bluuebunny/crossref_metadata_2025_split huggingface dataset:
Haemodynamic monitoring and liver function evaluation by pulsion cold system Z‐201 (PCS) during orthotopic liver transplantation
Authors: Díaz Susana , Pérez‐Peña José , Sanz Javier , Olmedilla Luis , Garutti Ignacio , Barrio José M. 
Published: March 2003

Abstract: Pulsion cold system (PCS, COLD) is a haemodynamic monitoring system that allows measurement of cardiac output (CO), partial blood volumes, lung water, and liver function. The aim of the study was to evaluate this monitoring system during human orthotopic liver transplantation (OLT) for the following: (a) to determine agreement between CO measurements via pulmonary artery thermodilution (CO TDpa), and aortic transpulmonary thermodilution (CO TDa); (b) to compare the preload dates obtained with the COLD with central venous pressure (CVP) and pulmonary capillary wedge (PCWP); and (c) to assess the use of the plasma disappearance rate (PDR) of indocyanine green (ICG) as a measure of graft function. Fifteen consecutive patients undergoing OLT were studied. Each patient received a pulmonary artery catheter and a 5F aortic catheter with an integrated thermistor. The thermistor of the aortic catheter were connected to one computer system (COLD‐Z201, Pulsion Medical Systems, Munich, Germany). Haemodynamic data were registred an all the phases of OLT. PDR was measured during surgery in 12 patients. Correlations between PDR and the other markers of graft function (transaminases, protrombine time, and bile production) were sought. The correlation coefficient between CO TDa (COLD) and CO TDpa was r = 0.766 (p < 0.001), and an additional analysis according to Bland–Altman was also performed. There was a better correlation between the cardiac index (determined by two monitoring systems) and the volume measurements than the correlation observed with pressure preload parameters. The best correlations were found between the cardiac index in the femoral artery and intrathoracic blood volume index (ITBVI) and pulmonary blood volume index (PBVI) (r = 0.79 and r = 0.72, respectively; p < 0.01). PDR measured in the group patients with bad early graft function were lower (13.6 ± 2.7) than those in the group with a good graft function (21.6 ± 9) (p < 0.05). The degree of discrepancy between femoral and pulmonary thermodilution cardiac output measures is very wide during OLT so as to make the techniques using the COLD machine clinically useless. On the other hand, the volumes measured by COLD, specially ITBVI and PBVI, are more useful to asses the pre‐load than pressure measurements. In OLT, the PDR measured within the first few hours after liver reperfusion may become a useful tool for early diagnosis of primary graft dysfunction (PDF).
Menstrual cycle related mood changes in women with bipolar disorder
Authors: Rasgon Natalie , Bauer Michael , Glenn Tasha , Elman Shana , Whybrow Peter C 
Published: March 2003

Objectives:  A relationship between affective symptoms and menstrual cycle in women with bipolar disorder (BPD) has been suggested. This study investigates the influence of the menstrual cycle on mood in women with BPD who are taking medication, but not selected for menstrual abnormalities.Methods:  Data from women with BPD (n=17) consecutively enrolled into a ChronoRecord validation study were included in the current analysis. All women received medication for BPD, in addition, 35% received oral contraceptives (OC). Participants entered mood, menstrual data, psychiatric medications, and life events daily for a 3‐month period using a computerized version (ChronoRecord) of an established paper based form for self‐reporting (ChronoSheet).Results:  The majority of women treated for BPD (65%) reported significant mood changes across the menstrual cycle. Long menstrual cycle was present in 59% of subjects, including those taking OC.Conclusions:  Women with BPD taking medication report a high rate of long menstrual cycles, and significant mood changes in relation to menstrual cycle phase.
Oral guar gum, a gel‐forming dietary fiber relieves pruritus in intrahepatic cholestasis of pregnancy
Authors: RIIKONEN SEIJA , SAVONIUS HANNELE , GYLLING HELENA , NIKKILÄ KATRIINA , TUOMI ANNA‐MAIJA , MIETTINEN TATU A. 
Published: March 2003

