bluuebunny/crossref_metadata_2025_split huggingface dataset:
Substandard care in maternal mortality due to hypertensive disease in pregnancy in the Netherlands
Authors: Schutte JM , Schuitemaker NWE , Van Roosmalen J , Steegers EAP ,   Dutch Maternal Mortality Committee
Published: April 2008

Objectives  To review the standard of care in cases of maternal mortality due to hypertensive diseases in pregnancy and to make recommendations for its improvement.Design  Care given to women with hypertensive disease in pregnancy was audited and substandard care factors identified.Setting  Confidential enquiry by the Dutch Maternal Mortality Committee (MMC) from the Netherlands Society of Obstetrics and Gynaecology.Population  All maternal deaths reported to the MMC due to hypertensive disease in pregnancy in the Netherlands during the years 2000–04.Methods  Assessment for substandard care factors using a checklist based on the Dutch guideline of ‘Hypertensive Disorders in Pregnancy’.Main outcome measures  Substandard care in cases of maternal mortality due to hypertensive diseases in pregnancy.Results  A total of 27 cases of maternal death due to hypertensive disease in pregnancy were reported to the committee in the study period. In 26 cases (96%), substandard care factors were present, of which in 17 cases (63%), these were for more than five different items. In community midwifery care, the most frequent substandard care factor was no testing for proteinuria when clearly indicated (41%). In hospital care, the most frequent substandard care was related to insufficient diagnostic testing when indicated (41%), insufficient management of hypertension by obstetricians (85%), no use or inadequate use of magnesium sulphate (67%), inadequate stabilisation before transport to tertiary care centres and/or delivery (52%) and failure to consider timely delivery (44%).Conclusions  Education of pregnant women concerning danger signs of hypertensive disease should be improved. Training of midwives and obstetricians should be improved in the following areas: performing basic diagnostic tests, adequate management of hypertension and eclampsia, with more attention to treatment of systolic blood pressure. This training should be guided by clear local protocols. Delivery should not be delayed in serious cases of hypertensive disease in pregnancy, not only after 32–34 weeks but also in early‐onset pre‐eclampsia as maternal risks often outweigh possible fetal benefits of temporising management.
Swyer syndrome: presentation and outcomes
Authors: Michala L , Goswami D , Creighton SM , Conway GS 
Published: April 2008

Objective  To establish the spectrum of presentation, natural history and gynaecological outcomes in women with Swyer syndrome.Design  Retrospective notes review.Setting  Tertiary referral centre for disorders of sex development.Population  A total of 29 adult women with Swyer syndrome.Methods  Information was collected on age at diagnosis, biometric characteristics, timing of gonadectomy, histology of gonad, bone mineral density, uterine size and fertility.Main outcome measures  Age at diagnosis, risk of gonadal malignancy, bone mineral density, uterine size.Results  With regard to presentation, 26/29 (90%) women in this series presented with delayed puberty, and the median age at diagnosis was 17.2 years (range 0–55 years). The median age at gonadectomy was 18 years (range 9–33 years). Histology of the gonad was available in 22 women and demonstrated streak gonads with no evidence of malignancy in 12, dysgerminoma in 7 and gonadoblastoma in 3. The youngest patient diagnosed with dysgerminoma was 10 years old. The median height of the women was 1.73 m (range 1.54–1.95 m). Twelve out of the 20 (60%) women had evidence of osteopenia on dual energy X‐ray absorptiometry scan. The uterine size and shape was assessed in eight women after completion of induction of puberty, and the uterine cross‐section was found to be significantly lower than that in normal controls. Fertility was achieved with ovum donation in three women, all of whom had live births and one subsequently had a second successful pregnancy.Conclusion  Early diagnosis of Swyer syndrome is necessary in view of the risk of dysgerminoma that can develop at an early age. Adequate hormone replacement is required to maintain bone mineral density and may improve the uterine size and shape.
The risk of unexplained antepartum stillbirth in second pregnancies following caesarean section in the first pregnancy
Authors: Wood SL , Chen S , Ross S , Sauve R 
Published: April 2008

