occurred in over 96% of our pregnant diabetic patients and was associated with an increased prevalence of maternal and neonatal complications. Earlier perinatal care has to be established in NIDDM patients, and obese young women should be screened to detect GDM from early gestation and advised to reduce weight before pregnancy ensues.