bluuebunny/crossref_metadata_2025 huggingface dataset:
Asthma and Behavior in Homeless 4- to 7-Year-Olds
Authors: Cutuli J.J. , Herbers Janette E. , Rinaldi Maria , Masten Ann S. , Oberg Charles N.
Published: December 2009

OBJECTIVE: Low-income, urban, ethnic minority children have higher rates of asthma, more severe symptoms, and more management issues, as well as high risk for academic and behavior problems. This study focused on asthma reported in young children who resided in a family emergency homeless shelter. Asthma rates were considered along with their relation to hospitalization and emergency department use and behavior that is important for school success, including cognitive function, conduct, and academic functioning.

METHODS: A total of 104 children (age 4.0–7.5 years) and parents were recruited while residing in an urban emergency homeless shelter for families. Children had no previously identified developmental delays and spoke English proficiently. Parents reported whether the child experienced asthma, as well as emergency department use and hospitalization. Parents and teachers completed measures of child inattention/hyperactivity and behavior problems. Cognitive function of children was directly assessed.

RESULTS: Asthma was reported for 27.9% of children, ∼3 times the national average. Children with asthma had been hospitalized more often, showed higher levels of inattention/hyperactivity and behavior problems, and evidenced lower academic functioning.

CONCLUSIONS: Young children in homeless family emergency shelters have high rates of asthma and related problems that could lead to higher hospitalization rates, more behavioral problems, and lower academic functioning at school. Screening and treatment of children who stay in emergency family shelters may be particularly important for reducing risks associated with asthma in highly mobile, low-income families.
Neonatal Neurobehavior Predicts Medical and Behavioral Outcome
Authors: Liu Jing , Bann Carla , Lester Barry , Tronick Edward , Das Abhik , Lagasse Linda , Bauer Charles , Shankaran Seetha , Bada Henrietta
Published: December 2009

OBJECTIVE: This study examined the NICU Network Neurobehavioral Scale (NNNS) as a predictor of negative medical and behavioral findings at 1 month to 4.5 years of age.

METHODS: The sample included 1248 mother–infant dyads (42% born at <37 weeks' gestational age [GA]) who were participating in a longitudinal study of the effects of prenatal substance exposure on child development. Mothers were recruited at 4 urban university-based centers and were mostly black and on public assistance. At 1 month of age, infants were tested with the NNNS. Latent profile analysis was conducted on NNNS summary scales to identify discrete behavioral profiles. The validity of the NNNS was examined by using logistic regression to predict prenatal drug exposure and medical and developmental outcomes through 4.5 years of age including adjustment for GA and socioeconomic status.

RESULTS: Five discrete behavioral profiles were reliably identified; the most extreme negative profile was found in 5.8% of the infants. The profiles showed statistically significant associations with prenatal drug exposure; GA and birth weight; head ultrasound; neurologic and brain disease findings; and abnormal scores on measures of behavior problems, school readiness, and IQ through 4.5 years of age.

CONCLUSIONS: The NNNS may be useful to identify infant behavioral needs to be targeted in well-infant pediatric care, as well as for referrals to community-based early intervention services.
Age at the Introduction of Solid Foods During the First Year and Allergic Sensitization at Age 5 Years
Authors: Nwaru Bright I. , Erkkola Maijaliisa , Ahonen Suvi , Kaila Minna , Haapala Anna-Maija , Kronberg-Kippilä Carina , Salmelin Raili , Veijola Riitta , Ilonen Jorma , Simell Olli , Knip Mikael , Virtanen Suvi M.
Published: December 2009

OBJECTIVE: The goal was to examine the relationship between age at the introduction of solid foods during the first year of life and allergic sensitization in 5-year-old children.

METHODS: We analyzed data from the Finnish Type 1 Diabetes Prediction and Prevention nutrition study, a prospective, birth cohort study. We studied 994 children with HLA-conferred susceptibility to type 1 diabetes mellitus for whom information on breastfeeding, age at the introduction of solid foods, and allergen-specific immunoglobulin E levels at 5 years was available. The association between age at the introduction of solid foods and allergic sensitization was analyzed by using logistic regression.

RESULTS: The median duration of exclusive breastfeeding was 1.8 months (range: 0–10 months). After adjustment for potential confounders, late introduction of potatoes (>4 months), oats (>5 months), rye (>7 months), wheat (>6 months), meat (>5.5 months), fish (>8.2 months), and eggs (>10.5 months) was significantly directly associated with sensitization to food allergens. Late introduction of potatoes, rye, meat, and fish was significantly associated with sensitization to any inhalant allergen. In models that included all solid foods that were significantly related to the end points, eggs, oats, and wheat remained the most important foods related to sensitization to food allergens, whereas potatoes and fish were the most important foods associated with inhalant allergic sensitization. We found no evidence of reverse causality, taking into account parental allergic rhinitis and asthma.

