bluuebunny/crossref_metadata_2025 huggingface dataset:
Transcervical resection of endometrium and fibroids: The outcome of 412 operations performed over 5 years
Authors: Istre Olav
Published: November 2007

Objective. To evaluate the value of transcervical resection of endometrium and fibroids in clinical practice.

Study design. A retrospective review of operative details of 412 transcervical resections of endometrium and fibroids and clinical outcome from 387 procedures performed over five years is reported.

Material and methods. Patients referred due to bleeding disturbance, treated with a standard urological resectoscopes, controlled after 6 and 12 months. Subsequent follow up was performed by questionnaire and patient bleeding diary.

Results. Operative complications (perforation, hemorrhage, absorption of more than 1500 ml glycine irrigating fluid) arose in 72 patients (18%). In 52 (14.4%) of 366 patients the outcome was not considered acceptable by either ourselves or the patients. This led to a repeat resection procedure being performed in 31 cases (9.0%) with favorable result in 21(68%) of these cases. Twenty‐one patients (6.1%) underwent a hysterectomy because of a persistently poor outcome. A favorable outcome was then reported in subsequent follow up of 335 patients (91%). In addition, pain associated with menstruation was reduced after the procedure and correlates with achieved result on bleeding intensity.

Conclusion. Endometrial resection is safe and acceptable treatment option for both menorrhagia and metrorrhagia associated with dysmenorrhoea.
Gastrin levels in mothers and neonates at delivery in various perinatal conditions
Authors: Morán Carlos , Carranza‐lira Sebastián , Ochoa Raquel , Martínez Juan C. , Herrera Moisés , Fonseca Eugenia , Zárate Arturo
Published: November 2007

Background. This study was designed to assess the variations of gastrin (Ga) serum levels in mothers and newborns at birth in some perinatal disorders.

Materials and methods. Ga levels were measured by RIA in maternal serum, amniotic fluid and cord sera of newborns in 55 cases with the following conditions: normal pregnancy and eutocic vaginal delivery (n=8), repeat cesarean section (n=10), and cardiotogographic register suggestive of fetal compromise (n=15), cephalopelvic disproportion (n=8), preeclampsia (n=7) and postdate pregnancy (n=7). Statistical analysis was performed by Mann‐Whitney U test.

Results. Ga levels in cord sera of newborn and amniotic fluid in normal pregnancy and eutocic delivery were significantly higher (p<0.02 and p<0.01, respectively) than those found in patients with repeat cesarean operation. Serum Ga concentrations in women with postterm pregnancy were significantly higher (p<0.02) than in women with prior cesarean section. Ga levels in amniotic fluid samples in the presence of suspected fetal compromise and postdate pregnancy were significantly higher (p<0.001) than those observed in women who had repeat cesarean operation.

Conclusion. Vaginal delivery and perinatal pathology may induce hypergastrinemia in both mother and neonate at birth.
Intraamniotic infection in patients with preterm labor and twin pregnancies
Authors: Mazor Moshe , Hershkovitz Reli , Ghezzi Fabio , Maymon Eli , Horowitz Shulamith , Leiberman Joseph Reuben
Published: November 2007

Background. Microbial invasion of the amniotic cavity plays a major role in the pathogenesis of preterm labor and delivery in singleton pregnancy. Nevertheless, this association is not well established among patients with multiple gestations. The purpose of our study was to explore the role of intraamniotic infection in the setting of twin pregnancies.

Methods. Consecutive women with twin gestations, intact membranes and preterm labor who underwent transabdominal amniocentesis under sonographic guidance. Amniotic fluid (AF) was retrieved from both sacs and cultured for aerobic and anaerobic microorganisms as well as for Mycoplasma species. Intraamniotic infection was defined as a positive AF culture for microorganisms. Mann Whitney U test or Student r‐test or Fisher's exact test were utilized for analysis.

Results. Amniotic fluid was obtained from 74 patients. Sixty‐eight women delivered prematurely (91.9%). Amniotic fluid culture results were positive for microorganisms in nine cases and all women with intraamniotic infection delivered prematurely as well as 59 (90.7%) patients with negative culture. Among the nine patients with intraamniotic infection, microorganisms were isolated from the presenting sac in five cases (55.6%), from both sacs in three patients (33.3%) and from the upper sac in the remaining case (11.1%). Patients with a positive AF culture had a more advanced cervical dilatation, a shorter interval amniocentesis‐to‐delivery and a higher incidence of clinical chorioamnionitis than those with a negative AF culture.

Conclusions. The prevalence of intraamniotic infection and clinical and histological chorioamnionitis in twin pregnancies and preterm labor is similar to singleton pregnancies and preterm labor. Therefore, women with multiple gestations and preterm labor should be managed as singleton pregnancies.
Stillbirths and maternal antibodies to Chlamydia trachomatis. A new EIA test for serology
Authors: Koskiniemi Marjaleena , Ämmälä Pirkko , Närvänen Ale , Saikku Pekka , Söderlund Maria , Koskela Pentti , Laurila Pekka , Vaheri Antti
Published: November 2007

Objective. The relationship between stillbirths and infections during pregnancy.

Methods, Antibodies to 13 different viruses and to Mycoplasma pneumoniae, Treponema pallidum, Toxoplasma gondii, and Chlamydia trachomatis, psittaci, and pneumoniae were studied from sera of 42 mothers with stillbirth and of matched case‐control pregnancies.

