bluuebunny/crossref_metadata_2025_split huggingface dataset:
The incidence, risk factors and obstetric outcome in primigravid women sustaining anal sphincter tears
Authors: Gupta Nandini , Usha Kiran Talakere , Mulik Varsha , Bethel Jackie , Bhal Kiron 
Published: December 2004

Background.  The incidence of anal sphincter tears is highest among nulliparous women. The aim of this study was to ascertain if there were other factors that increased their risk.Methods.  This was a retrospective study of all primigravid vaginal deliveries that had sustained an anal sphincter tear (n = 122), compared with deliveries that did not have this complication (n = 16 050). The study sample was drawn from a computerized maternity information database, comprising 52 916 deliveries in the South Glamorgan region during 1990–99. SPSS version 10 was used for statistical analysis.Results.  The incidence of anal sphincter tears in this study population was 0.8% (122/16172). Postdates (OR = 1.8, 95% CI = 1.3–2.6) and fetal macrosomia (OR = 3.8, 2.4–6) together with induction of labor (OR = 1.5, 1.01–2.2), use of spinal analgesia at delivery (OR = 3.1, 1.1–8.4), assisted vaginal delivery (OR = 1.9, 1.3–2.7; especially the use of forceps, OR = 2.2, 1.3–3.9) and doctor‐conducted deliveries (OR = 2.2, 1.6–3.2) were found to be associated with a significantly higher incidence of anal sphincter tears. Logistic regression revealed fetal macrosomia and doctor‐conducted deliveries to be independent risk factors that, when occurring together, were associated with a fourfold increase in the risk of occurrence of anal sphincter tears.Conclusions.  This study suggests that careful assessment and counseling of women, particularly > 40 weeks gestation or those potentially having macrosomic fetuses, especially if forceps are to be used for prolonged second stage in primigravid women, may help to identify those at significant risk of anal sphincter tears.
Preeclampsia is associated with increased susceptibility of serum lipids to copper‐induced peroxidation in vitro
Authors: Fainaru Ofer , Lichtenberg Dov , Pinchuk Ilya , Almog Benny , Gamzu Ronni , Kupferminc Michael 
Published: December 2004

Background.  Several reports suggest preeclampsia to be associated with oxidative stress. In view of potential experimental artifacts in these studies, we tested the effect of preeclampsia on the oxidizibility of maternal serum lipids, using an optimized ex vivo method.Methods.  This prospective study included 28 pregnant women with preeclampsia and 28 women matched for maternal and gestational age with normal pregnancies. Venous blood was drawn from the consenting women. Serum levels of lipid peroxidation products and the kinetics of copper‐induced oxidation ex vivo were monitored spectroscopically by continuous recording of absorbance at 245 nm.Results.  The initial optical density (OD) at 245 nm, attributed to preformed products of lipid peroxidation, was higher in the women with preeclampsia than in the controls (1.26 ± 0.02 vs. 1.17 ± 0.02 OD units; p = 0.01). The lag phase preceding oxidation, reflecting resistance of serum lipids to oxidation, was significantly shorter in the preeclampsia group than in the controls (47.4 ± 2.3 vs. 57.6 ± 4.0 min; p = 0.027).Conclusions.  High levels of serum hydroperoxides and increased susceptibility of serum lipids to copper‐induced peroxidation ex vivo indicate preeclampsia to be associated with high oxidative stress. The role of this high oxidizibility in the pathogenesis of preeclampsia has yet to be evaluated.
Adult victims of sexual assault: acute medical response and police reporting among women consulting a center for victims of sexual assault
Authors: Schei Berit , Sidenius Katrine , Lundvall Lene , Ottesen Gyda Lolk 
Published: December 2004

