bluuebunny/crossref_metadata_2025_split huggingface dataset:
Weight loss causes increased mortality: cons
Authors: Yang D. , Fontaine K. R. , Wang C. , Allison D. B. 
Published: March 2003

SummaryShort‐term studies indicate that intentional weight loss (IWL) among obese persons significantly improves health variables that are often precursors or markers of chronic diseases (e.g. heart diseases, type‐2 diabetes). Hence, it is logical to assume that IWL among obese persons would lead to increased longevity. On the whole, epidemiological studies, including recent ones that use conservative analytic approaches such as distinguishing between apparently IWL and unintentional weight loss (UWL), adjusting for potential confounders and excluding apparently unhealthy subjects, indicate that apparently IWL appears to neither increase nor decrease mortality rate. However, it is important to note that none of the existing studies were designed specifically to test the hypothesis that IWL reduces mortality rate, and given methodological problems, these studies do not provide a satisfactory way to address the body mass index (BMI)–mortality question. Several controlled clinical trials suggest that IWL may reduce mortality rate. However, even in these studies, it is important to acknowledge that subjects are randomized to conditions that produce more or less weight loss and not to distinct levels of weight loss per se. Nevertheless, while we await additional data from better designed studies, given our incomplete knowledge, we conclude that it seems more likely than not that IWL achieved by medically recommended methods does not increase and probably decreases mortality rate.
Low body weight and type of protease inhibitor predict discontinuation and treatment‐limiting adverse drug reactions among HIV‐infected patients starting a protease inhibitor regimen: consistent results from a randomized trial and an observational cohort
Authors: Kirk O , Gerstoft J , Pedersen C , Nielsen H , Obel N , Katzenstein Tl , Mathiesen L , Lundgren Jd 
Published: March 2003

Departments of Infectious Diseases,

1

Hvidovre Hospital, University of Copenhagen, Hvidovre,

2

Rigshospitalet, University of Copenhagen, Copenhagen,

3

Odense University Hospital, Odense,

4

Aalborg Hospital, Aalborg and

5

Marselisborg University Hospital, Aarhus, Denmark
Objectives  To assess predictors for discontinuation and treatment‐limiting adverse drug reactions (TLADR) among patients starting their first protease inhibitor (PI).Methods  Data on patients starting a PI regimen (indinavir, ritonavir, ritonavir/saquinavir and saquinavir hard gel) in a randomized trial (RAS, n = 318) and an observational cohort (OBC, n = 505) were used to document reasons for discontinuation and TLADR. Risk factors for discontinuation of the initialPI/developing TLADR were assessed in Cox models.Results  A total of 43 (RAS) and 48% (OBC) discontinued the initial PI therapy within less than 2 years. In both populations TLADR were the most common reason for discontinuation. The incidence of TLADR in RAS was: 8.5 (indinavir), 66.0 (ritonavir), 15.6 (saquinavir hard gel) per 100 person‐years of follow‐up (P < 0.001). Body weight and type of PI initiated were independent risk factors for treatment discontinuation and TLADR in both groups. In OBC, the risk of developing TLADR increased by 12% per 5 kg lower body weight when starting the PI regimen [the relative hazard (RH) was 1.12 (95% confidence interval: 1.05–1.19) per 5 kg lighter], and starting ritonavir was associated with a three‐ to sixfold higher risk of TLADR relative to other PI regimens. Very similar results were documented in RAS [RH for body weight was 1.18 (1.07–1.29)].Conclusions  Nearly half of the patients stopped treatment with the initial PI, most commonly as a result of adverse drug reactions. Low body weight and initiation of ritonavir relative to other PIs were associated with an increased risk of TLADRs. Very consistent results were found in a randomized trial and an observational cohort.
Successful treatment of angiosarcoma of the scalp by intralesional cytokine therapy and surface irradiation*
Authors: Ulrich Jens , Krause Markus , Brachmann Adna , Franke Ingolf , Gollnick Harald 
Published: March 2003

