bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hysteroscopic surgery in postmenopausal women
Authors: Cravello Ludovic , de Montgolfier RÉMy , D'ercole Claude , Boubli LÉOn , Blanc Bernard 
Published: November 2007

Objective. To assess the efficacy of hysteroscopic surgery in postmenopausal women presenting with abnormal uterine bleeding.Design. A retrospective audit of 102 patients.Setting. The Department of Obstetrics and Gynecology B, La Conception Hospital, Marseilles, France.Patients. One hundred and two women between the ages of 47‐67 years with postmenopausal bleeding or bleeding related to hormone replacement therapy were evaluated by pelvic ultrasound and diagnostic hysteroscopy. A benign organic cause was noted in 87 cases (polyps in 51 and fibroids in 36). Fifteen patients had no significant disease.Interventions. Resection of polyps or fibroids, endometrial ablation.Results. One hundred and seven procedures were performed on 102 patients. Major operative complications were rare and included one perforation and one case of glycine toxicity. Eighty‐eight patients were satisfied with the results. Six patients were subsequently treated by hysterectomy. Six patients complained of recurrent abnormal bleeding.Conclusions. This modality of treatment appears to be effective over the long term. The operative criteria should take the causes of bleeding and not just the age of the patient into account.
Maternal risk factors for retinopathy of prematurity – a population‐based study
Authors: Holmström Gerd , Thomassen Peter , Broberger Ulf 
Published: November 2007

Background. The aim of the study was to investigate maternal risk factors for retinopathy of prematurity (ROP) and also to describe risk factors for prematurity per se in our population. Design. A retrospective, population‐based study.Material and methods. The study group included the mothers (identified with the help of a National Birth Register) of 202 single‐born preterm infants with a birth weight of 1500 grams or less, from a previous population‐based study. From the same register we also received information on 307 mothers of full term pregnancies for description of risk factors for preterm birth. Data from antenatal clinics, labor rooms and neonatal units were studied.Results. Univariate analysis of maternal risk factors for ROP revealed a few positive findings. In a further logistic multiple regression analysis, apart from gestational age at birth and birth weight, only essential hypertension prior to pregnancy was a predicting risk factor (odds/ ratio 8.36, 95% confidence interval 1.62‐43.0).Conclusions. Prematurity per se remains the strongest risk factor for ROP.
A prospective study of high‐ versus low‐dose oxytocin for induction of labor
Authors: Hourvitz Ariel , Alcalay Menachem , Korach Jacob , Barkai Gad , Seidman Daniel S. 
Published: November 2007

Background. To assess the efficacy and safety of a high‐dosage oxytocin induction regimen.Methods. A randomized prospective study of 179 patients who received an initial dose of either 2.5 (n=98) or 1.25 (n=81) mU/minute of oxytocin, with increments of 2.5 mU/minute or 1.25 at 30‐minute intervals.Results. Failure rates (15.3% versus 19.8%), time to delivery, the number of assisted vaginal deliveries, cesarean sections, and maternal and fetal complications were not significantly different in the two protocols. However, the use of a high oxytocin dose resulted in significantly higher mean peak doses and increased total cumulative amounts. These were associated with a significant need to modify the oxytocin infusion protocol for hyperstimulation and fetal heart rate changes (65.1% versus 46.2%).Conclusions. Induction with higher dose oxytocin increments did not shorten time to delivery, but was associated with an increase in uterine hyperstimulation. Low‐dose oxytocin was found to be appropriate and safe for labor induction.
Warm tub bath during labor. A study of 1385 women with prelabor rupture of the membranes after 34 weeks of gestation
Authors: Eriksson Margareta , Ladfors Lars , Mattsson Lars‐Åke , Fall Ole 
Published: November 2007

Background. To evaluate the influence of a bath on infectious morbidity in mothers and neonates in women with prelabor rupture of the membranes after 34 weeks of gestation.Methods. A nonrandomized study of 1385 healthy women. During the first stage of labor 538 women wanted a bath while 847 did not. The women awaited spontaneous contractions up to 24 or 72 hours after the membranes had ruptured before labor was induced with oxytocin. Digital examinations of the cervix were avoided until onset of active labor or until the time induction was planned. For statistical analysis Fisher's exact test was used.Results. Chorioamnionitis during labor occured in 1.1% of the women in the bath group and in 0.2% in the reference group (p=0.06). Postpartum endometritis was found in three cases both in the bath group (0.6%) and in the reference group (0.4%) (p=0.68). The frequency of neonates receiving antibiotics was 3.7% and 4.8% respectively (p=0.43).Conclusion. A tub bath did not increase the risk of maternal or neonatal infection after premature rupture of the membranes and prolonged latency.
Treatment of severe ovarian hyperstimulation syndrome by a conservative medical approach
Authors: Balasch Juan , Fábregues Francisco , Arroyo Vicente , Jiménez Wladimiro , Creus Montserrat , Vanrell Juan A. 
Published: November 2007

