bluuebunny/crossref_metadata_2025_split huggingface dataset:
A new technique to test tubal patency under transvaginal sonographic control
Authors: Volpi Eugenio , De Grandis Tiziana , Rustichelli Sergio , Zuccaro Giancarlo , Patriarca Ambra , Slsmondi Plero 
Published: November 2007

Objective. Since 1990 we have undertaken a trial to evaluate if TVS, even without contrast media, could diagnose tubal patency.Materials and methods. A detailed description of the technique is given. Two hundred and seventy‐three patients underwent sonosalpingography in our department in the period 1990–1993. The sonographic findings were matched in 43 cases to hysterosalpingography and in 55 cases to laparoscopy.Results. Tubal patency was demonstrated in 218 patients (80.5%), monolateral patency in 41 (15.1%) patients and bilateral tubal occlusion in 12 (4.4%) patients. In the 43 patients undergoing hysterosalpingography, discordance between the two examinations was observed in five cases (11.6%). However, only six out of 86 salpinxes had different results (6.9%). In only one case was total discordance observed. In three out of four other cases the difference was due to patency diagnosed at SSG and occlusion at HSG. Of the 55 patients undergoing laparoscopy 12 cases (21.8%) had discordant results. Complete discordance was observed in two cases while in ten cases one salpinx had a different patency report. The discordance goes to 12.7% when we take into account all the salpinxes evaluated.Conclusion. Sonosalpingography gives very similar results to hysterosalpingography and may be used on clinical basis for tubal patency evaluation.
Use of pap‐smears in a population without a mass screening program
Authors: Forsmo Siri , Buhaug Harald , Stalsberg Helge 
Published: November 2007

Study objective. To analyze the use of Pap‐smears in a population where a screening program was not offered.Design. Retrospective analysis of pathology registry data on women resident in two counties of Norway.Setting. Evaluation of opportunistic screening by age and year of birth. Proportion of population tested during successive 3‐year periods.Material. 353 665 smears from 88048 women examined since 1973. For this purpose we concentrated on 257951 smears from 77431 women examined during the period 1981–90.Results. Between 62 and 67% of women examined during each 3‐year period were 20–39 years old, 14–16% were 50–69 years of age. Throughout the ten‐year period the frequency of Pap‐smear testing of women over 60 and under 20 increased slightly whereas it decreased for women 20–39 years old. Follow‐up of positive or atypical smears comprised about 25% of all smears. The highest proportion of follow‐ups was found among women 30–49 years old. About one third of women aged 20–59 years had more than one smear taken in a 3‐year period, follow‐up smears excluded.Conclusion. More than half of the women aged 50 and above have no smears or smears less than one every third year. This proportion increases with age. The use and distribution of smears by age is still far from the situation expected in an organized screening program although a slight amelioration was observed through the study period.
Breech at termmode of delivery?
Authors: Krebs Lone , Langhoff‐Roos Jens , Weber Tom 
Published: November 2007

Background. The present study was designed to determine neonatal mortality and morbidity in non‐malformed singleton term infants delivered in breech presentation and identify a possible correlation between outcome on the one hand and mode of delivery, parity and birth weight on the other.Methods. Register‐based cohort study of all (n=15718) singleton term breech deliveries of non‐malformed infants in Denmark 1982–1990. Process and outcome measures: mode of delivery, gestational age, birth weight, congenital malformations, intrapartum death, Apgar scores and early neonatal death.Results. A total of 3247 (20.7%) term infants were delivered vaginally, 7106 (45.3%) by elective and 5356 (34.1%) by emergency cesarean section. Infants delivered vaginally and by emergency cesarean section had significantly higher rates of mortality (intrapartum and early neonatal death) and morbidity (low Apgar scores) when compared to those delivered by elective cesarean section. In vaginal deliveries, parity was not correlated with outcome, but infants with a birth weight above 4000 grams had significantly higher rates of low Apgar scores.Conclusions. Register data on singleton term breech deliveries imply that vaginal delivery is associated with increased mortality and morbidity. However, validation of data and additional information from the medical records are needed before a recommendation of whether selection of parturients, structure of perinatal care or professional skills need to be improved, or all singleton term infants in breech presentation should be delivered by cesarean section.
Sexually transmitted diseases in Swedish women with experience of casual sex with men of foreign nationalities within Sweden
Authors: Arvidson Maria , Hellberg Dan , Mårdh Per‐Anders 
Published: November 2007

