bluuebunny/crossref_metadata_2025_split huggingface dataset:
Collagenous colitis: Oral low‐dose methotrexate for patients with difficult symptoms: Long‐term outcomes
Authors: Riddell James , Hillman Lybus , Chiragakis Louise , Clarke Anthony 
Published: September 2007

AbstractAim:  To perform a qualitative retrospective review of identified cases of collagenous colitis within the patient databases of local clinicians, with particular attention to the use and effectiveness of oral low‐dose methotrexate.Methods:  Gastroenterologists in the referral area were invited to identify collagenous colitis cases from their own databases for inclusion in the study. Patients were considered eligible if they had a symptom history and colonic mucosal histology consistent with collagenous colitis. The retrospective analysis identified age at diagnosis, previous therapies, date of commencement and duration and effectiveness of methotrexate, side‐effects, and repeat colonic mucosal histology (if available) after a period of treatment.Results:  Between 1986 and 2003, 43 eligible patients were identified, ranging in age from 32 years to 88 years at the time of diagnosis. Nineteen of the 43 received methotrexate over varying periods, and in 16 of these the clinical response was considered either ‘Good’ (14) or ‘Partial’ (2). In the methotrexate group 10 of the 19 underwent repeat colonoscopy and mucosal biopsy at some stage after commencing methotrexate. Of these, five had normal histology in comparison with pretreatment abnormal histology, two had improvement but not normalization of histology, and three had unchanged abnormal histology.Conclusion:  The data from this retrospective review suggest that methotrexate may have a beneficial effect on symptoms of collagenous colitis and may improve the underlying histological abnormality. A controlled trial of adequate power and duration is needed to further clarify the usefulness of methotrexate in this condition.
Personality, treatment choice and satisfaction in patients with localized prostate cancer
Authors: Block Craig A , Erickson Brad , Carney‐Doebbling Caroline , Gordon Susanna , Fallon Bernard , Konety Badrinath R 
Published: September 2007

Objectives:  Radical prostatectomy (RP), external beam radiation (XRT) and brachytherapy (BTX) are the most commonly used treatments for localized prostate cancer. We studied whether patient personality influences treatment choice and overall treatment satisfaction.Methods:  From 1998 to 2002, 219 consecutive patients treated with RP (n = 74), XRT (n = 73), or BTX (n = 72) at our institution who remained free of biochemical recurrence were sent the Big Five Inventory (BFI) and a satisfaction/treatment participation questionnaire. We compared personality, satisfaction and participation scores between the three groups. Correlation between personality and satisfaction was determined. Multivariate regression was used to determine association between personality and satisfaction/participation after controlling for patient‐ and disease‐related factors.Results:  Higher mean satisfaction and participation scores were observed within the RP and XRT groups, respectively (P = NS). No significant differences in personality were observed between groups. XRT patients tended to have higher extroversion, openness and agreeability scores, while RP patients tended to be more neurotic and conscientious (all P = NS). After controlling for other factors, a negative correlation was found between openness scores and satisfaction and a positive correlation between conscientiousness scores and satisfaction. Specific personality traits were associated with interest in participation in care for both RP and BTX patients but not for XRT patients.Conclusions:  There are mild variations in personality as measured by the BFI between patients undergoing treatment for localized prostate cancer. Certain BFI‐measured personality traits may be associated with levels of satisfaction following therapy. Disease concerns and provider recommendations may override the influence of personality in the decision‐making process.
Effect of kihito extract granules on cognitive function in patients with Alzheimer's‐type dementia
Authors: Higashi Keiko , Rakugi Hiromi , Yu Hisahiro , Moriguchi Atsushi , Shintani Takahiro , Ogihara Toshio 
Published: September 2007

