bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diagnosis and treatment of menorrhagia
Authors: HURSKAINEN R. , GRENMAN S. , KOMI I. , KUJANSUU E. , LUOTO R. , ORRAINEN M. , PATJA K. , PENTTINEN J. , SILVENTOINEN S. , TAPANAINEN J. , TOIVONEN J. 
Published: May 2007

AbstractOne‐third of all women experience heavy menstrual bleeding at some point in their life. In western countries, about 5% of women of reproductive age will seek help for menorrhagia annually. Half of all women who consult for hypermenorrhea have some uterine abnormality, most often fibroids (among patients under 40 years of age) and endometrial polyps (above 40 years of age). Appropriate treatment considerably improves the quality of life of these patients, and it is important to make a rigorous assessment of the patient to provide the best treatment options. This guideline provides instructions on how to examine and treat women of fertile age who have menorrhagia. The subject's own assessment of the amount of menstrual blood loss does not generally reflect the true amount. All patients should undergo a pelvic examination and, if the menstrual pattern has changed substantially or if anaemia is present, a vaginal sonography should be carried out as the most important supplemental examination. Vaginal sonography combined with an endometrial biopsy is a reliable method for diagnosing endometrial hyperplasia or carcinoma, but it is insufficient for diagnosing endometrial polyps and fibroids; these can be diagnosed more reliably by sonohysterography or hysteroscopy. Non‐steroidal anti‐inflammatory drugs and tranexamic acid reduce menstrual blood loss by 20–60%, and the effectiveness of a hormonal intrauterine system (IUS) is comparable with that of endometrial ablation or hysterectomy. Cyclic progestogens do not significantly reduce menstrual bleeding of women who ovulate. Treatment should be started with one of the drug therapies, i.e. the IUS, tranexamic acid, anti‐inflammatory drugs, or oral contraceptive. Drug treatment should be used and evaluated before surgical interventions are considered. With an effective training and feedback system, it is possible to organise the diagnostics, medical treatment and follow‐up of heavy menstrual bleeding in the primary health care setting or in outpatient clinics, which reduces the burden on specialist health care.
Mental Health Status of Aboriginal and Non-Aboriginal Australian Prisoners
Authors: Butler Tony , Allnutt Stephen , Kariminia Azar , Cain David 
Published: May 2007

Objective: To compare the mental health of Aboriginal and non-Aboriginal prisoners in New South Wales. Methods: The sample consisted of a cross-sectional random sample of sentenced prisoners, and a consecutive sample of reception prisoners. The sample was drawn from 29 correctional centres (27 male, two female) across New South Wales. Overall, 1208 men (226 Aboriginal), and 262 women (51 Aboriginal) participated in the study. Mental illness was detected using the Composite International Diagnostic Interview (CIDI-A) and a number of other screening measures incorporated into the programme. Results: No differences were detected in mental illness between Aboriginal and non-Aboriginal men, apart from depression, which was lower in the latter group. Aboriginal woman were more likely than non-Aboriginal women to screen positive for symptoms of psychosis in the prior 12 months and have a higher 1 month and 12 month prevalence of affective disorder; they also had higher psychological distress scores. Suicidal thoughts and attempts were the same in both groups. Conclusions: These findings confirm that the demand for mental health services in prisons is considerable, and that Aboriginal women are one of the most vulnerable groups. Services and programmes providing an alternative to incarceration are needed, as are culturally sensitive approaches to treatment.
Rural/Urban Differences in the Distribution of Eating Disorder Symptoms among Adolescents from Community Samples
Authors: Preti Antonio , Pinna Claudia , Nocco Silvia , Pilia Simona , Mulliri Emanuela , Micheli Valeria , Consuleo Casta Maria , Rita Petretto Donatella , Masala Carmelo 
Published: May 2007