Background.  The medical response to adult sexual assault should comprise: the collection of forensic evidence, the treatment of injuries, and follow‐up counselling. In the past, victims of sexual assault reporting directly to the police may not have received this total medical care. The Copenhagen Center for Victims of Sexual Assault at Rigshospitalet, Denmark offers a 24‐h service. Medical treatment and psychosocial follow up is offered independent of police reporting. The aim of this study was to assess whether adult sexual assault victims who reported to the police differed from those who did not report to the police.Methods.  Using clinical records, sociodemographics, characteristics of the assault, and type of preventive medical treatment received were obtained for 156 consecutive women consulting the Copenhagen Center (March 1st to December 31st 2000). Comparisons between characteristics of victims who reported to the police or not were determined.Results.  Ninety‐four (60.2%) of the women reported to the police. Women who sought services within 24 h of the assault, had experienced use of force, were subjected to assault outdoors, and among whom nongenital injuries were observed were more likely to report to the police (p < 0.05). However, in the multivariate model these associations fell below significance, and only the type of perpetrator remained significantly related to police reporting. The adjusted odds ratio for police reporting when the perpetrator was a friend was 0.4 (95% CI 0.17–0.94). There was no statistical difference between the victims who did or did not report to the police to request prophylactic antibiotics or emergency contraception.Conclusion.  Observed injuries and requests for prophylactic antibiotics or emergency contraception were not influenced by whether the woman did or did not report directly to the police. Hence the need for medical treatment appears to be similar in the two groups, and available specialized care for victims of sexual assault should not be restricted to those who immediately report to the police.
Quantitative analysis of trophoblast invasion in preeclampsia
Authors: Naicker Thajasvarie , Khedun Shaun M. , Moodley Jagidesa , Pijnenborg Robert 
Published: December 2004

Background.  The process of physiological conversion of spiral arteries is dependent on the invasion of the interstitium and spiral arteries of the uterine wall by invasive extravillous trophoblast thereby creating a high flow–low resistance vessel. Quantitative data on restriction of trophoblast invasion and failure of spiral artery transformation are limited in preeclampsia.Aim.  This study morphometrically analyzes interstitial trophoblast cells and trophoblast cells embedded in the wall of the converted spiral arteries within the decidua and myometrium of normotensive and preeclamptic Black African pregnant women.Methods.  Placental bed biopsies were obtained from 25 normotensive pregnant women and 30 pregnant women complicated with hypertensive disorders. Biopsies were processed and immunostained for trophoblast cell identification, using anti‐MNF 116 antibody. Image analysis of the trophoblast population within the decidua, myometrium and the spiral arteries was performed in the normotensive and in the severe proteinuric hypertensive groups.Results.  The mean field area percentage of trophoblast cells observed in the decidua of the normotensive women was 22.79 ± 2.1% in comparison to 18.14 ± 1.53% in the severe hypertensive group (p < 0.01). In the myometrium, the mean field area percentage of interstitial trophoblast cells (both mononuclear and multinuclear) was 10.04 ± 2.1% of the field area of the normotensive group compared to 2.81 ± 0.67% in the severe hypertensive group (p < 0.001). The mean field area percentage occupied by trophoblast cells in myometrial spiral arteries was 10.15% in the normotensive group compared to none in the severe hypertensive group. The latter group displayed medial disorganization, hyperplasia and endothelial vacuolation.Conclusion.  This study demonstrates restricted invasion of the trophoblastic cells in preeclampsia. This inadequate invasion may influence vascular remodeling required for delivering adequate volumes of maternal blood to the placenta.
Typing of human papillomavirus in Zimbabwean patients with invasive cancer of the uterine cervix
Authors: Stanczuk Grazyna A. , Kay Patti , Sibanda Elopy , Allan Bruce , Chirara Mike , Tswana Sam A. , Bergstrom Staffan , Williamson Anna‐Lise 
Published: December 2004

Background.  Cervical cancer affects 1 in 2000 Zimbabwean women. We investigated the type‐specific distribution of human papillomavirus (HPV) infection in Zimbabwean women with invasive cervical cancer.Methods.  We conducted a descriptive study on 98 women with invasive cervical cancer. The methods used were a nested polymerase chain reaction (PCR) for amplification of HPV‐DNA and restriction fragment length polymorphism (RFLP) to characterize the HPV types.Results.  HPV‐DNA was identified in 97% of the cases. HPV types 16, 33, 18 and 31 were identified in 61%, 39%, 18% and 4% of the patients, respectively. We typed one case each of HPV types 35 and 58. Multiple HPV infections were present in 24%. All patients (n = 3) with adenocarcinoma of the cervix were infected with the HPV. Patients infected with HPV‐16 alone presented at a median age of 46 years while those infected with HPV‐33 alone presented at 43 years. However, patients coinfected with both HPV‐16 and HPV‐33 were between 10 and 13 years older (median age of 56 years) than patients with either HPV‐16 or HPV‐33 as single infections. These differences were marginally significant (p = 0.08) or significant (p = 0.02), respectively.Conclusion.  We present the first prevalence data on HPV types in patients with cervical cancer in Zimbabwe and show that, provided appropriate techniques are employed, HPV infection can be identified in a majority of the patients. The distribution of HPV types should be taken into consideration in tailoring locally relevant vaccines against HPV.
Detection of connective tissue growth factor (CTGF) in human tear fluid: preliminary results
Authors: Van Setten G. B. , Blalock Timothy D. , Grotendorst Gary , Schultz Gregory S. 
Published: December 2004

