bluuebunny/crossref_metadata_2025_split huggingface dataset:
New disposable vaginal device (continence guard) in the treatment of female stress incontinence
Authors: Thyssen Hans , Lose Gunnar 
Published: November 2007

Background. To develop a new disposable vaginal device for use during the daytime, and test its efficacy and short‐term safely in the treatment of stress incontinence.Methods. The intravaginal support device was designed from polyurethane. a foam product with documented high tissue compatibility. It was tested in 26 women with the symptom of stress incontinence. Before and after one month's use of the device, a 24‐hour home pad weighing test, uroflowmetry, postvoid residual urine and a 3‐days voiding diary were made. A questionnaire about the subjective effect and adverse events was filled in. In vitro and in vivo microbiology testing were performed.Results. Four women discontinued the treatment because of discomfort or difficulties in using the device. Out of 22 women who completed the study nine (41%) were subjectively cured of incontinence, ten (45%) improved while three (14%) claimed unchanged incontinence. With the device in place all had decreased leakage at the 24‐hour pad weighing test and unchanged urodynamic tests. The subjective complaints were few, and no vaginal or urinary infections were found. All women whose condition both subjectively and objectively improved, (19/22) wanted to continue treatment with the device.Conclusions. The new disposable vaginal device is effective in alleviating the symptoms of stress incontinence. It is well accepted and safe.
Toxic Hepatitis: a Rare Complication Associated with the use of Ritodrine During Pregnancy
Authors: de Arcos Francisco , Gratacós Eduard , Palacio Montserrat , Cararach Vicenç 
Published: November 2007

Objectives. To evaluate the incidence of toxic hepatitis associated with the use of ritodrine in pregnancy.Design. A prospective study.Setting. A large teaching hospital in Barcelona. Spain.Patients: One hundred and twenty‐three consecutive pregnant women, 101 singleton and 22 multiple pregnancies, receiving intravenous ritodrine with normal transaminase levels prior to the initiation of therapy.Measurements. Serum glutamic pyruvic transaminase (SGPT) and glutamic oxaloacetic transaminase (SGOT). gamma‐glutamyl transpeptidase (GGT). alkaline phosphatase (PA), direct and total bilirubin.Results. In two (1.9%) of 101 singleton and two (9.1%) of 22 multiple pregnancies, elevation of SGOT and SGPT levels was detected. PA, GGT, and bilirubin were normal in all women studied. Other causes of hepatitis were ruled out, and no other signs of liver impairment were found in these women. Transaminase levels recovered rapidly in all cases after discontinuation of therapvConclusion. Elevation of liver enzymes is a rare complication of ritodrine. Discontinuation of therapy does not appear to be indicated as long as other signs of liver dysfunction are not present and tocolytic treatment is required.
Effect of Dehydroepiandrosterone Sulfate on Fetal Middle Cerebral Artery Flow Velocity Waveforms in term Pregnancy
Authors: Hata Toshiyuki , Senoh Daisaku , Hata Kohkichi , Kitao Manabu , Masumura Sumio 
Published: November 2007

Objective. To investigate whether bolus injection of dehydroepiandrosterone sulfate (DHAS) is associated with changes in fetal middle cerebral artery flow velocity waveforms in term pregnancy.Methods. Ten normal full‐term pregnant women received the administration of a 200‐mg intravenous dose of DHAS in 20 ml of 5% dextrose. Ten normal full‐term pregnant women received 20 ml 5% dextrose as controls. Color Doppler flow imaging and pulsed Doppler ultrasonographic assessments were made on fetuses in each group before and 10 min, 30 min, 60 min, 90 min, and 120 min after DHAS or dextrose administration. The pulsatility index (PI) values for the middle cerebral artery, and umbilical artery, and fetal heart rate were recorded.Results. In the DHAS group, middle cerebral artery PI decreased from baseline by 24% (p<.05) after 10 min, and the mean reduction was 22% (p<.05) after 30 min. The PI returned to the baseline value 60 min later. In the control group, there was no change in middle cerebral artery PI. No change was found in umbilical artery PI or fetal heart rate in the control or DHAS group.Conclusion. DHAS induces a significant decrease in the fetal middle cerebral artery PI, which suggests a possible decrease in fetal cerebral vascular impedance in term pregnancy.
Validity of Self‐Reported Smoking Habits in Pregnancy: a Saliva Cotinine Analysis
Authors: Parazzini Fabio , Davoli Enrico , Rabaiotti Manuela , Restelli Simona , Stramare Luca , Dindelli Moreno , La Vecchia Carlo , Fanelli Roberto 
Published: November 2007

