bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cost‐effectiveness analysis of levonorgestrel intrauterine system and thermal balloon ablation for heavy menstrual bleeding
Authors: Brown PM , Farquhar CM , Lethaby A , Sadler LC , Johnson NP 
Published: June 2006

Objective  To compare the cost‐effectiveness of levonorgestrel intrauterine system (LNG‐IUS) (Mirena®; Schering Co., Turku, Finland) and thermal balloon ablation (Thermachoice™; Gynecare Inc., Menlo Park, CA, USA) for the treatment of heavy menstrual bleeding.Design  An open, pragmatic, prospective randomised trial.Setting  A menstrual disorders clinic at National Women’s Hospital, Auckland, New Zealand.Population  Seventy‐nine women with self‐defined heavy menstrual bleeding randomised to the LNG‐IUS (40 women) or the thermal balloon ablation (39 women).Methods  Decision tree modelling using primary source data was used to identify the incremental cost‐effectiveness of the two treatments.Main outcome measures  Direct and indirect costs of medical treatment, including treatment costs, subsequent medical procedures, lost income and medical treatment for failed procedures. The change in quality of life as assessed by the Short Form‐36 (SF‐36) measured between time of treatment and 24 months was the primary outcome measure. Economic modelling examined the expected cost and outcome for a woman entering each treatment. Sensitivity analysis explored the robustness of the results.Results  The expected cost of treatment was $NZ1241 ($US869) for the LNG‐IUS and $NZ2418 ($US1693) for the thermal balloon ablation. The LNG‐IUS was associated with an increase of 15 points on the SF‐36 scale, compared with 12 points for the thermal balloon ablation. Sensitivity analysis indicates that the results are robust to a 25% decrease in the price of the primary cost drivers and to variations in the rates of failed treatment between the conditions.Conclusion  The LNG‐IUS would appear to be cost‐effective when compared with the thermal balloon ablation for treatment of heavy menstrual bleeding.
Maternal cardiac function in fetal growth restriction
Authors: Bamfo JEAK , Kametas NA , Turan O , Khaw A , Nicolaides KH 
Published: June 2006

Objective  To assess the maternal central haemodynamics in normotensive women with pregnancies complicated by severe fetal growth restriction (FGR).Design  Cross‐sectional study.Setting  A tertiary referral fetal medicine unit.Population  The study groups comprised 107 women with normal singleton pregnancies and 20 with singleton pregnancies complicated by FGR at 25–37 weeks. In the latter group, assessment was carried out within 10 days prior to their delivery. All the women were normotensive, without any medical problems.Methods  Two‐dimensional and M‐mode echocardiography of the left ventricle.Main outcome measures  Maternal left ventricular systolic and diastolic function.Results  In the FGR group, compared with the normal group, there was increased total vascular resistance (TVR), reduced systolic function characterised by lower cardiac output, stroke volume, heart rate, ejection time and septal and lateral long‐axis shortening. Mean arterial pressure (MAP) was not significantly different between the groups.Conclusions  Severe FGR is associated with reduced maternal systolic function and increased TVR but no change in MAP. TVR may be a useful tool in the classification and management of FGR. The findings suggest that in FGR, there is increased blood viscosity due to lack of intravascular space expansion.
Transvaginal, ultrasound‐guided, ovarian, interstitial laser treatment in anovulatory women with clomifene‐citrate‐resistant polycystic ovary syndrome
Authors: Zhu WJ , Li XM , Chen XM , Lin Z , Zhang L 
Published: June 2006

