bluuebunny/crossref_metadata_2025_split huggingface dataset:
Microalbuminuria following gestational diabetes
Authors: Friedman Shmuel , Rabinerson David , Bar Jacob , Erman Arie , Hod Moshe , Kaplan Boris , Boner Geoffrey , Ovadia Jardena 
Published: November 2007

Background. Microalbuminuria (MA) precedes clinical nephropathy in patients with insulin‐dependent diabetes mellitus, and is associated with an increased mortality, mostly due to cardiovascular disease in patients with non‐insulin‐dependent diabetes mellitus. Microalbuminuria is rarely detected in patients with diabetes of less than five years' duration. Our study was designed to determine whether MA and its sequelae also appear 5‐8 years after pregnancy complicated by gestational diabetes mellitus (GDM).Methods. We examined the presence of MA in 72 women who had not conceived since a previous GDM‐pregnancy 5‐8 years ago and compared them to a control group of 35 women who had no GDM history, and who were matched for age, parity and time since last pregnancy. Microalbuminuria was determined in all subjects using an overnight 8 hours urine collection. Mann‐Whitney rank‐sum test was used to compare data between the study and the control groups. Student's (test was used to compare data within the study group.Results. Median value of the urinary albumin excretion rate (AER) in the study group was significantly higher than median value of urinary AER of the control group (p<0.0001), but only 30.5% of the subjects of the study group were found to be microalbuminuria‐positive, defined as urinary AER value of more than 21 mg/24 h. No correlation between MA and blood pressure, fasting blood glucose, serum creatinine, blood urea nitrogen and parity was found.Conclusions. MA was found to be more frequent after GDM and no predisposing factors for its appearance were elucidated. Hence, we suggest that it may well be a sign of early renal disease and that long‐term follow‐up of all GDM patients for MA and other markers of renal disease is strongly indicated.
A quality of life perspective on who benefits from estradiol replacement therapy
Authors: Karlberg Johan , Mattsson Lars‐ÅKe , Wiklund Ingela 
Published: November 2007

Study objective. To examine who may benefit from estrogen replacement therapy from a quality of life (QoL) perspective, taking both disease‐specific and general aspects at baseline into account.Design. A double‐blind multi‐center randomized placebo‐controlled prospective study. The subjects were randomized to receive either transdermal estradiol or placebo for 12 weeks. QoL measures were disease‐specific and generic.Locution. University hospital, teaching hospital and private practice.Material. Post‐menopausal volunteering Swedish women (n=223) with mild to severe climacteric symptoms, as clinically evaluated by the Kupperman's Index.Results. All QoL assessments showed highly significant improvement in the estradiol group in comparison with the placebo group. The women receiving placebo treatment also improved. but their improvement reached a peak at six weeks of treatment and then declined. In the estradiol group the improvement continued throughout the 12 weeks. After 12 weeks of treatment the change in the placebo‐treated group was smaller on the disease‐specific scales than on the generic scales and the Kupperman's Index. A high correlation was seen between the baseline score for a certain QoL assessment and the change in this score during treatment. The most striking result was that the mean change in QoL for the two groups was statistically significant for almost any pre‐treatment QoL status.Conclusions. Women with slightly, moderately or severely diminished QoL status would benefit from estrogen treatment during the climacteric period. A similar tendency was seen in women with mild symptoms at baseline.
Computerized colposcopy and conservative management of cervical intraepithelial neoplasia in pregnancy
Authors: Mikhail Magdy S. , Anyaegbunam Akolisa , Romney Seymour L. 
Published: November 2007