Objective. To assess the value of a conservative medical therapeutic approach in the management of severe ovarian hyperstimulation syndrome (OHSS).Design. Prospective longitudinal study.Setting. Assisted Reproduction Unit of the Hospital Clinic i Provincial de Barcelona, a tertiary care setting.Patients. Twenty‐five women with ascites because of OHSS.Interventions. Patients were treated by strict bed rest, low‐sodium diet (60 mEq/day), plasma volume expansion with albumin (50 g/day of salt‐poor albumin) and diuretics (20 mg of furosemide given intravenously every 8‐12 hours).Main outcome measures. Measurement at admission and 48 hours after commencement of treatment of the following: body weight, mean arterial pressure, heart rate, hematocrit, hemoglobin concentration, leukocyte and platelet counts, urine volume, sodium excretion, serum sodium, serum creatinine, plasma renin activity, and plasma aldosterone, norepinephrine, antidiuretic hormone, and atrial natriuretic peptide concentrations.Results. After 2 days of therapy there was marked improvement in clinical symptoms, standard laboratory parameters, diuresis and urinary sodium excretion in all patients. There was also a significant decrease in the plasma levels of volume‐dependent endogenous vasoactive substances in the five patients in whom these measurements were repeated during treatment. The length of treatment with albumin plus furosemide ranged between 2 and 6 days with an average of 3.3 and it correlated directly with the severity of the syndrome. The hospital stay ranged from 4 to 10 days (mean 6.5 days). All patients recovered without any complication.Conclusions. Severe ovarian hyperstimulation syndrome can be managed using the proposed conservative medical approach.
Potentiating effect of hydrogen peroxide on the serotonin‐induced vasocontraction in human umbilical artery
Authors: Watanabe Kazushi , Okatani Yuji , Sagara Yusuke 
Published: November 2007

Background. Our objective was to investigate the role of hydrogen peroxide in the vasocontraction induced in the human umbilical artery by serotonin.Methods. Umbilical arteries collected from healthy women at term were cut helically and suspended in an organ bath to record isometric mechanical activity. In Study I, we measured the concentration‐contraction response to serotonin with or without pretreatment with hydrogen peroxide (0.01 ˜ 10 μM). In Study 2, vessels were pre‐incubated with L‐arginine (0.1 ˜ 10 mM), or with hydrogen peroxide (10 mM) and L‐arginine (1 mM), then serotonin was added cumulatively. In Study 3, vessels were suspended in a calciuim‐free solution containing potassium chloride 20 mM, and a cumulative concentration‐response curve to calcium chloride (10−5˜ 10−3 M) was constructed for vessels pretreated with hydrogen peroxide (10 μM). In Study 4, vessels were pre‐treated with M1, an inhibitor of 5‐HT2 serotoninergic receptors, and hydrogen peroxide (10 μM), and then prostaglandin F2α (9.0±10−7 M). Finally, we measured the 5‐HT1 receptor‐mediated relaxation induced by serotonin.Results. Hydrogen peroxide (1 or 10 μM) significantly potentiated the contractile response to serotonin (p<0.04, p<0.005). L‐arginine (1 or 10 mM) significantly reduced the contractile response to serotonin (p<0.02, p<0.0002). Pretreatment with L‐arginine significantly suppressed the potentiating effect of hydrogen peroxide on the serotonin‐induced contraction. The sensitivity of the arteries to calcium chloride in the presence of hydrogen peroxide did not differ from that in the control group. Pretreatment with hydrogen peroxide significantly reduced the 5‐HT, serotoninergic receptor‐mediated relaxation at higher concentrations of serotonin (1.23±10−4 M, 2.47±10−4 M, 2.47±10−4 M).Conclusion. Hydrogen peroxide potentiated the umbilical artery contraction induced by serotonin. This action may be mediated by suppression of endogenous nitric oxide activity.
Potentially avoidable perinatal deaths in Denmark and Sweden 1991
Authors: Langhoff‐roos Jens , Borch‐christensen Hanne , Larsen Steen , Lindberg Bo , Wennergren Margaretha 
Published: November 2007

