bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Maudsley bipolar disorder project. A survey of psychotropic prescribing patterns in bipolar I disorder
Authors: Frangou Sophia , Raymont Vanessa , Bettany David 
Published: March 2003

Objectives:  The outcome of Bipolar 1 Disorder (BD1) is greatly dependent on the adequacy and appropriateness of its treatment. As the treatment choices in BD1 disorder are increasing the aim of this study was to examine the current use of the pharmacological agents in BD1 patients and its association with clinical characteristics.Methods:  Case note review of the pharmacotherapy of a sample of BD1 patients from a specified South London sector of a National Health Service Trust.Results:  Half of the patients were on mood‐stabilizers (usually lithium) and their use was associated with female gender and multiple admissions. Antipsychotics were more commonly used in patients with psychotic features and multiple manic episodes. Antidepressants were rarely prescribed alone and were not associated with increased number of manic episodes. Combination treatments were mostly used in patients in acute episodes and with multiple hospitalizations.Conclusions:  In ordinary care, the treatment of BD1 is often driven by symptoms and falls short of the existing practice guidelines.
Subtraction libraries for the molecular characterization of gene–environmental interactions in bipolar disorder
Authors: Yolken Robert H 
Published: March 2003

Yolken RH. Subtraction libraries for the molecular characterization of gene–environmental interactions in bipolar disorder.  Bipolar Disord 2002: 4(Suppl. 1): 77–80. ©Blackwell Munksgaard, 2002Objectives:  We endeavoured to identify gene–environmental interactions related to bipolar disorder.Methods:  We generated subtraction libraries from the frontal cortex of brains obtained postmortem from individuals with bipolar disorder and age‐ and sex‐matched unaffected controls.Results:  There are a number of RNA transcripts which are apparently up‐regulated or down‐regulated in the frontal cortex of individuals with bipolar disorder as compared with the controls. Many of these transcripts are involved in processes crucial to brain function. Several are also related to pathways involved in infections or the inflammatory response in environmental stimuli.Conclusions:  Bipolar disorder may involve a complex set of interactions between genes which affect brain function and infections which control the expression of these genes.
Fetal fibronectin as a predictor of term labor:
Authors: KISS HERBERT , AHNER REGINE , HOHLAGSCHWANDTNER MARIA , LEITICH HARALD , HUSSLEIN PETER 
Published: March 2003

Objective. Accurately predicting the onset of delivery continues to be problematic notwithstanding the clinical relevance of this capability, especially with regard to the elective induction of labor. While the assessment of the cervix according to Bishop, to date, constitutes the single generally recognized method, the determination of fetal fibronectin (FFN) cervicovaginal secretions promises greater precision in this context.Design. English‐language medical literature was analyzed using the search parameter ‘fetal fibronectin’, ‘term delivery’, ‘induction of labor’, ‘labor’, and ‘birth’, respectively. All those original reports examining cervicovaginal FFN that were originally published in English and followed a prospective design were subsequently included in the study at hand. These reports were evaluated in regard to their findings on the predictive value of FFN for spontaneous delivery and induction of labor.Results. A total of eight reports were included in the present study: five of these, covering a total of 480 patients, discussed the relationship between FFN and the spontaneous onset of labor; the other three addressed the subject of FFN and the induction of labor (300 patients). All reports clearly related the presence of FFN in cervicovaginal secretions to the imminent onset of delivery; three studies, furthermore, demonstrated a correlation with the spontaneous onset of labor, with a sensitivity greater than 90%. In case of the studies concerning induction of labor, a positive FFN result was accompanied by a significantly shorter interval until delivery than a negative FFN result.Conclusion. Determining the presence of FFN in cervicovaginal secretions promises to provide an indicator relating to the prediction of term labor, as well as to the prediction of successful labor induction.
Shoulder dystocia – malpractice or acceptable risk?
Authors: SKOLBEKKEN JOHN‐ARNE 
Published: March 2003

