bluuebunny/crossref_metadata_2025_split huggingface dataset:
Symptoms across pregnancy in relation to psychosocial and biomedical factors
Authors: Rodriguez Alina , Bohlin Gunilla , Lindmark Gunilla 
Published: March 2003

Background.There is current interest in symptoms during pregnancy, but yet little is known about their prevalence and how often they are experienced across pregnancy. The reasons why some women experience more symptoms or experience them more often than others has received limited research attention.Objective.To document the prevalence and frequency of 27 pregnancy symptoms and to systematically investigate, cross‐sectionally and prospectively, the effect of psychosocial factors on the prevalence and frequency of these symptoms, while controlling for biomedical factors.Methods.Four hundred and seventy‐six nulliparous Scandinavian women who attended routine prenatal care in Uppsala county, Sweden, were studied six times during pregnancy (gestational weeks 10, 12, 20, 28, 32, and 36).Results.The prevalence of symptoms was high, but only a smaller portion of these symptoms were experienced frequently. Psychological stress particularly contributed to the prevalence and frequency of concurrent symptoms and predicted symptoms up to 16 weeks later, independent of medical risk, smoking, and weight gain.Conclusions.Prevalence rates may be inflated, because many symptoms were experienced only ‘occasionally’ during each of the 4‐week periods we sampled. By examining how frequently symptoms were experienced, we gained an indication of which symptoms are more likely to be bothersome or intrude upon daily activities. Psychosocial variables accounted for individual differences in symptom reports after taking biomedical factors into account. Attention to psychosocial variables in future studies will aid in our understanding of the etiology of pregnancy symptoms.
Peritoneal fluid concentrations of interleukin‐4 in relation to the presence of endometriosis, its stage and the phase of the menstrual cycle
Authors: Gazvani M. Rafet , Bates Michelle D. , Vince Gillian S. , Christmas Stephen E. , Lewis‐Jones D. Iwan , Kingsland Charles R. 
Published: March 2003

Background. Interleukin‐4 (IL‐4) is a cytokine with both stimulatory and inhibitory effects on the inflammatory system such as macrophage inhibition and T‐cell activation. It is known to regulate several monocyte functions, including inhibition of the synthesis of cytokines such as IL‐1, IL‐6 and TNF‐α as well as potentiating IL‐8.Method. In an attempt to clarify the association between IL‐4 and endometriosis, we measured the concentration of IL‐4 in the peritoneal fluid of 52 women; 24 with endometriosis and 28 with no endometriosis, controlling for the phase of the cycle and the stage of disease.Results. There was no difference in the concentrations of IL‐4 between women with (n=28) and without endometriosis (n=24). No difference was found between the IL‐4 concentrations in women with different stages of endometriosis. Levels of IL‐4 did not show a difference according to the phase of the cycle in either group.Conclusion. Our results indicate no association between peritoneal fluid levels of IL‐4 and endometriosis and hence suggest that IL‐4 is not involved in the pathogenesis of endometriosis.
Psychological distress before and after prenatal invasive karyotyping
Authors: Cederholm Maria , Sjödén Per‐Olow , Axelsson Ove 
Published: March 2003

Background. The aim was to evaluate the psychological and physical impact on women submitting to early amniocentesis or chorionic villus sampling and their preferences concerning fetal invasive procedures in a forthcoming pregnancy.Method. Fifty‐one women undergoing early amniocentesis or chorionic villus sampling at 10–13 weeks gestation participated. The women completed questionnaires including the Hospital Anxiety and Depression Scale on three occasions: before, immediately after, and one week after the invasive procedure.Results. The women were more concerned about a spontaneous abortion and waiting for the result than about a possible unreliable result. A majority of the women did not worry about the risk of fetal injury induced by the procedure. More women in the chorionic villus sampling group found the invasive procedure to be physically straining. Two‐thirds of the women experienced no or minor psychological strain but one‐third experienced major strain. Approximately 20% were classified as doubtful cases and cases of clinical anxiety. Nearly all women would choose to have an invasive procedure of the same kind in a forthcoming pregnancy.Conclusions. The psychological and physical impact on women undergoing invasive procedures for fetal karyotyping does not constitute a major clinical problem. However, a certain number of women report distress and anxiety which should be attended to by professionals involved in fetal invasive procedures. These women may benefit from more support.
Anal sphincter damage after vaginal delivery: functional outcome and risk factors for fecal incontinence
Authors: De Leeuw Jan Willem , Vierhout Mark E. , Struijk Piet C. , Hop Wim C. J. , Wallenburg Henk C. S. 
Published: March 2003

