bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk factors for cesarean section of primiparous women aged over 35 years
Authors: Kozinszky Zoltán , Orvos Hajnalka , Zoboki Tünde , Katona Márta , Wayda Kornélia , Pál Attila , Kovács László 
Published: March 2003

Background.  To determine the perinatal outcome of pregnancy in primiparous women over 35 years of age and to evaluate determinants predicting cesarean delivery in these women.Methods.  Two hundred and seven mothers aged at least 35 years (1.8% of the total deliveries) delivered in the Department of Obstetrics and Gynecology between 1995 and 2000. These women were matched with women aged 20–29 years according to gravidity. Multiple logistic regression analysis was used to evaluate the risk of cesarean delivery, with controls for possible confounding factors.Results.  Cesarean section was 2.09‐fold more prevalent among the older than among the younger women; the difference being significant (odds ratio, OR=3.36, 95%CI 2.22–5.09; p<0.001). The advanced maternal age was associated with a significantly higher rate of assisted reproductive techniques involvement (OR 6.54; 95%CI 3.54–12.38; p<0.001). The difference between the rates of preeclampsia in the two groups did not reach the level of significance (OR 1.85; 95%CI 1.02–3.34; p=0.056). There were no significant differences in perinatal outcome between the two groups. The logistic regression model demonstrated an increased risk of cesarean section among the primiparous women aged over 35 years.Conclusions.  The risk of cesarean section at this advanced age is 6.54‐fold. The determinants are included in the pregnancy, delivery and neonatal outcome.
Hemorrhage risk during operative hysteroscopy
Authors: Agostini Aubert , Cravello Ludovic , Desbrière Raoul , Maisonneuve Anne Sophie , Roger Valérie , Blanc Bernard 
Published: March 2003

Background.  To evaluate the risk of hemorrhage during hysteroscopic surgery.Methods.  Cases of hemorrhage during hysteroscopic surgery were assessed in a single center, observational, prospective study conducted from 1990 to 2000, including 2116 surgical hysteroscopies. Risk of hemorrhage was evaluated according to the hysteroscopic procedure. The management of this complication was also noted.Results.  Thirteen cases (0.61%) were reported. In six cases, hemorrhage stopped spontaneously. For six patients, a Foley (no. 10) probe was introduced into the uterine cavity and inflated for 24 h to stop hemorrhage. For one patient, immediately from the start of the procedure, the uterine arteries were ligatured through the vaginal route in order to stop bleeding. Haemorrhage risk was higher during hysteroscopic adhesiolysis compared with endometrial ablation {Relative risk [RR] 5.22 (1.26–21.64); p = 0.02}, polyp [RR 5.3 (1.04–27.09); p = 0.04], and fibroid resections [RR 6.55 (1.58–27.17); p = 0.01]. Haemorrhage risk was however, comparable for endometrial ablation, uterus septa section, polyp, and fibroid resections (p = 0.92).Conclusions.  Hemorrhage risk is higher during synechiolysis compared with other procedures. An inflated Foley probe may be an efficient means of stopping hemorrhage.
Randomized clinical trial of total vs. subtotal hysterectomy: validity of the trial questionnaire
Authors: Gimbel Helga , Zobbe Vibeke , Ottesen Bent S. , Tabor Ann 
Published: March 2003

Background.  To ensure the internal validity of a trial it is recommended to undertake a validation study of the method measuring the outcome.Aims.  To validate a self‐administered, postal questionnaire (http://www.gyncph.suite.dk/praes/gimbel/gihtm) used for measuring the outcomes of a randomized clinical trial of total vs. subtotal abdominal hysterectomy.Methods.  A study of the content validity (10 patients) and a combined qualitative and quantitative validation study (20 patients) were performed.Results.  The median kappa of the 74 questions was 0.71 (range 0.22–1.00) and the median overall agreement was 0.76 (range 0.25–1.00). Five questions (7%) had kappa values below 0.40, 11 questions (15%) between 0.40 and 0.60, and 58 questions (78%) above 0.61. Three questions with a kappa value below 0.40 had an overall agreement of 0.75 or more. Significant logical inconsistencies were found in five questions, where the operation method was expected to be known. The qualitative validation resulted in a total of 80 comments. The number of comments for any given subject ranged from 0 to 12. The comments could be grouped and processed into four categories.Conclusions.  The agreement was high. Inconsistencies regarding questions on the operation methods were found. Potential problems were identified in five questions (7%). The validation studies resulted in some changes to the questionnaire and we became aware of areas in which caution should be taken in the interpretation of the results of the randomized trial.
Plasma oxytocin levels in women during labor with or without epidural analgesia: a prospective study
Authors: Rahm Vivi‐Anne , Hallgren Anita , Högberg Hans , Hurtig Ingalill , Odlind Viveca 
Published: March 2003

