bluuebunny/crossref_metadata_2025_split huggingface dataset:
Deep Vein Thrombosis During Pregnancy
Authors: Bergqvist A. , Bergqvist D. , Hallböök T. 
Published: December 2009

Abstract. Seventeen women with thrombosis during pregnancy were studied prospectively. The deep venous thrombosis (DVT) was diagnosed objectively with phlebography, plethysmography and thermography. In many cases (13/17) the dominant symptom was diffuse pain in the lower abdomen and/or leg which in several cases caused a delay in the diagnosis. The traditionally typical thrombotic signs were often missing. Proximal thrombi were predominant (13/17) as were left‐sided ones (14/17). During pregnancy and lactation the patients were treated with heparin which, after the initial parenteral administration, was given subcutaneously by self‐administration.In conclusion, DVT must be suspected and non‐invasive diagnostic tests be liberally performed in cases of uncharacteristic lateral and/or declive abdominal pain or leg pain during pregnancy. The DVT must always be objectively verified before treatment. In patients with pregnancy DVT there is no indication for early labor induction and the patients can be delivered by the normal vaginal route. It is recommended that patients with DVT during pregnancy should be treated with heparin subcutaneously which can be self‐administered. The post‐partum treatment may be continued for 2 − 3 months with heparin subcutaneously or per‐oral anticoagulants.
Oral Oxytocics for Induction of Labor
Authors: Westergaard Jes G. , Lange Aksel P. , Pedersen Gunnar Thomsen , Secher Niels J. 
Published: December 2009

Abstract.A randomized comparative study of 387 consecutive patients admitted for induction of labor was carried out using two orally administered oxytocics (prostaglandin E2tablets (ProstinR) or Demoxytocin resoriblets for buccal administration (SandopartR)), the results of which are reported here.One‐hundred and twenty‐three cases were suitable for primary amniotomy; of these 48 were given PGE2tablets and 75 received demoxytocin resoriblets. In a further 264 cases, primary amniotomy was inadvisable and of these, 133 patients were allotted to the PGE2treatment group and 131 to treatment with demoxytocin.A significantly higher success rate was observed (p <0.05) in the PGE2group in cases where primary amniotomy had been carried out, as compared with the demoxytocin group.Parturition was successfully induced in 82.0% of the patients given PGE2tablets, as against only 63.4% of those receiving demoxytocin following 2 days of stimulation without primary amniotomy. This difference is statistically significant at the 0.001 level, and presumably due to the highly significant difference (p<0.0001) between patients with a Bishop score of 5 or less, where induction was successful in 75.4% given PGE2tablets, in contrast to a success rate of only 36.7% in patients receiving demoxytocin resoriblets. No difference was observed in the success rate between the two treatment groups when the Bishop score was 6 or more.No difference was recorded in the incidence of fetal distress, instrumental delivery or low Apgar score between the two treatment groups. However, a higher incidence of vomiting and diarrhea were observed in patients treated with PGE2tablets (11%) as compared with those receiving demoxytocin (1.5%). There was no difference with regard to the induction‐delivery time, nor to the different stages of labor between otherwise comparable treatment groups when the induction was successful.It is concluded in respect of induction of labor using orally administered oxytocics that PGE2(tablets) are preferable to demoxytocin (resoriblets) as it is the more effective of the two.
Supra Vaginal Uterine Amputation VS. Hysterectomy
Authors: Kilkku Pentti 
Published: December 2009

Abstract. The author has personally interviewed and examined 105 abdominal hysterectomy patients and 107 supra‐vaginal amputation patients, first preoperatively and then 6 weeks, 6 months and one year postoperatively. At 12 months the follow‐up percentage was 99.5 (211/212). This report concentrates on coital frequency and dyspareunia. In the statistical analysis, McNewar's test of symmetry and the Fisher exact test were used.With respect to coital frequency, no statistically significant changes occurred between or within the two groups. Dyspareunia was relieved by either operation, but more so by supravaginal amputation. When dyspareunia was experienced deep within the pelvis, removal of the uterus by either method almost always resulted in disappearance of the symptom.
Serum Estriol Level During Treatment with Betamethasone in the Last Trimester of Human Pregnancy
Authors: Kjer J. J. , Hess J. 
Published: December 2009