Objective  To assess the effectiveness of transvaginal, ultrasound‐guided, ovarian, interstitial laser coagulation treatment in anovulatory women with polycystic ovary syndrome (PCOS).Design  A pilot study.Setting  Assisted reproductive technology unit.Sample  Twenty‐three anovulatory women with clomifene‐citrate‐resistant PCOS.Methods  Ultrasound‐guided, transvaginal, ovarian, interstitial yttrium‐aluminium‐garnet laser treatment.Main outcome measures  Serum luteinizing hormone (LH), follicle‐stimulating hormone (FSH), testosterone, prolactin and estradiol levels, spontaneous ovulation rate and pregnancy rate were measured over 6 months of follow up.Results  Regular ovulation occurred in 19 out of 22 (86.4%) women in the 6 months following ovarian treatment (one woman was lost to follow up). On the postoperative second, fourth and sixth month, the mean serum LH levels were 4.54 SD 1.21 iu/l, 4.90 SD 2.18 iu/l and 4.42 SD 1.03 iu/l, significantly (P < 0.001, P < 0.001, P < 0.001) lower than the preoperative level of 13.89 ± 3.62 iu/l; the mean serum testosterone levels were 2.69 SD 1.83 nmol/l, 2.42 SD 1.11 nmol/l and 2.28 SD 1.96 nmol/l and significantly (P < 0.001, P < 0.001, P < 0.001) lower than the preoperative baseline value of 5.37 SD 3.09 nmol/l; the mean LH/FSH ratios of 0.93 SD 0.26, 0.88 SD 0.17 and 0.81 SD 0.14 were also significantly lower than the preoperative value of 2.78 SD 1.21 (P < 0.001). Pregnancy occurred in eight women and there was a cumulative pregnancy rate at 6 months of 36% (8/22) among the subjects. There were no significant operative complications.Conclusion  Ultrasound‐guided, transvaginal, ovarian, interstitial laser treatment appears effective in improving hormonal profiles and inducing ovulation and successful pregnancy in women with clomifene‐resistant PCOS.
Predictors of respiratory depression at birth in the term infant
Authors: Baskett TF , Allen VM , O‘Connell CM , Allen AC 
Published: June 2006

Objective  To evaluate predictive factors for respiratory depression at birth in infants ≥37 weeks.Design  A population‐based cohort study of respiratory depression at birth at term and post‐term.Setting  Nova Scotia, Canada.Population  All 126 604 nonanomalous, singleton deliveries ≥37 weeks in cephalic presentation from 1988–2002.Methods  An analysis of maternal, antenatal, intrapartum, and neonatal factors associated with respiratory depression at birth ≥37 weeks.Main outcome measures  A composite outcome of delay in initiating and maintaining respiration after birth, 5‐minute Apgar score ≤ 3, or neonatal seizures due to hypoxic–ischaemic encephalopathy.Results  The rate of respiratory depression at birth with delay in respiration was 5.2/1000, with Apgar ≤ 3 1.0/1000 live births, and with neonatal seizures 0.7/1000. A composite of any of the three respiratory depressions at birth criteria showed comparable low rates with spontaneous delivery (4.4/1000) and elective caesarean (4.8/1000). Compared with elective caesarean delivery, vacuum (13.2/1000, relative risk [RR] 3.97, P < 0.001), forceps (8.8/1000, RR 1.84, P= 0.003), failed vacuum (13.3/1000, RR 2.76, P= 0.005), failed forceps (33.3/1000, RR 6.93, P < 0.001), and caesarean in labour (17.0/1000, RR 3.54, P < 0.001) had significantly higher rates of the composite outcome.Conclusion  Overall, the rate of respiratory depression at birth in the term infant was low and the serious manifestation of seizures was less than 1 in 1000. There was a significant relationship between operative delivery in labour and respiratory depression at birth.
Vaginal delivery for fetuses at risk of alloimmune thrombocytopenia?
Authors: Van Den Akker ESA , Oepkes D , Brand A , Kanhai HHH 
Published: June 2006

Objectives  To evaluate the safety of vaginal delivery in pregnancies with fetal and neonatal alloimmune thrombocytopenia (FNAIT).Design  Prospective data collection.Setting  Leiden University Medical Centre, the national centre for management of severe red cell and platelet alloimmunisation.Population  Thirty‐two pregnancies with FNAIT, with a sibling with thrombocytopenia but without an intracranial haemorrhage (ICH).Methods  The mode of delivery, platelet count in cord blood and neonatal outcome were analysed. All women received weekly intravenous immunoglobulin from 32 to 38 weeks of gestation. Head ultrasound scan was performed in all neonates.Main outcome measures  Signs of ICH or other bleeding in the neonates.Results  Twenty‐three women delivered vaginally. Nine caesarean sections were performed, all for obstetric reasons. Median platelet count at birth was 142 × 109/l (range, 4–252 × 109/l), with severe thrombocytopenia (<50 ×109/l) in four neonates, of which three were born vaginally. None of the neonates showed signs of ICH or other bleeding.Conclusions  In pregnancies with FNAIT and a thrombocytopenic sibling without ICH, vaginal delivery was not associated with neonatal intracranial bleeding. These initial results support our noninvasive management of these pregnancies with FNAIT.
Attenuation of ethanol withdrawal syndrome by extract of Hypericum perforatum in Wistar rats
Authors: Coskun Ilke , Tayfun Uzbay I. , Ozturk Nilgun , Ozturk Yusuf 
Published: June 2006

