bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does the fetus lose weight in utero following fetal death: a study in preterm infants
Authors: Chard Tim 
Published: December 2003

Objective To evaluate whether the fetus loses weight in utero following fetal death, looking specifically at weight differences according to whether the death occurred during labour or before labour.Design Record linkage of maternity data and perinatal mortality data.Setting Scotland, UK.Population A group of 8069 singleton live and stillbirths without obvious congenital abnormalities delivered at 24–32 weeks.Main outcome measure Birthweight.Results Stillborn infants weighed less than liveborns of equivalent gestational age at delivery. Stillborn infants in whom the death occurred during labour weighed more than those in whom the death occurred before labour; this applied to both vaginal deliveries and those by caesarean section.Conclusions These findings could be attributed to the hypothesis that the low birthweight of stillborn infants is due to weight loss following the death, in addition to any process of growth restriction before the death. The analysis described here contains no data which would negate this hypothesis.
The development of a national database of the results of surgery for urinary incontinence in women
Authors: Kulseng‐Hanssen Sigurd 
Published: December 2003

Objective
To describe the development of a national network, database and reporting of data from a short‐form questionnaire recording the severity of symptoms, quality of life and objective outcome values pre‐ and post‐operatively, in women with stress and mixed incontinence.Design
A prospective descriptive study.Setting
Twenty‐three Norwegian departments of gynaecology.Participants
Eight hundred and eighty‐three women with stress and mixed incontinence.Methods
A short‐form questionnaire was used to record the severity of symptoms, quality of life and objective outcome values pre‐ and post‐operatively, in women with stress and mixed incontinence. Type of operation, the performance of a combined vaginal prolapse operation and an incontinence procedure and complications were recorded. The questionnaires were scanned and data were transferred to a national database. Twice a year the participating departments received a report where their own data were compared with the national average.Main outcome measures
Pre‐ and post‐operative Stress, Urge and Quality of Life Indices, Satisfactioin with the operation. Post‐operative mean Stress, Urge and Quality of Life Indices, leakage during stress test, and satisfaction with the operation, related to number of operations performed by each surgeon.Results
Eighty‐four percent of the operations performed were with the tension‐free vaginal tape operation and 13% were abdominal Burch colposuspensions. The post‐operative Stress and Urge Incontinence Indices and Quality of Life Index and all the objective outcome values except for the mean voiding volume were significantly lower than they were pre‐operatively. Eighty‐four percent of the women were very satisfied, 8% were moderately satisfied, 2% were neither satisfied nor dissatisfied, 3% were moderately dissatisfied and 2% were very dissatisfied with the operation. Women who had a tension‐free vaginal tape operation performed were significantly more satisfied, were leaking significantly less, had significantly lower stress incontinence and quality of life indices and had significantly less superficial infections post‐operatively than women who had had a Burch colposuspension. Surgeons performing fewer than 25 operations had a large variation in their results.Conclusion
A large number of Norwegian gynaecological departments are reporting to the database. The questionnaire and the objective outcome values are well suited to record the effect of incontinence operations and to make comparisons between surgical procedures, surgeons and departments.
The development of a questionnaire to measure the severity of symptoms and the quality of life before and after surgery for stress incontinence
Authors: Kulseng‐Hanssen Sigurd , Borstad Ellen 
Published: December 2003

