bluuebunny/crossref_metadata_2025_split huggingface dataset:
Causes of primary amenorrhea: A report of 295 cases in Thailand
Authors: Tanmahasamut Prasong , Rattanachaiyanont Manee , Dangrat Chongdee , Indhavivadhana Suchada , Angsuwattana Surasak , Techatraisak Kitirat 
Published: November 2011

AbstractAims:  The aim of this study was to determine the prevalence of etiologic causes of primary amenorrhea in Thailand.Methods:  A retrospective study was performed using 295 complete medical records of women with primary amenorrhea who attended the Gynecologic Endocrinology Clinic, Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Thailand from September 1992 to February 2009.Results:  The three most common causes of primary amenorrhea were Müllerian agenesis (39.7%), gonadal dysgenesis (35.3%), and hypogonadotropic hypogonadism (9.2%). Amongst 88 cases of gonadal dysgenesis, 59 cases (67.0%) incurred abnormal karyotype including 45X (n = 21), mosaic (n = 31), and others (n = 7).Conclusions:  The present study has currently been the largest case series of primary amenorrhea. Müllerian agenesis is the most prevalent cause in our study, while gonadal dysgenesis is the most common cause in the largest‐scale study in the USA. Hence, racial, genetic and environmental factors could play roles in the cause of primary amenorrhea.
Clinical evaluation of severe anemia in pregnancy with special reference to macrocytic anemia
Authors: Tripathi Reva , Tyagi Shakun , Singh Tejinder , Dixit Amrapali , Manju  , Mala Y. M. 
Published: November 2011

AbstractAims:  Anemia in pregnancy has been almost synonymous with iron‐deficiency anemia but there appears to be a changing trend with emerging evidence of macrocytic anemia. The aim of this study was to evaluate the clinical profile of patients having severe anemia in pregnancy.Methods:  This study included all antenatal patients presenting with severe anemia (hemoglobin < 7 gm%) over a period of 2 years from January 2008 to December 2009 in the Department of Obstetrics and Gynaecology, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi.Results:  Although iron‐deficiency anemia remains the most important cause of anemia (48.1%) there is also a high prevalence of macrocytic anemia (40%) amongst these cases of severe anemia in pregnancy. The maternal and fetal morbidity and mortality is higher in macrocytic anemia as compared to iron‐deficiency anemia.Conclusion:  There is an emerging trend of macrocytic anemia among antenatal patients with severe anemia. Both maternal and fetal morbidity appears to be higher in these cases. This has important implications in terms of diagnosis and therapy to optimize both maternal and perinatal outcomes. Once clinicians and health administrators recognize the magnitude of this problem it may be considered relevant to start public health interventions by way of requirement of appropriate food fortification.
Gestational diabetes and pre‐pregnancy overweight: Possible factors involved in newborn macrosomia
Authors: Olmos Pablo Roberto , Borzone Gisella Rosa , Olmos Roberto Ignacio , Valencia Claudio Nicolás , Bravo Felipe Andrés , Hodgson María Isabel , Belmar Cristián Gastón , Poblete José Andrés , Escalona Manuel Orlando , Gómez Bernardita 
Published: November 2011

AbstractAim:  Good glycemic control in gestational diabetes mellitus (GDM) seems not to be enough to prevent macrosomia (large‐for‐gestational‐age newborns). In GDM pregnancies we studied the effects of glycemic control (as glycosylated hemoglobin [HbA1c]), pre‐pregnancy body mass index (PP‐BMI) and gestational weight gain per week (GWG‐W) on the frequency of macrosomia.Methods:  We studied 251 GDM pregnancies, divided into two groups: PP‐BMI < 25.0 kg/m2 (the non‐overweight group; n = 125), and PP‐BMI ≥ 25.0 kg/m2 (the overweight group; n = 126). A newborn weight Z‐score > 1.28 was considered large‐for‐gestational‐age. Statistical analysis was carried out using the Student's t‐test and χ2‐test, receiver–operator characteristic curves and linear and binary logistic regressions.Results:  Prevalence of macrosomia was 14.9% among GDM (n = 202/251, 88.4%) with good glycemic control (mean HbA1c < 6.0%), and 28.1% in those with mean HbA1c ≥ 6.0% (n = 49/251, P < 0.025). Macrosomia rates were 10.4% in the non‐overweight group and 24.6% in the overweight group (P = 0.00308), notwithstanding both having similar mean HbA1c (5.48 ± 0.065 and 5.65 ± 0.079%, P = 0.269), and similar GWG‐W (0.292 ± 0.017 and 0.240 ± 0.021 kg/week, P = 0.077). Binary logistic regressions showed that PP‐BMI (P = 0.012) and mean HbA1c (P = 0.048), but not GWG‐W (P = 0.477), explained macrosomia.Conclusions:  Good glycemic control in GDM patients was not enough to reduce macrosomia to acceptable limits (<10% of newborns). PP‐BMI and mean HbA1c (but not GWG‐W) were significant predictors of macrosomia. Thus, without ceasing in our efforts to improve glycemic control during GDM pregnancies, patients with overweight/obesity need to be treated prior to becoming pregnant.
Tubal ligation and survival of ovarian cancer patients
Authors: Zhang Min , Holman C. D'Arcy J. 
Published: November 2011

