bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of maternal HIV infection with increase of infant mortality in Malawi
Authors: Hong Rathavuth 
Published: April 2008

Aim: To determine the association between maternal HIV infection and infant mortality in Malawi.Methods: A synthetic cohort life table based on the birth history of 2618 childbirths during 1999 and 2004, from the subsample of 2020 mothers who completed interview and were tested for HIV virus in the 2004 Malawi Demographic and Health Survey was used. The survey collected socio‐demographic and health data of a natural representative sample of women aged 15 to 49; and obtained voluntary counselling tests for HIV infection from one‐third of the representatives of the sample. Associations of maternal HIV status and other factors with infant mortality were estimated using survival regression analysis and the results are presented as hazard ratios (HR) with level of statistical significance (P‐value).Results: Children born to HIV‐infected mothers were more than two times as likely to die during infancy as those born to uninfected mothers (HR = 2.21;P < 0.01). Controlling for other risk factors and confounding factors for infant mortality further sharpened this relationship (HR = 2.70;P < 0.01). Boys are more likely to die in infancy than girls. Young mothers and mothers not receiving prenatal care, and low‐birthweight children and children living in rural areas, particular so in the northern region, were associated with a higher risk of infant mortality.Conclusion: Maternal HIV infection is strongly associated with infant mortality in Malawi independent of many other factors. Results from this study suggest that the HIV/AIDS epidemic has had an enormous impact on child well‐being, child survival and infant mortality. The impact increases as the HIV/AIDS epidemic matures and infection in mothers and adults increases.
A study of the complications of small bore ‘Seldinger’ intercostal chest drains
Authors: DAVIES Helen E. , MERCHANT Shairoz , McGOWN Anne 
Published: April 2008

Background and objective:  Use of small bore chest drains (<14F), inserted via the Seldinger technique, has increased globally over the last few years. They are now used as first line interventions in most acute medical situations when thoracostomy is required. Limited data are available on the associated complications. In this study, the frequency of complications associated with 12F chest drains, inserted using the Seldinger technique, was quantified.Methods:  A retrospective case note audit was performed of consecutive patients requiring pleural drainage over a 12‐month period. One hundred consecutive small bore Seldinger (12F) chest drain insertions were evaluated.Results:  Few serious complications occurred. However, 21% of the chest drains were displaced (‘fell out’) and 9% of the drains became blocked. This contributed to high morbidity rates, with 13% of patients requiring repeat pleural procedures. The frequency of drain blockage in pleural effusion was reduced by administration of regular normal saline drain flushes (odds ratio for blockage in flushed drains compared with non‐flushed drains 0.04, 95% CI: 0.01–0.37, P < 0.001).Conclusions:  Regular chest drain flushes are advocated in order to reduce rates of drain blockage, and further studies are needed to determine optimal fixation strategies that may reduce associated patient morbidity.
Long‐term outcome of secondary endopyelotomy after failed primary intervention for ureteropelvic junction obstruction
Authors: Park Jinsung , Kim Wan S , Hong Bumsik , Park Taehan , Park Hyung K 
Published: April 2008

Objective:  To evaluate the long‐term outcome of secondary endopyelotomy after failed primary intervention for uretero‐pelvic junction (UPJ) obstruction and to assess the effect of preoperative parameters on treatment outcome.Methods:  Twenty patients (13 men, seven women; mean age 30.7 years) who underwent secondary endopyelotomy after the failure of a primary intervention for the treatment of congenital UPJ obstruction were included in this retrospective analysis. Mean interval from primary treatment to secondary endopyelotomy was 27.2 months (range 3–123 months). The diagnosis of failure of the primary treatment was based on symptoms and the results of imaging studies. Treatment success was defined as symptomatic relief with either stable or improved renal function and improved wash‐out shown on diuretic renogram or excretory urography.Results:  Mean follow‐up was 47.2 months (range 6.2–138.8 months). Success rates were as follows: overall, 70%; after primary dismembered pyeloplasty, 66.7%; after primary endopyelotomy, 57.1%; after primary balloon dilatation, 100%. Kaplan‐Meier estimates of success were 64.4% at 5 years. Six patients in whom the procedure failed at a mean of 13.8 months (range 4–33 months) were treated with open pyeloplasty (four patients), simple nephrectomy (one), and a repeat endopyelotomy (one). Grade 4 hydronephrosis and significant obstruction occurred more often in the failure group.Conclusions:  Endopyelotomy is an acceptable minimally invasive secondary treatment option for UPJ obstruction. Preoperative severe hydronephrosis and the presence of a significant obstruction seem to be risk factors for the failure of a secondary endopyelotomy.
Pre‐eclampsia outcomes in different hemodynamic models
Authors: Mei Shuang , Gu Haihua , Wang Qi , Zhang Song , Zeng Yanjun 
Published: April 2008