Objectives
To develop and validate a short questionnaire recording the severity of symptoms and the quality of life, pre‐ and post‐operatively, in women undergoing surgery for stress incontinence.Design
The questionnaire was designed from previously designed questionnaires and pilot studies. In this study, it was tested for validity and reliability using standard psychometric techniques. Data from the questionnaire are reported to a national database, which generates reports for comparison of surgical procedures, departments and surgeons.Setting
Tertiary referral urogynaecology units at Bærum and Aker Hospitals, Norway, and 22 Norwegian departments of gynaecology.Population
Fifty and 65 women with stress incontinence from Bærum and Aker hospitals, respectively, and 628 women with stress incontinence from 22 Norwegian departments of gynaecology.Methods
Stress Incontinence, Urge Incontinence and Quality of Life Indices were constructed. Internal consistency of the indices was measured by Cronbach's alpha and test–retest reliability by Bland–Altman plots. Stress Incontinence Index was tested against stress test and Urge Incontinence Index and Stress Incontinence Index were tested against the 24‐hour pad test. Quality of Life Index was tested against a part of the King's College Hospital Quality of Life Questionnaire.Main outcome measure
Face and content validity. Missing velues of the questionnaire. Reliability and internal consistency. Criterion validity.Results
The 628 women completed a mean of 98.2% of all the questions. The content validity was good. The reliability was good in terms of test–retest reliability and internal consistency. The criterion validity of stress and urge incontinence was tested against the stress and 24 hour pad tests. The correlation between the indices and the objective tests was moderate. The correlation between the Quality of Life Index and the physical and social part of the previously validated King's College Hospital questionnaire was good.Conclusions
The questionnaire is easy to understand and complete and is a valid and reliable instrument for assessment of the symptoms of incontinence and the quality of life. Pre‐ and post‐operative evaluation of women with stress incontinence was performed in a standardised setting in 22 of the 37 Norwegian departments and the reporting to a national database was successful. Comparison of surgical procedures, departments and surgeons is possible.
Colonisation of extragenital sites by Candida in women with recurrent vulvovaginal candiosis
Authors: Mårdh Per‐Anders , Novikova Natalia , Stukalova Elena 
Published: December 2003

Objectives
To study colonisation of extragenital sites by Candida in women with a history of recurrent vulvovaginal candidosis and to determine the association of such colonisation with clothing and sexual practice.Design
A prospective case–control (current genital colonisation by candida organisms vs non‐colonisation) study.Setting
Outpatient clinic, University hospital, Kiev, Ukraine and Department of Obstetrics and Gynaecology, University Hospital, Lund, Sweden.Sample
Women with a history of recurrent vulvovaginal candidosis and an assumed new attack of the condition.Methods
Eighty‐six women with a history of recurrent vulvovaginal candidosis and an assumed current attack of this condition underwent culture for Candida from the genital tract, the perianal skin, the rectum, the mouth and from voided urine samples, using Sabouraud and chromogenic agar. The women were interviewed about some factors that have been considered to trigger colonisation with Candida spp.Main outcome measures
Colonisation of extragenital sites of women with recurrent vulvovaginal candidosis by different species of Candida. Correlation with oral and anal sex, and with clothing.Results
Candida spp. was isolated from the mouth, the rectum, the perianal skin and from voided urine in 11(13%), 24(28%), 35(41%) and 16(19%) of women, respectively. Candida was recovered from one or more of these sites in 44(51%) of the women. The rate of culture of Candida from the extragenital sites was significantly higher (P < 0.05) in women who had a positive culture from the introitus or the vagina. The recovery rates of Candida in the 46 vaginal culture‐positive women were 8 (17%), 24 (52%), 34 (74%) and 16 (35%) from the extragenital sites in the order mentioned. Species of Candida other than Candida albicans occurred more often at the extragenital than the genital sites. Neither oral nor anal sex was associated with colonisation of the mouth and the rectum with Candida spp. Neither tight‐fitting trousers nor underwear produced from synthetic material was associated with colonisation of the perianal skin with Candida spp.Conclusions
Extragenital sites are often colonised by Candida spp. in women with a history of recurrent vulvovaginal candidosis, but significantly more often if the genital tract is also colonised. Extragenital sites are significantly more commonly colonised with species other than C. albicans. Extragenital sites may be reservoirs for recolonisation of the genital tract in women with recurrent vulvovaginal candidosis. This has implications for treatment.
Acute increase in femoral artery resistance in response to direct physical stimuli in the human fetus
Authors: Smith Richard P. , Glover Vivette , Fisk Nicholas M. 
Published: December 2003