Abstract. A comparison was made between betamethasone disodiumphosphate/betamethasone acetate (CelestonR) and betamethasone disodiumphosphate (CelestonaR) in antena‐tally prophylactic treatment of respiratory distress syndrome syndrome (RDS).Altogether 65 pregnant women in the last trimester of pregnancy were treated with the first‐mentioned drug and 62 with the second. The RDS‐preventive effect was the same in the two groups. CelestonR has a much longer depressive effect on the level of plasma estriol than has CelestonaR. Use of this drug, betamethasone disodiumphosphate, is therefore recommended in the prophylaxis against RDS.
Incontinence Surgery in Female Motor Urge Incontinence
Authors: Meyhoff Hans‐Henrik , Walter Steen , Gerstenberg Thomas C. , Olesen Knud P. , Nordling Jørgen , Pedersen Poul H. , Hald Tage 
Published: December 2009

Abstract. Conventional incontinence surgery was performed in 41 consecutive female patients despite the finding of motor urge incontinence. The patients were reinvestigated 6 months to more than 2 years after operation. Twenty‐eight of the patients also had the symptom stress incontinence. Seventeen patients had coexisting symptomatic genital prolapse and were operated on without prior pharmacological treatment. The remaining 24 patients were all resistant to parasympatholytic treatment. The choice of operative procedure was based on vaginal examination as well as bladder suspension defect as demonstrated on voiding‐colpo‐cysto‐urethrography. Subjective cure and improvement rate was 73%. At follow‐up, 30% of the patients had normal de‐trusor reflex control, and a significant improvement in urge incontinence as well as frequency of micturition and noc‐turia was observed.Probably the primary treatment in females with motor urge incontinence should be pharmacological. However, in patients with symptomatic genital prolapse as well as in patients with ineffective medical treatment, conventional incontinence surgery seems to be well indicated in the absence of neurological disease‐providing the patient has an associated bladder suspension defect.
The Effect of Estrogen Therapy on Somatic and Psychical Symptoms in Postmenopausal Women
Authors: Furuhjelm Mirjam , Karlgren Erva , Carlström Kjell 
Published: December 2009

Abstract. The effect of oral estrogen replacement therapy upon somatic and psychical disturbances and sexuality was studied in a doubleblind investigation in 48 postmenopausal women using hormone preparations with two different levels of micronized estradiol‐17β (E2) as active estrogen component. The patients were treated for 8 months in four 2‐month periods with two preparations containing 1‐2 mg of E2 (TrisekvensR and EstrofemR), with one preparation containing 1‐4 mg of E2 (TrisekvensR forte) and with a placebo preparation. Investigations performed before and during treatment included general clinical chemical analysis, serum levels of FSH, LH and E2 and evaluation of the patients' somatic and psychical disturbances and sexuality.The patients were classified into three subgroups according to their pretreatment scores for mental distress and/or depression: severe (group I), moderate (group II), or no (group III) mental distress and/or depression. No significant differences between the three subgroups were found in pretreatment values from the general clinical chemical analysis or the hormone assays. Estrogen treatment significantly reduced S‐total cholesterol values in all three subgroups; otherwise no significant effects were revealed by the general clinical chemical analysis. During the period of optimal wellbeing, serum E2 levels corresponded to luteal phase values. The gonadotropin levels, although depressed by approx. 50%, were still within the postmenopausal range. There were no significant differences between the two subgroups in hormone levels obtained during optimal estrogen treatment. Twentyone patients had the best test results when treated with the larger dose (TrisekvensR forte) and 23 with the smaller dose (TrisekvensR and EstrofemR) and 4 during placebo treatment. The dose of estrogen did not significantly influence the hormone values found during optimal estrogen treatment. Vasomotoric and physical symptoms improved appreciably during estrogen treatment when compared with placebo or pretreatment scores. A certain placebo effect was noted for physical symptoms, which may be attributed to persisting effects of previous active estrogen treatment. The psychical symptoms too improved considerably during estrogen treatment, although placebo effects were also noted. In 10 patients, detrimental effects on psychical symptoms were observed during active estrogen treatment. Hormone analysis revealed very high E2 and low gonadotropin levels in these patients, which must therefore be considered as overtreated. In one patient with premenopausal depression periods and in 3 who surreptitiously took tranquillizers during the treatment period, no effects of estrogens upon the psychical symptoms were observed. The sexuality of the patients did not improve during estrogen treatment.The authors stress the need to individuate the dosage in estrogen replacement therapy.
THE HEMOSTATIC EFFECT OF TRANEXAMIC ACID IN CONISATIO COLLI UTERI
Authors: Lundvall Finn , Nielsen Niels Christian 
Published: December 2009