Background. In 1988 a new patient insurance system was introduced in Norway. It was initially described as an ‘objectified’ system, similar to one based on the no‐fault principle. Early doubts were raised about the system's status, as it contains rules stating that compensation will not be given if the medical intervention is adequate and the involved risk is acceptable. This study was undertaken to examine the practice of these rules.Methods. An archival study was performed on the 41 shoulder dystocia cases that had been closed in the decade from 1988–1997. These cases were selected as shoulder dystocia was found to be the obstetrical event most often leading to a decision on acceptable risk.Results. The most common injury in these cases was Erb's palsy, but fatalities and brain injuries were also observed. Compensation was given in nine cases, whereas it was denied due to an acceptable medical risk in the remaining cases. Indications of inconsistency among the reached decisions were found, and judged to be a result of differences of opinion between expert witnesses on the adequacy of the obstetrical practice.Conclusions. Doubts are raised as to whether similar decisions are reached in similar cases. Shoulder dystocia may be an acceptable risk in the sense that it is hard to predict and prevent. Whether the consequences of such a risk should be compensated, remains a political and economical issue. Present thinking leads to decisions that create a divide between the lucky unlucky and the plainly unlucky.
Vulvar vestibulitis: medical, psychosexual and psychosocial aspects, a case‐control study
Authors: DANIELSSON INGELA , SJÖBERG INGA , WIKMAN MARIANNE 
Published: March 2003

Background. Vulvar vestibulitis is suspected to be increasingly prevalent among young women, but the etiology is still unclear. The aim of this study was to explore the differences in medical, psychosexual and psychosocial factors between women with vulvar vestibulitis and a control group.Methods. A case‐control study was made with 38 women with vulvar vestibulitis and 71 healthy age‐matched controls. All the women answered a structured questionnaire about their medical and gynecological history which included psychosexual and psychosocial background factors and current aspects as well.Results. Women with vulvar vestibulitis have very much the same psychosocial and sexual background factors as their controls, whereas there are many differences in their medical background factors, both gynecological and others. It is very clear that they suffer from many other somatic symptoms more often than their controls.Conclusions. There are no indications of a primary sexual disturbance in women with vulvar vestibulitis. However, the finding that women with vulvar vestibulitis have many different somatic symptoms indicates a psychosomatic strain in the illness. Regardless of whether this is primary or secondary, it should be taken into consideration when treating the patients.
Apolipoprotein D expression in endometrial carcinomas
Authors: Rojo Julio Vázquez , González Luis O. , Lamelas Maria L. , Merino Antonio , Vizoso Francisco 
Published: March 2003

Background. Apolipoprotein D is a protein component of the human plasma lipid transport system but is also associated with a more favorable prognosis in breast cancer and ovarian cancer women. This study was undertaken to examine the tumoral expression of apolipoprotein D in endometrial cancer and to analyze the possible correlation with tumor and patients characteristics as well as androgen receptors and its prognostic significance.Methods. Immunohistochemical evaluation was used to examine apolipoprotein D expression in paraffin blocks from 58 endometrial carcinomas.Results. A total of twenty (34%) tumors stained positively. Staining was localized in tumor cells. No significant correlation was found between apo D expression and patients or tumor characteristics and androgen receptor status. In addition, apolipoprotein D expression was not associated with patient prognosis.Conclusions. Apolipoprotein D is expressed by a significant percentage of endometrial carcinomas without apparent association with other clinicopathologic parameters or with outcome of patients.
Twin pregnancy: the role of ultrasound in management
Authors: Sperling Lene , Tabor Ann 
Published: March 2003