CONCLUSION: Late introduction of solid foods was associated with increased risk of allergic sensitization to food and inhalant allergens.
Uses of symbolic resources in youth: Moving from qualitative to quantitative approach
Authors: Stankovic Biljana , Baucal Aleksandar , Zittoun Tania
Published: December 2009

Youth is a period of intense changes during which young people engage in various transitions resulting in theirs acquisition of a longer time perspective and a system of orientation, enabling to set priorities and values, and to guide their actions accordingly. In a socio-cultural theoretical background, both the establishment of values and the ability to think time require some psychological distancing from the here and now, distancing which is foremost enabled by semiotic mediation. In our former studies on youth transitions, we observed that young people may use songs, movies, arts, or novels as symbolic resources, that is, as external mediators that seem to support these developmental processes. Through an abductive process linking qualitative, ideographic data and theoretical elaboration, we proposed a theoretical 7 dimensional model for analyzing people's uses of symbolic resources. This model was then turned to a first, provisional questionnaire aiming at testing the model, whose items were extracted from the first empirical investigation. In this paper, we attempted to tests this questionnaire on a population of young people in Serbia. The symbolic resources questionnaire was tested on a sample of young people (N=475). A SEM analysis was used to test the model. At large, the theoretical model is verified. However, an unexpected, very strong correlation between the dimensions had to be explained. We finally propose a further adaptation to the questionnaire.
Effects of electrotherapy in treatment of neurogenic bladder in children with occult spinal dysraphism
Authors: Cirovic Dragana , Petronic Ivana , Nikolic Dejan , Brdar Radivoj , Pavicevic Polina , Knezevic Tatjana
Published: December 2009

Introduction Neurogenic bladder can develop as a result of various degrees of neurogenic lesion in spina bifida. The degree of bladder dysfunction depends on the level and type of spina bifida. Due to results upon complete diagnostic protocols, treatment options are applied. Objective Comparison of therapy results of patients with occult spinal dysraphism with neurogenic bladder that under-went medicamentous therapy and medicamentous with electrotherapy treatment. Methods We had 49 patients with neurogenic bladder that were treated at the University Children's Hospital in Belgrade in the period 2003-2008. The first group of children received medicamentous therapy and the second group received medicamentous therapy with transcutaneous electric nerve stimulation. In both groups we evaluated 4 symptoms: daily enuresis, enuresis nocturna, urgency and frequency and 4 urodynamic parameters: lower bladder capacity, unstable contractions and residual urine and detrusor sphincter dyssynergia. Follow-up urodynamic evaluation was done after 3, 6 and 12 months respectively. Results Our findings pointed out a high statistical significance of improvement in all evaluated urodynamic parameters of neurogenic bladder (predominantly in bladder capacity) in the group of children with combined therapy as well in resolution of symptoms (predominantly enuresis nocturna, urgency and frequency). Conclusion Combined therapy is more efficient in treatment of children with neurogenic bladder. Electrotherapy is non-invasive, easily applicable and has had a significant place in treatment of children with dysfunctional voiding.
Supplementation with bio-calcium from shells Pinctada maxima in postmenopausal women with decreased mineral bone density: Pilot study
Authors: Vujasinovic-Stupar Nada , Novkovic Snezana , Jezdic Ivana
Published: December 2009

Introduction Treatment of osteoporosis, in addition to a specific antiresorptive or anabolic treatment, requires supplementation with calcium and vitamin D. Widespread cultivation of pearl shells has made pearls available for commercial use for a very reasonable price. The main chemical compound of pearls from shells Pinctada maxima is calcium-carbonate (CaCO3). Recently developed technologies applied in a micronisation process have provided increased gastrointestinal resorption of calcium, estimated at over 90% of calcium intake. Objective The paper is aimed at monitoring of efficacy and tolerance of six-month bio-calcium supplementation in postmenopausal women with reduced bone mineral density. Methods Group I (30 patients) received, three times a day, capsules of pearl powder from shells Pinctada maxima (it is equal to 260 mg of elementary calcium); group II (20 patients) received a daily dose of 500 mg inorganic CaCO3. Both groups received 666 IU of cholecalciferol per day. In all patients, bone mineral density (BMD) of the spine or hip, serum blood and urine levels of Ca, phosphates and alkaline phosphatase, were measured before and after six months of the treatment. Results Group I/Group II: average age 61.7/61.7 years; beginning of menopause: 48.32 /48 years; menopause duration 13.4/13.7 years; average body mass index 27.2/27 kg/m2 . These two groups did not different significantly before supplementation. Six-month supplementation with CaCO3 of the biological origin led to the increase of BMD from 0.901 g/cm2 to 0.948 g/cm2 (p=0.067), while BMD remained the same in the group supplemented with inorganic CaCO3. Gastrointestinal tolerability of bio-calcium was excellent, without any adverse events. Conclusion These data could not strongly support the hypothesis of better efficacy of bio-calcium taking into account a small number of patients and a short follow-up period in this pilot study. Tolerance of CaCO3 of the biological origin was excellent and free of any adverse events. The results of laboratory values were within normal range.
Articles on elderly in Serbian medical journals
Authors: Despotovic Nebojsa , Milosevic Dragoslav , Erceg Predrag , Davidovic Mladen
Published: December 2009

