bluuebunny/crossref_metadata_2025_split huggingface dataset:
Renal angiographic findings in systemic sclerosis: ‘the Egyptian experience’
Authors: EMAD Yasser , EL‐GOHARY Tarek , MUSTAFA Hisham , BASSYOUNI Iman H. , AZAB Noha A. 
Published: March 2007

AbstractObjective:  This study was designed to search for a possible pathological involvement of renal arteries among patients with systemic sclerosis (SSc) and to correlate the findings with renal functions.Patients and methods:  Fourteen female patients with SSc were recruited for this study. The diagnosis and classification of SSc was based on the 1980 American College of Rheumatology criteria for classification of SSc. Nine patients had diffuse‐type SSc, and the remaining five belonged to the limited type of the disease. All patients were evaluated by history‐taking, clinical examination, laboratory investigations and renal angiography.Results:  Three out of the nine patients (33.3%) with diffuse SSc had tortuous renal arteries, but there were none in the limited type. Two patients (22.2%) with diffuse SSc had ectatic renal arteries and three (33.3%) had osteal renal artery stenosis. Tortuous abdominal aorta was detected in one patient (11.1%) with diffuse SSc and congenital double renal artery in another (11.1%). Two out of the five patients with limited‐type disease (40%) had osteal renal artery stenosis that was bilateral in one case. Bilateral renal artery affection was observed in 3/14 studied patients (21.42%), and two of these had diffuse disease and one had limited disease. Three patients had hypertension (two had diffuse pattern and one had limited pattern).Conclusion:  We consider that renal artery stenosis is the most important among all the findings detected and should be considered in SSc patients presenting with renal crisis because use of angiotensin converting enzyme (ACE) inhibitors in this situation may be deleterious rather than beneficial.
Supraorbital nodule biopsy leading to the diagnosis of giant cell arteritis
Authors: TESHA Paul , RAJENDRAM Ranjan , LAGNADO Ruby , BROWN Lawrence , SAMPATH Raghavan 
Published: March 2007

AbstractGiant cell arteritis is a systemic vasculitis which usually involves the cranial arteries. We report the case of a 57‐year‐old patient presenting with headache and painful subcutaneous supraorbital nodule. A subsequent biopsy of a supraorbital nodule led to the diagnosis of giant cell arteritis.
Childbirth in ancient Rome: From traditional folklore to obstetrics
Authors: TODMAN Donald 
Published: March 2007

AbstractIn ancient Rome, childbirth was a hazardous event for both mother and child with high rates of infant and maternal mortality. Traditional Roman medicine centred on folklore and religious practices, but with the development of Hippocratic medicine came significant advances in the care of women during pregnancy and confinement. Midwives or obstetrices played an important role and applied rational scientific practices to improve outcomes. This evolution from folklore to obstetrics was a pivotal point in the history of childbirth.
Maternal morbidity and mortality associated with elective Caesarean delivery at a university hospital in Nigeria
Authors: OLADAPO Olufemi T. , LAMINA Mustafa A. , SULE‐ODU Adewale O. 
Published: March 2007

AbstractBackground:  Data about maternal outcomes of elective Caesarean section in low‐income countries are limited.Aims:  To estimate the maternal morbidity and mortality associated with elective Caesarean delivery at a Nigerian University hospital.Methods:  Retrospective analysis of all elective Caesarean deliveries at the Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria (1990–2005). For each case of elective Caesarean delivery, four parturients who achieved non‐operative vaginal delivery following spontaneous onset of labour were selected to serve as a referent group. Morbidity outcomes and mortality among women who had elective Caesarean delivery were compared with those of the referent group to estimate their comparative risks. Level of significance was put at P < 0.05.Results:  A total of 164 elective Caesarean sections were performed out of 6882 deliveries (2.4%). All morbidities were more frequent among women who had elective Caesarean section compared to those who had vaginal delivery but only peripartum blood transfusion (11.6 vs 5.6%), puerperal febrile morbidity (11.0 vs 4.7%), unplanned readmission (4.3 vs 1.4%), mean fall in haemoglobin concentration (1.5 ± 0.6 vs 0.5 ± 0.7 g/dL) and mean hospital stay (13.3 ± 8.8 vs 6.2 ± 5.4 days) showed statistically significant differences. There was one maternal death among the elective Caesarean section group, giving a maternal mortality ratio of 6.1:1000 deliveries, which was not significantly different from 3.0:1000 deliveries in the referent group.Conclusion:  Elective Caesarean delivery in this hospital is certainly accompanied by considerable maternal risks and should be offered to pregnant women with extreme caution. Efforts should be made to improve its safety by investigating and rectifying the factors responsible for the associated severe maternal complications.
The Vabra aspirator versus the Pipelle device for outpatient endometrial sampling
Authors: NAIM Norzilawati M. , MAHDY Zaleha A. , AHMAD Shuhaila , RAZI Zainul Rashid M. 
Published: March 2007

