bluuebunny/crossref_metadata_2025_split huggingface dataset:
The cytological screening history of 469 patients with squamous cell carcinoma of the cervix uteri; does interval carcinoma exist?
Authors: Kenter Gemma G. , Schoonderwald Ernst M. , Koelma Ingeborg A. , Arentz Nelleke , Hermans Jo , Fleuren Gert Jan 
Published: November 2007

Background. To determine whether interval carcinomas occurred and to determine the level of screening‐participation by women who developed a cervical carcinoma.Methods. A retrospective study of the cytological history of 469 patients diagnosed between January 1980 and December 1989 with cervical squamous cell carcinoma in 12 hospitals in the western part of The Netherlands. Clinical data, and cervical smear histories in 3.5 years preceding the diagnoses were obtained. Cervical smears diagnosed as Pap I, II or IIIA were traced for review.Results. 306 patients data were completed. Two hundred and twenty‐three patients (72.9%) had never been screened and 83 patients (27.1%) had had at least one smear, of which 39 were normal. The percentage of women over 54 was higher in patients who had never been screened (58%) than in those screened (46%). Women over 54 were in higher Figo stage. Interval carcinoma was proven in six of 306 (2%) patients. Of the normal smears 53% were false negative.Conclusion. The high number of non‐participants still forms the main reason for the failure of cervical cancer screening. Secondly, the assumed existence of frequent interval carcinoma could not be demonstrated. There are grounds for changing the age limits of the current Dutch screening program without changing the screening interval.
Plasma platelet aggregating factor and platelet aggregation studies in pre‐eclampsia
Authors: Ahlawat Sunita , Pati Hara Prasad , Bhatla Neerja , Fatima Lali , Mittal Sunita 
Published: November 2007

Objective. A plasma platelet aggregating factor (PAF) has been implicated in the pathogenesis of platelet activation in thrombotic thrombocytopenic purpura (TTP) and hemolytic uremic syndrome (HUS). Similar mechanism may be operative in pre‐eclampsia. Methods. Coagulation profile and detailed in vitro platelet aggregation with various agonists were studied. PAF was demonstrated by spontaneous aggregation of normal platelets with test plasma. Non‐parametric Wilcoxon's rank sum test and Krauskal Wally's one way analysis of variance were applied.Result. Twenty‐two pre‐eclamptic patients and 20 normal pregnant controls were studied. Anti‐thrombin III levels were within normal range and fibrin degradation products were only border line raised (>10 <40 μg/ml) in 14 (65.4%) patients. In vitro platelet aggregation was abnormal in 17 (77.2%) patients. PAF was demonstrable in 10 of 22 (45.5%) patients.Conclusion. Platelet aggregation studies indicated the presence of both activated (hyperaggregable) as well as exhausted (hypoaggregable) platelets in circulation. PAF demonstrable in 45.4% pre‐eclampsia patients would suggest its role in the pathogenetic mechanism of platelet activation in this disease.
Cytogenetic evaluation of cystic hygroma associated with hydrops fetalis, oligohydramnios or intrauterine fetal death: the roles of amniocentesis, postmortem chorionic villus sampling and cystic hygroma paracentesis
Authors: Chen Chih‐Ping , Liu Fen‐Fen , Jan Sheau‐Wen , Lee Chen‐Chi , Town Dai‐Dyi , Lan Chung‐Chi 
Published: November 2007

