bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical significance of elevated serum levels of matrix metalloproteinase‐3 and C‐reactive protein in patients with rheumatoid arthritis
Authors: NAGASAWA Hayato , KAMEDA Hideto , AMANO Koichi , TAKEUCHI Tsutomu 
Published: August 2010

AbstractAim:  Serum levels of C‐reactive protein (CRP) and matrix metalloproteinase‐3 (MMP‐3) are used as indicators of the activity of rheumatoid arthritis (RA). The aim of this study was to characterize the clinical features of patients showing exclusive elevation of either serum CRP or MMP‐3, and the differences in the time‐course of changes between the serum levels of MMP‐3 and CRP after initiation of therapy.Methods:  A total of 129 RA patients were classified into four groups according to the serum levels of CRP and MMP‐3 at the time of enrolment: negative for both CRP and MMP‐3 levels; positive for both; positive for CRP alone (CRP‐positive group); and positive for MMP‐3 alone (MMP‐3‐positive group). The analysis included evaluation of the serum CRP and MMP‐3 levels, and the Lansbury Articular Index at enrolment and at final observation.Results:  In the CRP‐positive group (19%), 21% of the patients remained CRP‐positive at the final observation; 42% became double‐negative, and 31% became double‐positive. In contrast, in the MMP‐3‐positive group (9%), about two‐thirds of the patients remained MMP‐3‐positive at the final observation. The disease duration in the MMP‐3‐positive group was significantly longer, and the ratio of the number of large swollen joints to the total number of swollen joints was higher as compared with that in the other groups. Furthermore, elevated serum CRP responded faster to disease‐modifying antirheumatic drug therapy than elevated serum MMP‐3.Conclusions:  Serum CRP is a better predictor of the response to treatment than serum MMP‐3, which is associated to a greater extent with large joint involvement.
Ultrasonographic detection of spontaneous rupture in the Biceps tendon of a patient with rheumatoid arthritis
Authors: KIM Hyun‐Sook , JU Ji Hyeon , YOON Chong‐Hyeon , PARK Sung‐Hwan , KIM Ho‐Youn 
Published: August 2010

AbstractUltrasonography is a useful imaging modality for the diagnosis of pathologic conditions in the biceps tendon. We describe a 64‐year old man with rheumatoid arthritis (RA) who suddenly developed a painless lump in the antecubital region of the right arm. The bulging was prominent when he flexed his forearm. Proximal loss of the long head in biceps tendon could be demonstrated by ultrasonography. The ultrasonographic features of spontaneous isolated biceps tendon rupture occurring in a patient with RA are described.
Long‐standing ulcerative colitis complicated by right subclavian artery occlusion and upper limbs arteriolitis with digital ischemia
Authors: EMAD Yasser , RAGAB Yasser , EL‐MARAKBI Ahmed , MOHAMED HANFI Salama 
Published: August 2010

AbstractA 48‐year‐old male patient with long‐standing ulcerative colitis since February 2001 which was diagnosed by endoscopy, developed acute digital ischemia affecting both hands with fixed colour changes in the left index finger which was followed shortly by digital ulceration. Magnetic resonance angiography (MRA) of both upper limbs showed evidence of vasculitis affecting digital arterioles on both sided and right subclavian occlusion. The patient received pulse methylprednisolone followed by cyclophosphamide pulse therapy, the latter continuing on a monthly basis for 6 months with appreciable improvement and remission of the vasculitic process; follow‐up MRA showed reperfusion of the previously occluded subcalvian artery. To the authors’ knowledge vasculitis complicating the course of ulcerative colitis is a rare association and is only sporadically reported in the literature. This rare entity should be diagnosed early and aggressively treated; MRA is a very promising diagnostic tool that is suitable for both diagnosis and follow‐up of patients with this rare entity.
An unusual cause of calf hypertrophy: severe lumbar canal stenosis with S1 nerve root radiculopathy
Authors: ONG V. , JONES J. , STEUER A. 
Published: August 2010

