bluuebunny/crossref_metadata_2025_split huggingface dataset:
Values of β‐human chorionic gonadotropin as a risk factor for tubal obstruction after tubal pregnancy
Authors: Elito Julio , Han Kyung Koo , Camano Luiz 
Published: August 2005

Aim.  The hysterosalpingography (HSG) was evaluated after the clinical treatment of tubal pregnancy and the possible risk of tubal obstruction through the following parameters: β‐human chorionic gonadotropin (β‐hCG) levels, size of the adnexal mass, aspects of the image at ultrasound, and color Doppler.Methods.  Eighty patients were submitted to HSG after tubal pregnancy treatment from April 1994 to February 2002. Fifty received expectant management and 30 were treated with single‐dose methotrexate (MTX) (50 mg/m2 intramuscularly).Results.  The patency of the ipsilateral tube was 84% and 78% after the MTX and expectant treatments, respectively (P > 0.05). After the logistic regression was performed, it was observed that levels of β‐hCG >5000 mUI/ml were directly related to the tubal obstruction risk, odds ratio = 11.79 (95% CI = 2.27–61.32). Other variables were not directly related to the tubal obstruction risk.Conclusions.  In this study, the probability of ipsilateral tubal obstruction depends on the β‐hCG levels. The increase in β‐hCG levels is followed by an enhancement in tubal obstruction risk. Therefore, the β‐hCG may be effective for the prognostic of the reproductive future of these patients.
Review article: drug‐induced microscopic colitis – proposal for a scoring system and review of the literature
Authors: BEAUGERIE L. , PARDI D. S. 
Published: August 2005

SummaryThe pathophysiology of microscopic colitis is unknown, although it is thought to be because of an abnormal immune reaction to luminal antigens in predisposed hosts. Specific antigens have not been proved, although various infectious triggers and drugs have been proposed. The responsibility of several drugs has been questioned, some with strong clinical and/or histological evidence suggesting causality. The issue of drug‐induced microscopic colitis is important because of the burden of this disease. Thus, any case that can be cured by withdrawal of a drug must be identified. In this report, we propose a scoring system for drug‐induced microscopic colitis, adapting existing criteria of drug causality, and review the literature using this framework. Based on this review, several drugs are identified with intermediate or high likelihood of inducing microscopic colitis. Finally, we suggest how to treat individual patients suspected of having drug‐induced colitis according to the level of evidence for that particular drug.
Ciprofloxacin suppresses bacterial overgrowth, increases fasting insulin but does not correct low acylated ghrelin concentration in non‐alcoholic steatohepatitis
Authors: SAJJAD A. , MOTTERSHEAD M. , SYN W. K. , JONES R. , SMITH S. , NWOKOLO C. U. 
Published: August 2005

SummaryBackground: Insulin resistance and oxidative stress induced by products of small intestinal bacterial activity are putative factors in the pathogenesis of non‐alcoholic steatohepatitis. Acylated ghrelin is the biologically active form of an orexigenic gastric hormone that modifies insulin sensitivity and body composition.Aim: To investigate the effect of ciprofloxacin on small intestinal bacterial activity, ethanol, ghrelin and insulin in non‐alcoholic steatohepatitis patients.Methods: Twelve non‐alcoholic steatohepatitis patients and 11 controls were studied before and after ciprofloxacin 500 mg b.d. for 5 days. After an overnight fast, 75 g glucose was ingested and blood was sampled every 20 min for 120 min. Acylated and total ghrelin, ethanol and insulin were measured. Small intestinal bacterial activity was detected by glucose hydrogen breath test.Results: Mean (range) integrated plasma acylated ghrelin which was 102 (21–241) and 202 (88–366) pg/mL · 2 h in non‐alcoholic steatohepatitis and controls respectively (P = 0.015). This difference persisted after correction for body mass index and was unaffected by ciprofloxacin treatment. One of six non‐alcoholic steatohepatitis patients positive for small intestinal bacterial activity remained positive after ciprofloxacin. In contrast, the one healthy control positive for small intestinal bacterial activity remained positive after ciprofloxacin (P = 0.025). Ethanol was detected in two subjects in each group, becoming immeasurable after ciprofloxacin. In non‐alcoholic steatohepatitis patients median (range) fasting insulin increased from 113 (10–223) to 152 (32–396) pmol/L (P < 0.02), after ciprofloxacin. This was accompanied by similar changes in insulin resistance.Conclusions: Small intestinal bacterial activity is common in non‐alcoholic steatohepatitis. Low acylated ghrelin in non‐alcoholic steatohepatitis cannot be attributed to small intestinal bacterial activity. Changes in fasting insulin and ethanol following ciprofloxacin suggest that these parameters may be influenced by small intestinal bacterial activity.
Risk factors for inflammatory bowel disease in the general population
Authors: GARCÍA RODRÍGUEZ L. A. , GONZÁLEZ‐PÉREZ A. , JOHANSSON S. , WALLANDER M.‐A. 
Published: August 2005

