bluuebunny/crossref_metadata_2025_split huggingface dataset:
Third‐trimester fetal MRI in isolated 10‐ to 12‐mm ventriculomegaly: is it worth it?
Authors: Salomon LJ , Ouahba J , Delezoide A‐L , Vuillard E , Oury J‐F , Sebag G , Garel C 
Published: July 2006

Objective  The justification for magnetic resonance imaging (MRI) in isolated mild ventriculomegaly remains controversial. This study was undertaken to evaluate the contribution of third‐trimester MRI in isolated 10‐ to 12‐mm fetal ventriculomegaly.Design  Observational prospective cohort study.Setting  Universitary prenatal reference centre.Population  From February 2000 to May 2005, we prospectively collected data concerning fetuses referred to us for cerebral MRI following detection of ventriculomegaly by ultrasound scan (n= 310).Methods  Among these, we identified and analysed those cases in which ventriculomegaly was isolated and did not exceed 12 mm in ultrasound examinations prior to MRI scan (n= 185).Main outcome measure  Cases in which MRI provided additional information that was likely to have an impact on prenatal management were detailed.Results  During the study period, 310 MRI were performed because of fetal ventriculomegaly. Hundred and eighty‐five were suspected to be isolated 10‐ to 12‐mm ventriculomegalies in ultrasound scan and formed our database. MRI confirmed the 10‐ to 12‐mm isolated fetal ventriculomegaly in 106 cases (57.3%) and found other abnormalities in 5 (4.7%) of these 106 cases. MRI found ventricular measurement to be less than 10 mm in 43 cases (23.3%) and more than 12 mm in 36 cases (19.4%). Among these 36 fetuses with ventricle size more than 12 mm, 6 (16.7%) had other abnormalities, whereas MRI did not find other abnormalities in the 43 cases with ventricle size below 10 mm.Conclusion  Before advantages of MRI to ultrasound examination can be demonstrated, it seems reasonable that MRI should remain an investigational tool, restricted to selected clinical situations in which the results are expected to modify case management. Where ultrasound scan suspects isolated ventriculomegaly of 10 to 12 mm, our data suggest that when the finding is confirmed with MRI this could be expected in around 5% of cases. Therefore, the policy of routine MRI in such cases should depend on prenatal centres’ priorities.
Differential effect of nerve growth factor on dopaminergic neurotoxin‐induced apoptosis
Authors: Hirata Yoko , Meguro Tomotaka , Kiuchi Kazutoshi 
Published: July 2006

AbstractBoth rotenone and manganese are possible neurotoxins for a wide variety of cell and neuronal types including dopaminergic neurons and induce apoptosis in various cells. Neurotrophic factors have the potential for therapeutic development when used to prevent Parkinson's disease. In this paper, we focused on the differences between rotenone and manganese as toxins, and characterized the influence of neurotrophic factors on toxin‐induced apoptosis in PC12 cells. There were distinct differences in intracellular mechanisms between rotenone‐ and manganese‐induced apoptosis such as the production of reactive oxygen species, the response to antioxidants, and the activation of the c‐Jun N‐terminal kinase (JNK) and p38 mitogen‐activated protein kinase (MAPK). Nerve growth factor (NGF) almost completely prevented rotenone‐induced but not manganese‐induced caspase activation and DNA fragmentation. The differential effect of NGF was found to be mainly due to the down‐regulation of the Trk tyrosine kinase receptor by manganese but not by rotenone. Prevention of rotenone‐induced apoptosis by NGF was attenuated by the phosphatidylinositol 3‐kinase (PI 3‐kinase) inhibitor, LY294002, but not MAPK kinase (MEK) inhibitors, PD98059 or U0126. These results demonstrate that the potential neurotoxins for dopaminergic cells exert their toxic effect by activation of different signaling pathways of apoptosis and that NGF prevents rotenone‐induced apoptosis through the activation of the PI 3‐kinase pathway not MAPK pathway.
The antinociceptive activity of Muntingia calabura aqueous extract and the involvement of l‐arginine/nitric oxide/cyclic guanosine monophosphate pathway in its observed activity in mice
Authors: Zakaria Zainul Amiruddin , Sulaiman Mohd Roslan , Jais Abdul Manan Mat , Somchit Muhammad Nazrul , Jayaraman Kogilla Vani , Balakhrisnan Ganesh , Abdullah Fatimah Corazon 
Published: July 2006