Abstract. To evaluate the inhibitory effect of tranexamic acid (AMCA) on increased fibrinolyctical activity in connection with conisatio colli uteri we have carried out a randomized, double‐blind study with patients operated upon partly with an open method of operation (80 patients) and partly with modified Sturmdorff sutures (150 patients). In connection with the open method the frequency of late bleeding decreased from. 17.5% to 2.5%, which is significant. The corresponding decrease in connection with the other method was from 10.7% to 4.1%. This material was not sufficiently large to verify significance. The side effects of the prophylactic treatment with AMCA were few.The study indicates that AMCA affords good protection against late bleeding in conisatio colli uteri.
Oral Progesterone and Estrogen/Progestogen Therapy: Effects of natural and synthetic hormones on subfractions of HDL cholesterol and liver proteins
Authors: Ottosson Ulla‐Britt 
Published: December 2009

The pharmacokinetics of progesterone after oral administration were investigated. After a single dose of 100 mg, serum concentrations of progesterone around 50–60 nM and of 20α‐hydroxy‐4‐pregnene‐3‐one around 5–6 nM were recorded within 1–4 hours and elevated levels persisted for 8–12 hours. There were only minor changes in 17α‐hydroxyprogesterone concentrations and serum levels of androstenedione and cortisol were unaffected. A significant conversion of circulating progesterone into deoxycorticosterone was demonstrated. During clinical treatment with oral progesterone the individual serum concentrations of this potent mineralocorticoid were closely correlated to the progesterone concentrations. This observation could be important as regards the etiology of certain clinical disorders characterized by fluid retention. According to competitive binding analyses there was no evidence that progesterone or medroxyprogesterone acetate could cause significant displacement of cortisol from corticosteroid‐binding globulin during clinical treatment.The effects of natural and synthetic hormones upon subfractions of high density lipoprotein (HDL) cholesterol and liver proteins were followed in postmenopausal women during replacement therapy with various estrogen ‐ progestogen combinations. The total serum cholesterol level was significantly reduced during treatment with all estrogen regimens. The concentrations of HDL cholesterol, HDL2 cholesterol, apolipoprotein A I and A II were increased in a dose‐dependent pattern during unopposed estrogen therapy. The potency of 10 μg of ethinyl estradiol was estimated to be equivalent to 3–4 mg of estradiol valerate. Estrogen effects were significantly reversed by levonorgestrel 250 pg and also by medroxyprogesterone acetate 10 μg. During treatment with natural progesterone, no changes were recorded in HDL cholesterol or its subfractions. As compared with the lipoproteins, pregnancy zone protein and sex hormone binding globulin (SHBG) were found to be more sensitive to the alkylated than to the non‐alkylated estrogen. Both levonorgestrel and medroxyprogesterone acetate clearly reduced SHBG levels after 3 months, whereas micronized progesterone had no such effect. While tamoxifen counteracted the therapeutic and metabolic effects of estrogen the sequential addition of estriol had no apparent influence. Unopposed estrogen treatment enhanced liver lecithin synthesis along pathway 1, i.e. reduced the amount of stearic acid and increased the amount of palmitic acid. The effects were dose‐dependent and no qualitative differences between ethinyl estradiol and estradiol valerate were recorded.
AN ACARDIAC ACEPHALIC ANOMALY DETECTED ON SONOGRAPHY
Authors: Wexler S. , Baruch A. , Ekshtein N. , Libal Y. , Yedwab G. , Ornoy A. 
Published: December 2009

Abstract. A rare anomaly of acardiac fetus is presented in which the diagnosis was made by ultrasonography, in the 20th week of pregnancy. This is, to our knowledge, the first report of such a phenomenon in the literature.This anomaly is said to have an incidence of one in 34 600 births (1) and is possible only in multiple pregnancies, mostly in twins (4). This is the eleventh reported case in a triplet pregnancy.
Worldwide Studies Comparing Piroxicam and Naproxen
Authors: Plantema F. 
Published: December 2009