Background. Guar gum is a gel‐forming fiber, which increases fecal elimination of bile acids. It may therefore be beneficial in the treatment of intrahepatic cholestasis of pregnancy.Methods. Forty‐eight patients with intrahepatic cholestasis of pregnancy were randomized double‐blind to receive either guar gum or placebo until delivery. Serum bile acid concentration was measured. Pruritus was assessed by both the investigator and the patient.Results. At baseline, the intensity of pruritus and the serum bile acid concentration were significantly related. Guar gum diminished or prevented worsening of pruritus, while in the placebo group pruritus was enhanced (p<0.05). In the placebo group serum bile acid concentration increased significantly, whereas in the guar gum group it remained unchanged (p<0.05 between the groups). Guar gum treatment‐induced changes of the pruritus score and serum bile acid concentrations were significantly related (p<0.01).Conclusions. Guar gum relieved the intensity of pruritus without any side effects and prevented the rise in serum bile acid concentration in this placebo‐controlled and double‐blind study of patients with intrahepatic cholestasis of pregnancy.
Secular trends in peri‐ and neonatal mortality in breech presentation; Norway 1967–1994
Authors: ALBRECHTSEN SUSANNE , RASMUSSEN SVEIN , IRGENS LORENTZ M. 
Published: March 2003

Objectives. To assess secular trends in mortality rates in breech presentation in Norway and the effects of gestational age, birth defects and delivery method.Material and methods. The Medical Birth Registry of Norway 1967–1994, with 45,579 breech presentation births from 24 weeks of gestation onwards, with mortality rate comprising all stillbirths from 24 completed weeks of gestation and all neonatal deaths (extended peri‐ and neonatal mortality) as main outcome variable.Results. The extended peri‐ and neonatal mortality rate in breech presentation births declined during the study period from 9.2% in 1967–76 to 5.5% in 1977–86 and to 3.0% in 1987–94. The highest relative risk of mortality in breech presentation versus the total birth population was observed in intrapartum death and in mortality less than 24 hours after delivery. Stillbirth represented about half of the extended peri‐ and neonatal mortality throughout the study period. Also in infants with birth defects, the survival increased during the study period. The extended peri‐ and neonatal mortality was highest in vaginal deliveries, but decreased during the period, irrespective of delivery method.Conclusions. Probably due to improved obstetrical and neonatal care, mortality associated with breech presentation has substantially decreased. Increased focus especially on stillbirth, might be instrumental in further reducing the mortality associated with breech presentation.
Seroprevalence of Toxoplasma gondii among pregnant women in Sweden
Authors: PETERSSON KARIN , STRAY‐PEDERSEN BABILL , MALM GUNILLA , FORSGREN MARIANNE , EVENGÅRD BIRGITTA 
Published: March 2003

Background. Primary infection with Toxoplasma gondii during pregnancy can cause fetal infection with a risk of complications for the fetus. The proportion of women at risk of acquiring the infection during pregnancy in Sweden is not known.Methods. The seroprevalence of Toxoplasma gondii among pregnant women in Sweden was calculated when 40 978 blood samples collected on filter paper eluates from newborns were tested for Toxoplasma specific immunoglobulin G. The newborns in two geographically different areas (Stockholm County and Skåne County) were investigated during a 16‐month period between April 1997 and July 1998. The anti‐toxoplasma IgG antibodies detected in the eluates were considered to be of maternal origin and to reflect the immune status of the mother.Results. The seroprevalence was 14.0% in Stockholm County and 25.7% in Skåne County. The seroprevalence among women born in the Nordic countries was 11.1% in Stockholm and 24.9% in Skåne. The corresponding figures for women born outside the Nordic countries were 24.3% and 29.4%. On comparing the seroprevalence found in this study with older data, the overall seroprevalence in pregnant women born in the Nordic countries and living in Stockholm was found to have decreased between 1969 and 1998. The seroprevalence in different birth cohorts, longitudinally followed in the previous and the present studies, remained at the same level over 20 years despite the increasing age of the women.Conclusion. These results suggest that the majority of seropositive pregnant women in Sweden today have seroconverted before entering the childbearing period and that the percentage of women in Sweden acquiring toxoplasmosis during the childbearing period is low.
Exposure to and actions against passive smoking in non‐smoking pregnant women in Guangzhou, China
Authors: LOKE ALICE YUEN , LAM TAI HING , PAN SU CI , LI SU YUN , GAO XIAO JIAN , SONG YAN YAN 
Published: March 2003

