bluuebunny/crossref_metadata_2025_split huggingface dataset:
Chronic oxygen dependency in infants born at 24–32 weeks' gestation: The role of antenatal and neonatal factors
Authors: TODD DA , JANA A , JOHN E 
Published: August 2010

Objectives:To study the incidence of chronic oxygen dependency (COD) among ventilated survivors born at 24–32 weeks gestation from 1986 to 1994 and to identify antenatal and neonatal factors that may have changed with time; and to identify antenatal and neonatal factors that could contribute to the development of COD in infants born at 24–32 weeks gestation using a case control model.Methodology:Infants born at 24–32 weeks gestation in one tertiary referral centre between 1986 and 1994 and admitted to the neonatal intensive care unit for respiratory support were studied. Data accumulated prospectively since 1986 in survivors of ventilation were analyzed to identify antenatal and neonatal factors that could have changed with time. The cohort of infants who developed COD were matched for gestation and time of birth with a control group of infants who did not have COD. Significant factors that could have contributed to the development of COD were identified using forward logistic regression analysis.Results:The number of mothers admitted for threatened premature labour (TPL), and pregnancy induced hypertension decreased with time while the use of antenatal steroids and maternal antibiotics increased. More infants were delivered by Caesarean section during the later years. There was an increase in neonatal septicaemia with time while there were decreases in hyaline membrane disease, pneumothorax, pulmonary interstitial emphysema, use of high peak inspiratory pressures (PIP) and high inspired oxygen. The incidence of COD decreased. The case controlled study revealed a significant positive association between COD and male gender, birthweight less than the 10th percentile for gestation, PIP over 30 cm H2O, septicaemia and significant patent ductus arteriosus (PDA) requiring indomethacin. There was a negative association with TPL.Conclusions:Further decrease in COD can be achieved only if septicaemia, PDA and the use of high PIP can be avoided. The most effective way of reducing the incidence of COD is by reducing the incidence of prematurity.
The seasonal distribution of infant deaths by age: A comparison of sudden infant death syndrome and other causes of death
Authors: SPIERS PS , GUNTHEROTH WG 
Published: August 2010

Objective: To examine the possibility that among deaths in infancy the increase in the winter/summer ratio with increasing age is not peculiar to sudden infant death syndrome (SIDS). Methodology: Details of the winter (December‐February)/summer (June‐August) ratio among deaths in neonates (<28 days) and post neonates dying in the United States of America between 1979 and 1990 were abstracted from published statistics. The primary causes of death were classified according to the ninth Revision of the International Classification of Diseases. Results: For every non‐traumatic cause of death including SIDS, the winter/summer ratio was higher among postneonates than neonates. This was not seen for deaths due to trauma. Cases of SIDS and deaths due to infection had the highest ratios in both age categories. Causes of death occurring predominantly in the neonatal period (e.g. anencephaly) had the lowest overall ratios. Conclusions: Neither the greater number of SIDS cases in the winter, nor the increasing winter/summer ratio with increasing age is unique to SIDS.
Proposed new target height equations for use in Australian growth clinics
Authors: Hughes Ian P , Davies Peter SW 
Published: August 2010

AbstractEquations for target height estimation designed for easy use in the Australian growth clinics are presented that are based on the standard deviation score method of Hermanussen and Cole. These equations are superior to the commonly used corrected midparental height method as they account for assortative mating and regression to the mean. Simulations using different mating types were performed to compare different methods of target height estimation. While the equations relate directly to growth charts used in Australia, it is noted that neither account for the secular increase in height observed from generation to generation.
Two‐year‐old boy with cervical and liver abscesses
Authors: Fehon Rebecca , Mehr Sam , La Hei Erik , Isaacs David , Wong Melanie 
Published: August 2010

AbstractPyogenic liver abscesses are rare in children but relatively common in those with chronic granulomatous disease (CGD). We present a case of a 2 year old boy who initially presented with BCGitis and Staphylococcus aureus cervical adenitis, and then subsequently developed liver abscesses. A diagnosis of X‐linked CGD was confirmed. This case demonstrates the typical radiological features of liver abscesses in CGD, its management without surgical intervention, and the increasingly recognised complications of BCG vaccination in CGD.
‘I enjoy teaching but . . .’: Paediatricians' attitudes to teaching medical students and junior doctors
Authors: Peadon Elizabeth , Caldwell Patrina HY , Oldmeadow Wendy 
Published: August 2010