Objective: Rural/urban differences in the prevalence of mental disorders have often been reported in the last 30 years, among others in the distribution of eating disorder symptoms and suicide rates. The role of sex, age and socioeconomic status in the differences by place of residence has often been neglected in past studies. Method: Two independent community samples of students (mean age=17.4 years, SD=1.4), taken from among those attending high school in an urban district (Cagliari; n=817) and in a rural one (Carbonia; n=507) of south Sardinia, Italy, were invited to fill in the Eating Attitudes Test (EAT), the Bulimic Investigatory Test of Edinburgh (BITE), the Body Attitudes Test (BAT) and the revised Hopkins Symptom checklist (SCL-90-R). Results: Female students scored higher than male students on all inventories. In male participants, the scores on the EAT were higher in the urban than in the rural sample. Conversely, in both male and female students the rural sample reported higher scores on the BITE symptoms subscale. When the comparison was confined to the fraction of those who scored higher than the suggested cut-off on the EAT and the BITE, students in the urban sample outnumbered those in the rural sample. No other differences were found. Socioeconomic status and age did not influence the differences in the reporting of eating disorder symptoms by place of residence. Conclusions: Although caution is required when reading the findings drawn from self-report instruments, it is evident that the factors influencing the distribution of eating disorder symptoms and their psychological correlates by place of residence are far more complex than currently thought.
The IAT as a predictor of food choice: The case of fruits versus snacks
Authors: Richetin Juliette , Perugini Marco , Prestwich Andrew , O'Gorman Rick 
Published: May 2007

One of the issues concerning the application of implicit measures like the IAT is whether they can be successfully applied to consumer choices. The empirical evidence of the predictive validity of the IAT so far has been mixed, both at the level of eating habits and of specific behavioural food choices. Moreover, whereas the predictive validity of the IAT has been tested in a number of studies, its incremental validity has not been studied as thoroughly. In this contribution, four studies, run at different points in time and analysed as a single sample (N = 399), tested the predictive and incremental validity of an IAT of attitudes towards fruits versus snacks on the choice of a fruit or a snack at the end of the experimental session. Specifically, an additive pattern in which both implicit and explicit measures predict independently, and an interactive one in which implicit and explicit measures predict interactively, were tested for the prediction of the behavioural preference towards snacks or fruits. The results showed that the IAT has both predictive and incremental validity, over and above the significant prediction provided by explicit measures for behavioural food choice. Furthermore, no interaction effect between implicit and explicit measures in the behavioural prediction was obtained, supporting the additive rather than the interactive pattern. Finally, only the explicit attitude towards snacks predicted behavioural choice whereas the explicit attitude towards fruits did not. This result indirectly suggests that a single target IAT might be fruitfully adopted in future research.
Self‐esteem discrepancies and defensive reactions to social feedback
Authors: Schröder‐Abé Michela , Rudolph Almut , Wiesner Anja , Schütz Astrid 
Published: May 2007

Recent research has provided increasing evidence that discrepancies between implicit and explicit self‐esteem (SE) are related to defensiveness. However, only one pattern, called fragile SE (a combination of high explicit and low implicit SE), has been the focus of research so far. Relatively little attention has been paid to the second possible SE discrepancy (low explicit/high implicit). We propose that both types of discrepancies are maladaptive, because they indicate a lack of integration in self‐representation. We conducted two studies on the correlates of discrepant SE in the sphere of defensiveness. We hypothesized that persons with discrepant SE exhibit more defensive behaviour than individuals with congruent SE. In two student samples, explicit SE was measured by means of the Multidimensional Self‐Esteem Scale. Implicit SE was measured with the Name Letter Technique (Study 1) and an Implicit Association Test (Study 2). In Study 1 (N = 102) we examined effects of implicit and explicit SE on defensive reactions to ambiguous statements. For this purpose, we adapted the Ambiguous Statements Task (AST, Tafarodi, 1998), a procedure that measures participants' tendency to interpret ambiguous expressions in a positive vs negative manner. We found that the combination of low explicit SE and high implicit SE was associated with a more positive interpretation of the ambiguous statements. Study 2 (N = 87) investigated the effects of discrepant SE on reactions to SE threat in an experimental setting. The time participants spent reading positive or negative social feedback was used as an unobtrusive measure of defensiveness. We found that people with discrepant SE went through the negative feedback faster than people with congruent SE. In sum, the studies provide converging evidence that both kinds of discrepancies between implicit and explicit SE are related to defensive behaviour.
Vertebroplasty: magnetic resonance findings related to cement leakage risk
Authors: Koh Y. H. , Han D. , Cha J. H. , Seong C. K. , Kim J. , Choi Y. H. 
Published: May 2007