Background. Computerized colposcopy is the noninvasive digital processing of colposcopic images acquired using a charge‐coupled device camera. The purpose of this study was to evaluate the clinical applications of computerized colposcopy, and to record the colposcopic changes associated with progression or regression of cervical intraepithelial neoplasia in pregnancy.Methods. Forty‐one pregnant patients, with abnormal Papanicolaou smears and a fully visualized squamo‐columnar junction, were serially monitored throughout their pregnancies using computerized colposcopy. All patients had baseline computer‐assisted measurements of their cervical lesions and a repeat measurement at monthly intervals and at 3‐months postpartum. Results. During the period of gestation, 17.1% of lesions increased in size, 21.9% remained unchanged, 41.5% decreased in size and 19.5% disappeared completely. In patients with an increase in lesion size, a colposcopically directed punch biopsy was performed which revealed CIN III but no microinvasion. Cervical biopsy during pregnancy was unnecessary in 82.9% of cases.Conclusion. The ability to sequentially monitor and quantify colposcopically visualized lesions, using computerized colposcopy, provides a noninvasive objective mode to evaluate progression, stability, or regression of CIN lesions during pregnancy.
Perturbed (procoagulant) endothelium and deviations within the fibrinolytic system during the third trimester of normal pregnancy
Authors: Sørensen Jannie Dalby , Secher Niels Jørgen , Jespersen Jørgen 
Published: November 2007

Purpose. To evaluate the endothelial cell state and the possible relation to placental function in the third trimester of normal pregnancy by an indirect assessment of endothelial cell function.Study‐design. Twenty‐six pregnant women entered the study in the 30th week of pregnancy. Von Willebrand Factor, urate and key hemostatic variables were quantified at entry, and during the 33rd and 37th weeks of pregnancy.Results. Levels of von Willebrand Factor, PAI‐1 antigen, t‐PA antigen; variables produced by the endothelial cell, increased during the third trimester of pregnancy. Serum urate, which is correlated with clinical outcome of pregnancy, increased during the study period and correlated directly with von Willebrand Factor and PAI‐1 antigen, respectively. There was an inverse correlation between the concentrations of placenta‐derived PAI‐2 antigen and urate.Conclusions. In healthy human pregnancy the markers of endothelial related processes of coagulation and fibrinolysis pointed towards a procoagulatory state of the endothelial cell. However, the balance between fibrin formation and resolution seemed to be maintained in uncomplicated pregnancy. Our study indicated an association between this change of endothelial cell function and placental function.
Transvaginal sonography in the management of ectopic pregnancy
Authors: Sadek Abdel Latif , Schiøtz Hjalmar A. 
Published: November 2007

During a 3‐year period, 525 women referred to our department with abdominal pain and/or vaginal bleeding in the first trimester of pregnancy were evaluated by transvaginal sonography. Ectopic pregnancy was suspected and laparoscopy done when sonography showed an empty uterus or pseudosac together with free pelvic fluid and/or a tubal mass. Fifty‐seven patients fulfilled these criteriae. Among these patients, sonography showed an empty uterus in 48. pseudosac in five, a non‐diagnostic intrauterine echo in four, a tubal mass in 45 and free pelvic fluid in 54.Laparoscopy confirmed ectopic pregnancy in 53 patients (93.0%). There were only five tubal ruptures. Pelvic blood was found in all of the 54 patients with free fluid on sonography; i.e. in 51 of 53 patients with ectopic pregnancy and in three with miscarriage. Forty‐nine patients with ectopic pregnancy were managed by laparoscopy and four by laparotomy. All were hemodynamically stable. The diagnostic sensitivity and specificity of vaginal sonography for ectopic pregnancy was 96.2% and 99.4%, respectively, for the finding of free pelvic fluid, and 81.1%. and 99.6% for a tubal mass. All patients with ectopic pregnancy were correctly selected for laparoscopic management. Transvaginal sonography is a valuable tool in the early diagnosis of ectopic pregnancy.
In vitro production of cyclic AMP and steroids from an ovarian Sertoli‐Leydig cell tumor
Authors: Abrahamsson Gun , Dahlgren Eva , Hahlin Mats , Knutson Folke , Norström Anders , Janson Per Olof 
Published: November 2007