Results. Elevated antibody levels to Chlamydia trachomatis and human parvovirus B19 were observed in seven mothers with stillbirth as compared with one in matched case controls (p‐0.03 and p<0.06, Fisher's exact one‐ and two‐tailed p values). By a novel EIA test for C. trachomatis, based on synthetic polypeptide, 15 positive cases were detected in patients compared to seven in controls. Placental calcifications and fetal growth retardation appeared more often (p<0.001 and p<0.05, respectively) in the C. trachomatis‐ associated cases than in the others. There was no significant relation between stillbirth and the other antibodies.

Conclusions. We suggest C. trachomatis as a hitherto unrecognized possible cause of stillbirths besides human parvovirus B19. A new EIA test for C. trachomatis, one covering all strains, is promising and makes the future assays more convenient, and may thus make it possible to reduce the rate of stillbirths.
Cytologic changes in two cervical carcinoma cell lines after transfection of the wild‐type p53 gene
Authors: Iwasaka Tsuyoshi , Zheng Peng‐Sheng , Ouchida Mamoru , Yamasaki Humio , Yokoyama Masatoshi , Sugimori Hajime
Published: November 2007

Background. To examine morphological changes in cervical carcinoma cells after induction of overexpression of wild‐type (wt) p53.

Method. A dexamethazone‐inducible wt‐p53 cDNA was introduced into two cervical carcinoma cell lines (TMCC‐1 and ME180) and morphological changes were examined under a phase contrast microscope and following Papanicolaou staining.

Results. TMCC‐1 clones obtained by transfection with wt‐p53 gene had an altered morphology especially after induction of p53 expression by treatment with dexamethazone. These changes were characterized by cell flattening, multinucleation, micronucleation, and huge giant cells, yet the parental TMCC‐1 had none of these morphological changes even after treatment with dexamethazone. Similar cellular changes were observed in ME 180 clones obtained by transfection of wt‐p53 gene.

Conclusion. On the basis of our observations, we propose that the growth inhibition induced by expression of wt‐p53 in these cervical carcinoma cell lines carrying HPV DNA sequences is not the result of G1 arrest but rather relates to a blockade in the M phase of the cell cycle.
Doppler velocimetry in last trimester pregnancy complicated by insulin‐dependent diabetes mellitus
Authors: Grunewald Charlotta , Divon Michael , Lunell Nils‐Olov
Published: November 2007

Objective. To study the pulsatility index of the flow velocity waveform of the uterine and umbilical arteries and the fetal aorta in diabetic pregnancy.

Methods. Twenty‐four well‐controlled insulin‐dependent pregestational diabetics and 25 healthy pregnant women were studied with Doppler ultrasound on two occasions separated by a one month interval in the third trimester. In the study group, a random blood glucose was sampled at the time of the Doppler examination.

Results. At the first Doppler examination the median pulsatility index in the fetal thoracic aorta and in the uterine artery was significantly lower (p<0.01 and p<0.05, respectively) in the diabetic group as compared to the healthy controls, whereas the umbilical and uterine artery pulsatility indices were similar. At the second examination, a significant decrease in median pulsatility index of the umbilical artery and the fetal aorta (p<0.01) and the uterine artery (p<0.05) was observed in the controls whereas no such change occurred in the diabetics. There was no correlation between glycosylated hemoglobin or random blood glucose and pulsatility index values. An increased incidence of neonatal morbidity was noted in the study group.

Conclusion. The normal third trimester decline in uteroplacental and fetal placental pulsatility indices was absent in the diabetic group. The pulsatility index was not influenced by blood glucose regulation.
Perinatal complications following gestational diabetes mellitus how ‘sweet’ is ill?
Authors: Hod Moshe , Rabinerson David , Kaplan Bari , Peled Yoav , Bar Jacob , Shindel Bella , Merlob Paul , Ovadia Jardena , Neri Alexander
Published: November 2007

Objective. We tested the effect of patient compliance, fasting plasma glucose on oral glucose tolerance test, maternal body constitution, and the method of treatment (diet versus insulin) on the perinatal outcome of patients with gestational diabetes mellitus.

Study Design. A prospective, population‐based study compared the perinatal outcome of patients with gestational diabetes mellitus (n=470) (diabetic with regard to the parameters specified above) and a contemporaneous control group (nondiabetic, n=250).

Results. The diabetic and control groups were matched in demographic characteristics. Patient compliance reduced the rate of macrosomia (14.4%) and neonatal hypoglycemia (3.4%) but not to the levels of the control group (5.2% and 1.2% respectively, p<0.05). The level of fasting plasma glucose on the oral glucose tolerance test had no effect on perinatal outcome. Intensified (insulin) treatment reduced the rate of macrosomia and large‐for‐gestational age infants in the subgroups with intermediate and high levels of fasting plasma glucose on the oral glucose tolerance test (9.5%/14.2% and 12.2%/24.2% respectively), again not to levels of the control group (5.2%/10.8%). Obese patients were found to have more perinatal complications than lean patients. Intensified (insulin) treatment has proved to be beneficial in terms of reducing the rate of perinatal complications in the obese patients, but not to the corresponding levels of the control group. Such treatment had no effect on the lean patients.