Purpose: To find magnetic resonance (MR) findings predicting cement leakage in patients receiving percutaneous vertebroplasty (PVP) due to osteoporotic compression fractures. Material and Methods: MR was done in 43 patients (age 52–89 years) before PVP (56 vertebrae), which was done via a bipedicular approach with fluoroscopic monitoring. Shortly after the procedure, a non-contrast-enhanced computed tomography (CT) scan was done at the vertebroplasty sites for evaluation of bone cement leakage. The following MR findings of fractured vertebral bodies were retrospectively reviewed for correlation with leakage risk: severity of bone-marrow edema, presence of a T2-weighted low-signal-intensity line, percentage residual vertebral body height, presence of either a vacuum or cystic change within the vertebral body, and presence of a cortical disruption. Results: After PVP, cement leakage was detected in 35 vertebrae (62.5%). Leakage was most frequently observed in the anterior external vertebral venous plexus (46%). Cement leakage rate increased when there was a cortical disruption ( P = 0.037), especially at the endplates, while it decreased when there was a vacuum or a cystic change within the fractured vertebra ( P = 0.019). Other MR findings were not related to the risk of cement leakage. Conclusion: The risk of cement leakage in PVP increases when MR shows cortical disruption in a fractured vertebral body, especially at the endplates. It decreases when MR shows a vacuum or cystic change within the body.
Ultrasound, computed tomography, and laboratory findings in the diagnosis of appendicitis
Authors: Johansson E. P. , Rydh A. , Riklund Åhlström K. 
Published: May 2007

Purpose: To determine the diagnostic accuracy and the clinical impact of ultrasound (US) and computed tomography (CT) in diagnosing appendicitis, and to evaluate the impact of laboratory tests on the treatment of acute appendicitis. Material and Methods: All patients who, during 2005, underwent an acute ultrasound or CT investigation due to suspected appendicitis, or were diagnosed and/or surgically treated for appendicitis at Umeå University Hospital, Umeå, were included. The type of radiological investigation, its findings, the choice of treatment, final diagnosis, C-reactive protein (CRP), leukocyte particle count (LPC), body temperature, age, and sex were recorded for each patient. The histological result from surgery was considered the gold standard. Results: The material included 305 cases with an overall appendicitis prevalence of 58%. Fifty-two percent of the patients were female. The mean age was 29 years, with a total range of 2–94 years. Twenty percent (60/305) underwent a CT investigation, 40% (123/305) underwent an US investigation, 5% (14/305) underwent both a CT and an US investigation, and 35% (108/305) of patients did not undergo any radiological investigation at all. The sensitivities and specificities were 91% and 94% for CT, and 83% and 98% for US, respectively. The positive likelihood ratio was 15.1 and 45.5 for CT and US, and the negative likelihood ratio was 0.09 and 0.18 for CT and US, respectively. It was not possible to visualize the appendix in 31% of patients examined with US. The prevalence of appendicitis in this group was the same as the prevalence among patients where it was possible to see the appendix, i.e., 35%. The mean CRP for all patients with appendicitis was 59 (95% CI 10–491) mg/l, and the mean LPC was 11.1 (95% CI 2.6–28.1) ×10−9/l. The mean LPC level was significantly higher for the appendicitis patients. Body temperature could not significantly verify or exclude appendicitis. The overall negative appendectomy rate was 9% (16/176), and it was higher in women, i.e., 11% (9/79). The negative appendectomy rate was slightly higher in the group that was examined by CT and/or US, i.e., 12% (8/69) compared to 7% (8/107) in the group not examined radiologically. Conclusion: Diagnostic accuracy was high for US as well as for CT. US was better for diagnosing positive findings, while CT was better for excluding diagnosis of appendicitis. The diagnostic accuracy of LPC, CRP, and body temperature was low. By combining findings from the radiological examination with the results from the clinical examination and laboratory values, a low negative appendectomy rate can be achieved.
Magnetic resonance imaging in suspected rectal cancer: determining tumor localization, stage, and sphincter-saving resectability at 3-Tesla-sustained high resolution
Authors: Winter L. , Bruhn H. , Langrehr J. , Neuhaus P. , Felix R. , Hänninen Lopez E. 
Published: May 2007

