bluuebunny/crossref_metadata_2025_split huggingface dataset:
Medial Tibiofemoral-Joint Stiffness in Males and Females Across the Lifespan
Authors: Aronson Patricia , Rijke Arie , Hertel Jay , Ingersoll Christopher D. 
Published: June 2014

Context:
Analyzing ligament stiffness between males and females at 3 maturational stages across the lifespan may provide insight into whether changes in ligament behavior with aging may contribute to joint laxity.

Objective:
To compare the stiffness of the medial structures of the tibiofemoral joint and the medial collateral ligament to determine if there are differences at 3 distinct ages and between the sexes.

Design:
Cross-sectional study.

Setting:
Laboratory.

Patients or Other Participants:
A total of 108 healthy and physically active volunteers with no previous knee surgery, no acute knee injury, and no use of exogenous hormones in the past 6 months participated. They were divided into 6 groups based on sex and age (8–10, 18–40, 50–75 years).

Main Outcome Measure(s):
Ligament stiffness of the tibiofemoral joint was measured with an arthrometer in 0° and 20° of tibiofemoral-joint flexion. The slope values of the force-strain line that represents stiffness of the medial tibiofemoral joint at 0° and the medial collateral ligament at 20° of flexion were obtained.

Results:
When height and mass were controlled, we found a main effect (P &lt; .001) for age group: the 8- to 10-year olds were less stiff than both the 18- to 40- and the 50- to 75-year-old groups. No effects of sex or tibiofemoral-joint position on stiffness measures were noted when height and mass were included as covariates.

Conclusions:
Prepubescent medial tibiofemoral-joint stiffness was less than postpubescent knee stiffness. Medial tibiofemoral-joint stiffness was related to height and mass after puberty in men and women.
Plantar Loading During Cutting While Wearing a Rigid Carbon Fiber Insert
Authors: Queen Robin M. , Abbey Alicia N. , Verma Ravi , Butler Robert J. , Nunley James A. 
Published: June 2014

ContextStress fractures are one of the most common injuries in sports, accounting for approximately 10% of all overuse injuries. Treatment of fifth metatarsal stress fractures involves both surgical and nonsurgical interventions. Fifth metatarsal stress fractures are difficult to treat because of the risks of delayed union, nonunion, and recurrent injuries. Most of these injuries occur during agility tasks, such as those performed in soccer, basketball, and lacrosse.Objective:To examine the effect of a rigid carbon graphite footplate on plantar loading during 2 agility tasks.Design: Crossover study.Setting:Laboratory.Patients or Other Participants:A total of 19 recreational male athletes with no history of lower extremity injury in the past 6 months and no previous metatarsal stress fractures were tested.Main Outcome Measure(s): Seven 45° side-cut and crossover-cut tasks were completed in a shoe with or without a full-length rigid carbon plate. Testing order between the shoe conditions and the 2 cutting tasks was randomized. Plantar-loading data were recorded using instrumented insoles. Peak pressure, maximum force, force-time integral, and contact area beneath the total foot, the medial and lateral midfoot, and the medial, middle, and lateral forefoot were analyzed. A series of paired t tests was used to examine differences between the footwear conditions (carbon graphite footplate, shod) for both cutting tasks independently (α = .05).Results:During the side-cut task, the footplate increased total foot and lateral midfoot peak pressures while decreasing contact area and lateral midfoot force-time integral. During the crossover-cut task, the footplate increased total foot and lateral midfoot peak pressure and lateral forefoot force-time integral while decreasing total and lateral forefoot contact area.Conclusions:Although a rigid carbon graphite footplate altered some aspects of the plantar-pressure profile during cutting in uninjured participants, it was ineffective in reducing plantar loading beneath the fifth metatarsal.
Assessment of Cardiac Dysfunction in the Intrauterine Growth-restricted Fetuses from Pre-eclamptic Mothers
Authors: Stamatian Florin , Caracostea Gabriela 
Published: June 2014

ABSTRACT

Background
Although it is known that cardiac parameters have abnormal values in severely affected fetuses with intrauterine growth restriction (IUGR), recent research suggested that subclinical cardiac dysfunction may be present from the early stages of fetal deterioration. The identification and monitoring of cardiac dysfunction may be relevant for the management of these cases.

