bluuebunny/crossref_metadata_2025_split huggingface dataset:
Postmenopausal endometrial tuberculosis
Authors: Agboola Adekunle Julius , Walton Stuart M. , Hoffman Jonathan 
Published: March 2003

Objective We describe a case of endometrial tuberculosis where confirmatory biopsy material was obtained by selective resection. The hysteroscopic appearance of tuberculous granulomas is discussed. Subject A 62‐year‐old woman presented with breakthrough bleeding whilst on hormone replacement therapy. Endometrial biopsy obtained at diagnostic hysteroscopy showed the presence of granulomas on histological examination. At a second hysteroscopy subepithelial nodules were seen and resected. Histological examination confirmed the presence of non‐caseating epithelioid granulomas. The Heaf test was strongly positive. Conclusion Tuberculous granulomas can be seen hysteroscopically and selective resection will provide targeted biopsy material to aid diagnosis.
A safer laparoscopic hysterectomy. Laparoscopic hysterectomy using clamps: a new concept
Authors: Sinha Rakesh Y. , Warty Neeta R. , Hegde Aparna G. , Bapaye Charulata 
Published: March 2003

Objective  To evaluate the employment of the reusable laparoscopic hysterectomy clamp, Sinha's pedicle clamp (SpeC), in addition to intracorporeal suturing and/or endoloops during laparoscopic hysterectomy. Design  A study of 21 laparoscopic hysterectomy procedures carried out between January 1995 and March 1996. Interventions  A total of 52 pedicles were secured using clamps. We used 5‐mm curved clamps (right and left), with a ratchet locking mechanism to secure the grip, for all the vascular pedicles while performing a laparoscopic hysterectomy. The pedicles were then ligated with endoloops using no. 1–0 Vicryl on a curved body needle. The clamp was then gently released as the endoligature or suture was tightened. Conclusion  We are convinced that using clamps for laparoscopic hysterectomy would be safer than bipolar desiccation and the use of endo‐staples and would avoid major urological and haemorrhagic complications.
Thermal balloon endometrial destruction: the outcome of treatment of 117 women followed up for a maximum period of 4 years
Authors: Friberg Britt , Ahlgren Mats 
Published: March 2003

ObjectiveTo study the long‐term results of treatment for menorrhagia involving the thermal destruction of the endometrium by means of a balloon catheter.DesignBetween August 1993 and December 1996, 117 women were treated and, in a prospective study, 116 (99%) of them were followed up with consultations and questionnaires. No pretreatment with gonadotrophin‐releasing hormone (GnRH) analogues was given.SettingGynaecology department at a university hospital.ResultsThere were no immediate peroperative complications. The success rate after 25 months (range 10–49) was 94%, excluding women with preoperative intracavitary changes and pretreatment ultrasonographically identified submucosal leiomyomas. Life‐table analysis showed that the probability of assessing the treatment as ‘excellent’ or ‘good’ and avoiding hysterectomy over a 49‐month period was 81%, and the probability of avoiding hysterectomy over the same time period was 85% when no exclusions were made.ConclusionsFor women with menorrhagia, who have no further wish for pregnancy, this study shows that thermal endometrial destruction by means of the balloon catheter technique is a safe type of day case procedure with a high success rate. Pretreatment examination is important in order to select women well suited for the treatment. A successful result 1 year after treatment implies a successful result in the long term.
Endometrial ablation by electroballoon coagulation: long‐term results
Authors: Gallinat Adolf , Cosgriff Ned 
Published: March 2003

Objective To evaluate the safety and efficacy of electroballoon coagulation (Vesta™ system) for the treatment of dysfunctional uterine bleeding.Design Prospective single‐arm study with continuous follow up of at least 24 months.Setting Specialized free‐standing centre for gynaecological endoscopy.Patients 124 women suffering from menorrhagia in whom medical treatment had previously failed.Intervention Vesta endometrial ablation following hysteroscopic evaluation of the uterine cavity.Measurements and main results In 122 patients complete 24‐month follow‐up data were available; 52% of patients reported amenorrhea or very minimal bleeding and 34% of patients reported hypomenorrhea.Conclusion The Vesta system is a safe and effective method of endometrial ablation resulting in a very high success rate as evidenced by a low complication rate and the quantitative measure of post‐treatment menstrual bleeding.
A new knot pusher for secure slip knots in laparoscopic surgery
Authors: Hutchon David J. R. 
Published: March 2003

ObjectiveTo describe a new design of knot pusher which allows secure locking of some extracorporeal slip knots during a single pass.DesignDescription of the instrument and its use with review of the literature.ConclusionThis instrument provides an effective method of making secure slip knots in laparoscopic surgery.
An unusual case of delayed bowel trauma following uterine perforation and endometrial ablation
Authors: Jones Kevin , Anderson Harriet , Sutton Christopher 
Published: March 2003

To report the case history of a patient who sustained delayed bowel trauma following uterine perforation, and endometrial ablation.The clinical records of the patient were reviewed.Dysfunctional uterine bleeding unresponsive to medication was diagnosed, and the patient was booked to undergo a Vesta system endometrial ablation procedure. Following insertion of the electrode‐carrying balloon, the first warm‐up phase was aborted because of an impedance error, and the second warm up failed to reach a temperature of 75 °C on all electrodes. Uterine perforation was suspected. Inspection of the uterus revealed a lateral perforation below the endocervical os. A rollerball ablation of the endometrium was then carried out under laparoscopic control. At 3 months later the patient was admitted with symptoms and signs of acute abdominal pathology. She underwent a laparotomy, and a small bowel perforation was oversewn. During the operation, malrotation of the bowel was diagnosed. The patient continued to experience menorrhagia, and subsequently underwent a hysterectomy.This is an unusual case report of delayed bowel trauma following uterine perforation, and endometrial ablation in a patient with malrotation of the bowel.
Ureteral endometriosis
Authors: Nisolle Michelle , De La Osa Escribano Inigo Lopez , Squifflet Jean , Donnez Jacques 
Published: March 2003