Aim:  To explore consultant paediatricians' attitudes, motivations, and barriers to training medical students and junior doctors.Methods:  Qualitative research involving 24 paediatricians (with a diversity of specialties, experience, age, gender, teaching activity and employment status) from a tertiary paediatric hospital and clinical school in Sydney, Australia. Participants were engaged in semi‐structured focus group discussions which explored their attitudes to teaching medical students and junior doctors, their role and experience of teaching, their training in medical education, perceived barriers to teaching, and possible solutions to these barriers. Data from the transcriptions of the focus group discussions were coded using the constant comparative method and analysed for themes using NVivo 7 software. Differences in responses between participants were explored.Results:  All participants reported enjoying teaching. However, a number of factors which occurred at the consultant, learner and institution level affected the enjoyment or challenge of teaching. Consultant factors included time commitments, knowledge of and confidence in the learner's course, and comfort with teaching. Learner factors included level of knowledge, attendance, interest and enthusiasm, and cultural changes. Institution factors included acknowledgement of teaching contribution, communication, teaching support and resources, and attitude to teaching. These factors and the consultant's relationship with the learner and institution impacted on their ownership, involvement, and commitment to teaching.Conclusions:  Consultant paediatricians identified challenges to their involvement and commitment to teaching. Actions to address these challenges and improve the relationship between the consultant and the learner and the consultant and the institution may enhance the consultant's commitment to teaching.
IN VITRO COMPARISON OF THREE DIFFERENT MESH CONSTRUCTIONS
Authors: Weyhe Dirk , Belyaev Orlin , Buettner Goetz , Mros Kirsten , Mueller Christophe , Meurer Kirsten , Papapostolou Georgios , Uhl Waldemar 
Published: August 2010

Background:  Material amount and pore size have been recently discussed as probable important determinants of biocompatibility of mesh implants used in hernia repair. This study aimed to find out whether other constructional parameters affect the extent of early foreign body reaction in vitro.Materials and methods:  An NRK‐49F (mixed culture of normal rat kidney cells) fibroblast culture was incubated in the presence of a ‘light’ microporous mesh (35 g/m2, 0.25 mm thick), a ‘heavy’ polypropylene knitted mesh (95 g/m2, 0.55 mm thick) and a polypropylene/polyglactin composite mesh (35 g/m2, 0.5 mm thick). A mesh‐free cell suspension was used as a control group. Fibroblasts’ proliferation, invasion and apoptosis rates were measured by commercially available quantification tests. Levels of tumour necrosis factor‐α, transforming growth factor‐β1, interleukin (IL)‐1β, IL‐6 and IL‐10 secreted by the fibroblasts in the supernatant were dynamically measured in a time kinetics of 6–96 h.Results:  Invasion potential as well as proliferation and apoptosis rates of fibroblasts were enhanced by all meshes. The composite mesh stimulated the cell turnover with correspondingly increased levels of IL‐6 and suppressed levels of transforming growth factor‐β1 significantly more than the two pure polypropylene meshes and the control group.Conclusion:  Early biological response of fibroblasts as a major component of foreign body reaction was most affected by the filament construction of the mesh combining polypropylene with multifilament, partially absorbable polyglactin fibres. Material reduction did not weaken foreign body reaction. Confirming previous findings from animal experiments and clinical observations, the described in vitro model seems to be an appropriate primary tool for studying the biological tolerance towards meshes.
Brain infarction localized on left inferior temporal gyrus of presumed fetal onset
Authors: Yamamoto Yutaka , Kohno Yoshinori , Kato Zenichiro , Uchiyama Atsushi 
Published: August 2010

AbstractIdiopathic perinatal cerebral infarction is recognized to be more common in the preterm infant than previously realized. However, the pathogenic mechanisms and the onset time remain unclear. We encountered an extremely low birth weight female infant with severe intrauterine growth retardation and brain infarction localized on the left inferior temporal gyrus. The onset of the infarction and the precise sequential changes were evaluated with blood data, cranial ultrasound imaging, computed tomography, magnetic resonance imaging and magnetic resonance angiography. This is the first published fetal case with brain infarction specifically localized on the left inferior temporal gyrus. Careful observation with serial brain imaging is indispensable for high‐risk infarction groups, such as preterm infants with severe intrauterine growth retardation, to detect neurological abnormality earlier and precisely.
Polypropylene mesh used for adjuvant reconstructive surgical treatment of advanced pelvic organ prolapse
Authors: Lin Tzu‐Yin , Su Tsung‐Hsien , Huang Wen‐Chu 
Published: August 2010

