bluuebunny/crossref_metadata_2025_split huggingface dataset:
Maternal complications after Caesarean section in HIV‐infected pregnant women
Authors: Panburana Panyu , Phaupradit Winit , Tantisirin Orathai , Sriintravanit Narumon , Buamuenvai Jerdjai 
Published: December 2004

AbstractA study of maternal complications after elective Caesarean section in HIV‐infected women was carried out from January 1999 to April 2001. The control group consisted of all the seronegative pregnant women who underwent the elective Caesarean section during the study period. The study group was divided into two subgroups. Subgroup 1 patients were given 600 mg zidovudine (ZDV) orally and 300 mg lamivudine (3TC) daily from 34 to 38 weeks’ gestation. Subgroup 2 patients were given 600 mg ZDV orally daily from 34 to 38 weeks’ gestation and 150 mg nevirapine orally on the morning of the Caesarean section day. In both groups, the elective Caesarean section was carried out at 38 weeks’ gestation and ZDV syrup (2 mg/kg) was given orally to the newborn immediately in the operating theatre and then every 6 h for 4 weeks. No statistically significant differences in maternal complications were found between the HIV‐infected and non HIV‐infected women.
Hepatitis B surface antigen carrier status and its correlation to gestational hypertension
Authors: To William W. K. , Cheung Wai , Mok Ka‐Ming 
Published: December 2004

AbstractObjective: To determine whether chronic hepatitis B surface antigen (HBsAg) carrier status is associated with an increased incidence of gestational hypertension.Methods: A retrospective analysis of all deliveries in a regional obstetric unit over a 4‐year period using a comprehensive obstetric database.Results: The data of 13 792 patients were analysed, of which 1340 (9.71%) were chronic HBsAg carriers. Contrary to our hypothesis, the overall incidence of gestational hypertension was significantly lower in the HBsAg positive group (2.01%) as compared to the negative group (3.58%) (P < 0.01, odds ratio (OR) 0.55, 95% confidence interval (CI) 0.37–0.81). When comparing the incidence of severe preeclampsia, the difference remained significant (0.22 and 0.79%, respectively, P < 0.05, OR 0.28, 95% CI 0.08–0.88). There was otherwise no difference in the incidence of other major obstetric complications between the HBsAg positive and negative groups.Conclusion: The findings presented did not support a positive association between HbsAg carrier status and gestational hypertension. The data from the present study, and re‐evaluation of similar published data, in fact suggest the contrary observation of a lower than normal incidence of gestational hypertension in HbsAg positive mothers.
Anatomy of Complications Workshop: An educational strategy to improve performance in obstetricians and gynaecologists
Authors: Hammond Ian , Taylor John , McMenamin Paul 
Published: December 2004

AbstractMany specialist obstetricians and gynaecologists feel inadequately trained to deal with certain situations such as injury to bowel, bladder, ureter and major vessels, and value further training to prevent and manage these problems. We present the structure, objectives and rationale for a surgical skills workshop, which is an intensive practical learning experience aimed to improve the performance of obstetricians and gynaecologists. The overall objective of the workshop is improvement in the prevention and management of complications in obstetric and gynaecological surgery. Over 100 participants have completed the workshop so far. Pre‐workshop preparation includes anatomical illustrations to guide reading and a training video describing surgical skills, ewe anatomy and hysterectomy in the ewe. There are four modules: anatomy includes an interactive lecture, cadaveric dissection and examination of prosections with specific learning tasks. Surgical skills involves the demonstration, practice and learning of techniques needed to deal with unexpected operative injury to bowel, bladder, ureter and major blood vessels. Live animal surgery on a ewe allows further supervised practice of the previously learned skills plus the repair of serious vascular injury. Case presentations allow each participant to present a complicated case in a facilitated group session with discussion and feedback from their peers. This session is controlled, non‐threatening and a valuable interactive learning experience. Participant feedback suggests that this workshop format is useful and appears to improve the confidence, competence and performance of the participants. This workshop is presented as a template on which other educational activities can be developed.
Serum lipid and lipoprotein changes induced by preparations containing low‐dose ethinylestradiol plus levonorgestrel
Authors: Kiran Gurkan , Kiran Hakan , Ekerbicer Hasan C. 
Published: December 2004