Background:  It has been recently suggested that Japanese herbal (kampo) medicines, such as kami‐untan‐to, may improve cognitive function in elderly subjects with Alzheimer's disease. Polygalae radix is thought to be a useful component of kami‐untan‐to because it enhances the activity of choline acetyltransferase in cultured neuronal cells. The purpose of the present study was to investigate the safety and usefulness of kihito extract granules, a commercially available Japanese herbal medicine that contains P. radix, for elderly patients with senile dementia.Methods:  Seventy‐five elderly subjects (84.4 ± 6.4 years) with senile dementia of Alzheimer type according to Diagnostic and Statistical Manual of Mental Disorders, 4th edition criteria were randomly assigned to the non‐treatment, goshajinkigan (control kampo medicine) or kihito groups. Each medicine was given three times a day for 3 months.Results:  There was no severe adverse event in any of the groups. We examined the Mini‐Mental State Examination (MMSE), the activities of daily living (ADL) scale and cerebrovascular single photon emission computed tomography (SPECT) before and after treatment. MMSE scores were significantly improved only in the kihito group (+1.65 ± 0.53) but not in the non‐treatment (−0.3 ± 0.67) and goshajinkigan (−0.58 ± 0.49) groups. ADL scores remained unchanged in all groups. Treatment with kihito was not associated with an increase in cerebral blood flow.Conclusion:  These results propose that kihito may be useful and has potential to be tested as a medicine for Alzheimer's‐type senile dementia, although further examination is required to clarify the mechanism of the improving effect of kihito on cognitive function.
Dyslipidemia is a major determinant of systemic atherosclerosis in the elderly: An autopsy study
Authors: Naito Takahiro , Sawabe Motoji , Arai Tomio , Chida Kouji , Hamamatsu Akihiko , Harada Kazumasa , Ozawa Toshio , Murayama Shigeo , Muramatsu Masaaki 
Published: September 2007

Background:  Assessment of the pathobiological determinants of atherosclerosis is crucial for a better understanding of cardiovascular events.Methods:  The study was conducted in 178 autopsy cases of in‐hospital death (104 men and 74 women; mean age, 81 years), for whom serum lipid values recorded during outpatient follow ups for chronic diseases were available. Severity of the atherosclerosis was semiquantitatively assessed in 10 arteries, and the correlations with age, sex, serum levels of total cholesterol and high‐density lipoprotein cholesterol (HDL‐C), and the history of hypertension, diabetes mellitus and/or smoking were evaluated.Results:  The statistically significant risk factors differed between the genders and among the arterial systems. The effect of total cholesterol and HDL‐C was more prominent in women than in men. The odds ratio of an elevated total cholesterol value (per 0.1 g/L) for coronary atherosclerosis was 1.56 (95% confidence interval, 1.25–1.95, P < 0.001) in women and 1.19 (1.07–1.33, P = 0.002) in men. Hypertension, but not serum lipid profiles, was significantly associated with cerebral atherosclerosis in both genders (P < 0.05). Diabetes mellitus and smoking were associated with atherosclerosis in selected arteries.Conclusion:  Dyslipidemia is a major determinant of atherosclerosis in the elderly, and control of dyslipidemia is still necessary in the elderly population.
Non‐medical palliative care and education to improve end‐of‐life care at geriatric health services facilities: A nationwide questionnaire survey of chief nurses
Authors: Hirakawa Yoshihisa , Masuda Yuichiro , Kuzuya Masafumi , Iguchi Akihisa , Uemura Kazumasa 
Published: September 2007

Background:  Geriatric health services facilities (GHSF) are expected to assume a growing role in caring for the dying elderly. However, research in this area has so far been scant. The purpose of the present study is to reveal the status of non‐medical palliative care and staff education aiming at improving and enhancing end‐of‐life care at GHSF.Methods:  The subjects were 2876 chief nurses of GHSF. Data was collected through a mailed questionnaire in 2003. The questionnaire covered the following: (i) staff perception of end‐of‐life care policies; (ii) staff education; and (iii) available non‐medical care. To evaluate the factors correlated with end‐of‐life care policies at GHSF, we divided the facilities into two groups.Results:  We analyzed the answers collected from 313 facilities with a progressive policy toward end‐of‐life care (PP group) and 818 with a regressive policy toward it (RP group). It was found that staff training was conducted more frequently among PP facilities. Generally, nurses in the PP facilities were more confident that they could provide comprehensive on‐site end‐of‐life care and grieving support, but did not feel so sure about their ability to provide better end‐of‐life environments for dying residents and family by organizing outside support from voluntary and/or governmental organizations and religious organization for healing and to pursue appropriately a written follow‐up communication with the bereaved family.Conclusions:  Our results suggest that providing GHSF staff with education about end‐of‐life issues or setting up collaboration with the outside is an important factor to enhance overall end‐of‐life care at these facilities.
Hospital care of people living in residential care facilities: Profile, utilization patterns and factors impacting on quality and safety of care
Authors: Jayasinghe Sanjay , Young Lis , Santiano Nancy , Bauman Adrian , Dickson Hugh G , Rowland Jeffrey , Anderson Teresa 
Published: September 2007