AbstractAn 88‐year‐old woman presented to us with angiosarcoma of the scalp that had developed over a 6‐month period following previous trauma. Despite explicit information concerning the extremely malignant potential of the tumour the patient refused any surgical intervention. However, she agreed to receive local, intralesional interferon α‐2b and interleukin‐2 therapy. After partial remission of the tumour, the intralesional cytokine injections were combined with surface radiotherapy. This combination therapy led to a 2‐year remission of both the tumour and sonographically suspicious cervical lymph nodes. Apart from the typical, moderate side‐effects of interferon α‐2b and interleukin‐2 the therapy was well tolerated. In conclusion, in our limited experience intralesional cytokine therapy – alone as well as in combination with surface irradiation – seems to be an alternative therapeutic option for patients who is not a candidate for surgery.
Granulomatous folliculitis as a manifestation of post‐herpetic isotopic response
Authors: Schena D , Barba A , Chieregato C 
Published: March 2003

AbstractWe report a case of postherpetic granulomatous folliculitis in a 52‐year‐old female. The several cutaneous granulomatous eruptions following herpes zoster reported in the literature include annular, sarcoid and tuberculoid granuloma, granulomatous vasculitis and granulomatous folliculitis. The mechanism of granuloma formation is probably triggered by a delayed hypersensitivity response to the virus.
Pityriasis versicolor
Authors: Gupta AK , Bluhm R , Summerbell R 
Published: March 2003

ABSTRACTPityriasis versicolor is a common superficial fungal infection of the skin. It is caused by Malassezia spp., which are normal human saprophytes. Under certain conditions, both exogenous and endogenous, the fungus can convert from a yeast to a pathogenic mycelial form. This alteration results in mild inflammation of the skin, and in characteristic clinical and histological changes. The taxonomy of Malassezia spp. has recently been modified to include six obligatorily lipophilic species, all of which can be found on human skin, plus one non‐obligatorily lipophilic species, which only rarely colonizes human hosts.Learning objectives At the conclusion of this learning activity, participants should be aware of the role of Malassezia in the development of pityriasis versicolor, the clinical and histological changes arising from this dermatosis, and the diagnosis and treatment of this disorder.
Granulomatous folliculitis at sites of herpes zoster scars: Wolf's isotopic response
Authors: Fernández‐Redondo V , Amrouni B , Varela E , Toribio J 
Published: March 2003

ABSTRACTCutaneous eruptions described on herpes zoster scars are variable. We present a case of granulomatous folliculitis occurring 4 weeks after an episode of herpes zoster infection in a woman with cutaneous T‐cell lymphoma. The pathogenesis of the lesions remains unclear. The viral genome was detected only in early lesions.
Fetal echocardiography in multiple gestations
Authors: Copel J. A. , Inati M. , Green J. J. , Hobbins J. C. , Keinman C. S. 
Published: March 2003

AbstractWe reviewed fetal echocardiograms from 36 multiple gestations from 20 weeks gestation to term. Seven sets of twins plus one set of triplets were referred because of a suspect cardiac anomaly in one fetus; heart disease was confirmed in one fetus of six sets of twins and in one triplet. Six sets were referred because of extracardiac malformations and heart disease was confirmed in two sets (including both twins in one set). The remaining case was detected in a patient sent for evaluation of karyotypic abnormality. Thus 11 fetal cardiac defects were detected in ten pregnancies. Chromosomes were abnormal in three of the anomalous fetuses. Two sets discordant for heart disease were monochorionic. Intervention, including a change in the planned location of delivery, or maternal digitalization for fetal congestive failure, occurred in six. We conclude that fetal echocardiography is feasible and useful in appropriate multiple gestations. Although often ethically complex, the information gained can be applied to patient management. Copyright © 1991 International Society of Ultrasound in Obstetrics and Gynecology
Fetal aortic diameter pulse wave response to changes in maternal position after membrane rupture
Authors: Stale H. , Gennser G. 
Published: March 2003

AbstractAn ultrasonic phase‐locked echo‐tracking system was used in order to study human fetal hemodynamics in relation to maternal postural changes after membrane rupture. Diameter pulse waves were recorded in the descending aorta of 17 fetuses presenting by the vertex in normal singleton pregnancies, with the mother in three different positions. The first measurements were made with the mother in the slightly left lateral recumbent (horizontal), then upon transition to the upright (70°), and finally upon return to the horizontal. Change from the horizontal to the upright position produced a moderate but significant increase (p < 0.05) in maternal heart rate, while the systolic and diastolic blood pressures remained unchanged. No significant changes were seen in the fetal pulse wave variables (i.e. end‐diastolic diameter, relative pulse amplitude, maximum incremental velocity, late decremental velocity, pulse duration, relative crest time and pulse wave velocity). The absence of fetal hemodynamic changes possibly reflects the presence of a protective effect against I gravitational stress to the fetal cardiovascular system provided by the remaining volume of amniotic fluid and the abundant fetal extracellular water. Copyright © 1991 International Society of Ultrasound in Obstetrics and Gynecology
Myocardial contractility in the anemic human fetus
Authors: Lingman G. , Legarth J. , Rahman F. , Stangenberg M. 
Published: March 2003

