bluuebunny/crossref_metadata_2025_split huggingface dataset:
Quadrant root planing versus same‐day full‐mouth root planing
Authors: Apatzidou D.A. , Kinane D.F. 
Published: January 2004

AbstractObjectives: The aim of this study was to test the hypothesis that same‐day full‐mouth scaling and root planing (FM‐SRP) resulted in greater clinical improvement compared to quadrant scaling and root planing (Q‐SRP) in chronic periodontitis patients over a period of 6 months.Materials and Methods: Forty patients were recruited into this study. Subjects were randomised into two groups. The FM‐SRP group received full‐mouth scaling and root planing completed within the same day, while the Q‐SRP group received quadrant root planing at 2‐weekly intervals over four consecutive sessions. Whole‐mouth clinical measurements were recorded with a manual periodontal probe at baseline (BAS) and at reassessment 1 (R1) (approximately 6 weeks after the completion of therapy), and at reassessment 2 (R2) (6 months after the initiation of therapy). Selected site analyses were performed on the deepest site in each quadrant before and after therapy (R1 and R2) and clinical indices were recorded with an electronic pressure sensitive probe. In addition, during the active phase of treatment clinical data were collected at 2‐weekly intervals from the remaining untreated quadrants in the Q‐SRP group only.Results: Both therapies resulted in significant improvements in all clinical indices both at R1 and R2. A continuous clinical improvement was seen for both treatment groups during the experimental period, which reached peak levels at 6 months (ΔPD=1.8 mm, ΔCAL=1.1 mm, p<0.001; PD: pocket depth; CAL: clinical attachment level). The selected‐site analysis revealed no significant differences in any clinical index between the two treatment groups at R2 (ΔPD=2.8 mm, ΔRAL=1.1 mm; RAL: relative attachment level). At the selected sites, the analysis of the deep pockets (>7 mm) showed a significantly greater gain in RAL for the FM‐SRP group compared to the Q‐SRP group at R2 (p<0.05). The results of this analysis however, should be interpreted with care due to the small number of deep pockets. Data from the Q‐SRP group provided an insight into how treated and untreated quadrants responded during the initiation of plaque control measures. There were significant reductions in PD, suppuration (SUP), modified gingival index (MGI) and plaque index (PI) in the remaining untreated quadrants in the Q‐SRP group during the initial phase of treatment (p<0.05), while minimum changes in RALs and bleeding on probing (BOP) occurred. Nevertheless, the improvement in PD was clearly inferior to that seen after scaling and root planing.Conclusion: Following both therapeutic modalities, there were marked clinical improvements at both R1 and R2 (6 months) from baseline. The current study, in contrast to previous findings, failed to show that FM‐SRP is a more efficacious periodontal treatment modality compared to Q‐SRP. However, both modalities are efficacious and the clinician should select the treatment modality based on practical considerations related to patient preference and clinical workload.
Induced septic abortion: A major factor in maternal mortality and morbidity
Authors: Rana Ashma , Pradhan Neelam , Gurung Geeta , Singh Meeta 
Published: January 2004

AbstractBackground:  Septic abortion is an infection of the uterus and its appendages following any abortion especially, illegally performed induced abortions. It is characterized by a rise of temperature to at least 100.4°F, associated offensive or purulent vaginal discharge and lower abdominal pain and tenderness.Aim:  To study maternal mortality and morbidity in induced septic abortions.Methods:  Induced septic abortions were analyzed between April 1992 and September 1999 in TU Teaching hospital. Morbidity indicators were surgery other than curettage, prolonged hospitalization and permanent damage.Results:  In 92 cases of induced septic abortions, comprising 6% of total abortions; nine deaths occurred because of disseminated intravascular coagulation, acute renal failure and adult respiratory distress syndrome. Vaginal, intraperitoneal and gum bleeding; epistaxis and malaena resulted in severe anemia (Hb < 6 gm/L) in 11 cases. Wound debridement and skin graft cured two cases of necrotizing fasciitis. One of four conservatively managed tubo‐ovarian masses spontaneously drained rectally. In 15 cases laparotomy for pus drainage, salpingectomy, salpingo‐oophorectomy, hysterotomy/uterine rent repair was conducted, along with four bowel surgeries and six hysterectomies were performed. Post‐operative complications included burst abdomen (one case) and reopened pyoperitoneum, which resulted fecal fistula in three cases, one of these patients died.Conclusion: :  Induced abortion was proven to be a major detrimental factor for maternal mortality. Morbidity was four times higher than mortality to the extent that patients suffered hemiplegia and forced barrenness.
Combined diagnostic approach of laparoscopy and hysteroscopy in the evaluation of female infertility: Results of 612 patients
Authors: Shokeir Tarek A. , Shalan Hesham M. , El‐Shafei Mohamed M. 
Published: January 2004