AbstractWe report an unusual case of calf hypertrophy in a 62‐year‐old woman who developed progressive enlargement of the left calf in association with chronic lower back pain. Magnetic resonance imaging (MRI) of the affected calf confirmed enlargement of the soleus muscle. MRI of the lumbar spine showed multilevel degenerative changes. Electromyography revealed neurogenic features consistent with S1 radiculopathy. Our case illustrates that muscular hypertrophy may follow chronic denervation as a consequence of spinal neural compressive disease. The various mechanisms postulated for this distinct condition and therapeutic strategies are outlined.
Alveolar hemorrhage in systemic lupus erythematosus
Authors: GOGIA Atul , KAKAR Atul , SUREKA Rohit , BYOTRA S. , PRAKASH Ved 
Published: August 2010

AbstractAlveolar haemorrhage is a catastrophic though rare complication of systemic lupus erythematosus (SLE) and is associated with a high mortality rate with most studies showing a mortality of 23–92%. The treatment modalities available for such complications are pulse cyclophosphamide therapy with steroids and plasmapheresis in patients who do no respond to the above treatment. We report here a case of SLE with alveolar haemorrhage that despite being on immunomodulatory therapy developed alveolar haemorrhage and did not respond to plasmapheresis.
Pathergy test in Behcet's disease: change in incidence over the time
Authors: DAVATCHI Fereydoun , CHAMS‐DAVATCHI Cheyda , SHAHRAM Farhad , NADJI Abdolhadi , SHAMS Hormoz , GHODSI Zahra , AKHLAGHI Massoomeh , NADERI Nasim , SADEGHI‐ABDOLAHI Bahar 
Published: August 2010

AbstractIntroduction:  Pathergy phenomenon (PP) is used as a criterion in many diagnostic criteria for Behcet's disease (BD): Curth, Japan, Hubault and Hamza, Cheng and Zhang, Dilsen, International Study Group, Iran criteria (traditional format and the Classification Tree), Korea criteria, and the new International Criteria. PP is rather specific to BD. It has been reported with high frequency from most countries along the Silk Road, but with much lower frequency from other countries (UK, US). The incidence of PP has been reported from some countries (Japan, Turkey) to decrease gradually. The aim of this study was to test the above hypothesis in a large cohort of patients in Iran.Materials:  Patients (6057) were divided into several groups by two methods. Method 1: patients were divided into six groups according to the time of their first visit. Method 2: patients were divided into four groups according to the date of the beginning of their first manifestation.Results:  In method 1, the percentage of PP was 71.8% from patients 1–1000. The percentage became 55.9% from patients 1001–2000, 57.6% from patients 2001–3000, 58.8% from patients 3001–4000, 45.3% from patients 4001–5000, and 33.9% from patients 5001–6000. In method 2, the percentage of PP was 61.5% for patients with their disease onset before 1977. The percentage was 59.9% for patients with their disease starting between 1978 and 1987. The percentage dropped to 52.1% for patients with disease onset between 1988 and 1997. The percentage finally dropped to 41% for patients having their disease onset between 1998 and 2007.Conclusion:  The incidence of PP is decreasing gradually. It is now 34%, which is rather low for a criterion used in many diagnosis criteria. It is important to find a surrogate for it because with the decrease in the incidence of PP the sensitivity of the diagnosis criteria will drop significantly.
Urinary Oestriol Excretion in Retarded Intrauterine Fetal Growth
Authors: Elliott Peter M. 
Published: August 2010

Summary: Retarded intrauterine fetal growth is associated with a high perinatal mortality.Serial urinary oestriol excretion estimations were performed in the third trimester of 22 pregnancies associated with small babies and the amniotic fluid volume was measured in 16.Low oestriol excretion was observed in 18 pregnancies and in 10 of these it was very low. Low amniotic fluid volumes were found in 10 and were associated with reduced oestriol and clinically very small fetuses. When all 3 co‐existed placental failure appeared imminent.It is suggested that serial urinary oestriol estimations are a useful aid in assessing fetal prognosis and that judicious interpretation of the results with more widespread use of Caesarean section will result in improved fetal salvage.
Prolonged Labour in Primigravid Patients with Special Reference to The Use of Caudal Block and the Vacuum Extractor
Authors: Dudgeon Grahame I. 
Published: August 2010

Summary:A conservative form of management of prolonged labour in primigravid patients is presented, advocating the use of caudal or other epidural block, oxytocic stimulation in the event of secondary uterine inertia (providedthat bonydisproportion has been excluded by pelvic X‐ray) and delivery with the aid of the vacuum extractor if the cervix fails to reach full dilatation at the cessation of progress. No morbidity has been found in the mothers or babies which could be attributed to the method.Five case reports are given together with a summary of the author's previous experience with the procedure.
A history of caesarean section: From ancient world to the modern era
Authors: TODMAN Donald 
Published: August 2010