Conclusions. Strict control of maternal hyperglycemia and high patient compliance are imperative for an effective reduction of perinatal complication in patients with gestational diabetes mellitus. The desired plasma glucose level in the glycemic control of these patients should be further reduced, thus bringing the rate of perinatal complications to that of the normal population.
Intraocular pressure trends in pregnancy and in the third trimester hypertensive patients
Authors: Qureshi Imran Ahmad , Xi Xiao Rong , Wu Xiang Dong
Published: November 2007

Background:Systemic blood pressure is positively related to intraocular pressure. During the third trimester of pregnancy decreased intraocular pressure while increased blood pressure has been reported. After taking into account all those factors that can affect intraocular pressure, the present study investigated whether or not the high blood pressure found in late pregnancy influences the known ocular hypotensive effect of late pregnancy.

Subjects and methods.Normotensive subjects in all trimesters of pregnancy and non‐pregnant control groups along with third trimester hypertensive subjects were studied. Intraocular pressure was measured with the Goldmann applanation tonometer.

Results.In the second and third trimester subjects, the mean intraocular pressure was significantly lower than in the non‐pregnant control group. The differences between first and second, first and third, and second and third trimesters of pregnancy were (means.d.) −0.5±1.2 (p<0.05), −1.5±1.7 (p<0.001), and −1.0±2.1 (p<0.01) mmHg respectively. The mean difference between third trimester hypertensive and third trimester normotensive pregnant women was 0.53±1.5 mmHg (p<0.05).

Conclusions.With advancing pregnancy, intraocular pressure decreases. The mean intraocular pressures of third trimester hypertensive pregnant women were significantly higher from that of third trimester non‐hypertensives. Knowledge of the normal level of intraocular pressure in various stages of pregnancy may help glaucoma screeners.
Serum from endometriosis patients impairs the development of mouse embryos in vitro— comparison with serum from tubal obstruction patient and plasmanate
Authors: Ito Fumitosi , Fujino Yuji , Ogita Sachio
Published: November 2007

Background. The aim of this study was to evaluate the inhibitory effect of serum from endometriosis. To determine the effects of serum obtained from patients with endometriosis on mouse embryo development, we compared the fertilization and cleavage rates of mouse embryo in a standard mouse embryo culture system.

Methods. Sera were collected from 13 individuals who were diagnosed endometriosis and ten individuals who were diagnosed as having tubal obstruction. Mouse embryos were fertilized and cultured in vitro with serum supplement obtained from patients with endometriosis (n= 13) and tubal obstruction (n=10), and plasmanate (n=10).

Results. The fertilization rate was 26.6±14.9% in patients serum with endometriosis, and the cleavage rate was 21.2±9.1%, respectively. However, the fertilization rates were 60.9±12.5% (tubal obstruction group), and 77.3±14.7% (plasmanate group), the cleavage rates were 32.2±16.4% and 36.2±9.9%, respectively.

Conclusions. Serum from patients with endometriosis revealed toxic effects on mouse embryos in vitro. The use of plasmanate instead of whole serum from patients with endometriosis will hopefully bring a better understanding of embryo development.
Fetal exposure to tobacco smoke products: A comparison between self‐reported maternal smoking and concentrations of cotinine and thiocyanate in cord serum
Authors: Nafstad Per , Kongerud Johny , Botten Grete , Urdal Petter , Silsand Terje , Pedersen Babill Stray , Jaakkola Jouni J. K.
Published: November 2007

Background:The objective of the study was to assess the relationship between maternal smoking habits and biomarkers of tobacco smoke measured in cord serum.

Methods:The study population comprised 202 mothers, 42 daily smokers, 24 occasional smokers and 136 nonsmokers. Information on maternal smoking habits was collected in a self‐administered questionnaire at birth and compared with cotinine and thiocyanate concentrations in cord serum.

Results:In linear regression analysis, a unit increase in daily cigarette smoking corresponded to a 4.4 ng/ml (95% CI: 1.1‐7.6) increase in cotinine concentration and 2.3 μmol/l(0.8‐3.8) in thiocyanate. A cut‐off point of 14 ng/ml cotinine separated well between daily smokers (88% above) and nonsmokers (96% below), but revealed a classification problem in occasional smokers (46% above).

Conclusion:Cord serum cotinine and thiocyanate concentrations are related to daily smoking rate during pregnancy, but these concentrations vary considerably among occasional smokers. Detailed information on smoking habits is the key issue in understanding the adverse fetal effects of occasional smoking during pregnancy.
Breech infants: vaginal or cesarean delivery?
Authors: Obwegeser Reinhard , Ulm Martin , Simon Manfred , Ploeckinger Barbara , Gruber Walther
Published: November 2007

Background. This study was undertaken to determine whether planned vaginal or elective cesarean delivery is better for singleton term breech infants and their mothers.

Methods. We studied deliveries of 388 singleton term breech infants that were born in our teaching hospital in Vienna. We follow well defined criteria for vaginal delivery versus cesarean section of term breech fetuses. We thus compared 280 (72%) cases scheduled for vaginal delivery with 108 (28%) scheduled cesarean sections with regard to neonatal mortality and morbidity, including Apgar score, umbilical artery pH, and postpartum maternal morbidity.