In double‐blind, crossover studies, piroxicam was compared with naproxen. Piroxicam 40 mg was given once daily for two days, followed by 20 mg once daily and is compared with naproxen 750 mg daily for two days, followed by 500 mg daily (N = 85) and with naproxen 1000 mg daily (N = 83) in the treatment of primary dysmenorrhea. The different parameters studied included pain intensity, treatment preference and side effects.Piroxicam 40 mg/day was effective and well tolerated and produced a significantly greater reduction in menstrual pain on the first day of the cycle than naproxen 750 mg/day. When compared to naproxen 1000 mg/day, piroxicam 40 mg/day was equally effective. It is concluded that both drugs were well tolerated, but in both studies patients preferred piroxicam.
MENTAL HEALTH IN THE CLIMACTERIC
Authors: Hällström Tore , Samuelsson Sverker 
Published: December 2009

Abstract. A representative sample of 899 middle‐aged urban Swedish women underwent a psychiatric interview on two occasions with 6 years between studies (waves). The point prevalence of all mental disorders was 39.9% at the first wave and 39.0% at the second. The corresponding one‐year onset rates of all mental disorders were 18.0% and 14.2%. No significant differences were found between ages or between waves. Major depressive episodes accounted for about half of the psychiatric morbidity. Those women whose menopause started early were more often mentally impaired than others and they also tended to have been more often impaired even before the climacteric (ages 30‐39).Menopause was not associated with any onset risk of mental disorder, but a relationship was found between this rate and the weighted sum of other life events. The latter association remained significant even when correction was made for age, social class and marital status. Divorced and the childless women ran an increased risk of developing a mental disorder with functional impairment in the 6‐year period between the waves. Women from the lower social classes evidenced an increased risk of contracting some mental disorder during the same period.
Gonadal Steroids, Gonadotropins and Endometrial Histology in Postmenopausal Women with Malignant Ovarian Tumors
Authors: Jeppsson Sten , Karlsson Sten , Kullander Stig 
Published: December 2009

The concentrations of FSH, LH, 17‐β‐estradiol (E2), estrone (E1) and progesterone (P) were measured in peripheral and ovarian vein sera obtained at preoperative pelvic angiography from 5 postmenopausal women with malignant ovarian tumors. In 5 others the concentrations of E2, P and testosterone (T) were also measured in ascitic fluid collected at laparotomy.The investigation showed that most of these patients had increased concentrations of E2 and/or E1 and P as well in the peripheral blood. Significant gradients between the ovarian and peripheral vein concentrations were found for E2 and for P. High levels of E2, P and T were found in the ascitic fluid.FSH and LH levels were often lowered in peripheral blood compared with normal menopausal values and a gradient to ovarian tumor venous blood – with lower concentrations in the blood coming from the tumors, was found.Endometrial histology showed signs of steroid stimulation. These cases indicate that malignant ovarian tumors and/or the ovaries harboring them, are often capable of producing different sex steroids. These steroids may be found in the peripheral blood and in the ascitic fluid compartment and therefore may be used as tumor markers. The steroid production is probably not autonomous, but gonadotropin‐dependent.
Climacteric Symptoms and Estrogen Replacement Therapy In Women with Endometrial Carcinoma
Authors: Pettersson Birgitta , Adami Hans‐Olov , Persson Ingemar , Bergström Reinhold , Lindgren Anders , Johansson Elof D.B. 
Published: December 2009

A case‐control study was undertaken to investigate the influence of exogenous estrogens and climacteric symptoms on the risk of developing endometrial carcinoma. The study comprised 254 women with newly diagnosed endometrial carcinoma, resident in a defined geographical area, and 254 age‐matched population controls.Treatment with estrogens for 4 years or longer was significantly more common among patients than among controls (odds ratio = 4.5; 95% confidence limit (CL) = 1.2–17.3). A history of climacteric symptoms was reported by significantly fewer patients than controls (odds ratio =0.5; 95% CL = 0.3 —0.7) and this difference was shown to be independent of weight. The decrease in risk associated with climacteric symptoms was limited to women younger than 70 years.
Low Dose Oral Estriol Treatment in Elderly Women with Urogenital Infections
Authors: Brandberg Åke , Mellström Dan , Samsioe Göran 
Published: December 2009

