bluuebunny/crossref_metadata_2025_split huggingface dataset:
Extremely skewed X‐chromosome inactivation patterns in women with recurrent spontaneous abortion
Authors: BAGISLAR Sevgi , USTUNER Isik , CENGIZ Bora , SOYLEMEZ Feride , AKYERLI Cemaliye Boylu , CEYLANER Serdar , CEYLANER Gulay , ACAR Aynur , OZCELIK Tayfun 
Published: August 2006

AbstractBackground:  The role of extremely skewed X‐chromosome inactivation (XCI) has been questioned in the pathogenesis of recurrent spontaneous abortion (RSA) but the results obtained were conflicting.Aims:  We therefore investigated the XCI patterns in peripheral blood DNA obtained from 80 patients who had RSA and 160 age‐matched controls.Methods:  Pregnancy history, age, karyotype, and disease information was collected from all subjects. The methylation status of a highly polymorphic cytosine‐adenine‐guanine repeat in the androgen‐receptor (AR) gene was determined by use of methylation‐sensitive restriction enzyme HpaII and polymerase chain reaction.Results:  Skewed XCI (> 85% skewing) was observed in 13 of the 62 patients informative for the AR polymorphism (20.9%), and eight of the 124 informative controls (6.4%) (P = 0.0069; χ2 test). More importantly, extremely skewed XCI, defined as > 90% inactivation of one allele, was present in 11 (17.7%) patients, and in only two controls (P = 0.0002; χ2 test).Conclusions:  These results support the interpretation that disturbances in XCI mosaicism may be involved in the pathogenesis of RSA.
Customised birthweight: Coefficients for an Australian population and validation of the model
Authors: PAIN Scott , CHANG Allan M. Z. , FLENADY Vicki , CHAN Fung Y. 
Published: August 2006

AbstractBackground:  Published birthweight references in Australia do not fully take into account constitutional factors that influence birthweight and therefore may not provide an accurate reference to identify the infant with abnormal growth. Furthermore, studies in other regions that have derived adjusted (customised) birthweight references have applied untested assumptions in the statistical modelling.Aims:  To validate the customised birthweight model and to produce a reference set of coefficients for estimating a customised birthweight that may be useful for maternity care in Australia and for future research.Methods:  De‐identified data were extracted from the clinical database for all births at the Mater Mother's Hospital, Brisbane, Australia, between January 1997 and June 2005. Births with missing data for the variables under study were excluded. In addition the following were excluded: multiple pregnancies, births less than 37 completed week's gestation, stillbirths, and major congenital abnormalities. Multivariate analysis was undertaken. A double cross‐validation procedure was used to validate the model.Results:  The study of 42 206 births demonstrated that, for statistical purposes, birthweight is normally distributed. Coefficients for the derivation of customised birthweight in an Australian population were developed and the statistical model is demonstrably robust.Conclusions:  This study provides empirical data as to the robustness of the model to determine customised birthweight. Further research is required to define where normal physiology ends and pathology begins, and which segments of the population should be included in the construction of a customised birthweight standard.
Intrapartum analgesia and its association with post‐partum back pain and headache in nulliparous women
Authors: ORLIKOWSKI Christopher E. P. , DICKINSON Jan E. , PAECH Michael J. , McDONALD Susan J. , NATHAN Elizabeth 
Published: August 2006

AbstractBackground:  The effect of intrapartum analgesia on post‐partum maternal back and neck pain, headache and migraine, is uncertain.Aims:  To determine if nulliparous women having epidural analgesia during labour have a similar incidence of the above‐mentioned post‐partum symptoms compared with women managed using other forms of pain relief.Methods:  Secondary analysis of cohort data from a randomised trial in which nulliparous women intending to deliver vaginally were randomised to either epidural analgesia (EPI) or continuous midwifery support (CMS) at admission for delivery. Because of high cross‐over rates, groups were initially defined by the randomised treatment allocation and the actual treatment received (CMS–CMS n = 185, EPI–CMS n = 117, EPI–EPI n = 376 and CMS–EPI n = 314). Univariate analysis showed no difference between groups, so final analysis was based on the actual treatment received.Results:  Six hundred and ninety women received epidural analgesia (EPIDURAL) and 302 received other methods of pain relief including CMS. Back pain was common before, during and after pregnancy, and risk factors for post‐partum back pain at six months were back pain prior to pregnancy or at two months post‐partum. Epidural analgesia, mode of delivery, spontaneous or induced labour, birthweight and back pain during pregnancy had no significant relationship with post‐partum back pain at six months. Headache was significantly more common in the EPIDURAL group during pregnancy and at two months post‐partum, but not at six months. Migraine was not associated with intrapartum analgesia.Conclusions:  This analysis supports previous research suggesting that epidural analgesia is not a significant risk factor for persisting post‐partum back pain, headache or migraine.
The association between intratwin birthweight discordance and preterm birth in twin pregnancy
Authors: WEN Shi Wu , TAN Hongzhuan , WALKER Mark 
Published: August 2006