Objective  To determine if a previous caesarean section increases the risk of unexplained antepartum stillbirth in second pregnancies.Study design  Retrospective cohort study.Setting  Large Canadian perinatal database.Population  158 502 second births.Methods  Data were obtained from a large perinatal database, which supplied data on demographics, pregnancy complications, maternal medical conditions, previous caesarean section and pregnancy outcomes.Main outcome measures  Total and unexplained stillbirth.Results  The antepartum stillbirth rate was 3.0/1000 in the previous caesarean section group compared with 2.7/1000 in the previous vaginal delivery group (P= 0.46). Multivariate logistic regression modelling, including terms for maternal age (polynomial), weight >91 kg, smoking during pregnancy, pre‐pregnancy hypertension and diabetes, did not document an association between previous caesarean section and unexplained antepartum stillbirth (OR 1.27, 95% CI 0.92–1.77).Conclusion  Caesarean section in the first birth does not increase the risk of unexplained antepartum stillbirth in second pregnancies.
Lactate concentration in umbilical cord blood is gestational age‐dependent: a population‐based study of 17 867 newborns
Authors: Wiberg N , Källén K , Herbst A , Åberg A , Olofsson P 
Published: April 2008

Objective  To study the influence of gestational age on lactate concentration in arterial and venous umbilical cord blood at birth and to define gestational age‐specific reference values for lactate in vigorous newborns.Design  Population‐based comparative.Setting  University hospitals.Sample  Vigorous newborns with validated umbilical cord blood samples.Material and methods  From 2000 to 2004, routine cord blood gases, lactate and obstetric data from two university hospitals were available for 17 867 newborns from gestational week 24 to 43. After validation of blood samples and inclusion only of singleton pregnancies aimed for vaginal delivery, 10 700 women remained. Among those, reference values were defined in 10 169 vigorous newborns, that is in newborns with a 5‐minute Apgar score corresponding to the gestational age‐specific median value minus 1 point score, or better.Main outcome measures  Cord lactate concentration relative to gestational age.Results  The arterial and venous lactate concentrations increased monotonously with gestational age from 34 weeks. Considerable differences were found between mean and median values, but after logarithmic transformation the log‐lactate values were normally distributed. Simple linear regression analysis showed a significant association between the log‐lactate values and gestational age (P < 10−6, R2= 0.024). Reference curves were constructed after anti‐logarithmic transformation. Both the gestational age and the time of the second stage of labour influenced, independently of each other, the lactate concentrations.Conclusions  Lactate concentrations in arterial and venous umbilical cord blood are increasing significantly with advancing gestational age.
Delayed umbilical cord clamping at birth has effects on arterial and venous blood gases and lactate concentrations
Authors: Wiberg N , Källén K , Olofsson P 
Published: April 2008

Objective  To estimate the influence of delayed umbilical cord clamping at birth on arterial and venous umbilical cord blood gases, bicarbonate (), base excess (BE) and lactate in vigorous newborns.Setting  University hospital.Design  Prospective observational.Sample  Vaginally delivered term newborns.Material and methods  Umbilical cord arterial and venous blood was sampled repeatedly every 45 seconds (T0= time zero; T45= 45 seconds, T90= 90 seconds) until the cord pulsations spontaneously ceased in 66 vigorous singletons with cephalic vaginal delivery at 36–42 weeks. Longitudinal comparisons were performed with the Wilcoxon signed‐ranks matched pairs test. Mixed effect models were used to describe the shape of the regression curves.Main outcome measures  Longitudinal changes of umbilical cord blood gases and lactate.Results  In arterial cord blood, there were significant decreases of pH (7.24–7.21), (18.9–18.1 mmol/l) and BE (−4.85 to −6.14 mmol/l), and significant increases of PaCO2 (7.64–8.07 kPa), PO2 (2.30–2.74 kPa) and lactate (5.3–5.9 mmol/l) from T0 to T90, with the most pronounced changes at T0–T45. Similar changes occurred in venous blood pH (7.32–7.31), (19.54–19.33 mmol/l), BE (−4.93 to −5.19 mmol/l), PaCO2 (5.69–5.81 kPa) and lactate (5.0–5.3 mmol/l), although the changes were smaller and most pronounced at T45–T90. No significant changes were observed in venous PO2.Conclusion  Persistent cord pulsations and delayed cord clamping at birth result in significantly different measured values of cord blood acid–base parameters.
Transoesophageal echocardiography should be considered in patients with ischaemic stroke or transient ischaemic attack
Authors: Strandberg Marjatta , Marttila Reijo J , Helenius Hans , Hartiala Jaakko 
Published: April 2008