Introduction Population aging is a feature of all countries in the world. According to statistics, the Republic of Serbia is one of the countries with the majority of the elderly. Taking this into account, are articles on the elderly well represented in domestic medical journals? Objective The aim of the paper was to determine whether there was a sufficient number of articles on the elderly in domestic medical journals. Methods The articles on the elderly were searched using search engines in domestic and foreign medical journals for the last 5 years compared with the number of articles on children in the same publications for the same period. Results In the Serbian Citation Index, 11 articles on the topic of the elderly, and 487 on children were registered. In Srpski arhiv za celokupno lekarstvo, there was registered only one article on the topic of the elderly, and 30 on children. In Vojnosanitetski pregled, 2 articles on the elderly and 13 on children were registered (p<0001). For the last five years, in the New England Journal of Medicine, there were 593 articles on the elderly and 759 articles on children; in the JAMA, there were 63 articles on the elderly and 303 articles on children; and in The Lancet, in the last five years, 46 articles on the elderly and 148 articles on children were published. Conclusion The themes of the elderly were rarely represented in Serbian medical journals. This has reduced the interest of physicians in medical problems of this growing population of patients and further sent them away from making standards in the diagnosis and treatment of the elderly.
Myocarditis exacerbation in a child undergoing inguinal hernioplasty after viral infection
Authors: Simic Dusica , Milojevic Irina , Budic Ivana , Strajina Veljko
Published: December 2009

Introduction Immunosuppressive effects of general anesthesia and surgery could have unexpected consequences in a child with recent infection. The incidence of myocarditis in childhood is unknown. Case outline During general anesthesia for inguinal hernia repair, a seven-year-old boy suddenly developed heart failure. Clinical presentation included hypotension, pulmonary edema, drop in hemoglobin oxygen saturation, ST segment elevation and premature ventricular contractions. Homodynamic stability and adequate oxygenation were achieved with dopamine and furosemide. Preoperative history, physical examination and complete blood count were unremarkable. Moderate cardiomegaly and pulmonary edema were present on chest radiography. Diminished left ventricular contractility found on echocardiography increased troponin I and CK-MB levels suggested myocardial injury. Increased C-reactive protein with lymphocytosis suggested inflammation as its cause. Parents failed to report rubella 10 days before the operation. A clinical diagnosis of myocarditis as a complication of rubella was based on increased titer of IgM to rubella. With intravenous immunoglobulin, corticosteroids and symptomatic treatment for heart failure, his condition improved and ejection fraction reached 68 % one month after operation. Conclusion In future, we need protocols with instructions for pediatric patients undergoing elective surgery and anesthesia after viral infections.
Heparin-induced thrombocytopenia occurring after surgical treatment of atrial myxoma: A case report
Authors: Djunic Irena , Tomin Dragica , Antonijevic Nebojsa , Gradinac Sinisa , Kovac Mirjana , Vidovic Ana , Djurasinovic Vladislava , Elezovic Ivo
Published: December 2009

Introduction Heparin-induced thrombocytopenia (HIT) is an acquired, prothrombotic disorder, caused by antibodies to a complex of heparin and platelet factor 4 (PF4) that activates platelets, resulting in the release of procoagulant microparticles, thrombocytopenia occurrence, generation of thrombin, and frequent thromboses. Case Outline We present a case of severe HIT in a 68-year-old female, which occurred after cardiosurgery of the left atrial myxoma with the aim to point out the importance of differential diagnosis of thrombocytopenia in patients recently exposed to heparin. Platelet count dropped on the eleventh postoperative day, six days after unfractioned heparin and enoxaparine treatment, to 4?109/l. The correct diagnosis failed to be made at first. Since thrombocytopenia remained refractory to a corticosteroid treatment and platelet transfusion, the patient was hospitalized on the 13th postoperative day at the Institute of Hematology. The diagnosis of HIT was confirmed with the high-probability clinical score (4T's) and strongly positive antiheparin-PF4 (PaGIA) test as well as positive platelet aggregation test. The treatment started with a smaller therapeutic doses of danaparoid than recommended of 750 U intravenous bolus and was followed by continuous infusions of 100 U per 1 h and intravenous gammaglobulins in full dosage for four days. The platelet count started to rise on the third day and it was completely normalized on the 5th day of the therapy. Conclusion Treatment of severe HIT with small doses of danaparoid supplemented by intravenous gamma globulin was successful. Additional awareness of heparin-induced thrombocytopenia is needed, especially of HIT in differential diagnosis of thrombocytopenia in patients recently exposed to heparin.
Haemostatic disorders in orthopedic surgery: Laboratory diagnosis
Authors: Dunjic Radica , Elezovic Ivo , Vukasinovic Zoran
Published: December 2009

Coagulative disorders may result from a breakdown in the balance between coagulation and fibrinolysis. It is important to assess relative physiological states of coagulation and fibrinolysis related to operation. An ideal outcome in orthopedic surgical procedures is the achievement of adequate haemostasis without excessive bleeding despite transection of numerous blood vessels, a necessary part of any surgical procedure. Meticulous attention to secure intraoperative haemostasis is a surgeon's responsibility. The postoperative haemostatic response to injury must also lead to a hypercoagulable state and thrombosis because it is also accompanied by stasis and vessel injury, fulfilling Virchow's triad. For discussion of prophylaxis and treatment of venous thromboembolic disease and orthopedic surgical bleeding, the reader is referred to other articles. This paper discusses selected conditions leading to postoperative bleeding and thrombosis after orthopedic surgery as well as laboratory diagnosis.
Evidence-Based Education Policy: Lip Service or Common Practice? Empirical Findings from Germany
Authors: Dedering Kathrin
Published: December 2009