AbstractThe purpose of the present study was to evaluate the effects on lipid metabolism of a new low‐dose monophasic combination oral contraceptive with 100 µg levonorgestrel and 20 µg ethinylestradiol. Sixty healthy women aged 18–45 years were administered the medication during three cycles. The study participants were screened for lipid changes. The differences in cholesterol and triglyceride levels were not statistically significant, but high‐density lipoprotein levels were significantly lower and low‐density lipoprotein levels were significantly higher than the baseline. Women at risk of cardiovascular disease should be carefully monitored even when using low‐dose preparations.
Prophylactic and therapeutic enoxaparin during pregnancy: Indications, outcomes and monitoring
Authors: Rowan Janet A , McLintock Claire , Taylor Rennae S , North Robyn A 
Published: December 2004

AbstractObjectives: To evaluate the efficacy and safety of prophylactic and therapeutic enoxaparin in pregnancy.Study design: Three‐year prospective audit.Setting: Tertiary level obstetric hospital.Population: Fifty‐two women who received subcutaneous enoxaparin, either a prophylactic dose (40 mg daily) in 26 pregnancies or therapeutic dose (1 mg/kg twice daily) in 32 pregnancies.Materials and methods: Pregnant women treated with enoxaparin were prospectively entered into a register. Data were retrieved by case note review.Main outcome measures: Pregnancy outcomes, treatment complications and anti‐Xa levels.Results: In the prophylactic group there were no fetal losses, thromboembolic events or complications related to enoxaparin. In the therapeutic group there were four first trimester miscarriages, a termination and 27 live births. Therapeutic enoxaparin prevented further thromboembolism without complications. One woman was treated with intermediate dose enoxaparin when she presented at 5 weeks’ gestation on warfarin and 7 weeks after a venous thromboembolism. She developed a recurrent pulmonary embolus 3 weeks later and was subsequently treated with therapeutic enoxaparin. In the therapeutic group the enoxaparin dose/kg correlated poorly with anti‐Xa levels, and dose adjustments were made. Therapeutic mean (SD) trough and peak anti‐Xa levels were 0.33 U/mL (0.14) and 0.86 U/mL (0.24) in the first trimester and 0.48 U/mL (0.19) and 0.84 U/mL (0.23) in the third trimester.Conclusions: In the present series, prophylactic and therapeutic enoxaparin treatment during pregnancy was effective and safe. Studies are required to determine the optimal duration of treatment with therapeutic enoxaparin following venous thromboembolism in pregnancy and the clinical relevance of anti‐Xa monitoring.
Value of a structured participant evaluation questionnaire in the development of a surgical education program
Authors: Hammond Ian , Taylor John , McMenamin Paul 
Published: December 2004

AbstractObjective: To describe how the summative evaluation of attitudes and perceptions of participants at a surgical skills workshop influences and contributes to the development of the workshop.Materials and methods: One hundred participants from 11 workshops were invited to complete a structured scored anonymous questionnaire with 18 statements, at the end of each workshop. Space was provided for free comment next to each statement. The questionnaire covered all aspects of the workshop including the practical modules, learning materials, organisation, facilitators and the relevance of the workshop to their needs. Ninety‐eight of the 100 participants returned the questionnaire and this analysis is based on their responses.Results: All respondents considered the workshop content, structure and facilities enabled the educational objectives to be achieved. The scored responses to the structured statements helped to determine the degree of satisfaction with the workshop domains, but did not give direction for change. The informal ‘free’ comments gave insight as to how improvements could be achieved in specific domains. Numerous changes suggested by participants have been included in subsequent workshops.Conclusion: Summative evaluation of an educational program is important to determine participant satisfaction and to determine areas needing improvement. Structured scored questionnaires are helpful in determining levels of satisfaction with the various domains of the program. Informal written comments allow insight into specific areas requiring improvement and may provide guidance as to how improvement can be achieved. Space for such comment should be encouraged in any program evaluation questionnaire.
National audit of women with abnormal cervical smears in New Zealand
Authors: Sarfati Diana , Cox Brian , Jones Ronald W. , Sopoaga Tai , Rimene Christine , Paul Charlotte 
Published: December 2004

