bluuebunny/crossref_metadata_2025_split huggingface dataset:
Endothelin‐1 in feto‐placental tissues from normotensive pregnant women and women with pre‐eclampsia
Authors: Singh Harbindar Jeet , Rahman Abdul , Larmie Ernest Teiko , Nila Awang 
Published: March 2003

Aims. The pathogenesis of pre‐eclampsia is still unclear. Placental hypoperfusion, which precedes the maternal manifestations of pre‐eclampsia, could be due to some vasoconstrictor factor/s like endothelin‐1. The aim of the study therefore was to estimate the levels of endothelin‐1 in feto‐placental tissue homogenates from normotensive pregnant women and women with pre‐eclampsia.Method and material. Fresh, vaginally delivered placentae from ten normotensive pregnant women and nine women with pre‐eclampsia were carefully dissected and 4 gm each of amnion, chorion laeve, placental plate chorion, fetal placenta (fetal surface of the placenta) and maternal placenta (surface of the placenta attached to the uterine wall) were obtained. These tissues were then thoroughly washed in a 0.5 M phosphate buffer, pH 7.5, at room temperature and then individually homogenized for one minute in 4 ml of the same buffer. After centrifugation the supernatant was removed. The pellet was re‐suspended in buffer, re‐homogenized and then centrifuged. The supernatant was removed and the procedure was repeated once again and the three supernatants of each tissue were pooled. Endothelin‐1 was estimated by RIA. All results are presented as mean±SEM. Statistical analysis was performed using students ‘t’ test for unpaired samples and a ‘p’ value of <0.05 was considered significant.Results. In tissues from normotensive pregnant women, no significant differences were evident in endothelin‐1 concentrations in the chorion laeve, fetal placenta and maternal placenta but were significantly higher than those in the amnion and placental plate chorion (p<0.01). In tissues from pre‐eclamptic women, no significant differences were evident between endothelin‐1 concentrations in the chorion laeve, placental plate chorion and fetal placenta. Mean endothelin‐1 concentration in the amnion and maternal placenta were significantly lower than those in chorion laeve, placental plate chorion and fetal placenta (p<0.01). Endothelin‐1 concentrations were significantly higher in the amnion, chorion laeve, placental plate chorion and fetal placenta from women with pre‐eclampsia when compared to tissues from normotensive pregnant women (p<0.01).Conclusions. Endothelin‐1 levels were significantly higher in the placental tissues from women with pre‐eclampsia. Endothelin‐1, being a powerful vasoconstrictor, could cause significant vasoconstriction in the placental vasculature, and alterations in endothelin‐1 levels in placental vasculature may therefore have a role in the pathogenesis of pre‐eclampsia.
Who stops smoking during pregnancy?
Authors: Lindqvist Rune , Åberg Hans 
Published: March 2003

Background. The proportion of women who stop smoking during pregnancy has varied between 17 and 40% percent in Sweden with a tendency of lower prevalence in recent years. The aim of the present study was to examine the factors that might influence the ability to stop smoking during pregnancy.Method. One hundred and two women were interviewed shortly after their first visit to the antenatal clinic and a second time approximately one month after delivery. Two women who had late spontaneous abortions were excluded. The women were asked about background factors, smoking habits of their parents, smoking history and current smoking habits. The carbon monoxide in expiratory air was measured to verify reported smoking habits.Results. Fifty‐six of the 100 participating women had stopped smoking before the second interview. Having started smoking at an older age, having no previous children, smoking few cigarettes, a higher level of education, positive support from the partner and having lived with non‐smoking parents were all associated with stopping smoking when tested as single factors. Reported smoking habits could be verified. Age, smoking habits of the partner, passive smoking at work, quality of sleep, general perceived health, length of sick‐leave or amount of nausea were not correlated to stopping smoking.Conclusion. The presence of several factors found to influence stopping smoking during pregnancy, and the tendency for smoking habits to be passed over to the new generation, are reasons for comprehensive and individualized, anti‐smoking support.
Fear during labor
Authors: Alehagen Siw , Wijma Klaas , Wijma Barbro 
Published: March 2003

