bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fast track vaginal surgery
Authors: Ottesen Marianne , Sørensen Mette , Rasmussen Yvonne , Smidt‐Jensen Steen , Kehlet Henrik , Ottesen Bent 
Published: March 2003

Objective. Our aim was to describe the need for postoperative hospitalization after vaginal surgery for utero‐vaginal prolapse with well‐defined charts for postoperative care.Design. A prospective, descriptive study. Consecutive women admitted for first‐time vaginal surgery for utero‐vaginal prolapse at a public university hospital in Copenhagen, Denmark, underwent surgery and postoperative care in a fast track setting from September 15, 1999 to June 15 2000.Methods. A multimodal rehabilitation model with emphasis on information, standardized general anesthesia, reduced surgical distress, optimized pain‐relief, early oral nutrition and ambulation, minimal use of indwelling catheter and vaginal packing.Outcome measures.  Postoperative hospital stay, complications, re‐admission, success rate, patients' satisfaction and acceptability.Results. Forty‐one women with a median age of 69 years (range, 44–88 years) were included. All underwent anterior and/or posterior vaginal repair. Nineteen (46.3%) underwent vaginal hysterectomy, and eight (19.5%) underwent the Manchester procedure. Postoperative hospital stay was median 24 hr. Only three (7.3%) were discharged later than 48 hr. No re‐admissions occurred. The most frequent complications were urinary retention exceeding 450 ml, and urinary tract infection (12.2%, and 9.8%, respectively). Short‐term success rate was 97.6%. Patients' satisfaction rates were 85.4–95.1%. The median score of acceptability was 10 on a 0–10 points scale.Conclusion. The need for postoperative hospitalization was median 24 hr after vaginal surgery in a fast track setting, independently of the complexity of the procedure performed. Short‐term success rate, satisfaction rates, and acceptability were all excellent. Follow up has been established to evaluate long‐term success rates and recurrence.
The levels of five markers of hemostasis and endothelial status at different stages of normotensive pregnancy
Authors: Hayashi Masatoshi , Inoue Teruo , Hoshimoto Kazunori , Hirabayashi Hideo , Negishi Hideaki , Ohkura Takeyoshi 
Published: March 2003

Background.  Urinary 11‐dehydrothromboxane B2/creatinine (11‐DTXB2/Cr) is a marker for in vivo platelet activation and vascular constriction, blood thrombomodulin (TM) for endothelial damage and associated thrombosis, thrombin–antithrombin complex (TAT) for thrombin formation, and β‐thromboglobulin (β‐TG) and platelet factor 4 (PF‐4) for in vivo platelet activation and releasing reaction. Little is known about the quantitative relationship among them during pregnancy. The present study investigated levels of five markers at different stages of normotensive pregnancy.Methods.  Subjects were 17 healthy non‐pregnant women (Group 1, control) and 67 women carrying single fetuses in normotensive pregnancy. Of the pregnant women, 17 were in the 20th week of gestation (Group 2), 20 were in their 30th week (Group 3), and 30 were in their 36th week (Group 4). Urinary and circulating blood levels of 11‐DTXB2/Cr, TM, TAT, β‐TG, and PF‐4 were measured simultaneously.Results.  The 11‐DTXB2/Cr and TAT levels showed elevated values at the 20th and 30th weeks of gestation, and markedly elevated values at the 36th week, whereas the TM level remained constant throughout pregnancy. The β‐TG and PF‐4 levels maintained stable values at the 20th week, but showed elevated values at the 30th and 36th weeks.Conclusions.  Platelet aggregation, vascular constriction, and thrombin formation (detected by 11‐DTXB2/Cr and TAT) appear to be enhanced as early as the 20th week of gestation, continuously enhanced by the 30th week, and markedly enhanced by the 36th week. Platelet activation and releasing reaction (determined by β‐TG and PF‐4) gradually enhanced from the 30th to 36th weeks. In contrast, endothelial damage and associated thrombosis (detected by TM) were minimal throughout pregnancy. Investigating these markers of hemostasis and endothelial function in normotensive pregnancy may provide insights into related disease states.
Symptomatic venous thromboembolism in Chinese patients after gynecologic surgery: incidence and disease pattern
Authors: Chan Louis Yik Si , Yuen Pong Mo , Lo Wing Kit , Lau Tze Kin 
Published: March 2003