AbstractAim:  To elucidate the outcome of transvaginal pelvic reconstructive surgery using polypropylene mesh (Gynemesh; Ethicon, Somerville, NJ, USA) for patients with pelvic organ prolapse (POP) stage III or IV.Methods:  Thirty‐nine patients who underwent transvaginal pelvic reconstructive surgery from September 2004 through December 2005 were collected and analyzed. All patients underwent pelvic reconstructive surgery with anterior and posterior colporrhaphy with Gynemesh reinforcement.Results:  The average age of the patients was 64.1 years and average parity was 3.9. Thirty‐four patients had Pelvic Organ Prolapse Quantification (POP‐Q) stage 0, four patients had stage I, and one patient had stage II at a median follow‐up time of 18 months postoperatively. The success rate was 97.4%. Only one patient (2.6%) had recurrent genital prolapse (stage II) postoperatively. Quality of life was evaluated before and after the operations. The mean scores on the Urinary Distress Inventory‐6 (UDI‐6) and Incontinence Impact Questionnaire‐7 (IIQ‐7) were 5.0 ± 4.6 and 8.7 ± 6.2 before the operation and 3.0 ± 4.7 and 3.2 ± 5.6 after the operation, respectively (P = 0.03 and 0.01). The complication rate was 10.3 %, including one vaginal mesh erosion (2.6%), one dyspareunia (2.6%) and two prolonged bladder drainage (longer than 14 days, 5.1%). The mean duration of postoperative bladder drainage was 2.4 days and mean postoperative hospital stay was 5.1 days. Neither long‐term nor major complication was identified.Conclusion:  Transvaginal pelvic reconstructive surgery with polypropylene mesh reinforcement is a safe and effective procedure for POP on 1.5 years' follow‐ up. It also has positive influence on quality of life.
Changes in heart rate patterns by lipopolysaccharide and intermittent hypoxia‐ischemia in 7‐day‐old rats
Authors: Yang Li , Sameshima Hiroshi , Ikenoue Tsuyomu 
Published: August 2010

AbstractAim:  We previously reported that lipopolysaccharide (LPS) and hypoxia‐ischemia (HI) act additively to induce brain damage in the developing rat model. The present study was undertaken to determine whether LPS‐HI‐induced brain damage is associated with changes in heart rate (HR) patterns.Material & Methods:  Seven‐day‐old Wistar rats were administered LPS (1 mg/kg, n = 17) or saline (n = 15) intraperitoneally. After 4 h, the left common carotid artery was ligated and electrocardiogram electrodes were placed on the chest under ether anesthesia, followed by intermittent HI (8% oxygen for 6 min) at 10‐min intervals for a total of 10 times. Seven days later, rats were sacrificed and brains removed for histological examination. Neuronal damage for a single section was categorized as mild (≤25% of the surface area), moderate (25–50%) or severe (≥50%).Results:  Brain damage was induced only in the LPS/HI group, which was statistically significant when compared to the saline/HI group. Baseline HR increased significantly due to LPS administration (P < 0.05). In the LPS/HI group, the amplitude of hypoxia‐driven tachycardia decreased significantly in the last 5 hypoxic episodes in brain‐damaged rats compared to rats with no visible damage (28 ± 1 vs 16 ± 2 bpm). Baseline HR variability was also suppressed significantly during the last five hypoxic episodes in brain‐damaged rats compared to rats with no visible damage.Conclusions:  LPS administration caused a gradual decrease in baseline HR variability and blunted tachycardia in response to repetitive HI, suggesting these signs are indicative of future neonatal brain damage.
Postoperative concurrent chemoradiotherapy for the high‐risk uterine cervical cancer
Authors: Takeshita Shigeki , Kita Tsunekazu , Motoike Yoshiyuki , Umezawa Koichi , Sugisaki Soichi , Matsumoto Sachiyo , Matsumoto Yasuhiro , Ryo Eiji , Ayabe Takuya 
Published: August 2010