AbstractObjective:  To compare the effectiveness of the Vabra aspirator and the Pipelle device as an outpatient endometrial assessment tool.Method:  This was a randomised, prospective trial conducted for a period of one year.Results:  A total of 147 patients were recruited, of which 71 were in the Vabra group and 76 were in the Pipelle arm. The procedure success rate in the Pipelle group was significantly higher than the Vabra arm (98.7 vs 88.7%, P = 0.02). Adequate tissue yield was also significantly more in the Pipelle arm (73.3 vs 52.4%, P = 0.02). Cost–benefit analysis revealed a higher average cost per patient in the Vabra group compared to the Pipelle arm.Conclusion:  This study proved that the Vabra aspirator was not as effective as the Pipelle device in obtaining endometrial tissue for histological diagnosis. Despite its higher price per unit, the Pipelle device was a more cost‐effective tool for outpatient endometrial assessment.
The simple outpatient management of Bartholin's abscess using the Word catheter: A preliminary study
Authors: HAIDER Zara , CONDOUS George , KIRK Emma , MUKRI Faizah , BOURNE Tom 
Published: March 2007

AbstractIntroduction:  Bartholin's cysts/abscess affects 2% of women. Conventional treatment is marsupialisation under general anaesthetic. We evaluated a conservative approach in a non‐randomised prospective interventional study over 12 months.Method:  Women with a Bartholin's abscess were counselled and those who opted for the Word catheter (WC) had it inserted under local anaesthetic (follow up at one week and four weeks, when catheter was removed). Women recorded pain scores and completed a qualitative questionnaire and had telephone follow up at six months. Outcome measures were abscess resolution and acceptability of treatment.Results:  Fifty‐eight women attended with a Bartholin's abscess requiring drainage. Twenty‐three of 58 (40%) elected for marsupialisation. Thirty‐five of 58 (60%) women had a WC inserted. Twenty‐seven of 35 (77%) women retained their catheter for four weeks (three catheters fell out within 24 h of insertion, three catheters fell out within one week, one fell out after 11 days and there was one failed insertion). One woman had a recurrence six months after treatment. Abscess resolution occurred in 34 of 35 (97%). No woman reported significant discomfort at one week. Twenty‐four of 27 women (89%) said that if they suffered a recurrence, they would have another WC inserted. Three of 27 (11%) women had intercourse within the second week of catheter insertion and reported that it was not uncomfortable. Fourteen women who had marsupialisation were traced and none had suffered a recurrence six months after treatment.Conclusions:  The WC is a safe and effective treatment for a Bartholin's abscess. It may be considered as an alternative to marsupialisation.
The use of complementary medicine and therapies by patients attending a reproductive medicine unit in South Australia: A prospective survey
Authors: STANKIEWICZ Marcin , SMITH Caroline , ALVINO Helen , NORMAN Robert 
Published: March 2007