Since the late 1990s, it has been the practice in Germany that decisions in educational policy and educational administration should primarily be subject to evidence in terms of reliable empirical data. However, little research has been conducted so far as to the question of how actors in charge receive and process the existing data, and how they use them in decision-making processes. In this article, new empirical findings are presented concerning the way in which the reception and processing of educational scientific evidence is currently carried out. Moreover, differences in the use of data within the last decade are revealed. Relating to an explorative study that consists of 12 qualitative interviews with ministerial personnel in four German school ministries, the findings generally indicate that evidence-based educational policy in Germany is less a matter of paying lip service, but rather increasingly becoming common practice. On the whole, the findings indicate an increasing routine and a more professional treatment of the demands for processing data. All of the school ministries reveal approaches towards systematising the use of data.
Delay in the Second Stage of Labour due to Indurated Syphilitic Oedema
Authors: Ingerslev Mogens
Published: December 2009

The following case of indurated syphilitic oedema is published because it was responsible for delay in the second stage of labour and presented considerable difficulty in diagnosis.
Bilateral Multiple Lutein Cysts in Normal Single Pregnancy
Authors: Pettersson Folke
Published: December 2009

Abstract. A case of normal single pregnancy combined with bilateral multiple lutein cysts in the ovaries is reported. Similar cases in the literature are reviewed.
On Relationship Between Maternal Health and Intrauterine Growth of the Foetus
Authors: Hedberg E. , Holmdahl K.
Published: December 2009

Abstract. The relationship between maternal health and intrauterine growth of the foetus was studied. A prospective method of study was used and the series included 11 417 pregnant women. All infants of low birth weight and a subgroup of growth retarded infants were compared with a control group of normal weight infants. It became evident that the characteristics and complications of pregnancies resulting in infants of low birth weight differed from those of a control series. It was also apparent that pregnancies resulting in growth retarded infants differed from controls in other respects than those resulting in premature infants as a whole. In studying the causes of prematurity and in the clinical handling of the premature infants it is of utmost importance to be aware of the different categories of infants of low birth weight.
Plazentalokalisation Mit Verschiedenen Methoden
Authors: Jedberg H. , Notter G. , Söderholm B. , Vikterlöf K. J.
Published: December 2009

Abstract. Seit 1966 wurden bei 104 Patienten für die Lagebestimmung der Plazenta Angiographic, Szintigraphie, Ultraschallmessung und Thermographic vergleichsweise angewandt. Die Szintigraphie wurde in allen Fällen ausgeführt, Angiographic in 29, Ultraschallmessung in 62 und Thermographic in 49 Fällen. Die angiographische Methode erlaubte in allen Fällen eine korrekte Lokalisation der Plazenta. Sie scheidet aber aus Strahlenschutzgründen für die Routine aus. Die Szintigraphie war in dieser Untersuchung ebenso zuverlässig. Die geringe Strahlenbelastung der Patienten wird von uns nicht als eine Kontraindikation gegen die Anwendung der Methode angesehen. Die Szintigraphie wird daher von uns als die Methode der Wahl für die Plazentalokalisation angesehen, besonders bei der Anwendung kurzlebiger Radionuklide und moderner Apparatur. Die Thermographic und die Ultraschallmessung ermöglichte mit der in dieser Untersuchung angewandten Technik in ca. 70% der Fälle eine richtige Lokalisation der Plazenta. Auf Grund der messtechnischen Voraussetzungen kommt den beiden Methoden zur Zeit im Vergleich mit der Szintigraphie doch nur eine untergeordnete Bedeutung zu.
Multiple Severe Malformations in a Child of a Diabetic Mother Treated with Insulin and Dibein1 During Pregnancy
Authors: Pettersson Folke , Olding Lars , Gustavson K. H.
Published: December 2009

A case of multiple severe malformations in a child of a diabetic mother treated with insulin and dibein (phenforminichlorid) during pregnancy is reported. Treatment with oral hypoglycaemia drugs during pregnancy is discussed.
Isolated Torsion of the Fallopian Tube
Authors: Hansen Ole Hart
Published: December 2009

Abstract. After observing 2 cases of isolated torsion of the Fallopian tube, we inquired of all surgical and gynaecological departments on the Danish islands of Zealand and Lolland–Falster whether any such cases had been treated during the period 1957–1967. In this way we traced another 8 cases. As the departments concerned serve an area of Denmark with a population of about 3 millions, about half of whom are women, the annual incidence of isolated torsion of the Fallopian tube may be estimated as one in 1,500,000 women. The 10 case histories are briefly reported. Some theories on the aetiology of tubal torsion are mentioned, and the symptoms as well as treatment are discussed.
Recurrent Cholestasis of Pregnancy
Authors: Engström J. , Hellström K. , Posse N. , Sjövall J.
Published: December 2009

Abstract. This is a report of a 28‐year‐old woman with cholestasis occurring in the first month of gestation in four consecutive pregnancies. During the interval between the third and fourth pregnancy as well as during and after the fourth one the patient was regularly examined with regard to her liver function. Intensive itching and markedly elevated serum bile acids were the predominant symptom and laboratory finding during the fourth pregnancy. Both decreased during cholestyramine treatment. The bromsulphalein retention was quite normal six months after the third pregnancy but is still elevated two and a half years after the last one.
Ornithine‐8‐Vasopressin, a New Vasoconstrictor Used for Haemostasis During Operation for Genital Prolapse
Authors: Nielsen Ole Vagn , Valentin Niels
Published: December 2009