AbstractAim:  To clarify the role of a combined diagnostic approach using laparoscopy and hysteroscopy in the evaluation of female infertility in developing countries.Methods:  In a prospective study, 612 consecutive infertile women underwent complete fertility evaluation at a tertiary university infertility clinic: 300 complained of primary infertility, 221 of secondary infertility, and 91 were requesting reversal of a previous tubal ligation. All the patients were examined by simultaneous combined laparoscopy and hysteroscopy as a part of their routine infertility evaluation. Focused hysteroscopic evaluation of the region of utero‐tubal junction was attempted.Results:  Laparoscopy was successful in 608 and hysteroscopy in 597 patients. The most frequent pathologies detected hysteroscopically in the infertile group were adhesive in nature and believed to be post‐traumatic and/or post‐phlogistic. The number of intrauterine abnormalities found by hysteroscopy was significantly greater than by hysterosalpingography. The rate of diagnosis of significant lesions by laparoscopy of 64.3% rose to 76.6% when the hysteroscopic findings were included. A significant number of women with secondary infertility had abnormal hysteroscopic findings when compared to either women with primary infertility or those requesting sterilization reversal. Hysteroscopic evaluation of the region of utero‐tubal junction revealed significant lesions believed to have caused infertility in comparison with those requesting sterilization reversal.Conclusion:  The combined diagnostic approach of laparoscopy and hysteroscopy is recommended in the evaluation of female infertility in communities where the risk of pelvic infections is great.
Fetal heart rate and uterine contraction during automobile driving
Authors: Nakajima Yukari , Yamaji Kenji , Ohashi Kazutomo 
Published: January 2004

AbstractObjective:  The purpose of this study was to clarify the influence of automobile driving in the third trimester of pregnancy on fetal heart rate and uterine contraction.Methods:  Twenty‐nine pregnant women with singleton pregnancies after 28 weeks of gestation were monitored using a portable cardiotocogram during driving, and the results obtained before and after driving were compared.Results:  Baseline fetal heart rate and its variability, as well as periodic fetal heart rate patterns, showed no abnormal patterns during car driving. Automobile driving in late pregnancy was not a reinforcement factor for uterine activity. Maternal systolic and diastolic blood pressure and heart rate showed no specific characteristic or adverse change during driving.Conclusion:  The results of this study suggest that automobile driving in the third trimester of pregnancy has no adverse influences on either pregnant women or fetuses.
Uterine rupture of cesarean scar related to spontaneous abortion in the first trimester
Authors: Matsuo Koji , Shimoya Koichiro , Shinkai Tsuneo , Ohashi Hiroshi , Koyama Masayasu , Yamasaki Masato , Murata Yuji 
Published: January 2004

AbstractWe report the case of a 31‐year‐old Japanese female diagnosed by transvaginal ultrasonography to have a spontaneous uterine rupture in the first trimester. Her condition was complicated by diabetes mellitus type 1. Her previous pregnancy had resulted in an emergency cesarean section by transverse incision of the lower uterine segment with single‐layer suture at 37+4 weeks of gestation. Transvaginal ultrasonography displayed both a gestational sac located in the anterior lower uterine segment and a defect in the uterine wall located at the site of the previous cesarean delivery scar. Pelvic magnetic resonance imaging showed that the uterine muscle layer was discontinuous and the gestational sac was almost outside the uterine cavity, accompanied by mild hemorrhaging within the endometrial cavity. The defect in the lower uterine wall was round in shape and was 3 cm in diameter. Since uterine ruptures can occur during all gestational periods, it is important to pay attention to the uterine wall where any cesarean incision was previously made.
Schönlein–Henoch purpura during pregnancy: Case report and review of the literature
Authors: Koizumi Minako , Hagino Daisuke , Fukuyama Chiyoko , Abe Kanako , Inoue Kumiko , Arai Yuko , Takechi Kimihiro 
Published: January 2004