Materials and methods
In this prospective observational study, we evaluated 17 IUGR fetuses from nulliparous pregnant women diagnosed with pre-eclampsia. Cardiac structural assessment was performed using segmental sequential analysis. Cardiac function was assessed by conventional echocardiography and Tissue Doppler Imaging (TDI).

Results
Gestational age at admittance ranged between 24 and 30 weeks. A severe form of pre-eclampsia was diagnosed in 2 of 17 cases. Conventional cardiac examination showed low left and right ventricular diastolic filling with low E and A velocities, and increased myocardial performance indexes for both ventricles. Using TDI we observed decreased myocardial velocities and impaired contractility (demonstrated by low left and right diastolic velocities, as well as increased E’/A’ ratios).

Conclusion
Our study confirms the presence of early cardiac dysfunction in IUGR fetuses. Further studies are warranted to confirm the utility of TDI in obstetric ultrasound routine examination for monitoring fetal cardiac function in high-risk pregnancies.

How to cite this article
Caracostea G, Stamatian F. Assessment of Cardiac Dysfunction in the Intrauterine Growthrestricted Fetuses from Pre-eclamptic Mothers. Donald School J Ultrasound Obstet Gynecol 2014;8(2):123-127.
Neonatal Outcomes after Preconceptional Vaginal Micronized Progesterone Administration in Recurrent Pregnancy Loss: Five Years Prospective Study
Authors: Russu Manuela , Stănculescu Ruxandra , Păun Maria , Marin Jan Andi 
Published: June 2014

ABSTRACT

Objectives
The objective of this prospective study was to analyze the effect of vaginal micronized progesterone (VMP) daily administrated in women with recurrent pregnancy loss, recurrent miscarriage, and/or preterm birth on neonatal outcomes.

Methods
In the treat group patients received 200 mg/day VMP (14 days/month, during the luteal phase) from preconception until completed 36 weeks of gestation. Women from the control group did not receive VPM treatment. Ultrasonographic examination was performed for gestational age confirmation, assessment of cervical length and congenital malformation screening in fetus.

Results
Compared with the control group, the women from the VMP group had a decreased time to conception, lower frequency of miscarriages and higher gestational age at delivery. Newborns from mothers treated with VPM had significantly higher birth weight than newborns from the control group of mothers (p = 0.022). The frequency of stillbirths and the need for oxygen supplementation and mechanical ventilation was lower in the newborns from treated group of mother compared with control group.

Conclusion
Vaginal micronized progesterone 200 mg/day from preconception to 36 weeks of gestation in women with recurrent pregnancy loss reduced the frequency of miscarriages, stillbirths, preterm births and neonatal morbidity.

How to cite this article
Russu M, Stănculescu R, Păun M, Marin JA. Neonatal Outcomes after Preconceptional Vaginal Micronized Progesterone Administration in Recurrent Pregnancy Loss: Five Years Prospective Study. Donald School J Ultrasound Obstet Gynecol 2014;8(2):128-133.
Lung Malformations: Prenatal Ultrasound Diagnosis and Obstetrical Management
Authors: Iliev Gheorghe , Dumitrascu Irina , Grigore Mihaela , Mihalceanu Elena , Scripcaru Daniela , Zoican Gabriela , Aprodu Gabriel , Bivoleanu Anca , Petrariu Andrei , Stamatin Maria 
Published: June 2014

ABSTRACTPurposeWe present our experience in prenatal diagnosis and obstetrical management of congenital lung malformations (CLM).Materials and methodsThe diagnosis of CLM was performed during routine second and third trimester fetal morphology assessment. The extent of the disease was established according to the type, localization and size of the pulmonary lesion and the presence of fetal complications (mediastinal shift, fetal hydrops, hydramnios). Termination of pregnancy (TOP) was indicated in cases associated with extrapulmonary anomalies, untreatable cases and fetal hydrops. After delivery a pulmonary X-ray and surgical examination was performed in all newborns.ResultsWe diagnosed 15 cases with congenital lung malformations. Of these, 9 had congenital cystic adenomatoid malformation (CCAM). TOP was performed in 6 cases with CCAM. Three cases had a favorable pre/postnatal evolution. Bronchopulmonary sequestration (BPS) was diagnosed in 3 cases, all with favorable perinatal evolution. Right pulmonary agenesis was diagnosed in one case and the outcome was neonatal death. One case of congenital high airway obstruction syndrome was followed by TOP. One case of severe bilateral pulmonary hypoplasia (secondary to a severe bilateral hydrothorax) resulted in neonatal death.ConclusionObstetrical management is established individually depending on the severity of the cases.How to cite this articleIliev G, Dumitrascu I, Grigore M, Mihalceanu E, Scripcaru D, Zoican G, Aprodu G, Bivoleanu A, Petrariu A, Stamatin M. Lung Malformations: Prenatal Ultrasound Diagnosis and Obstetrical Management. Donald School J Ultrasound Obstet Gynecol 2014;8(2):134-143.
Ultrasound Features of the Formation of the Maternal-Placental Complex in Cases of Hyperandrogenism as Observed during the First and Second Trimesters of Pregnancy
Authors: Olga Malysheva , Elena Toropkina , Luybov Agarkova , Irina Bukharina , Sergey Logvinov 
Published: June 2014