AbstractThe effects of Hypericum perforatum (St John's wort) on ethanol withdrawal syndrome have been investigated in ethanol‐dependent rats. Adult male Wistar rats were subjects. Ethanol (7.2% v/v) was given to rats by a liquid diet for 15 days. Hypericum perforatum extract (HPE) (25–200 mg/kg) and saline were injected to rats intraperitoneally just before ethanol withdrawal. After second, fourth and sixth hour of ethanol withdrawal, rats were observed for 5 min, and withdrawal signs that included locomotor hyperactivity, stereotyped behavior and tremors were recorded or rated. A second series of injections was given at 6 h after the first one, and subjects were then tested for audiogenic seizures. HPE (25–200 mg/kg) produced some dose‐dependent and significant inhibitory effects on locomotor hyperactivity at second and sixth hour of ethanol withdrawal. In addition, it significantly reduced the number of stereotyped behaviors at the same dose range. HPE (50 and 100 mg/kg) produced some significant inhibitory effects on tremor and audiogenic seizures during withdrawal period. These results suggest that HPE has some beneficial effects on ethanol withdrawal syndrome in rats.
Water in British India: The Making of a ‘Colonial Hydrology’
Authors: D’Souza Rohan 
Published: June 2006

AbstractThe environmental history of India has moved on and considerably broadened since the first studies of Indian forestry were published. This essay surveys studies on water in British India, which it has clustered into three themes. While providing a rough description of some of the most important debates and discussions on the issue of colonial rule and its hydraulic interventions, the essay argues that interest on the subject must now attempt to pursue grand questions as well. Towards to this end, it is argued that much insight and theoretical traction may be gained from pursuing the conceptual notion of a ‘colonial hydrology’: the attempt to characterise the British experience as comprising an altogether distinct paradigm for hydraulic interventions.
Reading Landscapes: The American Suburbs
Authors: Scanlon Jennifer 
Published: June 2006

AbstractRecent scholarship problematizes the dichotomous reading of the American suburb as either middle‐class nirvana or homogeneous wasteland. Suburbs are spaces where race, class, and gender can be read onto landscapes in new and provocative ways. This article explores how suburban history was presented and explored in a gender and women’s studies/history course on the suburbs and their representation in American popular culture.
Phosphate binders: New products and challenges
Authors: BELLASI Antonio , KOOIENGA Laura , BLOCK Geoffrey A. 
Published: June 2006

AbstractOptimal phosphate control in dialysis patients is extremely challenging. A growing awareness of the deleterious effect of mineral metabolism imbalances together with the lack of a satisfactory explanation for the exaggerated mortality rate in patients undergoing renal replacement therapy has led to a renewed effort to refine our approach to hyperphosphatemia. However, despite the remarkable improvements in dialysis techniques, phosphate control has not substantially improved. Achieving normo‐phosphatemia presents a multitude of practical and scientific challenges related to the optimal target level, cardiovascular health, and drug toxicities. It is the aim of the present review to summarize briefly the controversies associated with currently available phosphate binders, a cornerstone in the current management of hyperphosphatemia.
Clinical characteristics and outcomes of new uremic patients with extreme azotemia in southern Taiwan
Authors: CHENG Meng‐Fu , LIU Hsin‐Liang , WU An‐Bang , HSIEH Ryh‐Yaw , GUO How‐Ran , HUANG Jeng‐Jong 
Published: June 2006

AbstractSerum creatinine (SCr) had been considered to be an important predictor of mortality in end‐stage renal disease (ESRD) patients at the start of renal replacement therapy (RRT). However, the data were limited about initially extreme azotemia (EA), exclusively defined as blood urea nitrogen (BUN)≥300 mg/dL, SCr≥30 mg/dL, or both. This retrospective study was conducted to clarify the characteristics and outcome in our EA patients. We had 1682 new ESRD patients from July 1988 to December 1996. With frequency match for age, gender, and starting RRT in the same period, 20 EA patients and 60 controls were included. Fifty percent of our EA patients had unknown etiology. The EA patients had significantly lower prevalence of underlying diabetic nephropathy, and comorbid hypertension. All the EA patients had late referral to nephrologists within 4 weeks before the initiation of RRT, and 90% of them had taken Chinese herbals. The EA group had significantly higher BUN, SCr, and iron storage as well as a higher prevalence of severe anemia, hyperkalemia, hypocalcemia, and acidemia. However, the similar prevalence of cardiomegaly and left ventricular hypertrophy as well as the similar early mortality rate and long‐term survival were noted. Age over 40 years, comorbid diabetes mellitus, and hypoalbuminemia were independent predictors of poor survival. Our EA patients had different initial presentations from other uremic ones at the start of RRT. However, the short‐term and long‐term mortality rates were similar. The lower prevalence of underlying diabetic nephropathy and comorbid hypertension among the EA patients might contribute to their fair outcome.
The role of docosahexaenoic acid on visual evoked potentials in one kidney‐one clip hypertension
Authors: Hacioglu Gulay , Agar Aysel , Yargicoglu Piraye 
Published: June 2006

