bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preoperative evaluation of endometrial carcinoma by contrast‐enhanced ultrasonography
Authors: Song Y , Yang J , Liu Z , Shen K 
Published: December 2008

Objective  To investigate the potential usefulness of contrast‐enhanced ultrasonography in the preoperative evaluation of endometrial carcinoma and observe its enhancement pattern and time–intensity curve.Design  A prospective study.Setting  Gynaecological department of a college hospital.Population  A total of 35 women diagnosed with endometrial carcinoma.Methods  The patients were evaluated with real‐time grey‐scale contrast‐enhanced ultrasonography. In 21 women, the parameters of time–intensity curve were compared between the endometrial lesion and normal myometrium. Findings about the depth of myometrial invasion on sonograms were compared with histological findings.Main outcome measures  Enhancement pattern, parameters of time‐intensity curve, depth of myometrial invasion detected on sonograms.Results  In visual evaluation, the brightness of the power Doppler signal and the amount of recognisable vascular areas increased in each tumour after contrast agent administration. Feeding vessels of the tumour were shown in 77.1% (27/35) of women. The other 22.9% (8/35) of women revealed that the signals were first visualised in the central portion of the tumour. The arrival time and peak time of endometrial lesion tended to be shorter than normal myometrium. The tumours started to enhance earlier than or at the same time as myometrium in 90.5% (19/21) of women. The peak intensity, enhancement intensity, and rising rate were higher in endometrial lesion than normal myometrium. There was no myometrial invasion in eight women, inner half myometrial invasion in 19 women and the outer half myometrial invasion in eight women. The corresponding values for ultrasound were 9, 17, and 9. The sensitivity of contrast‐enhanced ultrasonography in detecting deep invasion was 75.0%, while the specificity was 88.9%, and the accuracy was 85.7%. The overall accuracy of assessment of myometrial invasion was 68.6%.Conclusion  There is some benefit in contrast‐enhanced ultrasonography of endometrial carcinoma. It may provide better information in tumour imaging. Large studies are needed to determine the appropriate use and benefit of this new procedure.
Oral nifepidine versus subcutaneous terbutaline tocolysis for external cephalic version: a double‐blind randomised trial
Authors: Collaris R , Tan PC 
Published: December 2008

Objective  To evaluate oral nifedipine versus subcutaneous terbutaline tocolysis for external cephalic version (ECV).Design  A double‐blind randomised trial.Setting  A university hospital in Malaysia.Population  Non‐labouring women with a term singleton fetus in breech presentation or transverse lie suitable for elective ECV.Methods  Participants were randomised to either 10 mg oral nifedipine tablet and subcutaneous saline placebo or oral placebo tablet and 250 microgram bolus terbutaline subcutaneously. Participants and providers were blinded. Ultrasound assessment and cardiotocogram were performed prior to ECV. ECV was commenced 20–30 minutes after treatment. A maximum of two ECV attempts were permitted. Elective caesarean delivery or a repeat ECV attempt at a later date was offered to participants following failed ECV. After successful ECV, management was expectant.Main outcome measures  Primary outcomes were successful ECV (cephalic presentation immediately after ECV) and caesarean delivery.Results  Ninety women were randomised: 44 to nifedipine and 46 to terbutaline. Initial ECV success rate was 15/44 (34.1%) versus 24/46 (52.2%) (relative risk [RR] 0.7, 95% CI 0.4–1.1; P= 0.094), and caesarean delivery rate was 34/44 (77.3%) versus 26/46 (56.5%) (RR 1.4, 95% CI 1.01–1.85; numbers needed to treat to benefit 5, 95% CI 2.5–55; P= 0.046) for nifedipine and terbutaline groups, respectively. Neonatal outcome was not different.Conclusions  Bolus subcutaneous terbutaline tocolysis for ECV compared with oral nifedipine resulted in less caesarean deliveries. ECV success rate was not significantly higher. Larger studies are indicated.
A randomised trial comparing the H Pipelle with the standard Pipelle for endometrial sampling at ‘no‐touch’ (vaginoscopic) hysteroscopy
Authors: Madari S , Al‐Shabibi N , Papalampros P , Papadimitriou A , Magos A 
Published: December 2008