SummaryBackground and purpose:  In this present study, we tried to find out if there is a subgroup of patients that should not undergo transoesophageal echocardiography (TEE) after an ischaemic stroke or transient ischaemic attack (TIA).Methods:  A total of 441 consecutive unselected patients with ischaemic stroke or TIA suitable for anticoagulation were examined with TEE in the acute phase. The patients were divided into five subcategories according to their rhythm, age and the findings in carotid sonography, and into two groups according to the presence of clinical risk factors for ischaemic stroke or TIA.Results:  From the 441 studied patients, 60 (14%) had chronic or paroxysmal atrial fibrillation (AF) and 381 (86%) were in sinus rhythm (SR). Of the patients in SR, 46 (12%) were below 50 years old. The carotid sonography was conducted in 240 patients above 50 years old and in SR, and <50% internal carotid artery (ICA) stenosis was found in 194 (81%) patients and ≥50% ICA in 46 (19%) patients. Potential cardiac sources of embolism were found in patients both with AF or in SR (70% versus 46%), both below and above 50‐year‐old patients in SR (37% versus 47%), both in over 50‐year‐old patients in SR with <50% ICA stenosis and ≥50% ICA stenosis (41% versus 61%) and in patients in SR either without or with clinical risk factors for ischaemic stroke or TIA (43% versus 51%). On the basis of the TEE study, oral anticoagulation was started in 36 (9%) patients in SR.Conclusion:  These results support TEE in patients with ischaemic stroke or TIA who are candidates for receiving oral anticoagulation.
Effects of Poverty and Lack of Insurance on Perceptions of Racial and Ethnic Bias in Health Care
Authors: Stepanikova Irena , Cook Karen S. 
Published: April 2008

Objective.To investigate whether poverty and lack of insurance are associated with perceived racial and ethnic bias in health care.Data Source.2001 Survey on Disparities in Quality of Health Care, a nationally representative telephone survey. We use data on black, Hispanic, and white adults who have a regular physician (N=4,556).Study Design.We estimate multivariate logistic regression models to examine the effects of poverty and lack of health insurance on perceived racial and ethnic bias in health care for all respondents and by racial, ethnic, and language groups.Principal Findings.Controlling for sociodemographic and other factors, uninsured blacks and Hispanics interviewed in English are more likely to report racial and ethnic bias in health care compared with their privately insured counterparts. Poor whites are more likely to report racial and ethnic bias in health care compared with other whites. Good physician–patient communication is negatively associated with perceived racial and ethnic bias.Conclusions.Compared with their more socioeconomically advantaged counterparts, poor whites, uninsured blacks, and some uninsured Hispanics are more likely to perceive that racial and ethnic bias operates in the health care they receive. Providing health insurance for the uninsured may help reduce this perceived bias among some minority groups.
Does Hospital Performance on Process Measures Directly Measure High Quality Care or Is It a Marker of Unmeasured Care?
Authors: Werner Rachel M. , Bradlow Eric T. , Asch David A. 
Published: April 2008

Objective. Quality measures may be associated with improved outcomes for two reasons. First, measured activities may directly improve care. Second, success on these measures may be a marker for other unmeasured aspects of high quality care. Our objective is to test the contribution of both possible effects.Data Sources. 2004 Medicare data on hospital performance from Hospital Compare and risk‐adjusted mortality rates from Medicare Part A claims.Study Design. We studied 3,657 acute care U.S. hospitals and compared observed differences in condition‐specific hospital mortality rates based on hospital performance with expected differences in mortality from the clinical studies underlying the measures.Principal Findings. Differences in observed mortality rates across U.S. hospitals are larger than what would be expected if these differences were due only to the direct effects of delivering measured care.Conclusions. Performance measures reflect care processes that both improve care directly and are also markers of elements of health care quality that are otherwise unmeasured. This finding suggests that process measures capture important information about care that is not directly measured, and that these unmeasured effects are in general larger than the measured effects.
Premature Ventricular Contractions Arising from the Pulmonary Artery: The Use of Multielectrode Array Mapping and Cryoablation
Authors: SHANMUGAM NESAN , LIEW REG , SNEDDON JAMES , WARD DAVID 
Published: April 2008