Abstract. A new haemostatic agent POR‐8, a synthetic derivative of vasopressin, has been investigated under double blind trial conditions. It was found to be an effective haemostatic, significantly better than noradrenalin. Fully satisfactory haemostasis was obtained after local infusion of POR‐8 in such low concentration as 0.05 IU/ml. The risk of cardiac arrhythmias when POR‐8 is used with halothane appears to be minimal.
Treatment of the Umbilical Cord of the Newborn
Authors: Erik Tötterman L. , Autio S.
Published: December 2009

Abstract. Daily painting of the umbilical stump with Betadine®3 during the stay in the maternity ward reduced the incidence of umbilical infections. In clinical use a tiny rubber ring for closure of the cut umbilical cord proved more practical and cheaper than a clip, the use of the ring in conjunction with painting with Betadine® accelerated the separation of the stump.
Coagulation and Fibrinolysis in Mothers and their Newborn Infants Following Premature Separation of the Placenta
Authors: Nielsen Niels Chr.
Published: December 2009

Abstract. Investigation of the parameters of coagulation and fibrinolysis in mothers with premature separation of the placenta (P.S.P.) and their newborn infants, compared with normal prematurely delivered women and their normal premature infants, showed the following:

A. In the mothers: With increasing severity of the premature separation also increasing alteration in the parameters of coagulation i.e. decreasing platelet count, factor V, prothrombin‐proconvertin, fibrinogen content, and prolonged partial thromboplastin time. In severe cases the TAT three‐stage indicated a slightly increased content of coagulation‐activating components in the plasma.

No definite effect upon fibrinolytic activity of premature separation of the placenta.

B. In the infants: In premature separation of the placenta, the infants also exhibited changes in their coagulation status, most distinct in the most severe cases. These changes consisted of decreasing platelet counts, factor V, prothrombin‐proconvertin, fibrinogen content, and prolonged partial thromboplastin time. For platelet count and fibrinogen the changes were not significant. As for the mothers the TAT three‐stage showed an increased content of clot‐promoting components in the plasma in the most severe cases.

No definite effect of premature separation of the placenta upon fibrinolytic activity could be shown.

The cause of the demonstrated changes is discussed and therapeutic possibilities mentioned.
An Instrument to AID Laparoscopic Diagnosis
Authors: Nordvall Sven
Published: December 2009

Abstract.A description is given of a new device constructed to aid laparoscopic diagnosis. The instrument functions as an organ‐forceps to be inserted into the abdominal cavity during iaparoscopy, enabling the pelvic organs to be lifted up and examined more closely.
Effect of Intravenous Administration of Prostaglandin E1 and F2α on the Contractility of the Non‐Pregnant Human Uterus in Vivo
Authors: Roth‐Brandel U. , Bygdeman M. , Wiqvist N.
Published: December 2009

The effect on uterine contractility of prostaglandin E1 (PGF2α) and F2α (PGF2α) was studied in 19 non‐pregnant women. Uterine motility was recorded by the micro balloon method and the prostaglandins administered by single intravenous injections in increasing doses.

Doses above threshold levels of both PGE1 and PGF2α always resulted in stimulation of the uterus primarily in terms of tone elevation.

A short drop of tone during 40–60 seconds immediately following the injection was obtained in a few experiments after high doses of PGE1. This response preceeded the normal stimulatory effect.

The threshold dose for PGE1 was approximately 20 μg and that for PGF2α around 50 μg or lower.

The non‐pregnant uterus is probably more sensitive to PGF2α than the midpregnant uterus.

The number of experiments were too few to allow conclusions as to differences in uterine sensitivity during the various phases of the menstrual cycle.

Administration of oxytocin and vasopressin did not enchance the uterine sensitivity to stimulation by PGE1.
Post‐Menopausal Hyperoestrogenism Caused by Carcinoma of the Adrenal Cortex
Authors: Procopé Berndt‐Johan
Published: December 2009

Abstract. A case of carcinoma of the adrenal cortex in a post‐menopausal woman is described, in which a high excretion of urinary oestrogens, an increased oestrogen activity in vaginal smear and a clear oestrogen effect in the endometrium were observed. The possibility that a carcinoma in the adrenal cortex may produce oestrogens or their precursors is discussed.
The Effect of Oxytocin on the Complication Rate of Early Therapeutic Abortions
Authors: Johansson Elof D. B.
Published: December 2009

Abstract. The complication rate of early therapeutic abortions performed by curettage was studied in four series of patients. In the first series the complication rate was 71%. No or only a small dose of oxytocin was given. The second series was performed by one surgeon and 30 I.U. oxytocin were infused during surgery, resulting in only 11% complications. When the oxytocin drip was used by the entire staff the complication rate rose to 18% (third series). This rate was reduced to 12% when the curette was replaced by a suction device (fourth series). Oxytocin in a high enough dosage to cause contraction of the myometrium in early pregnancy drastically reduced the amount of bleeding during curettage. The number of infections was also reduced.
The Quantitative Estimation of Foetal Erythrocytes in Maternal Blood
Authors: Rasmussen Jens
Published: December 2009

Abstract. The number of foetal erythrocytes in maternal blood is determined by adding yeast cells to the sample before preparation of the smear, extraction and staining. 25–1100 foetal erythrocytes per μ1 blood, corresponding to a foeto‐maternal transfusion of about 20–900 μ1 are recovered with an average coefficient of variation of 20%. The clinical application of the method is demonstrated by following the rate of disappearance of the foetal erythrocytes from the maternal blood after a foetomaternal transfusion.
A Simple and Rapid Clinical Method for the Serial Estimation of Oestriol in Pregnancy Urine
Authors: de la Torre B. , Johannisson E. , Diczfalusy E.
Published: December 2009