Abstract.Purpose:  Connective tissue growth factor (CTGF) is one of the main regulators of fibrosis. We aimed to evaluate its presence in the human tear fluid of healthy individuals.Methods:  A total of 70 tear fluid samples were collected from eight volunteers prior to and after stimulation of reflex tears with onion vapour. Specific ELISA analysis was performed with goat IgG against human CTGF.Results:  Connective tissue growth factor was detected in seven samples (10%), with maximum levels of 17 ng/mL in basal tears. Induction of reflex tearing resulted in a fast and significant decrease of CTGF concentrations (r = − 0.95). No CTGF was detected in 90% of the samples.Conclusion:  Connective tissue growth factor may occur in tear fluid in healthy human eyes. This indicates a possible role for tear fluid CTGF in ocular surface fibrosis and wound healing.
Astigmatic axis and amblyopia in childhood
Authors: Abrahamsson Maths , Sjöstrand Johan 
Published: December 2004

Abstract.Purpose:  This study is part of a larger project whose aim is to evaluate the relationship between refractive errors and amblyopia. In an earlier study, we showed that there is a substantial increase in the prevalence of amblyopia among children with oblique astigmatism. To further evaluate this relationship, we examined children with astigmatisms of 1 dioptre or more and varying directions of the astigmatic axes.Methods:  Two groups of astigmatic children, with oblique and orthogonal astigmatism, respectively, were selected for the study at 1 year of age via a general health screening programme. The most emmetropic axis was identified in each child and used in the study. Visual acuity (VA) was tested when the children were between 4 and 4.5 years of age. The presence of amblyopia, defined as difference in VA between the eyes of 0.1 log unit or more, and any increase in acuity following occlusion therapy were noted.Results:  The angle of the astigmatic axis strongly relates to the risk of developing amblyopia. Axes ± 15 degrees from the main axes did not affect the risk of amblyopia but oblique astigmatism significantly increased the risk of developing amblyopia (p = 0.0024).Conclusions:  The results accord with earlier findings that oblique astigmatism increases the risk of developing amblyopia.
Reasons for pregnancy termination, contraceptive habits and contraceptive failure among Swedish women requesting an early pregnancy termination
Authors: Larsson Margareta , Aneblom Gunilla , Odlind Viveca , Tydén Tanja 
Published: December 2004

Background. More than 30 000 legal abortions are performed every year in Sweden despite sexual education in schools, widespread youth‐clinics and family planning services that are free of charge. The aim of this study was to investigate reasons for induced abortion, contraceptive habits and reasons for contraceptive failure among women presenting for induced abortion.Methods. A questionnaire was administered to 591 Swedish‐speaking women consecutively attending three different health care providers concerning an induced abortion during spring 2000.Results. The response rate was 88% (n = 518). As many as 43%, among daily smokers 53%, had experienced one or more previous legal abortions. The majority of the women (97%) had discussed the decision about abortion with someone. The most cited reasons contributing to their decision were financial concerns, worries about the relationship and bad timing of the pregnancy. Though 85% had used contraception during the previous year, 36% of the women had not used any contraceptive method at the time of conception. The main reason given for not using contraception was the belief that they could not at that time become pregnant (35%). Ninety percent of the women planned to use contraception after the abortion.Conclusion. Women's decisions regarding induced abortion are multifactorial. One important reason was ‘poor economy’. One out of three did not use any contraception, as they believed they could not become pregnant. Women presenting for induced abortion are a risk‐group for further terminations. Counseling must include information about the fertile window, effective contraceptives and the emergency contraceptive pill.
The role of sonographic assessment of cervical length in the prediction of preterm birth in primigravidae with twin gestation conceived after infertility treatment
Authors: Soriano David , Weisz Boaz , Seidman Daniel S. , Chetrit Angela , Schiff Eyal , Lipitz Shlomo , Achiron Reuven 
Published: December 2004