Background. The objective was to describe the extent of passive smoking exposure and preventive actions against passive smoking in non‐smoking pregnant women and to analyze factors associated with preventive actions.Methods. This was a cross‐sectional survey on 1449 never‐smoking pregnant women who made their first prenatal visit to the Women and Children's Hospital of Guangzhou, China during 1996–97.Results. 60.2% (95% Confidence Interval 57.7%–62.7%) of the never‐smoking pregnant women had a husband who currently smoked. Women with smoking husbands (n=872) were more exposed to ETS than those with non‐smoking husbands (n=577) at home (71% vs. 33%), in public places (77% vs. 66%) and at work (60% vs. 50% of working women), and they took less actions against passive smoking in public places. Women with better education and knowledge on smoking and passive smoking had stronger preventive actions.Conclusions. Non‐smoking pregnant women in China are often exposed to passive smoking and their preventive actions are weak. Passive smoking is an important obstetric and public health problem in developing countries and deserves urgent international attention.
Radiotherapy alone for invasive vaginal cancer: outcome with intracavitary high dose rate brachytherapy versus conventional low dose rate brachytherapy
Authors: Kucera Herwig , Mock Ulrike , Knocke Thomas H. , Kucera Elisabeth , Pötter Richard 
Published: March 2003

Purpose. Our aim was to compare the role of remote afterloaded high‐dose‐rate brachytherapy (HDRB) with traditional low‐dose‐rate brachytherapy (LDRB) for patients with invasive primary vaginal carcinoma.Methods. The study group comprised 190 patients with invasive carcinoma of the vagina. The patients were staged according to the International Federation of Gynecology and Obstetrics (FIGO) staging system. Eighty patients were treated with intracavitary high‐dose rate iridium 192 brachytherapy with or without external beam therapy. These patients are compared with a historical group of 110 patients treated with intracavitary low‐dose‐rate radium 226 or cesium 137 brachytherapy with or without external beam therapy.Results. No significant differences were found for stages, tumor grade or location between the two groups. Crude 5‐year survival for all patients was 41% in the former LDRB group, 81% in stage I and 43% in stage II. Overall actuarial 3‐year survival and disease‐specific survival rates for all patients in the HDRB series were 51% and 66%, respectively. Disease‐specific 3‐year survival attained 83% in stage I and 66% in stage II. There were no significant differences in local and distant recurrences between the treatment modalities. The comparison of treatments with or without external beam radiation and of complications showed no significant differences between the HDRB and LDRB series.Conclusion. With HDRB and its advantages of decreased radiation exposure and patient immobilization and precise positioning, treatment results to be obtained are at least similar to traditional LDRB for primary vaginal cancer.
The very preterm infant – a population‐based study
Authors: Holmgren Per Åke , Högberg Ulf 
Published: March 2003

Objectives. The aim of this study was to assess perinatal risk factors and the survival of the very preterm infant in comparison with birth beyond 32nd birthweek, as well as health care utilization by mothers and infants in the Northern Health Region of Sweden.Design. A population‐based study was designed of all children (66,646) born in the Northern Health Region of Sweden during 1991–1996 and registered in the Swedish Medical Birth Registry.Methods. Maternal and perinatal factors of infants born very preterm, that is, at ≤27 and 28–31 weeks of gestation, were analyzed for relative risk (RR), and a 95% confidence interval (CI), and compared with those of infants born 32–36 weeks of gestation.Results. Of the 66,646 infants registered, 3,493 (5.2%) were born at 32–36 weeks, 394 (0.6%) at 28–31 weeks, and 199 (0.3%) at 22–27 weeks’ gestation. No special socio‐demographic maternal factors characterized these preterm births. The very preterm infants were more prone to perinatal complications such as premature rupture of the membranes (PROM) (RR=4.13; 95% CI=3.07–5.55), and both PROM and hemorrhage (RR=7.80; 95% CI=3.43–17.72). Infants born very preterm were more often twins, growth‐retarded, malformed, and affected by sepsis and respiratory distress. There was significantly better survival of preterm infants born at ≤27 weeks’ gestation if their mothers were given tertiary perinatal care. For infants born extremely preterm, survival tended to be better if they were delivered by cesarean section.Conclusion. The very preterm birth is more often than not a result of a complicated pregnancy. The infant is often sick before birth, and for its survival is highly dependent on the highest level of perinatal care.
Complications of induced abortion and miscarriage in three African countries: a hospital‐based study among WHO collaborating centers
Authors: Goyaux Nathalie , Alihonou Eusèbe , Diadhiou Fadel , Leke Robert , Thonneau Patrick Fernand 
Published: March 2003