Abstract. A simple and rapid clinical routine method is described for the serial estimation of oestriol in pregnancy urine. It involves enzyme hydrolysis at an elevated temperature, ether extraction, solvent partition and colorimetric estimation by means of a modified Kober reaction. The method fulfils the established criteria of reliability, when applied to pregnancy urine specimens containing 2.0 μg oestriol per ml, or more. The procedure is so simple and rapid that the average technician can complete the analysis of 24 specimens within 5 hours.
Fibrinolytic Activity of Veins During Pregnancy
Authors: Åstedt Birger , Isacson Sune , Nilsson Inga Marie , Pandolfi Maurizio
Published: December 2009

Abstract. The fibrinolytic activity of the blood progressively decreases during pregnancy, and in the last month it is often barely demonstrable—not even after venous stasis. The fibrinolytic activity in the venous walls, as determined histochemically in venous biopsy specimens, is significantly reduced throughout pregnancy. It appears that the change in hormone balance during pregnancy results in a reduction of the synthesis of activators in the vessel walls and/or inhibition of the release of such activators to the blood stream.
The Significance of the Foetal Electrocardiogram During Labour with Detailed Report of One Case
Authors: Christian Paul , Davidsen Bülow
Published: December 2009

The preceding study reported continuous monitoring of the foetal heart rate (FHR) during labour in 86 cases. In 60 cases assessment of the FHR was based upon the foetal electrocardiogram (FECG) recorded by means of a lead from the presenting foetal part after rupture of the membranes. In 31 instances the FECG was of such good quality that the entire ECG complex was recorded distinctly. Of these deliveries 16 were entirely normal, while in 7 the infant was born with the cord around its neck and 8 were complicated by placental dysfunction. The average values for the normal FECG are presented. It is noted that the T wave is negative only in exceptional cases. In one case in which the cord was around the neck there was a period of extrasystoles and in another case transient notching of the initial complex. In placental dysfunction the T waves are usually negative without the infants being at all depressed. One case of severe placental dysfunction is described in detail. The foetus died during labour, and the FHR showed pronounced changes. In the electrocardiogram the T waves grew deep and peaked, and terminally there was a prolonged conduction time and notching of the initial complex. It is concluded that the FECG is a poor indicator of foetal welfare during labour.
Cytological Diagnosis of Endometrial Disorders with A Brush Technique
Authors: Johannisson Elisabeth , Engstrom Lars
Published: December 2009

Sixty‐two patients with various endometrial disorders or a normal endometrium were investigated by cervical and vaginal smears, endometrial smears and thorough curettage, and the results obtained by the three methods were compared. The endometrial smears were taken by using a modified “brush technique”. This technique makes it possible to take endometrial samples on frequently repeated occasions, without anesthesia and without dilatation of the cervix.

The results of this study indicate that the “brush technique” yields cytological material satisfactory for the diagnosis of some endometrial disorders.

Using endometrial material obtained by the “brush technique” planimetric measurements of the cell nuclei were carried out in four groups of five subjects each representing four different types of endometrial activity such as proliferative, early secretory, late secretory and athrophic. An analysis of variance revealed that the cell nuclei were highly significantly different at each of the four phases studied. It is concluded that the cytological material obtained by the “brush technique” is suitable for objective cell analysis e. g. planimetric measurements, cytophotometric studies etc. It is suggested that the “brush technique” also offers excellent possibilities for studying the metabolism of isolated endometrial cells.
Treatment of Carcinoma in Situ of the Cervix Uteri by Conization: A Five‐year Follow‐up
Authors: Kullander Stig , Sjöberg Nils‐Otto
Published: December 2009

226 patients were subjected to conization (including all cases with positive vaginal cytology and without clinical suspicion of invasion of the uterine cervix) at the Department of Gynaecology and Obstetrics, Malmo General Hospital, in 1963 and 1964. The operative technique was standard throughout the series which was followed up for 5 years.

Of the patients subjected to conization alone, nearly 95% showed no signs of recurrence at the end of the 5‐year period. Late sequelae were few and mild. Fertility after the operation was high and the course of pregnancies normal.

Conization therefore is very valuable not only as a diagnostic method but also as an effective treatment for preinvasive carcinoma of the uterine cervix.
Response of the Pregnant Human Uterus to Low and High Doses of Prostaglandin E1 and E2
Authors: Roth‐Brandel U.
Published: December 2009

Uterine sensitivity to low doses of prostaglandin E2 was compared at midpregnancy and at term. An analysis of the amniotic pressure recordings revealed that the uterus in midpregnancy responded by increased contractility to an infusion rate of the same order as that, commonly used for induction of labour at term. However, the absolute intensity of the contractions was significantly higher at term than at midpregnancy. Intravenous infusion of high doses of prostaglandin Et (maximum dose without consistent subjective side effects) at midpregnancy stimulated the uterus to frequent contractions (6–8 contractions per 10 min) of gradually increasing intensity, which reached an average value of 35 mmHg following 6 hours of infusion. The individual uterine response to prostaglandin varied considerably from one case to another. The “maximum tolerable infusion rate” which could be administered without major subjective side effects also varied within a wide range.
Hepatic Blood Flow During Late Pregnancy
Authors: Laakso L. , Ruotsalainen P. , Punnonen R. , Maatela J.
Published: December 2009