Purpose: To assess image quality and overall accuracy of 3-Tesla (3T)-sustained high-resolution magnetic resonance (MR) imaging for diagnostic preoperative workup in suspected rectal carcinoma. Material and Methods: Twenty-three patients with suspected rectal cancer underwent unenhanced and contrast-enhanced fat-suppressed pelvic high-resolution MR imaging using a four-channel phased-array pelvic coil at 3T. Image quality, tumor stage, distance from the anorectal margin, and sphincter-saving resectability were prospectively assessed by two blinded readers. The results were correlated with clinical, surgical, and histopathologic findings. Results: In all 23 patients, MR images were of diagnostic quality, and malignancy was correctly identified in 21 patients. The accuracy for determining sphincter-saving resectability was 100% (19/19). T stage and N stage were correctly diagnosed in 95% and 91%, respectively. MRI allowed correct identification of tumor extension and its relation to surgically relevant pelvic structures including the anorectal margin and mesorectal fascia. Transverse T2-weighted fast spin-echo images compared superiorly to all other sequences for the diagnosis of mesorectal infiltration and lymph node involvement. Moreover, transverse fat-suppressed contrast-enhanced T1-weighted images were valuable for identifying tumor infiltration, while sagittal sections were useful for the detection of longitudinal tumor extension. Conclusion: MR imaging with phased-array receiver coils at 3T facilitated both visualization of different pathologic conditions of the rectum and accurate determination of tumor stage in rectal carcinomas. Thus, this noninvasive diagnostic approach appeared highly suitable for the assessment of patients with suspected rectal carcinoma.
Contrast-enhanced magnetic resonance cholangiography with Gd-BOPTA and Gd-EOB-DTPA in healthy subjects
Authors: Dahlström N. , Persson A. , Albiin N. , Smedby Ö. , Brismar T. B. 
Published: May 2007

Purpose: To evaluate the biliary enhancement dynamics of the two gadolinium chelates Gd-BOPTA (MultiHance®) and Gd-EOB-DTPA (Primovist®) in normal healthy subjects. Material and Methods: Ten healthy volunteers were evaluated with both agents by magnetic resonance (MR) imaging at 1.5T using a breath-hold gradient-echo T1-weighted VIBE sequence. The relative signal intensity (SI) differences between the common hepatic duct (CHD) and liver parenchyma were measured before and 10, 20, 30, 40, 130, 240, and 300 min after contrast medium injection. Results: Biliary enhancement was obvious 10 min post-injection for Gd-EOB-DTPA and was noted at 20 min for Gd-BOPTA. At 40 min delay, Gd-BOPTA reached its peak biliary enhancement, but at neither 30 nor 40 min delay was there any significant difference compared with that of Gd-EOB-DTPA. At later delays, the contrast between CHD and liver continued to increase for Gd-EOB-DTPA, whereas it decreased for Gd-BOPTA. Conclusion: The earlier onset and longer duration of a high contrast between CHD and liver for Gd-EOB-DTPA facilitates examination of hepatobiliary excretion. Therefore, Gd-EOB-DTPA may provide adequate hepatobiliary imaging within a shorter time span than Gd-BOPTA and facilitate scheduling at the MR unit. Further studies in patients are required to compare the imaging advantages of Gd-EOB-DTPA and Gd-BOPTA in clinical practice.
Factors predicting complete necrosis rate after ultrasound-guided percutaneous laser thermoablation of small hepatocellular carcinoma tumors in cirrhotic patients: a multivariate analysis
Authors: Francica G. , Iodice G. , Delle Cave M. , Sarrantonio R. , Lapiccirella G. , Molese V. , Smeraldo D. , Scarano F. , De Marino F. 
Published: May 2007