Background. Since 1950 the perinatal mortality has been significantly higher in Denmark than in Sweden. In 1991 the rate in Denmark was 8.0/1000 deliveries compared to 6.5/1000 in Sweden. An international audit was designed to investigate whether the perinatal death rates in the two countries to some extent could reflect differences in the quality of care, indicated by the numbers of perinatal deaths in categories of potentially avoidable deaths.Material and methods. Medical records of 97% of all perinatal deaths in 1991 in the two countries were analyzed. A new classification focusing on potential avoidability from a health services perspective was elaborated at a Nordic‐Baltic workshop, using the variables: time of death in relation to admission and delivery, fetal malformation, gestational age, growth‐retardation and Apgar score at 5 min.Results. Rates of perinatal deaths of malformed infants (0.00195 and 0.00145) and intrapartum deaths of non‐malformed infants (0.00042 and 0.00019) was significantly higher in Denmark than in Sweden.Conclusion. Application of the Nordic‐Baltic Perinatal Death Classification on perinatal deaths in Denmark and Sweden in 1991 raises the questions as to why the rate of perinatal death of malformed infants is higher in Denmark than in Sweden and whether intrapartum care in Denmark could be improved.
Reproductive characteristics of a population of urban Swiss women
Authors: Morabia Alfredo , Khatchatrian Naira , Bernstein Martine , Walker Dilys M. , Campana Aldo 
Published: November 2007

Objective. To describe the variability of reproductive life, from menarche to menopause, in the Geneva female population.Design. Women's Health Survey, 1992‐1993.Setting. Mobile epidemiology unit of a University Hospital.Subjects. One thousand and thirty‐two women aged 30 to 74 years, resident in Geneva, Switzerland.Main outcome measure. Menstrual and reproductive history.Results. A ‘typical’ woman of Geneva has her menarche at 13 years, regular 28 day cycles with 5 days of menstrual flow. She is 26 years old when she first gives birth and has her last baby (which is typically the second) at age 31. She has 37 years of potential fecundity and a natural menopause at age 50. In addition, 11% of the women have tried to be pregnant during two years without success, 67% have ever used oral contraceptives, 20% had a first birth at age 30 or more and 23% were nulliparous. Younger women reported earlier ages at menarche. Women with lower education tended to be a younger age at the birth of her first child.Conclusions. In this first study of the reproductive characteristics of women in Geneva, nulliparity and a late first birth appeared unusually frequent, especially when compared with American or Chinese women. The observed distributions of reproductive history are compatible with the very high incidence rate of breast cancer in the Geneva population.
Immunohistochemical assessment of steroid hormone receptors in tissues of the anal canal
Authors: Franz Heiko B. G. , Wendler Diether , Oettling GÜNter 
Published: November 2007

Background. A prerequisite for a hormonal influence on anal continence in women is the presence of hormone receptors in the tissues of the anal canal. Using immunohistochemical techniques, we demonstrated and localized estrogen and progesterone receptors (ER, PR) in tissue sections of the anal canal.Methods. Thirty‐five specimens of the anorectal region from 21 patients (14 women, seven men) were examined histologically for smooth muscle (present in specimens from ten females and in seven males), striated muscle (present in three females and five males), and perimuscular connective tissue (present in 12 females and seven males). Immunostaining for ER and PR was then performed by incubating with primary anti‐ER and anti‐PR antibody and visualization of specific antibody binding by the ABC technique with DAB as chromogen.Results. Positive staining for ER and PR was seen exclusively over cell nuclei. Estrogen receptors were found in the smooth muscle cells of the internal sphincter of all females (10/10) and in four of the seven males. Staining for ER was detected in the perimuscular connective tissue of all females (12/12) and in four of the seven males. No specific staining for ER or PR was found in the nuclei of striated muscle cells of the external sphincter in males or females (n=8). In females, about 50% of the ER‐positive tissues were also found to be positive for PR. Amongst the male patients, only one exhibited staining for PR, and this was confined to the smooth muscle.Conclusions. Expression of ER is a constitutional feature of the connective tissue and smooth muscle cells of the anal continence organ. Estrogen receptors and PR are not detectable in the striated muscle fibers of the external anal sphincter in either sex. The presence of ER in the stroma and smooth muscles of the anal canal suggests that these tissues are targets for estrogen. This constitutes a theoretical basis for the beneficial effects of estrogen and progestin replacement on anal continence in postmenopausal women.
The number of follicles and ovarian volume in the assessment of response to clomiphene citrate treatment in polycystic ovarian syndrome
Authors: Fiçiciolu Gem , Api Murat , Özden Selçuk 
Published: November 2007