AbstractObjective: To evaluate the follow‐up of women with abnormal cervical smears identified by the National Cervical Screening Programme (NCSP) in New Zealand.Design: Survey and clinical audit.Setting: The study took place in New Zealand.Population: The population included women aged 20–69 years enrolled on the NCSP with first abnormal smear recorded in 1999.Methods: Participants were interviewed, and clinical data collected from the NCSP‐register, and from clinicians.Main outcome measures and results: The overall response rate was 57%. The proportions of women whose initial assessment, treatment or follow‐up fell outside recommended times were between 17 and 35%. Of women with high‐grade smears, 72% underwent a treatment procedure. Of these, 91% were excision biopsies, 6% hysterectomies and 4% ablation procedures. Approximately 10% of women had persistent or recurrent abnormalities at 6 and 12 months after treatment.Conclusions: Overall, results were largely reassuring, but limited by the low response rate. Most women were managed within current clinical guidelines. Areas requiring improvement were identified, in particular in relation to longer than recommended waiting times for assessment and treatment.
Effect of a ginger extract on pregnancy‐induced nausea: A randomised controlled trial
Authors: Willetts Karen E. , Ekangaki Abie , Eden John A 
Published: December 2004

AbstractObjective: To investigate the effect of a ginger extract (EV.EXT35) on the symptoms of morning sickness.Design: Double‐blind randomised placebo‐controlled trial.Setting: A tertiary metropolitan teaching hospital, March 1999–November 1999.Participants: The participants included 120 women less than 20 weeks pregnant, who had experienced morning sickness daily for at least a week and had had no relief of symptoms through dietary changes.Intervention: Random allocation of 125 mg ginger extract (EV.EXT35; equivalent to 1.5 g of dried ginger) or placebo given four times per day for 4 days.Main outcome measures: Nausea, vomiting and retching as measured by the Rhodes Index of Nausea, Vomiting and Retching.Results: The nausea experience score was significantly less for the ginger extract group relative to the placebo group after the first day of treatment and this difference was present for each treatment day. Retching was also reduced by the ginger extract although to a lesser extent. No significant effect was observed on vomiting. Follow‐up of the pregnancies revealed normal ranges of birthweight, gestational age, Apgar scores and frequencies of congenital abnormalities when the study group infants were compared to the general population of infants born at the Royal Hospital for Women for the year 1999–2000.Conclusion: Ginger can be considered as a useful treatment option for women suffering from morning sickness.
Aetiology and prevalence of lower limb lymphoedema following treatment for gynaecological cancer
Authors: Ryan Mary , Stainton M. Colleen , Slaytor Emma K. , Jaconelli Carmel , Watts Sally , MacKenzie Patricia 
Published: December 2004

AbstractObjective: To determine the prevalence and incidence of lower limb lymphoedema (LLL) in a cohort of women who had treatment for gynaecological cancer between May 1995 and April 2000.Design: A retrospective survey.Setting: The study took place at an urban referral centre in an Australian tertiary referral women's hospital.Sample: The data collection was based on 66% of 743 women on the database of the Gynaecological Cancer Centre.Methods: Interviews and assessments were conducted to determine the status of lower limbs; medical records were reviewed for age, weight, site and type of cancer and treatment.Main outcome measures: Leg swelling, diagnosed lower limb lymphoedema, no swelling of the legs and type of surgery were determined as the main outcome measures.Results and conclusions: The diagnosis of lower limb lymphoedema was made in 18% of the total sample: 53% of these were diagnosed within 3 months of treatment, a further 18% within 6 months, 13% within 12 months and the remaining 16% up to 5 years following treatment. Women most at risk for developing LLL were those who had treatment for vulvar cancer with removal of lymph nodes and follow up radiotherapy. For this subsample, the prevalence was 47%. The finding that LLL occurs within the first year is earlier than hitherto generally believed. It is therefore imperative for all health professionals to include care and assessment of the legs particularly during the immediate pre‐ and postoperative period.
Survey of the knowledge, attitudes and experiences of Western Australian women in relation to prenatal screening and diagnostic procedures
Authors: Rostant Kristie , Steed Lyndall , O'Leary Peter 
Published: December 2004