Results. Vaginally delivered fetuses of primiparas had lower five‐minute Apgar scores (5%<Apgar 7) and a lower umbilical artery pH (39% below 7.2). This is significantly different from the abdominally delivered primiparas (no Apgar below 7, only 11% with an artery pH below 7.2). Multiparas did not show significantly different results with regard to Apgar scores and umbilical artery pH between the different modes of delivery. Postpartum maternal morbidity was not different between the two groups.

Conclusion. The results suggest that planned vaginal delivery of singleton breech infants of primiparas result in newborns with lower Apgar‐scores, a lower umbilical artery pH and a poorer fetal outcome. On the other hand, it seems that singleton term infants of multiparas do not profit from cesarean delivery.
Contraceptive practice and attitudes in Sweden 1994
Authors: Oddens Björn J. , Milsom Ian
Published: November 2007

Objective. To investigate current contraceptive practice in Sweden and Swedish women's attitudes towards various contraceptive methods.

Methods. In 1994, a random sample of Swedish women (n=2330), aged 15‐45 years (stratified according to age and geographic distribution), were invited by telephone to participate in the study. Women (n=1788) who accepted the invitation to participate were sent a postal questionnaire.

Results. Completed questionnaires were returned by 1422 women (overall response rate: 61.0%). The sample was somewhat skewed towards higher educational level, but in other demographic respects no great deviations from the parent population were observed. The distribution of contraceptive methods in fertile, sexually active women who wished to avoid pregnancy was as follows: oral contraceptives (OCs) 33%, OC plus barrier method 5%, intrauterine device 21%, barrier methods 23%, sterilization 5% (female 3%; male 2%) and injectable steroids 2%. The overall pattern of contraceptive use in women aged 15‐45 years had changed very little compared to results of a similar survey performed in 1987. However, the use of less effective methods (periodic abstinence, coitus interruptus and no method grouped together) was considerably lower among teenagers in 1994 (3%) than in 1987 (18%). The use of these traditional methods was still high in women aged over 35 years (15–17%). A large number of women considered medical methods of contraception to be reliable and easy to use but many were concerned about the safety for health of medical methods.

Conclusions. Contraceptive practice changed towards more frequent use of medical, effective methods among young Swedish women, but not in the total female population. The latter was among others related to the relatively high use rates of less effective methods among women aged over 35. Women were concerned about the health safety of medical methods and relatively low percentages of women reported having received advice from health care professionals to use effective methods.
Book Reviews
Authors: Bergsjø Per
Published: November 2007

Andrews U. Color Atlas of Embryology. 176 color illustrations by Astried Rothenburger and Rüdiger Gay. 383 pages. New York: Thieme Medical Publishers, Inc., 1995. Price: DEM 48.00.

Lankinen KS, Bergström S, Mäkelä PH, Peltomaa M (eds.). Health and Disease in Developing Countries. 586 pages, illustrated. London and Basingstoke: The Macmillan Press Ltd, 1994. Price: see review text.
Increased release of tumor necrosis factor‐alpha and interleukin‐6 in women with the syndrome of hemolysis, elevated liver enzymes, and low platelet count
Authors: Hæger Magnus , Unander Margareta , Andersson Bengt , Tarkowski Andrej , Arnestad Jan Petter , Bengtsson Anders
Published: November 2007

Background. Complement is activated in preeclampsia and complement products are known to activate macrophages. The aim of this study was to determine whether the macrophage derived cytokines, interleukin‐1ß, interleukin‐6 and tumor necrosis factor‐alpha, are released in patients with a form of severe preeclampsia characterized by the syndrome of hemolysis, elevated liver enzymes, and low platelet count (HELLP syndrome).

Methods. Complement activation and plasma levels of cytokines were studied in 11 women with HELLP syndrome and in 11 controls with uncomplicated pregnancies. To further evaluate the connection between complement activation and cytokine release an in vitro study on heparinized whole blood incubated with recombinant C5a was performed.

Results. In the HELLP group, complement anaphylatoxin C5a was increased in plasma at delivery (p<0.01) and one day after delivery (p<0.05), terminal C5b‐9 complement complex was elevated in plasma at delivery (p<0.001) and one day after (p<0.01), plasma levels of interleukin‐6 were increased one day after delivery (p<0.01), and plasma concentrations of tumor necrosis factor‐alpha were elevated at delivery (p<0.01), compared with corresponding levels in controls. All parameters normalized within one week. Interleukin‐16 did not differ between the groups. In vitro, recombinant C5a incubated in whole blood gave a dose‐dependent release of interleukin‐6. No increased release of interleukin‐1 or tumor necrosis factor‐alpha was seen after incubation.

Conclusions. Since cytokine release occurs in severe preeclampsia, inflammatory mechanisms may participate in the pathophysiology of severe preeclampsia.
Immunohistochemical analysis of distribution of estrogen receptors and progesterone receptors in the postmenopausal endometrium
Authors: Koshiyama Masafumi , Yoshida Masumi , Takemura Maki , Yura Yasuichirou , Matsushita Katsuko , Hayashi Michiharu , Tauchi Kunihiko , Konishi Ikuo , Mori Takahide
Published: November 2007

Objective. To examine the expression of sex steroid receptors (ER: estrogen receptor; PR: progesterone receptor) in the postmenopausal endometrium (PMEM) and the relationship to clinical data for studying its characters.

