bluuebunny/crossref_metadata_2025_split huggingface dataset:
Labour characteristics and uterine activity: misoprostol compared with oxytocin in women at term with prelabour rupture of the membranes
Authors: Ngai Suk Wai , Chan Yik Ming , Lam Sze Wing , Lao Terence T. 
Published: August 2005

Objective
To compare the labour pattern and uterine activity of oral misoprostol with oxytocin for labour induction in women presenting with prelabour rupture of membranes at term.Design
Prospective randomised study.Setting
Department of Obstetrics and Gynaecology, Queen Mary Hospital, Hong Kong.Participants
Eighty women presenting with prelabour rupture of membranes at term.Methods
The women were randomised to receive either 100 μg misoprostol orally every 4 hours to a maximum of three doses, or intravenous oxytocin infusion according to the hospital protocol. Intrauterine pressure transducers were inserted one hour before induction of labour in both groups of women. We compared the pattern of uterine activity, the induction‐to‐delivery interval, duration of labour, mode of delivery and neonatal outcome between the two groups.Results
Both oxytocin and oral misoprostol caused an increase in uterine activity within one hour of labour induction. Peak uterine activity was reached 6–8 h after oral misoprostol, with persistent effects, and 8–10 h after oxytocin, requiring continuous titration of medication. The duration of labour was significantly reduced in nulliparous women, but not in those who were multiparous in the misoprostol group. The induction‐to‐delivery interval, the mode of delivery and the perinatal outcome were similar for the two groups.Conclusion
Oral misoprostol caused earlier peak uterine activity, compared with oxytocin (6–8 h vs 8–10 h). Oral misoprostol was not only as effective as oxytocin in inducing labour in women at term with prelabour rupture of the membranes, but it reduced significantly the duration of labour in nulliparous women.
Pregnancy outcomes and cardiac complications in women with mechanical, bioprosthetic and homograft valves
Authors: Sadler Lynn , McCowan Lesley , White Harvey , Stewart Alistair , Bracken Michael , North Robyn 
Published: August 2005

Objectives
Firstly, to compare pregnancy outcomes and cardiac complications in women with: 1. either mechanical or bioprosthetic valves at the mitral site; 2. mechanical valves treated with warfarin or subcutaneous heparin. Secondly, to determine pregnancy and cardiac outcomes in women with aortic homograft valves.Design
Historical cohort study.Setting
Greenlane Hospital, Auckland, New Zealand.Population
Young women (n= 255) who had valve replacements between 1972 and 1992. Seventy‐nine women underwent 147 pregnancies.Main outcome measures
Pregnancy loss, cardiac complications.Results
Pregnancy loss occurred in 59% of pregnancies with mitral mechanical valves (n= 50) and 7% with mitral bioprosthetic valves (n= 33) (RR 8.20,95% CI2.10–31.93). Pregnancy loss rate was 70% in pregnancies treated with warfarin, compared with 25% for those switched from warfarin to heparin (RR 2.81, 95% CI 1.03–7.73). All heparin‐associated losses occurred in the first trimester, whereas there were four stillbirths with warfarin. Cardiac complications occurred in 10 pregnancies (20%) in the women with mitral mechanical valves and four (13%) with mitral bioprosthetic valves (RR 1.55, 95% CI 0.53–4.52). All four thromboembolic complications with mechanical valves occurred in the 14 women treated with heparin throughout pregnancy. Structural valve deterioration occurred in four pregnancies (10%) with mitral bioprosthetic valves. No cardiac complications or known pregnancy losses occurred with aortic homograft valves (n= 41).Conclusion
The high pregnancy loss rate in women with mitral mechanical valves was associated with warfarin throughout pregnancy, whereas the thromboembolic cardiac complications were associated with heparin. Pregnancy outcome was very good in women with bioprosthetic and homograft valves.
Prostaglandin endoperoxide H synthase mRNA expression in the fetal membranes correlates with fetal fibronectin concentration in the cervico‐vaginal fluids at term: evidence of enzyme induction before the onset of labour
Authors: Mijovic Jane E. , Demianczuk Nestor , Olson David M. , Zakar Tamas 
Published: August 2005