A 27 year old nulliparous woman with a history of chronic anovulation and signs of virilization with a markedly elevated serum level of testosterone, underwent a laparotomy with peroperative bilateral ovarian vein catheterization and bilateral bisection of both ovaries. A solid, 1.5 cm, well delimited tumor located centrally in the right ovary, was excised. Testosterone levels in ovarian venous blood from the tumor bearing side, were 88.4 nmol/1 and from the contralateral ovary 3.9 nmol/1. Histopathological examination showed a Sertoli‐Leydig cell tumor which was radically extirpated. Postoperatively, the serum levels of androgen normalized, the woman had regular cycles, became pregnant and delivered a normal female baby. Pieces of tumor tissue were incubated for 2 h, with and without addition of gonadotropins and adrenocorticotropic hormone (ACTH). Human chorionic gonadotropin (CG), follicle stimulating hormone (FSH) and adrenocorticotropic hormone (ACTH) caused significant increases in cyclic monophosphate (cAMP) production in tumor tissue in vitro, as compared to controls. Furthermore, ACTH also significantly stimulated 17β‐estradiol production. In tumor cells cultured for 48 h, FSH slightly, but not significantly, increased the production of progesterone.In the cell culture, [3H]‐thymidine incorporation into deoxyribonucleic acid (DNA) was stimulated by IGF1α but not by hCG and FSH.It is concluded that Sertoli‐Leydig cell tumors may be sensitive to gonadotropins and ACTH and that their small size, solid shape and intra‐ovarian localization can cause diagnostic difficulties.
Estrogen and progestagen modify the hemodynamic response to mental stress in young women
Authors: Manhem Karin , Hansson Lennart , Milsom Ian , Pilhall Martin , Jern Sverker 
Published: November 2007

Objective. To evaluate separately the effects of estrogen and progestagen on the cardiovascular response to a standardized mental stress test.Methods. Seven women were studied during the early follicular phase (day 1‐4) of three different menstrual cycles after randomized oral administration of either 6 mg estradiol valerate or 15 mg norethisterone acetate or placebo. Heart rate and blood pressure were recorded at rest for 2 hours after administration and throughout the stress test. Forearm plethysmography was recorded at rest and during stress.Results. Estrogen had no effect on heart rate or blood pressure at rest. After estrogen administration the increases in heart rate (Δ14 bpm/10 bpm; p<0.01) and diastolic blood pressure (Δ14 mmHg/9 mmHg: p≥0.06) from baseline to stress were augmented compared to those observed after placebo administration. Heart rate, systolic and diastolic blood pressures reached higher levels during stress after estrogen administration compared to placebo (Δ5 bpm, and Δ7 mmHg and A5 mmHg respectively; p<0.05). Estrogen administration also caused a prolongation of the diastolic blood pressure response to stress. Progestagen compared to placebo induced an increase in heart rate already at rest (Δ4 bpm; p<0.01), and heart rate was maintained on a higher level throughout the stress test (p<0.05). Blood pressure at rest and pressor responses to stress were not significantly changed after progestagen administration.Conclusions. The results indicate that estrogen is responsible for the enhanced cardiovascular responses to stress, whereas progestagen provokes a parallel upward shift of basal heart rate which is independent of level of activation.
Quantitative and functional assessment of anti‐RhD: a comparative study of non‐invasive methods in antenatal prediction of Rh hemolytic disease
Authors: Filbey Derek , Garner Stephen F. , Hadley Andrew G. , Shepard Sarah L. 
Published: November 2007

Study objective. To investigate if the prediction of hemolytic disease of the newborn (HDN) in infants of RhD immunized women has been improved by introduction of AutoAnalyzer quantitation and may be further improved by the use of a functional assay.Methods. Manual antibody titration. AutoAnalyzer quantitation and chemiluminescence test (CUT) were compared by testing 42 sera from 38 RhD immunized mothers. The sera were also screened for the presence of monocyte‐reactivc antibodies which have the potential to protect the unborn.Results. Among the 42 infants there were 19 unaffected by HDN and 23 affected by HDN. Manual titration correctly predicted the occurrence of HDN in 29/42 (69%), AutoAnalyzer was correct in 28 42 (67%) and CLT showed correct predictions with 30/42 (71%). In babies born without signs of HDN. maternal monocyte‐reactive antibodies were found in 13/18 cases. The majority (9/13) were HLA class I‐specific, the remaining four antibodies were either HLA class II or monocyte‐specific. In affected HDN group, 8/16 monocyte‐reactive antibodies were HLA class II or monocyte‐specific.Conclusions. AutoAnalyzer and CLT improve the ability to discriminate unaffected babies from those affected by RhD HDN, when compared to manual titration. A protocol for the laboratory management of RhD immunized women is proposed that includes these tests to further improve the prediction of HDN. This study has also highlighted the need for more investigations into the protective role of monocyte‐reactive antibodies in HDN.
Central and peripheral hemodynamics in severe preeclampsia
Authors: Yang Jenn‐Ming , Yang Yuh‐Cheng , Wang Kuo‐Gon 
Published: November 2007