AbstractAim:  The aim of the present study was to investigate associations between ovarian cancer survival and reproductive, gynecological and hormone factors.Material and Methods:  A prospective follow‐up study was conducted in the Southeast of China. The cohort comprised 202 patients with histopathologically confirmed epithelial ovarian cancer who were enrolled during 1999–2000 and followed‐up for 5 years subsequently. One hundred and ninety five (96.5%) of the cohort or their close relatives were traced. Information was obtained on reproductive, gynecological and hormone factors prior to diagnosis, actual survival time and number of deaths. Cox proportional models were used to estimate mortality hazard ratios (HR) and associated 95% confidence intervals (CI) for tubal ligation, adjusting for age at diagnosis, body mass index (BMI), menopausal status, International Federation of Gynaecology and Obstetrics (FIGO) stage, histological grade of differentiation, cytology of ascites, and chemotherapy status.Results:  The HR was significantly increased and survival was worse in ovarian cancer patients with a previous tubal ligation, but not with any other reproductive, gynecological and hormone factor. Only 21 (38.9%) of 54 patients who had tubal ligation survived to the time of interview, in contrast to 95 women (67.4%) still alive among the 141 women without tubal ligation (P < 0.001). Compared to the patients who had no tubal ligation, the adjusted HR was 1.62 (95% CI 1.01–2.59; P = 0.04) for those who had tubal ligation. There was no association with age at menarche, menopausal status, parity, breastfeeding, hormone replacement therapy, oral contraceptive use, and hysterectomy.Conclusion:  Previous tubal ligation was an independently adverse prognostic factor for epithelial ovarian cancer survival. Further studies that examine the relationship are warranted to confirm these results.
Uterus‐like mass of ovarian ligament: Image diagnosis and management by laparoendoscopic single‐site surgery
Authors: Takeda Akihiro , Imoto Sanae , Mori Masahiko , Yamada Junko , Nakamura Hiromi 
Published: November 2011

AbstractUterus‐like mass composed of a cavity lined by mucosa resembling endometrium and surrounding smooth muscle layer simulating myometrium is an extremely rare disease entity of which the histogenesis is presently unknown. A 39‐year‐old, gravida 2, para 2, woman presented with sudden onset of lower abdominal pain and was found to have left adnexal mass with unusual image diagnostic appearance. The adnexal mass arising from the left ovarian ligament was excised by laparoendoscopic single‐site surgery. Histopathological diagnosis was uterus‐like mass of ovarian ligament.
Effects of aliskiren on QT duration and dispersion in hypertensive patients with type 2 diabetes mellitus
Authors: Fogari R. , Zoppi A. , Maffioli P. , Monti C. , Lazzari P. , Mugellini A. , Derosa G. 
Published: November 2011