Background. We examined the validity of self‐reported cigarette smoking during the third trimester of pregnancy using saliva cotinine as a markerMethods. Eligible for the study were 109 pregnant women attending the outpatient Prenatal Service of the Luigi Mangiagalli Clinic (the largest maternity clinic in Milan) for routine prenatal visits during the third trimester of pregnancy on twenty days in 1994. Women self‐reporting current smoking or quitting smoking in pregnancy were asked to provide a saliva sample. Cotinine concentration was analyzed and classified as follows: cotinine not detectable, not probable nicotine use or passive exposure; cotinine <10 ng/ml, not probable nicotine use/probable passive exposure; cotinine, $10 ng/m. probable occasional or regular nicotine use. Results. A total of 57 (52.3%) women were non‐smokers at conception and were excluded from any subsequent analysis. Of the remaining 52 women, 25 self‐reported quitting smoking in pregnancy and 27 were current smokers. Saliva cotinine levels were below 10 in 20 of the 25 subjects reporting quitting smoking in pregnancy. The five cases with cotinine $10 reported a husband smoking more than 10 cigarettes per day. Among the 26 current smokers, seven had a cotinine level $10 ng/ml (four reported smoking fewer then five cigarettes per day and two reported smoking five or more per day); in 20 cases the cotinine value was $10 ng/ml. Conclusions. These findings provide evidence of a satisfactory validity of self‐reported smoking habits in pregnancy.
The effects of estradiol valerate plus medroxyprogesterone acetate and conjugated estrogens plus medrogestone on climacteric symptoms and metabolic variables in perimenopausal women*
Authors: Egarter Christian , Geurts Paul , Boschitsch Ewald , Speiser Paul , Huber Johannes 
Published: November 2007

Background. Two sequential hormone replacement regimens, containing either estradiol valerate plus medroxyprogesterone acetate (E2V/MPA) or conjugated estrogens plus medrogestone (CE/MED). were compared with respect to effects on climacteric symptoms, lipid metabolism, and hemostasis.Methods. In an open, multicenter study. 51 perimenopausal women were randomized to E2V/ MPA and 50 to CE/MED. Assessment of climacteric complaints was performed at baseline and at months 1, 3. and 6. The effects on lipid and hemostatic variables were measured at baseline and at month 6. Quantitative data were analyzed using analysis of variance, the paired t‐test, or the χ2 Mantel‐Hänszel test, where appropriate.Results. Efficacy regarding treatment of climacteric symptoms was with E2V/MPA as good as with CE/MED. with a statistically significant reduction of most symptoms in both groups. After 6 months, total cholesterol and triglycerides had remained unchanged in both groups. High‐density lipoprotein cholesterol showed no significant change with E2V/MPA. whereas an increase was noted in the CE/MED group (p<0.05). Low‐density lipoprotein cholesterol was decreased with E2:V/MPA (p<0.05) and was unchanged in the CE/MED group. Hemostatic parameters showed no significant changes after 6 months, with the exception of a decreased prothrombin time with E2V/MPA (p<0.05). Acceptability was excellent, expressed by the low incidence of treatment‐related drop‐outs in both groups.Conclusions. E2V/MPA is a one tablet per day sequential HRT regimen, which is as effective and acceptable as hormone replacement therapy with CE/MED regarding treatment of climacteric symptoms. Neither preparation had negative effects on lipid metabolism and hemostatic variables.
Previous ectopic pregnancy should be considered a contraindication for microsurgery
Authors: Strandell Annika , Thorburn Jane 
Published: November 2007