AbstractObjective: To determine the knowledge, attitudes and experiences of women in Western Australia (WA) regarding prenatal procedures.Design: A self‐administered mail survey.Sample: The survey was sent to all women who gave birth during July 2001 (n = 1801). The participants were 633 women aged 15–45.Results: The mean total knowledge score was 16 out of a possible 26 (62%). The average score for all three attitude factors was four, ‘agree’, on a Likert scale of five. Women who reported they had private health insurance and women in the metropolitan area had significantly higher knowledge levels and had significantly more positive attitudes towards the adequacy of information. Those who did not have a screening test had less positive attitudes towards the value of the tests and had less confidence in results. Those with higher educational attainments had higher knowledge and less positive attitudes towards the value of the tests.Conclusions: Women felt positive towards the value of the tests, were confident in their results and felt positive towards the adequacy of information; however, their understanding of this information seems to be poor. It seems that the choice to undergo testing is not well informed. It was clear women need more support, information, explanations, and more time to absorb the information.
Is amniotic fluid volume status predictive of fetal acidosis at delivery?
Authors: Magann Everett F. , Chauhan Suneet P. , Martin James N. 
Published: December 2004

AbstractObjective: To ascertain if dye‐determined amniotic fluid volume just prior to delivery correlates with fetal acidosis at delivery.Design: The present was a prospective observational study.Setting: The study took place at the University of Mississippi Medical Center, Jackson MS, USA.Population: The population included 100 unlaboured women undergoing an amniocentesis for the assessment of fetal lung maturity before an elective Caesarean delivery between January 1997 and December 2000.Main outcomes measured: The amniotic fluid volume was estimated by ultrasound measurement and quantified by dye‐determined methodology immediately prior to Caesarean delivery. Umbilical cord artery pH was collected at the time of Caesarean delivery.Results: The predictive accuracy of an amniotic fluid index ≤ versus >5 to identify an umbilical artery pH of <7.20 had a sensitivity of 0%, a specificity of 84%, and a likelihood ratio of zero. None of the dye‐determined low amniotic fluid volumes were identified using the single deepest pocket technique. Dye‐determined low, normal, and high amniotic fluid volume groups contained a similar number of fetuses with umbilical cord arterial pH <7.20 (P = 0.371), <7.10 (P = 0.460), and <7.00 (P = 0.614). Receiver‐operating characteristic curves could not identify any amniotic fluid index from 0 to 18, single deepest pocket from 0 to 12, or dye‐determined amniotic fluid volume 100–1900 mL to differentiate between the two newborns with an umbilical cord artery pH <7 from 98 babies with cord pH ≥7.0.Conclusions: Neither ultrasound estimates nor dye‐determined amniotic fluid volumes are predictive of a low umbilical artery pH at delivery.
Quest for patient safety in a challenging environment
Authors: Court Denys 
Published: December 2004

AbstractWe are unable to guarantee our patients that the care we provide will do no harm. Up to 16% of hospital admissions will be associated with an adverse event, approximately half of which are preventable. It is a clinical imperative that we must strive to improve patient safety by improving the systems in which we work, such that they support us in providing better and safer care. For this to occur, an environment must develop where clinicians feel safe to report and allow analysis of adverse events and near misses. The greatest inhibitor of a reporting culture is the prevailing legal climate with its associated blame culture. A new social contract is required whereby systems analysis will predominate over the previous presumption that individual clinicians must be held responsible for each and every adverse outcome. Individual responsibility should be reserved for events where it becomes evident during the course of systems analysis that an individual's behaviour is truly blameworthy.
Effects of a single course of corticosteroids given more than 7 days before birth: A systematic review
Authors: McLaughlin Kristin J. , Crowther Caroline A. , Walker Natalie , Harding Jane E. 
Published: December 2004