Objectives  To evaluate the effectiveness and tolerance of H Pipelle compared with the standard Pipelle as an endometrial biopsy device at outpatient ‘no‐touch’ hysteroscopy.Design  A prospective randomised trial carried out in an outpatient diagnostic hysteroscopy clinic.Setting  A large undergraduate teaching hospital.Population  Sixty women investigated for abnormal menstruation in an outpatient diagnostic hysteroscopy clinic.Methods  Prospective randomised trial comparing the H Pipelle with the standard Pipelle de Cornier.Main outcome measures  Adequacy of the biopsy specimens and women’s experience.Results  Ninety‐three percent (H Pipelle) and 87% (Pipelle) of the biopsy specimens were judged to be adequate for histological diagnosis (P > 0.05). However, obtaining endometrial sampling with the H Pipelle was significantly quicker (median times: 39 seconds [H Pipelle] and 102 seconds [Pipelle], P < 0.0001) and less painful (median visual analogue scale score: 1 [H Pipelle] and 5 [Pipelle], P = 0.011).Conclusions  The H Pipelle not only makes it possible to perform hysteroscopy and endometrial biopsy with minimal instrumentation but is also associated with a shorter biopsy time and less discomfort than the standard Pipelle without any loss of biopsy adequacy.
In vivo magnetic resonance spectroscopy of gynaecological tumours at 3.0 Tesla
Authors: Booth SJ , Pickles MD , Turnbull LW 
Published: December 2008

Background  Magnetic resonance spectroscopy (MRS) uses the same hardware as MR imaging and allows us to analyse the biochemistry of tissues in vivo. Published data for gynaecological lesions are limited and are largely based on MRS carried out at the lower magnetic field strength of 1.5 Tesla (T).Objective  The purpose of this study was to determine whether in vivo proton MRS could be performed at the higher magnetic field strength of 3 T to characterise the spectra of a variety of benign and malignant gynaecological lesions.Design  Prospective, non‐randomised study.Setting  MRI department within a tertiary referral centre for gynaecological cancers.Sample  All women with a pelvic mass under going 3T MRI.Methods  We carried out MRS on nonrandomised women undergoing routine 3 T MRI within our MRI department during investigation for gynaecological lesions from February 2006 to April 2008. Only those women for whom histopathological data were available were included.Main outcome measures  The presence of choline detected by in vivo 3T MRS.Results  Eighty‐seven women underwent MRS, 57 of whom had newly diagnosed neoplasms. MRS data for 39 of these new women (18 were excluded because of technical errors or missing data) were used to detect the presence of choline, an indicator of basement membrane turnover. Overall, choline was present in 13 of the 14 ovarian cancers, 8 of the 11 cervical tumours and all 4 of the uterine cancers. There was no statistical significant difference between choline levels in various lesion types (P= 0.735) or between benign and malignant disease (P= 0.550).Conclusions  In vivo MRS can be performed at 3 T to provide biochemical information on pelvic lesions. The way in which this information can be utilised is less clear but may be incorporated into monitoring tissue response in cancer treatments.
Efficacy and safety of transvaginal mesh kits in the treatment of prolapse of the vaginal apex: a systematic review
Authors: Feiner B , Jelovsek JE , Maher C 
Published: December 2008

Background Vaginal mesh kits are being used to surgically treat apical vaginal prolapse; however, their safety and efficacy are currently unknown.Objectives To summarise success and complication rates for commonly used vaginal mesh kits in the treatment of apical prolapse.Search strategy MEDLINE and other scientific databases were queried for primary research addressing the use of vaginal mesh kits for apical prolapse published between 1950 and 2007, including abstracts presented in major scientific meetings.Selection criteria Studies describing the use of mesh to support either the anterior or posterior compartment alone, for incontinence or fistula repair or not addressing the vaginal apex were excluded.Data collection and analysis Identified studies were grouped by the mesh kit and complications categorised using the Dindo classification system. Weighted averages and confidence intervals were calculated on objective success, follow‐up length and complications.Main results Thirty studies totalling 2653 women met inclusion criteria. Objective success rates (95% CI) were Apogee™ (American Medical Systems Inc., Minnetonka, MN, USA) 95% (95–96), Prolift™ (Ethicon Women’s Health and Urology, Somerville, NJ, USA) 87% (86–87) and posterior intravaginal slingplasty 88% (87–89). Reoperations not requiring anaesthesia (Dindo IIIa) occurred in 0.4–2.3% and requiring anaesthesia (Dindo IIIb) in 1.5–6.0%, with a follow up between 26 and 78 weeks. Mesh erosion was the most commonly reported complication occurring in 4.6–10.7%.Author’s conclusions Overall objective success using transvaginal mesh kits in restoring apical vaginal prolapse is high. However, an increasing number of women require surgical intervention for mesh‐related complications based on limited data quality and short follow up. Further research addressing functional outcomes and the impact of these procedures on women’s symptoms and quality of life is mandatory.
The impact of viewing a hysteroscopy on a screen on the patient’s experience: a randomised trial
Authors: Ogden J , Heinrich M , Potter C , Kent A , Jones S 
Published: December 2008