SummaryBackground:  The aetiology of inflammatory bowel disease remains largely unknown.Aim:  We performed a comprehensive assessment of potential risk factors associated with the occurrence of inflammatory bowel disease.Methods:  We identified a cohort of patients 20–84 years old between 1995 and 1997 registered in the General Practitioner Research Database in the UK. A total of 444 incident cases of IBD were ascertained and validated with the general practitioner. We performed a nested case–control analysis using all cases and a random sample of 10 000 frequency‐matched controls.Results:  Incidence rates for ulcerative colitis, Crohn's disease, and indeterminate colitis were 11, 8, and 2 cases per 100 000 person‐years, respectively. Among women, we found that long‐term users of oral contraceptives were at increased risk of developing UC (OR: 2.35; 95% CI: 0.89–6.22) and CD (OR: 3.15; 95% CI: 1.24–7.99). Similarly, long‐term users of HRT had an increased risk of CD (OR: 2.60; 95% CI: 1.04–6.49) but not UC. Current smokers experienced a reduced risk of UC along with an increased risk of CD. Prior appendectomy was associated with a decreased the risk of UC (OR: 0.37; 95% CI: 0.14–1.00).Conclusions:  Our results support the hypothesis of an increased risk of inflammatory bowel disease associated with oral contraceptives use and suggest a similar effect of hormone replacement therapy on CD. We also confirmed the effects of smoking and appendectomy on inflammatory bowel disease.
Validation of the gastrointestinal symptom score for the assessment of symptoms in patients with functional dyspepsia
Authors: ADAM B. , LIEBREGTS T. , SAADAT‐GILANI K. , VINSON B. , HOLTMANN G. 
Published: August 2005

SummaryAim:  To validate the gastrointestinal symptom score as an outcome measure for functional dyspepsia.Methods:  In focus groups, 10 dyspepsia‐specific items including nausea, sickness, vomiting, bloating, abdominal cramps, early satiety, acidic eructation/heartburn, loss of appetite, retrosternal discomfort, epigastric pain/upper abdominal pain were identified. Ninety‐five patients with functional dyspepsia and 56 healthy controls were recruited and responsiveness evaluated by analysing gastrointestinal symptom score data from 357 patients from previous placebo‐controlled trials. Gastrointestinal symptom score response data were correlated with the patient's global assessments of efficacy. Convergent validity was assessed by correlating the gastrointestinal symptom score with the results obtained by the Nepean Dyspepsia Index.Results:  Sensitivity: In patients and healthy controls gastrointestinal symptom score yielded consistently different scores (all P < 0.0001). Test–retest reliability: Gastrointestinal symptom score determined at the two time points were significantly correlated (r‐values ranging from 0.842 to 0.901). Convergence validity: Gastrointestinal symptom score of both rating groups were significantly correlated with the symptom‐specific component of the Nepean Dyspepsia Index (r‐vales ranging from 0.666 to 0.764, P < 0.01). Responsiveness: Responses of gastrointestinal symptom score during treatment were different for patients with a global self assessment as responders compared with non‐responders (all P < 0.0055).Conclusion:  The gastrointestinal symptom score is a valid and reliable instrument to assess symptom intensities in patients with functional dyspepsia.
The effect of gastro‐oesophageal reflux and omeprazole on key sleep parameters
Authors: DIMARINO JR A. J. , BANWAIT K. S. , ESCHINGER E. , GREENBERG A. , DIMARINO M. , DOGHRAMJI K. , COHEN S. 
Published: August 2005