Background.  Venous thromboembolism is a common cause of postoperative morbidity and mortality in Caucasian populations, but it is widely believed that this complication is rare in Chinese.Methods.  We conducted a retrospective study from January 1998 to December 2000. Women with thromboembolic diseases after gynecologic surgery were identified and their medical records were reviewed.Results.  During the study period, thirty‐one women were diagnosed as having thromboembolic disease after gynecologic surgery. Over the study period, the total number of operations was 6077, giving an incidence of 5.10/1000 operations. There were two cases of pulmonary embolism and the others had deep vein thrombosis of which 90% were limited to calf veins only. The incidences were significantly higher in 1999 and 2000 (7.59 and 6.85/1000 operations, respectively) than that in 1998 (1.7/1000 operations) (P = 0.015), after a case of maternal death due to pulmonary embolism in early 1999. Most cases of thromboembolism were diagnosed after major surgery for malignancy (n = 14) or benign conditions (n = 12). In the remaining cases, three had evacuation of the uterus for retained products of conception and two had laparoscopy for suspected ectopic pregnancies.Conclusions.  Thromboembolic disease is not uncommon among Chinese women after gynecologic surgery. The incidence is similar to that of the Caucasian population, although the sites of vascular occlusion were different. The long belief that thromboembolism is rare among Chinese is at least partly due to under‐diagnosis.
C‐reactive protein: a serological marker for preterm delivery?
Authors: Hvilsom Gitte B. , Thorsen Poul , Jeune Bernard , Bakketeig Leiv S. 
Published: March 2003

Background.  We studied the association between the C‐reactive protein level in the maternal serum early in the second trimester with that in preterm delivery.Methods.  The present study is a prospective nested case‐control study including 84 singleton, preterm deliveries (cases) and 400 singleton, term deliveries (controls), based at the Odense University Hospital, Denmark. These cases were identified from a cohort of 2846 women, monitored from their first prenatal care visit until their delivery. All the participants were examined at enrollment (median 16.3 weeks of gestation). Conventional statistical methods were used for analyses.Results.  We found statistically significant differences in the C‐reactive protein levels measured in early pregnancy between the women delivering preterm and those delivering at term. Different statistically significant odds ratios of between 1.7 and 2.0 were calculated, depending on the C‐reactive protein level's cut‐off value, and ranged from 5.6 mg/l (75th percentile) to 16.4 mg/l (95th percentile). The highest level was achieved at the 85th percentile (7.6 mg/l); odds ratio 2.0 (95%CI, 1.2–3.5).Conclusion.  A high C‐reactive protein level at the beginning of a pregnancy is associated with a nearly twofold increased risk of preterm delivery; however, the clinical value at this point is still limited.
Maternal height, birthweight and cephalo pelvic disproportion in urban Nigeria and rural Malawi
Authors: Brabin Loretta , Verhoeff Francine , Brabin Bernard J. 
Published: March 2003

Background. Cephalo pelvic disproportion (CPD) has been attributed to short stature. It has been suggested that nutritional supplementation to promote linear growth would increase birthweight and the risk of CPD. The objective of this study was to examine the factors associated with CPD, with particular reference to birthweight, stature, parity and maternal age.Design. Factors associated with CPD were analyzed using data abstracted from a detailed early hospital report from Ibadan, Nigeria and from a recent rural pregnancy study conducted in the Shire Valley, Malawi.Results. In Nigeria, of 107 CPD cases admitted to hospital in Ibadan during 1953–54, 79% were women > 20 years. Birthweight values increased significantly with age and parity. In 19.6% of cases, the baby had a low birthweight (< 2500 g). In Malawi, among the 1523 women delivering, the incidence of CPD was 2.3%. Of the 35 cases of CPD, only four were adolescents. Birthweights increased with increasing parity, age and height (p < 0.001). In 6.4% of CPD cases, the baby had a low birthweight. Nulliparity (OR 4.0; CI 1.7–9.3; p = 0.0001), birthweight ≥ 3400 g (OR 4.6; CI 2.1–10.0; p = 0.0001) and height ≤ 154 cm (OR 3.8; CI 1.8–7.9; p = 0.0003) were associated with an increased risk of CPD. Adolescent mothers were less likely to experience CPD (OR 0.3; C.I. 0.8–0.9; p = 0.03).Conclusions. Adolescents are not at high risk of CPD. Nutritional supplementation of girls and adolescents should not be discouraged for fear of increasing the risk of CPD by improving birthweight. When CPD is present, it may result from childhood rickets and calcium deficiency.
Consequenses for HRT following the HERS II and WHI reports: The primum non nocere is important, but translation into quo vadis is even more essential
Authors: Skouby Sven O. 
Published: March 2003