SummaryForty‐one female geriatric in‐patients with recurrent urogenital infections took part in a cross‐over intervention study with oral estriol as an alternative to antibiotics.After one month of treatment with a dosage of 3 mg/day the vaginal flora of all patients showed a dominance of Lactobacilli, whereas without estriol treatment the flora was of a fecal type in two‐third of the cases. In all women the atrophic vaginal mucosa became restored and well vascularised.Antibiotics were given 16 times more often during the period without estriol treatment.It is concluded that treatment with estriol• restores the normal premenopausal vaginal flora and mucosa• prevents urogenital infections and disorders in postmenopausal women.
Pragmatic communication deficits in children with epilepsy
Authors: Broeders Mark , Geurts Hilde , Jennekens‐Schinkel Aag 
Published: December 2009

Background: Various psychiatric and neurological disorders including epilepsy have been associated with language deficits. Pragmatic language deficits, however, have seldom been the focus of earlier studies in children with epilepsy. Moreover, it is unknown whether these pragmatic deficits are related to general intellectual functioning. Both issues will be addressed in this study.Aims: 1) Explore pragmatic language deficits in children with epilepsy while controlling for having a neurological illness and having to visit a tertiary paediatric hospital regularly, and 2) Determine whether pragmatic difficulties, if present, are discrete or associated with general intellectual functioning.Methods & Procedures: The Children's Communication Checklist (CCC), a pragmatic language questionnaire, created by D. V. M. Bishop in 1998, was filled out by parents of 30 children with epilepsy (mean age = 10 years), 30 age‐matched children with various neurological disorders other than epilepsy, and 30 age‐matched typically developing controls. The full‐scale intelligence quotient (FSIQ) was individually measured to estimate the children's level of overall intelligence. The clinical groups were assessed in a tertiary paediatric hospital.Outcomes & Results: The pragmatic composite score distinguished between the two neurologically impaired groups, even after controlling for FSIQ. Of children with epilepsy, 23% had pragmatic deficits, whereas only 3% of the children with various other neurological disorders and none of the typically developing children had these deficits. When compared scale by scale with typically developing children, children in both clinical groups showed more structural language problems and problems of language use, but these differences disappeared when FSIQ was controlled for.Conclusions & Implications: Pragmatic deficits in communication are present in children treated for various neurological impairments, but more so in children whose seizures necessitate referral to a tertiary hospital. Clinicians should be sensitive to and inquire after pragmatic aspects of communication. Additional research is needed to elucidate mechanisms underlying these deficits.
Radiographic features of pelvis and hip joint development of English Bulldogs
Authors: Volta A. , Morgan J. P. , Bonazzi M. , Manfredi S. , Bottarelli E. , Zanichelli S. , Bertoni G. , Gnudi G. 
Published: December 2009

Summary
Objectives: To evaluate distinctive features of pelvis and hip joint development of English Bulldogs throughout the first year of life.
Methods: The pelves of 20 English Bulldogs were radiographed at three different ages (<4, 6–8, and 12–14 months). At each time point, the dogs were clinically evaluated and the abnormal hip joints were classified as mild, moderate, or severely deformed. The pelves were compared to a phantom study in which external rotation of a normal hemipelvis around its long axis was artificially created at different degrees, with different pelvic inclinations, and classified as either normal and without deformity, or as mild, moderate, or severely deformed. Hip joints and pelvic scores were statistically compared.
Results: Although none of the dogs were considered lame at the end of the study, none of the hips showed normal development; 77.5% were moderately to severely deformed at 12–14 months of age. At this age, 75% of the hemipelves had moderate to severe torsional deformity (>5.2° of external rotation), with retroversion of the acetabulum confirmed by the presence of the crossover sign. An external rotation of the hemipelvis on its long axis >5° was likely associated with a moderate to severely altered hip joint conformation.
Clinical Significance: Abnormal hip conformation was common in this series of English Bulldogs. Torsional deformity of the pelves with acetabular retroversion was a common and distinctive feature, which has not yet been thoroughly studied in dogs. These findings need further evaluation in English Bulldogs as well as in other breeds.