bluuebunny/crossref_metadata_2025 huggingface dataset:
Laparoscopic adhesiolysis for infertile patients with pelvic adhesive disease
Authors: Serour G.I. , Badraoui M.H. , El Agizi H.M. , Hamed A.F. , Abdel‐Aziz F.
Published: April 2004

Thirty patients with secondary infertility were subjected to laparoscopic adhesiolysis during the period January 1986 to February 1987 at Al‐Azhar Endoscopy and Microsurgery Unit. Second look laparoscopy (SLL) was performed after a period of 9–12 months. At laparoscopy, pelvic adhesive disease was staged according to the severity of the disease and compared with the finding at SLL. Five patients defaulted, three patients (12%) became pregnant and 22 patients underwent SLL. Ten patients (45.5%) showed no recurrence of adhesions. This study suggests that laparoscopy has a role in adhesiolysis of mild and moderate adhesions and SLL provides further opportunity to relyse reformed adhesions in some cases.
Actinomycosis mimicking pelvic malignancy
Authors: Snowman B.A. , Malviya V.K. , Brown W. , Malone J.M. , Deppe G.
Published: April 2004

Pelvic actinomyces, usually a complication of an intrauterine device (IUD), is uncommon and may present a diagnostic dilemma because of an atypical clinical presentation. We present a patient with a cervical tumor, extensive parametrial induration with involvement of the posterior bladder wall, and regional lymph nodes which mimicked advanced cervical cancer and presented a significant diagnostic problem.
Culture of seminal fluid in infertile men and relationship to semen evaluation
Authors: Gregoriou O. , Botsis D. , Papadias K. , Kassanos D. , Liapis A. , Zourlas P.A.
Published: April 2004

Bacterial flora of the seminal fluid and its influence on semen quality, was examined in 225 asymptomatic unselected men. Each semen sample was cultured aerobically, anaerobically, for genital mycoplasmas, and for Chlamydia trachomatis. Semen analysis was made according to standard methods recommended by the W.H.O. All 225 semen samples had microbial isolates. All isolates had colony counts of 102 colony forming units (cfu/ml). Thirty‐three cases had > 102 cfu/ml, 85 cases had > 103 cfu/ml and 78 cases > 105 cfu/ml. The most common organisms isolated were Ureaplasma urealyticum in 86 samples and C. trachomatis in 26 samples. The most frequent abnormal parameters were viability (117 of 212, 52%), motility (85 of 212, 40%) and number of sperm cells (74 of 225, 32.8%). No significant correlation was found between abnormal semen parameters and presence of U. urealyticum, and C. trachomatis. We concluded that asymptomatic bacteriospermia (infection) in the semen did not significantly affect the count, motility or morphologic features of the specimen.
The development and evaluation of a computerised antenatal questionnaire
Authors: Fawdry R.
Published: April 2004

A computerised questionnaire, for convenience entitled “PAM” (Programmed Aid for use in Midwifery), was created for use at the time of first antenatal assessment. The system required simple direct input by the expectant mother; and in response to a short descriptive letter, 73.4% of 349 women were prepared to try the new method. The response of 100 consecutive women who tried the system was further analysed. Seventy women liked PAM, four disliked the technique and the remainder had no strong feelings. Asked by the midwife which they would prefer, 46 women expressed a preference for the computer questionnaire and only nine would rather have had a traditional interview with a midwife asking the same questions. PAM or similar systems provide a new opportunity, both for research and as a means of reliably decentralising the initial assessment of a pregnancy.
Fetal macrosomia and pregnancy outcome in Lagos
Authors: Abudu O.O. , Awonuga A.O.
Published: April 2004

In an analysis of 6376 singleton births the prevalence of macrosomia was 4.9%; the attending perinatal mortality was 58/1000 compared to 18/1000 in controls. Eighty‐three percent perinatal deaths occurred in unbooked patients after prolonged and neglected labor. Mortality and morbidity were weight related; the macrosomic baby delivered by section or by diabetic mother or that died was significantly heavier. There was strong association between maternal age, parity, diabetes, mild hypertension, previous history of a big baby and macrosomia in this study. Pregnancy was significantly prolonged with higher incidence of emergency sections and primary postpartum hemorrhage in mothers of macrosomic babies. Fetal sex does not appear to be an important factor in macrosomia.
Severe abruptio placentae — still unpreventable
Authors: Rai L. , Duvvi H. , Rao U.R. , Vaidehi  , Nalini V.
Published: April 2004

The management of abruptio placentae remains a problem, despite advances in medical science. This study analyses severity of abruption, resultant morbidity, and maternal and fetal mortality in 105 cases. Among the contributory factors, hypertension (44%) and grand multiparity (24%) were common. There was no maternal death among these cases, mainly because of liberal use of blood transfusion, prompt delivery, and careful fetal monitoring, but perinatal mortality remained high (73%). Factors responsible for this high perinatal mortality and its prevention are discussed.
Analysis of 20,291 deliveries in a Turkish institution
Authors: Ayhan A. , Yüce K. , Kisnisci H.A.
Published: April 2004