Background. Pregnancies complicated by fetal cystic hygroma in the second and third trimesters are often associated with hydrops fetalis, oligohydramnios or intrauterine fetal death which may make genetic assessment more difficult. We investigated the roles of amniocentesis. postmortem chorionic villus sampling and cystic hygroma paracentesis in cytogenetic evaluation of cystic hygroma under such circumstances.Methods. Thirty‐five fetuses of cystic hygroma associated with hydrops fetalis, oligohydramnios, or intrauterine fetal death were studied. All fetuses were delivered at Mackay Memorial Hospital, Taipei, Taiwan between January, 1987 and July, 1995. Data collected included maternal age, prenatal sonograms, gestational age at diagnosis, fetal karyotypes and diagnostic procedures.Results. Of 35 fetuses, all had hydrops fetalis, 19 had suffered IUFD at the time of diagnosis, and 10 had severe oligohydramnios. Cytogenetic studies were performed via amniocentesis, postmortem chorionic villus sampling, or cystic hygroma paracentesis. Successful karyotyping was achieved in 32 fetuses and the karyotype of 45,X was found in 24 fetuses. In cases with IUFD, successful karyotyping rates on cells from amniotic fluid, chorionic villi and cystic hygroma fluid were 88.9% (8 of 9), 69.2% (9 of 13) and 20% (1 of 5), respectively, whereas, in cases with living hydropic fetuses, successful karyotyping was achieved in 12 of 12 amniotic fluid and 5 of 5 cystic hygroma fluid samples.Conclusions. Amniocentesis is a better method for cytogenetic evaluation of fetal cystic hygroma associated with intrauterine fetal death than postmortem chorionic villus sampling and cystic hygroma paracentesis. However, in the case with a living hydropic fetus and oligohydramnios. cystic hygroma paracentesis appears to be a practical alternative for cytogenetic assessment.
Outcome of short stay surgery in conventional gynecological operations
Authors: Meltomaa Seija S. , Mäkinen Juha I. , Kiilholma Pentti J. 
Published: November 2007

Background. To find out the suitability of increasingly common short stay surgery in major conventional gynecological operations.Methods. A retrospective study of sixty‐six patients who underwent major conventional gynecological operations on a short stay basis between January 1990 and December 1992, in a private hospital, at Turku. Finland, were enrolled to the study. The length of the operation, the time of hospitalization, the duration of the sick leave and possible complications were retrospectively studied. The postoperative long‐term outcome and the satisfaction of the patients with short stay surgery was evaluated with a questionnaire.Results. The patients were hospitalized for mean 2.6 days. There were no peroperative complications but four patients (6%) needed rehospitalization because of postoperative problems. Five minor complications (two wound infections and three urinary tract infections) were treated in outpatients after discharge. All patients were satisfied with the short stay surgery. The day of discharge was considered suitable by 80% of the patients and most of the patients (97%) would also recommend similar treatment to their acquaintances.Conclusion. These results suggest that short stay surgery in major gynecological operations can be considered as an alternative to conventional hospitalization.
Effects of L‐arginine on utero‐placental circulation in growth‐retarded fetuses
Authors: Neri Isabella , Mazza Vincenzo , Galassi M. Cristina , Volpe A. , Facchinetti Fabio 
Published: November 2007

Background To evaluate the effects of L‐arginine (ARG) infusion, the nitric oxide as substrate. on the utero‐placental circulation at third trimester.Methods Three groups of nine pregnant women each were infused i.v. with 30 g ARG, for 30 minutes. One group served as control, and the two remnants were composed by patients with intrauterine growth retardation with (IUGR‐B) or without (IUGR‐A) increased resistances in the utero‐placental circulation. Changes of blood flow velocity waveforms of both uterine arteries and umbilical artery were recorded for 60 minutes. Blood pressure, serum nitrites/nitrates and growth hormone levels were also measured.Results No hemodynamic changes in utero‐umbilical circulation were observed during infusion in any of the three groups. Considering the uterine arteries separately as placental and non‐placental sided we found a significant decrease of non‐placental side resistances in IUGR‐B women. Indeed, the pulsatility index was lowered by 14%, in respect of baseline value. Serum nitrites/nitrates as well as serum growth hormone levels were significantly increased by ARG, in every woman, irrespective of the presence of fetal growth retardation. Blood pressure remained unaffected during infusion in every woman.Conclusions These findings suggest that L‐arginine infusion affects utero‐placental circulation in patients with IUGR associated with increased uterine resistances. Such an action is specific and appears possibly to be mediated by a release of nitric oxide.
The pharmacokinetics of oral and intramuscular administration of dexamethasone in late pregnancy
Authors: Elliott Catherine L. , Read Graham F. , Wallace Euan M. 
Published: November 2007

