bluuebunny/crossref_metadata_2025_split huggingface dataset:
Differential expression of matrix metalloproteinase and tissue inhibitor of MMP in serosal tissue of intraperitoneal organs and adhesions
Authors: Chegini Nasser , Zhao Yong , Kotseos Kristina , Ma Chunfeng , Bennett Barbara , Diamond Michael P. , Holmdahl Lena , Skinner Kevin ,   Members of the The Peritoneal Healing and Adhesion Multi University Study (PHAMUS) Group are listed on page 1048
Published: December 2003

Objective
To comparatively analyse the expression of matrix metalloproteinase (MMP‐3) and tissue inhibitor of MMP (TIMP‐2) in serosal tissue of intraperitoneal organs and adhesions, as well as peritoneal fluid and serum of subjects with and without adhesions.Design
Cross sectional study.Setting
Academic research centres.Sample
Patients undergoing abdominal/pelvic surgery.Methods
Messenger ribonucleic acid (mRNA) and protein expression using quantitative reverse transcription polymerase chain reaction (Q‐RT‐PCR), ELISA and immunohistochemistry.Results
All the tissues examined express MMP‐3 and TIMP‐2 mRNA and protein at consistently varying levels ranging from 100‐ to 1000‐fold and 2‐ to 10‐fold mRNA and protein, respectively. Serosa of uterine, fallopian tube, ovary and partial peritoneum express a higher MMP‐3 mRNA compared with small and large bowels and omentum, while TIMP‐2 expression was less variable with the highest level found in uterine serosa (P < 0.05). The expression of MMP‐3 and TIMP‐2 mRNA in adhesions was not significantly different compared with parietal peritoneum. MMP‐3 and TIMP‐2 protein content in tissue extracts, peritoneal fluids and serum also varied with higher TIMP‐2 than MMP‐3 (P < 0.05). TIMP‐2 levels were lower in serum of subjects with moderate/extensive adhesions compared with subjects without adhesions. Immunoreactive MMP‐3 and TIMP‐2 proteins were detected in various cell types in these tissues. There was no correlation between MMP‐3 and TIMP‐2 expression, and age, gender or menstrual status of subjects with or without adhesions.Conclusion
MMP‐3 and TIMP‐2 are expressed at varying levels in serosal tissues of peritoneal organs and adhesions, with higher TIMP‐2 than MMP‐3. Based on the knowledge that tissue injury alters the expression of MMPs and TIMPs, such variations may predispose an organ to develop more adhesions than others. In addition, the results suggest that serum level of TIMP‐2 may represent a marker for subjects who will form adhesions with greater severity.
Iron plus folate is more effective than iron alone in the treatment of iron deficiency anaemia in pregnancy: a randomised, double blind clinical trial
Authors: Juarez‐Vazquez Jorge , Bonizzoni Erminio , Scotti Aurelio 
Published: December 2003

Objective
To evaluate whether folate supplementation to iron is able to accelerate solving of iron deficiency anaemia in pregnancy.Design
Multicentre, double blind, randomised clinical trial.Setting
Nine hospital gynaecologic units located in Mexico.Population
Three hundred seventy‐one women with iron deficiency anaemia between 14 and 27 weeks of pregnancy.Methods
Random allocation of the study population to receive 80 mg iron proteinsuccinylate, with or without 0.370 mg folinic acid daily for 60 days.Main outcome measure
Haemoglobin concentration increase.Results
Combined iron and folate therapy showed a better therapeutic response: the increase in haemoglobin levels from baseline was 1.42 (0.14) g/dL for women treated with both compounds vs 0.80 (0.125) g/dL for those given iron only (P < 0.001). A multivariable regression analysis showed that this effect was independent of basal levels of blood iron, ferritine and serum folate and was more evident in women with more severe anaemia. In the 64 women belonging to the subgroup defined by the per‐protocol (PP) population and the lowest quartile of baseline haemoglobin values (mean 8.96, range 5.9–9.8 g/dL), the increase at day 60 was estimated 2.3 (0.53) g/dL for the combined therapy vs 0.5 (0.5) g/dL for iron only (P= 0.07). No significant differences in tolerability were observed between the two groups.Conclusion
Folate supplementation is recommended in pregnant women with iron deficiency anaemia irrespective of the serum levels of folate.
Fetal bradycardia due to intrathecal opioids for labour analgesia: a systematic review
Authors: Mardirosoff Chahé , Dumont Lionel , Boulvain Michel , Tramèr Martin R. 
Published: December 2003

