bluuebunny/crossref_metadata_2025_split huggingface dataset:
The clinical application of a dual head gamma camera with coincidence detection in 20 women with suspected ovarian cancer
Authors: Lieberman G. , MacLean A.B. , Buscombe J.R. , Hilson A.J.W. , Adamson K. , Reid W.M. , Green A. , Begent R.H. 
Published: December 2003

Objective
To assess the effectiveness of a dual head coincidence gamma camera in identifying ovarian cancer as a less expensive alternative to the traditional 2‐[18F] fluoro‐2‐deoxy‐D‐glucose (18FDG) system using positron emission tomography.Design
Prospective study.Population
Twenty consecutive women suspected of having ovarian carcinoma. Inclusion was based on abnormal serum CA125 (reference range is 0–35 units/L), ultrasound, computerised tomography or clinical findings.Methods
Women underwent assessment before staging laparotomy. Two nuclear medicine physicians, who were blinded to the pre‐operative assessment, reported on 18FDG‐ dual head coincidence gamma camera imaging.Main outcome
measures The histology and operative staging were compared with the 18FDG‐ dual head coincidence gamma camera findings.Results
Twelve women had pelvic malignancies (nine primary and three recurrences), seven women had benign pathology and one patient had a borderline malignancy. We were able to image accurately all malignant pelvic masses with dual head coincidence gamma camera, as well as accurately demonstrate disease spread. Two of the benign pelvic masses localised 18FDG. The positive predictive value for detecting malignancy was 86%.Conclusions
Dual head coincidence gamma camera offers accurate and affordable imaging in suspected ovarian masses, with improved specificity over CA125, ultrasound and computerised tomography. These results are similar to those obtained on more expensive dedicated PET systems. We report on a series of patients believed to have primary or recurrent carcinoma and recognise the need to include patients more likely to have benign lesions to assess false positive results. However, we believe that dual head coincidence gamma camera is useful in the pre‐operative assessment of women with suspected ovarian cancer.
Overview of the relationship between use of progestogen‐only contraceptives and bone mineral density
Authors: Banks Emily , Berrington Amy , Casabonne Delphine 
Published: December 2003

Objectives
To summarise the available epidemiological evidence regarding the relationship between the use of progestogen‐only contraceptives and bone mineral density.Design and methods
Overview of the published epidemiological literature.Results
Overall, 17 studies of the use of progestogen‐only contraceptives and bone mineral density were identified, involving 1529 women exposed to progestogen‐only contraceptives and 2086 controls. Sixty‐eight percent of the data relate to the effects of use of depot medroxyprogesterone acetate. Average bone mineral density was reduced in current users of depot medroxyprogesterone acetate compared with non‐users, although density in users was within one standard deviation of the mean in non‐users. There was significant heterogeneity between the results of different studies (P<0.0001). The reduction in bone mineral density appeared to be greater at the lumbar spine, femoral neck and ultradistal forearm than at the midshaft of the ulna. Studies involving women with a longer average duration of use of depot medroxyprogesterone acetate displayed greater reductions in bone mineral density compared with studies of women with shorter durations of use. Based on limited data, no difference in bone mineral density was observed between former and never users of depot medroxyprogesterone acetate. Results regarding the effect of levonorgestrel implants were conflicting. Studies of progestogen‐only oral contraceptives and the progesterone vaginal ring were small and restricted to lactating women.Conclusions
Women currently using depot medroxyprogesterone acetate have a lower average bone mineral density than non‐users. The magnitude of this effect is uncertain but appears to be greater with longer durations of use.
Oxidative stress in the fetal lamb brain following intermittent umbilical cord occlusion: a path analysis
Authors: Rogers Michael Scott , Murray Henry George , Wang Chi Chiu , Pennell Craig E , Turner Anita , Yan Ping , Pang Calvin C. P. , Chang Allan M. Z. 
Published: December 2003