AbstractAim:  To evaluate whether there is a significant relationship between hemodynamic models and pre‐eclampsia outcomes.Method:  A controlled experimental study was performed. We analyzed 2910 hemodynamic series systematically sampled from 970 pregnant women three times every 2 weeks from the definite diagnosis of pre‐eclampsia until delivery. Women were divided into three groups based on total peripheral resistance (TPR): a low‐TPR group, a normal‐TPR group and a high‐TPR group. Every group was divided into three subgroups based on cardiac index (CI): a low‐CI subgroup, a normal‐CI group and high‐CI group. Common lab tests, electrocardiographic examination, fundus examination, cardiac function, liver function and kidney function were measured after every hemodynamic monitoring. Primary outcomes included various maternal and neonatal morbidity and neonatal and infant mortality.Results:  In our study we found seven hemodynamic models in pre‐eclampsia during the third trimester of pregnancy. No significant differences in maternal age, weight, and height were observed between the three groups. The low‐TPR and normal‐TPR groups showed better disease results than the high‐TPR group in respect of HELLP (P < 0.01), lung edema (P < 0.01), acute renal failure (P < 0.01), heart failure (P < 0.01), neonatal intensive care unit admission (P < 0.01), infant weight (P < 0.01), neonatal mortality (P < 0.01) and infant mortality (P < 0.01). The low‐TPR group had better results than the normal‐TPR group in respect of eclampsia (P < 0.01), liver hemorrhage (P < 0.01), birthweight (P < 0.01) and gestational week at birth (P < 0.05).Conclusion:  Among all the subgroups, the highest maternal and neonatal morbidity was in the high‐TPR‐high‐CI subgroup. There is clear relationship between hemodynamic and disease outcomes during the third trimester.
Pregnancy in uremic patients: An eventful journey
Authors: Bolignano Davide , Coppolino Giuseppe , Crascì Eleonora , Campo Susanna , Aloisi Carmela , Buemi Michele 
Published: April 2008

AbstractRenal damage, which can be caused by gestational anomalies such as pre‐eclampsia, carries a risk of gestational complications; the greatest risk being in women who become pregnant while on hemodialysis or peritoneal dialysis. If this rare event occurs, there is a marked increase in the risk of pre‐eclampsia, early uterine contractions and hydramnios, hypertensive crisis, preterm delivery and intrauterine growth retard. Furthermore, newborns are almost always of low birthweight. Patients who undergo renal transplantation are another high‐risk category. In such cases, the pregnancy itself can compromise the success of the transplant and the immunosuppressive therapy correlated to it can become a threat to the course of the pregnancy and normal fetal growth. Therefore, in view of the lack of appropriate guidelines for the best possible approach to the treatment of women on dialysis or of those with a renal transplantation, it is best to advise these patients against becoming pregnant and/or to provide a valid counselling service illustrating the extreme difficulties and dangers involved in becoming pregnant.
Thrombophilic mutations in pre‐eclampsia and pregnancy‐induced hypertension
Authors: Omar Siti Z. , Qvist Rajes , Khaing Si L. , Muniandy Sekaran , Bhalla Sunil 
Published: April 2008