Objective
To evaluate fetal and maternal adverse effects of intrathecal opioid analgesia during labour.Data sources
A systematic search was performed, in Medline, Embase, the Cochrane Library, bibliographies, and personal contact with authors, in any language, up to February 2001.Study selection
Full reports on randomised comparisons of any analgesia with intrathecal opioid (experimental group) with any non‐intrathecal opioid regimen (control group) during labour.Data extraction
Dichotomous data from 24 trials (3513 women).Results
With intrathecal opioids, there was a significant increase in the risk of fetal bradycardia: odds ratio 1.8 (95% confidence interval 1.0 to 3.1), number‐needed‐to‐harm 28. The risk of caesarean section due to fetal heart rate abnormalities was similar (6.0%versus 7.8%). The incidence of pruritus was significantly higher with intrathecal opioids: relative risk 29.6 (95% CI 13.6 to 64.6), number‐needed‐to‐harm 1.7.Conclusions
Intrathecal opioids for labour increase the risk of fetal bradycardia and maternal pruritus. The risk of subsequent caesarean section is not increased.
Predictive value of amniotic fluid cystatin C levels for the early identification of fetuses with obstructive uropathies
Authors: Mussap Michele , Fanos Vassilios , Pizzini Carla , Marcolongo Alma , Chiaffoni Graziella , Plebani Mario 
Published: December 2003

Objective
To compare the diagnostic accuracy of cystatin C with that of creatinine in discriminating renal function in fetuses without ultrasononographic evidence of renal malformations from those with obstructive uropathies.Design
Prospective, observational cohort study.Setting
Prenatal morphologic and functional evaluation of fetal obstructive uropathies throughout pregnancy.Population
A total of 96 healthy pregnant women at different stages of pregnancy, without any pregnancy‐related maternal disease. Eighty‐one pregnant women without clinical and ultrasonographic evidence of any fetal anomaly, confirmed at birth, were defined as controls; 15 pregnant women with various fetal obstructive uropathies, evidenced by repeated ultrasound examinations and confirmed at birth, were defined as cases.Methods
Creatinine was measured by a kinetic Jaffe picric acid method and cystatin C by a nephelometric immunoassay. Variables were analysed by applying conventional statistical tests; the non‐parametric receiver operating curves (ROC) analysis was used to evaluate the diagnostic efficiencies of the biochemical markers.Main outcome measures
Incidence of confirmed, diagnosed, neonatal obstructive uropathy by measuring baseline levels of cystatin C and creatinine in amniotic fluid.Results
Baseline levels of cystatin C in amniotic fluid were significantly higher (P= 0.0015) among cases than in controls with comparable gestational age; no significant difference was found for creatinine levels (P= n.s.). The maximum diagnostic accuracy of serum cystatin C in discriminating controls from fetal uropathies was 96%, while that of creatinine was 62%.Conclusion
Cystatin C may be considered a sensitive biochemical marker for the early identification of fetuses with obstructive uropathies.
Soluble P‐selectin levels during normal pregnancy: a longitudinal study
Authors: Holmes V.A. , Wallace J.M.W. , Gilmore W.S. , McFaul P. , Alexander H.D. 
Published: December 2003

Objective
To investigate soluble P‐selectin (sP‐selectin) levels and platelet parameters in normal pregnant women compared with non‐pregnant control subjects.Design
A longitudinal case–control study.Setting
Obstetric outpatient clinic in the Jubilee Maternity Hospital, Belfast.Population
One hundred and twenty normal pregnant women and 41 non‐pregnant age‐matched control subjects.Methods
The plasma concentration of sP‐selectin in pregnant women sampled at 12, 20 and 35 weeks of gestation, and, in a subgroup at three days postpartum, and non‐pregnant controls sampled in parallel, was determined using a commercial quantitative sandwich immunoassay kit. Platelet parameters on each blood sample were also recorded using a SYSMEX SE 9500 analyser.Main outcome measures
Plasma sP‐selectin as a measure of platelet activation in normal pregnancy.Results
Soluble P‐selectin was significantly higher in pregnant women than in non‐pregnant control subjects at 20 and 35 weeks of gestation, (P < 0.01, and P < 0.001, respectively). Correlation analyses showed positive correlation between sP‐selectin and platelet count in pregnant women at 20 and 35 weeks of gestation (r= 0.247, P < 0.05 and r= 0.360, P < 0.001, respectively). Soluble P‐selectin concentration per platelet was also significantly higher in pregnant women than in non‐pregnant control subjects at 20 and 35 weeks of gestation (P < 0.001).Conclusions
Our results show that sP‐selectin concentration is significantly higher in the second and third trimester of pregnancy when compared with non‐pregnant control subjects sampled in parallel. This finding clarifies previous conflicting results on platelet activation in normal pregnancy, and is in agreement with those earlier studies which reported, using other methods, increased platelet activation in normal pregnancy.
Herpes simplex virus type‐2 infection in pregnancy: no risk of fetal death: results from a nested case–control study within 35,940 women
Authors: Eskild Anne , Jeansson Stig , Stray‐Pedersen Babill , Jenum Pål A. 
Published: December 2003