Background. This study was performed in women who had attended the clinic for contraceptive advice to determine whether a history of casual sex with a foreign male, previously unknown to them (SFM) in their home country (Sweden), constituted an increased risk for acquiring sexually transmitted diseases (STD) as compared to women without such an experience (COMP).Methods. Of 996 women enrolled, and who were subjected to a structured deep‐interview performed by midwives, 595 (59.7%) stated that they had experienced casual sex within Sweden with for them a previously unknown Swedish male (SSM).Results. A history of SFM was reported by 120 (12.0%) women. A history of chlamydial infection (26.0%) and gonorrhea (13.0%) were more common in the SFM women than in either the COMP (16.0% and 3.0%) or the SSM (19.0% and 4.0%) groups. Genital warts (8.0%) and bacterial vaginosis (23.0%) were found more often in the SFM group as compared to both the COMP (3.0% and 12.0%) and the SSM (4.0% and 13.0%) group. Women in the SFM group more often had a current genital chlamydial infection (13.0%) than those in the COMP group (8.0%.). When adjustment was made for markers of sexual risk taking, only genital warts remained significantly (p=0.05) associated with SFM as compared to both SSM and COMP.Conclusions. To conclude, the study shows that women with experience of SFM had, more often, a history of one or more STDs and were more often carriers of STD agents than those lacking experience of SFM and/or SSM. However, there was no such difference when comparing the SFM and SSM women when making adjustments for sexual risk behavior. Thus a sexual risky lifestyle is more important than the origin of the sex partner for acquiring STDs with possible exception of HIV/AIDS in the society studied.
Ambivalence among women applying for abortion
Authors: Husfeldt Charlotte , Hansen Susanne Kierstein , Lyngberg Ann , Nøddebo Merete , Petersson Birgit 
Published: November 2007

Background. Our purpose was to characterize women expressing ambivalence when applying for abortion.Material and methods. Data were collected, by self‐administered questionnaires, from 339 women. Thirty percent were in doubt about the decision when the abortion was due. Socio‐economic factors more often influenced the choice among ambivalent women than among those not in any doubt.Results. Ambivalent women more often felt exposed to social pressure and some felt that the abortion was not their own choice. Their decision‐making was marked by doubt during the entire process.Conclusions. There is a need for professional support during this decision‐making process. Many of the ambivalent women stated that their decision might not have been the same under different personal circumstances.
Plasma cyclic GMP concentrations and their relationship with changes of blood pressure levels in pre‐eclampsia
Authors: Schneider Francis , Lutun Philippe , Baldauf Jean‐Jacques , Quirin Laurence , Dreyfus Michel , Ritter Jean , Tempé Jean‐Daniel 
Published: November 2007

Background. One of the possible mechanisms responsible for pre‐eclampsia is a loss of efficiency of the L‐arginine‐nitric oxide pathway with subsequent inactivation of the guanylyl cyclases of the vascular smooth muscle cells. As a result there should be a decrease in plasma cyclic 3′‐5′ guanosine monophosphate (cGMP) concentrations in pre‐eclampsia. We assessed the behavior of this nucleotid in the plasma of pre‐eclamptic women.Subjects and methods. Sixteen pre‐eclamptic women, 16 normotensive pregnant women matched for gestational age and six nonpregnant controls were investigated. Arterial blood pressure was recorded at inclusion time and then once a‐day until the fourth day after delivery concomitantly with the collection of blood samples for determining plasma cGMP, atrial natriuretic peptides (ANP). creatinine, uric acid and platelet counts. Also 24 h urines were simultaneously collected to calculate renal clearance of cGMP.Results. Before the initiation of antihypertensive treatment, plasma cGMP levels were significantly higher (p<0.01) in pre‐eclampsia women as compared both to pregnant normotensive controls and nonpregnant women (7.02±0.9 versus 4.8±0.76 versus 1.93±0.15 pmol‐ml−1, p<0.01). Under antihypertensive treatment, cGMP levels decreased significantly (p<0.05) to 5.48±0.9 pmol‐ml−1. The increase of plasma cGMP was associated with high ANP levels; the likelihood that a renal impairment could account for an increase in plasma cGMP was ruled out because the clearance of creatinine was not impaired. Similarly the possibility of a significant linear correlation between cGMP levels and blood pressure values or biological data was excluded in these women.Conclusion. Plasma cGMP concentrations are increased in pre‐eclampsia. They decrease to control values when blood pressure returns to normal values; they indicate enhanced guanylyl cyclase activation by ANP and additional factors, but cannot be considered as a direct index of the severity of pre‐eclampsia.
Towards regional equality in family planning: teenage pregnancies and abortions in Finland from 1976 to 1993
Authors: Kosunen Elise Anna‐Lisa , Rimpelä Matti Keijo 
Published: November 2007