SummaryBackground: The effect of gastro‐oesophageal reflux on sleep and sleep quality is highly controversial.Aim: To determine the temporal relationship of abnormal objective sleep parameters to gastro‐oesophageal reflux during acid suppression in patients with self diagnosed sleep disorders.Methods: Polysomnography during oesophageal pH monitoring was conducted in 16 subjects with and without gastro‐oesophageal reflux as determined by a standardized questionnaire. Subjects were studied before and after omeprazole.Results: All reflux events were followed by a sleep arousal or awakening. Nocturnal acid reflux events were not predicted by the Carlsson score. Omeprazole reduced acid reflux‐associated arousals from 11.6 ± 3.8 to 1.5 ± 0.8 (P < 0.01) and awakenings from 7.7 ± 1.2 to 3.7 ± 0.5 (P < 0.05). Sleep efficiency improved from 70.2% to 81.6% in a small subset of subjects with decreased sleep (P < 0.05); rapid eye movement sleep increased from 55.0 ± 4.5 to 94.5 ± 18.9 min (P < 0.05); total sleep time increased from 294.0 ± 15.9 to 345.6 ± 55.6 min (P < 0.05). Apnoea, hypopnoea and hypoxaemia were not associated with reflux.Conclusions: In subjects with gastro‐oesophageal reflux, sleep arousals and awakenings are closely related to acid reflux events. Reflux‐related arousals and awakenings are decreased by acid suppression. Acid suppression in selected subjects with reflux events and reduced sleep efficiency is associated with increased total sleep time, rapid eye movement sleep and sleep efficiency.
The mtDNA catalogue of all Portuguese autochthonous goat (Capra hircus) breeds: high diversity of female lineages at the western fringe of European distribution
Authors: PEREIRA F. , PEREIRA L. , VAN ASCH B. , BRADLEY D. G. , AMORIM A. 
Published: August 2005

AbstractGoat is believed to be the first true livestock domesticated and, apart from its historical importance, keeps playing an essential economic role in very diverse human societies. We have analysed the female gene pool of all Portuguese autochthonous breeds (Bravia, Serrana, Charnequeira, Serpentina and Algarvia) through the mtDNA HVI sequencing of 288 unrelated animals sampled throughout the country. All breeds proved to be extremely diverse (average haplotype diversity of 0.977), in contrast with the Portuguese peripheral geographic situation in the distribution range of the species. Moreover, observed genetic distances between breeds do not correlate with microgeography inside Portugal. These observations are consistent with recurrent refreshment of the breeding stock through the introduction of exotic animals. Fitting the new data into the still loosely defined female genetic pool landscape of goats, all Portuguese animals, one sample excepted (belonging to Bravia), are classified into haplogroup A and haplotype sharing is geographically very sparse, including a Far East match. Our results confirm that goats stand out among most of domesticates as exceptionally diverse and showing an unparalleled degree of mobility of animals (at least females) used for reproductive purposes.
Postoperative extradural analgesia with morphine and ropivacaine. A double‐blind comparison between placebo and ropivacaine 10 mg/h or 16 mg/h
Authors: Axelsson K. , Johanzon E. , Essving P. , Weckström J. , Ekbäck G. 
Published: August 2005