AbstractCaesarean section has been recorded in history since ancient times in both Western and non‐Western literature. Although the first use of the term in obstetrics was from the seventeenth century, its early history is obscured by mythology. The origin of the term caesarean is believed to be from the birth of Julius Caesar; however, this is unlikely considering his mother Aurelia Cotta lived for many years afterwards. In ancient times, it was performed only when the woman was dead or dying as an attempt to rescue the fetus. With few exceptions, this was the pattern until the era of anaesthesia in the nineteenth century. Developments in surgical technique from the later nineteenth century and through the twentieth century have refined the procedure, with resulting low morbidity and mortality. As a consequence, the objectives of caesarean section have evolved from rescuing the fetus or for cultural or religious reasons towards concerns for the safety of mother and child as well as considering the mother's preferences.
Perinatal HIV transmission and pregnancy outcomes in indigenous women in Western Australia
Authors: GILLES Marisa T. , DICKINSON Jan E. , CAIN Alison , TURNER Kate A. , MCGUCKIN Rosemary , LOH Richard , PRESCOTT Susan L. , FRENCH Martyn A. 
Published: August 2010

AbstractBackground:  Implementation of obstetric and neonatal interventions has reduced mother to child transmission of HIV. Health outcomes for Aboriginal people are often worse than for non‐Aboriginal people; was this the case for HIV infection in pregnancy?Aims:  To compare the management and outcomes of pregnancy in Aboriginal and non‐Aboriginal HIV‐positive women in Western Australia (WA).Methods:  A retrospective study of all pregnancies delivered in WA to HIV‐infected women from 1991 until 2005. Managed pregnancies were compared in Aboriginal and non‐Aboriginal women. Outcome measures were HIV status of the babies, birthweight, rates of caesarean delivery and perinatal mortality.Results:  Fifty‐six pregnancies occurred in 41 HIV‐infected women resulting in 54 live births. Of the 41 women, 16 (39%) were Aboriginal. In regard to birthweight, perinatal mortality, rates of caesarean section and rates of HIV perinatal transmission, there was no significant difference between babies born to Aboriginal and those born to non‐Aboriginal mothers. In contrast, of the eight pregnancies, with no contact with the multidisciplinary team, five babies (63%) were infected with HIV (2% vs 63%P = 0.001). There was no case of perinatal HIV infection in 22 pregnancies of the Aboriginal women that received care through the multidisciplinary team; perinatally acquired HIV occurred in the first pregnancy of one of these women before she was aware of her status when she was not managed by the team.Conclusions:  Similar outcomes can be achieved in both HIV‐positive Aboriginal and non‐Aboriginal women, through intensive, culturally appropriate, multidisciplinary care and without elective caesarean delivery.
Prophylactic antibiotics for the prevention of preterm birth in women at risk: A meta‐analysis
Authors: SIMCOX Rachael , SIN Wing‐To A. , SEED Paul T. , BRILEY Annette , SHENNAN Andrew H. 
Published: August 2010

AbstractBackground:  Preterm birth (PTB) is the major determinant of perinatal morbidity and mortality. Infection is implicated in a large proportion of preterm deliveries, but there is no consensus regarding the efficacy of antibiotic prophylaxis for women at risk.Aim:  To determine whether antibiotic treatment reduces the risk of preterm delivery in asymptomatic pregnant women at risk of PTB.Method:  Relevant publications were identified via electronic searches of MEDLINE (1966 to August 2005), The Cochrane Pregnancy and Childbirth Group trials register, the Cochrane Central Register of Controlled Trials (the Cochrane Library, Issue 3, 2005) and PubMed using multiple search terms related to PTB and antibiotics. Publications were limited to randomised controlled trials comparing antibiotics with placebo given to asymptomatic non‐labouring women. A random effect model was used, and combined risk ratios calculated for the various risk groups. Associations between treatment effect and the rate of PTB were analysed by meta‐regression.Results:  Seventeen trials were included, 12 identifying women at risk by abnormal vaginal flora, three on women at high risk from a previous PTB and two recruiting women based on positive fetal fibronectin status. There was no significant association between antibiotic treatment and reduction in PTB irrespective of criteria used to assess risk, the antimicrobial agent administered, or gestational age at time of treatment (overall combined random effect for delivery at less than 37 weeks RR 1.03 (95% CI 0.86–1.24)).Conclusions:  Treating women at risk of PTB with antibiotics does not reduce the risk of subsequent PTB.
Institution of universal screening for Group B streptococcus (GBS) from a risk management protocol results in reduction of early‐onset GBS disease in a tertiary obstetric unit
Authors: ANGSTETRA Donald , FERGUSON John , GILES Warwick B. 
Published: August 2010