Objective
To evaluate the relative contribution of cord occlusion length intervals between occlusions and experimental duration on oxidative stress in the fetal lamb brain.Design
Acute, partially exteriorised fetal lambs with intermittent total cord occlusion.Setting
The Vivarium of Westmead Hospital, University of Sydney, Australia and The Chinese University of Hong Kong.Main
outcome measures Arterio‐venous differences in the concentration of organic hydroperoxides, measured in paired samples of carotid arterial and jugular venous blood, as an index of oxidative stress in the brain.Methods
Thirty‐two fetal lambs were exposed to graded hypoxia, induced by intermittent total umbilical cord compression of 30 seconds, 60 seconds and 90 seconds duration, occurring every minute for a total of 27 occlusions over 81 minutes. Three sham experiments were also performed. In addition to organic hydroperoxides, carotid arterial blood samples were also assayed in 15 animals (two sham) for oxygen saturation, pH, hypoxanthine, xanthine and urate concentrations. A causal model for oxidative stress was defined: occlusions leading to hypoxia with a rise in hypoxanthine; reperfusion during intervals between occlusions leading to the accelerated production of xanthine and uric acid and the generation of oxygen free radicals, which in turn, are responsible for the rise in lipid peroxidation. Path analysis was performed to assess the strength of the relationships between these variables and the cord occlusion length, the interval between occlusions and the duration of the experiment.Results
Sham experiments showed no change in organic hydroperoxide production. Following 30‐second umbilical cord occlusions a sixfold drop in mean organic hydroperoxides was observed between carotid arterial and jugular venous levels. In contrast, following occlusions of 60 seconds duration (or longer) a median 20‐fold increase in organic hydroperoxide production was observed. Path analysis revealed a strong indirect pathway from occlusion length → hypoxanthine → urate and weak positive pathways from oxygen saturation→ urate and from interval between occlusions → urate. After accounting for these pathways reflecting oxidative stress, a strong direct path remained from time from first occlusion → organic hydroperoxide production.Conclusions
Peroxidation of lipids in the brain occurs under conditions of severe hypoxia and reperfusion associated with intermittent umbilical cord occlusions of 60 seconds or longer. The path analysis supported the causal model as originally defined, with the exception that the indirect pathway via pH was found to be trivial.
Factor V Leiden and G20210A prothrombin mutations are risk factors for very early recurrent miscarriage
Authors: Reznikoff‐Etiévant M.F. , Cayol V. , Carbonne B. , Robert A. , Coulet F. , Milliez J. 
Published: December 2003

Objective
To determine whether there is an association between early recurrent miscarriage (before 10 weeks of pregnancy) and Factor V Leiden and G20210A prothrombin mutations.Design
A prospective study.Setting
Department of Gynaecology and Obstetrics, Saint Antoine Hospital, Paris, France.Population
Two groups of women: those with early unexplained recurrent miscarriage before 10 weeks of pregnancy (n=260) and control healthy women without a previous history of thromboembolism (n=240).Methods
Screening for defects in the protein C anticoagulant pathway was performed using the anticoagulant response to agkistrodon confortrix venom (ACV test). Protein C and Factor V Leiden mutation testing was performed for each low ACV level. Each sample was tested for the G20210A prothrombin mutation.Results
Factor V Leiden and G20210A mutations were found to be associated with early recurrent spontaneous miscarriage before 10 weeks of pregnancy, the odds ratios being 2.4 (95% CI 1–5) and 2.7 (95% CI 1–7), respectively. Similar results were found whether or not women had had a previous live birth.Conclusions
Early recurrent miscarriage before 10 weeks of pregnancy is significantly associated with Factor V or G20210A prothrombin mutations. These results indicate a possible role for anticoagulant prevention in these early miscarriages.
Objective assessment of bladder neck elevation and urethral compression at colposuspension
Authors: Bombieri L. , Freeman R.M. , Perkins E.P. , Williams M.P. , Shaw S.R. 
Published: December 2003