AbstractSeverely anemic fetuses in Rh‐isoimmunized pregnancies are often found to have hydrops and the etiology is debated. Fifteen fetal blood samplings were performed in nine fetuses for determination of the degree of anemia and of the acid‐base balance. Waveform analysis was performed on the maximum blood velocity curve in the umbilical arteries and the ascending fetal aorta, obtained by means of a pulsed Doppler technique. The blood acceleration in the ascending aorta increased down to a hematocrit of 0.18 and a hemoglobin concentration of 65 g/l, which might constitute a cardiac response to the anemia aimed at maintaining the peripheral blood circulation. Below these levels there was a decrease in blood acceleration, which could be caused by impaired cardiac oxygenation. This relationship could be described as a six‐power function (r = 0.87; p = 0.032). A second‐power relationship was found between the umbilical artery pulsatility index and the blood acceleration in the fetal ascending aorta (r = 0.64; p = 0.0418), which suggests that the cardiac pump function can alter the blood velocity waveform in the umbilical arteries. Copyright © 1991 International Society of Ultrasound in Obstetrics and Gynecology
Ultrasound measurements of fetal limb bones
Authors: Exacoustos C. , Rosati P. , Rizzo G. , Arduini D. 
Published: March 2003

AbstractIn order to establish the growth patterns of fetal limbs, measurements of femur, humerus, tibia, fibula, radius and ulna were made by ultrasound and related to gestational age. To this end, 2317 normal singleton pregnant women were studied cross‐sectionally at 13–40 weeks of gestation. Patients were selected on the basis of a certain last menstrual period, history of regular cycles and at least one ultrasound scan before 16 weeks confirming gestational age. Linear growth of all limb measurements was observed between 13 and 28 weeks of gestation. From this gestational age onwards, a flattening of the growth curve was seen. A second‐degree polynomial equation turned out to be the best model to describe this phenomenon. The measurements of all six fetal long bones showed a high correlation with menstrual age (r ≥ 0.99). The femur displayed the largest mean weekly increments (2.8 mm per week from 13 to 28 weeks and 1.7 mm per week from 29 to 40 weeks of gestation) and the radius had the smallest (2.08 mm per week from 13 to 28 weeks and 1.25 mm per week from 29 to 40 weeks' gestation). Considering inter and intraoperator variations and the weekly increment of fetal long bone length, a correct evaluation of limb growth is possible for the femur every week before 28 weeks and every 2 weeks after 28 weeks. For the remaining limb bones, a correct evaluation is possible every 2 weeks at all gestational ages. Copyright © 1991 International Society of Ultrasound in Obstetrics and Gynecology
Fetal renal artery blood velocimetry in multicystic kidney disease
Authors: Kaminopetros P. , Dykes E. H. , Nicolaides K. H. 
Published: March 2003

AbstractColor flow mapping and Doppler velocimetry were used to measure impedance to flow in both renal arteries of 11 fetuses with unilateral multicystic kidney disease at 19–34 (mean = 26) weeks' gestation. In all cases, the pulsatility index in the renal artery of the multicystic kidney was higher than that of the contralateral normal kidney; the mean pulsatility index in the arteries of the affected kidneys was significantly higher than the normal mean for gestation. Copyright © 1991 International Society of Ultrasound in Obstetrics and Gynecology
Erythroblastosis in birth asphyxia
Authors: Thilaganathan B. , Nicolaides K. H. 
Published: March 2003

AbstractThe pH and erythroblast count in umbilical venous blood were measured in 27 term neonates with normal birth weights. In seven cases, infants were admitted to the neonatal intensive care unit because of birth asphyxia, and the findings in these cases were compared to the values of the 20 non‐asphyxiated neonates that were delivered either vaginally (n = 10) or by elective Cesarean section (n = 10). The umbilical venous blood pH in the asphyxiated group was significantly lower than that in the control group of infants that were delivered by Cesarean section, but not significantly different from the controls that were delivered vaginally. In contrast, the erythroblast count in the asphyxiated group was significantly higher than that in the controls, irrespective of the mode of delivery. These findings suggest that cord blood erythroblast count at delivery may provide a better measure of fetal tissue hypoxia than umbilical venous pH. Copyright © 1992 International Society of Ultrasound in Obstetrics and Gynecology
Prenatal diagnosis of an intra‐abdominal ectasia of the umbilical vein with color Doppler ultrasonography
Authors: Rizzo G. , Arduini D. 
Published: March 2003