Objective
To determine the relationship of prostaglandin endoperoxide H synthase (PGHS) expression in the gestational tissues and fetal fibronectin in cervico‐vaginal fluids before the onset of labour at term.Design
Cross‐sectional, observational study.Samples
Amnion, chorion laeve and decidua were collected from 24 term pregnant women following elective caesarean section. Samples of cervico‐vaginal secretions were obtained from the same women immediately before caesarean section.Methods
PGHS‐1 and PGHS‐2 mRNA levels in tissues were determined by specific ribonuclease protection assays. Fetal fibronectin concentrations in the cervico‐vaginal fluids were measured by enzyme‐linked immunosorbent assay. The abundance of PGHS mRNA was compared between groups of patients with the same mean gestational age but different cervico‐vaginal fetal fibronectin levels. Linear regression analysis was used to determine the association between PGHS levels and fetal fibronectin.Results
Two groups of women were identified who had significantly different fetal fibronectin values but the same gestational ages. The group with the higher fetal fibronectin concentrations had significantly higher PGHS‐1 and PGHS‐2 mRNA levels in the chorion laeve and higher PGHS‐2 mRNA levels in the amnion, than the group with lower fetal fibronectin concentrations. PGHS‐1 and PGHS‐2 mRNA levels in the chorion laeve and PGHS‐2 mRNA in the amnion showed an overall significant association with fetal fibronectin levels.Conclusions
High concentrations of fetal fibronectin in cervico‐vaginal secretions before the onset of spontaneous labour at term are associated with high levels of PGHS‐2 mRNA in the chorion laeve and the amnion and of PGHS‐1 mRNA in the chorion laeve. Increased expression of PGHS in these tissues may therefore be involved in the events leading to term birth.
Assessment of menstrual blood loss using a pictorial chart: a validation study
Authors: Reid Peter C. , Coker Adeyemi , Coltart Rosemary 
Published: August 2005

Objective
To assess the accuracy of a pictorial blood loss assessment chart (PBAC) as a method for estimating menstrual blood loss in women complaining of heavy periods.Design
A prospective analysis of 103 consecutive women complaining of excessive menstrual blood loss.Population
Women recruited into an on‐going study of menstrual blood loss in a large district general hospital.Main outcome measures
Correlation between pictorial assessment of blood loss and actual measured menstrual blood loss.Results
There was poor correlation between observed PBAC score and menstrual blood loss.Conclusion
We have not been able to validate previously published work. The pictorial assessment chart offers no significant improvement in the quality of objective diagnosis in women complaining of menorrhagia.
Correlation between placental bed biopsy findings, vascular cell adhesion molecule and fibronectin levels in pre‐eclampsia
Authors: Madazli Riza , Budak Erdal , Calay Zerrin , Aksu M. Feridun 
Published: August 2005

Objective
To determine the correlation between placental bed biopsy findings, and blood levels of the vascular cell adhesion molecule (VCAM‐1) and fibronectin in pre‐eclampsia/eclampsia, and to evaluate the relationship between these variables and severity of the disease.Design
A prospective case‐control study.Setting
Department of Obstetrics and Gynaecology, Cerrahpasa Medical Faculty, Istanbul.Sample
Thirty‐five women with pre‐eclampsia/eclampsia were compared with 25 healthy women with uncomplicated pregnancies. Twenty‐one placental bed biopsies from pre‐eclamptic pregnancies were compared with 17 from normal pregnancies.Main outcome measures
Peripheral venous blood levels of VCAM‐1 and fibronectin, measured by enzyme‐linked immunoassay and radial immune diffusion technique.Results
In pre‐eclampsia/eclampsia, blood VCAM‐1 and fibronectin levels were higher than in normal pregnancy. Levels of both fibronectin and VCAM‐1 correlated significantly with the diastolic blood pressure (r= 0.49 and r= 0.65, P < 0.001). There was also a significant direct linear correlation between plasma fibronectin and VCAM‐1 levels (r= 0.57, P < 0.001). Normotensive women all had normal placental bed biopsy findings and the incidence of pathological placental bed biopsy findings increased with the severity of the pre‐eclampsia.Conclusion
Inadequate trophoblastic invasion of spiral arteries, and elevated levels VCAM‐1 and fibronectin were found in women with pre‐eclampsia. The magnitude of defective trophoblastic invasion, and blood levels of VCAM‐1 and fibronectin correlate with the clinical severity of pre‐eclampsia.
Epidemiological assessment of misoprostol teratogenicity
Authors: Orioli Iêda M. , Castilla Eduardo E. 
Published: August 2005