ABSTRACTAn excess of maternal androgen adversely affects the implantation process and contributes to uterine circulatory disturbances and myometrium vessel sclerosis. Placental insufficiency is typically diagnosed at the end of the second trimester of pregnancy or at the beginning of the third trimester, when the treatment is not effectiveMany researchers have attempted to use early sonographic diagnostics to identify placental failure in various pathological states. Nevertheless, the peculiarities of the formation of the fetal-placental complex during the first and second trimesters are still undefined. In this study, we traced the process of placental formation under conditions of excess maternal androgen using ultrasound and Dopplerometry. Morphological examinations of the ñhorion and placental tissue were undertaken to ñompare any changes.Unfavorable chorion locations, heterogeneous chorion tissue structures, and marginal sinus dilatations were revealed by ultrasound. According to a Dopplerometric investigation, a statistically significant increase in peripheral vessel resistance in cases of hyperandrogenism was identified compared with healthy pregnancies. The negative influence of hyperandrogenism on placental formation was confirmed by morphological data (including the presence of immature decidual cells, defective villi that covered the epithelium, and the dissociative development of cotyledons).How to cite this articleOlga M, Elena T, Luybov A, Irina B, Sergey L. Ultrasound Features of the Formation of the Maternalplacental Complex in Cases of Hyperandrogenism as Observed during the First and Second Trimesters of Pregnancy. Donald School J Ultrasound Obstet Gynecol 2014;8(2):149-154.
Fetal Origin of Adult Disease
Authors: Bora Rishabh , Bora Neharika Malhotra 
Published: June 2014

ABSTRACTFetal origins of adult disease, a concept first popularized by Dr David Barker, has subsequently led to many studies which have provided the evidence that certain diseases do have links pointing to fetal origins—adverse influences early in development, and particularly during intrauterine life, can result in permanent changes in physiology and metabolism, which result in increased disease risk in adulthood.Links that are well-established are—reduced birth weight and increased risk of coronary heart disease, hypertension and stroke in adulthood.The concept of a fetal origin of adult disease have been extended well-beyond coronary heart disease and being a risk factor for coronary heart disease, and now includes investigations of the development of the central nervous system, early origins of adult mental health and cognitive function.By understanding fetal origin of adult disease, health care professionals and policy makers will make this issue a high health care priority and implement preventive measures and treatment for those at higher risk for chronic diseases.How to cite this articleMalhotra N, Malhotra J, Bora NM, Bora R, Malhotra K. Fetal Origin of Adult Disease. Donald School J Ultrasound Obstet Gynecol 2014;8(2):164-177.
Diagnostic Ultrasound Safety
Authors: Maeda Kazuo 
Published: June 2014

ABSTRACT
Ultrasound bioeffect is discussed from its physical property, i.e. thermal effect by thermal index, mechanical effect by mechanical index, and by the output intensity of ultrasound. Generally, thermal and mechanical indices should be lower than 1 in obstetrical setting, and threshold output intensity of no bioeffect is lower than SPTA 240 mW/cm2 in pulse wave. Pulsed Doppler ultrasound thermal and mechanical indices should be also lower than 1, and should be carefully used it in 11 to 13+6 weeks of pregnancy. Real-time B-mode, transvaginal scan, pulsed Doppler, 3D and 4D ultrasound were separately discussed in the ultrasound safety. Generally diagnostic ultrasound is safe for the fetus and embryo, if thermal and mechanical indices are lower than 1, and ultrasound devices are safe, if it is used under official limitation, e.g. the output intensity is less than SPTA 10 mW/cm2 in Japan. The ultrasound user is responsible ultrasound safety, e.g. higher thermal and mechanical indices than 1 should be lowered to be lower than 1, controlling the device output intensity. The user should learn bioeffects of ultrasound and prudent use of ultrasound under the ALARA principle.