Background:  Residents in residential care facilities (RCF) are frequent users of acute hospital services. However, the interface between the two sectors remains relatively unexplored. Our objective was to determine the patterns of utilization, characteristics and experiences of RCF residents accessing a tertiary referral center (TRC).Methods:  An observational study of RCF residents presenting to the TRC emergency department (ED). The experiences of acute care services were explored for more than one‐quarter of this group 2–3 days postdischarge. The carer within the RCF acted as the proxy respondent.Results:  During the study period, RCF residents accounted for 2.3% of all ED presentations. These presentations involved 526 residents. The dimension “continuity of care” for the Picker Patient Experience questionnaire had the highest proportion (53.1%) reporting a problem. The likelihood of reporting a problem for “continuity of care” (odds ratio [OR], 3.58; confidence interval [CI], 1.72–7.45) and “information and education” (OR, 2.62; CI, 1.14–3.01) were higher if the resident was admitted to a ward compared to ED only. If the resident had a low level care status the likelihood of reporting a problem for “continuity of care” (OR, 2.8; CI, 1.02–7.72) also increased. The odds of RCF staff reporting a problem for “ambulance service” were significantly higher if the resident's presentation was related to a fall. (OR, 3.35; CI, 1.28–8.8).Conclusion:  The utilization rates for acute hospital care in our study were similar to the two previous Australian studies. Factors at the patient and organizational level impacted significantly on problems relating to the quality and safety of care being reported.
Three‐dimensional sonographic volume measurement of the fetal spleen
Authors: Hata Toshiyuki , Kuno Atsushi , Dai Shu‐Yan , Inubashiri Eisuke , Hanaoka Uiko , Kanenishi Kenji , Yamashiro Chizu , Tanaka Hirokazu , Yanagihara Toshihiro 
Published: September 2007

AbstractAim:  The objective of this longitudinal study was to evaluate the growth of the fetal spleen in normal pregnancies, using three‐dimensional ultrasound.Methods:  Three‐dimensional sonographic examinations were performed on 14 appropriate‐for‐gestational‐age fetuses. Fetal splenic volume was measured every 2–3 weeks after 20 weeks of gestational age until delivery.Results:  Curvilinear relationships were found between the gestational age and splenic volume (R2 = 80.2%, P < 0.0001), and normal ranges of splenic volume measurements for estimating the growth of the fetal spleen during normal pregnancy were generated. We found that the splenic volume calculation based on the equation for the volume of the ellipsoid by conventional two‐dimensional ultrasound in previous investigations is about twice as large as that using three‐dimensional ultrasound in our study, whereas the present data described in this study is quite comparable with previous data from an autopsy series.Conclusion:  Our findings suggest that the standard curve for the fetal splenic volume using three‐dimensional ultrasound provides a superior means for evaluating the normal splenic growth in the fetus and for identifying splenic abnormalities in utero. However, the data and its interpretation in our study should be taken with some degree of caution because of the small number of subjects studied. Further studies involving a larger sample size would be needed to confirm these findings.
Placenta previa increta/percreta in Japan: A retrospective study of ultrasound findings, management and clinical course
Authors: Sumigama Seiji , Itakura Atsuo , Ota Toyohiro , Okada Mayumi , Kotani Tomomi , Hayakawa Hiromi , Yoshida Kana , Ishikawa Kaoru , Hayashi Kazumasa , Kurauchi Osamu , Yamada Satoru , Nakamura Hiromi , Matsusawa Katsuji , Sakakibara Katsumi , Ito Mitsuaki , Kawai Michiyasu , Kikkawa Fumitaka 
Published: September 2007