Objective
To verify if any of the 15 congenital defects already reported in association with misoprostol can be found within an epidemiological registry of congenital defects.Design
Case‐control study including case‐sick and case‐health controls.Methods
Comparison of misoprostol exposure for each specific defect, using the exposure for the rest of defects as a reference group.Population
Four thousand six hundred seventy‐three consecutive newborn infants with malformations of unknown aetiology, in the Latin American Collaborative Study of Congenital Malformation.Results
There was no difference in exposure rate between the malformed (34/4673) and nonmalformed (23/4980) newborns. Four of the five more frequently cited defects in the literature were found to be in excess: constriction ring, terminal transverse‐limb defects, hydrocephalus, and arthrogryposis. Equinovarus feet had a normal frequency in our study. Thirteen different defects not described in the literature were seen in our misoprostol exposed cases, but only holoprosencephaly and bladder exstrophy significantly exceeded the expected number.Conclusions
The confirmation from an epidemiological registry of an association for four of the five more commonly observed congenital defects among misoprostol exposed children described in the literature seems indicative of a real teratogenic effect. The defects are of vascular disruption type. However, additional attempts to achieve abortion could not be excluded as a concurrent contribution.
Fertility outcome following combined methotrexate treatment of unruptured extrauterine pregnancy
Authors: Debby Abraham , Golan Abraham , Sadan Oscar , Zakut Haim , Glezerman Marek 
Published: August 2005

Objective
To assess the effectiveness of systemic treatment with methotrexate in combination with local injection for unruptured tubal pregnancy, and to evaluate reproductive function following treatment.Design
Prospective, open clinical study.Setting
University clinic.Population
Sixty‐seven women with unruptured tubal pregnancy.Methods
Systemic methotrexate (intramuscular methotrexate 0.5 mg/kg for up to five days) in combination with local application of 12.5 mg methotrexate via laparoscopy.Main outcome measures
The subsequent surgical intervention required and future fertility.Results
In 89.6% of women no further surgical intervention was required and 47 women (81%) experienced subsequently an intrauterine pregnancy. In 39 of 40 women who underwent hysterosalpingo‐graphy following treatment, patency of the affected tube was observed.Conclusions
Combined local and systemic methotrexate treatment for unruptured tubal pregnancy seems to be more effective than each therapeutic modality alone.
Fertility following radical, conservative‐surgical or medical treatment for tubal pregnancy: a population‐based study
Authors: Bouyer J. , Job‐Spira N. , Pouly J. L. , Coste J. , Germain E. , Fernandez H. 
Published: August 2005

Objective
To investigate the factors influencing the choice of treatment for ectopic pregnancy and to compare the subsequent fertility rates of radical, conservative‐surgical or medical treatments.Design
Population‐based study of 835 ectopic pregnancies registered between 1992 and 1996.Setting
Auvergne Ectopic Pregnancy Register (France).Sample
Four hundred and seventy‐six women with tubal ectopic pregnancy who were not using contraception at the time of conception. Subsequent fertility was studied for the 291 women who attempted to conceive again.Methods
Comparison of reproductive outcomes according to ectopic pregnancy treatment. Cumulative fertility curves were calculated by the Kaplan‐Meier estimator and compared by log rank test for univariate analysis and by Cox regression to take into account confounding variables.Main outcome measure
Recurrence and fertility rates after ectopic pregnancy.Results
The first treatment given was ‘radical’ for 178 women (37%), ‘conservative‐surgical’ for 262 (55%), and ‘medical’ for 35 (8%). The treatment failed in 1% for radical treatment, 5% for conservative‐surgical treatment, and 36% for medical treatment. The two‐year cumulative rate of recurrence was 27% with no significant difference between treatments. For women with previous infertility factors (in particular diseased contralateral tube), the treatments differed significantly, with the rate of intrauterine pregnancy lower for radical treatment and higher for medical treatment than for conservative‐surgical treatment. For women with no infertility factor, there was no significant difference between treatments.Conclusions
These results should be confirmed in a controlled trial. The results of this study provide the elements necessary to plan such a trial.
The effect of smoking on pre‐eclampsia in twin pregnancy
Authors: Martin Christine L. , Hall Marion H. , Campbell Doris M. 
Published: August 2005

