bluuebunny/crossref_metadata_2025_split huggingface dataset:
Randomized, Placebo-Controlled Trial of Transplacental Antibiotic Prophylaxis of Neonatal Group B Streptococcal Colonization and Bacteremia in Rabbits
Authors: Lembet Arda , McDuffie Robert S. , Gibbs Ronald S. 
Published: March 2007

Objective:We evaluated the effect of maternal administration of ampicillin/sulbactam on colonization and bacteremia in newborn rabbits after intracervical inoculation of mothers with group B streptococci (GBS).Methods:New Zealand white rabbits on day 30 of a 31-day gestation were inoculated intracervically with104−105colony forming units (cfu) GBS. Two hours after inoculation mothers received ampicillin/sulbactam (50 mg/kg) or saline (control) intramuscularly as a single dose, in a randomized double-blinded manner. We induced labor 4 h later with intramuscular oxytocin. At delivery, cultures for GBS were taken from neonatal oropharynx. Thereafter, cultures were taken from neonatal oropharynx and anorectum daily and from neonatal heart at death or after 96 h. Sample size analysis showed a need for 17 pups in each group.Results:In the control group, induction failed in one animal that was excluded from analysis. At birth, 0 of 39 pups of treated does had positive oropharyngeal cultures compared to 26 of 27 (96%) pups of saline-treated does (P< 0.0001). Pups treated with antibiotic in utero were also significantly less likely to have positive oropharyngeal cultures at 24, 48, and 72 h after birth compared to controls (24 h, 0% vs. 100%,P< 0.0001; 48 h, 8% vs. 100%,P< 0.0001; 72 h, 16% vs. 100%,P< 0.0001). Treated pups were significantly less likely to have positive anorectal cultures at 24, 48, and 72 h after birth compared to control animals (24 h, 0% vs. 100%,P< 0.0001; 48 h, 0% vs. 95%,P< 0.0001; 72 h, 0% vs. 92%,P< 0.0001). Treated pups were significantly less likely to have positive heart cultures at 72 h after birth compared to controls (11% vs. 92%,P< 0.0002). Cumulative neonatal survival was higher in treated pups compared to controls at 72 and 96 h after birth (72 h, 32% vs. 0%,P= 0.0003; 96 h, 26% vs. 0%,P= 0.015).Conclusions:Single dose transplacental prophylaxis given 4 h before delivery resulted in decreased neonatal GBS colonization and bacteremia and improved neonatal survival in rabbits.
Cervical Ripening With Prostaglandin Gel andHygroscopic Dilators
Authors: Hibbard J. U. , Shashoua A. , Adamczyk C. , Ismail M. 
Published: March 2007

Objective: To study the effectiveness and morbidity of adding hygroscopic cervical dilators to prostaglandin
gel for cervical ripening and labor induction.Study design: Patients of at least 34 weeks’ gestation with a medical indication for induction of
labor and with a modified Bishop score of 5 or less were randomized to receive either prostaglandin
gel or prostaglandin gel with hygroscopic cervical dilators. Primary outcomes were time to delivery,
change in cervical score, and infection. Secondary outcomes included cesarean delivery rate and
deliveries before 24 hours of induction. Continuous variables were analyzed by Wilcoxon sum rank
test and categorical data by chi‐square or Fisher exact test, with P < 0.05 being significant.Results: Seventeen patients were randomized to intracervical prostaglandin alone and 23 patients
received intracervical prostaglandin plus hygroscopic dilators. No demographic differences were
noted between the groups. After six hours of ripening, the combined group achieved a greater
change in Bishop score (3.6 vs. 2.1, P = 0.007) and tended to have a shorter induction time (21.7 vs. 26.4 hours, P = 0.085). The combined therapy group had a higher infection rate than the prostaglandin‐only group (59% vs. 12%, P = 0.003).Conclusion: Combining cervical dilators with prostaglandin gel provides more effective cervical
ripening and a more rapid induction to delivery interval than prostaglandin alone but with a significant
and prohibitive rate of infection.
Compliance With Universal Precautions: Knowledgeand Behavior of Residents and Students in aDepartment of Obstetrics and Gynecology
Authors: Helfgott A. W. , Taylor-Burton J. , Garcini F. J. , Eriksen N. L. , Grimes R. 
Published: March 2007

