bluuebunny/crossref_metadata_2025_split huggingface dataset:
Metformin Treatment for Four Years to Reduce Total and Visceral Fat in Low Birth Weight Girls with Precocious Pubarche
Authors: Ibáñez Lourdes , López-Bermejo Abel , Díaz Marta , Marcos Maria Victoria , de Zegher Francis 
Published: March 2008

AbstractContext and Objective: A low birth weight (LBW) tends to be followed by overweight due to an excess of fat, including visceral fat. LBW girls with precocious pubarche (PP) (pubic hair &lt; 8 yr) are at high risk for developing an adipose state of hyperinsulinemic androgen excess that leads toward early menarche. We explored the effects of insulin sensitization with metformin in LBW-PP girls.Setting, Design, Patients, Intervention: Prepubertal LBW girls with PP (mean body weight 2.4 kg; age 7.9 yr; body mass index 18.4 kg/m2) were studied. Girls were randomly assigned to remain untreated (n=19) or receive metformin for 4 yr (n = 19; 425 mg/d for 2 yr, then 850 mg/d for 2 yr).Main Outcomes: At the start and after 4 yr, height, weight, fasting insulin, glucose, IGF-I, testosterone, lipids, leptin, high molecular weight adiponectin, body composition by absorptiometry, abdominal fat partitioning (only 4 yr) by magnetic resonance imaging, and menarcheal status were determined.Results: Metformin-treated girls gained on average 5.5 kg (or ∼50%) less fat, after 4 yr were less insulin resistant and less hyperandrogenic, had lower IGF-I levels and a less atherogenic lipid profile, and were less likely to be post-menarcheal than untreated girls, whereas their gain in height, lean mass, and bone mineral density were similar. After 4 yr, untreated girls had more visceral fat, a higher ratio of visceral-to-sc fat, and a higher leptin-to-high molecular weight adiponectin ratio (all ∼50% higher) than metformin-treated girls.Conclusion: Long-term metformin treatment appears to reduce total and visceral fat in LBW-PP girls, and to delay menarche without attenuating linear growth, thereby opening the perspective that adult height may be increased.
Generalized Glucocorticoid Resistance: Clinical Aspects, Molecular Mechanisms, and Implications of a Rare Genetic Disorder
Authors: Charmandari Evangelia , Kino Tomoshige , Ichijo Takamasa , Chrousos George P. 
Published: March 2008

AbstractContext: Primary generalized glucocorticoid resistance is a rare genetic condition characterized by generalized, partial, target-tissue insensitivity to glucocorticoids. We review the clinical aspects, molecular mechanisms, and implications of this disorder.Evidence Acquisition: We conducted a systematic review of the published, peer-reviewed medical literature using MEDLINE (1975 through February 2008) to identify original articles and reviews on this topic.Evidence Synthesis: We have relied on the experience of a number of experts in the field, including our extensive personal experience.Conclusions: The clinical spectrum of primary generalized glucocorticoid resistance is broad, ranging from asymptomatic to severe cases of hyperandrogenism, fatigue, and/or mineralocorticoid excess. The molecular basis of the condition has been ascribed to mutations in the human glucocorticoid receptor (hGR) gene, which impair glucocorticoid signal transduction and reduce tissue sensitivity to glucocorticoids. A consequent increase in the activity of the hypothalamic-pituitary-adrenal axis compensates for the reduced sensitivity of peripheral tissues to glucocorticoids at the expense of ACTH hypersecretion-related pathology. The study of functional defects of natural hGR mutants enhances our understanding of the molecular mechanisms of hGR action and highlights the importance of integrated cellular and molecular signaling mechanisms for maintaining homeostasis and preserving normal physiology.
Extraction of Rare Earth Elements from Nd–Fe–B Magnet Scraps by NH4Cl
Authors: Itoh Masahiro , Miura Koji , Machida Ken-ichi 
Published: March 2008

Abstract
Extraction of rare earth elements from the Nd–Fe–B magnet scraps through the chlorination with NH4Cl was performed to study the effective process for reusing metal iron as well as rare earths. The Nd2Fe14B primary phase was selectively converted to neodymium chloride in the yield of ca. 90%, together with α-Fe and Fe–B residue on the basis of the higher chlorine affinity of rare earths.
Habitat Use and Movement Patterns by Adult Saugers from Fall to Summer in an Unimpounded Small-River System
Authors: Kuhn Kristopher M. , Hubert Wayne A. , Johnson Kevin , Oberlie Dennis , Dufek David 
Published: March 2008