Data of 20,291 deliveries are presented; 6.85% (1389) of the patients were 19 years old or under and 6.24% (1276) were 35 or over; 7352 women had one child (primipara) and 1475 had five or more. Cephalic presentation constituted 94.2% of deliveries. The total induction rate was 9%. The incidence of prematurity and post‐term gestation was 13 and 7.2%, respectively. Prolonged labor was encountered in 4% of the patients. Anesthesia was employed in 65.8% of all deliveries. Total and primary cesarean section rates were 9.77 and 7%, respectively. The incidence of fetal mortality was 2.55% and congenital anomalies were seen in 1.53% of the infants. The birth weight was under 2499 g in 9.5% of the newborns. Pregnancy complications of different magnitude were encountered in 23.7% of the cases. Uterine rupture and inversion rates were 0.12% and 0.005% respectively. The maternal mortality rate was found to be 64.06 per 100,000 deliveries.
Risk factors for fever, endometritis and wound infection after abdominal delivery
Authors: Suonio S. , Saarikoski S. , Vohlonen I. , Kauhanen O.
Published: April 2004

Risk factors for postoperative fever, endometritis and wound infection were analyzed in 761 consecutive cesarean sections. Postoperative fever was observed in 12%, endometritis in 4.7% and wound infection in 3% of cases. The relative risk for postoperative fever was increased in cases with postoperative hematoma (relative risk = 16.0), in cases with blood loss over 500 g (relative risk = 1.8) and if the duration of labor exceeded 6 h (relative risk = 1.9). The only significant risk factors for endometritis were amnionitis (relative risk = 8.7), postoperative hematoma (relative risk = 5.0) and age under 24 years (relative risk = 3.0). Wound infections were less frequent in cases with previous cesarean sections (relative risk = 0.15) and after elective cesarean sections (relative risk = 0.22), but duration of operation over 1 h (relative risk = 2.8), induction of labor (relative risk = 3.2) and puerperal endometritis (relative risk = 7.9) increased the risk of wound infection. By elimination of amnionitis and postoperative hematomas the rate of endometritis would have diminished only from 4.7% to 3.8%, a percentage equally unacceptable; diagnostics and prevention should be directed to young patients undergoing caesarean section. Besides technical procedures prevention of endometritis is important for the prevention of wound infection. In hospitals with low postcesarean infectious morbidity antibiotic prophylaxis seems to be unwarranted.
Ectopic pregnancy in a defined Nigerian population
Authors: Makinde O.O. , Ogunniyi S.O.
Published: April 2004

All cases of ectopic pregnancy in the Ile‐Ife teaching hospital between 1977 and 1987 were reviewed. The incidence per 1000 births was 4.76, and this condition accounted for 2.75% of all gynecological admissions. The associated mortality was low (0.5%). An increasing incidence was observed during the study period, as was an increasing proportion of nulliparous patients. Tubal damage from pelvic infections might account for the trends.
Prevention of hepatitis B infection in infants born to hepatitis B carrier mothers: low dosage vaccination
Authors: Theppisai U. , Thanuntaseth C. , Chiewsilp P. , Siripoonya P.
Published: April 2004

Two groups of newborn infants born to HBeAg positive carrier mothers were given HBIG (200 IU) immediately after birth. Subsequently, at age 2 days and at 1, 2 and 12 months, the first group received 5 μg and the second group 2 μg of HBV vaccines. There was no significant difference in the anti‐HBs seroconversion rate (SR), and the protective efficacy rate (PER) at the age of 13 months in either group. The SR and PER of group I were 91.7% and 90.18%, and group II were 92.9% and 91.01%, respectively. Although the significant differences were observed in the geometric mean titers of anti‐HBs in group I (526.3 mIU/ml) and group II (371.4 mIU/ml), both were above the protective level. The immune responses to the reduced dosage of HBV vaccines are satisfactory in preventing HBV in the newborn infants of HBeAg positive carrier mothers.
Plasma zinc and copper in pregnant Nigerian women at term and their newborn babies
Authors: Okonofua F.E. , Isinkaye A. , Onwudiegwu U. , Amole F.A. , Emofurieta W.A. , Ugwu N.C.
Published: April 2004

The concentration of copper and zinc was determined by atomic absorption spectrophotometry in 26 normal Nigerian women at term and their newborn babies. Cord zinc was significantly greater than maternal zinc. In contrast, cord copper was lower than maternal copper. There was only a weak correlation between cord copper and maternal copper but none between cord zinc and maternal zinc. There was no correlation between maternal and cord zinc and neonatal birthweight. However, an inverse correlation was found between maternal and cord copper and neonatal birthweight. These results indicate that: (1) zinc has no effect on fetal growth in Nigerian women but (2) copper may have a negative effect on fetal growth.
Laparoscopy in the diagnosis of gynecologic chronic pelvic pain
Authors: Vercellini P. , Fedele L. , Molteni P. , Arcaini L. , Bianchi S. , Candiani G.B.
Published: April 2004

Laparoscopy was performed on 126 women with undiagnosed chronic pelvic pain. Abnormalities were demonstrated in 62.7% of the cases. Endometriosis was present in 32.5% of the women. Laparoscopy is useful in the differential diagnosis of chronic pelvic pain and is indicated when symptoms persist for over 6 months.
Ectopic pregnancy associated with tubal schistosomiasis in a Nigerian woman
Authors: Okonofua F.E. , Ojo O.S. , Odunsi O.A. , Odesanmi W.O.
Published: April 2004