Objective. To assess the role of anal sphincter damage following delivery in the development of anorectal complaints and urinary incontinence, and to identify obstetric factors associated with subsequent fecal incontinence.Methods. The retrospective cohort study with matched controls used a postal questionnaire and analysis of delivery and operation records from all women who underwent primary repair of a third or fourth degree perineal rupture in our hospital between 1971 and 1991, and their controls, matched for date and parity. Frequencies of complaints were compared using the Mantel‐Haenszel common odds ratio [OR] for matched‐control studies. Obstetric risk factors for fecal incontinence were assessed with multivariate logistic regression analysis.Results. In the period studied, 171 women underwent a primary repair. One hundred and forty‐seven of which returned the questionnaire (86%), compared with 131 of the controls (73%). Analysis was performed on 125 matched pairs with a median follow‐up of 14 years. Fecal incontinence was reported by 39 patients and 16 controls (OR: 3.09; 95% confidence interval: 1.57–6.10). Urinary incontinence was reported by 65 cases and 52 controls (OR:1.46; 95% CI: 0.91–2.37). Among women with anal sphincter damage, the extent of anal sphincter damage was an independent risk factor for fecal incontinence. (OR: 2.54; 95% CI: 1.45–4.45). Subsequent vaginal delivery was not associated with the development of fecal incontinence (OR: 2.32; 95% CI: 0.85–6.33). In primiparous women mediolateral episiotomy protected for fecal incontinence after anal sphincter damage (OR: 0.17; 95% CI: 0.05–0.60).Conclusions. Anal sphincter damage following delivery is significantly associated with subsequent anorectal complaints, but not with urinary incontinence. The extent of sphincter damage is an independent risk factor for the development of fecal incontinence. Mediolateral episiotomy protects for fecal incontinence in primiparous women.
Diagnostic evaluation of intrauterine fetal deaths in Stockholm 1998–99
Authors: Karin Petersson , Katarina Bremme , Roger Bottinga , Alexandra Hofsjö , Ingela Hulthén‐Varli , Marius Kublickas , Margareta Norman , Nikos Papadogiannakis , Kjell Wånggren , Kerstin Wolff 
Published: March 2003

Background. To evaluate the diagnostic methods and to elucidate the etiology of intrauterine fetal death.Material and methods. A prospective study was conducted on all intrauterine fetal deaths occurring in Stockholm County in 1998–99. During a 24‐month period, 188 cases of intrauterine fetal death with gestational ages of ≥ 22 weeks were investigated in accordance with structured test protocol. All information from antenatal and delivery records as well as all test results were entered in to an Internet‐based database for continuous evaluation.Results. A presumptive explanation to the stillbirth was established in 91% of the cases. The most common factors associated with intrauterine fetal death could be identified as infections (24%), placental insufficiency/intrauterine growth restriction (22%), placental abruption (19%), intercurrent maternal conditions (12%), congenital malformations (10%), and umbilical cord complications (9%).Conclusions. A relevant test protocol in cases of intrauterine fetal death reduces the number of unexplained cases to a minimum. An Internet‐based register on test results of fetal deaths may enable a continuous evaluation of the diagnostic tools and etiologic factors in an ever‐changing panorama. The results from the present study can serve as a base for a case‐control study in Sweden.
The value of routine estradiol monitoring in assisted conception cycles
Authors: Thomas Kevin , Searle Tom , Quinn Alison , Wood Simon , Lewis‐Jones Iwan , Kingsland Charles 
Published: March 2003