Background. The aims of the present study were to compare primiparous and multiparous women’s experiences of fear of delivery during an early stage of active labor (cervix dilatation 3–5 centimeters) and to study whether fear of delivery, measured during the early stage of active labor, was a predictor of the amount of pain relief received during the remaining part of labor (cervix dilatation 5 cm – partus), of the duration of the remaining part of labor, and of the occurrence of instrumental vaginal delivery and emergency cesarean section.Method. Thirty‐five primiparous and 39 multiparous women answered the Delivery Fear Scale (DFS) once during the early stage of labor and before they had received any pain relief.Results. Primiparous women reported higher levels of fear than multiparous women did. Fear during the first phase of labor predicted only the total amount of pain relief received during labor.Conclusion. The clinical implications of the study are that the delivery staff should consider women’s fear during labor and pay attention especially to primiparous women’s increased risk of higher levels of fear during an early stage of active labor, as compared with multiparous women’s. The challenge for staff of a delivery ward is to support the woman in labor in a way that decreases fear, which in turn might reduce the woman’s need of pain relief.
Recovery from vaginal hysterectomy compared with laparoscopy‐assisted vaginal hysterectomy:
Authors: Soriano David , Goldstein Andrei , Lecuru Fabrice , Daraï Emile 
Published: March 2003

Objective. To evaluate short‐term recovery of vaginal hysterectomy with those of laparoscopic assisted vaginal hysterectomy performed in a prospective, randomized multicentric study.Study design. Eighty patients referred for hysterectomy for benign pathology were randomized to either vaginal hysterectomy (40 patients) or laparoscopic assisted vaginal hysterectomy (40 patients). Inclusion criteria were uterine size larger than 280 g and one or more of the following: previous pelvic surgery, history of pelvic inflammatory disease, moderate or severe endometriosis, concomitant adnexal masses, and indication for adnexectomy. No upper limit of uterine size was set. All the laparoscopic and the vaginal hysterectomies were done under endotracheal general anesthesia.Results. There was no statistically significant difference in terms of patient’s age, parity, postmenopausal state, indication for surgery and mean uterine weight between the 2 groups. Laparoconversion was performed in three women in the laparoscopic group. Operative time was significantly shorter in the vaginal versus the laparoscopic groups 108±35 and 160±50 respectively (p<0.001). The use of paracetamol, non steroidal anti‐inflammatory drugs, and opioid during hospitalization were similar in the 2 groups. There was no difference in the 1st day hemoglobin level drop, time of passing gas and stool, or hospital stay between the 2 groups.Conclusion. In contrast with earlier reports, there was no difference in short‐term recovery between patients undergoing vaginal or laparoscopic hysterectomy. No advantage was found performing laparoscopic assisted vaginal hysterectomy in comparison with the standard vaginal hysterectomy.
The expression of cyclooxygenase 2 and inducible nitric oxide synthase indicates no active inflammation in vulvar vestibulitis
Authors: Bohm‐Starke Nina , Falconer Christian , Rylander Eva , Hilliges Marita 
Published: March 2003

Background. Although women with vulvar vestibulitis syndrome have principal symptoms of inflammation such as local erythema and pain in the mucosa around the vaginal introitus, it is not clear if vestibulitis is an inflammatory condition. Cyclooxygenase 2 and inducible nitric oxide synthase are known to be upregulated during inflammation. The aim of the present study was to analyze the expression of these enzymes in the vestibular mucosa in order to evaluate the inflammatory activity in the tissue.Methods. Ten women fulfilling Friedrich's criteria of vulvar vestibulitis syndrome and ten control subjects were included in the study. Punch biopsies were obtained from the vestibular mucosa for analysis of cyclooxygenas 2 and inducible nitric oxide synthase, using indirect immunohistochemistry and Western dot‐blot analyses.Results. Both methods used showed low expression of cyclooxygenas 2 and inducible nitric oxide synthase in the vestibular mucosa of all women. There was no difference observed between the groups.Conclusions. There is a low expression of the inflammatory markers cyclooxygenas 2 and inducible nitric oxide synthase in the vestibular mucosa of women with vulvar vestibulitis syndrome as well as in healthy control subjects. The results indicate no active inflammation present and imply that topical corticosteroids in the treatment of vulvar vestibulitis are unfounded.
Seropositivity of cytomegalovirus, parvovirus and rubella in pregnant women and recurrent aborters in Leningrad County, Russia
Authors: Odland Jon Ø. , Sergejeva Irina V. , Ivaneev Mikhail D. , Jensen Inge Panum , Stray‐Pedersen Babill 
Published: March 2003