Abstract
The Little Wind River drainage in Wyoming is a relatively small unimpounded river system inhabited by native saugers Sander canadensis. Radio telemetry was used to assess habitat use and movement patterns by adult saugers in the river system from fall through early summer. Fifty-four adult saugers were captured during fall 2004, surgically implanted with radio transmitters, and tracked through mid-July 2005. Tagged saugers selected large and deep pools. Such pools were abundant throughout the Little Wind River system and led to saugers being widely dispersed from fall to early spring. During fall, winter, and early spring, tagged saugers remained sedentary and moved short distances among pools in close proximity to each other. Longer movements by tagged saugers occurred from mid-spring to early summer, and were associated with both upstream and downstream movements to and from two river segments believed to be used for spawning. During early summer, most saugers returned to locations where they had been tagged the previous fall and had spent the winter. Our results provide evidence that preservation of the sauger fishery in the Wind River system will depend on maintaining fish passage throughout the portion of the watershed inhabited by saugers and preserving natural fluvial processes that maintain large and deep pools.
Estimating Fish Body Condition with Quantile Regression
Authors: Cade Brian S. , Terrell James W. , Porath Mark T. 
Published: March 2008

Abstract
We used quantile regression to compare the body condition of walleye Sander vitreus and white bass Morone chrysops before (1980–1988) and after (1989–2004) the establishment of alewives Alosa pseudoharengus in Lake McConaughy, Nebraska. Higher quantiles (percentiles = 100% × quantiles (0, 1)) of weight (W) at the same total length (TL) were indicative of better body condition in an allometric growth model that included separate slopes and intercepts for the before and after groups. All quantiles of walleye weights by TL increased in the years after alewife introduction, ranging from 1.01 to 1.12 times weights in the years before alewife introduction, with greatest increases for the lower (&lt;0.50) quantiles and greater TLs. Quantiles up to 0.25 (the lowest 25th percentiles) of white bass weights were reduced in years after alewife introduction for TLs less than 300 mm, ranging from 0.78 to 0.98 times weights in the years before alewife introduction. However, quantiles greater than or equal to 0.50 (the upper 50th percentiles) of white bass weights increased for all TLs, ranging from 1.01 to 1.06 times the pre-1988 weights. A three-group analysis, which improved the model fit for longer white bass, indicated a reduction (0.80–1.0) in white bass body condition across all TLs in the first 2 years (1989–1990) after alewife introduction, whereas body condition actually improved (1.02–1.12) across all TLs in later years (1991–2004). Thus, after the establishment of alewives in 1988, walleye body condition improved for all fish at all lengths (the greatest improvement occurring among fish in poorer condition), whereas white bass body condition was initially reduced for all fish at all lengths for 2 years and improved in subsequent years. The approach that we developed for comparing fish body condition before and after a management action in Lake McConaughy could be applied to other weight–length data sets typically evaluated with relative weight indices.
Maternal serum screening for Down's syndrome on population basis
Authors: Salonen Riitta , Turpeinen Ursula , Kurki Laina , Lappalainen Mari , Ämmälä Pirkko , Hiilesmaa Vilho , Teramo Kari , Von Koskull Harriet , Gahmberg Nina , Stenman Ulf‐HäKan 
Published: March 2008

Background. The favorable attitude among the public towards prenatal diagnostics in Finland allowed us to start a trial on population basis when screening for Down's syndrome by maternal serum markers and age was introduced.Methods. Screening by maternal serum markers for Down's syndrome was offered to all 17 200 pregnant women in the Helsinki area during the study period of 2.5 years. Screening due to advanced maternal age, 37 years or more, was continued as previously, and 1133 pregnant mothers used this option. Alpha‐fetoprotein, human chorionic gonadotrophin, and during the first year also unconjugated estriol were used as markers.Results. The uptake of serum screening was 84%. The proportion of false positive results i.e. risk for Down's syndrome, 1:350 or more at term, was initially 5.7%. After ultrasound scan 4.1% of the mothers remained ‘screen positive’. The amniocentesis or chorionic villus sampling uptake was 98.4%. Ten out of eighteen cases of Down' syndrome were detected by maternal serum screening, sensitivity 56%, 95% CI 31‐79%. Other chromosomal abnormalities were found in three cases, and there were four cases of mosaicisms confined to the placenta. These were trisomies 16, 7 and 2, and tetraploidy. Elevated serum alpha‐fetoprotein was found initially in 0.7% of the cases. One case of congenital nephrosis of the Finnish type and ten other, mainly structural, abnormalities were detected by high AFP.Conclusions. The screening was well received by the mothers. The detection rate of 56% is in the same range as in previous studies. Ultrasound scan before the test would effectively lower the false positive rate caused by incorrect timing.
Analysis of obstetric complications reported to the National Patient Insurance Association in Finland from 1987 to 1995
Authors: Kurki Tapio 
Published: March 2008