AbstractBackground:  Previous studies found that increased birthweight discordance among twins was associated with increased risk of perinatal mortality and morbidity, but there is disagreement regarding the relationship between birthweight discordance and the risk of preterm birth.Aims:  To examine the relationship between intratwin birthweight discordance and preterm birth, and the influence of total birthweight as a confounding factor.Methods:  We conducted a historical cohort study to assess the relationship between intratwin birthweight discordance and preterm birth, using the 1995–1997 twin registry data of the USA. Parallel analyses with and without adjustment for total birthweight were performed.Results:  A total of 147 262 eligible twin sets were included in the analysis. In the non‐stratified analysis, preterm birth (< 37 weeks) rates were 64.3 and 51.8%, respectively, in subjects with a birthweight discordance > 25% and in those ≤ 25%. In the analysis stratified by total birthweight, the rates of preterm birth were higher in subjects with a birthweight discordance > 25% than in those ≤ 25% at every total birthweight stratum. Changing the thresholds to define preterm birth or treating gestational age as a continuously distributed variable yielded similar results. Using other methods to adjust for total birthweight also reversed the direction of this relationship.Conclusions:  Increased intratwin birthweight discordance is associated with increased risk of preterm birth, and adjustment for total birthweight biases the relationship to the wrong direction. Clinicians should be aware of the possibility of a preterm birth when there are signs of discordance in birthweight between the two twins.
Pregnancy outcome in women presenting with pre‐eclampsia at less than 25 weeks gestation
Authors: BUDDEN Astrid , WILKINSON Lucille , BUKSH Mariam Jan , McCOWAN Lesley 
Published: August 2006

AbstractObjective:  We aimed to (i) assess maternal and perinatal outcomes in pre‐eclampsia at < 250 weeks; and (ii) determine if any antenatal factors were associated with adverse maternal and perinatal outcomes.Design:  A retrospective study.Setting:  Tertiary referral hospital, Auckland, New Zealand.Methods:  Data were extracted from the clinical record and hospital database. The study population involved women admitted with pre‐eclampsia at < 250 weeks, with a live singleton pregnancy, from 1997 to 2004 and managed expectantly.Outcome measures:  Maternal morbidity, perinatal death, neurodevelopmental outcome at 18 months, small for gestational age assessed by population and customised birthweight centiles.Results:  Gestation at admission was the only antenatal variable associated with adverse perinatal outcome. Of 14 women admitted < 23 weeks, no babies survived, but eight (62%) babies of women admitted in the 24th week (240−246) survived. Neurodevelopmental outcome was assessed in eight of nine survivors; two (25%) had moderate and two (25%) had minor disability. All babies in this cohort had birthweights < 5th customised centile. Only one baby (10%) weighing < 500 g survived.Conclusion:  Maternal morbidity was high in this expectantly managed cohort. As no babies survived when pre‐eclampsia occurred before 23 weeks, induction of labour should be considered. In the 24th week two‐thirds of babies survived and 25% had moderate handicap. This information may help clinicians and women in the future to make informed choices about management.
The quality and size of yolk sac in early pregnancy loss
Authors: CHO Fu‐Nan , CHEN San‐Nung , TAI Ming‐Hong , YANG Tsung‐Lung 
Published: August 2006