A case of ruptured tubal ectopic pregnancy is presented. On histological examination of the fallopian tube involved, ova of Schistosoma haematobium were found in the submucosal and intramural parts of the tube. The case illustrates a rare preventable cause of ectopic pregnancy in this population.
Pregnancy and complicated familial Mediterranean fever
Authors: Shimoni Y. , Shalev E.
Published: April 2004

Familial Mediterranean Fever (FMF) is an inherited disease, closely following the pattern of autosomal recessive inheritance. Amyloidosis is the most severe complication of the disease. The prevalence of pregnancy loss in women with FMF is considered to be high. There is no information to support the possibility of increase risk of late pregnancy complications or change in the natural course of the disease. Two cases are presented with complicated FMF. One case with proved amyloidosis and the second patient with ascites. Pregnancy and neonatal outcome were uneventful in both. No further deterioration in the systemic disease occurred.
Chronic utero‐rectal fistula with menochezia and amenorrhea
Authors: Pinto P. , Sharma L. , Kini P.
Published: April 2004

Utero‐intestinal fistulas are commonly acute in nature and usually follow malignancies of the intestines. Here we report a chronic uterorectal fistula with uncommon symptom of cyclical rectal bleeding (menochezia) and amenorrhea.
Features of menopause and menopausal age in Nigerian women
Authors: Okonofua F.E. , Lawal A. , Bamgbose J.K.
Published: April 2004

The age of menopause and the clinical features of menopause were investigated by questionnaire survey in 563 Nigerian women of Yoruba descent who have been menopausal for at least 5 years. The mean and median ages of menopause were 48.4 and 48.0 years, respectively. No relationship could be established between menopausal age and various biosocial factors such as age of menarche, social class, parity, smoking and place of residence. The commonest menopause related symptoms were joint pains and hot flush and only 42% of them still practiced sexual intercourse. These findings when compared to those from other populations indicate that there is need for more work on menopause in Nigerian women.
Conservative management of cerebellar hemorrhage in pregnancy
Authors: Kawasaki N. , Uchida T. , Yamada M. , Fukumura A. , Okamura H.
Published: April 2004

A case of cerebellar arteriovenous malformation (AVM) during pregnancy is reported. A 26‐year‐old primigravida had cerebellar hemorrhage at 32 weeks of gestation. She was conservatively controlled until term with a good outcome accomplished by elective cesarean section. AVM in the left cerebellar hemisphere was confirmed by angiography after delivery and successfully removed. Here we present a review of AVM during pregnancy and a few case reports of cerebellar AVM‐complicated pregnancy published in available literatures.
Ectopic pregnancy in Zimbabwe
Authors: De Muylder X.
Published: April 2004

One hundred four consecutive ectopic pregnancies were systematically analysed. During the study period, the incidence rate was 110 per 100 000 14–44 year old females per year. A history of prior pelvic infection was given by 53.8% of the cases and was suggested by surgical findings or by histological analysis among 74.9%. Serological evidence of previous chlamydial infection was much more common when ectopic pregnancy occurred in abnormal tubes than in normal tubes or compared to intrauterine pregnancies. The influence of schistosomiasis, endometriosis and ovarian cyst was limited to a very few cases. The analysis of contraceptive habits shows a much higher number of extrauterine pregnancies when the woman is using progestin‐only pill than when she is on combined oral tablets.
The variation of endometrial protein PP14 in different parts of the human endometrium
Authors: Li T.C. , Pockley G. , Bolton A.E. , Cooke I.D.
Published: April 2004

The levels of the endometrial protein PP14 were shown to vary greatly in different sites in the endometrium (coefficient of variation ranged from 55% to 92%, mean = 73%). The variation was found to have no consistent pattern in the seven subjects studied and was unlikely to be the result of problems related to tissue sampling, processing or assay (intra‐assay coefficient of variation of the PP14 assay used was less than 10%). Such a large variation in results suggests that the measurement of PP14 concentration in endometrial tissue may be of limited diagnostic value.
Transvaginal color Doppler imaging for hemodynamic assessment of reproductive tract tumors
Authors: Hata K. , Makihara K. , Hata T. , Takahashi K. , Kitao M.
Published: April 2004

Transvaginal color Doppler flow imaging was carried out on 68 Japanese women (normal, 10; uterine myoma, 21; cervical carcinoma, 7; endometrial carcinoma, 10; benign ovarian tumor, 12; ovarian carcinoma, 8). Blood flow velocity waveforms were evaluated by calculation of the resistance index (RI). In 6 patients with cervical carcinoma neovascularization was evident within the cervix. In all patients with endometrial carcinoma such signs were present adjacent to and/or within the endometrium. These findings were absent in normal women and in those with myomata. There was a significant difference between the RI (0.510 ± 0.097) in patients with cervical carcinoma and in normal women (0.881 ± 0.048) in the ascending branch. In endometrial carcinoma the RI (0.535 ± 0.158) was significantly lower in the arcuate artery compared to the normal uterus (0.768 ± 0.075) and patients with uterine myoma (0.679 ± 0.131), respectively. There was no area of neovascularization in the normal ovaries. Neovascularization was confirmed in four patients with a benign ovarian tumor and in all patients with an ovarian carcinoma. A significantly lower RI was obtained in cases of ovarian carcinoma (0.503 ± 0.122) than in patients with benign ovarian tumors (0.888 ± 0.216). Transvaginal color Doppler imaging and pulsed Doppler analysis may be useful diagnostic tools to differentiate benign and malignant tumors.
Ruptured uterus
Authors: Kafkas S. , Taner C.E.
Published: April 2004