Background. The objectives of this paper were to assess the prevalence of different viral infections in relation to late abortions, stillbirths, and congenital malformations in sera from Russian pregnant women and recurrent aborters in order to establish basic knowledge for future pregnancy care.Methods. Patients were recruited at the Women’s Clinic, Leningrad Regional Hospital during the period March–June 1995. One group of normally pregnant women (Group 1; n=182) and one group of recurrent aborters (Group 2; n=127) were evaluated, including demographic, medical, clinical, and serological data.Results and conclusions. The mean age of the two groups was 27.1 and 28.2 years, respectively. The mean number of deliveries was low (0.4 and 0.5, respectively). Thirty‐one point six percent of Group 1 and 41.9% of Group 2 were daily smokers. The group of normally pregnant women had a significantly increased frequency of induced abortions compared to the recurrent aborters, while the recurrent aborters reported more genital infections. There was little difference in total antibodies to cytomegalovirus (CMV) (78.0% and 81.1%, respectively) or B19 IgG (75.3% and 66.9%, respectively) between the groups, while the normal pregnant women had a significantly higher prevalence of rubella antibodies (77.5% and 59.8%, respectively). Our results indicate that less women remain susceptible to primary CMV infection in pregnancy in Russia compared to western Europe and North America. The prevalence of B19 IgG was slightly lower than data from Sweden. Natural immunization against rubella virus was lower than in other, unvaccinated female populations. Vaccination strategies for rubella are now initiated in the Russian Federation. Results from this study are utilized in a federally supported, comprehensive pregnancy care project of North‐West Russia.
Vulvar pain, sexual behavior and genital infections in a young population: a pilot study
Authors: Berglund Anna‐Lena , Nigaard Linda , Rylander Eva 
Published: March 2003

Background.  To study the prevalence of pain during intercourse in a young population and analyze factors that may be associated with vulvar pain.Methods.  During a 2‐month period, 172 women (aged 12–26 years) consulting four different adolescent health centres in Stockholm, Sweden, responded to a questionnaire concerning sexual habits, history of infections, and genital symptoms a priori vulvar pain. Multiple logistic regression model was used to evaluate the independent effects of the variables associated with vulvar pain.Results.  One‐third of the women reported regular pain during and/or after intercourse. Having regular sexual intercourse before the age of 16 years and using oral contraception for more than 2 years were independent variables increasing the risk of vulvar pain. There was a correlation trend between vulvar pain and lack of sexual desire, recurrent candida infections, and urinary tract infections. However, there was no correlation to sexually transmitted diseases. More than 4 years of regular intercourse and coitus at least 4 times a week were factors that inversely correlated to vulvar pain.Conclusions.  One‐third of young women answering a questionnaire at adolescent health centres reported regular pain during and/or after intercourse. Early regular coitus and long‐time use of oral contraceptives were factors associated with vulvar pain. Frequently rubbing a vulnerable mucosa may result in irreversible damage and vulvar vestibulitis syndrome.
Adverse obstetric outcome in fetuses that are smaller than expected at second trimester routine ultrasound examination
Authors: Nakling Jakob , Backe Bjørn 
Published: March 2003

Background.  Adverse obstetric outcome in fetuses that are smaller than expected at second trimester routine ultrasound examination.Aim.  To assess the obstetric outcome when the interval between the estimated date of delivery by last menstrual period and the estimated date of delivery by second trimester ultrasound exceeds 14 days.Materials and methods.  Population‐based prospective cohort study. Included were all women (n = 16 302) with a singleton pregnancy, in one Norwegian county from 1989 to 1999, with a reliable menstrual history and whose second trimester ultrasound examination was conclusive with a 35–60‐mm biparietal diameter.Results.  Adverse outcome was defined as preterm birth (< 37 weeks), perinatal death, low birthweight (< 2500 g) and small‐for‐gestational age (< 2 standard deviation). The risk for perinatal death (odds ratio = 2.3), preterm birth (odds ratio = 1.7), low birth weight (odds ratio = 1.5), and small‐for‐gestational age (odds ratio = 1.5) was highly significantly increased in deliveries where the discrepancy between the two terms was more than 14 days. The increased risk is not explained by differences in parity, maternal age, smoking, fetal malformations, or use of oral contraceptives before pregnancy.Conclusion.  Fetuses that are smaller than expected at the mid‐second trimester ultrasound corresponding to a discrepancy of more than 14 days have an increased risk for adverse obstetric outcome.
Reproductive tract infections and the risk of HIV among women in Moshi, Tanzania
Authors: Msuya Sia E. , Mbizvo Elizabeth , Stray‐Pedersen Babill , Sundby Johanne , Sam Noel E. , Hussain Akhtar 
Published: March 2003