AbstractBackground:  Accurate differentiation between normal pregnancy and pregnancy loss in early gestation remains a clinical challenge.Aims:  To determine whether ultrasound findings of yolk sac size and morphology are valuable in relation to pregnancy loss at six to ten weeks gestation.Methods:  Transvaginal ultrasonography was performed in 111 normal singleton pregnancies, 25 anembryonic gestations, and 18 missed abortions. Mean diameters of gestational sac and yolk sac were measured. The relationship between yolk sacs and gestational sacs in normal pregnancies was depicted. The yolk sacs ultrasound findings in cases of pregnancy loss were recorded.Results:  In normal pregnancies with embryonic heartbeats, a deformed or an absent yolk sac was never detected. Sequential appearance of yolk sac, embryonic heartbeats and amniotic membrane was essential for normal pregnancy. The largest yolk sac in viable pregnancies was 8.1 mm. Findings in anembryonic gestations included an absent yolk sac, an irregular‐shaped yolk sac and a relatively large yolk sac (> 95% upper confidence limits, in 11 cases). In cases of missed abortion with prior existing embryonic heartbeats, abnormal findings included a relatively large, a progressively regressing, a relatively small, and a deformed yolk sac (an irregular‐shaped yolk sac, an echogenic spot, or a band).Conclusion:  A very large yolk sac may exist in normal pregnancy. When embryonic heartbeats exist, the poor quality and early regression of a yolk sac are more specific than the large size of a yolk sac in predicting pregnancy loss. When an embryo is undetectable, a relatively large yolk sac, even of normal shape, may be an indicator of miscarriage.
Postnatal home visiting for illicit drug‐using mothers and their infants: A randomised controlled trial
Authors: BARTU Anne , SHARP Jennifer , LUDLOW Joanne , DOHERTY Dorota A. 
Published: August 2006

AbstractBackground:  Postnatal home‐visiting programs for illicit drug‐using mothers have reported some success in reducing harms in some areas but there is a lack of data on their impact on breastfeeding and immunisation rates.Aims:  To investigate the effect on breastfeeding, immunisation and parental drug use. The hypothesis was that the outcomes of the home‐visiting group (HVG) would be superior to the control group (CG).Method:  One hundred and fifty‐two illicit drug‐using women were recruited at 35–40 weeks gestation from King Edward Memorial Hospital, Perth, Western Australia and randomised after delivery to the HVG or the CG. The HVG had eight home visits; the CG had telephone contact at two months and a home visit at six months. The HVG received education and support for parenting, breastfeeding and child development. This was not provided by the research midwives for the CG.Results:  The main drugs were heroin, amphetamines, cannabis and benzodiazepines. Immunisation rates were similar for each group. Median duration of breastfeeding for the HVG was eight weeks (95% CI, 3.8–12.2); for the CG ten weeks (95% CI, 7.3–12.7). Drug use was reduced during pregnancy but increased by six months post‐partum in both groups. The retention rates were: HVG 93%; CG 86%.Conclusion:  The hypothesis for this study was not supported. Long‐term studies are urgently required to assess the effects of parental drug use on infant and child development.
Regional variations in prenatal screening across Australia: Stepping towards a national policy framework
Authors: O’LEARY Peter , BREHENY Nikki , REID Gabrielle , CHARLES Taryn , EMERY Jon 
Published: August 2006

AbstractBackground:  A relatively few centres across Australia provide screening tests for maternal serum markers or ultrasound measurement of fetal nuchal translucency to assess risk of fetal anomalies such as Down syndrome. While providers engage in external accreditation and quality assurance programs, state and federal governments have been slow to formulate relevant policies and standards.Aim:  In this paper we review the current practices across Australian states and territories and propose recommendations for developing a national policy framework.Methods:  Data on the number and types of screening tests provided as well as state policies, where they are available, were obtained from government reports and supplemented by a mail survey to selected stakeholders in each state or territory.Results:  At a jurisdictional level, our results highlight the need to integrate the collection and monitoring of antenatal population‐screening programs to assess clinical effectiveness and program performance (detection and screen‐positive rates, uptake of diagnostic tests as a result of screening). Women's expectations and satisfaction with the information they are provided should be evaluated and used to adjust education resources. At a local level, collaboration between providers of the separate tests, both public and private, would enable the ascertainment of outcomes of integrated screening programs. To complete the cycle, these data should inform decisions to improve antenatal screening programs at a national level.Conclusions:  A primary goal at a national level would be to develop a consensus on key performance indicators for programs that clarify best practice guidelines and establish optimal performance and accreditation standards.
The impact of fetal fibronectin testing for women with symptoms of preterm labour in routine clinical practice within a New Zealand population
Authors: GROOM Katie. M. , LIU Emily. , ALLENBY Keith. 
Published: August 2006