Background.A major goal of Finnish family planning policy since the 1970s has been to minimize unintended pregnancies by providing equal contraception and abortion services throughout the country. This report looks at how this policy has succeeded among teenagers.Methods.The data on childbirths, induced abortions and mean populations were collected from the national abortion and population registers. Regional and age‐specific rates were calculated for fertility, abortions and pregnancies in girls aged 15‐19.Results.In 1993, the teenage pregnancy rate was 20/1000 and the abortion rate 9.5/1000 in the whole country. Although the pregnancy rate had dropped by half since the 1970s, the regional differences were still there: the lowest rate was 18/1000 and the highest 29/1000 (in Lapland) in 1991‐93. The abortion rate ranged from 8/1000 to 14/1000. Childbirths decreased, particularly at the beginning of the study period, while abortions declined sharply towards the end of the period. In 1986‐88, the abortion ratio exceeded 100 in all provinces except two. In the 1990s, it dropped below 100 again except in the capital province. In 16‐17 year‐olds, the trends were quite equal in different provinces. In 18‐19 year‐olds, pregnancies remained more frequent in the north and were more often carried to term, while the choice of abortion was more likely in the south.Conclusions.Equally declining trends in pregnancies in all provinces suggest that teenage family planning services have a comprehensive coverage. However, regional differences still remain and imply a detailed analysis of their reasons.
Increased use of condoms among female university students: A 5‐year follow‐up of sexual behavior
Authors: Tydén Tanja , Björkelund Cecilia , Odlind Viveca , Olsson Sven‐Eric 
Published: November 2007

Objective. To ascertain any changes in sexual behavior and attitudes as an indication of the impact of intensified information activities aiming at decreasing the risk of spread of sexually transmitted diseases among university students.Methods. In 1989 questionnaires were offered to 275 consecutive female students visiting the Student Health Center. Identical questionnaires were mailed to 200 randomly selected women registered at Uppsala University. The study was repeated in 1994. The study was carried out in Uppsala, a city in Sweden with 27,000 university students.Results. At the Student Health Center 241 (88%) participated in the study in 1989 and 262 (95%) in 3994. Corresponding figures in the postal survey were 137 (69%) in 1989 and 151 (76%) in 1994. Compared with the findings in 1989, in 1994 the sexual behavior was unchanged in terms of mean age at first intercourse (17.6 years), median number of life partners (3‐4) and median number of sexual partners during the last 12 months (1), but the awareness of sexually transmitted diseases had increased. Their attitudes to using condoms had become more positive and the actual use of a condom had also increased both at the first intercourse and when changing partner, from 40 to 60%. Concerns about safety of oral contraceptives decreased significantly.Conclusions. This follow‐up shows that awareness of sexually transmitted diseases and condom use had increased between 1989 and 1994, possibly as a result of intensified information efforts.
Inhibition of contractile responses of human myometrium and intramyometrial arteries by potassium channel openers
Authors: Kostrzewska Anna , Laudaski Tadeusz , Batra Satish 
Published: November 2007