Objectives
1. To assess whether magnetic resonance imaging and intra‐operative measurements are useful in assessing bladder neck elevation and urethral compression at colposuspension; 2. to see if intra‐operative measurements could be a substitute for magnetic resonance scan measurements.Design
Prospective, observational study.Setting
Urogynaecology Unit, NHS Trust hospital.Population
Seventy‐seven women undergoing colposuspension.Methods
Bladder neck elevation was assessed using magnetic resonance imaging and measuring the amount of suture bow‐stringing intra‐operatively. Urethral compression was assessed using magnetic resonance imaging and by two intra‐operative measurements: the distance between the medial sutures (with a ruler) and the distance between the urethra and the pubic bone (using paired Hegar dilators).Results
The assessment of bladder neck elevation and compression against the pubic bone using magnetic resonance imaging was reliable (95% limits of agreement: −7.1mm to +7.1mm and −1.7mm to +3.8mm, correlation coefficient 0.92 and 0.87, respectively). The intra‐operative assessment of urethral compression with a ruler was also reproducible at both paravaginal and pectineal sites (95% limits of agreement −2.6mm to +2mm and −2.1mm to +2.4mm, respectively; correlation coefficient 0.99 for both distances). Other intra‐operative measurements of bladder neck elevation (suture bow‐stringing) and urethral compression (Hegars) did not correlate with equivalent magnetic resonance scan measurements (kappa =−0.046, P= 0.31; kappa = 0.052, P= 0.41, respectively).Conclusions
Measurements have been found that can reliably assess bladder neck elevation and urethral compression at colposuspension. These measurements should be suitable for investigating morbidity following colposuspension.
Why do women have voiding dysfunction and de novo detrusor instability after colposuspension?
Authors: Bombieri L. , Freeman R.M. , Perkins E.P. , Williams M.P. , Shaw S.R. 
Published: December 2003

Objective
To investigate the causes of voiding dysfunction and new detrusor instability after colposuspension.Design
Prospective, observational study.Setting
Urogynaecology unit, district general hospital.Population
Seventy‐seven women undergoing colposuspension for genuine stress incontinence.Methods
The following factors were investigated: 1. bladder neck elevation by magnetic resonance imaging before and after surgery; 2. urethral compression by measuring bladder neck approximation to the pubis with magnetic resonance imaging after surgery (anterior compression) and the distance between the medial stitches during surgery (lateral compression); 3. clinical and urodynamic factors.Main outcome measures
1. Post‐operative voiding function (i.e. first day of voiding and day of catheter removal); 2. objective evidence of detrusor instability three months post‐operatively.Results
Pre‐operative peak flow rate (P= 0.004), straining during voiding (P= 0.005), increasing age (P< 0.001), operative elevation (P< 0.001) and anterior urethral compression (P= 0.001) were associated with the number of days of post‐operative catheterisation. Increasing age (P= 0.02), previous bladder neck surgery (P= 0.04), operative elevation (P= 0.049) and anterior urethral compression (P< 0.001) were associated with detrusor instability at three months.Conclusion
Surgical factors (bladder neck elevation and compression) are associated with voiding dysfunction and detrusor instability after colposuspension. These findings have implications for prevention.
A randomised controlled trial of the closure or non‐closure of peritoneum at caesarean section: effect on post‐operative pain
Authors: Rafique Z. , Shibli K.U. , Russell I.F. , Lindow S.W. 
Published: December 2003

Objective
To compare the analgesic requirement in the post‐operative period after closure or non‐closure of the peritoneum at the caesarean delivery with a standardised anaesthetic and surgical technique.Design
A randomised double‐blind controlled trial was performed on 100 women who underwent elective caesarean delivery.Main outcome measures
Analgesic requirement assessed by morphine usage via patient controlled analgesia pump over the first 24‐hour period after surgery, oral analgesia used during the first four days, post‐operative pain assessed by a visual analogue scale and a verbal rating scale, and patient satisfaction assessed by verbal rating scale were the main outcome measures.Results
Pain scores at 24 hours were similar in both groups (43.5 in closure and 40.5 in non‐closure) but during the first 24 hours the non‐closure group had used significantly less morphine than the closure group (0.64mg/kg of body weight vs 0.82mg/kg, P= 0.04). The patients in non‐closure group had significantly higher satisfaction scores after 24 hours than the closure group.Conclusion
Non‐closure of both visceral and parietal peritoneum at the caesarean section produces a significant reduction in the post‐operative use of patient controlled analgesia pump morphine and significantly higher patient satisfaction at 24 hours post‐operatively.
Is there an increased maternal–infant prevalence of Factor V Leiden in association with severe pre‐eclampsia?
Authors: Currie Lea , Peek Michael , McNiven Michelle , Prosser Ian , Mansour Julia , Ridgway Jennifer 
Published: December 2003