Background:  Some controversy exists in the literature on the benefit of epidurals compared to patient‐controlled intravenous analgesia (PCA). Also, the dose of ropivacaine for epidural analgesia when combined with morphine remains uncertain. The aim of this study was to compare the epidural vs. PCA technique and high‐dose vs. low‐dose ropivacaine combined with morphine during knee replacement surgery.Methods:  In this prospective, randomized, double‐blind study, postoperative pain relief with a combination of epidural ropivacaine (Group L: 10 mg h−1, Group H: 16 mg h−1) and morphine (0.16 mg h−1) was evaluated in 30 patients. A placebo group (Group PL) of 15 patients having PCA morphine served as the control. Visual analog pain (VAS), morphine consumption, sensory and motor block and side‐effects were recorded during 48 h.Results:  VAS scores at rest were significantly lower in Groups L and H compared to Group PL. On movement, Group H had lower VAS scores than Group PL during 3–27 h (P < 0.05) and Group L during 4–9 h (P < 0.05), while Group L had lower a VAS than Group PL during 9–18 h (P < 0.05). Morphine consumption after 48 h was greater in Group PL (64.6 ± 36.3 mg) vs. Group L (23.3 ± 33.9 mg) (P < 0.001) and Group H (4.3 ± 9.6 mg) (P < 0.0001). Mild motor block was seen in Group H in 20% and 14% patients at 24 h and 48 h, respectively, but time to mobilization was similar between the groups. Pruritus was more common in the ropivacaine groups (P < 0.05).Conclusion:  Lumbar epidural analgesia using a combination of ropivacaine (16 mg h−1) and morphine (0.16 mg h−1) provides superior analgesia compared to the PCA technique or ropivacaine (10 mg h−1) and morphine (0.16 mg h−1). Although this resulted in a mild motor block during the first 12 h, patient mobilization was similar in all groups.
Combined general‐epidural anesthesia decreases the desflurane requirement for equivalent A‐line ARX index in colorectal surgery
Authors: Lu C.‐H. , Borel C. O. , Wu C. ‐T. , Yeh C.‐C. , Jao S.‐W. , Chao P.‐C. , Wong C.‐S. 
Published: August 2005

Background:  The present study used the A‐line ARX index, derived from auditory evoked potential measurements, to examine the effect of epidural lidocaine on the end‐tidal concentration of desflurane during general anesthesia.Methods:  Thirty ASA I–II patients scheduled for elective colorectal surgery were included and randomized, in a double‐blinded fashion, to receive general anesthesia, and 15 ml of either 2% lidocaine (group GE, n = 15) or normal saline (group GS, n = 15) was administered epidurally with a maintenance infusion rate of 6 ml h−1. After a 10‐min high‐flow oxygen wash‐in period, desflurane was titrated to a target A‐line ARX index (AAI) of 20 ± 5.Results:  Epidural lidocaine reduced the end‐tidal concentration of desflurane required to maintain an adequate clinical effect by 42% compared to general anesthesia alone (2.6% vs. 4.5%, respectively; P < 0.001). The initial mean value of AAI was 87.8 (range 78–99) in group GE and 88.13 (79–99) in group GS before general anesthesia induction, the AAI values were approximately 19.7 (15–25) in group GE and 20.2 (16–25) in group GS during anesthesia maintenance, and returned to 84.53 (77–98) in group GE and 86.87 (79–98) in group GS when the patients regained consciousness in the recovery room. No statistical difference in the AAI values was observed either before, during, or after emergence of anesthesia. No patient reported intraoperative awareness.Conclusions:  Lower‐than‐expected concentrations of volatile anesthetics are sufficient to maintain appropriate a clinical anesthesia effect during combined general‐epidural anesthesia under auditory‐evoked potential monitoring.
Colloid vs. crystalloid preloading to prevent maternal hypotension during spinal anesthesia for elective cesarean section
Authors: Dahlgren G. , Granath F. , Pregner K. , Rösblad P. G. , Wessel H. , Irestedt L. 
Published: August 2005