Methods. The immunohistochemical reactivity of the PMEM was studied using monoclonal antibodies against ER and PR, in 33 postmenopausal patients.

Results. The endometrium was thicker in patients who were postmenopausal for 1 to 10 years (1.48±1.31mm) than in patients who were postmenopausal for more than 10 years (0.79 ± 0.37mm) (p<0.05). Among the 33 postmenopausal endometrial samples, ER positivity was found in the glands in 26 cases (78.8%) and PR positivity was detected in 18 cases (54.5%). The average age of the patients with ER positive reactivity in the glands (61.69±7.26 years) was significantly lower than that of the patients with ER negative reactivity (66.00±3.56 years) (p<0.05). Furthermore, the endometrial thickness of the patients with ER or PR positive reactivity in the glands (1.24± 1.09mm and 1.47±1.20mm, respectively) was significantly greater than that of the patients with ER or PR negative reactivity (0.67± 0.26mm and 0.70± 0.40mm, respectively) (p<0.05).

Conclusion. ER in the glands of the PMEM was determined to decrease gradually with increased aging. The presence of ER and PR in the gland cells seemed likely to determine the thickness of the PMEM.
Zinc supplementation during pregnancy: a double blind randomised controlled trial
Authors: Jønsson Bo , Hauge Benedicte , Larsen Morten Falmer , Hald Finn
Published: November 2007

Objective. To investigate whether zinc supplementation during pregnancy improves maternal and fetal outcome.

Design. Controlled clinical trial started at registration until discharge of mother and child from hospital. Two thousand volunteer mothers were randomly assigned to receive zinc supplementation or placebo in a double blind trial.

Patients. Women less than 20 weeks pregnant at the first visit who agreed to take part in the study. One thousand two hundred and six mothers were available for study.

Interventions. Volunteers were randomly selected to receive two tablets of zinc (44mg zinc in total) or two placebo tablets containing inert substances, indistinguishable in appearance and taste from the zinc tablets.

Outcome measure. Large for gestational age (LGA), small for gestational age (SGA), premature rupture of the membrane (PROM), preterm labor (PL), preeclampsia and bleeding in the second or third trimester.

Results. There were no differences between mothers given zinc supplementation concerning the outcome parameters and those given placebo.

Conclusion. Zinc supplementation in pregnancy in a normal healthy middle class population in Denmark does not seem to offer any benefits to the mother or her fetus.
Female urethral diverticulum Clinical aspects and a presentation of 15 cases
Authors: Jensen Lars Meinert , Aabech John , Lundvall Finn , Iversen Hans‐Georg
Published: November 2007

Objective. Fifteen patients with female urethral diverticulum (FUD) were referred during nine years. In order to point out the symptomatology and findings and to evaluate the treatment we have reviewed these patients.

Methods. A retrospective analysis of 15 women treated with transvaginal diverticulectomy. The technique is described.

Results. The median age was 54 years. All the patients had symptoms of lower urinary tract disorder. The time from the first appearance of symptoms to referral was median 2 years (range, 4 days‐30 years). Seventy‐five percent of the cases had a pronounced tenderness. In 14 patients a suburethral mass could be found. Purulent material could be expressed in twelve cases. Three patients with symptoms for more than 10 years were characterized by stress incontinence and frequency and recurrent cystitis. No single diagnostic test proved to be specific for FUD. In eight patients (53%) the indication for operation was based only on symptomatology and the presence of a suburethral mass.

Conclusion. Diverticulum of the urethra is to be suspected in women with unexplained lower urinary tract symptoms. We recommend a collaboration of the two specialities: Gynaecology and Urology.
The Dangerousness of Psychiatrists
Authors: Ellard John
Published: November 2007

Since psychosis occasionally leads to behaviour requiring constraint, psychiatrists are involved in decisions which may lead to loss of liberty. In some places and at some times psychiatrists and their predecessors have made those decisions unrestrained. This essay considers how we have used that power in the past, indicates some of the abuses extant now, recognises that there is no satisfying solution to the problems which exist and argues for the consistency of the legal system with all its limitations rather than the uncertain and unrestrained judgment of individual psychiatrists.
Should Sex Offenders be Treated?
Authors: John Robert
Published: November 2007

The question of whether sex offenders should be punished or treated is currently receiving serious attention from health, welfare and correctional authorities. Considerable enthusiasm is being expressed for the apparent advantages of treatment. It has been argued that treatment of offenders is more likely than punishment to reduce further offending and is consequently better for the community and more cost effective. This review looks at some of these issues, especially as they affect young sex offenders.
Developmental Psychiatry: A Perspective
Authors: Solinski Sylvia
Published: November 2007

A brief historical introduction to developmental psychology puts twentieth century views into perspective. The ideas of continuity, critical periods and predictability are examined. The case for a developmental perspective of human development is argued, and the tenets underlying such a model are suggested. The utility of the study of human development is discussed.
The Psychiatric Assessment of the Patient Requesting Facial Surgery
Authors: Schweitzer Isaac
Published: November 2007