Background To compare the pharmacokinetics of orally administered dexamethasone with intramuscular administration in antenatal patients at risk of preterm delivery.Method Ten antenatal patients at risk for preterm delivery were given two intramuscular and then one oral dose of dexamethasone. Plasma which was collected at set intervals following the first intramuscular dose and the oral dose was assayed for dexamenthasone. The results were analyzed using pharmacokinetic data‐fitting software and pharmacokinetic parameters calculated.Results After oral administration of dexamethasone the mean maximum plasma concentration obtained was 65% that of the intramuscular dose and the bioavailability of the oral route was calculated as 72% of the intramuscular route. The terminal half‐lives of dexamethasone were similar for both routes.Conclusions These limited data would suggest that if dexamethasone is to be administered orally, which would be both preferable to patients and more economic, then a proportionately increased dose of oral dexamethasone would be required to provide similar maternal plasma pharmacokinetics to the intramuscular dose in current use. Further, larger studies are now required to confirm this.
Hemoglobin concentration in pregnant women
Authors: Bergsjø Per , Seha Ahmada M. , Ole‐kin'ori Naphtal 
Published: November 2007

Background Anemia in pregnancy is common in Tanzania. Previous information on distribu‐ton of hemoglobin concentration in total populations is scarce.Methods Standard measurement of hemoglobin concentration in consecutive first visit at‐tenders at the antenatal care clinic in Moshi, 1991‐1994, for a total of 1800, divided into three series of 600 each.Results Hemoglobin concentrations ranged from 41 to 146 g/1, mean 96.9 and s.d. 16.3. For international comparison, 74.5% were below 110 g/1 and 7.0% below 70 g/1. The median was 97.0; other percentiles were 10th: 75.0, 90th: 116.0. The distribution did not change with mother's age, but in the years 1991 and 1994 there were more low hemoglobin values than in the intervening years.Conclusions Low hemoglobin concentrations are prevalent among pregnant women in Moshi, Tanzania. Seven percent were found to have severe anemia, defined as a hemoglobin concentration below 70 g/1.
Relaxin is not related to symptom‐giving pelvic girdle relaxation in pregnant women
Authors: Hansen Annette , Jensen Dorte Vendelbo , Larsen Elisabeth , Wilken‐Jensen Charlotte , Petersen Lone Kjeld 
Published: November 2007

Background The pregnancy associated hormone relaxin induces loosening of the pelvic ligaments in several species. This study was undertaken to evaluate whether pregnant women with symptom‐giving pelvic girdle relaxation had increased serum relaxin concentrations during pregnancy.Method Serum relaxin concentrations were measured in 38 pregnant women with symptom‐giving pelvic girdle relaxation at the time of diagnosis, in the 30th and 38th week of pregnancy as well as 2 and 6 months after delivery. Fourteen pregnant women without symptoms served as a control group. Relaxin concentrations were measured by a homologous enzyme linked immuno‐sorbent assay. All participants were clinically examined including tests for symptom‐giving pelvic girdle relaxation.Results No differences in serum relaxin concentrations were found throughout pregnancy and after delivery between women with symptom‐giving pelvic girdle relaxation and positive clinical findings where compared to the control group. Moreover, there were no differences in serum relaxin concentrations in women with symptom‐giving pelvic girdle relaxation more than 2 months post partum when compared to women in whom the symptoms disappeared within two months after delivery.Conclusion The present results do not suggest an important role for relaxin in symptom‐giving pelvic girdle relaxation during human pregnancy.
Elevation of serum creatine phosphokinase and its MB isoenzyme during normal labor and early puerperium
Authors: Abramov Yoram , Abramov Dan , Abrahamov Ayala , Durst Rimona , Schenker Joseph 
Published: November 2007