Background.  Epidural analgesia (EDA) has been reported to prolong labor. Whether this is by interference with endogenous oxytocin release or other mechanisms is unclear. With increasing numbers of women receiving an EDA, it is important to study its effects on labor. The aim was to study the concentration of plasma oxytocin and the progress of labor in women with and without EDA.Methods.  Thirty‐four full‐term women in spontaneous labor were included, 17 with epidural and 17 controls, matched for cervical dilatation and parity. Oxytocin was measured by radioimmunoassay before analgesia, 60 min later and after placental discharge. No oxytocin augmentation was given during the first hour.Results.  EDA during labor was associated with a fall in plasma oxytocin. There was no difference in plasma oxytocin levels between the groups at inclusion. One hour later, oxytocin concentrations had decreased in the epidural and increased in the control group (Student's t‐test, p= 0049). The change in oxytocin levels between the first and second sample differed significantly between the groups (ancova, p= 0.028). No difference in cervix dilatation between the groups 1 h after inclusion was noted, but women with EDA had a longer labor compared with those without, especially those with epidural and oxytocin augmentation during the later phase of the first stage of labor.Conclusion.  EDA during labor may interfere with the release of plasma oxytocin, which may be one mechanism behind prolongation of labor. Larger studies are needed to clarify the effects of epidural analgesia and the role of oxytocin during labor.
Glaucoma following congenital cataract surgery: An 18‐year longitudinal follow‐up
Authors: Magnusson G. , Abrahamsson M. , Sjöstrand J. 
Published: March 2003

ABSTRACT.Purpose: To report the occurrence of postoperative glaucoma and to evaluate risk factors.Methods: Children born in four of the western counties of Sweden who were diagnosed with congenital cataracts formed a cohort (n=137). The following parameters were evaluated: age at cataract surgery; type of surgery; visual outcome; postoperative IOP; optic disc abnormalities; date of onset of the complication; number of reoperations, including treatment for secondary cataract; presence of systemic anomalies; microphthalmus; and eye‐related anomalies.Results: A diagnosis of glaucoma was recorded for 12% of the eyes. The mean follow‐up time was 9.6 years. There is a relationship between surgery before the age of 10 days and development of glaucoma. Microphthalmus is an important risk factor as well.Conclusions: Despite modern surgical techniques the incidence of aphakic glaucoma is 10% or higher. No time‐dependent increase in the incidence of late‐onset glaucoma between the 1980s and the 1990s could be proven.
Latanoprost: Experience of 2‐year treatment in Scandinavia
Authors: Alm Albert , Widengård Ingmar 
Published: March 2003

ABSTRACT.Purpose: The aim of the study was to assess efficacy and side effects of latanoprost during two years of treatment.Methods: The study was a randomized, parallel group, double‐masked, multicenter comparison between latanoprost and timolol in patients with open angle glaucoma or ocular hypertension, followed by an open‐label 18‐month extension during which all patients were treated with latanoprost.Results: Latanoprost caused a marked and sustained reduction of the intraocular pressure (IOP). IOP was reduced from baseline levels 25.1±3.5 mm Hg (mean±SD) in 183 patients initially randomized to treatment with latanoprost to 17.4±2.9 mm Hg (n=66) after 24 months of treatment. For patients initially randomized to treatment with timolol the corresponding figures were 24.3±2.3 mm Hg (n=72) and 17.4±2.6 (n=41) mm Hg after 18 months of treatment with latanoprost. Two patients were withdrawn because of uncontrolled IOP and 11 patients required additional timolol treatment to maintain an adequate IOP control. Patients initially treated with timolol and switched to latanoprost had a further reduction of the IOP of 1.0 mm Hg after 6 months of treatment with latanoprost (p<0.005). 46 patients were withdrawn from the study, mostly due to increased iris pigmentation or an iris color with known high risk of developing increased pigmentation. 22 patients developed increased pigmentation of the iris. The follow‐up revealed no previously unknown ocular or systemic side effects.Conclusion: Once daily applications of latanoprost cause a marked and sustained reduction of the IOP. The only clinically significant side effect noted was the increased pigmentation of the iris, most frequently seen in irides with a mixture of brown and blue/gray or green colors. No systemic side effect was observed.
NGF administered by microdialysis into rabbit vitreous
Authors: Waga Janina , Ehinger Berndt 
Published: March 2003