Objective
To determine whether fetal response to needling resembles the fetal ‘brain sparing’ response seen with hypoxaemia.Design
Prospective observational study.Setting
Centre for Fetal Care, Queen Charlotte's and Chelsea Hospital, London.Population
Eighty‐five pregnant women undergoing invasive procedures associated with fetal prenatal diagnosis and/or management.Methods
The femoral artery and the middle cerebral artery pulsatility index were measured by Doppler ultrasonography before and after 89 invasive procedures (fetal blood sampling, transfusion, bladder or cyst aspiration, shunt insertion and amniocentesis, between 17 and 36 weeks). Cases in which the fetal body was transgressed were compared with ‘control’ fetuses undergoing invasive procedures which did not directly involve needling the fetus (amniocentesis and placental cord insertion procedures).Main outcome measures
Femoral artery and middle cerebral artery pulsatility index.Results
The femoral artery pulsatility index rose after transgression [median change (Δ) 0.73; 95% confidence interval (CI) 0.51 to 0.98]. In contrast, there was no significant change in femoral artery pulsatility index after non‐transgression procedures (mean Δ 0.28; 95% CI −0.20 to 0.76). Analysis confirmed the fall in middle cerebral artery pulsatility index after transgression procedures (median Δ−0.19; 95% CI −0.07 to −0.35), but there was also a significant fall in middle cerebral artery pulsatility index after non‐transgression procedures (mean Δ−0.47; 95% CI −0.23 to −0.71).Conclusions
The human fetus mounts a peripheral haemodynamic response to invasive procedures involving transgression of the fetal body, which is consistent with the brain sparing effect. However, the change in middle cerebral artery pulsatility index in both transgression and control procedures suggests that the changes and mechanisms may be more complex than previously thought.
IDentify, Educate and Alert (IDEA) trial: an intervention to reduce postnatal depression
Authors: Webster Joan , Linnane John , Roberts Janice , Starrenburg Susan , Hinson Janis , Dibley Linda 
Published: December 2003

Objective
To test the effectiveness of a prenatal intervention in reducing the incidence of postnatal depression.Design
A randomized controlled trial.Setting
A large metropolitan obstetric hospital.Population or sample
Pregnant women with risk factors for postnatal depression.Methods
Women attending their first prenatal visit at the Royal Women's Hospital, Brisbane, were screened for risk factors for postnatal depression (IDentify). Positively screened women were randomly allocated to the intervention group or the control group. The intervention consisted of a booklet about postnatal depression, which included contact numbers; prenatal screening using the Edinburgh Postnatal Depression Scale; a discussion with the woman about her risk of developing postnatal depression (Educate); and a letter to the woman's referring general practitioner and local Child Health Nurse, alerting them of the woman's risk for postnatal depression (Alert).Main outcome measure
Edinburgh Postnatal Depression Scale Score> 12 at 16 weeks postpartum.Results
Of the 509 women who were sent a follow up questionnaire, 371 (72.9%) responded. The proportion of women who reported an Edinburgh Postnatal Depression Scale score of>12 was 26%. There were no significant differences between intervention (46/192, 24%) and control groups (50/177, 28.2%) on this primary outcome measure (OR 0.80; 95% CI 0.50–1.28).Conclusion
Over one‐quarter of women with risk factors will develop postnatal depression. It is a treatable disorder but under‐diagnosis is common. Efforts to reduce postnatal depression by implementing interventions in the prenatal period have been unsuccessful.
A systematic review of training in acute obstetric emergencies
Authors: Black Rebecca S. , Brocklehurst Peter 
Published: December 2003

Objective
To describe models used for the training of labour ward personnel in acute obstetric emergencies and to describe how these models have been evaluated and compared.Design
A systematic review of the following databases: Medline, the Cumulative Index of Nursing and Allied Health Literature, Embase, PsycLit, Allied and Alternative Medicine, Education Resources Information Center and the Cochrane Library using a structured search strategy.Setting
Labour ward.Population or Sample
Labour ward personnel.Inclusion criteria
All papers that described or evaluated any form of drill or training in acute obstetric emergencies involving any personnel in a labour ward environment were included. Descriptions of training in developing countries were excluded.Methods
Papers were classified as editorials or commentaries, papers describing a training programme or papers evaluating a training method. A data collection form was used to extract relevant information by two investigators independently.Main outcome measure
Description of training models.Results
Of 44 relevant papers, 22 were classed as editorials or commentaries. Six descriptions of training programmes were found and four papers involved an evaluation of such programmes. All evaluations involved the use of questionnaires to course participants. No studies comparing one form of training with another were found.Conclusions
With regard to training in acute obstetric emergencies, few training programmes have been described, and even fewer have been evaluated. Training methods need to be developed, described and evaluated; further well‐conducted research for this important intervention is urgently required.
Placental edge to internal os distance in the late third trimester and mode of delivery in placenta praevia
Authors: Bhide Amarnath , Prefumo Federico , Moore Jessica , Hollis Brian , Thilaganathan Basky 
Published: December 2003