In the Nordic countries the prevalence of hormonal replacement therapy (HRT) use in women from 50 to 70 years of age is slightly above 30% evaluated by sales figures and with some variation between the five countries.The premise for this commentary is to discuss the best clinical practice when prescribing HRT to post menopausal women following the publication of the most recent evidence from two well conducted randomized placebo controlled trials, namely the Heart and Estrogen/Progestin Replacement Study II (HERS II) and the Women's Health Initiative study (WHI ).
Predictive power of clomiphene citrate challenge test for failure of in vitro fertilization treatment
Authors: Csemiczky György , Harlin Jonas , Fried Gabriel 
Published: March 2003

Background.  To evaluate the impact of ovarian reserve on the outcome of in vitro fertilization (IVF) treatment in 140 women, in a total of 279 treatment cycles.Methods.  All women underwent a clomiphene citrate (CC) challenge test to assess their ovarian reserve before IVF treatment. One hundred and eighteen women (84%) had normal basal follicle stimulating hormone (FSH) levels (3.1–10.0 IU/l) and 22 women (16%) had elevated FSH levels (> 10.0–24.0 IU/l). The FSH levels measured on cycle day 10 showed that 106 (76%) of the women could be regarded as having a normal ovarian reserve and 34 (24%) a diminished ovarian reserve.Results.  In the group with diminished ovarian reserve, pregnancies and live births were dramatically lower than in the group with normal ovarian reserve. Counting only the first cycle (n = 140), the number of ongoing pregnancies and live birth rate were highly different between the two groups: 3% vs. 36% (1/33 vs. 28/78). Counting all treatment cycles (n = 210 + 69) the clinical pregnancy rate in the diminished ovarian reserve group was 6%–31% compared with the normal woman (4/69 compared 65/210). The number of started treatment cycles per woman were similar in the two groups. The length of the ovarian stimulations were slightly longer in the group with elevated FSH compared with the group with normal FSH levels. The number of cancellations resulting from insufficient ovarian response was significantly higher in the group with diminished ovarian reserve (n = 38, 55%) compared with the normal women (n = 32, 15%) (p < 0.0001). In addition, the average E2 levels before oocyte pick up were significantly lower in the group of women with diminished ovarian reserve compared with normal women (p < 0.0001). Calculation of the sensitivity and specificity of the CC test showed that an abnormal test has a high probability for a negative treatment outcome. The number of retrieved, fertilized oocytes, the number of divided oocytes, and the number of embryo transfers in the first as well as in all cycles differed significantly between the two of groups women (p < 0.001–0.009).Conclusions.  We found that the CC challenge test is a useful tool in assessing a woman's ovarian capacity before infertility treatment. The predictive value of the test for a negative outcome of IVF treatment was strong. We recommend performing the test before infertility treatment. This may prevent unnecessary treatment trials and unrealistic expectations from both patients and doctors.
Frequency of denial of pregnancy: results and epidemiological significance of a 1‐year prospective study in Berlin
Authors: Wessel Jens , Endrikat Jan , Buscher Ulrich 
Published: March 2003

Background.  There has been an increasing number of reports on denial of pregnancy. However, only very few studies have involved a large number of patients. To date, no reliable calculation of this condition's general frequency, also from an epidemiological perspective, has been available.Methods.  A prospective case sampling was performed between 1 July 1995 and 30 June 1996 in the metropolitan area of Berlin. All institutions in which deliveries have taken place were engaged. The lower limit for inclusion was the 20th week of gestation as the first physician's earliest diagnosis of pregnancy. Furthermore, the woman herself must not have had any subjective perception.Results.  Recruited women were divided into three groups. Altogether 62 cases and 29 462 deliveries within the 1‐year study period were valid for the frequency calculation, leading to a ratio of 1 : 475 (all cases) and of 1 : 2455 for totally unexpected births with a viable newborn (intrapartal diagnosis of the pregnancy).Conclusions.  This first prospective, population‐based study has also certain epidemiological relevance. From projecting the ratio of 1 : 475 for all of Germany, approximately 1600 cases of denied pregnancies per year are diagnosed, at the earliest, from the 20th week of gestation. Totally unexpected deliveries of a viable fetus without any presumption of being pregnant with 300 projected yearly births would occur threefold more often than triplets. Occurrence of denied pregnancy seems yet to be similar across different socio‐demographic conditions. The common view that denied pregnancies are exotic and rare events is no longer valid. More studies of similar design are needed.
Cytogenetic studies in patients with reproductive failure
Authors: Düzcan Füsun , Atmaca Münevver , ÇEtin G. Ozan , Baǧci Hüseyin 
Published: March 2003