ABSTRACT.Purpose: Microdialysis has been used in eye research for almost a decade. We have previously developed and used it mainly for chronic experiments and here it is used in acute experiments. It is highly suitable for both administration and withdrawal of substances from the eye, as it only permits molecules to cross the intraocular membrane without any net fluid movement in or out of the eye.Methods: We have here investigated the ability of 125I labeled NGF (nerve growth factor) to cross a previously implanted high permeability membrane of a new type (polyether sulphone, PES, cutoff at 100 000 daltons) in the rabbit vitreous. It was perfused for different time periods with a solution containing NGF. The radioactivity of the entire vitreous was then counted.Results: The results show detectable levels (up to 10−11M) of the substance after the perfusions.Conclusion: We conclude that microdialysis with PES membranes is a possible method for the intraocular administration of NGF.
The 30‐Hz flicker cone ERG for monitoring the early course of central retinal vein occlusion
Authors: Larsson Jörgen , Bauer Birgitta , Andréasson Sten 
Published: March 2003

ABSTRACT.Purpose: Investigation of the full‐field ERG (electoretinography) within 24 hours after the onset of symptoms in central retinal vein occlusion, and repeated examination within the following days and weeks.Methods: Seven patients with central retinal vein occlusion were examined with full‐field ERG within less than 24 hours after the onset of their symptoms and every second to third day during the first 3 weeks. They were then followed for a period of time of six months.Results: The amplitudes as well as the implicit times in the 30 Hz flicker ERG changed considerably within the first three weeks. In the three patients who developed rubeosis, the cone b‐wave implicit times as well as the amplitudes were altered considerably. In the patients that did not develop rubeosis, the cone b‐wave implicit times as well as the amplitudes in the 30 Hz flicker ERG were more stable.Conclusion: The full‐field cone ERG reflects the retinal function and the ERG parameters change considerably during the first weeks after the onset of the central retinal vein occlusion. The 30 Hz flicker ERG gives important information concerning the early development of the disease. The optimal time to do a predictive ERG could be after three weeks.
Mohs' micrographic surgery for basal cell carcinomas on the eyelids and medial canthal areaI
Authors: Lindgren Gun , Lindblom Bertil , Bratel Annika Ternesten , Mölne Lena , Larkö Olle 
Published: March 2003

ABSTRACT.Purpose: To analyse the characteristics of eyelid basal cell carcinomas excised using Mohs' micrographic technique.Methods: Sixty‐six eyelid basal cell carcinomas were excised using Mohs' micrographic technique. The tumours were classified into four subtypes; morpheiform, intermediate, nodular/micronodular and superficial. Data on previous treatment of the tumours were retrieved.Results: Thirty‐two tumours (48%) were primary, 8 tumours (12%) were incompletely excised using conventional excision surgery and 26 tumours (39%) were recurrent. Nineteen of the 26 (73%) recurrent tumours and 14 of the 32 (44%) primary tumours were nodular/micronodular. To achieve radical excision, superficial tumours needed an average of 2.0, nodular/micronodular 2.5, intermediate 2.0 and morpheiform tumours 2.9 excisions.Conclusions: Eyelid basal cell carcinomas with ill‐defined borders or recurrent tumours are well suited for Mohs' micrographic surgery. The extensions of the tumours are difficult to determine even in some less aggressive subtypes such as superficial and nodular/micronodular basal cell carcinomas.
Magnetic resonance imaging of a non‐pigmented adenoma of the ciliary epithelium
Authors: Nakazawa Toru , Abe, Toshiaki , Sato Yumi , Yuda Fumiaki , Omura Makoto , Tamai Makoto 
Published: March 2003