Background. Doppler velocimetry, a new tool for measuring blood flow, vascular resistance, and central hemodynamics can be applied to monitor those patients at risk and provide therapeutic concepts for preeclampsia. This study was designed to use a Doppler velocimetry stud to correlate the relationship between central hemodynamics, uteroplacental circulation, and the perinatal outcome in severe preeclampsia.Methods. Thirty‐one patients with severe preeclampsia, not superimposed with any medical disorder and not on antihypertensive treatment prior to admission, were enrolled in this study. On admission, laboratory determination of the maternal blood chemistry and hematogram. together with a Doppler ultrasound study of the maternal hemodynamics, and umbilical and uterine arteries, were performed. Antihypertensive agents including hydralazine, atenolol, and labetolol were given according to the state of the maternal central hemodynamics. Data were collected on the general status of the patients, the results of the Doppler ultrasound study, and the perinatal outcome.Results. Patients were divided into three groups based on the systemic vascular resistance. The left ventricular function and cardiac index declined with increase in vascular resistance. The high‐resistance group had a significantly high incidence of infants small for gestational age. Poor fetal growth in the high‐resistance group could be attributed to the summation of underperfusion due to decreased uteroplacental blood flow and was frequently associated with maternal hemoconcentration.Conclusions. Although global vasospasm has been considered to be the basic pathophysiology of preeclampsia, the central hemodynamics varies between, and even in the same, patients. Regional vasospasm in the uteroplacental circulation occurs earlier than in the systemic circulation as a whole. A high cardiac‐output in low systemic‐vascular‐resistance might compensate in those pregnancies with high uterine artery resistance to maintain adequate uteroplacental perfusion.
Pregnancy outcome after laser surgery for cervical intraepithelial neoplasia
Authors: Forsmo Siri , Hansen Marit H. , Jacobsen Bjarne K. , Øian Pal 
Published: November 2007

Background. Little is published about obstetrical problems after treatment of cervical intraepithelial neoplasia with the CO2‐laser. The aim of this study was to determine the risk of low birth weight in the subsequent pregnancy after laser conization or vaporization in a follow‐up study of women treated for cervical intraepithelial neoplasia (CIN).Methods. Of 319 women treated for CIN with the CO2‐laser in the Department of Obstetrics and Gynecology, University Hospital of Tromsø, Norway and followed for pregnancy outcome, 87 women had given birth (after 24th week) four to nine years after treatment. Sixty‐five women had undergone conization and 22 women had been treated with vaporization. For each delivery, two controls matched for parity, age (±3 years) and place of delivery were identified. The material was analyzed as a matched cohort study.Results. A strong relationship was found between conization and low birth weight. Mean birth weight after conization was 3185 g vs 3473 g in the control women (p=0.03). Thirteen (20%) infants from women subject to conization had birth weight less than 2500 g. Relative risk of birth weight<2500 g was 2.2 (1.04‐4.5) after conization, for<2000 g and<1500 g the risk was 3.5 (1.02‐12.0) and 10.0 (1.2‐85.6), respectively. Four women (6.2%) with normal deliveries prior to conization experienced one or several stillbirths after treatment. No difference in birth weight was observed for women after vaporization compared to their controls. Conclusion. Excisional surgery on the cervix increases the risk for low birth weight in subsequent pregnancies. Pregnant women with prior conization need careful antenatal care.
Oral contraceptives and risk of breast cancer
Authors: Tómasson Helgi , Tómasson Kristinn 
Published: November 2007