Background. The launch of the National Patient Insurance Association in 1987 off erred a good starting point to evaluate obstetric claims in Finland. In order to obtain full compensation after patient injury, proof of malpractice is no longer required. Thus, the register of the Association offers a solid data base to analyze these injuries.Methods. A nationwide descriptive study of obstetric claims reported to the National Patient Insurance Association from 1.5.1987 to 31.12.1995. The recorded statistical datafiles of the Association were used in the analysis.Results. A total of 801 obstetric claims were analyzed. This comprised 2% of all (n = 39189) claims during the same time period. Nearly all injuries leading to claims (683/801, 85%) occurred during delivery. In all, 156 (19.5%) claims resulted in compensation. The total sum of compensation paid was $ 1.3 million. Most often (30/80 37.5%) and highest compensation ($ 0.8 million) was paid due to delay in the diagnosis of fetal asphyxia. In all, 118 (0.3%) malpractice trials in court have arisen from all claims to the Association during the study period; only two (1.7%) resulted from obstetric causes.Conclusions. The data indicate that most common and serious obstetric complications are associated with delay in the diagnosis of fetal asphyxia. Thus, from both the legal and the medical points of view, pertinent fetal monitoring during delivery and umbilical artery blood gas analysis after delivery in all risk deliveries should be obligatory in all delivery units. Finally, and perhaps most importantly, the patient insurance has effectively prevented obstetric malpractice trials in court.
Preterm birth and cerebral palsy
Authors: Topp Monica , Langhoff‐Roos Jens , Uldall Peter 
Published: March 2008

Background. Preterm infants are at 8 times higher risk than term infants for pre‐ and perinatal brain damage, resulting in cerebral palsy. In this paper we have analysed the influence of prenatal and birth‐related risk factors on cerebral palsy in preterm infants.Methods. In a register‐based study, 175 preterm singleton infants with cerebral palsy, born in 1982‐86, were compared with 687 controls matched by gestational age and year of birth.Results. Statistically significant higher rates in cases were found in parity ≥3 (22% vs. 16%, p<0.05), Cesarean section (67% vs. 56%, p<0.01), and low Apgar scores at 1 minute (45% vs. 36%, p<0.05). By multivariate analyses, two variables remained statistically significant: parity ≥3 (adjusted OR=1.53 (95% CI 1.00‐2.34), p<0.05) and Cesarean section (adjusted OR=1.57 (95% CI 1.07‐2.32), p<0.05).Conclusions. Pregnancy complications preceding preterm birth did not imply a higher risk of cerebral palsy. Delivery by Cesarean section was a prognostic factor for developing cerebral palsy, and the predictive value of Apgar scores was highly limited.
Effects of prostaglandin treatment and paracervical blockade on postoperative pain in patients undergoing first trimester abortion in general anesthesia
Authors: Hall Gerd , Ekblom Anders , Persson Elisabeth , Irestedt Lars 
Published: March 2008