Acta Obstet Gynecol Scand 2003; 82: 53–56. © Acta Obstet Gynecol Scand 2003Background. Cytogenetic studies in patients with reproductive failureAim.  To investigate the contribution of chromosomal abnormalities in sub fertility and in couples with repeated abortions.Methods. Hundred and 13 couples who had at least two or more spontaneous abortions and 65 women and 63 men with infertility were analyzed cytogenetically.Results. Major chromosomal rearrangements were found in 8% and minor variants in 6% in the study population. Major chromosomal aberrations were judged to explain 4.9% of recurrent abortions and 13% of infertility. Chromosomal abnormalities in infertile men occurred in 5% and in infertile women in 21.5%. The chromosomal abnormalities were structural (57%), numerical (18%) or mosaics (25%).Conclusions. Chromosomal aberrations in recurrent abortions are mostly structural ones and those in female infertility mosaicism of sex chromosomes. Turner's syndrome, Turner variants and XY females are detected as a cause of female infertility. The structural and numerical aberrations of either sex or autosomal chromosomes were found in infertile men.
Endometrial ablation with NovaSure™ GEA, a pilot study
Authors: Busund Bjorn , Erno Lars Espen , Grønmark Anne , Istre Olav 
Published: March 2003

Acta Obstet Gynecol Scand 2003; 82: 65–68. © Acta Obstet Gynecol Scand 2003Objective. A prospective, single‐arm, multicenter, controlled, observational pilot study to assess the safety and efficacy of the NovaSure™ Global Endometrial Ablation (NovaSure™ GEA) system in women with severe menorrhagia secondary to dysfunctional uterine bleeding (DUB).Setting. University tertiary referring center and central hospital.Patients. Forty‐six premenopausal women aged 41.3 years with menorrhagia secondary to DUB unresponsive to medical therapy, who had completed childbearing, with non‐distorted uterine cavities were included in the study.Methods. Bleeding score was recorded before, 6 and 12 months after treatment. All patients received the treatment under intravenous sedation with para‐cervical block and were treated with Nova Sure endometrial ablation for mean 94 s at the day surgery unit.Results. No serious intraoperative complications were observed. Treatment time averaged 94 s. Forty‐six patients have completed 6‐months of follow‐up and 45 patients completed the 12‐months follow‐up. 50% of the patients were amenorrheic at 6 months follow‐up and 58% had complete cessation of uterine bleeding (amenorrhea) at 12 months follow‐up.Conclusions. Preliminary results indicates that the NovaSure GEA System is an effective treatment for DUB, achieving 58% amenorrhea after 12 months.
Retinal detachment after silicone oil removal
Authors: Scholda Christoph , Egger Stefan , Lakits Adalbert , Walch Katharina , Von Eckardstein Eva , Biowski Robert 
Published: March 2003

ABSTRACT.Purpose: To evaluate the causes of retinal detachment after silicone oil removal, to define possible risk factors and the anatomical and functional prognosis of this complication.Methods: 112 eyes that underwent silicone oil removal were included. The group of eyes with retinal detachment after oil removal (18/112 eyes, 16.1%) was compared with the group with no postoperative retinal detachment.Results: The most common cause for retinal detachment after oil removal was anterior PVR (77.8%). Initial PVR detachment, advanced PVR stages, anterior PVR, more preceding operations, aphakia/pseudophakia, myopia and shorter duration of the oil tamponade were significantly more represented in the group of eyes with retinal detachment after oil removal. The prognosis of retinal detachment after oil removal is poor.Conclusion: Some criteria could be regarded as risk factors for retinal detachment after silicone oil removal. Improvement of the results should be possible by considering these factors and by control of reproliferations.
Surgical effects of combined trabeculotomy and sinusotomy compared to trabeculotomy alone
Authors: Mizoguchi Takanori , Nagata Makoto , Matsumura Miyo , Kuroda Shin‐ichirou , Terauchi Hiroo , Tanihara Hidenobu 
Published: March 2003