Background. To estimate the risk of subsequent ectopic pregnancy (EP) after tubal surgery, given that the woman becomes pregnant, by means of a logistic model, a retrospective study was initiated.Methods. During the period 1986‐1990. 221 women with tubal infertility underwent microsurgery. Subsequent fertility was evaluated in 1991. Ninety women conceived, of whom 84 were included in the study (30 with EP and 54 with intra‐uterine pregnancy as the only outcome). Clinical background factors of importance, surgical procedures used, scoring systems for tubal lesions, adnexal adhesions and risk of EP were analysed for possible correlation to subsequent EP. These factors were further used in a logistic model to estimate the risk of subsequent EP as only outcome.Results. The risk of EP after microsurgery is minimum 15% without any risk factors. Previous EP and endometriosis could be identified as factors with prognostic power in the logistic model. One previous EP implies a 60% risk, whereas two previous EPs and endometriosis increases the risk to 95%.Conclusion. Patients with previous EP should generally not be considered for microsurgery owing to the high risk of recurrence and to the reduced chance of intra‐uterine pregnancy.
Abdominal hysterectomy should not be considered as a primary method for uterine removal: A prospective randomised study of 100 patients referred to hysterectomy
Authors: Langebrekke Anton , Eraker Runar , Nesheim Britt‐Ingjerd , Urnes Arne , Busund Bjørn , Sponland Geir 
Published: November 2007

Objective. The present study is a prospective randomized comparison of laparoscopically assisted vaginal hysterectomy (LH) with total abdominal hysterectomy (TAH).Methods. 100 patients referred for uterine removal were included in the study, 46 undergoing LH and 54 TAH. at two teaching hospitals in Norway.Results. In the LH group, the duration of surgery was longer while duration of hospitalization and time from operation to return to normal activity were shorter as compared to the TAH group. Postoperative pain, assessed by the need for analgesics, was less in the LH group. All these differences were statistically significant. There were two ureteral lesions in the LH group, and one center withdrew early from the study for this reason.Conclusions. In expert hands. LH as a primary method for uterine removal is superior to TAH.
A study of monoamine oxidase activity in fetal membranes
Authors: Sekizawa Akihiko , Ishikawa Hiromi , Morimoto Taro , Hirose Kazuhiro , Suzuki Akira , Saito Hiroshi , Yanaihara Takumi , Arai Yuichiro , Oguchi Katsuji 
Published: November 2007

Objective. To study the role of decidual monoamine oxidase (MAO) ‐A and ‐B activities before delivery, the relationship between MAO activity in fetal membranes and catecholamine (CA) concentration in amniotic fluid (AF) was determined.Methods. Fetal membranes and AF were obtained at the time of elective Cesarean section (CS group, n=11) and Cesarean section due to fetal distress without labor pains (FD group, n=5). MAO‐A and ‐B activities were radiometrically measured using 14C‐5‐hydroxytriptamine for MAO‐A substrate and 14C‐benzylamine for MAO‐B substrate. CA concentrations in AF were measured by high performance liquid chromatograph with an electro‐chemical detector.Results. Both MAO‐A and ‐B activities in decidua obtained from CS were significantly lower than those obtained from FD. Both norepinephrine (NE) and epinephrine (EP) concentrations were significantly lower in the CS group than the FD group. A significant positive correlation between decidual MAO‐A activity and NE concentration in AF was observed. No significant correlation was observed between MAO‐B activity and the concentration of NE in AF. There was no correlation between EP concentrations and MAO activities.Conclusion. These results suggest that CA concentration in AF may be related to the activity of MAO in fetal membranes, determined by certain physiological processes during pregnancy. It has been suggested that metabolism of monoamines in fetal membranes also plays an important role in reducing monoamine influx into maternal myometrium from the AF.
Pregnancy related changes in some cardiovascular risk factors
Authors: Berge Lillian Nordbø , Arnesen Egil , Forsdahl Anders 
Published: November 2007

Background. Certain risk factors for development of ischemic heart disease are influenced by pregnancy related changes of female sex hormone levels.Postpartum values were similar to prepregnancy levels, except serum triglycerides which remained 35% higher (p<0.001) and blood glucose (p<0.05).Conclusions. The major serum lipid fractions, and blood glucose, were significantly different during pregnancy and postpartum, which may influence the risk of cardiovascular disease development in women.Methods. As a part of the cardiovascular risk factor studies in Finnmark county, Norway, 1974‐75 and 1977‐78, cross‐sectional clinical and non‐fasting laboratory data were obtained prior to conception (n=463), during pregnancy (n=335), and following delivery (n=451).Results. Compared with prepregnancy values, total cholesterol was on average 7% lower in the first trimester (p<0.001), and 30% higher at the end of gestation (p<0.001). High density lipoprotein cholesterol was 38% higher at mid‐pregnancy (jxO.001), but only 14% higher in the last trimester (p<0.01). Serum triglycerides were 18% lower in the first (p<0.001) and 123% higher in the third trimester (p<0.001). Blood glucose was 5% lower than baseline in mid‐pregnancy (p<0.001). Except for the second trimester, when only 27% of women smoked, more than 40% of the women examined were smokers.
Sexual risk behavior and history of sexually transmitted diseases in relation to casual travel sex during different types of journeys
Authors: Arvidson Maria , Hellberg Dan , Mårdh Per‐Anders 
Published: November 2007