The liver blood flow in non‐pregnant women (15 cases) and in late pregnancy (20 cases) was studied by colloidal heat‐denatured serum albumin labelled with 131I. The dose used was 10 μCi. The results were evaluated visually by gamma camera or two collimated detectors one of which was directed to the vessels of the thigh and the other placed over the right lobe of the liver. In addition, blood samples were drawn at fixed intervals and their radioactivity was measured. Using previously developed mathematical formulae, the half‐time of plasma activity was found to be 2.0 ± 0.4 min in the control group, 2.0 ± 1.1 min in normal pregnancy and 3.0 ± 1.1 min in toxaemia. Because of the great individual variation no significant changes between the groups were demonstrable. The isotope diagnostic method used was found to be suitable for measurement of the hepatic blood flow of patients with a stable liver disease, but because of the changing vital functions and the individual variations during pregnancy this method does not bring out the changes between non‐pregnant cases and late pregnancy.
Influence of Vaginal Flora on Body Temperature During the Puerperium
Authors: Jacobsen Stig
Published: December 2009

Vaginal smears from 542 pregnant women were studied 4 weeks before expected term.

70 patients were subsequently excluded because of Caesarean section, manual removal of the placenta, or fever caused by extragenital infection during the puerperium. The smears were classified as suggested by Wied. 56% showed no infection (A), 14% showed a predominance of Bacillus vaginalis Döderlein (B), 7% showed cocci (C), 11% showed Trichomonas vaginalis (D), and in 12% mixed infection was found (E).

The non‐infected (A + B) and the infected (C + D + E) patients were divided into 4 groups each, according to whether more or less than 12 hours had elapsed from rupture of the membranes to delivery and whether < or ≥ 3 pelvic examinations had been performed after rupture of the membranes. The mean temperature graph for the “infected” and the “non‐infected” patients in the various groups was compared, but no significant differences were demonstrated.

Nine patients developed puerperal fever, i.e. a rectal evening temperature exceeding 38°C, after the first day which could not be ascribed to an extragenital focus. Four of these patients had normal vaginal flora antenatally, while five had evidence of antenatal infection. On statistical calculation, however, puerperal fever was not significantly more common among patients with infected than in those with non‐infected vaginal smears.

Two infants developed fever after birth. Both mothers had non‐infected vaginal smears.
Early Malignant Disease of the Chorion
Authors: Teoh Eng Soon , Ratnam S. S. , Dawood M. Yusoff
Published: December 2009

Early malignant disease of the chorion recognised within a month of hydatidiform mole occurred in 9.6% of 532 molar pregnancies. Malay patients and patients above 40 years showed an increased risk of malignancy. The local and metastatic features of the disease are described. A secondary rise in serum HCG is typical. Treatment of choice is methotrexate. The overall mortality is 3.9%.
A Routine Clinical Method for the Estimation of low Polar Oestrogens in Human Urine
Authors: Carlström Kjell , Furuhjelm Mirjam
Published: December 2009

A simple, rapid and sufficiently specific method for the estimation of low polar oestrogens in human non‐pregnancy urine is described. It involves hot acid hydrolysis, ether extraction, a simple, highly effective alkaline washing, isolation of the phenolic fraction, saponification, methylation and treatment with hydrogen peroxide. The methylated low polar oestrogen fraction is further purified by a washing procedure and finally subjected to adsorption chromatography on aluminium oxide. Quantitation is made by Kober colorimetry. During a five day working week one technician can maintain a daily output of more than ten analyses. The method is well suited for general clinical routine use. By omission of the adsorption chromatography the method is converted into a rapid procedure in which the analytical answer can be given in less than one working day. This variant can be used when rapid answers are necessary and when a light “overestimation” is not important, e.g. monitoring gonadotrophin stimulation therapy.
Benign Gynaecological Tumours and Radioisotope Renography
Authors: Kokkonen Juha , Koskela Osmo , Vahala Jaakko
Published: December 2009

A series of 91 patients with various benign gynaecological tumours is presented. There were 51 myomas, 21 ovarian tumours, and 19 cases of endometriosis etc. Pre‐operatively the ureteral evacuation was disturbed in 29 of the 91 patients (i.e. 32%). The dysfunction disappeared after the operation.
Comparison Between Nitrous Oxide and Methoxyflurane for Obstetrical Analgesia
Authors: Bergsjø Per , Lindbæk Ellen
Published: December 2009

A mixture of 50% nitrous oxide and 50% oxygen was compared with methoxyflurane (Penthrane) in analgesic concentrations during labour. Both drugs were self‐administered, nitrous oxide by demand flow through face masks, and methoxyflurane through a spscial inhaler (Analgizer). The patients used both drugs in succession, with an interval of one labour pain between the two drugs, and were then asked which drug they preferred. The order in which the drugs were given, was decided at random.