AbstractAim:  To determine the effect of institution of a universal screening protocol as per CDC 2002 guidelines had on the incidence of early‐onset Group B streptococcal (GBS) and non‐GBS disease in a tertiary obstetric unit.Methods:  A prospective study with historical control data reporting the incidence of early‐onset GBS and non‐GBS disease following institution of a universal screening strategy at John Hunter Hospital, Newcastle, Australia. We compared the incidence of early‐onset GBS and non‐GBS disease during prescreening (1994–2002) with screening period (2004 to June 2006). The outcome measure was the incidence of early‐onset GBS disease. We specifically reported the number of women needed to treat (NNT) with antibiotics and the number of women needed to screen.Results:  The incidence of early‐onset GBS and non‐GBS during the prescreening period was 0.84/1000 and 0.94/1000 live births, respectively. After institution of universal screening, the incidence was 0.00/1000 and 0.72/1000 live births, respectively. This is a statistically significant reduction in early‐onset GBS disease by 84% (χ2 = 5.75; P = 0.016). There was no difference in non‐GBS disease (χ2 = 0.14; P = 0.71). The NNT is 1191 and we needed to screen 5704 women to prevent one case of early‐onset GBS disease.Conclusion:  Screening for GBS rather than by assessing risk factors has significantly reduced the incidence of early‐onset GBS disease in our unit. Despite low incidence of early‐onset GBS prior to screening period, we still found a significant decrease in early‐onset GBS disease after institution of universal screening protocol. These results support the screening‐based approach at 34–37 weeks gestation.
Maternal risk factors associated with fetal death during antenatal care in low‐resource tertiary hospitals
Authors: OLADAPO Olufemi T. , ADEKANLE Daniel A. , DUROJAIYE Bankole O. 
Published: August 2010

AbstractBackground: Data on maternal characteristics that could predict antepartum fetal death in women receiving antenatal care in resource‐constrained settings are limited.Aims: To identify maternal sociodemographic and clinical risk factors for antepartum fetal death among women receiving antenatal care in a developing country setting.Methods: Case‐control analyses of risk factors in the occurrence of singleton fetal death before labour at two university hospitals in south‐west Nigeria over 4–5 years. A total of 46 cases and 184 controls were compared for 31 sociodemographic and clinical risk factors. Unconditional multivariate logistic regression analysis was applied to determine independent risk factors. Level of significance was set at P < 0.05.Results: The incidence of antepartum fetal death among women receiving antenatal care was 10.8 per 1000 total births during the period. Significant risk factors at univariate level include proteinuria, pregnancy‐induced hypertension, pre‐existing hypertension, reduced weight gain per week, previous antepartum fetal death, antepartum haemorrhage, previous miscarriage, symphysiofundal height–gestational age disparity = 4 cm and perception of reduced fetal movements. The independent risk factors were proteinuria (adjusted OR 4.23, CI: 1.57–11.42), pregnancy‐induced hypertension (adjusted OR 8.24, CI: 3.01–22.51) and perceived reduction in fetal movements (adjusted OR 7.17, CI: 1.57–45.76).Conclusions: The identified factors should serve as potential targets for antenatal interventions to prevent antepartum fetal death in these institutions. Awareness of these factors should stimulate appropriate risk assessment geared towards the prevention of antepartum fetal deaths by clinicians in these centres and centres in similar setting.
Predicting a failed induction
Authors: BECKMANN Michael 
Published: August 2010