Objectives. The study investigated if women with experience of casual travel sex, with a previously unknown man abroad, on different types of journeys (charter, vagabond, business and education trips), differ with regard to sexual risk behavior and history of sexually transmitted diseases (STDs).Study design. The study population consisted of 996 women. Of these, 27.7% admitted that they had had casual sex during journeys. The remaining women were used as a comparison group. History of STDs and sexual risk behaviors were investigated.Results. The frequency of women who had more than ten lifetime sexual partners were greatly increased in all groups, as compared to the controls. A history of gonorrhea was most frequent among the charter travellers. A history of genital chlamydial infection was most common among the vagabond travellers. The lowest frequencies of a history of STDs was observed in women engaging in casual sex on “business’ journeys and they had significantly less often a history of STDs as compared to the charter travellers. A high frequency of STDs were seen in women who had experience of casual sex on different types of journeys.Conclusion. Women on business trips, although they had a similar sexual risk behaviour as the other groups of travellers, had less often a history of STDs.
Biochemical changes in the cervical mucus after application of laminaria tent
Authors: Maradny Emad El , Kanayama Naohiro , Halim Abdul , Maehara Kayoko , Kobayashi Takao , Terao Toshihiko 
Published: November 2007

Background This research was aimed to study the biochemical changes in cervical mucus after application of laminaria tent.Material and methods Cervical mucus was collected before and after insertion of laminaria tent from 20 normal pregnant women in the first and second trimesters. Interleukin‐1β, IL‐8, collagenase activity, elastase activity, PGE2 and PGF2α were measured in the collected samples.Laminaria tent was also inserted in one vaginal cervix of five non‐pregnant rabbits and the clinical and histological changes were compared with five non‐treated rabbits. Collagen contents were assessed histologically and Leukocyte number was counted. Results IL‐1β and IL‐8 and elastase activity were significantly increased after insertion of laminaria (p < 0.0001, 0.001 and 0.001 respectively). Collagenase activity was not significantly changed. Whereas concentration of PGE2 and PGF2α in the mucus were markedly increased (p < 0.0001 and 0.001 respectively).Collagen contents were significantly decreased in laminaria and opposite side cervices (p < 0.0001). No significant changes in leukocyte count could be observed in treated and non treated cervices.Conclusions Insertion of laminaria leads to increase concentration of IL‐1β, IL‐8, PGE2, PGF2α and elastase activity. Mechanical stretching of the cervix and biochemical changes in cervical mucus may explain the mechanism of cervical ripening induced by laminaria.
Second trimester routine ultrasound and abnormal findings
Authors: Eurenius Karin , Axelsson Ove , Eriksson Lars 
Published: November 2007

Objective To estimate the detection rate of abnormal findings, especially fetal anomalies, at second trimester ultrasound screening performed in a way representative of Swedish antenatal clinics.Design A prospective study carried out over two years in Uppsala county, Sweden, including 8,228 unselected pregnant women (8,345 fetuses). The ultrasound scans were performed by specially trained mid wives.Main outcome measures The number of abnormalities suspected by the midwives and the number of abnormalities confirmed by the obstetricians were registered, as was pregnancy outcome for these cases.Results Midwives reported suspected abnormalities at the screening procedure in 59 cases (0.7%), abnormalities were confirmed by obstetricians in 42 cases (0.5%, of which 0.36% were fetal malformations). Seventeen of these 42 pregnancies were terminated and 11 ended with miscarriages or intrauterine fetal deaths. Fourteen of the 42 pregnancies ended with a live born infant, of which two died postnatally.Conclusions The described ultrasound screening procedure led to suspected abnormalities in 0.7% of the scanned cases and to confirmed abnormalities in 0.5% of the cases. The outcome for the confirmed abnormalities was poor, as 71% were either terminated or ended with miscarriage or perinatal death.
Uterine evacuation by vaginal misoprostol after second trimester pregnancy interruption
Authors: Bugalho Antonio , Bique Cassimo , Pereira1 Caetano , Granja Ana Carla , Bergstrom Staffan 
Published: November 2007