Abstract.Purpose:  To investigate the effects of polyunsaturated fatty acid (PUFA) docosahexaenoic acid (DHA) on visual evoked potentials (VEPs) in a one kidney‐one clip (1K‐1C) hypertension model in rats.Methods:  Five experimental groups were formed: a control group, a sham group, a group supplemented with DHA, a 1K‐1C group, and a 1K‐1C + DHA group. The DHA groups were treated for 60 days. In the 1K‐1C groups, the right kidney was removed and a silver clip with a 0.2‐mm gap was placed on the left renal artery.Results:  The DHA‐supplemented rats had lower blood pressure than their respective controls (p < 0.01). The increased brain and retina thiobarbituric acid reactive substances (TBARS) levels in hypertensive rats were abolished by DHA administration. The brain nitrite levels were lower in the DHA, 1K‐1C and 1K‐1C + DHA groups compared with the control group (p < 0.01), and the retina nitrite level was higher in the 1K‐1C + DHA group compared with the DHA and 1K‐1C groups (p < 0.01). There was an improvement of P2, N2 and P3 components following DHA supplementation in 1K‐1C hypertensive rats compared with the 1K‐1C group.Conclusion:  The present study suggests that DHA supplementation has the potential to prevent VEP changes caused by an experimental model of hypertension. This state might be related to the lipid peroxidation lowering effect of DHA.
Topography of the posterior arteries supplying the eye and relations to the optic nerve
Authors: Erdogmus Senem , Govsa Figen 
Published: June 2006

Abstract.Purpose:  The aim of the study was to investigate the arterial blood supply of the intraorbital part of the optic nerve.Methods:  The location, course, length and diameter of the central retinal artery (CRA) and posterior ciliary arteries were studied in 19 adult white male preserved cadavers of between 35 and 75 years of age.Results:  In right eyes, the first branch of the intraorbital part of the ophthalmic artery was the CRA in 26.3% (5/19) and the CRA and medial posterior ciliary artery in 21% (4/19) of eyes. In left eyes, the first branch of the intraorbital part of the ophthalmic artery was the CRA in 47.4% (9/19) and the CRA and medial posterior ciliary artery in 26.3% (5/19) of eyes. The CRA was observed as a single branch in 57.9% and a trunk in 42.1% of right eyes, and as a single branch in 52.6% and a trunk in 47.3% of left eyes. The outer diameter of the CRA measured 0.6 ± 0.1 mm (min–max 0.5–0.9 mm) in right eyes and 0.6 ± 0.2 mm (min–max 0.4–0.9 mm) in left eyes. The CRA entered the optic nerve 7.5 ± 2.2 mm (min–max 5.3–12.5 mm) behind the ocular bulb in right eyes and 7.4 ± 2.3 mm (min–max 5.3–14.1 mm) behind it in left eyes, at its lower and medial side. The posterior ciliary arteries ran forward, divided into multiple branches and pierced the sclera close to the optic nerve medially, laterally or superiorly. The longitudinal capillaries ran between the optic nerve and the CRA antero‐posteriorly, while the transverse capillaries surrounded the optic nerve. Collaterals from both the longitudinal and transverse capillaries joined to form a complicated capillary plexus.Conclusion:  This article confirms the well known variability of the arterial circulation of the intraorbital part of the optic nerve. Better understanding of the arterial anatomy of the intraorbital part of the optic nerve should enable appropriate modification of surgical techniques.
Photodynamic treatment in a rabbit model of glaucoma surgery
Authors: Stasi Kalliopi , Paccione Jeff , Bianchi Glen , Friedman Alan , Danias John 
Published: June 2006