Aim: To evaluate the effect of aliskiren compared to amlodipine on QT duration and dispersion in hypertensive patients with type 2 diabetes.Methods: A total of 170 outpatients aged 50–75 years with mild to moderate hypertension (SBP >130 and <180 mmHg and DBP >80 and <100 mmHg) and type 2 diabetes were randomly treated with aliskiren 300 mg or amlodipine 10 mg, both given once daily for 24 weeks, according to a prospective, open label, blinded‐end point, parallel group design. At the end of the placebo run‐in, and after 12, and 24 weeks of treatment blood pressure (BP) measurements (by mercury sphygmomanometer, Korotkoff I and V), plasma biochemistry and a standard 12‐lead surface ECG were evaluated.Results: Both aliskiren and amlodipine significantly reduced systolic blood pressure (SBP)/diastolic blood pressure (DBP) values (−27.2/−14.3 mmHg, p < 0.001 vs. placebo and −27.8/−14.2 mmHg, p < 0.001 vs. placebo, respectively), with no statistical difference between the two drugs. Aliskiren, but not amlodipine, significantly reduced maximum QT interval (QTmax) (−14 ms at 12 weeks and −17 ms at 24 weeks, both p < 0.05 vs. placebo) and corrected QT max (QTc max) (−26 ms and −31 ms, p < 0.01) as well as the dispersion of both QT (−11 ms and −13 ms, p < 0.01) and QTc (−18 ms and −19 ms, p < 0.01).Conclusions: Despite similar BP lowering effect, aliskiren, but not amlodipine, reduced QT duration and dispersion, which might be related to the ability of aliskiren to interfere with mechanisms underlying myocardial electrical instability in the heart of diabetic hypertensive patients.
A synthesis of existing systematic reviews and meta‐analyses of school‐based behavioural interventions for controlling and preventing obesity
Authors: Khambalia A. Z. , Dickinson S. , Hardy L. L. , Gill T. , Baur L. A. 
Published: November 2011

SummarySchools are an attractive and popular setting for implementing interventions for children. There is a growing body of empirical research exploring the efficacy of school‐based obesity prevention programs. While there have been several reviews on the topic, findings remain mixed. To examine the quality of evidence and compare the findings from existing systematic reviews and meta‐analyses of school‐based programs in the prevention and control of childhood obesity. This paper systematically appraises the methodology and conclusions of literature reviews examining the effectiveness of school‐based obesity interventions published in English in peer‐reviewed journals between January 1990 and October 2010. Eight reviews were examined, three meta‐analyses and five systematic reviews. All of the reviews recognized that studies were heterogeneous in design, participants, intervention and outcomes. Intervention components in the school setting associated with a significant reduction of weight in children included long‐term interventions with combined diet and physical activity and a family component. Several reviews also found gender differences in response to interventions. Of the eight reviews, five were deemed of high quality and yet limited evidence was found on which to base recommendations. As no single intervention will fit all schools and populations, further high‐quality research needs to focus on identifying specific program characteristics predictive of success.
SCORAD 75: a new metric for assessing treatment outcomes in atopic dermatitis
Authors: Harari M. , Dreiher J. , Czarnowicki T. , Ruzicka T. , Ingber A. 
Published: November 2011

AbstractObjective  The scoring atopic dermatitis (SCORAD) is a well‐established severity‐scoring tool for atopic dermatitis (AD). Dead Sea climatotherapy (DSC) is a natural selective balneo‐phototherapy utilized for many years to treat severe AD. The study’s goal was to evaluate the impact of DSC on AD patients through assessment of SCORAD scores and to identify parameters associated with greater improvement.Methods  The files of 78 European patients (37 male patients and 41 female patients, mean age 37.8 years) with AD undergoing DSC were included in this retrospective study. Three sub‐groups were delineated based on disease severity (as determined using the SCORAD). Demographic and clinical parameters as well as treatment characteristics – maximal and cumulative sun exposure doses – were recorded. SCORAD values were again recorded for assessment of treatment response. SCORAD 75 was defined as ≥75% decrease in SCORAD values following therapy. Statistical analysis including logistic regression models was used in multivariable analysis.Results  After an average of 30 days of treatment, mean SCORAD values dropped from 50.5 to 11 (76.7%, P < 0.001). 64.1% of all patients, regardless of sub‐group, reached SCORAD 75, whereas 78.9% of patients with severe disease achieved this result. In a multivariate logistic regression, factors associated with achieving SCORAD 75 were maximal sun exposure, family history of AD and age at disease onset (P = 0.002, P = 0.009 and P = 0.040 respectively).Conclusion  Dead Sea climatotherapy is a particularly effective treatment method for the sub‐population of adults with severe AD. The SCORAD 75 can be useful for defining sub‐populations in which treatment is more likely to be successful.
Human placenta and chorion: potential additional sources of hematopoietic stem cells for transplantation
Authors: Bárcena Alicia , Muench Marcus O. , Kapidzic Mirhan , Gormley Matthew , Goldfien Gabriel A. , Fisher Susan J. 
Published: November 2011