Background Chest pain or discomfort are infrequent complaints among women during labor and early puerperium, but when present they raise the suspicion of myocardial ischemia. The diagnosis of the latter is based upon serum elevation of certain enzymes, such as aspartate amino transferase, lactate dehydrogenase and creatine phosphokinase. Nevertheless, the normal patterns of these enzymes in the serum during labor and early puerperium have not been characterized well.Objective To determine serum creatine phosphokinase, lactate dehydrogenase and aspartate amino transferase levels in late pregnancy, and throughout labor and early puerperium.Methods Fifty women having normal pregnancies followed by uneventful vaginal deliveries were prospectively studied for serum lactate dehydrogenase, aspartate amino transferase and creatine phosphokinase including its MB isoenzyme before, during and after labor. Cardiac status was evaluated in all women using serial electrocardiographic and physical examinations.Results All women were found to have low to normal antepartum serum enzymes levels. However, during labor total creatine phosphokinase increased markedly, reaching a peak of 2‐4 fold baseline levels 24 hours postpartum. It then declined gradually back to baseline. Nulliparous women reached substantially higher levels than muciparous women. The MB or so‐called cardiospecific isoenzyme was found to be an important contributor to creatine phosphokinase surge in most women. Correlation was demonstrated between length of the active phase of labor and both total and MB creatine phosphokinase activity. There was no clinical or electrocardiographic evidence for cardiac muscle damage in any of the study patients. Serum lactate dehydrogenase and aspartate amino transferase were not altered during or after labor.Conclusions Serum total creatine phosphokinase and its MB isoenzyme increase substantially during normal vaginal labor without evidence of myocardial ischemia. The uterus and placenta, two organs which were reported to embody substantial amounts of these enzymes, and which participate actively in the process of labor, are thought to release these enzymes to the circulation during labor. Knowing the normal patterns of these enzymes in the serum during labor and puerperium may prevent erroneous diagnoses of myocardial ischemia or infarction. Lack of electrocardiographic abnormalities and low lactate dehydrogenase and aspartate amino transferase levels may assist in excluding such diagnoses.
Hysterectomy in a Danish cohort. Prevalence, incidence and socio‐demographic characteristics
Authors: Settnes Annette , Jørgensen Torben 
Published: November 2007

Background The aim has been to assess the frequency of hysterectomy in relation to sociode‐mographic characteristics.Materials and methods A cross‐sectional survey of 2,403 women selected at random from the population in the western part of Copenhagen County. One thousand seven hundred and sixty‐five Danish women (77%) filled in the questionnaire and took part in the interview. The cohort was followed for eight years through central registers to assess the incidence of hysterectomy. Logistic and Cox regression were used as main statistics. Results. Life time prevalence of hysterectomy was 10.4%. In the prevalence study, hysterectomy on benign diagnoses (85%) was related to short schooling, lack of vocational education. and low social status personally as well as regards the family. In the multivariate analyses school education, vocational education, and ascending social status by marriage were independent explanatory variables. In the incidence study, the crude rate of hysterectomy on benign diagnoses was 3.4 pr. 1000 years, with the 40‐year‐old women having the highest rate (7.8 pr. 1000 years). Risk factors as regards hysterectomy due to bleeding disorders and uterine fibroids at ages <50 (premenopausal) were unemployment and lack of vocational education, only the latter reached significant level in the multivariate analysis. Conclusion. There are social inequalities regarding premenopausal hysterectomy on benign diagnoses, but the socio‐demographic indicators of interest have changed through the last decades. Short schooling and lack of social mobility by marriage were only associated with the hysterectomies performed before 1982. whereas lack of vocational education was related to hysterectomy independent of the calendar period involved. A woman without education has a relative risk of 2.2 (1.1‐4.4) for hysterectomy compared to an educated woman.
Primary cancer of the fallopian tube
Authors: Jereczek Barbara , Jassem Jacek , Kobierska Anna 
Published: November 2007

Background Due to rarity of fallopian tube cancer most series on this tumor are small and many problems have remained unsolved. The aim of this report is to review our experience with this neoplasm and to compare it with previously published data.Methods Retrospective study of 26 patients with fallopian tube cancer treated in one institution between 1974 and 1994. All patients underwent primary surgical treatment and 18 received adjuvant therapy including pelvic irradiation in 14 cases and chemotherapy in four. Results. Relapse occurred in 18 out of 25 followed up patients. Upper abdominal component of relapse was encountered in 12 patients (67%), pelvic component ‐ in eight (44%) and extraperitoneal component ‐ in six (33%). Pelvic relapse occurred in two out of 13 followed up patients treated with postoperative irradiation and in six out of 12 who did not receive postoperative radiotherapy. Survival ranged from 6 to 218 + months (median 23 months). Five‐year actual survival was 33%. There were no 2‐year survivors in patients presenting with stage II‐IV disease. No correlation was found between tumor grade and survival.Conclusions Fallopian tube cancer is a treatable disease but cure can be only achieved in patients with early tumor. Postoperative radiotherapy may result in better local control but does not preclude extrapelvic dissemination, therefore adjuvant chemotherapy should be considered in high risk patients. Registration of all new cases as well as prospective multicenter studies are warranted to establish optimal management.
The effect of work activity in pregnancy on the risk of fetal growth retardation
Authors: Spinillo Arsenio , Capuzzo Ezio , Baltaro Federica , Piazzi Gaia , Nicola Sabrina , Iasci Angela 
Published: November 2007