Objectives. The effects of cromakalim and pinacidil on the contractile activity of the isolated human myometrium and intramyometrial arteries were studied.Material and method. Myometrial strips and pieces of uterine arteries were obtained from women undergoing hysterectomy. Contractions were recorded under isometric conditions.Results. Both compounds (10−9 M‐5±10−6 M) inhibited the spontaneous activity of the myometrium and vasopressin induced contractions of myometrium and intramyometrial arteries. There was no statistically significant difference in the responses of both tissues to cromakalim or pinacidil. Both compounds reduced responses of myometrium and intramyometrial arteries to low concentrations of K+ (<40 mM) but did not decrease contractions induced by 40 mM and 80 mM.Conclusion. The combined effect on the uterus and intrauterine vasculature would suggest a potential in the use of cromakalim or pinacidil for the treatment of dysmenorrhea.
Variation in lipid levels during pregnancy in women with different types of hypertension
Authors: Gratacós Eduard , Casals Elena , Sanllehy Carolina , Cararach VicenÇ , Alonso Pedro L. , Fortuny Albert 
Published: November 2007

Objectives. To evaluate the levels of serum lipids (cholesterol and triglycerides) in pregnant women with different types of hypertension, at the first, second and third trimesters of pregnancy.Methods. Cholesterol and triglyceride levels at the first, second and third trimesters of gestation were recorded for 115 women with hypertension during pregnancy, and 115 healthy pregnant women matched for age and body mass index. Cases were classified as having mild gestational hypertension (25), severe gestational hypertension (15), mild preeclampsia (20), severe preeclampsia (20), chronic hypertension (20), and superimposed preeclampsia (15).Results. Cholesterol levels were not statistically different between cases and controls in any form of hypertension. At 20 and 34 weeks' gestation, triglyceride levels were significantly higher than controls in women with severe gestational hypertension, mild and severe preeclampsia, and superimposed preeclampsia, but not in mild gestational hypertension or chronic hypertension. The significant elevation in triglycerides was already present at 10 weeks in mild and severe preeclampsia.Conclusions. The data suggest that the alterations in lipid metabolism observed in preeclampsia are already present at the first trimester of pregnancy. Women with severe gestational hypertension presented a pattern of triglycerides similar to that of preeclamptic women, but mild gestational hypertension resembled chronic hypertension in this respect. This supports the concept that, although in many cases gestational hypertension represents latent essential hypertension, some of these women, probably the most severe cases, present with true pregnancy‐induced hypertension, or nonproteinuric preeclampsia.
Infections after hysterectomy a prospective nation‐wide Swedish study
Authors: Persson Elisabeth , Bergström Mats , Larsson Per‐Gunnar , Moberg Peter , Platz‐christensen Jens Jörgen , Schedvins Kjell , Wølner‐hanssen Pal ,   The Study Group on Infectious Diseases in Obstetrics and Gynecology within the Swedish Society of Obstetrics and Gynecology
Published: November 2007

Background. An increased use of prophylactic antibiotics to avoid postoperative infections in women undergoing hysterectomy has been observed in Sweden. This investigation was performed a) to study the infection rate to enable future evaluation of the effect of prophylactic antibiotic regimens and b) to identify subgroups suitable for intervention.Method. A prospective study comprising all women undergoing pelvic surgery with hysterectomy during a two month period at forty‐two Departments of Obstetrics and Gynecology in Sweden. Relevant information regarding the surgical procedure and the postoperative course was included in a standardized form at discharge from hospital and at a follow‐up visit 4 to 6 weeks after surgery.Results. Of the 1060 women included in the study, 23% developed postoperative infections; 9.4% had wound‐, cuff‐, and/or deep infections, 13% urinary tract infections, and 4% other infections unrelated to the surgical site. Only half of the wound/cuff‐/deep infections were diagnosed before discharge from the hospital. Wertheim‐Meigs procedures, bleedings per‐operatively exceeding 1000 ml, and presence of bacterial vaginosis (BV) were associated with an increased risk of postoperative infections. Among women undergoing abdominal hysterectomy for benign reasons, (n=159), wound‐cuff/deep infection was significantly associated with preoperative BV, i.e. 7 of 28 (25%) vs. 11 of 131 (8%), respectively (relative risk=3.0, p= 0.01). Infection was associated with prolonged postoperative hospital stay. Antibiotics were given pre‐ or postoperatively to 236 (22%) of the 1060 women. Reduction in the postoperative infection rate was seen among women undergoing vaginal hysterectomy who were given pre‐or postoperative antibiotics.Conclusion. The postoperative infection rate after hysterectomy was clinically significant in this population. Wertheim‐Meigs procedures, peroperative bleeding > 1000 ml and BV were identified as risk factors for postoperative infections after hysterectomy.
The Initial Prodrome in Psychosis: Descriptive and Qualitative Aspects
Authors: Yung Alison R. , McGorry Patrick D. 
Published: November 2007