Objectives.  The objectives of the study were to determine the prevalence of HIV and reproductive tract infections (RTIs); to compare the occurrence of RTIs among HIV‐infected and non‐infected women; and to assess the association of HIV with RTIs and behavioral factors among women aged 15–49 years.Methods.  A cross‐sectional study was conducted in late 1999 among 382 consenting women attending three primary healthcare clinics. They were interviewed and screened for HIV‐1 and RTIs.Results.  The prevalence of HIV‐1 was 11.5%. Sixty‐four percent of the women had one ongoing treatable RTI. Endogenous and sexually transmitted RTIs were higher in HIV‐positive than negative women and 84% of the HIV seropositive women were co‐infected with one treatable RTI. HIV was significantly associated with cervicitis (chlamydial or gonococcal) [OR = 3.2 (CI 1.1–13.2)], HSV‐2 [OR = 2.6 (CI 1.3–5.1)], bacterial vaginosis [OR = 1.9 (CI 1.1–4.1)], genital warts [OR = 4.8 (CI 1.1–22.2)], and presence of vaginal discharge [OR = 2.7 (CI 1.3–5.2)]. Having more than one lifetime sexual partner, a history of infant mortality or a partner who had other wives or resided away from home > 6 months, were risk factors for HIV infection.Conclusion.  HIV‐1 and RTIs are a major public health problem among women in this population. Integration of routine screening and treatment of RTIs in the reproductive health clinics will be an important strategy to combat HIV in the area. Further, innovative behavior interventions targeting both men and women, preferably as couples are needed.
The use of clomiphene citrate/human menopausal gonadotrophins in conjunction with GnRH antagonist in an IVF/ICSI program is not a cost effective protocol
Authors: Mansour Ragga T. , Aboulghar Mohammed A. , Serour Gamal I. , Al‐Inany Hesham G. , Fahmy Ibrahim , Amin Yehia 
Published: March 2003

Acta Obstet Gynecol Scand 2003; 82: 48–52. © Acta Obstet Gynecol Scand 2003Objective.  To evaluate the cost effectiveness of a clomiphene citrate (CC)/human menopausal gonadotropin (hMG)/GnRH antagonist protocol versus a long‐acting GnRH agonist/hMG protocol.Participants & Methods.  One hundred eighty nine couples having their first trial of ICSI for male factor infertility were divided into two groups. Group I (no = 33) received CC 100–150 mg/day for five days starting from day 2 of the cycle and 150 IU of hMG/day on days 6–10. GnRH antagonist (Centrorelix) 0.25 mg/day was started when the leading follicle reached 16 mm in the absence of an LH surge. Group II (no = 156) received 0.1 mg Deacapeptyl/day as our standard long protocol.Results.  Clinical pregnancy was observed in 8 out of the 33 cases in group I (24%) while in group II, 92 out of 156 achieved clinical pregnancy (59%), the difference was statistically significant (P = 0.019). The cost of medications/cycle was estimated to be 1110±492 E.P in group I, while it was 1928±456 E.P. in group II. However, the total cost per pregnancy was 19653 EP in group I and 10047 EP in group II.Conclusion.  The use of the clomid/hMG/antagonist protocol is not a cost effective strategy and should not be recommended in IVF‐ICSI cycles.
Quality improvement project in cervical cancer screening: practical measures for monitoring laboratory performance
Authors: Tarkkanen Jussi , Geagea Antoine , Nieminen Pekka , Anttila Ahti 
Published: March 2003