Premature ventricular contractions with a left bundle branch block‐like morphology and inferior axis typically originate from the right ventricular outflow tract; however, they can also originate from the pulmonary artery.We report two patients with frequent premature ventricular contractions who underwent successful cryoablation of ectopics arising from the posterolateral region of the pulmonary artery. The safe and effective use of cryoablation within the pulmonary artery is discussed. We recommend the use of noncontact mapping with multielectrode array catheter in facilitating the technique and providing a more accurate localization of the ectopic focus within the pulmonary artery, compared with conventional pace mapping methods.
When an ICD is Not the Answer… Hypothyroidism‐Induced Cardiomyopathy and Torsades de Pointes
Authors: ELLIS CHRISTOPHER R. , MURRAY KATHERINE T. 
Published: April 2008

Introduction:
An increasing number of patients with left ventricular (LV) dysfunction are referred for placement of an implantable cardioverter‐defibrillator (ICD).
Case Report:
A 78‐year‐old female with fatigue, palpitations, and presyncope was referred for consideration of an ICD because of a cardiomyopathy and nonsustained ventricular tachycardia (VT). Her evaluation revealed severe hypothyroidism, marked QT prolongation, and episodes of torsades de pointes. With levothyroxine therapy, her ventricular arrhythmias rapidly abated, with subsequent normalization of LV function and the QT interval.
Conclusions:
This report highlights the critical importance of detecting hypothyroidism as an unusual cause for reversible cardiomyopathy and ventricular arrhythmias.
Quantitative Analysis of the Duration of Slow Conduction in the Reentrant Circuit of Ventricular Tachycardia After Myocardial Infarction
Authors: LI YI‐GANG , WANG QUN‐SHAN , ISRAEL CARSTEN W. , GRÖNEFELD GERIAN , LU SHANG‐BIAO , EHRLICH JOACHIM R , HOHNLOSER STEFAN H. 
Published: April 2008

Background:
Few data are available to define the circuits in ventricular tachycardia (VT) after myocardial infarction and the conduction time (CT) through the zone of slow conduction (SCZ). This study assessed the CT of the SCZ and identified different reentrant circuits.
Methods:
During VTs, concealed entrainment (CE) was attempted. The SCZ was identified by a difference between postpacing interval (PPI) and VT cycle length (VTcl) ≤30 ms. Since the CT in the normally conducting part of the VT circuit is constant during VT and CE, a CE site within the reentrant circuit with (S‐QRS)/PPI ≥ 50% was classified as an inner reentry in which the entire circuit was within the scar, and a CE site with (S‐QRS)/PPI < 50% as a common reentry in which part of the circuit was within the scar and part out of the scar.
Results:
CE was achieved in 20 VTs (12 patients). Six VTs (30%) with a (S‐QRS)/PPI ≥50% were classified as inner reentry and 14 VTs (70%) with a (S‐QRS)/PPI <50% during CE mapping as common reentry. The EG‐QRS interval (308 ± 73 ms vs 109 ± 59 ms, P < 0.0001) was significantly longer and the incidence of systolic potentials higher (4/6 vs 0/12, P < 0.001) in the inner reentry group. For the 14 VTs with a common reetry, the CT of the SCZ was 348 ± 73 ms, while the CT in the normal area was 135 ± 50 ms.
Conclusion:
According to the proposed classification, 30% of VTs after myocardial infarction had an entire reentrant circuit within the scar. In VTs with a common reentrant circuit, the CT of the SCZ is approximately four times longer than the CT in the normal area, accounting for more than 70% of VTcl.
Emerging roles for protein histidine phosphorylation in cellular signal transduction: lessons from the islet β‐cell
Authors: Kowluru Anjaneyulu 
Published: April 2008