Objective
To compare the prevalence of the Factor V Leiden mutation in children and maternal–infant pairs in pregnancies affected by severe pre‐eclampsia with unmatched normal controls.Design
Prospective cohort study.Setting
Department of Women's and Children's Health, The Canberra Hospital, Garran, ACT, Australia.Sample
Forty‐eight maternal–infant pairs where the index pregnancy was affected by severe pre‐eclampsia; 46 unmatched maternal–infant pairs where the index pregnancy was defined as normal.Methods
DNA analysis of cheek swab samples obtained from maternal–infant pairs for the Factor V Leiden mutation.Main outcome measure
The prevalence of the Factor V Leiden mutation in mothers, infants and maternal–infant pairs in association with severe pre‐eclampsia compared with unmatched controls.Results
No difference was detected in the prevalence of Factor V Leiden mutation between the women and children of both groups, nor the maternal–infant pairs from each group.Conclusions
No evidence was found of an increased prevalence of the Factor V Leiden mutation in either the mothers or children in association with severe pre‐eclampsia. This result argues against a Factor V Leiden fetal or maternal contribution to the development of severe pre‐eclampsia.
Definition of a type of abnormal vaginal flora that is distinct from bacterial vaginosis: aerobic vaginitis
Authors: Donders Gilbert G.G. , Vereecken Annie , Bosmans Eugene , Dekeersmaecker Alfons , Salembier Geert , Spitz Bernard 
Published: December 2003

Objective
To define an entity of abnormal vaginal flora: aerobic vaginitisDesign
Observational study.Setting
University Hospital Gasthuisberg, Leuven, BelgiumSample
631 women attending for routine prenatal care or attending vaginitis clinic.Methods
Samples were taken for fresh wet mount microscopy of vaginal fluid, vaginal cultures and measurement of lactate, succinate and cytokine levels in vaginal fluid. Smears deficient in lactobacilli and positive for clue cells were considered to indicate a diagnosis of bacterial vaginosis. Aerobic vaginitis was diagnosed if smears were deficient in lactobacilli, positive for cocci or coarse bacilli, positive for parabasal epithelial cells, and/or positive for vaginal leucocytes (plus their granular aspect)Results
Genital complaints include red inflammation, yellow discharge, vaginal dyspareunia. Group B streptococci, escherichia coli, staphylococcus aureus and trichomonas vaginalis are frequently cultured. Vaginal lactate concentration is severely depressed in women with aerobic vaginitis, as in bacterial vaginosis, but vaginal succinate is not produced. Also in contrast to bacterial vaginosis, aerobic vaginitis produces a host immune response that leads to high production of interleukin‐6, interleukin‐1‐β and leukaemia inhibitory factor in the vaginal fluidConclusion
Aerobic vaginitis is associated with aerobic micro‐organisms, mainly group B streptococci and E. coli. Its characteristics are different from those of bacterial vaginosis and elicit an important host response. The most severe form of aerobic vaginitis equals desquamative inflammatory vaginitis. In theory, aerobic vaginitis may be a better candidate than bacterial vaginosis as the cause of pregnancy complications, such as ascending chorioamnionitis, preterm rupture of the membranes and preterm delivery
Women's perceptions and experiences of routine enquiry for domestic violence in a maternity service
Authors: Bacchus Loraine , Mezey Gill , Bewley Susan 
Published: December 2003

Objective
A qualitative study examining women's perceptions and experiences of routine enquiry for domestic violence in a maternity service.Design
Purposive sampling was used to select a sub‐sample from a larger group of women who participated in a domestic violence in pregnancy screening study undertaken at Guy's and St Thomas' Hospitals in London.Setting
Interviews were conducted in women's homes and general practitioner's surgeries.Sample
Ten women who experienced domestic violence in the last 12 months (including pregnancy), six women who experienced domestic violence in the last 12 months, but not in pregnancy, and 16 women with no history of domestic violence.Methods
Semi‐structured interviews conducted during the postpartum period (up to 14 months).Main outcome measures
Women's views on the acceptability and relevance of routine enquiry for domestic violence.Results
Routine enquiry for domestic violence in maternity settings is acceptable to women if conducted in a safe, confidential environment by a trained health professional who is empathic and non‐judgemental. The effectiveness of routine enquiry to elicit a history of domestic violence is influenced by factors such as lack of time, confidential consulting time, continuity of care, training and availability of resources.Conclusions
Further research is needed to determine whether the use of on‐site specialist domestic violence workers will increase midwives' ability to routinely enquire about domestic violence.
Uterine artery embolisation for the treatment of symptomatic fibroids in 114 women: reduction in size of the fibroids and women's views of the success of the treatment
Authors: Watson G.M.T. , Walker W.J. 
Published: December 2003