AbstractAims:  To perform a comparative analysis of antenatal management received according to the results of cervico‐vaginal fetal fibronectin (fFN) testing, and to review preterm delivery rates and fFN predictive values within a New Zealand population of women presenting with threatened preterm labour.Methods:  Case note review of all fFN tests performed at Middlemore Hospital, South Auckland from August 2003 to March 2005 (n = 199). Data collected included risk factors for preterm delivery, signs and symptoms at presentation, antenatal management received after fFN test and outcome and delivery details. Positive and negative fFN results were compared.Results:  Women with a positive fFN were more likely to receive antenatal corticosteroids (96.4 vs 4.7% RR 8.74 (95% CI 5.40–14.17)) and tocolysis (71.4 vs 2.4% RR 8.10 (95% CI 4.49–14.59)) and to be admitted antenatally (96.4 vs 54.4% RR 1.77 (95% CI 1.50–2.10)) with a higher mean cost of treatment ($NZ967.47 vs $NZ335.27 P < 0.05). Rates of delivery < 34 weeks were higher in those with a positive fFN (41.9 vs 0.7% RR 62.06 (95% CI 8.43–457.14)).Conclusion:  Women with a positive fFN result received different treatment to those with a negative fFN. Use of fFN test in routine clinical practice allows management and resources to be targeted more appropriately and may limit unnecessary interventions.
Readmission risk and metabolic, biochemical, haematological and clinical indicators of severity in hyperemesis gravidarum
Authors: TAN Peng Chiong , JACOB Reena , QUEK Kia Fatt , OMAR Siti Zawiah 
Published: August 2006

AbstractIn a retrospective analysis of 192 cases of presumed hyperemesis gravidarum, there were no biochemical markers that predicted hospital readmission. There was, however, statistically significant negative predictive value in abnormal liver function tests. This could represent acute self‐limited illness with a component of hepatitis as the cause for the clinical presentation, rather than hyperemesis.
Tuberculosis in pregnancy – Case studies and a review of Australia's screening process
Authors: MCCARTHY Fergus P. , ROWLANDS Shelley , GILES Michelle 
Published: August 2006

AbstractFew changes have occurred in the management of tuberculosis over the past two decades and many of the recent developments are in the area of diagnostics. The application of these to the pregnant population is not yet established. Two cases recently managed at the Royal Women's Hospital, Melbourne highlight the need for clinicians managing pregnant women to rethink this condition and, with changes in migration and epidemiology, reconsider our screening practice.
The Role of Ethnicity and Language in Contingent Valuation Analysis
Authors: Loomis John , Ellingson Lindsey , Gonzalez‐Caban Armando , Seidl Andy 
Published: August 2006

Abstract.  In order to satisfy legal requirements, many federal agencies must assess the potential effects of their policies on the public. This is often done through surveys, but frequently those surveys are only administered in English. This paper tests whether there are differences in survey response rates, refusals to pay, and willingness to pay (WTP) across different ethnicities and language for forest fire reduction in the State of California. The ethnicities studied were Caucasian, African American, and Hispanic (half in Spanish, half in English).There was a statistical difference in survey response rates across all ethnicities, and no statistical difference among ethnicities for reasons of refusing to pay. The influence of ethnicity and language was tested using a logit model with ethnicity intercepts and bid slope interaction terms. The Hispanic‐Spanish intercept shifter and the Hispanic‐English dollar bid amount interaction terms were statistically significant and positive. There was a significant difference in the logit willingness to pay coefficients between Hispanics surveyed in Spanish with each of the other ethnicities. The annual willingness to pay of Hispanics taking the survey in Spanish was twice that of Caucasians, but no statistical difference in mean and median WTP between these two groups was found, due to large confidence intervals around each estimate. Nonetheless, the WTP of both Hispanics and Caucasians for the forest thinning program is substantial, and statistically different from zero, suggesting there may be broad support for this program in California.
Stem cell apoptosis in HIV‐1 alopecia
Authors: Barcaui Carlos Baptista , Gonçalves da Silva Ana Maria , Sotto Mírian N. , Genser Bernd 
Published: August 2006