AbstractObjectives: To determine the risk of fetal, neonatal and maternal mortality and morbidity for women and their infants who remained undelivered more than 7 days following a course of prenatal corticosteroids.Design: Systematic review.Population: Women who gave birth more than 7 days after a course of prenatal corticosteroids compared with women not administered corticosteroids.Methods: Seven randomised controlled trials were identified which reported outcomes for women and their babies who remained undelivered more than 7 days after exposure to a single course of corticosteroids compared with a placebo/no treatment group.Main outcome measures: Fetal, neonatal and maternal mortality and morbidity.Results: Seven trials involving 862 infants, 434 born to corticosteroid treated women and 428 to control women were included in this review. For corticosteroid treated infants there was no reduction in the risk of respiratory distress syndrome (relative risk (RR), 0.72; 95% confidence interval (CI), 0.49–1.07), or stillbirth (RR, 1.67; 95% CI, 0.86–3.25). However, there was a tripling in risk of death for liveborn corticosteroid treated infants (RR, 3.24; 95% CI, 1.32–7.96; P = 0.01), and a doubling in risk of perinatal mortality (RR, 2.13; 95% CI, 1.27–3.57; P < 0.01). Corticosteroid treated infants were born on average 5 days earlier than controls (95% CI, −9.15 to −0.85 days, P = 0.02). Their mothers were more likely to have chorioamnionitis (RR, 2.91; 95% CI, 1.25–6.74; P = 0.01).Conclusions: Infants exposed to corticosteroids more than 7 days before birth had no reduction in risk of respiratory distress syndrome but increased perinatal mortality.
Role of Ca2+ in corticosterone‐induced muscle growth retardation
Authors: DOI Junko , HARA Tomoko , OHTSUKA Akira , HAYASHI Kunioki 
Published: December 2004

ABSTRACTThe increased plasma glucocorticoid concentration in stressful conditions stimulates muscle protein degradation, and results in growth retardation in animals. However, the mechanism is still to be clarified. The present study was undertaken to examine the participation of Ca2+ in the glucocorticoid action, using nifedipine (NIF), a Ca2+ channel antagonist. The effects of NIF on growth, differentiation, and protein degradation were examined in glucocorticoid‐treated primary cultured chick muscle cells. Muscle cell growth and cell differentiation were assessed by protein content and creatine kinase (CK) activity, respectively, and the rate of myofiblillar protein degradation was estimated by the release of Nτ‐methylhistidine (MeHis). Creatine kinase activity was increased by corticosterone (CTC) and this effect was minimized by NIF. Protein content was decreased by CTC and normalized by NIF. Nτ‐methylhistidine release was significantly increased by CTC and tended to be minimized by NIF. The present results indicate that CTC increases skeletal muscle proteolysis followed by muscle growth retardation partially because of enhanced Ca2+ influx through the NIF‐sensitive Ca2+ channel. Enhanced muscle differentiation by CTC is mediated also by the NIF‐sensitive Ca2+ channel.
Chemical compositions, feed intakes and digestibilities of crop residue based rations in non‐lactating Red Sokoto goats in the subhumid zone of Nigeria
Authors: MALAU‐ADULI Bunmi S. , EDUVIE Lawrence , LAKPINI Clarence , MALAU‐ADULI Aduli E. O. 
Published: December 2004

AbstractThe present study was conducted to evaluate the chemical composition, intake and digestibility of crop residue based rations by Red Sokoto goats maintained on natural pastures and Digitaria smutsii hay during the dry season of the year. Twenty‐eight non‐lactating does were blocked for weight and assigned to 7 treatment groups comprising 4 does each in a completely randomized design. Ration A, the conventional concentrate ration, was used as the positive control, Rations B and C were the two crop residue based test rations, while Ration D, the unsupplemented treatment, was used as the negative control. Each of the supplementation rations was fed at 1% and 2% of the doe's body weight. Ration A had the highest crude protein percentage of 17.19% while Rations B and C had 9.54 and 10.38%, respectively. The naturally grazed pastures and Digitaria smutsii hay (Ration D) contained the least protein: 2.76 and 4.75%, respectively. Ration D also had the highest percentages of acid detergent fiber, neutral detergent fiber and lignin (49.14, 74.73 and 9.49% in hay and 50.29, 8.27 and 11.5% in grazed pastures, respectively). Ration A on the other hand, had the lowest percentages of acid detergent fiber (20.00%), neutral detergent fiber (40.01%) and lignin (4.64%). The results indicated that the supplemented group of does had significantly higher (P < 0.05) dry matter and crude protein intakes as well as nutrient digestibilities than the unsupplemented groups. A comparison of the unsupplemented animals with all the other treatment groups revealed that dry matter digestibility improved by a range of 4.1–27.9%, while crude protein digestibility improved by 17.1–42.2%, the highest value being in does on Ration A. It was concluded that goats were able to subsist and make appreciable gains in the long dry season on crop‐based diets that compared favorably with the conventional concentrate rations. Of the two tested crop residue based rations, Ration C is a better supplementation package than Ration B.