BACKGROUND: Hematopoietic stem cell (HSC) transplantation is an essential element of medical therapy, leading to cures of previously incurable hematological and nonhematological diseases. Many patients do not find matched donors in a timely manner, which has driven efforts to find alternative pools of transplantable HSCs. The use of umbilical cord blood (UCB) as a source of transplantable HSCs began more than two decades ago. However, the use of UCB as a reliable source of HSCs for transplantation still faces crucial challenges: the number of HSCs present in a unit of UCB is usually sufficient for younger children but not for adults, and the persistent delayed engraftment often seen can result in high rates of infection and mortality.STUDY DESIGN AND METHODS: We propose a new approach to a solution of these problems: a potential increase of the limited number of UCB‐HSCs available by harvesting HSCs contained in the placenta and the fetal chorionic membrane available at birth.RESULTS: We investigated the presence of hematopoietic progenitors and HSCs in human placenta and chorion at different gestational ages. The characterization of these cells was performed by flow cytometry and immunolocalization, and their functional status was investigated by transplanting them into immunodeficient mice.CONCLUSION: HSCs are present in extraembryonic tissues and could be banked in conjunction to the UCB‐HSCs. This novel approach could have a large impact on the field of HSC banking and, more crucially, on the outcome of patients undergoing this treatment by greatly improving the use of life‐saving hematopoietic transplants.
Applying the Global Positioning System and Google Earth to Evaluate the Accessibility of Birth Services for Pregnant Women in Northern Malawi
Authors: Chen Solomon Chih‐Cheng , Wang Jung‐Der , Yu Joseph Kwong‐Leung , RN Tzu‐Yi Chiang , Chan Chang‐Chuan , RN Hsiu‐Hung Wang , Nyasulu Yohane M. Z. , Kolola‐Dzimadzi Rose 
Published: November 2011

Introduction: The objective of this study was to validate the combined use of the Global Positioning System (GPS) and Google Earth for measuring the accessibility of health care facilities for pregnant women in northern Malawi. Methods: We used GPS and Google Earth to identify 5 major health care facilities in Mzuzu (Malawi) and the homes of 79 traditional birth attendants (TBAs). The distance and time required for each TBA to reach the nearest health care facility were measured by both GPS and by self‐report of the TBAs. A convenience sample of 1138 pregnant women was interviewed about their choices of birth sites for current and previous pregnancies and the time and cost required to access health care facilities. Results: The correlation coefficient between the objective measurements by GPS and subjective reports by TBAs for time required from their homes to health care facilities was 0.654 (P < .001). Among pregnant women, 45.6% reported that they could reach a health care facility within 2 hours; 23.8% reported paying more than $1 for transportation to health care facilities. For the current study, 82.6% of women intended to give birth at a health care facility. However, only 48.7% of women actually gave birth in a health care facility in a previous pregnancy, and 32.6% were assisted by TBAs. Discussion: Combined GPS and Google Earth can be useful in the evaluation of accessibility of health care facilities, especially for emergency obstetric care.
Acceptability and Feasibility of a Multiple‐Behavior, Computer‐Tailored Intervention for Underserved Pregnant Women
Authors: Mauriello Leanne , Dyment Sharon , Prochaska Janice , Gagliardi Amy , Weingrad‐Smith Jan 
Published: November 2011

Introduction: A pilot test of a computer‐tailored intervention designed to promote positive health behaviors during pregnancy among a low‐income population across multiple ethnic groups was conducted. Methods: Intervention content, based on the transtheoretical model, offered pregnant women assistance with smoking cessation, stress management, and increasing fruit and vegetable consumption. Pregnant women (N = 87) were recruited from federally qualified health centers. After completing the intervention, women answered a 16‐item evaluation. Results: Participants rated the program very positively, with 89.7% to 95.5% of participants agreeing or strongly agreeing with all evaluation items. For example, 95.4% of respondents reported that the program could help them be healthier, that they learned new information, and that the program was designed for pregnant women like themselves. Additionally, the majority of participants (92%) reported that they would recommend the program to a friend. There were no significant differences in the ratings based on demographic characteristics of the participants. Qualitative responses support acceptability for the program. Further, assessments before and after completion of the program indicated an increase in intention to make behavioral changes. Discussion: With acceptability and feasibility confirmed, the next steps are to test efficacy and consequently to distribute the program to populations of underserved pregnant women.
Recurrence Risk of Hyperemesis Gravidarum
Authors: Fejzo Marlena S. , MacGibbon Kimber W. , Romero Roberto , Goodwin T. Murphy , Mullin Patrick M. 
Published: November 2011