Uterine rupture, an important cause of maternal and fetal mortality, is still occasionally seen in our region. In this study we reviewed 41 cases of uterine rupture encountered between the years 1983 and 1988, in a total of 3962 hospital deliveries with a frequency of 1 in 96.6 deliveries. Sixteen cases (39.0%) were over 35 years old. Twenty‐five patients (60.9%) were grand multiparous (more than five pregnancies). There were no uterine ruptures in primigravid women. Ruptures were mostly (75.6%) due to cephalopelvic disproportion. Subtotal hysterectomy was the first choice of management for 35 cases. The maternal mortality rate was 7.3% while fetal mortality was 82.9%. Midwife education, regular antenatal care and hospital deliveries are important factors in prevention of this obstetric hazard.
Multiple myeloma in pregnancy
Authors: Pajor A. , Kelemen E. , Mohos Z. , Hambach J. , Váradi G.
Published: April 2004

This is a report on pregnancy complicated by multiple myeloma. Severe refractory anemia was present throughout the pregnancy and multiple myeloma was diagnosed in the second trimester. The anemia ceased after delivery but recurred one year later along with other signs of disease progression. The infant remained healthy after a 2‐year follow‐up.
Pregnancy and its complications after cardiac valve replacement
Authors: Ayhan A. , Yapar E.G. , Yüce K. , Kişnişci H.A. , Nazli N. , Özmen F.
Published: April 2004

The outcome of 64 pregnancies in 40 women who conceived after cardiac valve replacement were reviewed. Fetal wastage was 53.2% (25/47) in coumarin administered pregnancies, 36.4% (4/11) using heparin and 16.7% (1/6) without anticoagulants. Two fetal malformations were noted in coumarin administered pregnancies. There were two maternal deaths. Maternal morbidity due to antenatal bleeding, atrial fibrillation, thromboembolic episodes and cardiac failure were found to be 20.0% (8/40), 17.5% (7/40), 10.0% (4/40) and 10.0% (4/40), respectively.
Fetal binocular distance as a predictor of menstrual age
Authors: Tongsong T. , Wanapirak C. , Jesadapornchai S. , Tathayathikom E.
Published: April 2004

The relation between fetal binocular distance and menstrual age was determined by cross‐sectional analysis of 555 normal fetuses (14–40 weeks) using real‐time sonography. Mathematical modelling of the data demonstrated that the binocular distance growth curve, similar to the biparietal diameter, is nonlinear. Predicted binocular values at various points in gestation were comparable to the results of other investigators. Predicted menstrual age in weeks for specific binocular distance measurements in millimeters were calculated and are reported in tabular form. The variability (±2 SD) associated with predicting menstrual age from binocular distance is ±14 days between 14 and 27 weeks, but between 29 and 40 weeks the variability is ±24 days. Binocular distance can be used as an adjunct in estimating menstrual age and may be useful in the diagnosis of some abnormalities, e.g. hypotelorism or hypertelorism.
Maternal weight, weight gain during pregnancy and pregnancy outcome
Authors: Ekblad U. , Grenman S.
Published: April 2004

OBJECTIVE: To evaluate the effects of abnormal maternal weight or weight gain on pregnancy outcome. METHOD: Records for 191 mothers with abnormal prepregnancy weight (≥20%) above, or under, ideal body weight for height) or weight gain ≥20 kg, or ≤ 5 kg during pregnancy were reviewed. The control group ccnsisted of 166 mothers with normal prepregnancy weight and normal weight gain during pregnancy. Data on mothers and their infants were analyzed by one‐way analysis of variance. RESULTS: Obese women and mothers with excessive weight gain during pregnancy had an increased incidence of induced labor (P ≤0.05) and tendency for emergency cesarean sections during the delivery. Obese women had more large‐for‐date babies than controls (P ≤0.05). Weight gain ≤5 kg during pregnancy was most common in slightly obese women and did not carry any special obstetric or neonatal risk. Underweight women had a significant risk for delivering a small‐for‐data baby. CONCLUSION: Obese women and women with excessive weight gain during pregnancy need special follow‐up and counseling during pregnancy and delivery. Underweight women may need prepregnancy nutritional counseling to guarantee normal fetal growth. In developed countries suboptimal weight gain (≤5 kg) during pregnancy seems not to need any medical intervention.
Potential relationship between dengue fever and neural tube defects in a Northern District of India
Authors: Sharma J.B. , Gulati N.
Published: April 2004

A sudden increase in number of births of newborns with neural tube defects (NTD) was observed from June, 1989 to September, 1989 in Medical College and Hospital, Rohtak and various other government and private hospitals of the district of Rohtak. Out of a total 4785 deliveries whose records were collected, there were 87 newborns with NTD with an incidence of 18.18/1000 births which was three times higher than the previous incidence of 6.8/1000 births in the preceding 4 years. There was an epidemic of dengue fever in this area from September, 1988 to December, 1988 affecting almost one member from each family. This coincided with the period of their first trimester. Of these, 18 patients suffered clinically from dengue fever, 21 patients had positive dengue fever history in their family members, 21 patients had positive history in their neighbors. The cluster of NTD appears to be due to dengue virus infection.
Maternal morbidity in developing countries: A review and comments
Authors: Liskin L.S.
Published: April 2004