Recent years have witnessed an increasing demand for cosmetic or reconstructive facial surgery. This paper addresses the pre-operative psychiatric assessment of the patient requesting facial surgery. Most patients adjust well to surgery and appreciate and accept the outcome. The psychiatrist who helps to screen difficult cases needs specific skills and must understand the body image issues involved. The psychiatrist needs to evaluate the patient's motivations, expectations and understanding of the risks and implications of surgery. Potential problem patients are described, including the minimal defect patient, the patient with secondary gain from the deformity, the older patient, the patient in crisis, the polysurgical patient, the paranoid patient, the schizophrenic patient, and the male patient. Guidelines for evaluating the patient need to be applied flexibly. The psychiatrist must communicate with the surgeon to appreciate clearly the concerns the surgeon has about each patient.
Investigation of Osteopaenia in Anorexia Nervosa
Authors: Hay Phillipa J. , Hall Anne , Delahunt John W. , Harper Guy , Mitchell Alex W. , Salmond Clare
Published: November 2007

Sixty-nine female patients, mean age 27.5 years (range 20-40), with a past or current history of anorexia nervosa (DSM Ill-R) had spinal trabecular bone density assessed by single energy quantitative CT scan. Current exercise and dietary calcium levels were assessed by detailed questionnaires and categorized. A semi-structured interview was used to record weight, menstruation, exercise and dietary calcium intake histories from early adolescence. Serum sex hormones and total calcium assays were measured. Bone density was significantly lower in the patients compared to 31 controls. Bone density was significantly positively correlated with body mass index, and negatively correlated with illness duration and duration of amenorrhoea. Exercise levels, dietary calcium intake and taking an oestrogen pill did not correlate significantly with bone density. Recovered patients did not have osteopaenia but they had shorter illness histories than non-recovered patients. Management to minimise bone loss should focus on weight gain and resumption of normal menstruation.
Low Plasma β-Endorphin in Post-Traumatic Stress Disorder
Authors: Hoffman Linda , Watson Paddy Burges , Wilson George , Montgomery Joan
Published: November 2007

We compared serum cortisol, ACTH and plasma P-endorphin in 21 Post-Traumatic Stress Disorder patients and 20 controls. Although we found no important disturbance in diurnal rhythms, the PTSD patients had significantly higher A.M. serum cortisols compared with controls. Both A.M. and P.M. plasma P-endorphins in PTSD patients were significantly lower compared with controls. These data suggest that plasma P-endorphin may be a marker for PTSD and that chronic endogenous opioid depletion may play a role in the pathogenesis and perpetuation of this disorder.
Alcohol-Related Problems in the Emergency Room of an Indian General Hospital
Authors: Adityanjee  , Mohan D. , Wig N. N.
Published: November 2007

Alcohol-related problems made up 17.6% of the case load of psychiatric emergencies in an Indian general hospital. The police brought three-quarters of them, 45% for quarrels, street-fights and under influence of alcohol and 20% for minor offences like abusing in public. A psychiatric illness was definitely present in 40% of the cases. Only 10% of the patients with alcohol-related problems were referred for outpatient treatment, Eighty-five percent were not given any follow-up advice because the patients said they needed no help.
Obsessive Compulsive Disorder: A Sufferer's Viewpoint
Authors:   Anonymous, Tiller John
Published: November 2007

This is a personal account of trying to live and cope with obsessive compulsive disorder (OCD) written primarily by a sufferer attending the Victorian OCD Support Group. It outlines some of the suffering and distress of having the disorder, some of the efforts and techniques used in trying to understand and cope with the disorder, the fortitude and endurance required, the difficulty in seeking and accepting treatment and some of the sufferer's hopes for a better future.
Psychoanalysis: A Creed in Decline
Authors: Mullen Paul E.
Published: November 2007

Psychoanalysis is in decline. Its methods disbar it from serious consideration as a natural science and its claims to therapeutic efficacy are in tatters. The role it performed earlier in the century as part of the narrative knowledge of western culture is in eclipse. Trainees in psychiatry are still, however, on occasion seduced by its faded charms, to their detriment. The time has come to relegate psychoanalysis to its proper place as a moment in the historical development of psychiatry and a ripple in 20th century western culture.
Suicide: The Role of the Media
Authors: Goldney Robert D.
Published: November 2007

Studies addressing the issue of media reporting of suicide and subsequent suicide are reviewed. the majority demonstrate a statistically significant association between the amount of such reporting and ensuing increases in suicide. Restraint is clearly indicated. the media could assist by publicising alternative coping mechanisms, rather than “normalizing” suicidal behaviour by reporting it.
Australian Adolescents' Perceptions of their Parents
Authors: Cubis Jeffrey , Lewin Terry , Dawes Fiona
Published: November 2007

We examined the characteristics of a self-report measure for assessing perceptions of parents, the Parental Bonding Instrument (PBI), in an adolescent community sample (N = 2,147; mean age = 15.4 years). Using factor analysis, three PBI dimensions were identified — the original Care factor and two Protection factors: perceived social control and personal intrusiveness. Important sex differences were found which were not evident in the two factor structure recommended by Parker [1, 2]. Relative to sons, daughters saw their fathers as more personally intrusive and their mothers as less socially controlling and much more caring. Overall, adolescents perceived mothers as more caring but more personally intrusive than fathers. Adolescents who saw their father as uncaring and their mother as controlling tended to have the least positive psychosocial profiles.
Psychiatry, Molecular Genetics and Ethics: The New Discoveries and the New Issues
Authors: McGrath John
Published: November 2007