Objective
The aim of this study was to assess the association of fetal death with herpes simplex virus type‐2 (HSV‐2) antibody status during pregnancy: 1. presence of antibodies in first trimester; 2. appearance of antibodies (incident infection); 3. increase in antibody titre; and 4. loss of antibodies.Design
Prospective study.Population
The source population was a cohort of 35,940 pregnant women in Norway.Methods
Nested case–control study within the cohort. Cases were all women in the study population who experienced a fetal death after the 16th weeks of gestation (n= 281), and controls were 961 randomly selected women with a live born child.Main outcome measures
HSV‐2 antibody status.Results
Twenty‐nine percent (82/281) of women with a fetal death and 27% (256/961) of the controls had of HSV‐2 antibodies present in the first trimester (odds ratio 1.1, 95% CI 0.8–1.5). HSV‐2 antibodies appeared in 2% (3/136) of initially seronegative cases and 3% (16/623) of the controls during pregnancy (odds ratio 0.9, 95% CI 0.2–3.0). An increase in HSV‐2 antibodies occurred in 4% (2/55) of initially seropositive cases and 7% (16/231) of the controls (odds ratio 0.5, 95% CI 0.1–2.3). Loss of HSV‐2 antibodies in initially seropositive women was not associated with fetal death, 42% (23/55) of the cases and 45% (104/231) of the controls seroreverted (odds ratio 0.8, 95% CI 0.5–1.6). Differences in follow up time, age and parity were controlled and did not influence the comparisons between cases and controls.Conclusion
This study provides no evidence of an association between HSV‐2 infection during pregnancy and fetal death.
Dose–response analysis of effects of tibolone on climacteric symptoms
Authors: Landgren M.B. , Bennink H.J.T. Coelingh , Helmond F.A. , Engelen S. 
Published: December 2003

Objective
To assess the clinically optimal tibolone dose for the relief of climacteric complaints.Design
A randomised, double blind, placebo‐controlled trial.Setting
Twenty‐eight centres in Norway, The Netherlands, Sweden and Finland.Population
Seven hundred and seventy‐five healthy postmenopausal women were randomised to tibolone in a daily dose of 0.625, 1.25, 2.5 or 5.0 mg or placebo for 12 weeks.Methods
At baseline, and after 4, 8 and 12 weeks, hot flushes, sweating, vaginal bleeding and adverse experiences were recorded.Main outcome measures
Change in frequency and intensity of hot flushes and sweating over 12 weeks.Results
From week four onwards, 2.5 and 5.0 mg tibolone were significantly more effective than placebo, regarding the frequency of hot flushes and sweating (P < 0.001), whereas the 0.625 mg dose was not significantly different from placebo during the study. The frequency of hot flushes with the 1.25 mg dose was statistically significantly different from placebo, only from week eight onwards. The incidence of dropouts due to insufficient therapeutic effect was much higher in the tibolone 1.25 mg group (9.5%) than in the 2.5 (1.9%) and 5.0 mg (1.3%) groups. A dose‐related increase in incidence of vaginal bleeding or spotting was observed (P < 0.0001). Bleeding incidence in the 5.0 mg dose group was about twice as high as in the 2.5 mg dose group. There was no difference in incidence of adverse experiences between the 2.5‐ and the 1.25 mg dose group.Conclusion
A daily dose of 2.5 mg tibolone is the clinically optimal dose for the treatment of climacteric complaints in postmenopausal women.
Erythromycin inhibits prostaglandin F2α‐induced contractions of myometrium isolated from non‐pregnant rats
Authors: Celik Husnu , Ayar Ahmet , Baltaci Abdulkerim , Tug Niyazi 
Published: December 2003