ABSTRACT.Purpose: A non‐pigmented adenoma of the ciliary epithelium is rare. No good documentation has been reported in which magnetic resonance imaging (MRI), histological examination, and immunohistological evaluation have all been conducted. We showed how this tumor differed from ciliary body melanoma.Methods: We evaluated the ciliary body tumor by MRI, histological examination, and immunohistochemical examination. The data was compared with previously reported cases.Result: The tumor was classified as an adenoma of the non‐pigmented ciliary epithelium with extracellular pools of hyaluronidase‐sensitive mucopolysaccharide. The MRI appearance of the vitreous in our patient showed hyperintensity on T1, isointensity on T2 and marked enhancement with gadolinium. None of 3 other reported patients exhibited the same signals.Conclusion: MRI appearance is most variable in adenomas and no microscopical diagnosis can be based on that. Our patient showed isointensity on T2 with marked enhancement by gadolinium when compared to malignant melanoma.
Quantitative anomaloscopy and optical coherence tomography scanning in central serous chorioretinopathy
Authors: Bek Toke , Kandi Maria 
Published: March 2003

ABSTRACT.Background: Dyschromatopsia is a prominent sign in a variety of central retinal diseases, such as central serous chorioretinopathy (CSC). The changes in colour vision may be due to either optical or neuronal factors in the diseased retina. The relative contribution from the two causes is unknown, but may be elucidated by obtaining knowledge of the anatomical derangement in the diseased retina in CSC.Methods: Twenty‐six normal persons had their colour vision tested using the Tomey anomaloscope. The calculation of setting range (SR) and central mean point (CMP) for Rayleigh match and Moreland match was optimized, and normal ranges for these values were defined. Subsequently 24 patients with CSC were examined by anomaloscopy and optical coherence tomography scanning, and the measures of colour vision were related to the anatomical changes observed on the scans.Results: The algorithm for calculating SR and CMP which is integrated into the Tomey anomaloscope could be considerably improved to increase sensitivity and reproducibility of these measures. Fifteen patients had abnormal colour vision. Nine patients had pseudo‐protanomaly, seven patients had pseudo‐tritanomaly, and three patients had abnormalities in both matches. There was no relation between these colour vision abnormalities and the anatomical derangement as seen by OCT in the diseased central retina.Conclusion: The findings argue against the notion that the density of retinal cell nuclei, the orientation of photoreceptors, or the size of the central serous detachment are related to the colour vision abnormalities in CSC. The question of whether these abnormalities are due to optical or neuronal factors remains open.
Detection of changes of the optic disc in glaucomatous eyes: Clinical examination and image analysis with the Topcon Imagenet system
Authors: Azuara‐Blanco Augusto , Katz L. Jay , Spaeth George L. , Nicholl Jamie , Lanzl Ines M. 
Published: March 2003

ABSTRACT.Purpose: This study was designed to evaluate the clinical agreement in the detection of optic disc changes and the ability of computerized image analysis to detect glaucomatous deterioration of the optic disc.Methods: Pairs of stereophotographs of 35 glaucomatous optic discs taken 5 years apart and of 5 glaucomatous discs photographed twice on the same day. Two glaucoma specialists examined the pairs of stereophotographs (35 cases and 5 controls) in a masked manner and judged whether the optic disc showed changes in the optic disc compatible with progression of glaucomatous damage. The stereophotographs of the five optic discs photographed twice on the same day (which by definition did not change) and of five cases judged to have deteriorated by both glaucoma specialists were analyzed by computerized image analysis with the Topcon ImageNet system. Intra‐ and inter‐observer agreement in the detection of optic disc changes (evaluated using kappa statistic), and changes in the rim area to disc area ratio (evaluated using descriptive statistics and paired t‐test).Results: Intra‐observer agreement had a kappa value of 0.75 for observer 1 and 0.60 for the observer 2. Inter‐observer agreement between the glaucoma specialists had a kappa value of 0.60. The image analyzer did not discriminate between controls and cases with clinically apparent glaucomatous change of the optic disc.Conclusion: Clinical agreement in detecting changes in the optic disc was moderate to substantial. Computerized image analysis with the Topcon ImageNet system appeared not to be useful in detecting glaucomatous changes of the optic disc.
A Forced Choice Comfort Study of Olopatadine Hydrochloride 0.1% versus Ketotifen Fumarate 0.05%
Authors: Artal Maria Natalia , Luna José Domingo , Discepola Marino 
Published: March 2003