AbstractBackground:  A failed induction usually refers to failure to progress to the active phase of labour; however, there is no consensus regarding when an induction has failed.Aims:  To investigate the factors (particularly length of latent phase) that may influence mode of birth for women undergoing Syntocinon induction of labour.Methods:  A retrospective analysis of 978 nulliparous women undergoing Syntocinon induction of labour following artificial or spontaneous rupture of membranes was performed.Results:  As the length of the latent phase increased, the likelihood of birth by caesarean section increased significantly (P < 0.001). After ten hours of Syntocinon administration, the 8% of women not in the active phase of labour had approximately a 75% chance of being delivered by emergency caesarean section and after 12 h the chance was almost 90%. Multivariate analysis also suggested an association between birth by caesarean section and use of prostaglandin gel (P < 0.001) or mechanical methods of cervical priming (P = 0.004), maternal height < 155 cm (P = 0.020) and cervical dilation prior to commencement of Syntocinon (P = 0.018).Conclusions:  It would seem reasonable to continue a Syntocinon infusion for at least ten hours in women undergoing induction who have yet to reach the active phase of labour ( 4 cm), and unclear benefit in continuing an induction beyond 12 h. The duration of latent phase is a helpful predictor of subsequent mode of birth.
Prediction of a caesarean delivery by labour and delivery nurses
Authors: SCHULTZ Carrie C. , WOOD Janine Y. , MAGANN Everett F. , CAMPBELL Lori A. , CHAUHAN Suneet P. , MORRISON John C. 
Published: August 2010

AbstractThe predictive accuracy of a nurse on labour and delivery to foretell the route of delivery is unknown. Registered nurses directly involved in managing women's labour predicted the route of delivery on 199 women between September 2005 and September 2006. The sensitivity to identify women who subsequently would deliver by caesarean was 26% (95% CI 13–42%); positive predictive value of 38% (20–39%) and likelihood ratio of 2.6 (1.3–7.5). Experience did not improve the predictive accuracy.
Self‐obtained vaginal swabs for PCR chlamydia testing: A practical alternative
Authors: ROSE Sally B. , LAWTON Beverley A. , BROMHEAD Collette , MACDONALD E. Jane , LUND Kim A. 
Published: August 2010

AbstractThis study shows that given a choice, New Zealand women at high risk for sexually transmitted infections (STI) opt to provide a self‐taken vaginal swab over a clinician‐taken sample for STI testing. Self‐obtained vaginal swabs have previously been shown to have equal sensitivity and specificity to endocervical swabs and greater sensitivity than urine for the detection of Chlamydia trachomatis by polymerase chain reaction (PCR). We suggest that self‐obtained vaginal swabs should be a readily available option offered to women for chlamydia testing by PCR in New Zealand.
Lifetime prevalence of cervical neoplasia in addicted and medical patients
Authors: REECE Albert 
Published: August 2010

AbstractBackground:  The prevalence and timing of cervical dysplasia among substance use disorder (SUD) patients is not well studied.Methods:  A cross‐sectional pilot survey was undertaken among our primary practice female medical and SUD patients by patient recall of cervical screening history.Results:  One hundred and fifty‐three SUD patients were compared with 77 general medical patients younger than 45 years old. The substances abused in this population have previously been described. There was no difference in the mean number of Pap smears (mean ± SEM 6.30 ± 0.55 vs 5.68 ± 0.70, respectively) or the time since last screening (2.93 ± 0.29 vs 1.60 ± 0.26 years). Limiting the analysis to patients younger than 45 years effectively controlled for the difference in ages between SUD and medical patients (29.94 ± 0.52 and 30.21 ± 1.04 years). Significant differences in cytological abnormalities (OR = 5.88, CI 1.92–23.92; P = 0.0005), cervical intraepithelial neoplasia (CIN) (OR = 14.4, CI 2.20–602.92, P = 0.001) and high‐grade CIN‐cancer (P = 0.002) were noted. When diagnoses were scored and charted, the trend of the lines of best fit in the two groups was significantly different (P < 0.00001). There were five and two cancers noted in the two groups. There were two and ten hysterectomies performed in the two groups which were for two and one indications of cancer, respectively. In the addicted group invasive cancer was diagnosed at 23‐, 23‐, 34‐ and 37‐years olds.Conclusion:  SUD patients have a very high rate of abnormalities on cervical screening including precancerous lesions and these changes occurred at significantly younger ages. The possibility of some form of cancer promotion merits further investigation.