Introduction
Protein histidine phosphorylation in prokaryotes and eukaryotes
Identification and characterization of histidine kinases in the pancreatic β‐cell
A membrane‐associated histidine kinase phosphorylates the Gβ‐subunit of trimeric G‐proteins
A novel histone H4‐phosphorylating histidine kinase in islets β‐cells
Regulation of protein histidine phosphorylation in islet β‐cells
Functional consequences of protein histidine phosphorylation
Regulation of the mitochondrial function via protein histidine phosphorylation
Regulation of ion channels
Regulation of isoprenoid metabolism
Protein histidine phosphatases
• Potential defects in histidine phosphorylation in
islets derived from the Goto‐Kakizaki rat, a model for type 2 diabetes
Conclusions and future research
AbstractProtein phosphorylation represents one of the key regulatory events in physiological insulin secretion from the islet β‐cell. In this context, several classes of protein kinases (e.g. calcium‐, cyclic nucleotide‐ and phospholipid‐dependent protein kinases and tyrosine kinases) have been characterized in the β‐cell. The majority of phosphorylated amino acids identified include phosphoserine, phosphothreonine and phosphotyrosine. Protein histidine phosphorylation has been implicated in the prokaryotic and eukaryotic cellular signal transduction. Most notably, phoshohistidine accounts for 6% of total protein phosphorylation in eukaryotes, which makes it nearly 100‐fold more abundant than phosphotyrosine, but less abundant than phosphoserine and phosphothreonine. However, very little is known about the number of proteins with phosphohistidines, since they are highly labile and are rapidly lost during phosphoamino acid identification under standard experimental conditions. The overall objectives of this review are to: (i) summarize the existing evidence indicating the subcellular distribution and characterization of various histidine kinases in the islet β‐cell, (ii) describe evidence for functional regulation of these kinases by agonists of insulin secretion, (iii) present a working model to implicate novel regulatory roles for histidine kinases in the receptor‐independent activation, by glucose, of G‐proteins endogenous to the β‐cell, (iv) summarize evidence supporting the localization of protein histidine phosphatases in the islet β‐cell and (v) highlight experimental evidence suggesting potential defects in the histidine kinase signalling cascade in islets derived from the Goto‐Kakizaki (GK) rat, a model for type 2 diabetes. Potential avenues for future research to further decipher regulatory roles for protein histidine phosphorylation in physiological insulin secretion are also discussed.
Caveolin‐1: an ambiguous partner in cell signalling and cancer
Authors: Quest Andrew F. G. , Gutierrez‐Pajares Jorge L. , Torres Vicente A. 
Published: April 2008

Introduction
The caveolins
Caveolin‐1 in cell physiology
Caveolin‐1 in cancer
Concluding remarks
AbstractCaveolae are small plasma membrane invaginations that have been implicated in a variety of functions including transcytosis, potocytosis and cholesterol transport and signal transduction. The major protein component of this compartment is a family of proteins called caveolins. Experimental data obtained in knockout mice have provided unequivocal evidence for a requirement of caveolins to generate morphologically detectable caveolae structures. However, expression of caveolins is not sufficient per seto assure the presence of these structures. With respect to other roles attributed to caveolins in the regulation of cellular function, insights are even less clear. Here we will consider, more specifically, the data concerning the ambiguous roles ascribed to caveolin‐1 in signal transduction and cancer. In particular, evidence indicating that caveolin‐1 function is cell context dependent will be discussed.
Improved outcome of EAN, an animal model of GBS, through amelioration of peripheral and central inflammation by minocycline
Authors: Zhang Zhi‐Yuan , Zhang Zhiren , Fauser Uwe , Schluesener Hermann J. 
Published: April 2008

AbstractExperimental autoimmune neuritis (EAN) is a widely used animal model of the human acute inflammatory demyelinating polyradiculoneuropathy, which is the most common subtype of Guillain‐Barré Syndrome. EAN is pathologically characterized by breakdown of the blood‐nerve barrier, infiltration of reactive immune cells, local inflammation, demyelination in the peripheral nervous system and mechanical allodynia. Minocycline is known to have neuroprotective and anti‐inflammatory effects. Furthermore, relieve of neuropathic pain following minocycline administration was observed in a variety of animal models. Here, we investigated the effects of minocycline on rat EAN. Suppressive treatment with minocycline (50 mg/kg body weight daily immediately after immunization) significantly attenuated the severity and duration of EAN. Macrophage and T‐cell infiltration and demyelination in sciatic nerves of EAN rats treated with minocycline were significantly reduced compared to phosphate‐buffered saline (PBS)‐treated EAN rats. mRNA expressions of matrix metallopeptidase‐9, inducible nitric oxide synthase and pro‐inflammatory cytokines interleukin‐1 β and tumour necrosis factor‐α in EAN sciatic nerves were greatly decreased by administration of minocycline as well. Furthermore, minocycline attenuated mechanical allodynia in EAN rats and greatly suppressed spinal microglial activation. All together, our data showed that minocycline could effectively suppress the peripheral and spinal inflammation (immune activation) to improve outcome in EAN rats, which suggests that minocycline may be considered as a potential candidate of pharmacological treatment for autoimmune‐mediated neuropathies.