Determination of chorionicity is one of the most important issues in the management of twin pregnancy.Modern ultrasound equipment has made it possible to accurately assess placentation already in the first trimester with the lambda sign. With regard to prenatal diagnosis, it is important to know the chorionicity in order to calculate the risk of chromosomally abnormal fetuses.Accurate chorionicity offers the obstetricians the opportunity to observe the monochorionic twins more intensively than is required for twins with dichorionic placentation. This review gives an update of the state of the art for clinicians caring for twin pregnancies.
Effects of umbilical arterial resistance on its arterial blood flow velocity waveforms
Authors: Mine Makiko , Nishio Junko , Nakai Yuichiro , Imanaka Motoharu , Ogita Sachio 
Published: March 2003

Background. We propose to clarify the effect of umbilical arterial resistance on umbilical arterial blood flow patterns in normal pregnant women.Subjects. Pulsed Doppler examination was administered to 145 pregnant women of between 28 and 31 weeks of normal gestation without any prenatal complications.Methods. The arterial flow velocity waveforms from two different arteries, one in the intra‐abdominal portion and the other at the placental insertion, were sampled with the color flow mapping method, and the peak systolic velocity and the resistance index were calculated.Results. The peak systolic velocity and resistance index on the placental side were significantly lower than those of the fetal side.Conclusion. A major difference exists between the umbilical arterial flow velocity waveforms on the fetal and placental sides, which might be caused by difference in the umbilical arterial resistance.
Intrauterine insemination with donor semen. An evaluation of prognostic factors based on a review of 1131 cycles
Authors: Khalil Mohammed Rohi , Rasmussen Per Emil , Erb Karin , Laursen Steen Broch , Rex Sven , Grabow Westergaard Lars 
Published: March 2003

Objective. To identify prognostic factors influencing the outcome of infertility treatment using intrauterine insemination with donor semen (IUI‐D).Design. Retrospective study of all patients undergoing IUI‐D between August 1st, 1990 and July 31st, 1998.Setting. University‐affiliated infertility clinic.Patients. Three hundred and five couples undergoing 1131 IUI‐D treatment cycles.Main outcome measures. Type of hormonal treatment, number of follicles, length of follicular phase, endometrial pattern, female age, infertility diagnosis and semen quality related to clinical pregnancy rate, cumulative birth rate and multiple gestations.Results. Throughout the nine year period the overall clinical pregnancy rate per cycle was 22.3%, with an increase from 12.9% in 1990 to 34.6% in 1998. The multiple birth rate was 20.6%. The birth rate per couple was 61.1% after a mean of 3.2 treatment cycles. The pregnancy rate was highest in the first treatment cycle and the cumulative birth rate rose only slightly after the sixth treatment cycle. The following parameters were positively and significantly correlated to a successful outcome of IUI‐D: i) the first treatment cycle– compared to the following up to six treatment cycles; ii) number of mature follicles– more than one – at the time of insemination, however, with an unacceptable high rate of multiple pregnancies when more than 3 mature follicles were present; iii) time of insemination after the 12th day in the cycle; iv) insemination after ovulation has occurred and; v) female age under 30 years.Conclusions. IUI‐D is a simple and inexpensive treatment giving acceptable pregnancy rates for up to six treatment cycles if at least 2 mature follicles have developed at the time of insemination, which implies that hormonal ovarian stimulation and induction of ovulation is used, and ovulation has occurred at the time of insemination, which ought to take place after cycle day (cd) 12 with at least two million motile spermatozoa.
Prognosis in four syndromes of pregnancy‐related pelvic pain
Authors: Albert Hanne , Godskesen Mona , Westergaard Jes 
Published: March 2003