Introduction: The purpose of this study is to describe the recurrence risk for hyperemesis gravidarum (HG). Methods: Women who registered on a Web site sponsored by the Hyperemesis Education and Research Foundation as having had one HG‐complicated pregnancy were contacted to follow‐up on a subsequent pregnancy. Participants completed an online survey. Results: One hundred women responded. Fifty‐seven had become pregnant again, 2 were trying to conceive, 37 were not willing to get pregnant again because of HG, and 4 did not have a second pregnancy for other reasons. Among the 57 women who responded that they had become pregnant again, 81% reported having severe nausea and vomiting in their second pregnancy. Among the women reporting recurrent HG, 98% reported losing weight and taking prescribed medication for HG, 83% reported treatment with intravenous fluids, 20% reported treatment with total parenteral nutrition or nasogastric tube feeding, and 48% reported hospitalization for HG. Discussion: This study demonstrates both a high recurrence rate of HG and a large percentage of women who change reproductive plans because of their experiences with HG.
Midwives’ Knowledge, Attitudes, and Practices Related to Newborn Hearing Screening
Authors: Goedert Martha Hoffman , Moeller Mary Pat , White Karl R. 
Published: November 2011

Introduction: Hearing loss is the most common congenital condition screened for at birth in the United States, and more than 95% of newborns are currently screened for hearing. Newborn hearing screening is most effective when infants receive timely and effective interventions. Unfortunately, follow‐up rates for newborns not passing their initial hearing screenings are as low as 50% in some states. Midwives are well‐positioned to encourage families to follow‐up with their neonatal providers when newborns are referred for further testing. Newborn hearing screening is a relatively new practice in the United States and, to date, there has been no research regarding the informational needs and practices of certified nurse‐midwives or certified midwives related to hearing screening. This study examined the knowledge, attitudes, and follow‐up practices of midwives related to newborn hearing screening and intervention. Methods: A survey instrument was developed and sent to 5255 American College of Nurse‐Midwives members in 50 states and 2 territories. Results: Five hundred and eighteen surveys were returned, yielding a response rate of 9.9%. Only 68% of respondents said it was very important to screen all newborns for hearing loss. Respondents reported significant gaps in their knowledge about screening procedures, steps for referral, and the availability of resources when newborns did not pass the test. Midwives also reported the need for information about hearing loss conditions and genetics, screening guidelines, protocols for follow‐up, referral networks, and therapies available. Discussion: Current practices in newborn hearing screening and intervention programs can be enhanced by strengthening the basic midwifery knowledge of and rationale for follow‐up when newborns fail their hearing screenings. Midwives can play an integral role in optimizing hearing, speech, and family interaction by assuring that each newborn has access to the best hearing screening and referrals.
Lost in Translation: Reproductive Health Care Experiences of Somali Bantu Women in Hartford, Connecticut
Authors: Gurnah Khadija , Khoshnood Kaveh , Bradley Elizabeth , Yuan Christina 
Published: November 2011

Introduction: Reproductive health problems are the leading cause of women's morbidity and mortality worldwide. In the United States, officially sponsored refugee women continue to face challenges in accessing reproductive health programs despite having access to health insurance. Methods: The objective of this study was to explore the reproductive health experiences of 1 such population—Somali Bantu women in Connecticut—to identify potential barriers to care experienced by marginalized populations. The study was qualitative, consisting of key informant interviews, a focus group session, and a semistructured survey. Results: Although all the women in the study reported having access to reproductive health care services, they also reported having unmet health needs resulting from barriers to care that included ethnic distinction/language barriers, passive acceptance of incorrect care, cultural discordance in family planning services, patient‐provider sex discordance, and desire but limited scope for ownership in health care outcomes. The root cause of the various types of patient‐provider discordance was the lack of recognition that the Somali Bantu are distinct in culture, language, and solidarity from ethnic Somalis, resulting in Language Line translation services being conducted in a Somali language that the Somali Bantu women did not understand. Discussion: The results of the study primarily highlight the larger issue of information asymmetry within the health care system that, if left unaddressed, will persist as new vulnerable populations of refugees arrive in the United States.