AbstractThe clinical features of Schönlein–Henoch Purpura (SHP) consist of non‐thrombocytopenic purpura in association with joint, gastrointestinal and renal involvements. Because it is uncommon in adults, there is little information on the effects of SHP on pregnancy in the literature. This report documents the clinical findings and outcome of an uncommon case of SHP affecting a woman who was 25 weeks pregnant. Prompt steroid‐therapy induced a rapidly favorable course and successful vaginal delivery at 40 weeks gestation. If SHP develops during pregnancy, it is not always easy to distinguish from obstetrical complications such as pre‐eclampsia. An early diagnosis is important especially if renal involvement exists, because the prognosis for this disease can include nephropathy and it therefore needs close monitoring.
Evaluation of depressive conditions among Japanese patients at a menopause clinic
Authors: Takamatsu Kiyoshi , Kasuga Michiko , Makita Kazuya , Nozawa Shiro 
Published: January 2004

AbstractAim:  To examine current depressive tendencies among Japanese patients visiting a menopause clinic with complaints of climacteric symptoms.Methods:  The subjects were 389 Japanese women (age range: 45–60 years; mean: 51.4 ± 3.8 years) who visited the menopause clinic in Department of Obstetrics and Gynecology, Keio university hospital, reporting climacteric symptoms. Their depressive tendencies were examined with the SDS (Self‐rating Depression Scale, filled out by the patient).Results:  The SDS was computed to be 42.4 ± 9.9. Ninety‐three (23.9%) suffered from an intermediate or higher level depressive tendency; 132 (33.9%) had a mild depression; and 164 (42.2%) were free of any depressive tendency. It was concluded that more than one‐half of the subjects suffered from some form of depression. Correlations between age, time after menopause/oophorectomy, and depressive tendency were ambiguous. In comparing the total scores of SDS for pre‐, peri‐, and postmenopause groups, the incidence of probable depression was higher in the second group, but no significant differences were noted among each group. When the parameters were compared in relation to their hormonal environments, the natural menopause group rated significantly higher in the scores related to sleep disturbance, hopelessness and dissatisfaction than the premenopause group. The number of those who probably exhibited mild or more exaggerated depression was significantly lower in the surgical menopause group in comparison with the natural menopause group.Conclusion:  A depressive tendency occurred frequently among Japanese patients with menopausal disorders. It is important to evaluate the mental status of these patients with the aid of an appropriate tool.
Investigation of the incidence of hepatitis E virus among pregnant women in Turkey
Authors: Cevrioglu Arif Serhan , Altindis Mustafa , Tanir Hüseyin Mete , Aksoy Fatih 
Published: January 2004

AbstractAim:  The aim of our study was to determine the prevalence of hepatitis E virus (HEV) among pregnant and non‐pregnant women in Middle Anatolia, identify the factors that affect being HEV positive and to study the effects of HEV positivity on mother and fetus.Methods:  The study included 245 pregnant women who applied to various health centers and 76 cases in the same age range as the control. Blood samples taken from the cases were tested in terms of anti‐HEV, IgM and IgG using the microELISA method.Results:  None of the blood samples tested revealed anti‐HEV IgM positive, an indicator of acute infection, while 31 pregnant women (12.6%) and nine cases in the control group (11.8%) were found to have anti‐HEV IgG positive (P > 0.05). It was seen that in pregnant women such factors as advanced age, lower educational and income levels and rural residence were correlated with higher anti‐HEV IgG positive values (P < 0.05). HEV infection is endemic in Afyon and its vicinity. There were no statistical differences between pregnant women and non‐pregnant women at similar ages in terms of HEV seropositivity.Conclusion:  It can be suggested that pregnancy does not constitute a predisposition to HEV infection.
Down‐regulation of members of glycolipid‐enriched membrane raft gene family, MAL and BENE, in cervical squamous cell cancers
Authors: Hatta Mitsuko , Nagai Hisaki , Okino Keiko , Onda Masamitsu , Yoneyama Koichi , Ohta Yujirou , Nakayama Hiroki , Araki Tsutomu , Emi Mitsuru 
Published: January 2004