Recent developments in molecular genetics are examined with particular reference to psychiatry. the new technologies available have allowed significant advances in the understanding of certain illnesses such as familial Alzheimer's disease and Huntington's chorea, and will provide powerful tools to explore many other important psychiatric illnesses. the area of genetic counselling is already characterized by complex ethical issues. We can expect that as the new technologies provide the prospect of positive germ line genetic engineering, these ethical issues will become more complex. It is important that psychiatrists prepare themselves for these future developments and take an active role in leading the debate.
Bulimia: Symptoms and Syndromes in an Urban Population
Authors: Ben-Tovim D. I. , Subbiah Nandini , Scheutz Brenton , Morton Jacqueline
Published: November 2007

The widely used DSM-Ill criteria for the diagnosis of bulimia essentially define bulimia as a syndrome of guilty, secretive and subjectively hard to control binge over-eating. A self-report questionnaire for bulimic behavior was administered to three community and two hospital populations in South Australia. 13% of females in the community samples could be categorized as bulimic according to the DSM-Ill criteria. Those criteria did not adequately define the behaviour of patients in treatment for bulimia in a Weight Disorders Unit, 85% of whom not only binged, but induced vomiting afterwards. When diagnostic criteria were more closely aligned to clinical experience, the prevalence of bulimia in the community appeared closer to 1–2%. New DSM criteria (DSM-Ill-R) have been proposed and prevalence rates using them fell within the 1–2% range.
The Psychiatric Nurse in Liaison Psychiatry
Authors: Hicks Susanne
Published: November 2007

The role of nursing staff in a liaison consultative unit is by no means established in this country although precedents exist in the United States. Nevertheless, there are clear theoretical reasons for including psychiatric nurses in the liaison team. This report concerns a model of intervention based on one of three models identified in the US studies. the model involves a collaborative/consultative relationship between the psychiatric nurse and the psychiatrist, therefore maximising opportunities for successful intervention and cross-referral. Two clinical vignettes illustrate this. the clinical presentations of 200 patients presenting primarily to the nurse specialist are compared with 200 presenting to the psychiatric department. the patterns of referrals and also the agencies referring differed. the differences in those profiles, together with the management implications, are discussed. High stress areas of nursing, such as cardiology, neurosurgery and haematology, provided a fertile area for referrals to the nurse where referrals to the psychiatrists had not been high.
The First 200 Years of Australian Psychiatry
Authors: Dax Eric Cunningham
Published: November 2007

Accomplishments in the various fields of Australian psychiatry are traced from the first asylums, through the history of the peaks and troughs of progress, down to the present state of disorganisation of the services and the struggle for psychiatry to find an honourable place in Australian history.
Beethoven'S Creative Illness
Authors: Bower Herbert
Published: November 2007

One phase of Beethoven's life, between his 45th and 50th year, characterized by very low creativity and overwhelming stress situations, is subjected to a psychiatric interpretation. the historical background is briefly sketched and 5 precipitating stress factors are outlined. the symptoms of his illness are described, using Beethoven's letters as source material. A brief discussion of Beethoven's musical style prior to and after his illness is based on quotations from three eminent musical scholars. A resume of Beethoven's physical and psychological disorders during his life are given and the conclusion is reached that between 1815 and 1820, Beethoven experienced a creative illness which was psychotic in type, ended in recovery and radically changed his musical creativity.
Plsa Syndrome in a Chinese Patient
Authors: Chiu Helen F.K. , Li Siu Wah , Lee Sing
Published: November 2007

A Chinese female with 10 years' history of a special form of tardive dystonia (Pisa syndrome) is described. Mild improvement has occurred after 5 months' treatment with tetrabenazine despite the long duration of dystonia and the presence of secondary structural changes.
Reserpine Withdrawal Psychosis
Authors: Samuels A. H. , Taylor A. J.
Published: November 2007

A case of reserpine withdrawal psychosis is reported. This uncommon condition is described as a true withdrawal psychosis and may be due to dopamine receptor supersensitivity.
Sources of Public Prejudice against Electro-Convulsive Therapy
Authors: Durham James
Published: November 2007

Recent legislation in NSW betrays a prejudice against electro-convulsive therapy. Factors probably contributing to popular prejudice against ECT are discussed.
The Validity of the Assessment of Psychopathology in the Psychoses
Authors: McGorry Patrick D. , Copolov David L. , Singh Bruce S.
Published: November 2007

This paper reviews recent progress in the assessment of the psychopathology of psychosis and focuses upon a number of persistent limitations. In particular the over-emphasis upon reliability at the expense of validity is highlighted and the relationship between reliability and validity is reconsidered. A number of strategies aimed at improving the validity of psychopathological measures are outlined. Proposals to deploy such variables differently in research strategies and analyses are endorsed.
Quantum Metaphors in Deep Psychotherapy
Authors: Morstyn Ron
Published: November 2007

Most psychodynamic theories are based on Freud's models of mental dynamics which were significantly influenced by Newtonian physics. Freud's attempts to use the then current scientific metaphors led to theoretical and clinical dilemmas particularly in deep psychotherapy and especially with borderline patients. The author argues that as Newtonian principles are useful for describing macroscopic reality, so Freud's Newtonian constructs are useful to a certain depth of therapy. Beyond that point, scientific metaphors can be retained but the appropriate metaphors are those of quantum physics. Quantum metaphors are used to explore duality, free will and patient-therapist interaction.
Christchurch Psychiatric Epidemiology Study, Part I: Methodology and Lifetime Prevalence for Specific Psychiatric Disorders
Authors: Wells J. Elisabeth , Bushnell John A. , Hornblow Andrew R. , Joyce Peter R. , Oakley-Browne Mark A.
Published: November 2007