Objectives
To correlate transvaginal ultrasound findings with mode of delivery in cases of placenta praevia.Design
Cohort study.Setting
A London Teaching Hospital.Methods
Retrospective review of all cases of placenta praevia diagnosed by transvaginal ultrasound between February 1997 and March 2002.Main outcome measures
Likelihood of vaginal delivery and major obstetric haemorrhage.Results
A total of 121 pregnancies were studied with a mean scan‐to‐delivery interval of 10.5 days. In the 64 women who laboured, the likelihood of vaginal delivery rose significantly as the placental edge to internal os distance increased. Caesarean section rate was 90% when the placental edge–internal os distance was 0.1 to 2.0 cm, falling to 37% when this measurement was over 2.0 cm (P < 0.00045).Conclusion
Trial of vaginal delivery is appropriate in cases with a placental to internal os distance>2 cm. The term ‘praevia’ should be restricted to cases where the placental edge is ≤2 cm from the internal os, as the likelihood of operative delivery and significant postpartum haemorrhage is high. Cases where the placenta is more than 2 cm from the internal os have a greater than 60% chance of vaginal delivery and should be defined as ‘low lying’ in order to reduce the clinician's bias towards operative delivery.
FE 200 440: a selective oxytocin antagonist on the term‐pregnant human uterus
Authors: Nilsson Lotta , Reinheimer Torsten , Steinwall Margareta , Åkerlund Mats 
Published: December 2003

Objective
To compare a newly developed oxytocin antagonist, FE 200 440, with atosiban and ANTAG III, as to potency and selectivity of inhibitory effects on oxytocin‐ and vasopressin‐induced myometrial responses. FE 200 440 has high affinity for the human cloned oxytocin receptor, approximately 300‐fold that for the vasopressin V1a receptor, whereas atosiban binds well to both receptors.Design
In vitro study of human myometrial contractility.Setting
The Research Laboratory of the Department of Obstetrics and Gynecology, Lund University Hospital, Sweden.Participants
Forty‐seven term‐pregnant women not in labour who were delivered by caesarean section.Interventions
Concentration–response curves with oxytocin and arginine vasopressin on isolated myometrial strips were recorded in control experiments, in the presence of atosiban in concentrations of 25, 250 and 750 nmol/L, and after pretreatment with ANTAG III and FE 200 440, both in concentrations of 2.5, 25 and 250 nmol/L.Main outcome measure
pA2 values (i.e. an index of inhibitory action).Results
With oxytocin as the agonist, the median pA2 values for atosiban, ANTAG III and FE 200 440 were 10.6, 9.5 and 8.3, respectively. With vasopressin as the agonist, the pA2 values for atosiban and ANTAG III were 8.8 and 8.7, whereas no inhibitory effect of FE 200 440 was seen in five out of six experiments.Conclusion
The new analogue FE 200 440 is a selective oxytocin antagonist and, in contrast to atosiban and ANTAG III, has practically no effect on vasopressin‐induced contractions of isolated term‐pregnant human myometrium.
The WHO classification of MDS does make a difference
Authors: Howe Robert B. , Porwit-MacDonald Anna , Wanat Robert , Tehranchi Ramin , Hellström-Lindberg Eva 
Published: December 2003