ABSTRACT.Purpose: To elucidate long‐term surgical results and problems of combined trabeculotomy and sinusotomy in comparison with trabeculotomy alone.Methods: The study included 91 glaucomatous eyes in 57 patients with primary open angle glaucoma, who underwent either combined trabeculotomy and sinusotomy (40 eyes) or trabeculotomy alone (51 eyes). The mean follow‐up period (±standard deviation) was 46.1±10.4 months (range: 30 to 60 months).Results: At the final examination, in 37 (93%) of the 40 eyes after combined trabeculotomy and sinusotomy and in 40 (78%) of the 51 eyes after trabeculotomy alone, intraocular pressures were well controlled. The mean intraocular pressures at the end of the first postoperative year were 15.6±3.0 mmHg in the 40 eyes after the combined procedure, and 17.8±3.1 mmHg in the 51 eyes after trabeculotomy alone (p=0.0001, unpaired t‐test). Complications included Descemet's membrane detachment in 1 eye (3%) and 4 eyes (8%), and transient elevation of intraocular pressure to higher than 30 mmHg (IOP spike) in 6 eyes (15%) and 11 eyes (22%), respectively, after the combined procedure and trabeculotomy alone.Conclusion: Combined trabeculotomy and sinusotomy is a useful surgical modality for the treatment of primary open angle glaucoma to obtain lower intraocular pressure levels than those after trabeculotomy alone.
Peribulbar anesthesia and sub‐Tenon injection for vitreoretinal surgery: 300 cases
Authors: Calenda Emile , Olle Priscille , Muraine Marc , Brasseur Gérard 
Published: March 2003

ABSTRACT.Background and objectives: We carried out a prospective study in order to evaluate the efficacy and safety of peribulbar anaesthesia supplemented by a sub‐Tenon injection in case of inadequate analgesia during vitreoretinal surgery.Methods: We performed 300 consecutive vitreoretinal procedures. Patients received a mean volume of 17±4.5 ml of a mixture of etidocaine 1%, bupivacaine 0.50% and hyaluronidase (25 UI/ml).Supplementation was represented by a sub‐Tenon infiltration of lidocaine 2% (2 or 3 ml). This volume was not included in the mean volume.Results: Analgesia was adequate throughout surgery without any supplementation in 85% of cases and with a sub‐Tenon infiltration in 99%. Akinesia was complete in 82%, mild in 15% and absent in 3% of cases. The sub‐Tenon injection was performed immediately before starting the procedure in 58% of cases and during the surgery with a delay of 80±21 min in 42%. Eleven patients (3.66%) were agitated during surgery and two of them needed a general anaesthesia to allow for the procedure. Generalised epilepsy was encountered in two patients (0.66%) immediately after the peribulbar injection in one patient and 15 min later in the other. The systolic blood pressure severely decreased between 60 to 70 mm Hg 40 min after the accomplishment of the peribulbar in 2 patients and at 90 min in 2 others.Conclusion: Our results demonstrate that peribulbar anaesthesia alone offers excellent analgesia in 85% of patients and supplemented by a sub‐Tenon injection in 99%.
The influence of age, gender, refractive error, and optic disc size on the optic disc configuration in Japanese normal eyes
Authors: Kashiwagi Kenji , Tamura Masahiro , Abe Keitetsu , Kogure Satoshi , Tsukahara Shigeo 
Published: March 2003

ABSTRACT.Purpose: To investigate the influence of age, gender, refractive error, and optic disc size on optic disc configuration in Japanese normal eyes.Methods: Ninety‐two eyes from 92 visually normal Japanese subjects (mean refractive error±SD: −1.26±2.25 D, range −8 D to +3 D) were examined using a confocal scanning laser tomograph, TopSS®. The following disc parameters were investigated: disc size, total or quadrant C/D area ratio and neuroretinal rim area, half‐depth area, volume below, and average cup depth.Results: The disc diameter ( mean±SD: 1.84±0.16 mm) and disc size showed highly significant correlations with the C/D ratio (p<0.001) and the neuroretinal rim area (p<0.001). No other correlation was observed.Conclusion: These results indicate that the optic disc diameter and disc size have higher correlations with the optic disc configuration than age, gender, and refractive error in Japanese. These results are similar to those data reported for eyes of Caucasians or Afro Americans, and should be considered when optic discs are evaluated.