Objective
The aim of this study was to investigate the effects of erythromycin on prostaglandin F2α (PGF2α)‐induced contractions of isolated myometrial strips from non‐pregnant rats.Design
In vitro pharmacological study.Setting
Firat University Faculty of Medicine.Sample
Myometrium samples were taken from 55 adult Wistar rats.Methods
Myometrial strips were isolated from mature, non‐pregnant Wistar rats. Isometric contractions of these strips were induced with 1 μM PGF2α. Effects of 0.01, 0.1, 0.2, 0.5 and 1 mM erythromycin on the frequency and amplitude of these PGF2α‐induced contractions were recorded.Main outcome measures
The inhibition of prostaglandin F2α‐induced contractions in vitro.Results
Application of 0.01 mM erythromycin had no effect on either amplitude or frequency of contractions. However, 0.1, 0.2, 0.5 and 1 mM erythromycin decreased the frequency and amplitude of PGF2α‐induced contractions. The inhibitory effect of erythromycin on amplitude was 27%, 38%, 54% and 83% (P < 0.05), and that on frequency was 10%, 16%, 32% and 61% (P < 0.05) at 0.1, 0.2, 0.5 and 1 mM concentrations, respectively.Conclusion
The results of this study demonstrate that erythromycin inhibits PGF2α‐induced contractions in rat myometrium. Because PGF2α‐induced contractions have been suggested to be involved in the pathogenesis of primary dysmenorrhoea, effects of erythromycin in this clinical entity may present a new approach for the treatment.
Comparative study of the effects of a progestogen‐only pill containing desogestrel and an intrauterine contraceptive device in lactating women
Authors: Bjarnadóttir Ragnheidur I. , Gottfredsdóttir Helga , Sigurdardóttir Kristín , Geirsson Reynir T. , Dieben Thom O. M. 
Published: December 2003

Objective To evaluate the effects of desogestrel 75μg/day, as a progestogen‐only pill compared with a copper‐bearing intrauterine contraceptive device (IUCD) on lactation and to study the safety of both treatments in mothers and children. Transfer of etonogestrel to breast milk was studied in a subgroup of desogestrel users. The children were to be followed up until 2.5 years of age.Design An open, non‐randomised, group‐comparative study in lactating women.Setting University Hospital, Reykjavik, Iceland.Participants A total of 83 lactating women; 42 received desogestrel and 41 had an IUCD inserted for seven consecutive treatment cycles of 28 days.Methods Evaluation visits were planned at baseline and at the end of treatment cycles 1, 4 and 7. The amount of breast milk was determined by weighing the infants before and after feeding, at baseline and after treatment cycles 1 and 4. Milk samples were obtained at the same time for constituent measurements. Safety was studied by structured medical examinations and by recording adverse experiences in mothers and children.Results There were no significant differences between the desogestrel and IUCD groups in composition and quantity of breast milk nor in growth and development of the children followed up to the age of 2.5 years. In the desogestrel group a slightly higher incidence of mild adverse experiences of a hormonal nature was reported among both mothers and infants. Of the children 82% were followed until 1.5 years of age and 50% until 2.5 years.Conclusion The use of desogestrel 75μg/day did not change the amount and composition of breast milk nor did it affect growth and development of the breastfed children. It appears to be a safe and effective contraceptive method for lactating women
Glomerular endotheliosis in normal pregnancy and pre‐eclampsia
Authors: Strevens Helena , Wide‐Swensson Dag , Hansen Alastair , Horn Thomas , Ingemarsson Ingemar , Larsen Svend , Willner Julian , Olsen Steen 
Published: December 2003