Abstract.Purpose:  To evaluate the safety and efficacy of postoperative verteporfin photodynamic treatment as an adjunct to glaucoma experimental filtration surgery in rabbits.Methods:  Dutch belted (n = 15) rabbits underwent full thickness sclerectomy in one eye. The experimental group (group 1, n = 7) underwent i.v. injection of verteporfin and subsequent photoactivation at the operative site on postoperative day 1 (POD 1). Control groups of animals received either light exposure (group 2, n = 4) or verteporfin (group 3, n = 2), or no intervention (group 4, n = 2). Intraocular pressure (IOP) was measured prior to the procedure (POD 0) and daily thereafter for the first week after sclerectomy (PODs 1−7) and every other day for the second week (PODs 9, 11, 13, 15). Percentage IOP reductions of operated over contralateral control eyes were compared among the various groups. Success rates (percentage IOP reduction > 15%) were also compared between the experimental and control groups. Eyes were histologically examined for evaluation of fibrosis.Results:  Rabbits in the experimental group (group 1) had a mean ± SEM percentage IOP reduction of 25 ± 3% during the follow‐up period. In contrast, groups 2, 3 and 4 had IOP reductions of 4 ± 5%, 12 ± 7% and 4 ± 6%, respectively (p < 0.005, anova among all four groups). Successful IOP reduction (≥ 15%) over the contralateral eye at POD 15 was achieved in six of seven experimental animals, but only in one of eight control animals (p < 0.02, chi‐squared test). Bleb failure occurred significantly earlier in the control eyes compared with eyes receiving PDT (p < 0.003, log rank test). Blebs in the experimental group differed from those in the control groups histologically, lacking significant collagen deposition in the area of the sclerostomy.Conclusions:  Wound healing in glaucoma surgery may be successfully modulated postoperatively using photodynamic therapy with i.v. administered photosensitizer.
Photodynamic therapy in subfoveal and juxtafoveal idiopathic and postinflammatory choroidal neovascularization
Authors: Ruiz‐Moreno José M. , Montero Javier A. , Arias Luis , Sanabria Maria R. , Coco Rosa , Silva Rufino , Araiz Javier , Gomez‐Ulla Francisco , Garcia‐Layana Alfredo 
Published: June 2006

Abstract.Purpose:  To evaluate the efficacy of photodynamic therapy (PDT) in the treatment of idiopathic and inflammatory choroidal neovascularization (CNV).Methods:  This study represents a non‐randomized, multicentre, interventional case series. Sixteen eyes of 16 patients with classic or predominantly classic sub‐ and juxtafoveal idiopathic CNV and 26 eyes of 24 patients with classic or predominantly classic sub‐ and juxtafoveal CNV secondary to inflammatory conditions were treated with PDT with verteporfin. Best corrected visual acuity (BCVA) before and after PDT, the number of lines gained or lost and the number of PDT sessions were analysed.Results:  The mean follow‐up periods were 20 months (SD 11) and 16 months (SD 9) for the idiopathic and inflammatory groups, respectively. The mean BCVA in idiopathic CNV changed from 0.63 logMAR (SD 0.37) before treatment to 0.82 logMAR (SD 0.43) after treatment (p = 0.16; Student's t‐test paired data). The number of treatments performed averaged 2.1 (range 1−4, SD 0.9). The mean BCVA in postinflammatory CNV changed from 0.60 logMAR (SD 0.4) before treatment to 0.57 logMAR (SD 0.6) after treatment (p = 0.79; Student's t‐test paired data). The mean number of treatments was 2.6 (range 1−6, SD 1.2).Conclusions:  Photodynamic therapy with verteporfin may be useful in stabilizing BCVA in patients with sub‐ and juxtafoveal postinflammatory CNV and subfoveal idiopathic CNV.
Donor corneas for transplantation: a scanning electron microscopic study of the epithelium
Authors: Slettedal Jon Klokk , Lyberg Torstein , Ramstad Hanne , Nicolaissen Bjørn 
Published: June 2006

Abstract.Purpose:  Donor corneas are processed in eye banks and used for transplantation as a standard routine. The maximum time limit post‐mortem for harvesting donor tissue varies greatly between eye banks. This study aimed to examine the corneal epithelium for structural changes post‐mortem.Methods:  A total of 51 corneas harvested between 14 and 163 hours post‐mortem were examined using scanning electron and light microscopy.Results:  Cell loss occurred through desquamation of flat superficial cells during the first days. In corneas with a post‐mortem time of more than 2−3 days, large superficial cell sheets and deeper cells detached, starting centrally. Deep peripheral cells remained. The loss of the superficial cells revealed the 3‐dimensional structure of the epithelium and the membrane characteristics of deeper cells.Conclusion:  The longer the time post‐mortem, the greater the epithelial cell loss. However, a rim of peripheral cells remained, even after 7 days. The superficial cell layer showed signs of strong lateral attachment and broke up in a sheet‐like fashion. The intercellular adhesion between deeper cells and adhesion between the basal cells and the basement membrane appeared to be weak post‐mortem. The cell membrane structures of the remaining cells were surprisingly well retained. The clinical implication of the study is discussed.