AbstractA cystic lesion in the anterior upper part of the abdomen was detected in utero by ultrasonography. Color and pulsed Doppler studies performed over the mass revealed a marked turbulent flow through the cystic lesion in connection with the umbilical vein, suggesting the existence of an intra‐abdominal ectasia of the umbilical vein. Copyright © 1992 International Society of Ultrasound in Obstetrics and Gynecology
Accuracy of transvaginal ultrasound and serum hCG in the diagnosis of ectopic pregnancy
Authors: Gabrielli S. , Romero R. , Pilu G. , Pavani A. , Capelli M. , Milano V. , Bevini M. , Bovicelli L. 
Published: March 2003

AbstractTransvaginal ultrasound was performed upon admission of 127 patients with a clinical suspicion of ectopic pregnancy in association with human chorionic gonadotropin (hCG) determination. Failure to visualize with sonography an intrauterine gestational sac with an hCG level superior to 1000 mIU/ml identified 25/42 tubal pregnancies with a positive predictive value of 86% and a specificity of 93%. Abnormal adnexal findings occurred in 95% of the ectopic pregnancies. Extrauterine gestational sacs with or without embryos could be confidently detected in 19 ectopic pregnancies (45%). A complex adnexal mass was seen in 19 cases and yielded a positive predictive value of 90% (19/21). Adnexal gestational sacs and complex masses were seen more frequently in those ectopic pregnancies with an hCG level above 1000 mIU/ml but the difference was not significant (100% versus 78%). Simple adnexal cysts were found more frequently in intrauterine pregnancies, and fluid in the cul‐de‐sac was also not indicative of ectopic pregnancy (positive predictive value, 29%). Transvaginal ultrasound has a primary role in the diagnosis of ectopic pregnancy. The combined use of uterine and adnexal sonography associated with elevated hCG levels allows a definitive diagnosis in the vast majority of cases at a very early stage, when the chances for a successful conservative treatment are greater. Copyright © 1992 International Society of Ultrasound in Obstetrics and Gynecology
The role of ultrasound in gynecological emergencies
Authors: Mould T. A. J. , Byrne D. L. , Morton K. E. 
Published: March 2003

AbstractThe expanding use of ultrasonography in gynecology puts increasing strain on the resources of ultrasound departments; any mechanism to increase the diagnostic efficiency of the scan and reduce unwarranted investigation would, therefore, be welcome.This prospective study examines the use of abdominal ultrasound examination in gynecological emergencies over a 6‐month period in a London teaching hospital. The examination changed the clinical management in 33% of cases where the pregnancy test was positive, but in only 14% where it was negative. In the former group, the confirmation of viable intrauterine pregnancy reassured both patient and clinician in 84% of the cases, making the test a useful investigation in 89% of the total cases where the pregnancy test was positive. When the pregnancy test was negative, the ultrasound scan was more likely to be useful if requested by doctors with gynecological experience. In cases of incomplete spontaneous abortion, ultrasound was not found to be a useful investigation.Access to ultrasound equipment by, and basic ultrasound training of admitting junior doctors with gynecological experience would reduce referrals to the ultrasound department and reduce admissions to hospital, whilst improving appreciation of the role of ultrasound in gynecological emergencies. Copyright © 1992 International Society of Ultrasound in Obstetrics and Gynecology
Fetal atrioventricular and outflow tract flow velocity waveforms during conducted and blocked supraventricular extrasystoles
Authors: van der Mooren K. , Wladimiroff J. W. , Stijnen Th. 
Published: March 2003