Objective
To investigate the proportion of women with findings characteristic for pre‐eclampsia, as opposed to renal disease, in a controlled study of hypertensive pregnant women undergoing antepartum renal biopsy.Design
An observational prospective controlled study.Setting
University Hospital of Lund, Sweden.Sample
Thirty‐six previously healthy women with hypertensive disease in pregnancy, consecutively admitted to the antenatal ward at onset of disease during a 20 month period and giving informed consent, as well as 12 voluntary healthy pregnant controls.Methods
Renal biopsy samples were obtained from all participants and evaluated by light microscopy, electron microscopy and immunofluorescence techniques.Main outcome measures
Presence and degree of glomerular endotheliosis.Results
Glomerular endotheliosis was present in all women with pre‐eclampsia and gestational hypertension, and in 5 of the 12 controls, although significant differences in the degree of endotheliosis were found between the groups. Clinically undetected renal disease was not diagnosed in any of the women.Conclusion
Glomerular endotheliosis was found in women with normal pregnancy as well as in both non‐proteinuric and proteinuric hypertension and is consequently not, as earlier believed, pathognomonic for pre‐eclampsia. The transition between normal term pregnancy, gestational hypertension and pre‐eclampsia appears to be a continuous process, perhaps of increasing adaptation to pregnancy. Pre‐eclampsia may be the extreme of the adaptational process, rather than a separate abnormal condition. Clinically undetected renal disease could be a rare cause of hypertension in pregnancy.
Reproductive health in rural Malawi: a population‐based survey
Authors: van den Broek N.R. , White S.A. , Ntonya C. , Ngwale M. , Cullinan T.R. , Molyneux M.E. , Neilson J.P. 
Published: December 2003

Objectives
To assess pregnancy outcome, maternal mortality and health‐seeking behaviour in a rural African population and to assess the effects on these of women's education, distance from a health centre and household type.Design
Descriptive population‐based study.Setting
A rural community in southern Malawi.Population
All women living in the catchment area of a rural health centre.Methods
Interviews with women in 20,649 households using structured questionnaires.Main outcome measures
Pregnancy outcome, the effect of women's education, distance from a health centre and household type on pregnancy outcome, maternal morbidity and estimates of maternal and perinatal mortality.Results
Educational level was lower for women than for men. A significant association was found between educational level and fertility. Women aged 45–49 reported an average of six pregnancies with four resulting in currently living children. Successful pregnancy outcome was more likely with increased education and if the woman lived closer to the health centre. Despite living an average of 5 km from the health centre, over 90% of women attended antenatal clinic with a mean of five visits. Assistance at delivery by a trained health care worker was more likely as education increased and was less likely as distance from the health centre increased. Maternal mortality was reported at 413 per 100,000 deliveries (95% CI 144–682). The perinatal mortality rate in this population was estimated at 30 per 1000. An increased perinatal mortality was noted for women who were delivered by a female relative. Perinatal mortality rates were similar for delivery by a traditional birth attendant or a trained nurse–midwife. Education and proximity to the health centre were both associated with improved outcome.Conclusions
Many women in this rural community suffer the consequences of high pregnancy loss. Maternal and perinatal mortality are high. Improved education and skilled assistance at delivery can result in improved pregnancy outcome. Proximity of any household to a health centre has an effect on outcomes.
A randomised controlled trial of educational counselling on the management of women who have suffered suboptimal outcomes in pregnancy
Authors: Tam Wing Hung , Lee Dominic Tak Sing , Chiu Helen Fung Kum , Ma Kwok Chiu , Lee Albert , Chung Tony Kwok Hung 
Published: December 2003

Objectives
To study whether proactive educational counselling, in addition to routine clinical care, reduces psychological morbidity and improves quality of life and client satisfaction among women who suffer suboptimal outcomes during childbirth.Design
A randomised controlled trial.Setting
Obstetric unit of a tertiary teaching hospital.Population
Women who had unexpected antenatal, intrapartum or postpartum events leading to suboptimal outcomes during pregnancy and childbirth.Intervention
Educational counselling provided by a trained research nurse in the postnatal ward after delivery. Women in the control group received routine clinical care.Main outcome measures
The Hospital Anxiety and Depression Scale, the General Health Questionnaire and the Clinical Global Impression (before and after counselling, at six weeks and six months post‐delivery) and the World Health Organisation Quality of Life scale (WHO‐QOL) (at six weeks and six months post‐delivery).Results
There was no significant difference in psychological morbidity, quality of life or client satisfaction between the counselling group and the control group. Participants who underwent elective caesarean section and who had the educational counselling had significantly lower depression scores [mean 2.6 (SD 2.6)] compared with those receiving routine care [mean 3.9 (SD 3.2)]. On the other hand, educational counselling may have deleterious effect to women's quality of life in those who had instrumental delivery. Participants allocated to the counselling group had a lower mean score 68 (SD 13) in the physical domain of WHO‐QOL than those in the intervention group 74 (SD 13).Conclusion
Educational counselling, given on top of routine clinical care, does not give additional beneficial effects on the psychological wellbeing and quality of life of women who encountered suboptimal outcomes during pregnancy.