Objective. To evaluate whether the number of follicles and ovarian volume have any significance in evaluating the response to clomiphene citrate treatment in polycystic ovarian syndrome (PCOS).Design. A prospective study of 70 infertile women, 44 of which were diagnosed with polycystic ovarian syndrome.Main outcome measures. Follicle numbers and volumes in both ovaries, hormonal profile, response to Clomiphene Citrate(CC).Results. Ovarian volume was significantly greater in cases with polycystic ovarian syndrome than controls. However, ovarian volume in the Clomiphene Citrate nonresponders was significantly greater than in Clomiphene Citrate responders in the polycystic ovarian syndrome group. The number of small follicles was significantly higher in cases with polycystic ovarian syndrome than controls, and in the Clomiphene Citrate nonresponder group this number was also significantly higher than in Clomiphene Citrate responders. Endocrine features of patients with polycystic ovarian syndrome revealed that Dehydroepiandrostenedione sulfate, Androstenedione, follicle stimulating and luteninizing hormone do not discriminate between patients who respond to Clomiphene Citrate and those who do not respond. However, Testosterone and luteinizing hormone levels differ significantly in responders and nonresponders.Conclusions. Small multiple follicles (>9) and enlarged ovarian volume (>6.8 ml) were the most prominent transvaginal ultrasonographic features of ovaries in Clomiphene Citrate non‐responsive patients with polycystic ovarian syndrome. Higher levels of Testosterone, luteinizing hormone and significantly higher number of small follicles were associated with lack of Clomiphene Citrate response. These ultrasonographic features and laboratory assays could be clinically useful for distinguishing better the Clomiphene Citrate nonresponders from responders.
Recurrent first trimester spontaneous abortion associated with antiphospholipid antibodies:
Authors: Marzusch Klaus , Dietl Johannes , Klein Reinhild , Hornung Daniela , Neuer Andreas , Berg Peter A. 
Published: November 2007

Background. Antiphospholipid antibodies, unassociated with an underlying connective tissue disease, have repeatedly been detected in women suffering from recurrent spontaneous abortions. Several therapeutic regimens have been advocated for pregnant women with recurrent fetal loss and antiphospholipid antibodies. However, most of these approaches were empirical, using several drugs simultaneously, and most reports describe single cases or limited series.Patients and interventions. In a pilot study, thirty‐eight women with a history of three or more consecutive first trimester spontaneous abortions and antiphospholipid antibodies were treated with intravenous immunoglobulin. As soon as pregnancy had been confirmed, intravenous immunoglobulin was administered at a dose of 300 mg/kg bodyweight, and infusions were repeated at three‐weekly intervals until the 16th–17th week of pregnancy.Results. Pregnancy proceeded beyond the first trimester in 34 of the patients (89.4%), and 31 patients (81.4%) gave birth to healthy infants at 37 to 42 weeks' gestation.Conclusions. Although the results are promising, randomized placebo‐controlled trials are necessary to exclude the influence of other factors (e.g. intense obstetric supervision and psychological factors) on pregnancy outcome and confirm the effectiveness of intravenous immunoglobulin in patients with recurrent spontaneous abortions and antiphospholipid antibodies.
Morphological action of tamoxifen in the endometrium of persistent estrous rats
Authors: Patriarca Marisa Teresinha , Simotes Rosana Durães , Smaniotto Salete , de Teves Danilo Carreiro , Simães Manuel De Jesus , Evěncio‐neto Joaquim , De Freitas Vilmon , De Lima Geraldo Rodrigues 
Published: November 2007