AbstractAim:  To determine whether concurrent chemoradiotherapy (CCRT) can improve the survival rate of high‐risk uterine cervical cancer.Material & Methods:  We analyzed 16 cases of uterine cervical cancer that had undergone radical hysterectomy and pelvic lymphadenectomy from 2003 to 2008. The patients were eligible if they had histologically confirmed positive parametrial involvement, positive pelvic lymph nodes or non‐squamous cell carcinoma. They received 50 Gy of external beam radiotherapy (RT) for the pelvis which was combined with chemotherapy. Cisplatin was administered intravenously every 3 weeks at a dose of 70 mg/m2 during the RT. For renal function complication case, carboplatin was administered weekly. For control purposes, there were 14 cases treated in our hospital from 1995 to 2003 who had received only RT.Results:  We did not find any statistically significant difference in the disease‐free survival rate between the CCRT group and the RT group. However, the overall survival rate was significantly higher for patients in the CCRT group compared with the RT group in positive lymph node cases and non‐squamous cell carcinoma cases. Adverse effects were more frequent in the CCRT group. Over grade 3 toxicities were manifested as leukopenia, diarrhea and anemia. There was no local recurrence in CCRT group patients.Conclusion:  CCRT seems to be beneficial for improving the survival rate of either positive lymph node or non‐squamous cell carcinoma cases in high‐risk uterine cervical cancer patients.
Association of maternal serum high sensitive C‐reactive protein level with body mass index and severity of pre‐eclampsia at third trimester
Authors: Ertas Ibrahim E. , Kahyaoglu Serkan , Yilmaz Bulent , Ozel Murat , Sut Necdet , Guven Melih A. , Danisman Nuri 
Published: August 2010

AbstractAim:  To assess a maternal serum level of high sensitive C‐reactive protein (hs‐CRP) as a useful clinical parameter in prediction of pre‐eclampsia severity and, to evaluate the correlation between hs‐CRP and body mass index (BMI).Material & Methods:  Using cross‐sectional study design, CRP was measured by a high sensitive immunoturbidimetric method between 24 and 40 weeks of gestation in normotensive controls (n = 115), in mild (n = 63) and severe (n = 34) pre‐eclamptic patients. The receiver operating characteristic analysis was used to estimate the optimal threshold score of hs‐CRP.Results:  For disease severity evaluation, a hs‐CRP concentration of 9.66 mg/L was determined as cut‐off point with 88% sensitivity, 81% specificity, 71% positive predictive value and 92% negative predictive value. When all three groups of patients were adjusted for gestational age [24°/7–27,6/7 28°/7–33,6/7 34°/7–406/7] and BMI, hs‐CRP levels of severe pre‐eclamptic patients were significantly higher than mild ones and controls in the study group with BMI < 25 kg/m2 (P < 0.001). In the study group with BMI ≥ 25 kg/m2, only severe pre‐eclamptic patients between 28°/7 and 336/7 weeks of gestation had significantly higher hs‐CRP levels when compared with control and mild pre‐eclamptic group (P < 0.001). When the patients were subgrouped as high (≥9.66 mg/L) and low hs‐CRP group (<9.66 mg/L), adverse outcomes for hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome and intrauterine growth‐restricted baby were statistically significant higher in high hs‐CRP group (P = 0.004 and P < 0.001, respectively).Conclusion:  Elevated level of hs‐CRP is a useful parameter in the severity of clinical risk of pre‐eclampsia in patients with BMI < 25 kg/m2 at third trimester.
The electronically‐controlled axis‐traction handle: Preliminary report
Authors: Perone Nicola 
Published: August 2010

AbstractAim:  The scope of this preliminary report is to illustrate the performance characteristics of an electronically‐controlled axis‐traction handle.Material & Method:  Preclinical testing was conducted with a prototype of the innovative device, using a childbirth simulator.Results:  The simulated forceps deliveries demonstrated that the innovative device allows the obstetrician to measure (unencumbered by dials, scales and cable connections) the traction applied, to be alerted when the preset 50 lbs (22.68 kg) safety limit is approached, and to generate a hard copy print‐out of the traction data.Conclusion:  The electronically‐controlled axis‐traction handle represents a major technologic advance, that could help improve the training and safe practice of forceps deliveries.
Microsurgical training in a rat model: an approach and concept for gynecological surgeons
Authors: Kraemer Bernhard , Hoffmann Juergen , Wallwiener Markus , Wallwiener Christian , Rajab Taufiek Konrad 
Published: August 2010