Background. Traditional monitoring of an in vitro fertilization (IVF) treatment cycle includes regular estradiol levels and ultrasound scans in an attempt to reduce the risk of ovarian hyperstimulation syndrome (OHSS). The need for estradiol monitoring remains controversial.Methods. We reviewed 538 consecutive cycles of IVF that were carried out in our unit to ascertain whether routine estradiol monitoring was of help in preventing OHSS and could be used to predict treatment outcome. Two hundred and sixty‐eight patients had their ovarian response monitored with ultrasound (USS) and estradiol levels on the day of hCG administration. The following 270 had USS monitoring but only had an estradiol level checked if they were deemed to be at high risk of OHSS (> 20 follicles on USS or symptomatic).Results. Pregnancy rates per treatment cycle and per embryo transfer were similar in the two groups (all p > 0.05). There were two patients in each group requiring admission to hospital for OHSS.Conclusions. Estradiol levels did not correlate with IVF outcome. In summary therefore estradiol levels are a poor predictor of treatment success and done routinely do not reduce the incidence of OHSS. It is only necessary to measure the estradiol level in those patients at risk of OHSS on USS monitoring.
An evaluation of midwives' counseling of pregnant women in fear of childbirth
Authors: Ryding Elsa Lena , Persson Asa , Onell Cecilia , Kvist Linda 
Published: March 2003

Acta Obstet Gynecol Scand 2003; 82: 10–17. © Acta Obstet Gynecol Scand 2003Background.  The aim of this clinical evaluation was to study birth experience, post‐traumatic stress symptoms, and satisfaction with care in new mothers who had consulted specially trained midwives because of a fear of childbirth during pregnancy.Methods.  Sixty‐two women were eligible for the study, of whom 53 (85%) participated at 1–14 months postpartum. For comparison, a group of 53 women were matched for parity and mode of delivery. All 106 women completed two self‐rating scales, the Wijma Delivery Experience Questionnaire (W‐DEQ) and the Impact of Event Scale (IES), and answered several open questions about their opinion of the antenatal preparation given.Results.  Those women who had been treated for fear of childbirth reported a rather more frightening experience of delivery, and more frequent symptoms of post‐traumatic stress related to delivery than did the women in the comparison group. Nevertheless, satisfaction with care was manifest in the study group.Conclusions.  Women who seek help for fear of childbirth are a vulnerable group. Because the counseling received by the women in this study did not accord them the same positive experience of childbirth as the average parturient at the unit, more effective forms of treatment may be necessary. However, as most of the women were very satisfied with their care and with the outcome, one may assume that the care given had improved their situation to some degree.
Comparability of three‐dimensional optic disc imaging with different techniques
Authors: Gundersen Kjell Gunnar , Heijl Anders , Bengtsson Bo 
Published: March 2003

ABSTRACT.Purpose: We wanted to compare optic nerve head topography measurements and discrimination between normal and glaucomatous eyes with two entirely different three‐dimensional optic disc imaging techniques, confocal scanning laser tomography (Heidelberg Retina Tomograph, Heidelberg Engineering) and raster tomography (Glaucoma‐Scope, Ophthalmic Imaging Systems).Methods: Both eyes of 225 normal subjects and 229 eyes of 166 patients with glaucoma at different stages were imaged with the Heidelberg Retina Tomograph and the Glaucoma‐Scope. Optics discs were analysed in 15° sectors around the circumference. Depth measurements were calibrated on objects with known dimensions.Results: We observed no significant differences in absolute measurements of maximum cup depth and cup area between the two instruments. We observed small differences in absolute measurements of disc anti rim area between the two instruments. Discrimination between normal and glaucomatous eyes was close to identical for the two instruments. Both instruments had the same ability to distinguish glaucomatous regional alterations of optic nerve head topography from normal disc configuration.Conclusion: Both instruments while using entirely different principles for three‐dimensional optic disc imaging gave very similar results. This correspondence of results implies that the same optic disc parameters can be analysed, and the results interpreted similarly for both methods, and probably with other three‐dimensional imaging instruments. It may also indicate that results of studies with one of the instruments have general validity.
Corneal epithelial changes due to adenovirus type 8 infection
Authors: Tabery Helena M. 
Published: March 2003

ABSTRACT.Purpose: To investigate corneal epithelial changes in human adenovirus type 8 (Ad8) infection, and compare them with herpes simplex virus type 1 (HSV1) changes.Material and method: 12 patients with Ad8 infection: in 10 verified by tissue culture, in 2 clinically. The corneae were photographed by non‐contact photomicrography.Results: Within the first days the epithelium showed multiple elevations measuring about 20–30 μm in diameter, and from about day 5 large numbers of scattered subsurficial abnormal cells. At the end of the first week larger (about 150–200 μm in diameter) epithelial foci started to appear. No focal ulcerative changes were observed.Conclusions: The subsequent stages of Ad8 cytopathic effect are difficult to discern. The primary virus target seems to be the deeper epithelial layers. The damaged cells are probably successively transported toward the surface and desquamated. The etiology of larger focal changes is unclear. The presence (HSV1) or absence (Ad8) of ulcerative changes differentiates these two infections.
Atrial septal defect with interatrial aneurysm and Axenfeld‐Rieger syndrome
Authors: Bekir Necdet A. , Güngör Kıvanç 
Published: March 2003