ObjectiveTo assess the effect of smoking on the incidence of pre‐eclampsia and on perinatal outcome in twin pregnancy.DesignRetrospective study using Aberdeen Maternity and Neonatal Databank.SettingGrampian, Orkney and Shetland.PopulationAll 1575 twin pregnancies delivered in the years 1969–1971 and 1976–1997 (when smoking data were available).MethodsIn all twin pregnancies the effects of smoking on pre‐eclampsia were analysed by parity and gestation at delivery. The effect of smoking upon late miscarriage and perinatal outcome was analysed without subdivision.Main outcome measuresPre‐eclampsia and perinatal outcome.ResultsPrimiparae had significantly higher rates of pre‐eclampsia than multiparae and were'delivered significantly earlier. The incidence of pre‐eclampsia in smokers was significantly lower only in multiparae. Length of gestation was significantly shorter in multiparous smokers. The effect of smoking on pre‐eclampsia appeared to be direct in multiparae but possibly indirect in primiparae (by causing earlier delivery). Smokers had a higher late miscarriage rate than nonsmokers.ConclusionsIn twin pregnancy the apparent protective effect of smoking against pre‐eclampsia is significant only in multiparae, suggesting that in primiparae the smoking effect is overwhelmed by the other reasons for the development of pre‐eclampsia. Smoking in twin pregnancy is not recommended due to the worse fetal outcome rates.
Private Equity Performance: Returns, Persistence, and Capital Flows
Authors: KAPLAN STEVEN N. , SCHOAR ANTOINETTE 
Published: August 2005

ABSTRACTThis paper investigates the performance and capital inflows of private equity partnerships. Average fund returns (net of fees) approximately equal the S&P 500 although substantial heterogeneity across funds exists. Returns persist strongly across subsequent funds of a partnership. Better performing partnerships are more likely to raise follow‐on funds and larger funds. This relationship is concave, so top performing partnerships grow proportionally less than average performers. At the industry level, market entry and fund performance are procyclical; however, established funds are less sensitive to cycles than new entrants. Several of these results differ markedly from those for mutual funds.
On the Industry Concentration of Actively Managed Equity Mutual Funds
Authors: KACPERCZYK MARCIN , SIALM CLEMENS , ZHENG LU 
Published: August 2005

ABSTRACTMutual fund managers may decide to deviate from a well‐diversified portfolio and concentrate their holdings in industries where they have informational advantages. In this paper, we study the relation between the industry concentration and the performance of actively managed U.S. mutual funds from 1984 to 1999. Our results indicate that, on average, more concentrated funds perform better after controlling for risk and style differences using various performance measures. This finding suggests that investment ability is more evident among managers who hold portfolios concentrated in a few industries.
Effects of Intravenous Magnesium in a Prolonged QT Interval Model of Polymorphic Ventricular Tachycardia Focus on Transmural Ventricular Repolarization
Authors: CHINUSHI MASAOMI , SUGIURA HIROTAKA , KOMURA SATORU , HIRONO TAKASHI , IZUMI DAISUKE , TAGAWA MINORU , FURUSHIMA HIROSHI , AIZAWA YOSHIFUSA 
Published: August 2005

Background: This study was performed to clarify the antiarrhythmic effects of magnesium sulfate (Mg++) in a prolonged QT interval canine model of polymorphic ventricular tachyarrhythmia (VTA).
Methods: In six experiments in a canine model of prolonged QT by anthopleurin‐A, Mg++ was administered in boluses of 0.2 mL/kg during repetitive episodes of self‐terminating polymorphic VTA or frequent premature ventricular complexes (PVCs). The distribution of ventricular repolarization across the left ventricular(LV) wall and dispersion of transmural repolarization were analyzed before, and 30 and 120 seconds after Mg++ administration, during ventricular pacing at 100 bpm. Transmural unipolar electrograms were recorded from multipolar needle electrodes, and local activation‐recovery intervals (ARI) were measured.
Results: Mg++ rapidly eliminated self‐terminating polymorphic VTA and all isolated PVCs. During ventricular pacing at 100 bpm, Mg++ caused modest shortening of ARI at all recording sites. Since the magnitude of ARI shortening was greater at mid‐myocardial sites than at other ventricular sites, mean transmural ARI dispersion decreased from 80 ± 22 to 45 ± 18 ms within 30 seconds after Mg++ injection. However, this effect was transient, and, at 120 seconds after Mg++ administration, ARI had increased all sites and transmural ARI dispersion lengthened to 65 ± 18 ms. Besides suppression of triggered premature activity, homogenization of transmural ventricular repolarization was associated with the antiarrhythmic effects of intravenous Mg++ in this model.
Conclusion: Since these effects were transient, a continuous intravenous infusion of Mg++ is preferred to prevent recurrences of VTA.
Reentry Within the Cavotricuspid Isthmus: An Isthmus Dependent Circuit
Authors: YANG YANFEI , VARMA NIRAJ , KEUNG EDMUND C. , SCHEINMAN MELVIN M. 
Published: August 2005