AbstractAim:  Placenta accreta is an abnormally firm attachment of placental villi to the uterine wall, which may cause postpartum hemorrhage resulting in maternal morbidity and mortality. The purpose of the present study was to clarify the incidence, clinical background and prognosis of placenta previa increta/percreta treated with different modalities in Japan.Methods:  Medical records of cases with placenta previa increta/percreta in eight tertiary centers between January 1994 and December 2004 were reviewed. Placenta accreta without actual invasion into the myometrium confirmed by pathology was not included in placenta increta/percreta. Details of obstetric history, maternal background, ultrasonographical findings, the course of delivery, subsequent complications and management were noted.Results:  Among the total of 59 008 deliveries, 45 261 were by the vaginal route (76.7%) and 13 747 by cesarean section (23.3%). In this study, 408 cases were diagnosed as placenta previa (0.69%), 18 of these being placenta increta and 5 placenta percreta. Only 1.1% of cases of placenta previa without prior cesarean section were increta/percreta, in contrast to 37% of placenta previa after prior cesarean sections. Mean intraoperation blood loss was 3630 ± 2216 g (increta) and 12 140 ± 8343 g (percreta). One patient with placenta previa percreta died of hemorrhage. Stepwise treatment (cesarean section without separation of the placenta, arterial embolization and hysterectomy) was applied for 4 cases, which had the least blood loss.Conclusions:  Placenta previa increta/percreta is a life‐threatening disease. Patients who undergo hysterectomy after uterine arterial embolization demonstrate reduced intraoperation blood loss, and this treatment should be incorporated to reduce maternal morbidity.
Ultrasound‐determined fetal subcutaneous tissue thickness for a birthweight prediction model
Authors: Larciprete Giovanni , Valensise Herbert , Barbati Giulia , Di Pierro Giuseppe , Jarvis Sheba , Deaibess Therese , Gioia Stefano , Giacomello Francesco , Cirese Elio , Arduini Domenico 
Published: September 2007

AbstractAim:  The aim of this study was to explore a birthweight prediction model using ultrasound determined tissue thickness (SCTT) parameters.Methods:  We measured routine ultrasonographic biometric parameters and in addition, fetal SCTT in 201 healthy singleton pregnancies. Mid‐arm fat and lean mass, mid‐thigh fat and lean mass, subscapular fat mass and abdominal fat mass (AFM) were measured in order to calculate a birthweight prediction model. Ultrasound measurements were analyzed using an ‘anovarepeated measures model’. The growth rate (β‐slope) of the selected parameters was computed and the correlation coefficient with the birthweight and the Kendall rank correlation tau, were calculated.Results:  From the ultrasound determined SCTT parameters, only abdominal circumference (AC), AFM, and MTLM showed a statistically significant trend. The β‐slope of mid‐thigh lean mass was excluded since it exhibited significant correlation with the β‐slope of AFM. The final regression model could be calculated as: birthweight (gr.) = intercept +α1(AFM β‐slope) + α2(AC β‐slope), where α1, α2 represent regression coefficients.Conclusions:  We provide a graphical birthweight prediction model for clinical practice using conventional and specific ultrasound measurements of fetal subcutaneous tissue thickness. This model is based upon an overall analysis of the ultrasound estimated body components.
Length of the third stage of labor at term pregnancies is shorter if placenta is located at fundus: Prospective study
Authors: Altay M. Metin , İlhan Ali Kemal , Haberal Ali 
Published: September 2007

AbstractAim:  To investigate how the location of the placenta at term pregnancies affects the duration of the third stage of labor and to discuss the possible mechanisms affecting the duration of the third stage. We believe that this is the first prospective study comparing the duration of the third stage of labor according to placental location.Methods:  The placental implantation was determined as anterior (n = 78), posterior (n = 59), or fundal (n = 64) by ultrasound, in 201 women with singleton pregnancies. After delivery of the newborn, oxytocin infusion was routinely given. Duration of the third stage of labor was compared by anova. P < 0.05 was determined as significant.Results:  The duration of the third stage of labor was 10.36 ± 5.94 min, 10.44 ± 5.35 min, and 8.12 ± 4.25 min with placentas located anteriorly, posteriorly, and fundal, respectively. The length of the third stage was significantly shorter in the fundal placenta group.Conclusion:  In this study, the length of the third stage of labor was approximately 2 min shorter with placentas located at the fundus compared to the other two groups. The mechanism responsible for shorter duration may be the bipolar separation of fundal placentas in contrast to usual unipolar down‐up separation of anterior or posterior placentas. Another contributing factor may be the use of oxytocin infusion for the management of the third stage, however this should be investigated by further studies by using real time ultrasonography.
Evaluation of pregnant women with scarred uterus in a low resource setting
Authors: Agarwal Anjoo , Chowdhary Poonam , Das Vinita , Srivastava Aarti , Pandey Amita , Sahu Meenakshi T. 
Published: September 2007