Objective: This study aimed to describe in detail, using a retrospective approach, the prodromal symptoms in first-episode psychosis patients. This initial prodrome, the period of disturbance preceding a first psychotic episode, is potentially important for early intervention, identification of biological markers, and understanding the process of becoming psychotic. Method: A consecutive series of 21 first-episode patients was recruited from the Early Psychosis Prevention and Intervention Centre, a specialised service for young people aged between 16 and 30 with first-episode psychosis. Subjects were interviewed in the recovery phase after the acute episode, about the period leading up to the psychosis, using a combination of unstructured and semi-structured techniques. Results: A wide variability of phenomena and sequence patterns was found, with symptoms being a mixture of attenuated psychotic symptoms, neurotic and mood-related symptoms, and behavioural changes. Symptoms were often disabling and some, such as suicidal thoughts, potentially life-threatening. Conclusions: The findings highlight the loss of information that has resulted from disregarding early phenomenological studies of the psychotic prodrome and instead focussing on behavioural features. The ground work has been laid for the development of better methodologies for assessing and measuring first psychotic prodromes with increased emphasis on experiential phenomena. This has the potential to lead to the early recognition and more accurate prediction of subsequent psychosis, as well as a deeper understanding of the neurobiology of the onset of psychotic disorder.
Hanging and Poisoning Autopsies in Fiji
Authors: Pridmore Saxby , Lawler Anthony , Couper David 
Published: November 2007

Objective: Fiji is a Pacific nation with roughly equal numbers of indigenous Fijians and Indians. Previous studies, using police and medical records, have suggested significant racial, regional, age and gender differences in suicidal behaviour. The objective of the present study is to use a unique data set (autopsy reports) in the evaluation of earlier reports and to identify groups at greater risk. Method: Hanging and poisoning autopsy reports from two distinct regions were examined. Results: The rate of autopsy (per 100 000 population per year) among Indians (19.5) is significantly greater (p<0.0001) than among Fijians (1.53). In the north, among the Indians, there are more autopsies in females (21.2) than males (16.8), and hanging constitutes 85% of total suicides, while in the Central and Eastern Divisions hanging constitutes only 58% of the total. These are regional influences. Among Fijians, the rates of hanging autopsy are significantly greater (p<0.001) in males (1.98) than females (0.40); however, among Indians there is no significant difference. This is a racial difference. Hanging remains the preferred option for all groups. The mean age at autopsy is 31.7. There is no significant difference between the mean ages of the races, the sexes or the regions. There is no significant difference between the mean age of poisoning (31.5) and hanging (31.8). Conclusion: There is a significant racial difference in rates of suicide but the influences of region, age and method are relatively slight.
Carrot Addiction
Authors: Kaplan Robert 
Published: November 2007

Objective: A case report of carrot addiction is presented with a review of the literature and comment on the role of beta carotene in addictive behaviour. Clinical Picture: The addiction occurred in a 49-year-old woman under conditions of stress due to marital problems, leading to a depressive illness and increased smoking. The patient maintained that the sensations of carrot craving and withdrawal were quite distinct from those associated with smoking. Treatment: The patient was advised to record her daily carrot consumption. Outcome: The patient did not return for several months, but stopped eating carrots after an operation, at which time she also stopped smoking. Conclusion: Compusive carrot eating, regarded as a rare condition, has received scant documentation, unlike hypercarotenemia due to unusual diets or food fads. Nervousness, craving, insomnia, waterbrash and irritability are associated with withdrawal from excessive carrot eating. The basis for the addiction is believed to be beta carotene, found in carrots. Does carrot eating, an aggressively oral activity, merely act as a behavioural substitute for smoking? Or does beta carotene contain a chemical element that replicates the addictive component of nicotine? Further study of this unusual but intriguing addiction may reveal more about the basis of all addictions, with particular implications for the cessation of cigarette smoking.