Objective. The aim of this study was to describe two of the outcomes of pregnancy, induced abortion and miscarriage, in three African countries. Major maternal risk factors were also evaluated.Methods. The study was prospective and based on the medical files of all 1,957 women admitted to participating health care structures.Results. Overall, 988 women were admitted for complications of miscarriage, and 969 for complications of induced abortion. Gestational age was lower in women with miscarriages (p<0.002). The level of use of contraceptive methods ((p<0.003) and educational level ((p<0.005) were lower in women who had had an induced abortion. In our study, 26 maternal deaths were recorded, 22 of which were associated with induced abortion. Infection was the most important risk factor for death (OR=4.8; 1.9–12.4).Conclusion. Maternal deaths related to abortion complications often occurred shortly after hospital admission and with signs of sepsis. This demonstrates the importance of effective emergency services. Unfortunately, hospital‐based studies alone cannot assess all maternal death risk factors, especially those for maternal death related to induced abortion complications. It is therefore important to determine what happened to the woman before hospital admission and during her stay in hospital. Combinations of qualitative and quantitative methods could be used to increase our understanding of this problem and to help us to solve it.
Transvaginal ultrasonography and hysteroscopy in postmenopausal bleeding
Authors: Sousa Rita , Silvestre Margarida , Almeida E Sousa Luis , Falcão Francisco , Dias Isabel , Silva Teresa , De Oliveira Carlos , Oliveira Henrique Miguel 
Published: March 2003

Objective. To determine the diagnostic value of transvaginal ultrasonography and hysteroscopy in patients with postmenopausal bleeding.Material and methods. Between January 1, 1998 and June 30, 1999, 88 outpatient women with postmenopausal bleeding were enrolled in a prospective study. They underwent transvaginal ultrasonography and hysteroscopy, and were submitted to directed biopsy during hysteroscopy. Findings were classified as normal endometrium, suggestive of atrophy, focal abnormality (benign or suspicious), and diffuse thickness (benign or suspicious). Data was compared with the final diagnosis, established by histological examination, as atrophy, benign pathology, atypical hyperplasia and endometrial carcinoma.Results. Among 88 women enrolled, 15 were excluded because hysteroscopy was impossible, and four had abandoned the study. The histological findings were scanty material in 12 (17.4%), atrophy in 24 (34.8%), cystic atrophy in one (1.4%), normal endometrium in five (7.2%), tuberculous endometritis in one (1.4%), polyps in 12 (17.4%), leiomyoma in one (1.4%), non‐atypical hyperplasia in three (4.3%), atypical hyperplasia in one (1.4%) and endometrial carcinoma in nine cases (13.0%). For the assessment of endometrial carcinoma, ultrasonography revealed sensitivity 77.8%, specificity 93.3%, positive predictive value 63.6%, negative predictive value 96.6%; and hysteroscopy revealed sensitivity of 88.9%, specificity 98.3%, positive predictive value 88.9%, negative predictive value 98.3%. The combined use of both methods revealed sensitivity 100%, specificity 91.7%, positive predictive value 64.3%, negative predictive value 100%.Conclusions. Both imagiological methods were found to be useful screening tests for endometrial carcinoma. Hysteroscopy was a superior diagnostic procedure.
Psychosocial predictors of disappointment with delivery and puerperal depression
Authors: Saisto Terhi , Salmela‐Aro Katariina , Nurmi Jari‐Erik , Halmesmäki Erja 
Published: March 2003