Abstract
The purpose of this study was to determine the facility and reliability of the World Health Organization (WHO) classification of myelodysplastic syndromes (MDSs) with several observers reviewing the same diagnostic specimens. We also wanted to determine if the WHO classification provided additional information about predictability of clinical response outcome. To accomplish these goals we reviewed 103 previously diagnosed cases of low-risk MDS. We found 92% interobserver agreement (P &lt; .001). Sixty-four of these patients had been entered into clinical trials using growth factors by the Nordic MDS Study Group. The WHO classification reliably predicted therapeutic response to the combination of granulocyte colony-stimulating factor (G-CSF) and erythropoietin (Epo). The response rate differed significantly between refractory anemia with ringed sideroblasts (RARS) and refractory anemia with multilineage dysplasia and ringed sideroblasts (RCMD/RS) with regard to therapeutic response (75% versus 9%; P = .003). Also, in the group of patients with less than 5% marrow blasts, there was a difference in median survival between patients with unilineage dysplasia (51% surviving at 67 months) and those with multilineage dysplasia (median survival, 28.5 months; P = .03). (Blood. 2004;103:3265-3270)
Morphological and functional maturation of a skeletal muscle regulated by juvenile hormone
Authors: Rose Uwe 
Published: December 2003

SUMMARYReproductive behaviour of animals requires a well-adapted muscular system. This study examines the structural and functional development of ovipositor muscle properties in female locusts during reproductive development. A possible regulation by juvenile hormone (JH) was assessed by comparing muscle properties in immature and mature females and with those whose JH production was inhibited by allatectomy early in adult life. The results are related to the reproductive behaviour of locusts.Histological and ultrastructural comparison of muscle fibres and their associated cuticular structures (apodemes) revealed dramatic growth during the first 2 weeks of reproductive development. The cross-sectional area of muscle fibres increased sevenfold, and their mass-per-length 5.3-fold. Ultrastructural examination showed growth of mitochondria, development of sarcoplasmic reticulum and increasing levels of structural organisation of myofibrils. Muscles of mature females displayed pronounced fatigue resistance,contracted more powerfully (twitch, 33.22±10.8 mN; 50 Hz,623.66±115.77 mN) and had almost two times faster kinetics than those of immature females (twitch, 6.5±2.6 mN; 50 Hz, 14.19±2.58 mN). Together with muscular maturation, cuticular apodemes, which serve as attachment sides for ovipositor muscles, grow considerably in length and width and assume a complex surface structure. Most of the described changes were suppressed in females deprived of JH (allatectomised). The results demonstrate an adaptation of muscle properties to the requirements of reproductive behaviour that is largely regulated by juvenile hormone.
Walking and running in the red-legged running frog,Kassina maculata
Authors: Ahn A. N. , Furrow E. , Biewener A. A. 
Published: December 2003

SUMMARYAlthough most frog species are specialized for jumping or swimming, Kassina maculata (red-legged running frog) primarily uses a third type of locomotion during which the hindlimbs alternate. In the present study,we examined Kassina's distinct locomotory mode to determine whether these frogs walk or run and how their gait may change with speed. We used multiple methods to distinguish between terrestrial gaits: the existence or absence of an aerial phase, duty factor, relative footfall patterns and the mechanics of the animal's center of mass (COM). To measure kinematic and kinetic variables, we recorded digital video as the animals moved over a miniature force platform (N=12 individuals). With respect to footfall patterns, the frogs used a single gait and walked at all speeds examined. Duty factor always exceeded 0.59. Based on COM mechanics, however, the frogs used both walking and running gaits. At slower speeds, the fluctuations in the horizontal kinetic energy (Ek) and gravitational potential energy (Ep) of the COM were largely out of phase,indicating a vaulting or walking gait. In most of the trials, Kassinaused a combined gait at intermediate speeds, unlike cursorial animals with distinct gait transitions. This combined gait, much like a mammalian gallop,exhibited the mechanics of both vaulting and bouncing gaits. At faster speeds,the Ek and Ep of Kassina's COM were more in phase, indicating the use of a bouncing or running gait. Depending on the definition used to distinguish between walking and running, Kassina either only used a walking gait at all speeds or used a walking gait at slower speeds but then switched to a running gait as speed increased.