AbstractThe present study was carried out to investigate on the possible involvement of l‐arginine/nitric oxide/cyclic guanosine monophosphate (l‐arginine/NO/cGMP) pathway in the aqueous extract of Muntingia calabura (AEMC) leaves antinociception in mice assessed by abdominal constriction test. The AEMC, obtained by soaking the dried leaves in distilled water (DH2O) (1 : 2; w/v) for 24 h, was prepared in concentrations of 10%, 50% and 100% that were approximately equivalent to doses of 27, 135 and 270 mg/kg, and administered subcutaneously (s.c.) 5 min after pre‐treatment (s.c.) of mice with DH2O, l‐arginine (20 mg/kg), NG‐monomethyl‐l‐arginine acetate (l‐NMMA; 20 mg/kg), NG‐nitro‐l‐arginine methyl esters (l‐NAME; 20 mg/kg), methylene blue (MB) (20 mg/kg), respectively. The AEMC was found to exhibit a concentration‐dependent antinociception after pre‐challenge with DH2O. Interestingly, pre‐treatment with l‐arginine was found to block significantly (P < 0.05) the AEMC antinociception but only at the highest concentration (100%) of AEMC used. On the other hand, pre‐treatment with l‐NAME was found to significantly (P < 0.05) enhance the low concentration but inhibit the high concentration AEMC antinociception. MB was found to significantly (P < 0.05) enhance AEMC antinociception at all concentrations used. Except for the higher concentration of AEMC used, co‐treatment with l‐NAME was found to insignificantly and significantly (P < 0.05) reverse the l‐arginine effect when given alone or with low concentration AEMC, respectively. In addition, co‐treatment with MB significantly (P < 0.05) reversed the l‐arginine effect when given alone or with 10% concentration AEMC but failed to affect the activity of the rest of concentrations used. As a conclusion, this study has demonstrated the involvement of l‐arginine/NO/cGMP pathway in AEMC antinociception.
Breeding biology of the Red Kite Milvus milvus in Corsica
Authors: MOUGEOT FRANÇOIS , BRETAGNOLLE VINCENT 
Published: July 2006

The breeding biology of the Red Kite Milvus milvus is still little known in the southern part of its range (Mediterranean), despite recent conservation concerns and major declines in most insular populations (Sicily, Sardinia and Balearics). We report here on the breeding biology of the Red Kite in Corsica in 1996–99 and on recent population trends there. In a 42‐km2 study area located in the northwest of the island (Balagne region), breeding density was locally high (1.17–1.78 breeding pairs/km2). Breeding dispersion ranged from loosely colonial to dispersed, with average nearest‐neighbour distance of 444 ± 316 m (range 50–2000) (all data as means ± sd). Kites established breeding territories in January–February, and 92.4% of territorial pairs laid a clutch (n = 238). Laying took place between February and May (mean lay date: 27 March ± 16 days, n = 147). Clutch size averaged 2.44 ± 0.71 (1–5 eggs, n = 96), hatching success 66.9% and fledging success 78.6%. Productivity averaged 1.33 ± 0.88 young per breeding attempt (n = 221) and 1.65 ± 0.65 young per successful breeding attempt (n = 173). Overall breeding success was 51.4 ± 38.0% (n = 88). We describe the growth of young (wing, weight, tarsus and bill) and show a marked seasonal decline in clutch size and breeding performance, with pairs laying earlier producing larger clutches and being more successful than later breeding pairs. Unlike most other insular Mediterranean Red Kite populations that have recently declined, the breeding population in the northwest of Corsica, which accounts for c. 25% of the whole island population, increased from 25 to 35 pairs in 1989 to a maximum of 80–90 pairs in 1997. This increase was probably related to the lack of persecution and a local increase in abundance of Rabbits Oryctolagus cuniculus, following their introduction in the late 1970s, which provided an important feeding resource for Kites. Finally, we compare our results with those from other Red Kite populations studied in Europe. We found that there is a latitudinal gradient in laying date and productivity across Western Europe populations, but no evidence of an insular syndrome in the Corsican population.
Variation in Chemotherapy Utilization in Ovarian Cancer: The Relative Contribution of Geography
Authors: Polsky Daniel , Armstrong Katrina A. , Randall Thomas C. , Ross Richard N. , Even‐Shoshan Orit , Rosenbaum Paul R. , Silber Jeffrey H. 
Published: July 2006