The incidence and prevalence of postpartum maternal morbidity in developing countries are poorly understood. Methodologic problems, such as lack of standard definitions, misclassification of illnesses, use of nonrepresentative samples, and inadequate validation for self‐reported data, tend to compromise existing studies. Available data suggest that serious acute illnesses are common, affecting as many as 20% of mothers who deliver in hospitals in some areas. Providing good antenatal and family planning services should significantly reduce acute and chronic sequelae after parturition.
Tuberculous vesico‐vaginal fistula
Authors: Ba‐Thike K. , Than‐Aye  , Nan‐Oo
Published: April 2004

A 32‐year‐old female with a past history of pulmonary tuberculosis presenting with dribbling of urine per vaginam had a small fistulous opening in the anterior vaginal wall. Chest X‐ray showed active tuberculosis. Right hydronephrosis and hydroureter with autonephrectomy of left kidney and vesico‐vaginal fistula were demonstrated on intravenous urography. On cystoscopy, the bladder was contracted with two small fistulous openings. Cecocystoplasty and repair of fistulae were successfully done. Histology of bladder wall showed tuberculous cystitis.
Anticardiolipin antibodies in eclampsia
Authors: Arun Rao A. , Ananthakrishna N.C.
Published: April 2004

Twenty patients with eclampsia were studied for the presence of anticardiolipin antibodies by the standard microflocculation test (quantitative) used in the VDRL. Four out of 20 patients (20%) were positive for anticardiolipin antibodies. Anticardiolipin antibodies which are antiphospholipid antibodies by decreasing the prostacyclin production may damage the vascular endothelium and cause thrombosis in the vessels. Hence, the presence of anticardiolipin antibody in eclampsia may have association with antiphospholipid antibody syndrome described by Harris et al. (Lancet ii: 1211, 1983) and its central nervous system sequelae.
Nutritional factors and rest reduce pregnancy‐induced hypertension and pre‐eclampsia in positive roll‐over test primigravidas
Authors: Herrera J.A.
Published: April 2004

OBJECTIVE: The possibility of reducing pregnancy‐induced hypertension and preeclampsia in primigravidas with low doses of nutritional factors and relative rest in the left lateral position was investigated in a randomized controlled, double‐blind trial. METHOD: Seventy‐four normotensive women at 28–29 weeks' gestation, judged to be at risk of PIH or pre‐eclampsia because they presented with a mean blood pressure of 80 mmHg or higher and a positive roll‐over test, were studied. The treatment protocol was received by 37 women and the other 37 women received standard antenatal control until delivery. RESULT: Twenty‐nine (78.3%) women in the control group developed PIH and/or pre‐eclampsia, as opposed to only 4 (10.8%) cases in the treatment group (P < 0.001). There were no adverse effects of treatment in mothers or infants. CONCLUSION: This protocol reduces PIH and pre‐eclampsia in primigravidas judged to be at risk of hypertension. Further studies are required to evaluate prostacyclin and prostanglandin E2changes.
Anuric acute renal failure due to bilateral accidental ureteric ligation during abdominal hysterectomy
Authors: Mate‐Kole M.O. , Yeboah E.D. , Affram R.K. , Ghosh T.S.
Published: April 2004

OBJECTIVE: To determine the incidence of accidental ureteric ligation causing acute anuric renal failure (AARF) at the KorleBu Teaching Hospital, Accra, Between August 1984 and December 1991. METHOD: The records and operative data of all cases managed with acute anuric renal failure at the hospital during the period were reviewed. RESULT: The 7 patients with AARF presented with mean pre‐referral anuria of 3.2 days. Total abdominal hysterectomy (4 for fibroids, 2 for carcinoma of uterus and 1 for post partum hemorrhage) was the cause of ureteric ligation. The 7 patients mean age 38.5 years were anemic (mean HB 4.1 g/dl) and uremic (mean blood urea 40.51 mmol/l) on admission. Abdominal ultrasonography was useful for diagnosis of obstructive uropathy. Hemodialysis was required in all cases prior to laparotomy and ureteroneocystostomy. The ureters were usually ligated at the distal 3 cm. Five survived ureteroneocystostomy and 2 died before laparatomy from septicemia and/or pulmonary edema. CONCLUSION: Abdominal hysterectomy is a major cause of anuric acute renal failure and early recognition and treatment prevents death.
Cervical human papilloma virus infection of women attending social hygiene clinics in Hong Kong
Authors: Ngan H.Y.S. , Collins R.J. , Wong K.Y. , Cheung A. , Lai C.F. , Liu Y.T.
Published: April 2004

OBJECTIVE: To find the prevalence of HPV infection in women attending a sexually transmitted disease clinic in Hong Kong. METHOD: Cervical HPV infection was identified by cervical cytology and DNA filter in situ‐hybridization (Virapap™) techniques in 207 women attending a social hygiene clinic. Other risk factors for cervical cancer were assessed and any association with HPV infection was sought. Statistical analysis was carried out using the χ2‐test. RESULT: The prevalence of HPV infection in the 207 Chinese women was 8.2% by cervical smear and 12.6% by DNA filter in‐situ‐hybridization. Risk factors for cervical cancer were not significantly associated with HPV infection in this group, 95% of whom were prostitutes. CONCLUSION: The prevalence of HPV infection in this group at high risk for cervical cancer is higher than in low‐risk pregnant women, however the prevalence of HPV infection in Hong Kong is at the low end of the range of figures quoted for Caucasians. The cause of such a low prevalence is yet to be determined.
Influence of labor and route of delivery on the frequency of respiratory morbidity in term neonates
Authors: Hales K.A. , Morgan M.A. , Thurnau G.R.
Published: April 2004