AbstractAim:  Management of post cesarean pregnancy continues to be a dilemma. The present study was undertaken to evaluate the outcome of such pregnancies in a resource constrained setting so that an appropriate management protocol can be decided.Methods:  An observational study was conducted in the Department Of Obstetrics And Gynecology, King George's Medical University, Lucknow, India. The outcome of all of the women admitted with pregnancy with a previous cesarean section was noted.Results:  A total number of 447 women with a post cesarean pregnancy underwent delivery. These comprised 13.7% of total deliveries over the same period. 124 women (27.7%) had successful vaginal delivery while 323 (72.3%) had a repeat cesarean section. Maternal morbidity and perinatal mortality were both significantly higher in the vaginal delivery group (P = 0.00211 and P = 0.0426, respectively).Conclusions:  Vaginal birth after cesarean (VBAC) is associated with higher maternal morbidity and perinatal mortality. Therefore the decision for VBAC must be taken only after proper consideration and counseling of the couple.
Impact of laparoscopic cystectomy on fecundity of infertility patients with ovarian endometrioma
Authors: Nakagawa Koji , Ohgi Shirei , Kojima Rieko , Sugawara Kana , Ito Megumu , Horikawa Takashi , Irahara Minoru , Saito Hidekazu 
Published: September 2007

AbstractAim:  To clarify the effect of laparoscopic cystectomy for ovarian endometrioma in infertility patients, the pregnancy outcome was evaluated.Methods:  This was a retrospective study. From August 2002 to February 2006, 33 infertility patients with ovarian endometrioma underwent laparoscopic cystectomy at our center. According to the laparoscopic findings 33 were divided into two groups; 10 were evaluated as the patients who need assisted reproductive technologies (ART) treatment (IVF subgroup) and 23 were evaluated as the patients who do not need ART treatment but conventional infertility treatment (non‐IVF subgroup). During the same period, 70 patients who were age‐matched and received ART treatment without laparoscopy were defined as control (control group). Following up to 12 months after laparoscopy, the cumulative pregnancy rate in the non‐IVF subgroup was calculated.Results:  The patients age, duration of infertility and size of endometrioma were equal in the IVF and the non‐IVF subgroups. The revised‐American Society of Reproductive Medicine (r‐ASRM) score in the IVF subgroup was significantly higher than that in the non‐IVF group (P < 0.05). The pregnancy rates after laparoscopic cystectomy in IVF and non‐IVF subgroups were 50.0% and 60.9%, respectively. These rates in the IVF and the non‐IVF groups were slightly higher than that in control group (41.4%), but these differences were not significant. The cumulative pregnancy rate in the non‐IVF group reached 52.2%, 12 months after laparoscopic surgery.Conclusions:  Laparoscopic surgery should be performed prior to ART treatment not only for making a decision about the treatment course but also for establishing a good pelvic condition to induce a pregnancy during ART treatment in infertility treatment with ovarian endometrioma.
Efficacy and outcome of anterior vaginal wall repair using polypropylene mesh (Gynemesh)
Authors: Jo Hoenil , Kim Jae Weon , Park Noh Hyun , Kang Soon Beom , Lee Hyo Pyo , Song Yong‐Sang 
Published: September 2007

AbstractAim:  The aim of the present study was to assess the safety and efficacy of anterior vaginal wall repair using polypropylene mesh for the correction of anterior vaginal wall prolapse.Methods:  From May 2001 to March 2005, 38 patients with cystoceles or uterine prolapse underwent transvaginal repair with implantation of polypropylene mesh. In all 38 patients anterior vaginal wall repair was done concurrently with other procedures: vaginal hysterectomy, n = 18 (47.4%) and tension‐free vaginal tapes n = 22 (57.9%).Results:  Preoperatively 26 patients (68.4%) had stage III/IV prolapse on pelvic organ prolapse quantification examination. After mean follow up of 23.4 months, the objective cure rate at 12 and 18 months was 94.5% and 94.3%, respectively. As for complications associated with placement of the polypropylene mesh, no tissue erosion or infection was found.Conclusions:  Transvaginal implantation of polypropylene mesh is an effective and safe technique for the correction of anterior vaginal wall prolapse.