Objective
To assess the reduction in size of fibroids following uterine artery embolisation and to analyse women's views of the success of treatment.Design
An uncontrolled case series of 114 consecutive women who underwent uterine artery embolisation for the treatment of fibroids over two years.Setting
The Diagnostic and Interventional Radiology Department at The Royal Surrey County Hospital, Guildford, UK.Methods
Bilateral uterine artery embolisation was performed for the treatment of symptomatic fibroids. Magnetic resonance imaging was carried out before and six months following embolisation. Women completed outcome questionnaires following their treatment.Main outcome measures
The sites, imaging signal characteristics and percentage reduction in the volume of three dominant fibroids were determined from the magnetic resonance scans. Outcome was measured by questionnaire. Women were asked whether their symptoms resolved completely, improved, remained unchanged or deteriorated.Results
One hundred and sixty‐five fibroids of 114 women (mean age 42) were analysed. Forty‐five percent of women had complex fibroid masses and 50% had fibroids ≥8.5cm in diameter. The median reduction in the fibroid volume was 58%. The median reduction of the volume of complex fibroid masses, submucous fibroids, fibroids ≥8.5cm and fibroids with high and low signal on T2 weighted sequences were 58%, 63%, 50%, 62% and 51%, respectively. Ninety‐one percent of the women's symptoms had resolved or improved following embolisation.Discussion
The majority of women were satisfied with their outcome. We have shown that uterine artery embolisation is a successful treatment for symptomatic fibroids of all types, sizes and signal characteristics.
Histologic chorioamnionitis and umbilical serum levels of pro‐inflammatory cytokines and cytokine inhibitors
Authors: Døllner Henrik , Vatten Lars , Halgunset Jostein , Rahimipoor Shahnaz , Austgulen Rigmor 
Published: December 2003

Objective
To study 1. whether leucocyte infiltration in placenta tissues is associated with elevated umbilical serum levels of inflammatory mediators, and 2. whether leucocyte infiltration in the presence of neonatal disease is associated with additional increase in mediator levels.Setting
University hospital.Population
Two groups of women with either normal delivery (n= 82) or delivery complicated by prolonged rupture of the membranes, clinical signs of intrauterine infection or preterm labour (n= 139).Methods
Umbilical cord blood and placenta tissues were collected after delivery. Placentas were classified as non‐inflamed (i.e. without leucocyte infiltration, n= 74), or as mild (n= 84), or severe chorioamnionitis (n= 63). Mediator levels were compared between groups.Results
Severe chorioamnionitis was associated with elevated levels of tumour necrosis factor (TNF)α, interleukin (IL)‐1β, IL‐6, IL‐8, soluble TNF receptor p55 and p75, IL‐1 receptor antagonist (IL‐1RA), and C‐reactive protein compared with non‐inflamed placentas (all P < 0.05). No differences were found between mild chorioamnionitis and placentas without infiltration. In all, 49 babies suffered from various perinatal diseases, such as clinical sepsis, respiratory distress and asphyxia, and 172 were healthy. Severe chorioamnionitis with subsequent neonatal disease (n= 23) had higher levels of all mediators, except IL‐1β and C‐reactive protein, than severe chorioamnionitis without neonatal disease (n= 40, all P < 0.01), but severe chorioamnionitis was also accompanied by a more intense and widely distributed leucocyte infiltration when neonatal disease developed.Conclusion
High grade leucocyte infiltration in placenta tissues is associated with elevated levels of TNFα, IL‐1β, IL‐6, IL‐8, p55, p75, IL‐1RA and C‐reactive protein in umbilical serum. The presence of neonatal disease is associated with advanced chorioamnionitis, and highly elevated levels of both pro‐ and anti‐inflammatory mediators in umbilical serum.