Background  The introduction of patient screens for outpatient procedures is becoming increasingly common. To date, the impact on the patient of viewing the screen remains unknown.Objectives  To explore how viewing the screen during a hysteroscopy procedure affects the patient’s experience.Setting  The outpatient clinics at the Royal Surrey Hospital in Guildford and the Royal Infirmary in Bradford.Design  A randomised control trial.Sample  Women undergoing a hysteroscopy procedure were randomly allocated to see the screen (n = 81) or not to see the screen (n = 76).Methods  A quantitative study with measures taken before and after the intervention.Main outcome measures  Pain perception, mood, illness cognitions, communication.Results  Seeing the screen or not had no impact on several measures of pain perception, mood, illness cognitions or communication. However, women who did not see the screen were more optimistic about the effectiveness of their treatment and felt that the health professional was more receptive to them during the consultation compared with those who saw the screen. After controlling for the use of a local anaesthetic, those who did not see the screen also reported a greater decrease in anxiety after the procedure. However, those who saw the screen described pain more positively (i.e. in terms of comfort, reassurance or encouragement) compared with those who did not see the screen.Conclusion  Viewing the screen does not benefit the patient and may interfere with the patient–physician interaction.
The feasibility of a less invasive method to assess endometrial maturation—comparison of simultaneously obtained uterine secretion and tissue biopsy
Authors: van der Gaast MH , Macklon NS , Beier‐Hellwig K , Krusche CA , Fauser BCJM , Beier HM , Classen‐Linke I 
Published: December 2008

Objective  To compare the assessment of endometrial maturation parameters in endometrial secretion samples obtained by a novel minimally invasive technique with those assessed in tissue biopsies.Design  Prospective study.Setting  University Hospital.Population  Healthy female volunteers attending a gynaecological outpatient clinic.Methods  Endometrial secretion fluid and tissue sampling 5 days after a spontaneous ovulation assessed with ultrasound.Main outcome measures  Progesterone (P) receptor, Ki‐67 expression and the Noyes criteria were used to date endometrial biopsies. In the endometrial fluid samples, glycodelin A (GdA), leukaemia inhibitory factor (LIF) and P levels were analysed, and protein content and electrophoresis patterns were determined.Results  All data were correlated to estradiol (E2) and P serum concentrations. The dating according to histology and immunohistochemical staining patterns correlated significantly with GdA levels (r = 0.376, P =0.048) in endometrial fluid samples as well with serum levels of E2 (r = 0.568, P =0.001) and P (r = 0.408, P =0.023). No correlation was observed between tissue dating and LIF levels and protein content in endometrial fluid samples.Conclusions  The measurement of GdA in endometrial secretion samples may provide a less invasive method for assessing endometrial maturation in potential conception cycles without disrupting implantation.
Proteomic biomarkers for the diagnosis and risk stratification of polycystic ovary syndrome: a systematic review
Authors: Atiomo W , Khalid S , Parameshweran S , Houda M , Layfield R 
Published: December 2008