Objectives: To assess the knowledge of universal precautions for the delivery and operating rooms
by residents and students and to evaluate their use of universal precautions.Study Design: Obstetrics and gynecology (ob/gyn) residents (n = 30) and students (n = 31) from
an inner‐city, teaching hospital were polled by anonymous questionnaire to assess their knowledge
of the appropriate barrier equipment for certain ob/gyn procedures. To determine actual compliance
with universal precautions, 459 0b/gyn procedures were observed. We noted the use of appropriate
barrier equipment for each procedure: gloves for pelvic exam and face shields, gowns,
gloves, and booties for vaginal delivery, cesarean delivery, and dilation and curettage. The True
Epistat statistical software program was used to perform simple regression analysis.Results: Thirty residents (100%) knew the appropriate barrier equipment required for each type
of procedure performed. One student (<1%) did not know that booties were appropriate for the
surgical procedures. Rationale for lack of compliance with universal precautions elicited by the
questionnaire included time constraints (64%), inconvenience (52%), and presumption that patient
was not infected (34%).The observed rate of compliance with universal precautions by participants indicates that individual
compliance was inversely related to the years of experience (overall compliance rate of
students was 96%; for first‐year residents, 92%, second‐year residents, 89%, third‐year residents,
84%, fourth‐year residents, 78%; r = ‐0.9918, P = 0.0009).Conclusions: Knowledge regarding universal precautions was nearly 100%, while overall observed
compliance was only 89%. Compliance with universal precautions was better among students
(96%) than among residents (88%). Compliance with universal precautions was inversely
related to years of experience.
The Effects of Escherichia coli STa (Heat Stable) Toxinon the Contractility of Isolated Human MyometriumIn Vitro
Authors: de Carrera A. Leal , Carrera-Leal B. , Pierdant-Perez G. , Deleon F. D. , Mcfadden T. M. 
Published: March 2007

Objective: The purpose of the study was to assess the effects of Escherichia coli STa (heat stable)
toxin on isolated human myometrial response to oxytocin.Methods: One hundred and sixteen muscle strips were obtained from the lower uterine segment
of 42 women undergoing cesarean section at term. Amniotic membranes and decidua were excluded.
Uterine contractility in response to cumulative doses of E. coli STa toxin was recorded, as
well as uterine response to cumulative doses of oxytocin before and after incubation with STa toxin
or vehicle. The 50th percentile effective oxytocin concentration (EC50) of muscle strips with and
without spontaneous activity before and after the incubation with STa toxin or vehicle was calculated.
A paired t test was used for comparison.Results: Muscle strips with and without spontaneous activity responded to cumulative doses of
oxytocin before and after the incubation with STa toxin or vehicle. No differences in contraction
force, duration, or frequency were noted between the groups (P > 0.05). Furthermore, this toxin
was not able to induce uterine contractility when tested alone.Conclusions: The inability of this toxin to affect myometrial response to oxytocin in this study may
be due to the absence of amnion cells, chorion, or decidua. Other possible explanations for the lack
of response are discussed.
The Role of Bacterial Vaginosis in Infection After Major Gynecologic Surgery
Authors: Lin L. , Song J. , Kimber N. , Shott S. , Tangora J. , Aroutcheva A. , Mazees M. B. , Wells A. , Cohen A. , Faro S. 
Published: March 2007

Purpose:Previous studies have reported an association between bacterial vaginosis (BV) and postoperative fever and infection. This prospective study investigated whether the intermediate or definite stages of BV are risk factors for postoperative infection after major gynecologic surgery.Methods:Vaginal cultures were obtained preoperatively from 175 women undergoing gynecologic surgery. The diagnostic criteria for BV were based on Nugent's standardized method of Gram stain interpretation. Postoperative fever was defined as at least one temperature equal to 101.0℉ or greater, or two or more temperatures more than 6 hours apart equal to 100.4℉ or greater.Results:Thirty-six percent of the positive-BV group developed a postoperative fever, compared with 20% of theLactobacillus-predominant group and 12% of the intermediate-BV group (P= 0.017). The differences between the positive-BV group and theLactobacillus-predominant group, and between the positive-BV group and the intermediate-BV group, with respect to postoperative fever, were statistically significant (P= 0.045 andP= 0.007, respectively). The difference between the intermediate-BV group and theLactobacillus-predominant group was not statistically significant (P= o.28).Conclusions:Although the association between BV and postoperative febrile morbidity could be a spurious result of confounding with other variables, it may be prudent for the surgeon to identify patients with BV and treat them preoperatively. Infect. Dis. Obstet. Gynecol. 7:169–174, 1999.
Do Antepartum Herpes Simplex Virus Cultures Predict Intrapartum Shedding for Pregnant Women With Recurrent Disease?
Authors: Garland S. M. , Lee T. N. , Sacks S. 
Published: March 2007