How to cite this article
Maeda K, Kurjak A. Diagnostic Ultrasound Safety. Donald School J Ultrasound Obstet Gynecol 2014;8(2):178-183.
Apert Syndrome in the Era of Prenatal Diagnosis
Authors: Stamatian Florin , Caracostea Gabriela , Kovacs Tunde , Militaru Mariela 
Published: June 2014

ABSTRACT
Apert syndrome is a rare autosomal dominant disorder characterized by severe craniosynostosis, hypoplastic mediofacial structures and symmetric syndactyly. The syndactyly involves both cutaneous and osseous structures of the upper and lower limbs. Apart from skeletal anomalies, affected fetuses may often present central nervous system malformations and various visceral malformations (congenital heart defects, genitourinary anomalies, choanal stenosis, tracheal abnormalities, diaphragmatic hernia and omphalocele). Mental retardation is frequently encountered, as are a large variety of craniofacial and neurocognitive phenotypes. The incidence of Apert syndrome is approximately one in 65,000 newborns, representing 4.5% of all craniosynostosis cases. The first cases of Apert syndrome were diagnosed by ultrasound and fetoscopy in the third trimester of pregnancy. With the introduction of three-dimensional (3D) ultrasonography, identification of fetal changes characteristic of Apert syndrome is possible in the second trimester of pregnancy. Diagnosis confirmation requires fetal DNA analysis by fibroblast growth factor receptor 2 gene amplification (FGFR2) followed by sequencing and digestion with restriction enzymes. Recently, noninvasive prenatal diagnosis was reported using free fetal DNA analysis with cell-free fetal DNA (cffDNA) in maternal plasma by Polymerase Chain Reaction (PCR) assay and enzymatic digestion with restriction enzymes. As the syndrome has rarely been reported in Romania, we present the case of a fetus diagnosed with Apert syndrome in the second trimester of pregnancy. Early ultrasound detection of suggestive signs for this syndrome (craniosynostosis, syndactyly) was followed by confirmation of the diagnosis by prenatal fetal DNA analysis.

How to cite this article
Stamatian F, Kovacs T, Militaru M, Caracostea G. Apert Syndrome in the Era of Prenatal Diagnosis. Donald School J Ultrasound Obstet Gynecol 2014;8(2):222-225.
Physiological Changes and Blood Flow in Murrah Buffaloes during Summer and Winter Season
Authors: Upadhyay R. C. , Kumar Parveen , Kumar Y. , Devi Rajni , Singh A. K. 
Published: June 2014

Present study was designed to investigate the changes in physiological reactions and blood flow during different seasons in Murrah buffaloes. Six Murrah buffalo heifers of 18-24 months were selected as experimental animals. The respiration rate (RR), heart rate (HR) and blood pressure was measured through BPL-Excello multi parameter monitor. Rectal temperatures were recorded with electronic thermometer. Skin surface temperatures at the different body sites were recorded using infrared thermometer (Metravi MT-2). The blood flow was measured on Perimed Multichannel Laser Doppler system using skin perfusion probe 408 at dorsal region, abdomen region and middle ear. Results showed a significant difference for respiration rate (P<0.001); rectal temperature (P<0.05) and heart rate (P<0.001) during summer and winter season. The mean blood pressure was 93.74/186.36 mmHg in summer and 97.40/198.08 mmHg in winter, respectively. In the present experiment, both diastolic and systolic pressure differed significantly (P<0.001) during different seasons. The mean skin surface temperature in summer was 37.03±0.39, 36.12±0.27 and 33.15±0.98°C at dorsal, abdomen and middle ear, respectively; whereas, during winter it was 29.87±0.69, 29.92±0.40 and 23.82±1.12°C at dorsal, abdomen and middle ear, respectively. The skin surface temperature among the different parts of the body differed significantly (P<0.001). During summer, the mean blood flow was 4.71±0.49, 14.85±1.63 and 16.72±1.47 PU; whereas, during winter, it was low, 1.10±0.16, 8.96±0.58 and 12.16±0.95 PU at dorsal, abdomen and middle ear, respectively. The difference in the blood flow among the different parts of the body differed significantly (P<0.001) in summer and winter. The results indicated that blood flow was positively correlated with temperature of the body parts and it varied in different seasons. This study concluded that, summer stress evokes a series of physiological changes in the Murrah buffalo’s, which affects production during summer season.
The HIV Modes of Transmission model: a systematic review of its findings and adherence to guidelines
Authors: Shubber Zara , Mishra Sharmistha , Vesga Juan F. , Boily Marie‐Claude 
Published: June 2014