ABSTRACT.Purpose: The aim of this presentation is to report a rare association between interatrial aneurysm and Axenfeld‐Rieger syndrome.Methods: We present a 20‐year‐old girl with Axenfeld‐Rieger syndrome, in whom the diagnosis was confirmed by the facial dysmorphic appearance, slit‐lamp examination, applanation tonometer, gonioscopy, and cardiovascular examination.Results: The patient had prominent Schwalbe's line in all quadrants, iris atrophy, and secondary glaucoma in both eyes. The echocardiogram revealed an atrial septal defect with interatrial aneurysm.Conclusion: This is the first case report of coexisting Axenfeld‐Rieger syndrome and interatrial aneurysm. We would like to stress that aneurysm can be a potential occult source of cerebral embolism.
Retinopathy of prematurity in a Copenhagen high‐risk sample 1997–98
Authors: Fledelius H. C. , Kjer Birgit , Rosenberg Thomas 
Published: March 2003

ABSTRACT.Purpose: From two recent materials to describe the present clinical status regarding retinopathy of prematurity in Denmark, and to outline trends over time.Methods: A) Results of regular ophthalmic surveillance of 201 clinically selected (higher risk of ROP than average) pre‐term infants of birth year 1997–98 taken care of in the two greater Copenhagen tertiary neonatal units, in an intended prospective design. Gestational age range was 24–32 weeks at delivery; birth weights 490–2200 g. Median values 28 weeks and 1090 g. B) A brief account of the latest ROP‐associated registrations of visual impairment in Danish children aged 0–17 years (n=138).Results: A) ROP was observed in 31.3% (n=201). Retinal cryotherapy was given to eleven ‘own’ cases and to two from elsewhere (n=13, gestational age at delivery 25–31 weeks). Five had cryotherapy twice. Four of the 13 were later registered for visual impairment. B) Comparing the first and the latest third of the registrations, visual impairment has dropped in frequency and severity over the period from 1981 till now.Conclusions: Compared to previous data the present clinical profile of ROP in Denmark indicates a relatively lower overall frequency of ROP and a decrease in eventual severe visual impairment. Undoubtedly, the continued refinement of neonatal care has been of relevance, but the definite decline in visual impairment further reflects a more complete ophthalmic surveillance, on a national basis. The advanced cases are generally detected in time and retinal ablation therapy offered.
Macular hole surgery without routine membrane excision or use of adjuvants
Authors: Byhr Eva , Lindblom Bertil 
Published: March 2003

ABSTRACT.Purpose: To present results of macular hole surgery without adjunctive treatment or routine membrane dissection, but with a long duration tamponade.Methods: Fifty‐one consecutive eyes underwent surgery with vitrectomy. Membrane peeling was performed only when traction was obvious. Pure perfluoropropane gas was injected as a tamponade followed by prone positioning for two weeks. All eyes were examined with scanning laser ophthalmoscopy (SLO) before and after surgery.Results: The macular hole was closed successfully in 48 eyes (94%) after one procedure. Visual acuity improved to 0.50 or more in 18 eyes (35%). Improvement of two or more lines was achieved in 35 eyes (69%). Two eyes developed retinal detachments and two eyes showed post‐operative visual field defects previously reported after macular hole surgery.Conclusion: In this series the results and complication rates compare favourably with other reports of macular hole surgery. However, in contrast to many previous studies, membrane peeling was not done. The extent and long duration of the gas tamponade was thought to be important for the surgical success.
Pars plana vitrectomy for regression of choroidal neovascularization with age‐related macular degeneration
Authors: Ikeda Tsunehiko , Sawa Hiroshi , Koizumi Kan , Yasuhara Toru , Yamasaki Toshihide 
Published: March 2003