Background  The exact causes of polycystic ovary syndrome (PCOS) are uncertain, and treatment could be improved. Discovery‐based approaches like ‘proteomics’ may result in faster insights into the causes of PCOS and improved treatment.Objectives  To identify the number and nature of proteomic biomarkers found in PCOS so far and to identify their diagnostic and therapeutic potential.Search strategy  All published studies on proteomic biomarkers in women with PCOS identified through the MEDLINE (1966–2008), EMBASE (1980–2008) and the ISI web of knowledge (v4.2) databases.Selection criteria  The terms ‘polycystic ovary syndrome’ and ‘proteomic’, ‘proteomics’, ‘proteomic biomarker’ or ‘proteomics biomarker’ without any limits/restrictions were used.Data collection and analysis  Original data were abstracted where available and summarised on a separate Microsoft Excel (2007) database for analysis.Main results  Seventeen articles were identified, of which 6 original papers and 1 review article contained original data. Tissues investigated included serum, omental biopsies, ovarian biopsies, follicular fluid and T lymphocytes. Sample sizes ranged from 3 to 30 women. One hundred and forty‐eight biomarkers were identified. The biomarkers were involved in many pathways, for example the regulation of fibrinolysis and thrombosis, insulin resistance, immunity/inflammation and the antioxidant pathway. Eleven groups of biomarkers appeared to be independently validated. The individual sensitivities for the diagnosis of PCOS were reported for 11 named biomarkers and ranged from 57 to 100%.Author’s conclusions  Proteomic biomarker discovery in PCOS offers great potential. Current challenges include reproducibility and data analysis. The establishment of a PCOS‐specific biomarker data bank and international consensus on the framework of systematic reviews in this field are required.
The limits and rewards of political opportunism: How electoral timing affects the outcome of currency crises
Authors: WALTER STEFANIE 
Published: December 2008

AbstractPoliticians are often assumed to be opportunistic. This article examines both whether there is a limit to this opportunism and whether voters reward policy makers for opportunistic behaviour. By looking at currency crisis situations, the article presents a graphic rational opportunistic political business cycle model in which incumbents face a tradeoff between their wish to signal competence and the economic constraints imposed by the crisis. It analyses how electoral incentives affect policy makers' management of currency crises and how this management in turn affects the subsequent election outcome. The empirical results of probit models with selection using a sample of 122 crises in 48 industrial and developing countries between 1983 and 2003 confirm the model's prediction that under certain circumstances some types of policy makers do indeed have incentives to deviate from optimal policy in the run‐up to elections – and that voters reward this behaviour by re‐electing policy makers who follow such strategies. However, there is a limit to the readiness to manipulate: when speculative pressure is too severe, incumbents no longer manipulate policy but implement the least painful policy option instead.
Hemoglobin Control, ESA Resistance, and Regular Low‐Dose IV Iron Therapy: A Review of the Evidence
Authors: Singh Ajay 
Published: December 2008

AbstractAnemia management in hemodialysis patients has progressed following the introduction of erythropoiesis‐stimulating agents (ESAs) and intravenous (IV) iron. However, maintaining a stable hemoglobin (Hb) level can be challenging. Patient comorbidities and variable dosage administrations of ESA therapy can lead to great variability in Hb concentrations over time. Fluctuating Hb levels is associated with increased complications. This article reviews factors that affect Hb control, with a focus on management practices (e.g., regular low‐dose administration of IV iron) that can help improve anemia management.
Attraction of male winterform pear psylla to female‐produced volatiles and to female extracts and evidence of male–male repellency
Authors: Guédot Christelle , Horton David R. , Landolt Peter J. 
Published: December 2008

AbstractPear psylla, Cacopsylla pyricola (Förster) (Homoptera: Psyllidae), is a major pest of commercial pears in North America and Europe. Olfactometer trials have shown that males of both the summer and winter morphotype are attracted to female‐infested host material. Additional work with the summer morphotype has shown that males are attracted to females even in the absence of the host plant, which is evidence that female C. pyricola produce a volatile sex attractant. Here, we describe similar results with the winterform, confirming for this morphotype that the female psylla rather than the infested host material is the source of the attractant. Male winterforms displayed attraction to odors from live females in the absence of the host plant, freshly killed females, and female whole body extracts. The female whole body extracts were at least as attractive as a comparable number of live females, suggesting that we were successful at extracting the components of the attractant with this procedure. All previous olfactometer trials with C. pyricola used the insect as the attractant source; the current study is the first to demonstrate that volatile chemicals isolated from the female insect were attractive to male conspecifics. Winterform males were also assayed to odors produced by conspecific males. We found that male psylla avoided volatile odors from live males, freshly killed males, or whole body extracts of males. To our knowledge, these results are the first indication that males of any member of the Psyllidae avoid odors associated with conspecific males.
Misclassification and the use of register‐based indicators for depression
Authors: Thielen K. , Nygaard E. , Andersen I. , Rugulies R. , Heinesen E. , Bech P. , Bültmann U. , Diderichsen F. 
Published: December 2008