Of 63 patients significantly more chose nitrous oxide than methoxyflurane. Both drugs gave excellent or good analgesia in 92% of the cases. Side effects in the mother were in the same order of magnitude for the two drugs. No adverse effects could be detected in the children, by clinical examination. The more frequent choice of nitrous oxide is likely to be due to the differences in the inhalation procedure for the two drugs in this trial, rather than to their analgesic properties. Both can be recommended for pain relief during labour.
Tissue Progesterone Assay by Means of Competitive Protein Binding
Authors: Nilsson Ingrid
Published: December 2009

An assay technique is described which permits the estimation of nanogram amounts of progesterone in tissues. After primary extraction of the tissue homogenate, the extract is purified by means of thin layer and column chromatography. Progesterone is then measured by competitive protein binding. With this technique it is possible to determine the amount of progesterone in less than 1 gram of myometrial or endometrial tissue.
Ureteric Dilatation and Renal Cortical Index After Normal and Pre‐Eclamptic Pregnancies
Authors: Kauppila A. , Satuli R. , Vuorinen P.
Published: December 2009

Ureteric dilatation was established by intravenous pyelography in the early puerperium in 78% of the 41 patients and 4‐6 months post partum in 32% of the 18 patients examined. The change occurred in the early puerperium in 90% of the patients after a normal and in 67% after a preeclamptic pregnancy. The statistically almost significant difference was attributed in preeclampsia to the reducing effect it exerts on uterine circulation. Dilatation was more common on the right than on the left side.

Pre‐eclampsia or dilatation of the upper urinary channels did not affect the ratio of the roentgenologic area of the renal pelves and the kidneys.

The length of the kidneys for the group examined 4‐6 months post partum was 0.7 cm shorter on the right and 0.7‐0.9 cm shorter on the left side than for the patients investigated in the early puerperium.

Ureteric compression caused by venous dilatation from the intensified uterine blood flow during pregnancy was considered to have an important role in the etiology of ureteric dilatation in pregnancy.
Encircling Suture of the Cervix in Placenta Praevia: Ten Years Experience
Authors: von Friesen Bo
Published: December 2009

Over a ten‐year period, placenta praevia occurred in 41 instances among 12 485 deliveries (ratio 1: 305). In 19 of these, cervical suture was undertaken in order to prevent severe bleeding while prolonging pregnancy. Infants weighing 2 500 g or less were delivered in seven of the 41 cases (17.1%). Of 43 infants, two, of which one was a twin, failed to survive (4.7%). Calculated in terms of single pregnancies, the figures correct to 12.8 and 2.6%, respectively. These figures are lower than any previously published.
Total Protein Content in Amniotic Fluid from Normal Pregnancies and from Pregnancies Complicated by Rh‐Isoimmunization
Authors: Jonasson Lars‐Erik
Published: December 2009

Amniotic fluid total protein content was measured in 129 samples from 112 normal pregnancies and 223 samples from 118 pregnancies complicated by Rhisoimmunization. A few samples were also obtained from pregnancies with other complications. A biuret method was used. The results showed that the total protein content is elevated in cases of mild and of very serious fetal disease. Intermediate stages of isoimmunization were associated with comparatively low protein levels. This may indicate that a high protein level may have a protective influence against the effects of isoimmunization. Because of the inability to discriminate between mild and very serious cases of isoimmunization protein estimations will be of limited value in the practical management of isoimmunized pregnancies. Due to the progressive decrease in total protein concentrations after the 24th week in normal pregnancies protein estimations may be of some value in determining fetal age.
Short‐Term Progestogen Treatment of Endometrial Carcinoma: Histological, Histochemical and Hormonal Studies
Authors: Moe Narve
Published: December 2009

Thirteen women with adenocarcinoma of the endometrium were treated with standardized doses of hydroxyprogesterone caproate for 3 weeks. Histological and histochemical studies of tumour tissue were performed before and after the treatment. Most of the well differentiated carcinomas showed secretory and acantho‐matous changes after the treatment, whereas such changes were more rarely seen in tumours with low degree of differentiation. There was a great variability in the enzyme pattern. Alkaline phosphatase activity seemed to decrease during the treatment, whereas acid phosphatase and adenosine triphosphatase activities were mostly unaffected. The serum levels of LH decreased, whereas the plasma level of corticoids and the urinary excretion of oestriol and pregnandiol showed no definite changes during the treatment.
Caesarean Section
Authors: Johnell Hans E.
Published: December 2009

Caesarean sections (C.S.) performed in the County of Kopparberg during 1951–1960 were studied. During this period 41 179 deliveries took place. The C.S. rate was 1.6%. In the Central County Hospital the rate was 2.7% and in the County Hospitals 1.6%. Two maternal deaths occurred (0.3%). The perinatal mortality was 9.0%. In the Central County Hospital 25 of 436 infants were lost and in the County Hospitals 37 of 254. In the latter group the number of stillborn infants was high. In a group of elective C.S. performed at term on healthy mothers only 1 of 163 infants died neonatally.
Long‐Term Use of Depot Medroxy Progesterone Acetate as a Contraceptive
Authors: El‐Mahgoub S. , Karim M. , Ammar R.
Published: December 2009

Depot Medroxy Progesterone Acetate 150 mg every 3 months was given to 231 women followed through 4 671 woman/months. The same progestogen in 300 mg dosage was given as six‐monthly injections to 92 women followed through 904 woman/months. These two dosage schedules were 100% effective in fertility control, the crude drop out rate reached 33.7% and 51.0% respectively. The menstrual cycles were markedly disorganized. The re‐establishment of normal menstrual and endometrial cycles and fertility after stopping therapy was reported. The effects on the genital organs, glucose tolerance, thyroid and liver function tests were studied.