Background:  Hypotension associated with spinal anesthesia for cesarean section is still a clinical problem. Colloid solutions seem preferable to crystalloid solutions for preloading. In most studies the overall rate of hypotension is reported. Few studies have, however, investigated the maternal and neonatal consequences of different levels of maternal hypotension.Methods:  In this randomized, double‐blinded study 110 patients presenting for elective cesarean section received either 1000 ml acetated Ringer's solution or 1000 ml 3% dextran 60 solution immediately before spinal anesthesia. The effect on overall hypotension, clinically significant hypotension (hypotension associated with maternal discomfort defined as nausea, retching/vomiting, dizziness or chest symptoms) and severe hypotension (systolic arterial pressure <80 mmHg) was studied.Results:  Dextran reduced the incidence of overall hypotension from 85 to 66% (P = 0.03), reduced the incidence of clinically significant hypotension from 60 to 30% (P = 0.002) and reduced the incidence of severe hypotension from 23 to 3.6% (P = 0.004) compared to Ringer's solution. There were neither differences in neonatal outcome between treatment groups nor between neonates grouped after severity of maternal hypotension.Conclusion:  Clinically significant hypotension seems to be a more suitable outcome variable than overall hypotension. The protective effect of the colloid solution increased with increased severity of hypotension.
Continuous peripheral nerve blockade in lower extremity surgery
Authors: Navas Á. M. , Gutiérrez T. V. , Moreno M. E. 
Published: August 2005

Peripheral nerve blocks afford numerous benefits for lower extremity surgery. There is growing interest in continuous peripheral nerve blocks, mainly for treatment of postoperative pain, a field that represents a challenge to the anaesthesiologist. This paper seeks to review the efficacy of continuous lower limb blocks for postoperative pain relief. Not only do continuous peripheral nerve blocks afford specificity of analgesic area but current research has shown that they enhance postoperative analgesia and patient satisfaction. New techniques and devices are increasingly appearing, and catheters are constantly being developed and improved; an example being the stimulating catheter, which represents one of the newest advances in this area.The above techniques show that continuous postoperative analgesia with catheters in the lower extremities is not only possible, but indeed provides sustained effective postoperative analgesia, reduces use of opioids, and improves rehabilitation and patient well‐being with minimal side‐effects. These techniques could prove an alternative to postoperative pain treatment following ambulatory surgery.
Effective systolic orifice area of the aortic valve: implications for Doppler echocardiographic cardiac output determinations
Authors: Schmidt C. , Theilmeier G. , Van Aken H. , Flottmann C. , Wirtz S. P. , Kehl H‐G. , Hoffmeier A. , Berendes E. 
Published: August 2005

Background:  Substantial research using echocardiography has established that stroke volume (SV) or cardiac output (CO) can be measured non‐invasively at the level of the aortic valve (AV) with high accuracy. Stroke volume is the product of the velocity time integral occurring at the sampling site and the effective systolic AV orifice area (AVOAeff). Nevertheless, a generally accepted method for the determination of AVOAeff is still lacking.Methods:  Aortic valve OAeff was measured in 228 consecutive patients scheduled for coronary artery surgery. Two widely adopted methods were applied to approximate the constantly changing orifice area of the AV: (1) the circular orifice model (AVOA–CM), and (2) the triangular orifice model (AVOA–TM). Aortic valve OA–CM assumes the shape of a circle as an appropriately time averaged geometrical model, and AVOA–TM takes the shape of an equilateral triangle for granted.Results:  The AV was easily imaged by echocardiography in both short‐ and long‐axis views in all patients. Relying on AVOA–CM, AVOAeff was 3.49 ± 0.77 cm2. AVOA–TM estimates were 2.80 ± 0.55 cm2 (mean ± SD). The results did not agree (bias analysis).Conclusions:  The echocardiographic measurement of SV or CO at the level of the AV has to be reconsidered.
Antithrombin III pretreatment reduces neutrophil recruitment into the lung and skeletal muscle tissues in the rat model of bilateral lower limb ischemia and reperfusion: a pilot study*
Authors: Duru S. , Koca U. , Öztekin S. , Olguner Ç. , Kar A. , Çoker C. , Ulukuş Ç. , Taşc C. , Elar Z. 
Published: August 2005