Background. The aim of the present study was to describe, on the basis of specific classification criteria and for a period of two years after delivery, the prognosis for women suffering from pregnancy‐related pelvic joint pain, and to describe the characteristics influencing the prognosis.Methods. One thousand seven hundred and eighty‐nine pregnant women who were booked for delivery at Odense University Hospital formed a cohort to investigate the prognosis. Women whose reported daily pain from pelvic joints could be objectively confirmed were divided, according to symptoms, into five subgroups (n=405) – four classification groups (pelvic girdle syndrome, symphysiolysis, one‐sided sacroiliac syndrome and double‐sided sacroiliac syndrome) and one miscellaneous. The women in the five subgroups were re‐examined at regular intervals for two years after delivery or until disappearance of symptoms (whichever was less). Thre hundred and forty‐one women from the 5 subgroups participated in the postpartum follow‐up.Results. The majority (62.5%) of women in the four classification groups experienced disappearance of pain within a month after delivery. Two years after parturition 8.6% were still suffering from pelvic joint pain (determined subjectively and objectively). Persistence of pain was found to vary significantly from one classification group to another. None of those initially classified as suffering from symphysiolysis had pain 6 months after delivery in comparison to the 21 percent of those with pelvic girdle syndrome who continued to have pain at the two‐year mark.Conclusions. This study shows that pregnancy‐related pelvic joint pain had an excellent postpartum prognosis (in general) in three out of four classification groups. The women with pelvic girdle syndrome (pain in all 3 pelvic joints) had a markedly worse prognosis than the women in the other three classification groups. High number of positive test and a low mobility index were identified as giving the highest relative risk for long term pain.
Are thyroid hormones or hCG responsible for hyperemesis gravidarum? A matched paired study in pregnant Chinese women
Authors: Panesar Nirmal S. , Li Chi‐Yin , Rogers Michael S. 
Published: March 2003

Objective. To determine the relative importance of thyroid hormones and human chorionic gonadotropin in the etiology of hyperemesis gravidarum.Design. A prospective study comparing the hormonal status in women with hyperemesis gravidarum (5–18 weeks), with healthy pregnant controls, matched for gestational age. Sensitive thyroid stimulating hormone, free thyroxine, free triiodothyronine and total beta human chorionic gonadotropin were measured by immunoassays. The hormone results for hyperemesis gravidarum group (n=58) were compared with pregnant control women (n=58) using the Mann Whitney test. Stepwise logistic regression analysis was performed to determine which variables were significantly associated with hyperemesis gravidarum and to estimate the probability of each woman having hyperemesis gravidarum. The strength of the resulting association was tested by generating a receiver operating characteristic curve for predicting hyperemesis gravidarum using these probabilities.Results. Maternal age and all hormones were significantly different between the hyperemetic and control groups. However, logistic regression analysis demonstrated that only maternal age, free thyroxine and thyroid stimulating hormone were significant independent variables. The area beneath the receiver operating characteristic curve for prediction of hyperemesis gravidarum was 0.84.Conclusion. Human chorionic gonadotropin is not independently involved in the etiology of hyperemesis gravidarum but may be indirectly involved by its ability to stimulate the thyroid. Differences in maternal age and thyroid function are highly discriminatory with regard to hyperemesis gravidarum.
Women with a history of placental abruption: when in a subsequent pregnancy should special surveillance for a recurrent placental abruption be initiated?
Authors: Rasmussen Svein , Irgens Lorentz M. , Albrechtsen Susanne , Dalaker Knut 
Published: March 2003

Background. It is common to admit to hospital or start intensive ambulatory antenatal care of pregnant women with a previous placental abruption using the gestational age of the previous placental abruption as a starting point. In some instances, close surveillance may be commenced much earlier. There is no consensus when in a subsequent pregnancy such measures should be initiated.Objective. The analyses aimed at the prevention of complicated (preterm, small for gestational age, or perinatal death) recurrent placental abruptions, assessing at which time in a subsequent pregnancy special surveillance should start in order to anticipate and prevent a recurrence.Design. A cohort study based on the Medical Birth Registry of Norway. Calculation of gestational age specific risks of placental abruption in a second pregnancy and estimation of when to initiate surveillance in order to reduce an increased risk of recurrent placental abruption to the initial level of initial abruption in the second pregnancy.Results. In women with a complicated (preterm, small for gestational age, or perinatal death) first delivery, the risks of an initial and recurrent complicated placental abruption in the second pregnancy were 7/1000 and 33/1000, respectively (relative risk 4.9). To reduce the recurrence risk in a second pregnancy to 7/1000, special surveillance six weeks prior to the gestational age of the initial abruption would be necessary. In women with an uncomplicated first delivery, the risks in the second pregnancy of an initial and recurrent complicated abruption were 3 and 19/1000, respectively (relative risk 7.1). To reduce the recurrence risk to 3/1000, surveillance at least 12 weeks prior would be necessary.Conclusion. The increased recurrence rate would necessitate increased awareness in terms of special surveillance in the second pregnancy. In pregnancies at risk of a recurrent placental abruption, monitoring up to three months before the gestational age of the initial abruption is necessary.
The significance of asymptomatic bacteremia for the newborn
Authors: Petanović Mirna , Žagar Živojin 
Published: March 2003