AbstractAim:  The aim of the present study was to determine the existence or prevalence of thrombophilic markers such as Factor V Leiden, prothrombin G20210A, protein S, protein C, activated protein C and anti‐thrombin in pre‐eclampsia and pregnancy‐induced hypertensive patients.Methods:  Blood samples were collected from a total number of 124 women at the maternity unit, University of Malaya Medical Center. These included 49 patients with pre‐eclampsia, 63 patients with pregnancy‐induced hypertension and 12 normal pregnant women. DNA was extracted from the blood samples. Factor V Leiden (Taq I) and prothrombin G20210A (Hind III) genotyping was done on polymerase chain reaction–restriction fragment length polymorphism. Anti‐thrombin activity and the concentrations of protein C, protein S and activated protein C were measured using the IL Coagulation System (Hemosil).Results:  Of the 124 subjects, one pre‐eclampsia patient was homozygous for Factor V Leiden mutation but prothrombin G20210A mutation was not present in any of the subjects. The subject with Factor V Leiden mutation also had a low activated protein C resistance and a low protein S concentration.Conclusions:  Factor V Leiden mutation is present in the Asian population and may very well serve as one of the genetic factors responsible for pre‐eclampsia and other adverse pregnancy outcomes.
Underlying pathology of women with “atypical squamous cells, cannot exclude high‐grade squamous intraepithelial lesion” smears, in a region with a high incidence of cervical cancer
Authors: Kietpeerakool Chumnan , Srisomboon Jatupol , Tantipalakorn Charuwan , Suprasert Prapaporn , Khunamornpong Surapan , Nimmanhaeminda Kanchana , Siriaunkgul Sumalee 
Published: April 2008

AbstractAim:  To evaluate the histopathology of women who had “atypical squamous cells, cannot exclude high‐grade squamous intraepithelial lesions” (ASC‐H) on cervical cytology in a region with high incidence of cervical cancer.Methods:  This study was conducted at Chiang Mai University Hospital, Chiang Mai, Thailand. All women with ASC‐H, who had undergone colposcopic and histolopathologic evaluation between October 2004 and January 2007, were recruited. Similar cohorts with other squamous cell abnormalities on a Pap‐smear, who had undergone colposcopy during the same period, were included as comparative groups.Results:  During the study period, 85 women who had ASC‐H smears underwent colposcopic and histopathologic evaluation. The mean age was 45.3 years (range, 20–64 years). The histopathologic results of these 85 women were as follows: cervical intraepithelial neoplasia (CIN) II‐III, 52 (61.2%); invasive cancer, 7 (8.2%); CIN I, 6 (7.1%); and no lesions, 20 (23.5%). The incidence of underlying CIN II or higher in an ASC‐H smear (69.4%) was intermediate between atypical squamous cell of undetermined significance (22.7%), low‐grade squamous intraepithelial lesion (44.7%) and high‐grade squamous intraepithelial lesion (90.5%) smears. There was no statistically significant difference in the incidence of CIN II or higher between women who were 40 years old or more and those who were younger (68.7% and 71.4%, respectively, P = 0.81), or between pre‐menopausal and post‐menopausal women (71.4% and 63.6%, respectively, P = 0.49).Conclusion:  Reporting ASC‐H cytology in our population is strongly associated with significant cervical pathology, particularly invasive cancer that is possibly at a rate higher than previously reported. Women who have ASC‐H smears should therefore be referred for immediate colposcopy regardless of age and menopausal status.
Oligohydramnios and pulmonary hypoplasia: A case in which involvement of an angiotensin II receptor antagonist was suspected
Authors: Kato Kaoru , Okuda Mika , Ishikawa Hiroshi , Takahashi Tsuneo , Hirahara Fumiki 
Published: April 2008

AbstractAdministration of an angiotensin II receptor antagonist (ARB) during the second trimester of pregnancy is known to cause irreversible renal damage in the fetus. We report a case in which ARB was given to the mother from the first trimester until 26 weeks' gestation. The patient had diabetic nephropathy with accompanying nephrotic syndrome. At 8 weeks' gestation, she was started on candesartan cilexetil (an ARB). At 26 weeks' gestation, she was transferred to our center. Severe oligohydramnios was noted. The pregnancy was terminated, and she delivered at 27 weeks' gestation. The neonate weighed 884 g and died 1 h after birth. Autopsy revealed that the lung/bodyweight ratio was 0.0096 (>0.015) and pulmonary hypoplasia was noted. Histological examination of the kidneys showed tubular dysgenesis with poor differentiation of the proximal tubules.
Umbilical cord strangulation by an amniotic band resulting in a stillbirth
Authors: Lurie Samuel , Feinstein Michael , Mamet Yaakov 
Published: April 2008