AbstractAims:  This study aims to introduce a training program for microvascular anastomosis that includes an in vivo model which is elegant and effective.Material & Methods:  The infrarenal abdominal aorta or inferior vena cava of anesthetized live Sprague–Dawley rats were dissected, clamped and divided. Two trainees each created 12 microsurgical anastomoses in six animals. The training effect was measured by comparing the time taken to perform the initial anastomoses with the final attempts for each trainee. Afterwards, each anastomosis was probed to check whether the procedure was successful.Results:  The training model was practical and easy to set up. The average diameter of the aorta measured 1.5 mm and the vein measured 2.1 mm, which reflects the situation in human gynecological reconstructive surgery. The achieved training effect over the course of the training was highly significant. Arterial anastomosis time improved by an average of 8.5 min (P < 0.01) and venous anastomosis time improved by an average of 13.2 min (P < 0.01). The success rate for arterial anastomoses was 67%. In contrast, venous anastomosis was a more difficult exercise, with a success rate of 36% (P < 0.05).Conclusion:  The study establishes a practicable in vivo model of microvascular anastomotic training for gynecologists.
Cesarean section and hernia repair: simultaneous approach
Authors: Gabriele Raimondo , Conte Marco , Izzo Luciano , Basso Luigi 
Published: August 2010

AbstractAim:  Hernias of the abdominal wall occurring during pregnancy are usually treated a few weeks after delivery. The aim of this study was to retrospectively evaluate the clinical outcome of inguinal or umbilical hernioplasty performed at the time of the cesarean section, and to compare the outcome of this group with a control population, who received a cesarean section alone.Material & Methods:  We reviewed 28 women who developed an inguinal or umbilical hernia during pregnancy from January 1, 2000 to December 31, 2007 and who received a combined cesarean section and hernia repair, and we compared this group with 100 women (controls) who only received a cesarean section.Results:  In the group of women who received a combined cesarean section and inguinal or umbilical hernia repair, median age was 23.8 years and hospital stay ranged from 3 to 5 days (versus 3–4 days for cesarean sections alone). The time employed for the combined surgical procedure was of 50 ± 7 min and 70 ± 4 min, respectively, for umbilical and inguinal hernia (versus 37.4 ± 12.6 min for cesarean sections alone). No complication was recorded during the perinatal and follow‐up periods, and no recurrences were observed.Conclusion:  Our analysis suggests that cesarean section and hernia repair, performed in one session, avoids need for readmission to hospital, is safe, effective, and well accepted. It neither increases the complication rate nor prolongs the hospital stay, with clear advantages for both the patients and the hospital budget.
Transvaginal color Doppler study of uterine artery: Is there a role in chronic pelvic pain?
Authors: Somprasit Charintip , Tanprasertkul Chamnan , Suwannarurk Komsun , Pongrojpaw Densak , Chanthasenanont Athita , Bhamarapravatana Kornkarn 
Published: August 2010

AbstractAim:  To determine the value of transvaginal color Doppler study of uterine artery and investigate the differences in blood flow of uterine artery among women with chronic pelvic pain (CPP).Material & Methods:  A total of 50 female patients were recruited. The study group consisted of 25 women with CPP of possible gynecological origin. Twenty‐five women without CPP made a control group. All women were examined using transvaginal color Doppler ultrasonogram after negative finding of pelvic examination. The mean pulsality index (PI) and resistant index (RI) of the uterine arteries were recorded and compared.Results:  The mean ages were 36.6 ± 10.6 and 32.0 ± 6.7 years in the study group and control group, respectively. The duration of pain ranges from 6–48 months (mean, 14.8). The mean PI and RI values of the uterine arteries in patients with CPP were significantly lower than in the control group; PI = 2.12 ± 0.78, 2.76 ± 0.84 and RI = 0.79 ± 0.19, 0.89 ± 0.05, respectively (P < 0.05).Conclusions:  Doppler flow indices demonstrated significant increase of uterine arteries vascularization in CPP women related to pelvic causes. Transvaginal ultrasound with noninvasive Doppler study could be a useful primary investigation for CPP women, especially when financial resource is an issue.