Objective. To identify the risk factors for preterm birth in primigravidae with twin gestation and the role of transvaginal ultrasonographic assessment of the cervix.Methods. Between January 1996 and December 1996, 54 twin pregnancies were prospectively enrolled. All women were at their first pregnancy. All women conceived following infertility treatments and all had a normal uterine cavity proven by hysterosalpingography (HSG) or hysteroscopy. Multiple logistic regression analysis was used to evaluate the association between the length of the cervix at 18–24 weeks of gestation and outcome variables, controlling for possible confounding factors.Results. The mean ± SD maternal age was 30.9 ± 5.3 years (range 22–46), and five of them were aged 40 or more. Nine patients (20.5%) delivered prematurely, defined as spontaneous delivery at or before 34 weeks of gestation. There was no statistically significant difference between women who delivered before or after 34 weeks of gestation in regard to maternal age, body mass index (BMI), weight gain in pregnancy, smoking and work during pregnancy. The mean cervical length of patients who delivered before 34 weeks of gestation (30.1 ± 6.1 mm) was significantly shorter than that of women who delivered after 34 weeks of gestation (42.2 ± 6.2 mm; P < 0.001). Cervical length longer than 35 mm predicted delivery after 34 weeks of gestation with sensitivity and specificity of 88.5% and 88.9%, respectively. The positive and negative predictive values were 96.9% and 66.7%.Conclusion. A transvaginal ultrasonographic measurement of the cervix > 35 mm at 18–24 weeks in twin gestation can identify patients at low risk for delivery before 34 weeks. Maternal age, BMI, weights gain, smoking and work during the pregnancy did not influence the duration of the pregnancy.
Is it possible to recommend an ‘optimal’ postoperative management after hysteroscopic metroplasty? A retrospective study with 52 infertile patients showing a septate uterus
Authors: Nawroth Frank , Schmidt Torsten , Freise Claudia , Foth Dolores , Römer Thomas 
Published: December 2004

Background. The aim of the retrospective study was to evaluate the ‘optimal’ postoperative management after hysteroscopic metroplasty.Methods. Fifty‐two  infertile patients with a septate uterus were included. Hysteroscopic metroplasty was performed using electrocautery (dissection needle) with postoperative cyclical hormone replacement therapy (HRT) + intrauterine device (IUD) insertion for 3 months (Group 1, n = 22), or HRT alone for 3 months (Group 2, n = 13), or without postoperative therapy (Group 3, n = 17).Results. During a median follow‐up of 21±16.9 months 40.9% in Group 1, 53.8% in Group 2 and 41.2% in Group 3 (p > 0.05) resulted in ongoing pregnancies. The rates of delivery at term were 53.3%, 64.4% and 88.9%, respectively.Conclusions. A postoperative 3‐months HRT + IUD insertion or a HRT alone after hysteroscopic metroplasty are not necessary.
Oestrogen receptor β is expressed in adult human skeletal muscle both at the mRNA and protein level
Authors: Wiik A. , Glenmark B. , Ekman M. , Esbjörnsson‐Liljedahl M. , Johansson O. , Bodin K. , Enmark E. , Jansson E. 
Published: December 2004

AbstractAim:
There are two known oestrogen receptors (ER), oestrogen receptor α (ERα) and the recently cloned oestrogen receptor β (ERβ). ERα mRNA has been detected in mouse, rat, bovine and human skeletal muscle. ERβ mRNA has been detected in bovine skeletal muscle. To our knowledge, no study has investigated the expression of oestrogen receptor β in human skeletal muscle. Therefore, the primary aim of the present investigation was to study ERβ mRNA and protein expression in human skeletal muscle. In addition the ERα expression was also studied.Methods:  Muscle biopsies were taken from vastus lateralis in six healthy adults (three women and three men). mRNA expression was detected with real‐time PCR (TaqMan) and protein localization by immunohistochemistry.Results:  A clear expression of ERα and ERβ mRNA was seen in skeletal muscle in all subjects. The ERα mRNA expression was 180 fold higher compared with that of ERβ mRNA. Immunohistochemistry demonstrated positive staining for ERβ, but not for ERα, with localization to the nuclei of skeletal muscle fibres. On average, 70% of all nuclei were ERβ‐positive.Conclusion:  The present study shows for the first time ERβ mRNA and protein expression in human skeletal muscle tissue in both males and females.
Myocardial vasoactive intestinal peptide and fibrosis induced by nitric oxide synthase inhibition in the rat
Authors: Ye V. Z. C. , Hodge G. , Yong J. L. C. , Duggan K. A. 
Published: December 2004