AbstractPersistent human papillomavirus infections cause infected epithelial cells to lose cellular polarity leading to cell transformation. Glycolipid‐enriched membrane (GEM) rafts are implicated in polarized sorting of apical membrane proteins in epithelial cells and even in signal transduction. The MAL and BENE are essential component of the GEM raft's machinery for apical sorting of membrane proteins. In this study we demonstrated down‐regulation of MAL and BENE mRNA in over two‐thirds of primary cervical squamous cell cancers (14 and 15 of 20 cases, for MAL and BENE, respectively) when compared to corresponding non‐cancerous uterine squamous cells. Allelic loss or hyper‐methylation was not accompanied by MAL or BENE mRNA down‐expression in human primary cervical cancers in microsatellite allelic analysis and HpaII‐PCR‐based methylation analysis of the MAL and BENE genomic region. In addition, we note down‐regulation of these genes in established cervical cancer cell lines. These results suggest that down‐regulation of MAL and BENE genes, which are essential components of the cellular polarized sorting system, play an important role in human cervical squamous cell cancer development.
Capturing lay perspectives in a randomized control trial of a health promotion intervention for people with osteoarthritis of the knee
Authors: Victor Christina R. , Ross Fiona , Axford John 
Published: January 2004

AbstractOsteoarthritis (OA) is a common and often disabling condition that predominately affects older adults. It is the commonest cause of locomotor disability and forms a major element of the workload in primary care. Previous studies suggest that there are both deficits in the knowledge patients have about their disease and extensive ‘unmet’ information needs. This paper explores the patients’ perspective on the meaning and significance of living with arthritis, identified through quantitative and qualitative approaches undertaken during a trial that evaluated the effectiveness of a primary care‐based patient education programme. This paper draws on qualitative and quantitative data from: the baseline interview (knowledge of arthritis, satisfaction with services and support received in primary care); patient diaries (individual goals and reflections on treatment); and group teaching sessions (themes describing the patient's experience). The different data sources were interrogated for common and divergent themes. One hundred and ninety‐four participants were identified and 170 completed baseline interviews. Participants were predominantly female (73%), with a mean age of 63 and arthritis of long‐standing; 55% reported that they had had it for 5 years or more. Use of primary care services was high, with 41% consulting their GP in the 2 weeks before interview. Levels of information were low, with less than 25% receiving support/advice about the disease, pain management or its impact upon daily life. Set against negative perceptions of the quality of services, patients’ personal priorities were for improved pain management and enhanced mobility/functional ability. The combined quantitative and qualitative data provide insight into the patients’ perspective on the causes and impact of knee OA, individual goals desired from treatment and the quality of care. There is consistent evidence of unmet needs for information and support and the priority placed by patients on finding strategies to cope with OA and maintaining independence. Even within a tightly defined study sample participating in the intervention, a diversity of experience and goals were revealed, which highlights the importance of taking account of contextual factors and individual differences when evaluating complex interventions.
Evaluating the treatment of hypertension in diabetes mellitus: a need for better control?
Authors: Sequeira Reginald P. , Al Khaja Khalid A. Jassim , Damanhori Awatif H.H. 
Published: January 2004