ABSTRACT.Objective: In age‐related macular degeneration, the posterior vitreous surface often remains attached to a higher degree than expected for the patient's age, suggesting the involvement of the posterior vitreous membrane in the pathophysiology of choroidal neovascularization. Thus, we performed simple pars plana vitrectomy and artificial posterior vitreous detachment in order to induce regression of choroidal neovascularization.Methods: Vitrectomy was performed in 12 eyes of 11 patients with age‐related macular degeneration in whom the posterior vitreous surface remained attached, and in whom there was evidence of highly active choroidal neovascularization. The posterior vitreous membrane was artificially detached during surgery, but photocoagulation and/or a subretinal procedure for choroidal neovascularization was not performed. Patients underwent fluorescein and indocyanine green angiography both pre‐ and postoperatively to assess the status of choroidal neovascularization.Results: Six months after surgery, 6 of the 12 eyes showed regression of choroidal neovascularization, and in 2 eyes it had disappeared completely. Subretinal exudative changes in 8 eyes had improved. Visual acuity testing showed improved vision in 4 eyes, unchanged vision in 4 eyes, and worsening of vision in 4 eyes. The final best corrected visual acuity was 10/20 or better in one eye, 10/20 to 20/200 in 7 eyes, and 20/200 or worse in 4 eyes.Conclusion: The results of the present study suggest the involvement of the posterior vitreous membrane in the pathophysiology of age‐related macular degeneration. Furthermore, the minimally invasive pars plana vitrectomy may represent a new treatment for age‐related macular degeneration.
Diffuse retinal hemorrhages (ocular decompression syndrome) after trabeculectomy with mitomycin C for neovascular glaucoma
Authors: Danias John , Rosenbaum Jacob , Podos Steven M. 
Published: March 2003

ABSTRACT.Purpose: To describe a case of ocular decompression syndrome in a patient after trabeculectomy with mitomycin C for neovascular glaucoma.Results: Diffuse retinal hemorrhages developed in the posterior pole of a patient with neovascular glaucoma after he underwent trabeculectomy with mitomycin C. The hemorrhages persisted for less than 9 months.Conclusions: Acute decompression of the eye in patients with high intraocular pressure can lead to the development of posterior pole hemorrhages. The course of this rare syndrome is relatively benign.
Myopia profile in Copenhagen medical students 1996–98. Refractive stability over a century is suggested
Authors: Fledelius Hans C. 
Published: March 2003

ABSTRACT.Purpose: To assess the myopia prevalence and profile in today's Danish medical students and to compare the pattern with previous and contemporary investigations.Methods: As part of the tutoring in ophthalmology 1996–98 Copenhagen medical students of five successive terms (in their 10th semester, n=294) were interviewed and spot‐checked about their refraction. Myopia from −0.5 D was recorded and myopia onset age stated.Results: The age range was 22–41 years, median age 26. Myopia ranging from −0.5 to −8 D was encountered in 147 students (50% of all; females 53.9%, males 45%). In seven the myopia was unilateral. Median values for myopia degree and onset age were −2.5 D and 16 years in female myopes (n=89) which differed significantly from the male values (n=58) of −1.5 D and 18 years. Including the age of 18 as lower cut‐off for adult‐onset myopia 44.9% of the myopes belonged to this category.Conclusions: The results are in close agreement with recent Norwegian student investigations, and there is no obvious trend of a worsening of the academic myopia issue in our part of the world. This is in marked contrast to student myopia profiles as reported in Taiwan, Singapore, and Hong Kong where myopia is booming, by number and degree.
Visually impaired Swedish children. The 1980 cohort study; aspects on mortality
Authors: Blohmé Jonas , Tornqvist Kristina 
Published: March 2003

ABSTRACT.Purpose: Assessment of the burden of mortality in a cohort of visually impaired children in a geographically defined area.Methods: A 19‐year follow‐up of medical records and death certificates.Results and conclusions: Of the initial 128 patients, born 1962–76, 17 (13%) had died, giving a highly significant increase in mortality compared to the equivalent age‐specific Swedish population (p‐value <0.000001). All deceased had additional impairments. Respiratory causes of death were found in 12/17 cases. The primary ophthalmological diagnosis was cerebral visual impairment in 8 cases, optic atrophy in 6 cases, one each of congenital cataract, microphthalmus and chorioretinitis. A more pronounced level of visual impairment gave an increased risk of mortality. A significantly higher mortality rate among multiply impaired was seen in the combined group with ‘childhood blindness’ (visual acuity <0.05) and `visual impairment, undetermined or unknown' opposed to the group with ‘low vision’ (visual acuity 0.05–<0.3) (p=0.047).