Background. So far, there has been no systematic detection of asymptomatic bacteremia in pregnant women. Consequently, its possible effects on newborn infants have not been discussed. The aim of this study was to determine the incidence of asymptomatic bacteremia in pregnant and parturient women and neonates as well as to assess its influence on the health condition of newborn infants during the first three months of life.Methods. A total of 626 blood cultures were taken from 353 pregnant women (with single‐fetus pregnancy)and their newborns: 156 during pregnancy, and immediately after delivery from 235 mothers and their 235 newborns. Blood culture results were clinically and statistically analyzed along with data on the development of the newborns.Results. Positive blood culture was found in 12% of pregnant women, in 19% of parturient women and 25% of the newborns.The most often isolated bacteria were: Staphylococcus epidermidis in 36 cases (18%), Escherichia coli in 35 cases (17.5%) and Enterococcus in 20 cases (10%).Asymptomatic bacteremia was found to be in a statistically significant correlation with signs and symptoms of life‐threatening conditions (p<0.01), early‐onset and late‐onset infections and other disorders occurring in newborn infants (p<0.05), mostly of the female sex.Conclusion. It seems that asymptomatic bacteremia cannot be considered harmless but appears to influence the health of newborns.
The relationship between cervical dilatation, interleukin‐6 and interleukin‐8 during term labor
Authors: Hebisch Gundula , Grauaug Alfred A. , Neumaier‐Wagner Peruka M. , Stallmach Thomas , Huch Albert , Huch Renate 
Published: March 2003

Background. To determine interleukin‐6 and interleukin‐8 levels in amniotic fluid, retroplacental blood and maternal serum and relate these values with cervical dilatation in term labor.Methods. Prospective study. n=78 healthy women undergoing term cesarean section, divided into four groups: controls,n=42, (elective cesarean section; no contractions, membrane rupture or cervical dilatation); latent labor,n=12, (latent phase labor; cervix <2 cm dilated); established labor, n=12, (active labor, cervix 2–5 cm); advanced labor,n=12, (active labor, cervix >5 cm). Interleukin‐6 and interleukin‐8 were determined by ELISA (pg/ml), placenta and placental bed biopsy examined histopathologically, and amniotic fluid also microbiologically. Results were expressed as median and ranges or mean and standard deviations, as appropriate. For statistical analysis, Mann‐Whitney U‐tests or Kruskal‐Wallis tests were used as applicable (Statview 4.5). Power and linear regression analyses were performed. p<0.05 was considered significant, p<0.001 highly significant.Results. Compared with controls, IL‐6 and IL‐8 increased significantly with cervical dilatation in all compartments tested for almost all labor groups (p<0.05 to p<0.0001). Significant changes were also seen between latent and advanced labor groups in some compartments (p<0.05), but not between established and advanced labor groups. Intrauterine infection was excluded in any of the patients clinically and on histopathological or microbiological analysis of placentae and amniotic fluid.Conclusions. In term labor without intraamniotic infection, interleukin‐6 and interleukin‐8 at the fetomaternal interface and in maternal serum rise significantly with cervical dilatation. These cytokines could be used as markers of active labor if vaginal examination is not applicable.