Background:  Anti‐inflammatory action of Antithrombin III (AT III) is still not well understood in ischemia/reperfusion (I/R) injury. In the present study, we aimed to investigate the anti‐inflammatory action of AT III on remote lung and local skeletal muscle tissue injury in a rat model of bilateral lower limb I/R model.Methods:  Bilateral lower limb ischemia and reperfusion were produced by means of tourniquets occlusions and releases, respectively. Three groups of rats were used in this controlled study: sham group (sham, n=3) underwent 5 h of anesthesia only; control group (I/R, n=7) underwent 3 h of bilateral lower limb ischemia followed by 2 h of reperfusion; and AT III pretreated group (I/R‐AT III, n=6) underwent the same procedure as the control group, but also received i.v. 250 U kg−1 AT III 30 min before ischemia induction under midazolam and fentanyl anesthesia.Measurements and results:  Lung and muscle tissue accumulation of polymorphonuclear leukocytes (PMN) were assessed by measuring tissue myeloperoxidase (MPO) activity. Histopathological changes in tissues were assessed by PMN counts in the lung, and muscle tissues and by histological lung injury score. Plasma 6‐keto prostaglandin F1α and tumor necrosis factor alpha levels were measured by an enzyme immunoassay technique. Myeloperoxidase activity could not be detected in the muscle tissues of all groups. The lung and muscle tissue PMN counts in the I/R group were significantly higher compared with the I/R‐AT III group (P < 0.05).Conclusions:  Data from the present study provides some evidence that AT III pretreatment attenuates remote lung and local skeletal muscle tissue injury caused by lower limb I/R.
Impact of postoperative shed blood transfusion, with or without leucocyte reduction, on acute‐phase response to surgery for total knee replacement
Authors: Muñoz M. , Cobos A. , Campos A. , Ariza D. , Muñoz E. , Gómez A. 
Published: August 2005

Background:  In patients undergoing total knee replacement (TKR) most blood loss occurs postoperatively and return of unwashed filtered shed blood (USB) from postoperative drainage may represent an alternative to allogeneic blood transfusion (ABT). We evaluated the impact of USB return, with or without leucocytes, on the acute‐phase response (APR) after TKR.Patients and methods:  Forty‐eight TKR patients, intended to receive postoperative USB, entered the study. Blood samples were obtained before and 6, 24, 72 h and 7 days after surgery, and from the USB before and after it passed through a 40‐µm filter (Group F40) or a leucocyte‐reduction filter (Group LRF). Haematimetric parameters, APR proteins (albumin, prealbumin, ceruloplasmin, haptoglobin, C‐reactive protein), complement C3 and C4, and cytokines (IL‐1β, IL‐6, IL‐8, IL‐10, and TNF‐α) were measured in all samples.Results:  Twenty‐eight patients (Group F40 = 14, Group LRF = 14) received a mean of 1.2 USB units, without any clinically relevant incident, and did not need additional ABT. Sixteen out of the 20 remaining patients who received neither USB nor ABT served as a control group for the postoperative APR study. All patients showed the typical postoperative APR profile and there were no significant differences between groups for APR parameters, postoperative complications, or hospital stay.Conclusions:  Postoperative blood salvage and return, with or without a LRF, after TKR does not present any clinically relevant side‐effects and does not modify APR induced by surgery. These findings seem to confirm the clinical experience that postoperative USB return is safe and questions the beneficial effect of using LRF.