Objective: To examine antenatal screening as a predictor of intrapartum shedding of herpes simplex virus (HSV) and to determine its usefulness in guiding the appropriate route of delivery for patients with recurrent HSV in pregnancy.Methods: A population of 198 pregnant women with a history of recurrent genital HSV were cultured in the last weeks of their pregnancy by specially‐trained personnel and intrapartum by their delivering attendants.Results: Of cultures from a total of 906 antenatal visits, 17% were culture positive, with an asymptomatic shedding rate of 3.4%. Asymptomatic shedding occurred in 12.6% of women. Over the 8‐week antepartum period, viral culture‐positivity rates for each visit ranged from 11% to 19.5%. This provided an expected delivery culture‐positivity rate of 15.3%. However, actual intrapartum viral culture positivity occurred in only three of 191 women (1.5%; P < 0.001). Because previous studies have suggested antepartum culture positivity fails to predict intrapartum viral shedding, evaluations, including cultures, as well as predictive values for subsequent culture positivities, were determined under the supervision of an infectious disease specialist. Under these conditions, positive predictive values were 59% when the interval between visits was 2 days, but only 19% when days between visits were >2 (P < 0.0001). No cases of neonatal herpes were seen in this population, although cesarean deliveries were performed in 31% of the patient population, with genital herpes as the indication for 56% of those.Conclusions: Antepartum serial screening by viral culture is not predictive of an infant′s risk of intrapartum viral exposure when conducted at weekly intervals. However, more frequent assessments of patients can be predictive of an infant′s exposure risk to HSV; for patients with frequent recurrent disease near term or primary infection in pregnancy, frequent late antepartum screening may be appropriate. Infect. Dis. Obstet. Gynecol. 7:230–236, 1999.
Puerperal and Intrapartum Group A Streptococcal Infection
Authors: Anteby Eyal Y. , Yagel Simcha , Hanoch Josef , Shapiro Mervyn , Moses Allon E. 
Published: March 2007

Objective: To determine the demographic and clinical variables characteristic of non‐epidemic intrapartum or puerperal group A streptococcal (GAS) infection.Methods: The records of 47 patients diagnosed with intrapartum or puerperal GAS infection over a 6 1/2 year period at Hadassah‐University Hospital‐Mt. Scopus, Jerusalem were reviewed. Data regarding 25,811 women, the general population of women that delivered during that period, were obtained from their computerized medical records. Frequency distributions, t‐test, chi‐square, and Spearman′s Rank Correlation were used, as appropriate, to analyze and compare demographic and clinical variables associated with development of GAS infection, its clinical course and subsequent
development of septic shock.Results: Mean age of mothers with GAS infection was higher than that of our general pregnant population (30.4 versus 27.4 years, P = 0.0019), and a higher proportion of GAS infected patients (30% versus 12%, P < 0.005) experienced PROM. Thirty‐one (66%) women had fever as their sole presenting symptom, eight (17%) had fever and abdominal pain, seven (15%) had fever and abnormal vaginal bleeding, and one patient (2%) presented with a rash. Three patients (6%) developed a septic shock. Two of these patients presented with symptoms more than 14 days after delivery.Conclusions: We describe the characteristics of non‐epidemic intrapartum or puerperal GAS infection. Data from our study and review of the literature suggest that some patients who develop septic shock may present later in the puerperium than patients with an uncomplicated GAS infection. Infect. Dis. Obstet. Gynecol. 7:276–282; 1999.
Views of oncology patients, their relatives and oncologists on cardiopulmonary resuscitation (CPR): questionnaire-based study
Authors: Ackroyd Rajeena , Russon Lynne , Newell Rob 
Published: March 2007