Background. The postoperative analgesic efficacy of a paracervical blockade (PCB) as an adjunct to general anesthesia (GA) during outpatient abortion (dilatation and curettage) is unclear, and the present study was initiated to evaluate if PCB is of significant importance per‐or postoperatively.Methods. Two hundred women (aged 18‐49 years) were assigned to one of four groups; group 1 received vaginal prostaglandin (PG) (PGE1, gemeprost lmg) for softening of the cervix preoperatively and surgery was performed in GA, group 2 received preoperative PG and surgery was performed in GA + PCB; group 3 did not receive PG treatment and surgery was performed in GA and group 4 were subjected to GA + PCB without preoperative PG.Results. Women receiving preoperative prostaglandin treatment (groups 1 and 2) reported significantly higher pain intensity already preoperatively, but also postoperatively as compared to patients not treated with PG. The patients subjected to prostaglandin treatment (groups 1 and 2) also had a significantly higher consumption of analgesics as compared to non‐PG treated groups (3 and 4). The addition of PCB did not influence pre‐ and postoperative pain intensity significantly or consumption of analgesics. Patients receiving PG also reported significantly more nausea than the others although nausea was of low intensity. Patients receiving PG were, however, discharged earlier than the others from the hospital.Conclusions. Preoperative treatment of the cervix with prostaglandins was associated with significantly higher pain intensity both pre‐and postoperatively, and increased need for analgesics postoperatively and more intense nausea. PCB given just before surgery did not result in significant postoperative analgesia. More efficient techniques for pain control should be developed for women subjected to first trimester abortion with preoperative PG treatment.
Oral contraceptive use among female elite athletes and age‐matched controls and its relation to low back pain
Authors: Brynhildsen Jan , Lennartsson Helena , Klemetz Maria , Dahlquist Pia , Hedin Barbro , Hammar Mats 
Published: March 2008

Background. Exogenous and endogenous female sex steroids may influence the risk of low back pain. The fact that back pain is a very common symptom during pregnancy supports this theory. Back pain is also more common among female than male athletes. Oral contraceptives have been suggested to increase the risk of low back pain.Objective. To evaluate whether the prevalence of low back pain is higher among oral contraceptive users than non‐users and if it differs between women taking part in different sports.Methods. A questionnaire was sent to female elite athletes in volleyball (n=205), basketball (n=150), and soccer (n=361) as well as to age‐matched controls (n=113). The questionnaire comprised questions about age, constitution, occupation, parity and use of contraceptive method as well as previous and current back pain and possible consequences of the back problems.Results. The response rate was 85%. Between 42% and 52% of the women in the different groups used oral contraceptives. The groups were similar in most background variables, except that the volleyball and basketball players were taller. The prevalence of current low back pain was between 21% and 34% in the different athlete groups with an average of 30%, whereas only 18% of the controls suffered from low back pain (p<0.01). The prevalence of low back pain within each group, athletes as well as controls, was similar in women who used, and did not use oral contraceptives.Conclusions. This study does not support the theory that low back pain is affected by the use of oral contraceptives. Instead, constitutional factors and mechanical stress during intense physical activity is probably more important.
Spirometric disorders in women with genital descensus
Authors: Strinić Tomislav , Eterović Davor , Dujić Željko , Marković Vinko , Tocilj Jadranka 
Published: March 2008

Background. We hypothesized that abnormalities in connective tissue, found in women with genital descensus, could impact their pulmonary function.Method. Therefore we compared lung flows and volumes between women with (n = 100) and without (n = 100) descensus.Results. Patients exhibited highly significant decrements in all expiratory flows, especially in the peak expiratory flow (‐35%) and other flows at large lung volumes. The forced vital capacity and forced expired volume at 1 second, but not their ratio, were also decreased (−16% and −17%, respectively). These differences were exaggerated in postmenopausal subjects and in patients with third degree of descensus, but did not depend on the presence of stress incontinence. Lung flows and volumes did not change between follicular and luteal phase of the cycle, either in patients or in controls. The forced vital capacity decreased with increasing years past the menopausis in patients (65 ± 10 ml per year), but not in controls.Conclusion. In women with genital descensus deteriorations in lung ventilatory function were observed in association with the presence and duration of postmenopausis.
Pyospermia and preterm, prelabor, rupture of membranes
Authors: Kjaergaard Niels , Hansen Dennis , Hansen Estrid Staehr , Schoenheyder Henrik Carl , Uldbjerg Niels , Madsen Hans 
Published: March 2008