In 1986 the Christchurch Psychiatric Epidemiology Study obtained interviews with a probability sample of 1498 adults aged 18 to 64 years. The Diagnostic Interview Schedule (DIS) was used to enable DSM-III diagnoses to be made. This paper describes the methodology of the study and reports the lifetime prevalence of specific psychiatric disorders. The highest lifetime prevalences found were for generalised anxiety (31%), alcohol abuseldependence (19%) and major depressive episode (13%). Men had higher rates of substance abuse whereas women had higher rates of affective disorders and most anxiety disorders. Compared with results from the Epidemiologic Catchment Area Program, Puerto Rico and Edmonton, Christchurch has the highest rates for major depression and is among the highest for alcohol abuse/dependence.
A Phenomenology of Jealousy
Authors: Mullen Paul E.
Published: November 2007

Phenomenology is the study of conscious mental events [1]. That it is conscious events requires emphasis, particularly at this moment in the historical development of psychiatry when we are still emerging from the thrall of psychodynamic causalities, said to lie in unconscious and unknowable realms, and are in danger of descending into another mythology of extra conscious mechanisms compounded from neurobiological speculations.
Who Goes to Grow?
Authors: Shannon Peter J. , Morrison David L.
Published: November 2007

GROW is a self help group which commenced in Sydney 30 years ago to assist mental patients rehabilitate. Some fear that this is not occurring. This study aimed to assess, by questionnaires, the mental health status of GROW at-tenders in Western Australia. There was a 93% response rate with demographic variables similar to an earlier Australia-wide survey. Individual scores on the GHQ and a Work, Leisure and Family Life Questionnaire showed a higher level of dysfunction than that in a “normal” population with men, on the average, scoring higher than women. Questions on medical care indicated that between 50—70% of attenders had previously been treated for a nervous condition. It is concluded that GROW is reaching a group of people with significant mental morbidity.
The Development of the New South Wales Service for the Treatment and Rehabilitation of Torture and Trauma Survivors (Startts): The First Year
Authors: Reid Janice , Silove Derrick , Tarn Ruth
Published: November 2007

Many immigrants to Australia are refugees, some of whom have experienced acute stress and trauma, including torture, prior to or during their escape from their home countries. In response to a growing recognition that the health care services may not be meeting the needs of these people the NSW Department of Health funded the establishment of a community-based rehabilitation service for traumatised refugees. This paper provides an overview of the recent history of the service, some of the organisational and staffing issues faced during its first year, some characteristics of the first 200 clients, principles of treatment, clinical, nosological and therapeutic issues and relationships with other agencies.
Do Psychosocial Factors Predict Weight Loss Following Gastric Surgery for Obesity?
Authors: Schrader Geoffrey , Stefanovic Snezana , Gibbs Andrew , Elmslie Ronald , Slavotinek Anthony , Higgins Bruce
Published: November 2007

This study was undertaken to determine whether psychosocial factors determined during a pre-operative semi-structured psychiatric interview were associated either with the amount of weight loss following obesity surgery or with dropping out from follow-up after surgery. Multiple regression and discriminant function analysis of weight loss at six, twelve, twenty four and thirty six months showed no correlation between psychosocial variables and the amount of weight lost or with dropping out from follow-up. It is concluded that the type of psychiatric interview performed in this study does not yield information which reliably predicts weight loss after surgery for obesity.
Understanding the Culture and Behaviour of East Asians — A Confucian Perspective
Authors: Cheng Stephen K. K.
Published: November 2007

The economic miracle of East Asia is followed by the emergence of a new common identity in Confucianism among the nations in the region. Being the predominant cultural determining force in East Asia, Confucianism has deeply influenced East Asian behaviour. Three behavioural traits in East Asians are discussed. First, the East Asian's lack of “personality” is traced to the Confucian social institution of Li — rules of propriety. Second, the East Asian's lack of principled moral thinking is linked to the dyadic, relation-based character of the Confucian ethic, its lack of hypothetical reasoning and its hierarchical view of human relationships. Third, the East Asian's lack of assertiveness is rooted in the Confucian ideal of man as a reflection of harmony in the cosmos and the Confucian ideal of society as based on the fulfilment of duties rather than the assertion of rights. The implications of these Confucian traits suggest the need to re-formulate Western conceptions of and approaches to East Asian behaviour.
A Systems Model of Chronic Musculo-Skeletal Pain
Authors: Large Robert , Butler Michael , James Frances , Peters Janet
Published: November 2007

A comprehensive systems model of chronic musculo-skeletal pain is presented. Physical and mechanical events may impinge directly upon the organism to produce pain. In addition life experience, as interpreted by each individual, may result in unpleasant affect which may lead through three psychosomatic pathways to musculo-skeletal pain. The suggested pathways are conversion, dysponesis and neurotransmitter disturbance. It is suggested that the construing of the self as being “ill”, “an invalid” or a “pain person” is a crucial step in the development of the chronic pain syndrome and that therapies which fail to change this self-construct are unlikely to meet with long-term success.