Background The purpose was to study the capacity of vaginal misoprostol in combination with methylergometrine to achieve complete evacuation of the uterus without ensuing surgical evacuation of the uterine cavity.Methods We performed this trial on 228 women seeking pregnancy interruption. Vaginal misoprostol was given in a dosage of 800 μg in early second trimester. All women received concomitant treatment with peroral methylergometrine from the moment of misoprostol application every 8 hours until uterine evacuation. Follow‐up was continued until the first menstruation after interruption.Results Complete uterine evacuation was achieved in 173/228 cases (76%) [group 1]. The remaining 55 women [group 2] underwent manual evacuation of placental remnants trapped in the cervix. In seven of these women a conventional curettage was carried out due either to ultrasound evidence of placental remnants or due to uterine bleeding. The interval between misoprostol application and fetal expulsion averaged 14.9 hours (s.d. 9.6) in group 1 and 21.0 hours (s.d. 14.5) in group 2 (p = 0.006).Conclusions Misoprostol, in combination with methylergometrine, is a remarkably efficient drug in achieving uterine evacuation also in the absence of surgical evacuation of the uterine cavity. The present study provides justification for a more expectant attitude after vaginal misoprostol treatment for pregnancy interruption. The avoidance of close to 80% of otherwise conventional curettages would seem to represent a major advantage, particularly in settings where manpower and material resources are scarce.
Effect of the non‐peptide, vasopressin V1a receptor antagonist, SR 49059 and its enantiomer, SR 49770, on isolated human myometrium
Authors: Bossmar Thomas , Rasmussen Thomas , Åkerlund Mats 
Published: November 2007

Background. Vasopressin seems to be an important etiological factor for the myometrial hyperactivity and reduced blood flow in primary dysmenorrea. Substances which block the action of vasopressin on the uterus are therefore of interest.Methods. The effect of an orally active, non‐peptide vasopressin V1a receptor antagonist, SR 49059, as well as its enantiomer, SR 49770, which is 50 to 100 fold less potent in binding studies, were tested in vitro on myometrium from 14 subjects. Two doses of the compounds, 2 nmol/L and 10 nmol/L, were used for counteracting the contractile effect of arginine vasopressin in a concentration of 0.7 nmol/L.Results. SR 49059, in the lower concentration, significally decreased the response to arginine vasopressin, measured as area under the recording curve, to 48 per cent of that to the agonist alone, and in the higher dose to 28 per cent. SR 49770 was much less potent in reducing the response to vasopressin.Conclusion. The myometrial action of arginine vasopressin is exerted via V1a receptors. The potent stereospecific inhibitory effect of SR 49059 on arginine vasopressin‐induced myometrial activity indicates that the compound acts specifically through V1a receptors and may have a therapeutic potential in primary dysmenorrea.
Endometrial and fetoplacental markers in pregnancies with fetal congenital nephrosis
Authors: Heinonen Seppo , Ryynänen Markku , Kirkinen Pertti , Saarikoski Seppo 
Published: November 2007

Objective. Congenital nephrotic syndrome of the Finnish type [CNF] is an autosomal recessive disorder leading to death in early childhood, if treated conservatively without early renal transplantation. Prenatal screening at midtrimester is feasible by measuring maternal serum alpha‐fetoprotein [MSAFP], elevated amniotic fluid [AF] AFP being the only diagnostic test in population screening. We studied whether concentrations of other pregnancy‐related markers offer any ancillary procedure for screening.Methods. In a prospective case‐control study, the concentrations of maternal serum human chorionic gonadotropin [hCG], unconjugated estriol [uE3], human placental lactogen [hPL] and placental protein 14 [pp14] were measured in samples from six singleton pregnancies associated with fetal CNF and from 18 matched controls at 15 weeks of gestation.Results. In the CNF group, mean hCG and pp 14 concentrations were slightly elevated, whereas uE3 and hPL concentrations were within the lower normal range. None of these differences were statistically significant and the distribution of these values was too wide to use them for screening.Conclusions. Low unconjugated E3 and elevated hCG concentrations were expected, since newborns with CNF are growth‐retarded and have large placentas. The extent of these alterations was not sufficient to identify high risk pregnancies. Substantial differences in the maternal serum concentrations of hPL and pp 14 were not observed. Hence, MSAFP screening at midtrimester is the strategy of choice for prenatal detection of CNF.