OBJECTIVES: The purpose of this study is to compare the frequency of respiratory morbidity (RDS‐Type I, RDS‐Type II and PFC) in term neonates relative to three different delivery modes (cesarean delivery without labor, cesarean in labor, vaginal delivery). METHODS: A case‐control study was performed consisting of 692 maternal/neonate pairs at term gestation with either a documented mature lung profile at an obstetrical age ≥37 weeks' gestation or a Dubowitz age ≥ 38 weeks' gestation. RESULTS: Overall, the frequency of neonatal respiratory morbidity was 5.1%. Neonatal respiratory morbidity was observed in 23 (12.4%) of 186 cases when cesarean delivery was performed prior to the onset of labor; in 10 (5.6%) of 177 cases when the cesarean delivery was performed after labor had ensued; and in 2 (0.6%) of 329 cases when the fetus was delivered vaginally (P < 0.001). CONCLUSION: The frequency of respiratory morbidity in term neonates is influenced by labor and route of delivery, and it is highest when cesarean delivery is performed prior to the onset of labor.
Institutional maternal mortality in Mali
Authors: Mallé D. , Ross D.A. , Campbell O.M.R. , Huttly S.R.A.
Published: April 2004

Objectives: To measure the institutional maternal mortality ratio (MMR) in Mali and suggest ways to reduce it. Methods: Routinely recorded data from 24 health institutions in three regions were reviewed for 1988 to 1992. Results: The overall MMR in the institutions was 201 maternal deaths per 100 000 live births. Hemorrhage, toxemia and infections accounted for 80% of the 360 recorded maternal deaths, almost all of which were preventable. The main reasons why these conditions result in death lie in poor quality and maldistribution of health services, lack of transport and late use of allopathic services. Conclusions: Maternal mortality is still a major public health problem in Mali, even among the small proportion of women who reach health facilities. Substantial new initiatives are urgently needed to reduce this major cause of preventable adult female mortality.
Preterm breech delivery in a developing country
Authors: Malhotra D. , Gopalan S. , Narang A.
Published: April 2004

OBJECTIVES: To determine if cesarean section offers any advantage over vaginal delivery for a preterm breech fetus in a developing country. METHODS: A retrospective analysis from hospital records was done at a tertiary care center in North India. Two hundred and twenty‐four preterm breech deliveries (28–36 completed weeks) between January 1988 and December 1991 from a total of 13 149 deliveries at the hospital during this period formed the study group. Fetal death and lethal congenital malformations diagnosed antepartum were excluded. Intrapartum and neonatal morbidity and mortality in vaginal versus cesarean deliveries were the main outcome measures. RESULTS: Although the combined intrapartum and neonatal mortality was significantly higher for vaginal delivery (35.9% vs. 17.7%), there was no significant difference when the data was correlated with birthweight or gestational age. The neonatal morbidity was also similar in both these groups. In women with a poor obstetric history, the neonatal survival was better in the cesarean group (93% vs. 43%; P = 0.0004). CONCLUSION: Even with optimum neonatal care facilities, cesarean section does not offer any advantage over vaginal delivery for a preterm breech fetus in a developing country. The present study does not advocate the routine use of cesarean section for this group of fetuses. However, it is the preferred route of delivery for women with a poor obstetric history.
Evaluating the systematic use of humor in psychotherapy with adolescents
Authors: Prerost Frank J.
Published: April 2004

Adolescents often experience psychological difficulties associated with the demands and changes of puberty. Humor can be an effective response to express troublesome emotions associated with aggression. Self‐descriptions of an adolescent client demonstrate the value of a controlled use of humor in individual psychotherapy for certain persons in this developmental age period.
The influence of a return to school on the long‐term adjustment of school refusers
Authors: Valles Enrique , Oddy Michael
Published: April 2004

There is currently a strong emphasis on an early return to school in the management of school refusers. However, many of the studies in this area show a certain similarity in that the efficacy of treatment is measured by the disappearance of school avoidance rather than the long‐term adjustment of the child. Very few studies have followed the school refuser into adulthood and even fewer have looked at the prognostic implications of a return to school.

This paper reports a study of 34 young people all of whom had been admitted to an in‐patient adolescent unit because of school refusal. Half had returned to school and the other half had never done so. The influence of this return on their emotional and social adjustment in young adulthood was assessed.
Beggary in West Africa
Authors: D'Hondt Walter , Vandewiele Michel
Published: April 2004