Objective. This study investigates geographic variation in chemotherapy utilization for ovarian cancer in both absolute and relative terms and examines area characteristics associated with this variation.Data Sources. Surveillance, Epidemiology, and End Results (SEER) Medicare data from 1990 to 2001 for Medicare patients over 65 with a diagnosis of ovarian cancer between 1990 and 1999. Chemotherapy within a year of diagnosis was identified by Medicare billing codes. The hospital referral region (HRR) represents the geographic unit of analysis.Study Design. A logit model predicting the probability of receiving chemotherapy by each of the 39 HRRs. Control variables included medical characteristics (patient age, stage, year of diagnosis, and comorbidities) and socioeconomic characteristics (race, income, and education). The variation among HRRs was tested by the χ2 statistic, and the relative contribution was measured by the ω statistic. HHR market characteristic are then used to explain HRR‐level variation.Principal Findings. The average chemotherapy rate was 56.6 percent, with a range by HRR from 33 percent to 67 percent. There were large and significant differences in chemotherapy use between HRRs, reflected by a χ2 for HRR of 146 (df=38, p<.001). HRR‐level variation in chemotherapy use can be partially explained by higher chemotherapy rates in HRRs with a higher percentage of hospitals with oncology services. However, an ω analysis indicates that, by about 15 to one, the variation between patients in use of chemotherapy reflects variations in patient characteristics rather than unexplained variation among HRRs.Conclusions. While absolute levels of chemotherapy variation between geographic areas are large and statistically significant, this analysis suggests that the role of geography in determining who gets chemotherapy is small relative to individual medical characteristics. Nevertheless, while variation by medical characteristics can be medically justified, the same cannot be said for geographic variation. Our finding that density of oncology hospitals predicts chemotherapy use suggests that provider supply is positively correlated with geographic variation.
Analyzing Multiple Informant Data from an Evaluation of the Health Disparities Collaboratives
Authors: James O'Malley A. , Landon Bruce E. , Guadagnoli Edward 
Published: July 2006

Objective. To use multivariate regression methods to analyze simultaneously data obtained from multiple respondents or data sources (informants) at health centers.Data Source. Surveys of executive directors, medical directors, and providers from 65 community health centers (176 informants) who participated in an evaluation of the Health Disparities Collaboratives.Study Design. Cross‐sectional survey of staff at the health centers during 2003–2004.Statistical Methods. In order to illustrate this method, we analyze the association between informants' assessments of the culture of the center and participation in the collaborative, and the association between computer availability and the effort made by management to improve the quality of the care and services at their center. Multivariate regression models are used to pool information across informants while accounting for informant‐specific effects and retaining informants in the analysis even if the data from some of them are missing. The results are compared with those obtained by traditional methods that use data from a single informant or average over informants' ratings.Findings. In both the Collaborative participation and quality improvement efforts analyses, the multivariate regression multiple informants' analysis found significant effects and differences between informants that traditional methods failed to find. Participating centers emphasized developmental (entrepreneurship, innovation, risk‐taking) and rational culture. The effect of hierarchical culture (stability and bureaucracy) on participation depended on the informant; executive directors and medical providers were the most discrepant. In centers that participated in the Collaborative, the availability of computers was positively associated with the effort that management made toward improving quality.Conclusions. The multiple informants model provided the most precise estimates and alerts users to differential effects across informants. Because different informants may have different insights or experiences, it is important that differences among informants be measured and ultimately understood by health services researchers.
Mechanisms regulating cytotrophoblast invasion in normal pregnancy and pre‐eclampsia
Authors: LYALL Fiona 
Published: July 2006