AbstractObjectives  To determine how well and to what extent blood pressure (BP) is controlled in diabetic hypertensive patients treated by primary care doctors, and to evaluate drug therapy in the backdrop of risk factors and laboratory findings.Methods  A therapeutic audit of the medical records of diabetic hypertensives from nine primary care health centres in Bahrain.Results  In 266 diabetic hypertensives (82 males and 184 females), the recommended target BP < 130/< 85 mmHg (WHO/ISH guidelines, 1999) was achieved in  20 (9.8%) with a BP of 119 ± 4/76 ± 5 mmHg. Among those who did not achieve target BP, 70 (34.5%) lacked systolic BP control (BP = 153 ± 17/79 ± 3 mmHg), four (2%) lacked diastolic BP control (BP = 123 ± 3/86 ± 3 mmHg) and 109 (53.7%) lacked both systolic and diastolic BP control (BP = 158 ± 20/94 ± 7 mmHg). The mean age of the group achieving target BP was significantly lower than the group which lacked systolic BP control (51.6 ± 9 vs. 63.5 ± 9 years; P < 0.0001). While there were no significant differences in fasting blood glucose, glycosylated haemoglobin, triglycerides, urea, creatinine, uric acid and serum electrolytes between the group achieving target BP vs. groups without target BP, a significant difference in total cholesterol was seen.Patients  with ischaemic heart disease and/or isolated systolic hypertension did not achieve the target BP. Antihypertensive monotherapy was prescribed in 145 (54.5%) patients, whereas two‐ and three‐drug combinations were prescribed in 32.3 and 8.2% of patients, respectively. As monotherapy, angiotensin‐converting enzyme (ACE) inhibitors were the most frequently prescribed drugs followed by β‐blockers, calcium channel blockers (CCBs) and diuretics. As two‐drug combinations, an ACE inhibitor with a β‐blocker/diuretic and a β‐blocker with   a  CCB/diuretic  were  usually  prescribed.Conclusions  According to the WHO/ISH 1999 guidelines, approximately one out of 10 diabetic hypertensives achieved target BP control. In many instances, the drug therapy prescribed was inappropriate considering the comorbidity in patients and their laboratory findings. Improved BP control is needed in treating high‐risk groups such as patients with diabetes mellitus, and efforts should be made to improve the treatment of hypertension in the primary care setting.
Strategies for ensuring effective surveillance in post‐transplant patients: practical organization and clinical evaluation
Authors: Jurewicz W. Adam , Miles Andrew 
Published: January 2004

AbstractResults of renal transplantation have improved steadily over the years. This article reviews the current status of patient and graft survival and discusses major causes of mortality and renal allograft failure. Review of recent literature demonstrates that the traditional enemies of transplantation, acute rejection and opportunistic infections are no longer major problems facing transplantation. Chronic graft nephropathy and death with functioning graft due to cardiovascular disease are the main challenges in the current era. An impact of an early graft thrombosis, recurrent renal disease and post‐transplant malignancies are also reviewed. Chronic graft nephropathy is examined in a context of differences between two calcineurin inhibitors, cyclosporin microemulsion and tacrolimus. Strategies of post‐transplant surveillance are suggested.
Patient experience of time duration: strategies for ‘slowing time’ and ‘accelerating time’ in general practices
Authors: Buetow Stephen 
Published: January 2004

AbstractApproaches to time management in general practices characteristically focus on objective ‘clock time’, for example, through appointment scheduling. No less important, however, is how patients experience time duration. Time is experienced as having passed slowly (time prolongation), quickly (time compression) or in rough synchronization with clock time. Duration has been theorized to be positively associated with information processing. This paper builds on that theory to suggest how practices can influence patients’ subjective experience of duration in the practice environment, for example, by making waiting times appear to quicken and consultations appear to slow.
Predictors of HIV/AIDS among individuals with tuberculosis: health and policy implications
Authors: Kennedy Stephen B. , Campbell James , Malanda Bernard 
Published: January 2004

AbstractThe purpose of this report was retrospectively to assess the application of clinical predictors (i.e. signs and symptoms) for the diagnosis of the human immunodeficiency virus (HIV) infections, including the acquired immunodeficiency syndrome (AIDS), among tuberculosis (TB)‐positive subjects enrolled within an urban heterosexual sero‐discordant couple (one partner HIV‐positive and the other HIV‐negative) cohort study at an HIV prevention and research centre in Lusaka, Zambia. Available medical, clinical and laboratory records from 1994 to mid‐1998 were reviewed, with follow‐up visits to the local chest clinics and sputum analyses laboratories instituted as additional quality assurance measures. A nested case‐control study was employed. The World Health Organization clinical case definition for HIV/AIDS (WHOCCDA) was observed to be significantly more likely to predict HIV/AIDS among TB‐positive HIV‐positive subjects than TB‐positive HIV‐negative subjects. Therefore, this report documents the relative effectiveness of the WHOCCDA in predicting HIV/AIDS cases and discusses the health and policy implications, especially for the developing world which accounts for a significant proportion and impact of HIV/AIDS. Further research studies based on prospective randomized controlled trails or other rigorous evaluation strategies are warranted to substantiate these findings.