Objective:  To study the degree to which depression indicators based on register data on hospital and antidepressant treatment suffer from differential misclassification with respect to gender, age and social group.Method:  Data on 7378 persons were obtained by linking a cross‐sectional survey of Danish adults aged 40 and 50 years with population‐based registers. Misclassification was analysed by comparing survey data to register data on major depression using the method proposed by Rothman and Greenland.Results:  Differential misclassification was found. Adjustment for misclassification reduced women’s odds ratios from 2.18 to 1.00 for hospital treatment and from 1.70 to 1.10 for antidepressants. For the lower social group, the corresponding odds ratios increased from 1.18 to 3.52, and from 1.35 to 2.32 respectively, whereas odds ratios with respect to age remained almost unchanged.Conclusion:  Differential misclassification should be considered when register‐based information about hospital and antidepressant treatment are used as depression indicators.
Brain functional changes during placebo lead‐in and changes in specific symptoms during pharmacotherapy for major depression
Authors: Hunter A. M. , Ravikumar S. , Cook I. A. , Leuchter A. F. 
Published: December 2008

Objective:  Brain functional changes during placebo lead‐in have been associated with antidepressant response in clinical trials for major depressive disorder (MDD); however, the relationship between such non‐pharmacodynamic changes in brain function and changes in specific symptoms is unknown.Method:  Fifty‐eight adults with MDD completed a 1‐week single‐blind placebo lead‐in preceding 8 weeks of double‐blind randomized treatment with fluoxetine or venlafaxine (n = 30) or placebo (n = 28). Brain functional change during lead‐in was assessed using quantitative electroencephalographic (qEEG) prefrontal theta‐band cordance. Symptoms were assessed using the Symptom Checklist‐90‐Revised (SCL‐90‐R).Results:  The multiple regression model examining the qEEG parameter in relation to SCL‐90‐R subscales was significant [F(9,9) = 4.27, P = 0.021, R2 = 0.81] in females, with a significant association for the interpersonal sensitivity subscale (beta coefficient = 1.94, P = 0.001).Conclusion:  Prefrontal neurophysiologic change during placebo lead‐in may indicate subsequent antidepressant‐related improvement in symptoms of interpersonal sensitivity.
Participation of the secreted dipeptidyl and tripeptidyl aminopeptidases in asaccharolytic growth of Porphyromonas gingivalis
Authors: Oda H. , Saiki K. , Tonosaki M. , Yajima A. , Konishi K. 
Published: December 2008

Background and Objective:  Porphyromonas gingivalis secretes gingipains, endopeptidases essential for the asaccharolytic growth of this bacterium. P. gingivalis also secretes dipeptidyl aminopeptidases (DPPIV and DPP‐7) and a tripeptidyl aminopeptidase (PTP‐A), although their role in asaccharolytic growth is unclear. The present study was carried out to elucidate the role of these dipeptidyl/tripeptidyl aminopeptidases on the asaccharolytic growth of P. gingivalis.Material and Methods:  Knockout mutants for the DPPIV (dpp), dpp7 and/or PTP‐A genes were constructed. Brain–heart infusion medium supplemented with sterile hemin and menadione (BHIHM) was used as a complex medium, and the minimal medium used was GA, in which the sole energy source was a mixture of immunoglobulin G and bovine serum albumin. Growth of P. gingivalis was monitored by measuring the optical density of the culture.Results:  All knockout mutants for DPPIV, dpp7 and PTP‐A grew as well as strain W83 in BHIHM. In GA, growth of single‐knockout and double‐knockout mutants was similar to that of W83, whereas growth of a triple‐knockout mutant (83‐47A) was reduced. We purified recombinant DPPIV and recombinant PTP‐A from recombinant Escherichia coli overproducers, and purified DPP‐7 from the triple‐knockout mutant 83‐4A. GA supplemented with the three purified dipeptidyl/tripeptidyl aminopeptidases supported the growth of 83‐47A.Conclusion:  DPPIV, DPP‐7 and PTP‐A contribute to the normal growth of P. gingivalis by cleaving substrate peptides into short‐chain polypeptides that are efficient energy sources for P. gingivalis.