Background. The aim of this study was to evaluate the action of tamoxifen on the endometrium in states of chronic anovulation.Methods. Thirty‐eight rats inducted to persistent estrous (testosterone propionate) confirmed by hormonal colpocytology were divided into a control and an experimental group; the latter received tamoxifen and had fragments of the uterine horns processed for morphological and morphometrical analysis. Data were analysed statistically by the Mann‐Whitney and Student's t tests.Results. Our findings revealed minor uterine weight, epithelial thickness; number of endometrial glands and low eosinophil counts in the group that received tamoxifen. These results were statistically significant. We often observed areas of metaplasic stratified squamous epithelium between cylindrical epithelial cells in both groups.Conclusions. Our results indicate that antiestrogenic effect of tamoxifen was only partial in persistent estrous, since there was no blocking against the squamous metaplasia of the endometrium.
Cost‐effectiveness of intracytoplasmic sperm injection in comparison with donor insemination
Authors: Granberg Maria , Wikland Matts , Hamberger Lars 
Published: November 2007

Background. Due to the need for cost containment in the national health services in many countries, there is a demand for analysis of both medical and cost benefits of new technologies. Intracytoplasmic sperm injection has in recent years been proved to be the method of choice for treating severe infertility. It also needs to be shown that intracytoplasmic sperm injection is a cost‐effective treatment.Aim and methods. The aim of this study was to evaluate the cost‐effectiveness of intracytoplasmic sperm injection over a two‐year period and to compare it with the cost‐effectiveness of donor insemination. The mean direct and indirect costs of the two modes of treatment were compared with the outcome of the subsequent pregnancies and the cost per delivery in the two groups were calculated.Results and conclusions. The cost analysis showed a direct and indirect cost per delivery after intracytoplasmic sperm injection of 264.300 SEK in 1993, decreasing to 174.900 SEK in 1994. The corresponding cost of donor insemination was 88.900 SEK during the two‐year period. The cost analysis showed a 34% increase in cost‐effectiveness of intracytoplasmic sperm injection from the first to the second year, an increase that will most probably continue. In the near future intracytoplasmic sperm injection will be a cost‐effective treatment and, in addition, intracytoplasmic sperm injection will have the advantage of resulting in genetic children in a majority of the treated couples suffering from severe male subfertility.
Tubal artery blood flow in evaluation of tubal pregnancy
Authors: Stefanovic Vedran , Cacciatore Bruno , Ylöstalo Pekka 
Published: November 2007

Objective. To evaluate whether the assessment of tubal blood flow can indicate the side of the tubal pregnancy.Methods. Using transvaginal color Doppler ultrasonography, we measured blood flow in the tubal arteries on both sides in 46 women with early ectopic pregnancy. We compared the resistance index (RI) and pulsatility index (PI) values of the tubal artery flow on the tubal pregnancy side to the contralateral side.Results. The Resistance index (RI) and Pulsatility index (PI) values were lower at the tubal pregnancy side in 70% and 61%, respectively, when compared with the contralateral side. However, in the mean values of RI and PI the difference between the sides was not statistically significant. During the follow up in cases with spontaneous resolution between‐side difference was often subjected to changes.Conclusion. Assessment of tubal blood flow by using transvaginal color Doppler sonography in the evaluation of the side of tubal pregnancy has limited clinical value.
Immunohistochemistry in the diagnosis of the gestational trophoblastic disease
Authors: Lösch Alexander , Kainz Christian 
Published: November 2007

Objective. The gestational trophoblastic disease summarizes all types of hydatidiform moles, placental site trophoblastic tumor and choriocarcinoma. It is of clinical relevance to distinguish between complete hydatidiform mole and partial hydatidiform mole to predict prognosis of re‐currency of molar pregnancy and the risk of the devolopment of malign and metastatic gestational trophoblastic disease. Differential diagnosis of choriocarcinoma versus placental site trophoblastic tumor, carcinoma or sarcoma with low differentiation can cause problems in borderline‐cases. The present study investigates the value of immunohistochemistry in the diagnosis of gestational trophoblastic disease.Method. Nine cases of patients with complete hydatidiform mole, 20 cases of partial hydatidiform mole and seven cases of choriocarcinoma were analyzed for the immunohistochemical reaction with antibodies against human choriogonadotropin (hCG), human placental lactogen (hPL), placental alkaline phosphatase (PLAP), cytokeratine and vimentin.Results. Complete hydatidiform mole shows strong expression of hCG and weak expression of PLAP. Weak hCG and strong PLAP expression is found in partial hydatidiform mole. Choriocarcinoma presents strong expression of hCG and weak expression of hPL and PLAP. All tissues show positive reaction with anticytokeratine and negative reaction with anti‐vimentin.Conclusion. Our study proves immunohistochemistry as useful tool for differential diagnosis in borderline cases of gestational trophoblastic disease.