AbstractBackground:  Amniotic band syndrome with umbilical cord strangulation is extremely rare and is usually described during second trimester. We present a case of umbilical cord strangulation causing fetal demise in a full‐term otherwise healthy fetus.Case:  A 39‐year‐old gravida 15 para 12 after one previous cesarean section presented with reduced fetal movements at the 41st gestational week. On admission, fetal heart tracing, biophysical profile and oxytocin challenge test were normal. Later, an intrauterine fetal demise was diagnosed. After delivery, an amniotic band causing strangulation of the umbilical cord was observed. The fetus was without apparent anomalies.Conclusion:  Although extremely rare, constriction of the umbilical cord by an amniotic band can cause its strangulation followed by a stillbirth even in full‐term otherwise healthy fetus.
Uterine choriocarcinoma accompanied by an extremely high human chorionic gonadotropin level and thyrotoxicosis
Authors: Hsieh Tsung‐Ying , Hsu Keng‐Fu , Kuo Pao‐Lin , Huang Soon‐Cen 
Published: April 2008

AbstractThe conventional treatments given to a 24‐year‐old woman with metastatic uterine choriocarcinoma and clinical and biochemical thyrotoxicosis did not appear to have any effect, probably due to an extremely high serum human chorionic gonadotropin (hCG) level which was up to 11 910 000 mIU/mL, and were initially underscored in light of the ‘high‐dose hook effect’. To our knowledge, no extremely high hCG level in a uterine choriocarcinoma patient has been reported in the literature. Her decapacitating symptoms subsided after the first course of chemotherapy by etoposide, methotrexate, and actinomycin D‐cyclophosphamide and vincristine (EMA‐CO) regimen. The serum hCG level, which reflects the quantification of host tumor burden, returned to the reference range after the fifth course of chemotherapy and the thyroid function reached euthyroid status before the third course of chemotherapy; two final courses were administered after the hCG level became undetectable. Two years after remission of disease, the patient experienced a normal pregnancy, and a term baby girl was delivered vaginally. No recurrence of uterine choriocarcinoma has been noted for 7 years.
Granulocyte‐colony stimulating factor for the treatment of ritodrine‐induced neutropenia
Authors: Kikkawa Masashi , Matsubara Shigeki , Takatoku Masaaki , Kuwata Tomoyuki , Ohkuchi Akihide , Izumi Akio , Watanabe Takashi , Suzuki Mitsuaki 
Published: April 2008

AbstractWe report on three pregnant women with ritodrine‐induced neutropenia who were successfully treated with granulocyte‐colony stimulating factor (G‐CSF). The neutropenia occurred after continuous intravenous infusion of ritodrine for preterm labor. Ritodrine was discontinued and G‐CSF was administered. Neutrophil counts returned to normal an average of 4.3 days after the administration. No infectious morbidity or adverse side‐effects occurred in the mothers or infants. G‐CSF is one possible treatment in women with ritodrine‐induced neutropenia.
An integrated view of L‐selectin and trophinin function in human embryo implantation
Authors: Fukuda Michiko N. , Sugihara Kazuhiro 
Published: April 2008

AbstractDetermining molecular mechanisms of human embryo implantation is an extremely challenging task due to the limitation of materials and significant differences underlying this process among mammalian species. Recently, L‐selectin and its ligand carbohydrate have been proposed as a system that mediates initial adhesion of human blastocysts to the uterine epithelia. We have also identified trophinin as a unique apical cell adhesion molecule potentially involved in the initial adhesion of trophectoderm of the human blastocyst to endometrial surface epithelia. In the mouse, the binding between ErbB4 on the blastocyst and heparin‐binding epidermal growth factor‐like growth factor on the endometrial surface enables the initial step of the blastocyst implantation. The evidence suggests that L‐selectin and trophinin are included in human embryo implantation. This review summarizes findings relevant to the functions of L‐selectin and trophinin in human embryo implantation, and proposes a model that reconciles these cell adhesion mechanisms.
Isolation of novel bacteria, including a candidate division, from geothermal soils in New Zealand
Authors: Stott Matthew B. , Crowe Michelle A. , Mountain Bruce W. , Smirnova Angela V. , Hou Shaobin , Alam Maqsudul , Dunfield Peter F. 
Published: April 2008