AbstractBackground:  There is limited research describing the use of complementary medicines (CM) and therapies among patients with infertility.Objective:  (i) To examine the use of CM by subjects attending an infertility clinic at their first consultation and six months later; (ii) to examine men's and women's views on the effectiveness and safety of these practices; and (iii) to examine the documentation of the use of CMs and therapies in clinical notes.Design:  A prospective survey of 100 consecutive new patients presenting to an infertility clinic. Subjects were requested to complete a self‐administered questionnaire at their first visit and six months later. A retrospective audit of 200 patient records.Results:  A response rate of 72% was obtained. Sixty‐six percent of patients attending the infertility clinic in South Australia used CMs. Six months following the initial consultation the use of CMs had declined. The most commonly used CMs included multivitamins, herbs, and mineral supplements, and subjects consulted most frequently with naturopaths, chiropractors and acupuncturists. The use of CMs and therapies was poorly documented by clinical staff.Conclusion:  Complementary medicines and therapies are widely used by patients with infertility. Health‐care practitioners and fertility specialists need to be proactive in acquiring and documenting the use of these practices. There is a need to provide further information to patients on the use of CMs and therapies. Further research examining the reasons for use of CMs and therapies is needed.
Randomized clinical trial comparing two options for postoperative incisional care to prevent poststernotomy surgical site infections
Authors: Segers Patrique , De Jong Antonius P. , Spanjaard Lodewijk , Ubbink Dirk T. , De Mol Bas A.J.M. 
Published: March 2007

ABSTRACTSurgical site infection (SSI) remains an important complication of cardiac surgery. Prevention is important, as SSI is associated with high mortality and morbidity rates. Incisional care is an important daily issue for surgeons. However, there is still scant scientific evidence on which guidelines can be based. A randomized clinical trial was performed to compare two options for postoperative incisional care. Patients undergoing sternotomy for cardiothoracic surgery were eligible. To protect an incision from exogenous contamination or direct inoculation by endogenous pathogens, the study group received an adhesive drape, impermeable to water and air. The control group was treated with a water‐ and air‐permeable absorbent dressing. Primary outcome measure was SSI. Between March 2003 and January 2005, 1,185 patients were included. Both groups were comparable for base‐line characteristics. No significant difference was found in the incidence of sternal SSI between groups (2.6 vs. 3.3%). In our study, an incisional‐care program using a sterile, impermeable adhesive drape did not perform better than an absorbent dressing in reducing SSI after cardiothoracic surgery. In our view, future studies in the field of prevention of SSI should concentrate on other areas of interest.
Randomized trial of two foam dressings in the management of chronic venous ulceration
Authors: Franks Peter J. , Moody Marion , Moffatt Christine J. , Hiskett Gill , Gatto Pauline , Davies Claire , Furlong Winnie T. , Barrow Erica , Thomas Hazel ,   On behalf of the Wound Healing Nursing Research Group
Published: March 2007

ABSTRACTA multicenter prospective randomized clinical trial was undertaken to compare two foam dressings (Allevyn Hydrocellular, Smith & Nephew and Mepilex, Molnlycke Health Care AB) in the management of chronic venous leg ulceration. Patients were also randomized to two compression bandage systems (4‐layer vs. cohesive short stretch) as a factorial design. Those with causes of ulceration other than venous disease were excluded. In all, 156 patients met the entry criteria and were randomized from the 12 clinical centers with a median (range) ulcer size of 4.33 (0.33–123.10) cm2. After 24 weeks a total of 100 (64.1%) patients had complete ulcer closure, 46 (29.5%) had withdrawn from the trial, nine (5.8%) remained unhealed and one patient died. Of the patients randomized to Mepilex, 50/75 (66.7%) had complete ulcer healing compared with 50/81 (61.7%) on Allevyn. The hazard ratio for healing after adjustment for bandage type and trial center was 1.48 (95% C.I. 0.87–2.54,p=0.15), which only marginally changed following adjustment for baseline variables, neither of which achieved statistical significance (p=0.16). Withdrawal rates were similar between groups (23, 30.7% Mepilex vs. 23, 28.4% Allevyn). Pain improved following treatment with both dressings (p<0.001), but with no difference between dressings.
Trehalose lyophilized platelets for wound healing
Authors: Pietramaggiori Giorgio , Kaipainen Arja , Ho David , Orser Cindy , Pebley Walter , Rudolph Alan , Orgill Dennis P. 
Published: March 2007