AbstractMaximum flow velocity waveforms at atrioventricular and outflow tract level were studied cross‐sectionally in 19 human fetuses with conducted and/or blocked supraventricular extrasystoles ranging from 25 to 38 weeks of gestation. At outflow tract level, peak systolic velocity and acceleration time for extrasystolic and post‐extrasystolic beats were compared with those for the immediately preceding normal beat. Regression lines were calculated for peak systolic velocities with filling time. At atrioventricular level, peak‐E wave and peak‐A wave velocities and E/A ratio for the extrasystolic and post‐extrasystolic beats were compared with those for the normal beat. At all levels, time‐averaged velocities were compared with reference charts standardized for gestational age.Peak systolic velocity and acceleration time during the post‐extrasystolic beat were higher than during the normal beat; the Frank‐Starling mechanism, post‐extrasystolic potentiation as well as reduced ventricular afterload may all play a role in this. At all measuring levels, time‐averaged velocity during the extrasystolic beat was strikingly lower than the reference velocities. It is postulated that the increased blood volume and contraction force during the post‐extrasystolic beat cause the valve area to become larger, resulting in a relative decrease in velocities measured by Doppler ultrasound. Copyright © 1992 International Society of Ultrasound in Obstetrics and Gynecology
Cephalocele and cystic hygroma: diagnosis and differentiation in the first trimester of pregnancy with transvaginal sonography. Report of two cases
Authors: van Zalen‐Sprock M. M. , van Vugt J. M. G. , van der Harten H. J. , van Geijn H. P. 
Published: March 2003

AbstractTwo case reports are presented of fetuses with malformations in the neck region, detected in the first trimester of pregnancy by transvaginal ultrasonography. In one fetus a septated cystic hygroma was visualized. Trisomy 18 was found. The other fetus presented with a cephalocele. The ultrasound diagnosis was confirmed at autopsy in both cases. Sonographic criteria to distinguish between cystic hygroma and occipital cephalocele in the first trimester of pregnancy are discussed. Copyright © 1992 International Society of Ultrasound in Obstetrics and Gynecology
The clinical significance of resolving polyhydramnios
Authors: Rochelson B. , Wagner J. , Shmoys S. 
Published: March 2003

AbstractPolyhydramnios is associated with multiple maternal and fetal abnormalities. Although the risks of persistent polyhydramnios are well described, the clinical implications of polyhydramnios that resolves prior to delivery are not. Thirty‐four non‐diabetic patients with resolving polyhydramnios were studied. An amniotic acid index of ≥ 20 was used to define polyhydramnios. Antepartum and postpartum outcomes were compared with those patients with persistent polyhydramnios, and a control group of 102 singleton term deliveries. Patients with resolving polyhydramnios did not have a significant increase in congenital anomalies. An 8% incidence of congenital anomalies was noted in patients with persistent polyhydramnios; this was significant compared with controls (p < 0.05). Idiopathic resolving polyhydramnios was associated with a higher mean birth weight (p < 0.05) than controls, with significantly more babies weighing more than 4200 g. An increase in placental thrombus formation was noted in patients with idiopathic resolving and persistent polyhydramnios compared to the control group (p < 0.01). The etiology of this is unclear. Obstetricians should be aware of the risk of macrosomia and the possibility of placental disease in these fetuses. Copyright © 1992 International Society of Ultrasound in Obstetrics and Gynecology
Ovarian cysts during pregnancy: the role of ultrasonically guided transvaginal aspiration
Authors: Aboulghar M. , Mansour R. , Serour G. 
Published: March 2003

AbstractThree cases of ovarian cysts, with a mean diameter measuring more than 6 cm during the second trimester of pregnancy, were aspirated transvaginally, guided by ultrasound. All cysts were unilocular, thin‐walled with no internal echoes. Cytological examination of the aspirated fluid revealed benign luteinized granulosa cells. No complications occurred and the pregnancies continued to full term. It is believed that needle aspiration of simple ovarian cysts of 6 cm diameter or more during pregnancy is a safe and effective treatment that is capable of reducing the risk of torsion, hemorrhage or rupture and avoiding unnecessary laparotomy. Copyright © 1992 International Society of Ultrasound in Obstetrics and Gynecology
The acardiac twin: a case report using color Doppler ultrasonography
Authors: Crade M. , Nageotte M. P. , MacKenzie M. L. 
Published: March 2003

AbstractThe use of color Doppler sonography has expanded our understanding of the normal and abnormal pregnancy. A case is presented here in which color Doppler imaging was utilized to confirm a long‐held theory concerning the strikingly abnormal dynamics of arterial flow to an acardiac twin and observations are also presented concerning the possible route of venous return contrary to presumed theories established within the literature. Copyright © 1992 International Society of Ultrasound in Obstetrics and Gynecology