Westerners visiting Africa for the first time are often surprized—if not shocked—at the large number of beggars in the streets and the relative ease with which people solicit or give help although pure adherents of Islam are in favour of restricting beggary. A first reason for this is that most West African societies are deeply Islamized and that begging is a characteristic feature of Islamic societies. But a closer look at the traditional structures shows that the ancestral principle of mutual solidarity is also at the basis of most people's attitude. However, the increasing number of beggars and forms of begging have turned the phenomenon into a national concern. Senegalese novelists and film‐makers, even Senegalese members of the Parliament often engage in debates about that national plague and what to do about it. This paper analyzes the various motives for begging and giving alms and discusses youth's attitude towards the issue. Its tentative conclusion is that despite the overall acceptance of the phenomenon for religious reasons—a position of principle—there are clear indications of an increasingly critical attitude towards begging.
Cognitive correlates of adolescents' aspirations to leadership: a developmental study
Authors: Singer Ming
Published: April 2004

The study examined age and gender differences in leadership aspirations among teenage adolescents. It was hypothesized that adolscents' valence, self‐efficacy and attribution perceptions about leadership would be predictive of their aspirations to leadership. Altogether 52 fourth form and 78 seventh form high school students completed a questionnaire measuring (a) overall leadership aspirations, (b) 13 valence‐instrumentality expectancies for 13 leadership outcomes, (c) self‐efficacy perceptions, and (d) attributions of effective leadership. The results revealed significant gender differences in valence scores and significant age differences in self‐efficacy and attribution measures. Regression analyses indicated that fourth formers' leadership aspirations were significantly predicted from their “ease‐of‐success” self‐efficacy expectation; whereas seventh formers from either valence perceptions (males) or self‐efficacy and attribution scores (females). These results were discussed in the context of the valence and self‐efficacy models of career decision‐making processes and attribution theory.
Health promotion for adolescents: preventive and corrective strategies against problem behavior
Authors: Hurrelmann Klaus
Published: April 2004

This paper, in its first part, gives an overview of research on “problem behavior” in adolescence. Adolescence is considered to be a stage in life characterized by more experimentation, exploration, risk‐taking, and rebellion than any other stages. Many health‐damaging behaviors (drug consumption, precocious sexual activity, riskful driving, aggressive behavior, etc.) have important psychosocial functions in adolescents' developments. Some of these behaviors can be signals of “stress”, defined as a bio‐psycho‐social state of tension resulting from a variety of stressors which confront adolescents daily in modern industrial societies.

In the second part of the paper, the implications of this research for strategies of intervention are discussed. The systematic analysis distinguishes between different stages in the process by which problem behavior emerges and separates “preventive” from “corrective” forms of intervention. Additionally, the analysis differentiates between the dimensions targeted by the measures: interventions addressed toward individual behavior (“personal resources”) on the one hand, and living conditions (“social resources”) on the other hand. The resulting types of intervention approaches are illustrated with examples and discussed in view of how appropriate they are for health promotion in adolescence. Implications for “social policy for adolescents” are discussed.
Identity status and self‐construct systems: process X structure interactions
Authors: Berzonsky Michael D. , Rice Kenneth G. , Neimeyer Greg J.
Published: April 2004

This study investigated the relationship between identity status and structural dimensions of individuals' self‐theories or personal construct systems. The sample was composed of 31 Achievers, 31 Moratoriums, 30 Foreclosures, and 26 Diffusions. Participants completed a modified version of Kelly's (1955) Role Construct Repertory test designed to assess their personal sense of integrative continuity over time. Status differences in self‐construct differentiation, integration, and self‐certainty were analyzed. Results indicated that Moratoriums and Diffusions had the highest self‐construct differentiation. Achievers were the most self‐certain in their ratings, Diffusions the least. Status differences in self‐theory integration were found, but only when a qualitative, structural analysis of levels of self‐construct differentiation and integration was performed. No sex effects were found. Results are discussed as replicating and extending previous work in the area, and future research directions are noted.
An outpatient treatment alternative for suicidal youth
Authors: Gutstein Steven E. , Rudd M.David
Published: April 2004

The present study demonstrates the safety and effectiveness of an outpatient treatment program for suicidal children and adolescents. Pre‐ and post‐treatment measures of patient behavior and family functioning are presented for 47 adolescents and latency‐aged children who received treatment from the Systemic Crisis Intervention Program at the Houston Child Guidance Center. Follow‐up was conducted at three and six months and at a point between 12–18 months. All measures indicated significant long‐term improvement. Data concerning post‐institutional use and suicidal behavior are also presented.
Relations among early adolescent temperament, parent and peer demands, and adjustment: a test of the goodness of fit model
Authors: Talwar Rachna , Nitz Katherine , Lerner Richard M.
Published: April 2004

This study assessed whether the goodness of fit—between early adolescents temperaments and their parents and peers demands, or “ethnotheories”, regarding temperament—was more related to adjustment than were acontextual measures of temperament alone. Data from the Pennsylvania Early Adolescent Transitions Study, a short‐term longitudinal investigation of 153 adolescents from the beginning of sixth grade to the end of seventh grade, were used. Temperament was indexed by the nine attributes measured by the Revised Dimension of Temperament Survey, and the measures of demands regarding temperament were derived from different versions of this instrument. Adjustment was indexed by teacher ratings of academic and social competence and by parent ratings of problem behaviors. At the end of Grade 6 and the beginning of Grade 7, the number of significant relations between the adjustment measures and the fit scores tended to be greater than the number of significant relations between adjustment and temperament, measured alone. Moreover, groups formed on the basis of high vs. low temperament fit showed differential adjustment scores: adolescents in the low fit group in regard to both peer‐ and parent‐demands received lower teacher ratings of scholastic competence, and higher parent ratings for conduct and school problems, than did the adolescents in the high fit group.
Condoms and coitus: adolescents attitudes to AIDS and safe sex behavior
Authors: Moore Susan M. , Rosenthal Doreen A.
Published: April 2004