ABSTRACTFresh platelet preparations are utilized to treat a wide variety of wounds, although storage limitations and mixed results have hampered their clinical use. We hypothesized that concentrated lyophilized and reconstituted platelet preparations, preserved with trehalose, maintain and possibly enhance fresh platelets' ability to improve wound healing. We studied the ability of a single dose of trehalose lyophilized and reconstituted platelets to enhance wound healing when topically applied on full‐thickness wounds in the genetically diabetic mouse. We compared these results with the application of multiple doses of fresh platelet preparations and trehalose lyophilized and reconstituted platelets as well as multiple doses of vascular endothelial growth factor (VEGF) and wounds left untreated. Trehalose lyophilized and reconstituted platelets, in single and multiple applications, multiple applications of fresh platelets and multiple applications of VEGF increased granulation tissue deposition, vascularity, and proliferation when compared with untreated wounds, as assessed by histology and immunohistochemistry. Wounds treated with multiple doses of VEGF and a single dose of freeze‐dried platelets reached 90% closure faster than wounds left untreated. A single administration of trehalose lyophilized and reconstituted platelet preparations enhanced diabetic wound healing, therefore representing a promising strategy for the treatment of nonhealing wounds.
Tissue concentration of transforming growth factor β1 and basic fibroblast growth factor in skin wounds created with a CO2 laser and scalpel: A comparative experimental study, using an animal model of skin resurfacing
Authors: Manolis Evangelos N. , Kaklamanos Ioannis G. , Spanakis Nicholas , Filippou Dimitrios K. , Panagiotaropoulos Theophanis , Tsakris Athanassios , Siomos Konstadinos 
Published: March 2007

ABSTRACTAlthough a number of ablative‐laser techniques based on CO2 and Er: YAG laser devices have been successfully developed and used in the clinical setting, the bio‐molecular processes influencing wound healing after exposure to laser energy are not well elucidated. In this study, we aim to assess the impact of the mechanism of injury on the secretion of transforming growth factor β1 (TGF‐β1) and basic fibroblast growth factor (bFGF) in various stages of wound healing, in wounds created with a CO2 laser and scalpel. Ten Wistar rats were used to determine the levels of growth factor proteins TGF‐β1 and bFGF after CO2 laser‐ and scalpel‐induced skin injury. Tissue was excised on day 0 for untreated skin (control sites), and on days 1, 10, 30, and 90 following laser and scalpel surgery. Specimens were processed for histopathological analysis and for determining the concentration of growth factors by a Western blot technique. The concentration of TGF‐β1 increased markedly, at day 1 postinjury, from a baseline of 130±16 mm2 (mean surface area of blotted‐protein lanes) to 261±23 mm2 and 394±22 mm2 for laser‐inflicted injury and scalpel wounds, respectively; the latter values were found to differ significantly (p<0.001). The concentration of b‐FGF on day 10 postinjury differed significantly (p<0.001) between the laser sites (553±45 mm2) and the corresponding scalpel sites (418±41 mm2). Laser energy alters local tissue secretion of TGF‐β1 and bFGF of skin injuries created with the CO2 laser compared with wounds created with a scalpel. These differences might have an impact on various aspects of wound healing of skin injuries created by a laser.
Local injection of insulin‐zinc stimulates DNA synthesis in skin donor site wound
Authors: Zhang Xiao‐jun , Chinkes David L. , Sadagopa Ramanujam V. M. , Wolfe Robert R. 
Published: March 2007

ABSTRACTOur group has reported the ability of local insulin‐zinc injection to accelerate skin wound healing. This experiment was conducted to investigate the metabolic mechanisms of locally injected insulin‐zinc in accelerating wound healing. A partial thickness skin donor site wound was created on the back, and indwelling catheters were placed in the carotid artery and jugular vein in anesthetized rabbits. On day 7 after injury, the wound was either injected with 0.2 U of insulin‐zinc, 0.4 μg zinc (the amount of zinc in 0.2 U of insulin‐zinc), or not injected; stable isotope tracers were infused for measurement of wound DNA synthetic rate as a reflection of cell proliferation. Wound protein synthetic and breakdown rates were also measured. The local insulin‐zinc injection increased wound insulin concentration from below 5 pmol/L to 1,260±780 pmol/L with minor changes in blood glucose concentration that did not require exogenous glucose replacement. In the insulin‐zinc–injected wound, the total DNA synthetic rate was increased by ∼50% (p<0.05 vs. control). In the zinc‐injected wound, whereas total DNA synthetic rate was increased (p<0.05 vs. control), net protein deposition (synthesis–breakdown) was less (p<0.05) than those in the control and insulin‐zinc groups. We conclude that local insulin‐zinc injection stimulates wound DNA synthesis, which would be expected to accelerate wound reepithelialization.
Hyperbaric oxygen stimulates epidermal reconstruction in human skin equivalents
Authors: Kairuz Evette , Upton Zee , Dawson Rebecca A. , Malda Jos 
Published: March 2007