Background: Doctors are justified withholding a treatment, such as cardiopulmonary resuscitation (CPR), if it is unlikely to benefit a patient. The success rates for CPR in patients with cancer is <1%. Guidelines produced in 2001 recommended that CPR should be discussed with patients, even when it is unlikely to be successful. Therefore, should oncologists always discuss resuscitation, even when it is likely to be futile? Method: Sixty oncology in-patients and 32 of their relatives were asked their views on CPR, and their views were compared with the oncologist involved in their care. Results: Some 58% of patients wanted to be resuscitated. There was a moderate-strong correlation between patients and their next of kin and the desire for resuscitation. There was also a positive correlation between the doctor’s views on suitability for resuscitation, patient’s prognostic score, and World Health Organisation (WHO) performance score. Conclusion: Most patients wanted to be resuscitated despite being given the likely poor survival rates from CPR. They also wanted to be involved in the decision-making process, and wanted their next of kin involved, even when, medically, the procedure was unlikely to be successful. The findings that patient and next of kin views correlated well shows that relatives’ views are a good representation of patient views. In contrast, consultant’s decisions were strongly correlated with the patient’s performance status and clinical state. No patients were upset by the study, although nine patients declined to participate.
Demographic factors and awareness of palliative care and related services
Authors: Koffman Jonathan , Burke Geraldine , Dias Angela , Raval Bharti , Byrne Judi , Gonzales Juan , Daniels Charles 
Published: March 2007

Background: Palliative care is not accessed by all those who can benefit from it. Survey aim: To explore awareness of palliative care and related services among UK oncology out-patients, and to analyse the relationship between demographic characteristics and knowledge. Design: Cross-sectional interview-based survey. Analysis comprised univariate and multiple logistic regression. Participants and settings: Oncology out-patients receiving curative treatments at two district general hospitals in north-west London between December 2004 and April 2005. Results: A total of 252 (94%) eligible clinic patients were interviewed. Only 47 (18.7%) patients recognised the term ‘palliative care’, but 135 (67.8%) understood the role of the hospice, and 164 (66.7%) understood the role of Macmillan nurses. Age-adjusted multiple logistic regression showed that recognizing the term ‘palliative care’ was more likely among the most socially and materially affluent patients than those who were the poorest (OR: 8.4, CI: 2.17-31.01, p =0.002). Understanding the role of Macmillan nurses was also more likely among the most socially and materially affluent patients compared with the poorest patients (OR: 7.0, CI: 2.41-18.52, p <0.0001), and was independently less likely among patients from black and minority ethnic groups than those who were classified as being white British (OR=0.5, CI:0.25-0.96, p =0.04). Conclusions: Awareness of palliative care and related services was low among black and minority ethnic groups, and the least affluent.
Dying trajectories in heart failure
Authors: Gott Merryn , Barnes Sarah , Parker Chris , Payne Sheila , Seamark David , Gariballa Salah , Small Neil 
Published: March 2007

Objectives: To explore dying trajectories in heart failure. Design: Prospective, longitudinal study. Setting: Sixteen GP surgeries in four demographically contrasting areas of the UK. Participants: A total of 27 heart failure patients, >60 years of age, who completed questionnaires for at least five time-points before death. Main outcome measures: Kansas City Cardiomyopathy Questionnaire Physical Limitation Scale. Results: No ‘typical’ dying trajectory could be identified, and only a minority of patients conformed to the theoretical trajectory of dying in heart failure. Conclusions: This study provides the first prospective data regarding physical decline prior to death in heart failure. Findings challenge current efforts to plan and deliver palliative care services on the basis of the theoretical heart failure dying trajectory.
TAMEE: data management and analysis for tissue microarrays
Authors: Thallinger Gerhard G , Baumgartner Kerstin , Pirklbauer Martin , Uray Martina , Pauritsch Elke , Mehes Gabor , Buck Charles R , Zatloukal Kurt , Trajanoski Zlatko 
Published: March 2007

Abstract

Background
With the introduction of tissue microarrays (TMAs) researchers can investigate gene and protein expression in tissues on a high-throughput scale. TMAs generate a wealth of data calling for extended, high level data management. Enhanced data analysis and systematic data management are required for traceability and reproducibility of experiments and provision of results in a timely and reliable fashion. Robust and scalable applications have to be utilized, which allow secure data access, manipulation and evaluation for researchers from different laboratories.