AbstractAims:  In both normotensive and hypertensive rats, the degree of myocardial fibrosis is inversely correlated with the concentration of vasoactive intestinal peptide (VIP) in the myocardium. Treatment with nitric oxide (NO) synthase inhibitors also causes myocardial fibrosis. In this study, we sought to determine whether the myocardial fibrosis induced by treatment with the NO synthase inhibitor N(G)‐nitro‐l‐arginine methyl ester (l‐NAME) was also associated with depletion of VIP in the myocardium.Methods:  Male Wistar Kyoto (WKY) and spontaneous hypertensive rats (SHR) rats treated with l‐NAME were randomized to low, intermediate or high salt content diets. After 4 weeks, the hearts were harvested, the degree of fibrosis quantified and VIP concentration measured.Results:  In WKY, systolic blood pressure increased with increasing dietary sodium (P < 0.05). Myocardial fibrosis also increased with increasing dietary sodium (P < 0.005). Myocardial VIP concentration decreased with increasing dietary sodium (P < 0.025). In contrast, in the SHR treated with l‐NAME, systolic blood pressure increased but the increase was not affected by sodium intake. Further, myocardial fibrosis and myocardial VIP were unchanged by increased dietary sodium. Higher doses of l‐NAME in the SHR did not increase the systolic blood pressure, increase the degree of myocardial fibrosis or decrease the myocardial concentration of VIP. These differences in myocardial VIP concentration may reflect differing effects of l‐NAME on VIP metabolism, as l‐NAME increased VIP metabolism in the WKY (P < 0.05) but did not change VIP metabolism in the SHR.Conclusions:  We conclude that depletion of VIP in the myocardium is associated with increasing myocardial fibrosis in l‐NAME treated WKY. As VIP depletion occurs in other models of myocardial fibrosis, it appears to be a common mechanism. Myocardial VIP depletion may therefore be a new and important factor in the pathogenesis of cardiac fibrosis.
Non‐invasive assessment of cardiac output during exercise in healthy young humans: comparison between Modelflow method and Doppler echocardiography method
Authors: Sugawara J. , Tanabe T. , Miyachi M. , Yamamoto K. , Takahashi K. , Iemitsu M. , Otsuki T. , Homma S. , Maeda S. , Ajisaka R. , Matsuda M. 
Published: December 2004

AbstractAims:  The Modelflow method can estimate cardiac output from arterial blood pressure waveforms using a three‐element model of aortic input impedance (aortic characteristic impedance, arterial compliance, and systemic vascular resistance). We tested the reliability of a non‐invasive cardiac output estimation during submaximal exercise using the Modelflow method from finger arterial pressure waveforms collected by Portapres in healthy young humans.Methods:  The Doppler echocardiography method was used as a reference method. Sixteen healthy young subjects (nine males and seven females) performed a multi‐stage cycle ergometer exercise at an intensity corresponding to 70, 90, 110 and 130% of their individual ventilatory threshold for 2 min each. The simultaneous estimation of cardiac output (15 s averaged data) using the Modelflow and Doppler echocardiography methods was performed at rest and during exercise.Results and Conclusion:  The Modelflow‐estimated cardiac output correlated significantly with the simultaneous estimates by the Doppler method in all subjects (r = 0.87, P < 0.0001) and the SE of estimation was 1.93 L min−1. Correlation coefficients in each subject ranged from 0.91 to 0.98. Although the Modelflow method overestimated cardiac output, the errors between two estimates were not significantly different among the exercise levels. These results suggest that the Modelflow method using Portapres could provide a reliable estimation of the relative change in cardiac output non‐invasively and continuously during submaximal exercise in healthy young humans, at least in terms of the relative changes in cardiac output.
Mechanisms of NH4+ and NH3 transport during hypokalemia
Authors: Wall S. M. 
Published: December 2004

AbstractAlong the collecting duct, secretion of ammonium (NH) is thought to occur through active H+ secretion in parallel with the non‐ionic diffusion of ammonia (NH3). Thus NH3 is secreted into the collecting duct lumen down its concentration gradient. Moreover, the low NH permeability and high NH3 permeability observed in collecting duct epithelia minimizes back diffusion of NH. In general, an increase in the NH3 concentration gradient between the interstitium and the collecting duct lumen correlates with increased NH secretion. However, our laboratory and others have shown an important role of direct NH transport by the Na,K‐ATPase. As K+ and NH compete for a common extracellular binding site on the Na,K‐ATPase, reduced interstitial K+ concentration, such as during hypokalemia, augments NH uptake. Na,K‐ATPase‐mediated NH uptake provides an important source of H+ for net acid secretion during hypokalemia and contributes to the increase in NH excretion and metabolic alkalosis observed in this treatment model.