ABSTRACTThe crucial role of oxygen during the complex process of wound healing has been extensively described. In chronic or nonhealing wounds, much evidence has been reported indicating that a lack of oxygen is a major contributing factor. Although still controversial, the therapeutic application of hyperbaric oxygen (HBO) therapy can aid the healing of chronic wounds. However, how HBO affects reepithelization, involving processes such as keratinocyte proliferation and differentiation, remains unclear. We therefore used a three‐dimensional human skin–equivalent (HSE) model to investigate the effects of daily 90‐minute HBO treatments on the reconstruction of an epidermis. Epidermal markers of proliferation, differentiation, and basement membrane components associated with a developing epidermis, including p63, collagen type IV, and cytokeratins 6, 10, and 14, were evaluated. Morphometric analysis of hematoxylin and eosin‐stained cross sections revealed that HBO treatments significantly accelerated cornification of the stratum corneum compared with controls. Protein expression as determined by immunohistochemical analysis confirmed the accelerated epidermal maturation. In addition, early keratinocyte migration was enhanced by HBO. Thus, HBO treatments stimulate epidermal reconstruction in an HSE. These results further support the importance of oxygen during the process of wound healing and the potential role of HBO therapy in cutaneous wound healing.
Digit tip regrowth and differential gene expression in MRL/Mpj, DBA/2, and C57BL/6 mice
Authors: Chadwick Robert B. , Bu Liming , Yu Hongrun , Hu Yan , Wergedal Jon E. , Mohan Subburaman , Baylink David J. 
Published: March 2007

ABSTRACTMRL/Mpj mice are the only known strain of mouse that can regenerate cardiac lesions and completely heal ear punches without scarring. This study was undertaken to determine if MRL mice also have greater regrowth capabilities in amputated digit tips. Right paw digit tips of neonatal MRL mice were dissected, with the left front paws as uncut controls. Controls used for regrowth comparison were the DBA/2 and C57BL/6 inbred mouse strains. Consecutive x‐ray images were captured of front paws at 0, 7, 14, 21, and 28 days postamputation. MRL mouse digit tips were found to distally regrow more quickly and reform nails partially and completely to a greater degree in comparison with DBA and B6 mice (p<0.05). We next undertook microarray expression analysis to identify the genes involved in digit tip regrowth. Four hundred genes out of 15,000 were significantly differentially expressed (p<0.05) in MRL, DBA, and B6 mice at day 4 in comparison with day 0 control tissue. Multiple differences between MRL, DBA, and B6 strains were found in genes that are implicated in the WNT signaling pathway and transcription. We conclude that MRL mice regrow digits distally more rapidly and partially and completely regrow nails to a greater degree than B6 and DBA strains. This enhanced regrowth is likely due to strain‐specific increased expression of genes involved in growth and development.
Insurance, Bond Covenants, and Under‐ or Over‐investment With Risky Asset Reconstitution
Authors: Hau Arthur 
Published: March 2007

AbstractTraditional theory predicts that the shareholders of a limited liability company financed partly by bonds may underinvest by not replacing damaged company assets. It also precludes the possibility of overinvestment. By relaxing the restrictive assumption maintained under traditional theory, namely, that the effects of reconstituting damaged assets are nonstochastic, this article shows that both over and underinvestment are possible. It is shown that these moral hazard problems can be mitigated by incorporating appropriate insurance requirements into bond covenants. Moreover, it is shown that the insurance requirements for alleviating underinvestment and overinvestment are quite different. Particularly, for underinvestment, the required insurance only needs to make the bonds riskless in the best asset reconstitution states of the loss states in which the company value falls short of the promised bond repayment; however, for overinvestment, the required insurance should make the bonds totally riskless. The difference in insurance requirements is especially important when insurance is actuarially unfavorable such that more‐than‐required insurance is always undesirable.