IntroductionThe HIV Modes of Transmission (MOT) model estimates the annual fraction of new HIV infections (FNI) acquired by different risk groups. It was designed to guide country‐specific HIV prevention policies. To determine if the MOT produced context‐specific recommendations, we analyzed MOT results by region and epidemic type, and explored the factors (e.g. data used to estimate parameter inputs, adherence to guidelines) influencing the differences.MethodsWe systematically searched MEDLINE, EMBASE and UNAIDS reports, and contacted UNAIDS country directors for published MOT results from MOT inception (2003) to 25 September 2012.ResultsWe retrieved four journal articles and 20 UNAIDS reports covering 29 countries. In 13 countries, the largest FNI (range 26 to 63%) was acquired by the low‐risk group and increased with low‐risk population size. The FNI among female sex workers (FSWs) remained low (median 1.3%, range 0.04 to 14.4%), with little variability by region and epidemic type despite variability in sexual behaviour. In India and Thailand, where FSWs play an important role in transmission, the FNI among FSWs was 2 and 4%, respectively. In contrast, the FNI among men who have sex with men (MSM) varied across regions (range 0.1 to 89%) and increased with MSM population size. The FNI among people who inject drugs (PWID, range 0 to 82%) was largest in early‐phase epidemics with low overall HIV prevalence. Most MOT studies were conducted and reported as per guidelines but data quality remains an issue.ConclusionsAlthough countries are generally performing the MOT as per guidelines, there is little variation in the FNI (except among MSM and PWID) by region and epidemic type. Homogeneity in MOT FNI for FSWs, clients and low‐risk groups may limit the utility of MOT for guiding country‐specific interventions in heterosexual HIV epidemics.
Chorioamniotic Membrane Separation Over the Cervical Os (“Moon Sign”) in Twin‐Twin Transfusion Syndrome
Authors: Patel Shivani , Korst Lisa M. , Llanes Arlyn , Lee Richard H. , Ouzounian Joseph G. , Chmait Ramen H. 
Published: June 2014

ObjectivesTo determine whether chorioamniotic membrane separation from the internal cervical os, the “moon sign,” is associated with preterm premature rupture of membranes (PPROM) in twin‐twin transfusion syndrome (TTTS).MethodsA retrospective study of patients with TTTS treated with laser surgery was performed. Membrane separation before and after surgery was tested against any PPROM, PPROM within 7 days, and PPROM within 21 days. Because intrauterine fetal demise (IUFD) was weakly associated with PPROM, these cases were studied separately.ResultsAmong 304 consecutive patients, 247 patients (81.3%) had no IUFD, and preoperative and postoperative membrane separation rates were 13.4% and 13.0%, respectively. In 7 cases (2.8%), preoperative membrane separation disappeared postoperatively, and in 6 cases (2.4%), membrane separation appeared postoperatively; 26 cases (10.5%) had membrane separation at both times. Rates of PPROM did not differ between those who did and did not have preoperative membrane separation (30.3% versus 28.0%; P= .9511). Among those with and without postoperative membrane separation, the rates of any PPROM were 34.4% and 27.4%, respectively (P = .5473), and the rates of PPROM within 21 days were 15.6% and 5.6% (P = .0524). Those with postoperative membrane separation were 3 times more likely to have PPROM within 21 days (odds ratio, 3.13; 95% confidence interval, 1.02–9.58; P= .0453). Preterm premature rupture of membranes was not associated with preoperative or postoperative membrane separation in patients with IUFD.ConclusionsThe preoperative moon sign does not appear to be associated with PPROM in TTTS. Postoperatively, membrane separation may be weakly associated with PPROM at 21 days, but further research is required to confirm this association.