AbstractThe placental bed underlies the placenta and includes the decidua basalis and underlying myometrium containing the uterine spiral arteries. For successful human haemochorial placentation, the placental bed spiral arteries must undergo considerable alterations. These physiological modifications are thought to be brought about by the interaction of invasive cytotrophoblast with the spiral artery vessel wall. Failure of spiral artery transformation is thought to play an important role in the sequence of events that gives rise to pre‐eclampsia. The mechanisms that control human trophoblast invasion in normal, let alone abnormal pregnancy, are still poorly understood. Much of the information on the early physiological changes within the placental bed comes from studies on intact hysterectomy specimens.1 Details of such events in late pregnancy and in pregnancies complicated by pre‐eclampsia and fetal growth restriction are principally derived from the study of placental bed biopsies taken at Caesarean section. The methods of sampling the placental bed have been reviewed elsewhere.2 Many investigators have relied on in vitro models of trophoblast invasion. In vitro models can be extremely useful in dissecting out some of these processes but may be open to artefacts. The mechanisms underlying normal and failed trophoblast invasion appear to be complex. In this manuscript the mechanisms that control the invasion of trophoblast into the decidua and myometrium are reviewed. Along with this is a review of the purported mechanisms underlying failed spiral artery transformation. Particular emphasis has been placed on topics that have been best studied.
Leptin and leptin receptor levels in pregnant women with hyperemesis gravidarum
Authors: AKA Nurettin , ATALAY Sacide , SAYHARMAN Sema , KILIÇ Düzgün , KÖSE Gültekin , KÜÇÜKÖZKAN Tuncay 
Published: July 2006

AbstractObjective:  To investigate the association between the leptin, leptin receptor and hormone levels and hyperemesis gravidarum, and to determine whether these two parameters may be early markers for hyperemesis gravidarum.Methods:  The study group consisted of 18 pregnant women with hyperemesis gravidarum and the control group consisted of 18 healthy pregnant women. Demographic characteristics were recorded and body mass index (BMI) values were calculated for all the pregnant women. Serum leptin, leptin receptor, insulin, cortisol, thyroid hormone and human chorionic gonadotrophin (hCG) levels were measured.Results:  When the two groups were compared with respect to leptin levels, the group with hyperemesis gravidarum was found to have significantly higher leptin levels (P = 0.037). No intergroup differences were observed in serum cortisol, insulin, hCG, thyroid hormone levels or BMI values. In the group with hyperemesis gravidarum, an inverse correlation was detected between cortisol and leptin (r = –0.762, P < 0.01), and hCG and thyroid‐stimulating hormone (r = –0.503, P < 0.05), whereas a significant correlation was detected between insulin and leptin (r = 0.538, P < 0.05), leptin and BMI (r = 0.711, P < 0.01), and between TT3 and hCG (r = 0.605, P < 0.01).Conclusion:  It was concluded that leptin could play a role in, and be defined as, a marker of hyperemesis gravidarum.
Obstetric management of the next pregnancy after an unexplained stillbirth: An anonymous postal survey of Australian obstetricians
Authors: ROBSON Stephen , THOMPSON Jane , ELLWOOD David 
Published: July 2006

AbstractBackground:  Women who have an unexplained stillbirth are more likely to be delivered early, by induced labour or Caesarean section, in their next pregnancy. It is unclear whether these birth outcomes result from characteristics of the next pregnancy, or represent management strategies of obstetricians.Aim:  To investigate obstetricians’ management strategies in the next pregnancy after an unexplained stillbirth.Methods:  Anonymous postal survey of Australian obstetricians. Respondents were given a clinical scenario regarding a previous unexplained stillbirth and were asked about management.Results:  The response rate was 69%. Tests of ‘fetal well‐being’ were undertaken by the majority of respondents. Additional third trimester ultrasound surveillance was recommended by 87% of respondents, regular cardiotograph monitoring by 72% and formal fetal movement charting by 39%. Elective induction of labour (in the absence of any other obstetric indication) was recommended by 93% of respondents, and elective Caesarean delivery by 35%.Conclusions:  The tendency for subsequent pregnancies after an unexplained stillbirth to be delivered earlier, and more often by Caesarean section, may be due in part to altered management strategies, not solely as a result of complications of the pregnancy itself.
Recurrence after treatment for high‐grade dysplasia: Should we modify our post‐treatment surveillance protocols?
Authors: CARTER Jonathan , SIM Janie , LAND Russell , DALRYMPLE Christopher , ABDEL‐HADI Mohammed , PATHER Selvan 
Published: July 2006

AbstractA cohort of women, having undergone an excisional procedure for high‐grade cervical dysplasia, was studied to identify those patients who developed recurrent high‐grade cervical dysplasia post‐treatment. We have confirmed that recurrent histologically confirmed high‐grade cervical dysplasia is uncommon after complete excision and appears not to occur within the first 6 months post‐treatment. Post‐treatment surveillance protocols should incorporate these findings.
Vigorous exercise and birth outcomes in a sample of recreational exercisers: A prospective study across pregnancy
Authors: DUNCOMBE Dianne , SKOUTERIS Helen , WERTHEIM Eleanor H. , KELLY Leanne , FRASER Virginia , PAXTON Susan J. 
Published: July 2006