ABSTRACT.Purpose: To compare the ocular comfort of two ophthalmic anti‐allergic agents: olopatadine hydrochloride 0.1% and ketotifen fumarate 0.05%.Subjects and Methods: In a double‐masked, multi‐centered, randomized trial, 80 subjects were asked to make a ‘forced choice’ based on ocular comfort between one drop of olopatadine hydrochloride 0.1% instilled in one eye and one drop of ketotifen fumarate 0.05% instilled in the contralateral eye. At one site, the incidence of adverse reactions was also reported.Results: All subjects (100%) selected olopatadine as the more comfortable formulation. One site (n=35) reported a 49% incidence of moderate burning and a 49% incidence of mild burning after ketotifen instillation. One subject (2% of population) at this site experienced no ocular discomfort with ketotifen. There were no reports of discomfort associated with olopatadine instillation.Conclusion: Olopatadine is a more comfortable ophthalmic preparation than ketotifen.
Latanoprost versus combined therapy with timolol plus dorzolamide: IOP‐lowering effect in open‐angle glaucoma
Authors: Polo V. , Larrosa J. M. , Gomez M. L. , Pablo L. , Honrubia F. M. 
Published: March 2003

ABSTRACT. Purpose: To compare the effect on intraocular pressure of latanoprost versus timolol plus dorzolamide in open‐angle glaucoma.Methods: Thirty‐five patients with open‐angle glaucoma were randomized, 18 to latanoprost once daily and 17 to timolol plus dorzolamide twice daily. Intraocular pressure and ocular side effects were recorded at baseline, and after 2 weeks and 3 months of treatment.Results: Latanoprost reduced the intraocular pressure 1.09 and 1.58 mm Hg more than timolol plus dorzolamide after 2 weeks and 3 months of treatment, respectively. These differences were statistically significant (p<0.05) at the end of the study. After 3 months of treatment, 32.3% of the eyes in the latanoprost group reduced the intraocular pressure in 30% or more with respect to baseline, while 15.6% of the eyes in the timolol plus dorzolamide group achieved this reduction.Conclusions: Latanoprost administered once daily reduced the intraocular pressure at least as well as timolol plus dorzolamide twice daily in patients with open‐angle glaucoma.
Recurrent episcleritis associated with brucellosis
Authors: Güngör Kıvanç , Bekir Necdet A. , Namıduru Mustafa 
Published: March 2003

ABSTRACT. Purpose: To document the clinical course and the treatment of episcleritis associated with brucellosis.Methods: Three consecutive cases of patients with recurrent episcleritis associated with brucellosis were evaluated through clinical and laboratory data including serology (tube agglutination), blood culture, and synovial fluid culture.Results: All the patients had ingested contaminated milk and/or fresh cheese. The diagnosis of brucellosis was confirmed by high antibody titer, positive blood culture, negative synovial fluid culture and unresponsive condition to the previous nonspecific therapy for episcleritis and reactive arthritis. The patients responded well to the therapy with doxycycline and rifampicin.Conclusion: We proposed that recurrent episcleritis had a co‐occurence with reactive arthritis in the course of the brucellosis, and that it responded well to the antibrucellar antibiotics rather than to steroids. This also implies that brucellosis as a rule is an underlying triggering infection associated with reactive arthritis.
Strabismus and binocular function in children with Down syndrome. A population‐based, longitudinal study
Authors: Haugen Olav H. , Høvding Gunnar 
Published: March 2003

ABSTRACT. Purpose: We have performed a population‐based, longitudinal study on strabismus in children with Down syndrome. The aims of the study were to examine the frequency and type of strabismus, the age at onset, and the binocular potential.Methods: An unselected population of 60 children with Down syndrome born 1988–1999 was followed with repeated examinations. Mean follow‐up time was 55±23 months (range 24–115). The alignment of the eyes was examined using Hirschberg corneal reflex test and cover test for near fixation. To evaluate binocular function, Titmus House Fly Test and Lang’s stereo test were used.Results: Twenty‐five patients (42%) had strabismus (21 esotropias, two exodeviations and two vertical deviations). Only one case of infantile esotropia was found, the other esotropias were acquired forms. The mean age at “onset” (e.g. when strabismus was first noticed) was 54±35 months. In the acquired esotropia group (n=20), 15 (75%) were associated with hypermetropia (mean spherical equivalent +4.3±1.7 D). Seventeen of the strabismic patients had an accommodation weakness. Eleven of the strabismus patients gave a clearly positive response to one or both stereotests.Conclusions: The majority of the Down syndrome children with strabismus have an acquired esotropia and hence a potential for binocularity. Hypermetropia and accommodation weakness are probably important factors in esotropia in Down syndrome patients.