Objectives. To investigate the possible association between presence of clinically unrecognized, specific genito‐urinary tract microorganisms in men and preterm, prelabor rupture of membranes (PPROM) in their spouses.Study design. Case control study. Eleven couples with PPROM were enrolled in the case group and 18 couples with normal pregnancies in the control group. For each man, samples of urine and semen were collected and a urethra swab was obtained. Microbiological assessment included, for each woman, cultures from vagina/cervix, urine and placenta. A smear from the vagina was obtained.Results. In the case group, pyospermia was found in three men. Two of these men, as well as their spouses, were Chlamydia trachomatis positive, and in the third man no microorganisms could be detected. None of the controls had pyospermia (p=0.045). Among the eight cases without pyospermia one man and one woman with Chlamydia trachomatis was found, but their spouses were negative. In the control group, no Chlamydia trachomatis was detected (p=0.014). Among the women two cases and one control had positive culture of Group B streptococci (NS).Conclusion. We suggest that the genital microflora of the man is associated with PPROM.
The relationship between umbilical artery Doppler findings, fetal biophysical score and placental inflammation in cases of premature rupture of membranes
Authors: Yücel Neşe , Yücel Og̈uz , Yekeler Hayrettin 
Published: March 2008

Background. To assess the relationship between placental inflammation, umbilical artery Doppler waveforms and fetal biophysical profile score, umbilical artery Doppler studies and fetal biophysical evaluations were performed in 24 preterm pregnants with premature rupture of membranes (PROM).Subjects. After delivery, the placentas were microscopically examined and two subgroups were formed including noninflamed or inflamed placentas.Results. In the first group, which includes 14 cases with no histological signs of placental inflammation, we found increased systolic/diastolic ratio only in one patient, whereas in the second group including ten cases with microscopically proven inflammation, nine were found to have increased systolic/diastolic ratios (p< 0.05). Mean systolic/diastolic ratio in the first and the second groups were 2.74 ± 0.18 and 4.64 ± 0.93 respectively (p<0.001). Mean biophysical profile score was 9 ± 1.04 in the first group and 7 ± 1.05 in the second group (p<0.001). Conclusion. Abnormal biophysical profile scores along with increased arterial systolic/diastolic ratios have been shown to be the markers of impending clinical infection.
Superovulation combined with insemination or timed intercourse in the treatment of couples with unexplained infertility and minimal endometriosis
Authors: Isaksson Rita , Tiitinen Aila 
Published: March 2008

Background. To compare intrauterine insemination (IUI), direct intraperitoneal insemination (DIPI), and timed intercourse (TI), each combined with superovulation, in the treatment of couples with unexplained infertility, including couples with minimal endometriosis.Methods. A retrospective analysis of 233 superovulation cycles in 70 couples with unexplained infertility or minimal endometriosis. Stimulation protocol, pregnancy rate, pregnancy outcome, and complications of treatment were analyzed.Results. The pregnancy rare was 8.6% per cycle and 28.5% per couple. A majority of all treatment pregnancies (85%) occurred during the first four cycles of treatment. The duration of infertility did not influence the pregnancy rate. The pregnancy rate in patients with unexplained infertility was higher, but not significantly, than in patients with minimal endometriosis (27.7% versus 18.4%). No predictive marker for successful stimulation was found, except for the higher luteal progesterone level in cycles resulting in pregnancy. The multiple pregnancy rate was high: 30% of all pregnancies and 40% of all deliveries were multiple.Conclusions. Superovulation in combination with insemination or intercourse is effective and is still recommended in the treatment of couples with unexplained infertility.
Ovarian cysts and cyclic hormone replacement therapy: is there an association?
Authors: Bar‐Hava Itai , Orvieto Raoul , Vardimon David , Manor Yoram , Weissman Ariel , Nelinger Roni , Ben‐Rafael Zion 
Published: March 2008

Objectives. To evaluate whether there may be an association between postmenopausal ovarian cysts and hormone replacement therapy.Methods. The study comprised 564 consecutive, asymptomatic, postmenopausal women who were referred for routine, transvaginal ultrasound examinations between January 1 and December 31, 1995. Various demographic and ultrasonographic parameters were recorded on a prospectively‐created, computerized data base.Results. There was no difference in the prevalence of ovarian cysts with or without hormone replacement therapy (10.5% vs. 12.5%, respectively). However, in the subgroup of early postmenopausal women (40‐55 years), the use of hormone replacement therapy was associated with a significantly reduced prevalence of ovarian cysts (10.4% vs. 28.6%; p<0.05). Conclusions. Hormone replacement therapy is associated with a reduced prevalence of ovarian cysts in early postmenopause.