Background. The goal of this study is to quantify the risk of breast cancer related to use of oral contraceptives while adjusting for known risk factors, e.g. age at first delivery, number of children, and family history, as well as minimising memory bias.Methods. A historical prospective study design was used. Data collected over a period of 25 years in the screening program of a cancer detection clinic for women aged 25‐69 years were utilised. Information on breast cancer among those attending the screening program was searched for in the national cancer registry. Women with breast cancer were matched on date of birth with on average 5.3 control women who were still alive when the diagnosis was made. Mothers and sisters of cases and controls were identified through a national genealogy registry.Results. The odds ratio of developing breast cancer among women with a first degree relative with breast cancer was about 2, but for those ever using oral contraceptives it was 0.92 and even lower (0.50‐0.75) if the cancer was diagnosed before the age of 45 years.Conclusions. Use of oral contraceptives (OC) does not seem to increase the risk of developing breast cancer among women in Iceland.
Controversies in Assessment of Ovarian Tumors with Transvaginal Color Doppler Ultrasound
Authors: Tekay Aydin , Jouppila Pentti 
Published: November 2007

Background. The observations made in the late 1980s indicated that the transvaginal color Doppler ultrasound can be used in the detection of ovarian cancer. This has generated a stream of clinical trials. The conflicting results of numerous publications, however, have led to a major controversy. The aim of this communication is to review the literature and our own observations in order to provide more insight into the subject.Results. The performance characteristics of the 32 previous transvaginal color Doppler ultrasound studies showed a considerable heterogeneity: the sensitivity was 25%‐100%, the specificity was 46%‐100%. the positive predictive value was 28.6%‐100% and the negative predictive value was 63%‐100%. The accuracy varied between 57% and 100%. An indisputable overlap was found between the ranges of pulsatility index (PI) and resistance index (RI) values from the benign and malignant adnexal tumors. The RI was <0.40 in 43% of benign tumors and in 25% of the normal vascular ovaries.Conclusion. The current cut‐off levels for PI or RI values should not be used in clinical decision making due to their poor specificity.
Endometrial Destruction by Hyperthermia — a Possible Treatment of Menorrhagia
Authors: Friberg Brut , Persson Bertil R. R. , Willén Roger , Ahlgren Mats 
Published: November 2007

Background. Treatment of menorrhagia by heat‐destruction of the endometrium, intended to be an alternative to hysterectomy, was investigated in an experimental study. Method. A specially designed catheter (Cavatermtm) with a silicone balloon containing a self‐regulating heating element is inserted into the uterus, filled with glycine to a pressure of around 180 mmHg and heated to about 75°C. We investigated the treatment effect in vitro in five extirpated uteri (series A) and in vivo in three patients treated peroperatively just before hysterectomy, temperatures being monitored in the surrounding tissues (series B). In both series we monitored the following variables: heating‐power, balloon‐pressure, temperature of the heating element (around 85d`gC) and the temperatures at five locations from top to bottom of the balloon surface.Results. After 30 min in vitro treatment at 75°C, the endometrium was partly destructed, and condensed. Histological examination showed smooth muscle cells to be destroyed to a depth of 2‐5 mm close to the endometrium.With in vivo treatment for 30 min at a heating power of about 20 W (resulting in balloon surface temperatures of 58‐65°C). the increases in temperature of the surrounding tissue were too small to measure accurately (±1°C). Histological examination showed destruction of cells in the corpus uteri to a maximum depth of 8 mm.Conclusion. Findings in in vitro and in vivo experiments suggest that 30 min heating of the endometrium to 58‐65°C with an intrauterine silicone balloon filled with a liquid to a pressure of 180 mmHg exerts therapeutic effects on both endometrium and uterine cavity smooth muscle cells without damage to surrounding tissues.
The hazards of reproduction in space
Authors: Sullivan Richard 
Published: November 2007

NASA Medical Standards for space Might (JSC 11570) specifically disqualify any flight crew member who is pregnant. A variety of factors led to this recommendation including the effects of radiation exposure on fetal development. Additionally, other concerns such as toxic chemical exposure, microgravity. pregnancy accidents, plus alterations in breathing gas mixtures and decompression preclude pregnant flight crew members from missions in the forseeable future.The future of space travel will require reproduction beyond the confines of earth's environment. This makes it all the more necessary to identify the potential hazards associated with reproduction m space.