SummaryWe examined bacterial diversity of three geothermal soils in the Taupo Volcanic Zone of New Zealand. Phylogenetic analysis of 16S rRNA genes recovered directly from soils indicated that the bacterial communities differed in composition and richness, and were dominated by previously uncultured species of the phyla Actinobacteria, Acidobacteria, Chloroflexi, Proteobacteria and candidate division OP10. Aerobic, thermophilic, organotrophic bacteria were isolated using cultivation protocols that involved extended incubation times, low‐pH media and gellan as a replacement gelling agent to agar. Isolates represented previously uncultured species, genera, classes, and even a new phylum of bacteria. They included members of the commonly cultivated phyla Proteobacteria, Firmicutes, Thermus/Deinococcus, Actinobacteria and Bacteroidetes, as well as more‐difficult‐to‐cultivate groups. Isolates possessing < 85% 16S rRNA gene sequence identity to any cultivated species were obtained from the phyla Acidobacteria, Chloroflexi and the previously uncultured candidate division OP10. Several isolates were prevalent in 16S rRNA gene clone libraries constructed directly from the soils. A key factor facilitating isolation was the use of gellan‐solidified plates, where the gellan itself served as an energy source for certain bacteria. The results indicate that geothermal soils are a rich potential source of novel bacteria, and that relatively simple cultivation techniques are practical for isolating bacteria from these habitats.
Molecular link of different stages of the trematode host of Neorickettsia risticii to Acanthatrium oregonense
Authors: Gibson Kathryn E. , Rikihisa Yasuko 
Published: April 2008

Summary Neorickettsia risticii, the obligatory intracellular bacterium that causes Potomac horse fever, has been detected in various developmental stages of digenetic trematodes in the environment. Neorickettsia risticii‐infected gravid trematodes were identified as Acanthatrium oregonense, based on morphologic keys. However, whether immature trematodes harbouring N. risticii are also A. oregonense was unknown. The objective of this study was to infer the life cycle of N. risticii‐positive trematode hosts and transstadial transmission of the bacterium by molecularly characterizing the relationship among adult and immature stages of trematodes confirmed infected with N. risticii. Sequences of 18S ribosomal RNA genes up to 1922 bp in size were obtained from infected adult gravid trematodes, sporocysts and cercariae, and metacercariae. The sequences from the different immature stages of trematode are closely related to those of adult trematodes, some with 100% sequence identity; thus, they likely are life stages of A. oregonense. Comparisons with known 18S ribosomal RNA gene sequences of other digenetic trematodes indicated that all tested stages of the N. risticii‐positive trematodes belong to the family Lecithodendriidae, supporting the morphological identification.
Over‐diagnosis and under‐diagnosis of screen‐ vs non‐screen‐detected prostate cancers with in men with prostate‐specific antigen levels of 2.0–10.0 ng/mL
Authors: Pelzer Alexandre E. , Colleselli Daniela , Bektic Jasmin , Schaefer Georg , Ongarello Stefano , Schwentner Christian , Aigner Fritz , Mitterberger Michael , Steiner Eberhard , Bartsch Georg , Horninger Wolfgang 
Published: April 2008

OBJECTIVESTo evaluate possible over‐ and under‐diagnosis of prostate cancer in a screened vs a referral population in the same range of prostate‐specific antigen (PSA).PATIENTS AND METHODSIn all, 1445 patients undergoing radical prostatectomy and with a PSA level of <10 ng/mL were evaluated; 237 were from outside Tyrol (Austria) and represented the unscreened group, and 1208 were Tyrolean screening volunteers. Over‐diagnosis was defined as a pathological stage of pT2a and a Gleason score of <7 with no positive surgical margins. Under‐diagnosis was defined as a pathological stage of ≥pT3a or positive surgical margins. The chi‐square test was used to assess the differences, with P < 0.05 considered to indicate statistical significance.RESULTSThere were no significant differences in patient age or PSA levels between the study groups. There was over‐diagnosis in the screening and referral groups in 17.4% and 8.9%, respectively, and under‐diagnosis in 18.6% and 42.2%, respectively.CONCLUSIONThis study suggests that patients with prostate cancer participating in a screening programme are less likely to be under‐diagnosed or have extracapsular disease than their counterparts in a referral population, even in the same PSA range, after radical prostatectomy. Furthermore, there was more under‐diagnosis in the referral group than over‐diagnosis in the screened group.