AbstractObjective:  This study examined the question of whether vigorous exercise undertaken by recreational exercisers across pregnancy, defined in two ways, were associated with reduced infant birthweight and gestational age at birth.Methods:  A prospective approach was implemented. A total of 148 pregnant women participated. Average intensity duration and frequency of vigorous exercise reported were examined and compared with two existing definitions of vigorous exercise. Participants completed questionnaires (including retrospective reports on 3 months prepregnancy) and an exercise diary at 16–23 weeks pregnancy, 24–31 weeks pregnancy and 32–38 weeks pregnancy, and at 7 to 14 days post‐partum a birth outcomes questionnaire was completed.Results:  There were no significant differences between exercise groups for birthweight and gestational age at birth.Conclusions:  There was no evidence that the intensity duration and frequency of vigorous exercise were associated with significant reductions in mean birth outcomes for the infants of women who participated in the study. Replication in a large, more diverse sample is recommended.
Perinatal outcome of pregnancies after inadvertent exposure to gonadotrophin‐releasing hormone analogue
Authors: TAN Heng Hao , YEONG Cheng Toh , LOH Kia Ee Sheila 
Published: July 2006

AbstractBackground:  The use of gonadotrophin‐releasing hormone agonists (GnRHa) in in vitro fertilisation (IVF) cycles is accepted as standard practice. However, the safety profile of this drug with inadvertent exposure in pregnancy is still in question.Aim:  To evaluate the pregnancy outcomes in a group of infertile patients who conceive spontaneously while undergoing IVF with unrecognised daily exposure to GnRHa during the downregulation regime.Methods:  A review of all women undergoing planned treatment cycles in our IVF centre, comprising of a total of 1949 fresh and 154 frozen embryo cycles from January 1996 to December 2001. All spontaneous pregnancies were recorded and case records reviewed.Outcome measure:  Course and clinical outcome of pregnancies.Results:  Nine spontaneous pregnancies were recorded (0.43%). The median duration of inadvertent exposure to subcutaneous leuprolide acetate was 22 days (range 21–25). The median age of the patients was 35 years (range 28–39) and the median duration of infertility was 3.5 years (range 1.5–8). Nine pregnancies resulted in miscarriages. Seven pregnancies progressed to term and resulted in singleton live births with no apparent evidence of fetal abnormalities or aneuploidies. One pregnancy was complicated by parvovirus infection at 19 weeks gestation with transient fetal hydrops. The pregnancy outcomes appear favourable even when compared to those conceived through the completed IVF cycles within the same cohort.Conclusion:  Our experience reaffirms current evidence from earlier studies that accidental exposure to GnRHa in early pregnancy is safe. However, we believe that contraception prior to GnRHa is still prudent pending definitive data.
Longitudinal ultrasound assessment of fetal presentation: A review of 1010 consecutive cases
Authors: FOX Alice J. Sophia , CHAPMAN Michael G. 
Published: July 2006

AbstractBackground:  Abnormal presentation (detected in the early third trimester) causes concern for pregnant women and their carers. Definitive ultrasound‐based data on the risk of persistence of abnormal presentation is lacking to allow appropriate counselling. Comparison of pregnancy outcome was made on the basis of maternal age at delivery.Methods:  Notes of 1010 women (426 primigravidae, 584 multigravidae), with singleton pregnancies, confined between 1997 and 2005 were reviewed to extract: (i) the gestation based on 18–20‐week ultrasound in conjunction with the patient's recorded last menstrual period, and (ii) the presentation of each antenatal visit from 28+ weeks until delivery. Previous obstetric history, maternal age, mode of delivery, birthweight and outcomes were also documented.Results:  At 28–30 weeks, 216 babies presented abnormally. By 38+ weeks, 54 persisted as either a breech or a transverse lie. Thus, an abnormal presentation in the early trimester carries a 22.2% chance of persisting at term. Continuance of abnormal presentation at each subsequent week of the third trimester increased the risk of a Caesarean delivery at term. Conversely, in only six cases, a cephalic presentation at 28–30 weeks converted to a breech or other presentation during the third trimester – a risk of 0.75%.Conclusion:  These statistics provide a useful tool in advising women of the chances of abnormal presentation at term based on the presentation at various stages of the third trimester, and prepare them for the potential requirement of a Caesarean section.