Background:  Diffuse alopecia occurs in almost 7% of HIV‐1‐infected patients. Telogen effluvium is the main pathogenic mechanism involved. Apoptotic keratinocytes in the outer root sheath at bulge level was described as the most characteristic histopathologic finding of this kind of hair loss.Methods:  A case–control study was conducted to investigate the occurrence of apoptosis of follicular stem cells at the bulge in diffuse alopecia of HIV‐1 infection. We applied a double‐staining procedure to transverse scalp sections from 15 HIV‐1‐infected patients and 12 controls, with the monoclonal antibody anticytokeratin 19 as stem cell marker and TUNEL technique to identify apoptosis.Results:  Eighty percent of cases and 25% of controls presented at least one double‐stained follicle. The proportion of positive follicles per section was 48% (±7%) for cases and 26% (±13%) for controls.Conclusion:  Our study demonstrated that diffuse alopecia related to HIV‐1 infection represents a hair cycle disturbance and that part of the follicular stem cell population become apoptotic in a higher proportion than normal subjects. We found no cytotoxic folliculitis. Owing to its cell‐cycle interaction and caspase‐induction capacities, we propose HIV‐1 viral protein R as a possible follicular stem cell apoptosis inductor.
Immunoreactivity of CD99 in invasive malignant melanoma
Authors: Wilkerson Anne E. , Glasgow Meriden A. , Hiatt Kim M. 
Published: August 2006

Background:  CD99, also known as p30/32, is a glycoprotein product of the MIC2 gene. It was originally utilized in immunohistochemistry as a unique marker for Ewing sarcoma, other primitive neuroectodermal tumors, and subsequently in other tumors. Its expression in malignant melanoma (MM) has not been well documented, with just two isolated cases of MM recently reported. Recent studies have documented CD99 expression in a significant percentage of atypical fibroxanthomas (AFX), posing potential diagnostic problems in differentiating these two entities. As mistaking MM for AFX based on immunohistochemical staining pattern has significant consequences, we sought to determine the percentage of invasive MM in our archives that have this staining pattern.Methods:  Seventy‐eight cases of invasive melanoma were retrieved from our files. Each case was stained with mouse anti‐human CD99 and evaluated for membranous expression.Results:  Our evaluation revealed that 47 of 78 MM cases (60%) stain positive for CD99.Conclusion:  This study is the first to demonstrate, in a large series, the prevalence of CD99 expression in primary cutaneous melanoma. Additionally, this introduces in the histologic differential diagnosis of CD99 expressing dermal spindle cell lesions.
Type I interferon‐associated cytotoxic inflammation in lichen planus
Authors: Wenzel Joerg , Scheler Marina , Proelss Julia , Bieber Thomas , Tüting Thomas 
Published: August 2006

Introduction:  Lichen planus (LP) is an inflammatory autoimmune skin disease of unknown origin. Evidence has accumulated that autoreactive cytotoxic CD8+ T lymphocytes cause destruction of keratinocytes. Recent studies suggested that type I interferons (IFNs) play a central role in cytotoxic skin inflammation by increasing the expression of IP10/CXCR10 and recruiting effector cells via CXCR3. Here, we investigated whether type I IFNs are also involved in the pathogenesis of LP.Patients and methods:  Skin biopsies of altogether 17 donors (seven LP and 10 healthy controls) were analyzed by immunohistochemistry using monoclonal antibodies against CD3, CD4, CD8, CD20, CD68, CXCR3, granzyme B, IP10/CXCL10, CD123, and the MxA protein, which is specifically induced by type I IFNs.Results:  Our analysis revealed a significant expression of the MxA protein in all LP skin biopsies, indicating involvement of type I IFNs. Expression of MxA was closely associated with the recruitment of CXCR3+ and granzyme B+ lymphocytes, indicating a Th1‐biased cytotoxic immune response. Strong expression of the CXCR3 ligand, the interferon‐inducible protein IP10/CXCL10, links type I IFN expression and recruitment of CXCR3+ lymphocytes. Plasmacytoid dendritic cells (pDCs) appear to be a major source of type I IFNs in LP.Discussion:  Our observations support the hypothesis that lesional type I IFNs produced by pDCs plays an important role in chronic cytotoxic inflammation of LP by recruiting cytotoxic effector lymphocytes via IP10/CXCR3 interactions.