Purpose: To assess factors affecting the effectiveness of percutaneous laser ablation (PLA) under ultrasound (US) guidance in terms of complete ablation achievement. Material and Methods: The clinical records of 86 hepatocellular carcinoma (HCC) tumors (mean diameter 23.7 mm) in 60 cirrhotic patients (mean age 68.3 years; 36 males; 57 HCV+; 53 Child's class A, seven Child's class B) treated by means of PLA were reviewed. PLA was performed with a continuous-wave Nd:YAG laser by a single operator who positioned two to four 300-µm optic fibers advanced in 21-gauge needles into target lesions under US guidance. Triphasic computed tomography (CT) studies were used to verify treatment effectiveness 1 month after PLA completion. The association between characteristics of the lesion and outcome (complete or incomplete ablation) was evaluated by logistic regression, taking into account the following predictive factors: tumor size, pattern of growth (infiltrating or not) at imaging, location, first diagnosis of HCC (naïve tumors vs. non-naïve tumors), number of sessions (1/>1), total delivered energy, and years of treatment in 2001–2002 (first period) vs. 2003–2004 (second period). Results: Complete ablation was obtained in 62 nodules (72%). Statistically significant predictors of incomplete ablation after the first PLA course at both univariate and multivariate analysis included: infiltrating growth pattern (odds ratio (OR) 12.3, P<0.002), non-naïve tumors (OR 8.7, P<0.001), and first period of treatment (OR 10.3, P<0.002). Conclusion: The effectiveness of US-guided PLA for HCC tumors ⩽4 cm turned out to be negatively affected by both operator-related (the beginning of the operator's experience with the technique) and tumor-related factors (non-naïve, infiltrating HCC tumors).
Magnetic resonance elastography of brain tumors: preliminary results
Authors: Xu L. , Lin Y. , Han J. C. , Xi Z. N. , Shen H. , Gao P. Y. 
Published: May 2007

Purpose: To investigate the potential value of magnetic resonance elastography (MRE) in evaluating the consistency of brain tumors. Material and Methods: Six patients with known solid brain tumor underwent brain MRE studies. Consistency of brain tumors was evaluated at surgery. Correspondence of MRE evaluation with operative result was studied. Results: The elasticity of tumors in six patients evaluated by MRE agreed with the tumor consistency given by the operative results. Conclusion: MRE could be used as an imaging technique for noninvasive assessment of the consistency of brain tumor in vivo.
Regionally specific compensation for bone loss in the tibial trabeculae of estrogen-deficient rats
Authors: Sheng Z. F. , Dai R. C. , Wu X. P. , Fang L. N. , Fan H. J. , Liao E. Y. 
Published: May 2007

Background: Bone mineral density (BMD) and microstructural variations have been extensively investigated in recent years; however, the compensation for bone loss between different regions is still unclear. Purpose: To fully characterize regional variations in bone mineral density (BMD) as well as the microstructure and dynamic changes of rat tibial trabeculae that occur with bone loss associated with estrogen deficiency. Material and Methods: Female Sprague-Dawley rats were ovariectomized (OVX), sham-operated (sham), or left unoperated (baseline control). The left tibiae were harvested at baseline, and at postoperative weeks 3 and 15. High-resolution micro-computed tomography (µCT) was used to identify the densitometric and microstructural properties of trabeculae in the proximal ends of the rat tibia, specifically the epiphysis and metaphysis. Results: Volumetric BMDs at the organ (organ BMD) and tissue (tissue BMD) levels were significantly higher for trabeculae at the epiphysis than metaphysis. Moreover, trabeculae at the epiphysis were thicker, and fewer in number and connectivity than those at the metaphysis, which were more rod like. Trabeculae at the metaphysis were more susceptible to bone loss induced by estrogen deprivation than at the epiphysis, and the regions varied greatly in their adaptation to this loss. At the metaphysis, trabecular tissue BMD and thickness were unexpectedly higher at postoperative week 15 than week 3 or baseline. In contrast, at the epiphysis, tissue BMD did not change with time, but trabecular thickness significantly increased at week 15 compared to baseline and was also greater in OVX compared to sham rats. Conclusion: Metaphyseal and epiphyseal trabeculae show regionally specific variations in BMD and microstructure. The former are more susceptible to bone loss induced by estrogen deficiency and would be strengthened by either hypertrophy or hypermineralization, while epiphyseal trabeculae are mainly strengthened by thickening.