Background: We describe a new cavotricuspid isthmus (CTI) circuit.
Methods: This study includes 8 patients referred for atrial flutter (AFL) ablation whose tachycardia circuit was confined to the septal CTI and the os of the coronary sinus (CSOS) region. Entrainment mapping was performed within the CTI, CSOS, and other right atrial annular sites (tricuspid annulus (TA)). Electroanatomic mapping was available in 2 patients.
Results: Sustained AFL occurred in all patients with mean tachycardia cycle length (TCL) of 318 ± 54 (276 − 420) ms. During tachycardia, fractionated or double potentials were recorded at either the septal CTI and/or the region of CSOS in all, and concealed entrainment with post‐pacing interval (PPI) − TCL ≤ 25 ms occurred in this area; but manifest entrainment with PPI > TCL was demonstrated from the anteroinferior CTI and other annular sites in 7/8 patients. In one, tachycardia continued with conduction block at the anteroinferior CTI during ablation. Up to three different right atrial activation patterns (identical TCL) were observed. The tachycardia showed a counterclockwise (CCW) pattern in 6, a clockwise pattern in 2, and simultaneous activation of both low lateral right atrium and septum in 5. Electroanatomic mapping was available in 2, showing an early area arising from the septal CTI in 1, and a CCW activation sequence along the TA in another. Radiofrequency application to the septal CTI terminated tachycardia in 4, and tachycardia no longer inducible in all.
Conclusions: We describe a tachycardia circuit confined to the septal CTI/CSOS region, and hypothesize that this circuit involves slow conduction within the CTI and around the CSOS, which acts as a central obstacle.
Current Perspectives on the Clinical Assessment and Diagnosis of Female Sexual Dysfunction and Clinical Studies of Potential Therapies: A Statement of Concern
Authors: Althof Stanley E. , Dean John , Derogatis Leonard R. , Rosen Raymond C. , Sisson Melanie 
Published: August 2005

ABSTRACT

Introduction
The assessment and diagnosis of female sexual dysfunction (FSD) are in a state of transition because of evolving concepts of female sexuality and suggested changes to the FSD diagnostic framework.

Aim
To review the problems with current FSD diagnosis.

Methods
Multidisciplinary experts from five countries were assembled to convene a “Postmenopausal FSD Roundtable on specific topics related to FSD.”

Main Outcome Measure
Expert opinion was based on a review of evidence-based medical literature, presentation, and internal discussion.

Results
Current FSD diagnosis is challenging because of poorly defined distinctions between normal and abnormal, a limited ability to integrate subjective and objective findings and an inability to incorporate contextual factors that play a significant role in sexual behavior. The availability of self-administered questionnaires (SAQs) that assess various domains of female sexual function, as well as those developed specifically for postmenopausal women, suggests that a more structured approach to assessment and diagnosis may be possible. Several SAQs reflecting proposed changes to the FSD diagnostic framework by the American Foundation for Urologic Disease (AFUD), including the Sexual Function Questionnaire (SFQ) and the Female Sexual Distress Scale (FSDS), have been introduced and recently incorporated into a Structured Diagnostic Method (SDM). Recent regulatory decisions and events affecting the development of FSD interventions have highlighted the lack of consensus with regard to clinically meaningful FSD outcomes, as well as shortcomings in a U.S. Food and Drug Administration draft document that provides the primary guidance for conducting FSD clinical studies in the United States.

Conclusions
Given the high cost and inherent risk of clinical studies, continued development efforts toward FSD therapies are unlikely to proceed in the absence of significant changes in regulatory guidance that reflect the current understanding of FSD and incorporate validated assessment tools.