Acta Obstet Gynecol Scand 2003; 82: 82–88. © Acta Obstet Gynecol Scand 2003Background.  We conducted a quality improvement project in a cervical cancer screening programme in Helsinki in order to see if detection of precancerous lesions could be influenced by external (participation rate) and internal (laboratory praxis) quality measures.Methods.  In order to increase the participation rate, a second personal invitation to Pap‐test was mailed to nonparticipants of the first call. In order to improve the quality of screening, the cytotechnicians monitored their performance longitudinally by recording the number of slides reviewed per day, the pick‐up rate of abnormal smears, the report of the consulting cytopathologist, and the number of histologically verified lesions detected from the cases that they had screened. Regular sessions were held to compare the histological findings with the cytological findings of all cases referred for colposcopy. No pressure was applied on the cytotechnicians to ensure that they felt comfortable with their daily workload.Results.  A total of 110 000 smears were screened for cervical cancer at the Helsinki City Hospital during 1996–99. Initially, the overall participation rate increased from 62% to 71%. The number of histologically confirmed precancerous lesions (CIN 1–3) more than doubled and their detection rate increased from 0.32% to 0.72%.Conclusions.  Continuous education and feedback from daily work performance were important, yet rather inexpensive means in increasing laboratory performance. Additional measures are needed to further increase the participation rate. Impact of the quality measures on cancer incidence needs to be assessed later on.
Impaired dark adaptation in polycythemia. Improvement after treatment
Authors: Havelius Ulf , Berglund Stig , Falke Pia , Hindfelt Bengt , Krakau Torsten 
Published: March 2003

ABSTRACT.Purpose: To determine if dark adaptation is reduced in individuals with polycythemia and if so whether there is any improvement in dark adaptation after treatment.Methods: Dark adaptation was recorded monocularly by automatic dark adaptometry in ten consecutive patients with polycythemia before and after treatment. Analogue investigations were performed in 31 healthy control subjects.Results: Dark adaptation was markedly impaired in the patients as compared with the control subjects. After reduction of the red cell count and normalization of the hematocrit and hemoglobin the dark adaptation was markedly improved. There was no significant change in dark vision in the control subjects negating a confounding learning effect.Conclusion: The findings indicate a sustained but reversible neuronal hypofunction secondary to polycythemia. As the rheological abnormality was normalized, dark adaptation was improved, probably secondary to normalized microcirculation within the retina or the brain, or both, possibly with reactivation of formerly inactive neuronal cells.
The acoustic lighthouse effect
Authors: Fledelius Hans C. , Scherfig Erik 
Published: March 2003

ABSTRACT.Purpose: To discuss and possibly explain the ultrasonic lighthouse effect, a metaphor suggested for an artifact‐like phenomenon sometimes found by B‐scan in eyes having had intra‐ocular perfluorocarbon and/or silicone oil injected as part of vitreoretinal surgery.Method: Analysis of the ultrasonic findings with a view to the specific gravities of the above injected substances. Compared to water, perfluorocarbon has a higher and silicone oil a lower gravity; they are heavy and light, respectively.Results: The elicited lighthouse effect may appear localized or ‘mobile’. When evoked only from specific positions on the globe, most likely it is explained by a lens‐like accumulation of material trapped at the vitreous base just under the transducer. When mobile it depends on head position; there is a gravitational shift in position of the material, as evident in particular when becoming visible in the anterior chamber.Conclusions: In case reports in literature slit‐lamp verified anterior segment perfluorocarbon remnants have caused acoustic disturbances of a similar nature. In this study we found evidence that also silicone oil can underlie the acoustic lighthouse effect.
Spontaneous involution of a large retinal arterial macroaneurysm
Authors: Ohno‐Matsui Kyoko , Hayano Masato , Futagami Soh , Tokoro Takashi , Ohno Seiji 
Published: March 2003

ABSTRACT.Background: Acquired retinal macroaneurysms are round dilatations of retinal arterioles that occur in the posterior fundus. They tend to rupture before they grow large and cause a visual decrease. The average diameter of macroaneurysms in the previous reports is 281 micrometer.Methods: A 63‐year‐old man complained of a sudden decrease of visual acuity in the left eye. Fundus examination of his left eye revealed a large protruded mass, 2 disc diameters in size, at the first bifurcation of the inferotemporal retinal artery. Preretinal vitreous bleeding and serous retinal detachment were observed around the lesion. Indocyanine green (ICG) angiography showed this mass to be continuous with the inferotemporal retinal artery and ICG dye leaked from the retinal artery into the lumen of the mass, with pulsation.Results: Six months later, the large macroaneurysm underwent spontaneous involution.Conclusion: As shown in this patient, retinal macroaneurysms may grow extremely large. ICG angiography was useful to diagnose this large retinal arterial macroaneurysm.