This study investigated the relationship between sexual risk taking and attitudes to AIDS precautions among a sample of approximately 1000 non‐virgin adolescents attending 15 colleges and universities in Victoria, Australia. Four attitudinal dimensions were isolated: Antiprecautions, Risk Denial, Abrogation of Responsibility and Fatalism. These attitudes showed meaningful relationships with different types of sexual risk: risk with a casual partner, risk with a regular partner, and multiple partnering. Different patterns of association emerged for males and females, with female risk behavior being more strongly related to antiprecautions attitudes. These differences were discussed in the light of gender‐stereotypic responses to sexual situations, and their implications for educational interventions were explored.
Amusement machine playing in childhood and adolescence: A comparative analysis of video games and fruit machines
Authors: Griffiths Mark D.
Published: April 2004

The introduction of video games has met with mixed reviews. In the US, an ongoing debate focusing on the potential problems of video game playing has been taken up by parents, politicians and social scientists. A number of the concerns that have been raised about the playing of video games in the US are very similar to the concerns raised about the playing of fruit machines (slot machines) in the UK. This paper attempts to put the ongoing US and UK amusement machine debates into an empirical perspective and attempts a comparative analysis of video games and fruit machines by examining: incidence of play, sex differences and psychological characteristics of machine players, observational findings in arcade settings, the alleged negative consequences of amusement machine playing (i.e. increased aggression and addiction), and an appraisal of amusement machines' positive aspects. Future directions and an expanded version of Brown's (1989) developmental model of a pathology of man‐machine relationships are also discussed.
Coping strategies used by adolescents in dealing with family relocation overseas
Authors: Vercruysse Natalie J. , Chandler Louis A.
Published: April 2004

This study investigated: (a) the types of coping strategies adolescents commonly employ in response to family relocation overseas; and (b) whether sex, age, self‐concept, behavioral adjustment, and previous history of moves affect the types of strategies used by these sojourners. For this purpose, we selected a widely used model of coping which distinguishes between approach and avoidance strategies and a sample of teenagers whose families had recently relocated in Belgium. Four assessment instruments were utilized: the Background Information Data Sheet, the Stress Response Scale, the Piers—Harris Children's Self‐Concept Scale, and the Coping Responses Inventory — Youth Form. Results indicated that adolescent sojourners selected both approach and avoidance strategies to cope with family relocation overseas. Correlational analyses further showed that females and older teenagers tended to rely significantly more on approach strategies than on avoidance strategies. Self‐concept and behavioral adjustment were also found to be related to the type coping strategies employed, while the history of previous relocation was not.
Solvability of nonlinear Dirichlet problem for a class of degenerate elliptic equations
Authors: Cavalheiro Albo Carlos
Published: April 2004

We prove an existence result for solution to a class of nonlinear degenerate elliptic equation associated with a class of partial
differential operators of the form , with Dj = ∂/∂xj, where aij : Ω → ℝ are functionssatisfying suitable hypotheses.
Verrucous squamous cell carcinoma of the female genital tract. Report of three cases and survey of the literature
Authors: Väyrynen M. , Romppanen T. , Koskela E. , Castren O. , Syrjänen K.
Published: April 2004

Three new cases of gynecological verrucous squamous cell carcinomas are reported; one in the uterine cervix, and two in the vulva. The English literature covering the 49 cases reported previously is surveyed with special reference to the diagnostic and therapeutic aspects of these tumors, as well as with their clinical behavior and possible relationship to viral (HPV) lesions (Condylomas) of the genital tract.

It was concluded that so far the exact relationship between the different verrucous squamous cell lesions in the genital tract remains obscure, all such lesions should be regarded as potentially malignant, and treated accordingly by radical surgery.
The significance of cholera outbreak in the prognosis of pregnancy
Authors: Ayangade Okun
Published: April 2004

Five hundred sixty‐one persons were treated in a comprehensive cholera unit during the 1979–1980 cholera outbreak at Ile‐Ife. Sixty‐one pregnant cholera patients were identified and followed up. Compared to the general female population, all female cholera patients in the 15–29 year age group show significantly more resistance to the disease than those aged 30 years and above. The pregnant cases, as well as all reproductive‐years age groups, showed significantly less mortality than both the non‐pregnant patients and those at both extremes of age. Our findings show that pregnancy does not render the woman more susceptible and may, in fact, render her less susceptible after the first trimester, when prognosis brightens for both the mother and the fetus.
An international system for the education of students of medicine and other health professionals in human reproduction. The FIGO teaching manual: A status report
Authors: Taylor Howard C. , Magarick Ronald H.
Published: April 2004

An analysis of the effectiveness of FIGO's Teaching Manual on Human Reproduction is reported on the basis of answers to a questionnaire received from 100 heads of teaching departments, chiefly of obstetrics and gynecology. These represented 32 countries widely distributed throughout the developing countries of the world. The most significant finding was the evidence of the very large number of medical and other students that could be reached through the principle of placing superlatively good teaching material in the hands of key educators in their native country. Additional answers to the questionnaire provided information on the way courses were organized about the material and suggestions as the useful changes, possible expansion of subject matter, and the felt need for an updated edition.