Results
TAMEE (Tissue Array Management and Evaluation Environment) is a web-based database application for the management and analysis of data resulting from the production and application of TMAs. It facilitates storage of production and experimental parameters, of images generated throughout the TMA workflow, and of results from core evaluation. Database content consistency is achieved using structured classifications of parameters. This allows the extraction of high quality results for subsequent biologically-relevant data analyses. Tissue cores in the images of stained tissue sections are automatically located and extracted and can be evaluated using a set of predefined analysis algorithms. Additional evaluation algorithms can be easily integrated into the application via a plug-in interface. Downstream analysis of results is facilitated via a flexible query generator.

Conclusion
We have developed an integrated system tailored to the specific needs of research projects using high density TMAs. It covers the complete workflow of TMA production, experimental use and subsequent analysis. The system is freely available for academic and non-profit institutions from http://genome.tugraz.at/Software/TAMEE.
Lercanidipine in the Treatment of Hypertension
Authors: Beckey Cherylyn , Lundy Amber , Lutfi Nahla 
Published: March 2007

Objective: To review the literature regarding the efficacy, tolerability, and utility of lercanidipine in the treatment of hypertension. Data Sources: A search of the literature was performed using MEDLINE (1966'September 2006), EMBASE Drugs and Pharmacology (1980'September 2006), and Current Contents/Clinical Medicine (week 24, 2005'week 30, 2006). Package inserts from lercanidipine, nifedipine, felodipine, and amlodipine were also reviewed for comparison of adverse effects. Study Selection And Data Extraction: Articles were limited to clinical trials, abstracts, and review articles published in English. Data Synthesis: Lercanidipine is a novel dihydropyridine (DHP) calcium-channel blocker indicated for the treatment of mild-to-moderate hypertension. Although it is not yet available in the US, lercanidipine has been utilized extensively in other countries. In 2 randomized controlled trials of approximately 400 patients with mild-to-moderate hypertension, lercanidipine showed efficacy similar to that of 2 other DHPs, felodipine and slow-release nifedipine, in significantly reducing systolic blood pressure and diastolic blood pressure (DBP) after 4 weeks. In a longer trial (12 mo), lercanidipine 10 mg/day led to normalized blood pressure in 49% of patients after 4 weeks. A postmarketing trial of 9050 patients corroborated the results observed in previous clinical trials, with 64% of patients achieving a DBP of less than 90 mm Hg and 32% attaining blood pressure control (<140/90 mm Hg). in elderly patients, lercanidipine was found comparable with lacidipine and nifedipine, showing similar decreases in DBP when compared with nifedipine ('18.3 vs '17.7 mm Hg, respectively). What distinguishes lercanidipine from other members of the DHP class is its lower incidence of adverse effects, particularly edema. One study showed that fewer patients withdrew secondary to adverse drug reactions in the lercanidipine (0.9%) and nifedipine (3.8%) group compared with the felodipine (4.5%) group. Lercanidipine has also shown efficacy similar to that of other antihypertensives, including atenolol, captopril, and losartan. Conclusions: Lercanidipine may be an option in the treatment of hypertension, as current literature suggests comparable antihypertensive efficacy and better tolerability. Further randomized, double-blind clinical trials must be conducted in order to clarify its position among other antihypertensive medications.
Olmesartan Medoxomil–Induced Angioedema
Authors: Nykamp Diane , Winter Erin E 
Published: March 2007

Objective: To report a case of olmesartan medoxomil-induced angioedema in an angiotensin-converting enzyme (ACE) inhibitor–naïve patient. Case Summary: A 61-year-old white woman with hypertension experienced significant swelling of her face, neck, and lips 10 days after initiation of olmesartan medoxomil 20 mg/day. After discontinuation of the drug, symptoms resolved within 10 days. Use of the Naranjo probability scale indicated a probable association between angioedema and olmesartan medoxomil. Discussion: An angiotensin receptor blocker (ARB) is, in many cases, considered a safe alternative to an ACE inhibitor since serum bradykinin is thought not to be affected. However, angioedema has been reported with the use of ARBs, suggesting alternative pathways or mechanisms that result in this adverse reaction. Although not proven in humans, one explanation is that a secondary stimulation of angiotensin II AT2 receptors produces an increase in tissue bradykinin, resulting in angioedema. Conclusions: As of February 26, 2007, this is the first published reported case of olmesartan medoxomil–induced angioedema. Practitioners should be aware of this rare but potentially serious adverse event.