Background. The relationship between physical activity at work and risk of fetal growth restriction is controversial. For the most part, previous studies investigated the effect of work activity on birthweight alone. We evaluated the impact of type of occupation and physical effort at work on the risk of ultrasonographically confirmed fetal growth retardation among nulliparous women.Methods. We compared the characteristics of work and the intensity of occupational fatigue (work posture, weekly working hours, physical effort at work) in 349 patients with ultrasonographically confirmed fetal growth retardation and 698 control pregnancies with appropriate fetal growth. Physical demands at work were evaluated by interview at birth. Logistic regression analysis was used to evaluate the association of employment status, type of occupation, and intensity of occupational fatigue with the risk of fetal growth retardation, correcting for potential confounders (maternal age, pre‐pregnancy body mass index, mean weight gain in pregnancy, education, partner's social status, smoking in pregnancy, alcohol use, illicit drug use, time of stopping work, and hypertension).Results. After adjusting for confounding, the risk of fetal growth retardation was similar between unemployed and formally employed women at the beginning of pregnancy (OR=1.26; 95% confidence interval=0.86‐1.83). However, manual workers were at slightly higher risk of IUGR than not formally employed women (OR=1.81; 95% CI=1.15‐2.85). Among formally employed women, standing or walking at work, and working 30 hours a week were not significantly associated with IUGR. Finally, the risk of IUGR was significantly higher (OR=2.4; 95% CI=1.36‐1.21) among women reporting moderate‐to‐heavy as compared to light physical effort at work.Conclusion. Formal employment at the beginning of pregnancy is not associated with an increased risk of IUGR. However, moderate‐to‐heavy physical effort at work seems to increase the risk of sonographically confirmed fetal growth retardation.
Central nervous system involvement in gestational trophoblastic neoplasia
Authors: Ayhan Ali , Tuncer Z. Selçuk , Tanir Mete , Erbengi Aykut 
Published: November 2007

Background. To review the experience of seven cases of gestational trophoblastic neoplasia with central nervous system involvement.Methods. Seven patients among 50 cases of malignant gestational trophoblastic neoplasia were analyzed retrospectively in a single institution.Results. The mean age of the patients at diagnosis was 28.7 years (range: 20‐34). While five of the patients presented initially with symptoms related to cranial involvement, the remaining two developed cerebral metastases during the therapy. In two patients, the presentation was so similar to a primary cranial pathology that craniotomy and biopsy revealed the trophoblastic involvement. The sites of involvement were the parietal lobe in three, temporal lobe in two and frontal lobe in two patients. Besides central nervous system involvement, four had additional lung and one had pelvic metastases. In terms of therapy, while five patients received methotrexate+actinomycin‐D+cyclophosphamide regimen for 3 to 5 courses, only two could be administered additional intrathecal methotrexate. Since one patient exhibited a fulminant clinical course, she could not be delivered a chemotherapy regimen and was lost in two months of initial diagnosis. The other patient was administered modified Bagshawe protocol (5 courses) which was switched to etoposide+methotrexate+actinomycin‐D+vincristine+cyclophosphamide (6 courses) due to development of resistance. She was still alive and free of disease after 24 months of initial diagnosis. Six of the patients were also delivered whole‐brain irradiation simultaneously with chemotherapy.Conclusions. The prognosis of brain metastases still seems to be poor despite combination chemotherapy and radiotherapy. Measures should be focused on early diagnosis and prophylaxis.