Background. To examine the extent to which personality characteristics, depression, fear and anxiety about pregnancy and delivery, and socio‐economic background, predict disappointment with delivery and the risk of puerperal depression.Methods. Two hundred and eleven women filled in questionnaires measuring personality traits, socio‐economic factors, and marital satisfaction once before and once after the 30th week of pregnancy, and 2–3 months after delivery, when obstetric data about pregnancy and delivery was also collected.Results. The women who were disappointed with their delivery or suffered from puerperal depression had been more depressed already in early pregnancy. Regression analysis showed that the strongest predictors of disappointment with delivery were labor pain (increase in R2=0.14, p<0.001) and emergency Cesarean (increase in R2=0.18, p<0.001).Puerperal depression was predicted by depression (increase in R2=0.16, p<0.001), and by personal traits such as general anxiety, vulnerability and neuroticism (increase in R2=0.32, p<0.001), both before 30 weeks of pregnancy and prior to the delivery (for depression increase in R2=0.05, p<0.001, and for anxiety and vulnerability increase in R2=0.04, p<0.01). The strongest predictors were depression at both time points before delivery (beta=0.51, p<0.001, and beta=0.39, p<0.001). Pregnancy‐ and delivery‐related anxiety prior to the delivery also predicted puerperal depression, but complications of the pregnancy and delivery did not.Conclusions. Depression in early pregnancy predicts disappointment with the delivery and is a strong predictor of puerperal depression.
Serum leptin levels in pregnant women with type 1 diabetes mellitus
Authors: Lauszus Finn F. , Schmitz Ole , Vestergaard Henrik , Klebe Joachim G. , Pedersen Oluf 
Published: March 2003

Background. Leptin is an important weight regulator and during pregnancy leptin is not only synthesized in adipose tissue but also in the placenta.Aim. To examine changes in serum leptin levels in women with type 1 diabetes mellitus during pregnancy and post delivery in relation to concomitant changes in maternal body weight, birth weight, glycemic control, and blood pressure.Methods. Non‐fasting serum leptin from 45 women with type 1 diabetes mellitus were studied consecutively throughout pregnancy and 3 months post partum.Results. Serum leptin was positively associated with HbA1c in week 18, 22 and 30 (r=0.38, 0.41, and 0.54, respectively, p<0.05, adjusted for body weight). Moreover, serum leptin correlated positively with maternal body weight and BMI (0.45<r<0.66, p<0.05). Serum leptin was significantly lower after delivery than during pregnancy where the levels showed no change from gestational week 14 to week 38. In obese women (BMI >25 kg/m2), the changes during pregnancy and the level of serum leptin were significantly greater compared to lean women (p<0.05). The women with low ambulatory blood pressure (lower tertile, mean arterial blood pressure <83.4 mmHg) showed the lowest level of serum leptin throughout pregnancy and it changed significantly differently from the women with higher blood pressure (p<0.05).Conclusion. Changes in serum leptin levels of pregnant women with type 1 diabetes mellitus were associated with parallel changes in maternal body weight and glycemic control. Women with low blood pressure had the lowest serum leptin levels throughout pregnancy.
Transvaginal ultrasonography sonohysterography and operative hysteroscopy for the evaluation of abnormal uterine bleeding
Authors: Krampl Elisabeth , Bourne Tom , Hurlen‐Solbakken Heidi , Istre Olav 
Published: March 2003

Objective. To evaluate the diagnostic accuracy of transvaginal ultrasonography, sonohysterography and hysteroscopy in patients presenting with abnormal uterine bleeding.Design. Prospective, blind, comparative study.Setting. Outpatient clinic and day surgery unit of a district hospital specializing in operative hysteroscopy.Patients. One hundred consecutive patients referred with abnormal uterine bleeding (AUB).Interventions. Transvaginal ultrasonography and sonohysterography were performed in the outpatient clinic. Within 1 week, all patients underwent operative hysteroscopy.Main outcome measures. All diagnoses established by transvaginal ultrasonography, and sonohysterography were compared to the appearance of the cavity using hysteroscopy as well as the histological diagnosis from removed tissues.Results. In 88 patients information suitable for analysis was obtained by all methods. The detection rate of focal intrauterine pathology using sonohysterography was (94.1%), but was significantly lower with transvaginal ultrasonography (23.5%). In about 75% of all cases none of the methods used was able to correctly detect endometrial hyperplasia.Conclusions. Sonohysterography was significantly better than transvaginal ultrasonography in detecting focal intrauterine pathology. Visual examination at operative hysteroscopy yielded no additional information to the detection or exclusion of focal lesions than was obtained at outpatient sonohysterography. All methods performed equally in assessing endometrial pathology. We conclude that sonohysterography may replace diagnostic hysteroscopy in many patients with AUB.