ObjectiveTo evaluate the prevalence of ureteral endometriosis and to describe the laparoscopic surgery.DesignThis is a prospective study.ResultsIn a series of 306 patients with rectovaginal adenomyotic nodules, preoperative intravenous pyelography revealed ureteral stenosis with ureterohydronephrosis in 14 cases (4.5%). In four patients, complete ureteral stenosis was observed, and kidney scintigraphy revealed damaged kidney parenchymal function varying from 18% to 42%. Laparoscopic ureterolysis was possible in 13 women, and a significant postoperative decrease in ureterohydronephrosis was noted. In only one case, ureteral resection and uretero‐ureterostomy were needed.ConclusionIn cases of rectovaginal adenomysois more than 3 cm, the prevalence of ureteral endometriosis is high. The preoperative IVP is needed before laparoscopic ureterolysis which will avoid the silent loss of real function.
Molecular characterization of haemophilia A & B in Indians
Authors: Shetty  , Ghosh  , Pathare  , Jijina  , Mohanty  
Published: March 2003

Forty‐seven haemophilia A patients from 43 pedigrees and 34 haemophilia B patients from 31 pedigrees were screened for the presence of mutations by Southern blotting using factor VIII and IX cDNA and genomic DNA probes. Three deletions and two restriction site variants were detected among 47 haemophilia A patients and one deletion and two restriction site variants were detected in 34 haemophilia B patients. Overall, the frequency of mutations in haemophilia A was 10.6%; the frequency of deletions was 6.4% and that of point mutations was 4.2%. In haemophilia B, the frequency of mutations detected was 9%; deletions 9% and point mutations 6%.The present report, the first from India, shows that like other earlier published reports from Europe and the United States, mutations in haemophilia are heterogeneous, and that RFLP using Southern blotting did not detect most of the mutations in this disorder and is an insensitive and inefficient procedure.
Novel prothombin mutations in Puerto Rican children
Authors: Ortiz IR , Lefkowitz JB , Weller A , Santiago‐Borrero PJ 
Published: March 2003

Prothrombin (FII) deficiency is a rare congenital bleeding disorder. We have identified 8 children (7 families) with this condition, accounting for 6% of the congenital coagulation disorders (excluding VWD), followed at the Puerto Rico Pediatric Hemophilia Treatment Center.The mean age at first significant bleeding episode was 5.9 years, ranging from 9 months to 14 years. The first bleeding symptoms were mostly mucosal, with only one child with a joint bleed. Sex distribution was even, and all but one had family history of a coagulation disorder. FII activity levels ranged from 10% to 27% with a mean FII level of 17.3%. The PT and PTT were slightly abnormal in all, with a mean PT of 14.3 sec and mean PTT of 38.4 sec. DNA sequencing has been done on four patients from three families. One patient was found to be homozygous for a prothrombin mutation previously described in a patient of Puerto Rican origin, Arg‐457→Gln (Prothrombin Denver V). Probands in two families were compound heterozygotes for the Denver V mutation and two novel mutations. One of these, named Prothrombin Puerto Rico I, is a point mutation predicting a Gla‐16→Gln substitution. The other mutation, designated Prothrombin Puerto Rico II, is a five base deletion in Exon XIII resulting in a premature stop codon.FII deficiency is the third most common congenital coagulation factor deficiency in Puerto Rican children, suggesting a higher prevalence in our population. Our studies have identified two novel mutations in the prothrombin genes of these children.
Integrating species and habitat data for nature conservation in Great Britain: data sources and methods
Authors: Griffiths G. H. , Eversham B. C. , Roy D. B. 
Published: March 2003

Summary 1.Britain is unusual in the quantity and quality of species and habitat data available, at both national and regional scales. This paper reviews the sources, coverage and quality of these data. 2.Habitat and species data are used by conservation agencies in England, Scotland and Wales for site selection and for monitoring habitat quality. The paper argues, however, that neither habitat data nor species distribution data on their own are sufficient to locate and monitor habitats for nature conservation purposes effectively. 3.Differences in sampling methodologies between habitat and species surveys present methodological difficulties for the development of an integrated monitoring system that uses both types of data. These problems need to be overcome if habitat and species data are to be used more effectively for nature conservation in the wider countryside. 4.A more integrated system based on the concept of biotope occupancy is proposed and discussed. The implementation of the system would assist with understanding those factors that explain observed patterns in species distribution and diversity, thereby helping to improve the effectiveness of policies for nature conservation.
Vegetation gradients in Atlantic Europe: the use of existing phytosociological data in preliminary investigations on the potential effects of climate change on British vegetation
Authors: Duckworth J. C. , Bunce R. G. H. , Malloch A. J. C. 
Published: March 2003

Abstract

This paper aims to demonstrate the use of available vegetation data from the phytosociological literature in preliminary analyses to generate hypotheses regarding vegetation and climate change.
Geographical ecology of South American desert small mammals: consequences of observations at local and regional scales
Authors: Kelt Douglas A. , Marquet Pablo A. , Brown James H. 
Published: March 2003

AbstractFive major drylands in South American display very low levels of faunal similarity. The remarkable consistency of faunal structure, however, suggests that it may be possible to extend earlier conclusions based only on the mammal fauna of the Altiplano and the Atacama Desert to all of South America's arid lands.
Chance and determinism in the development of isolated communities
Authors: Ward S. A. , Thornton I. W. B. 
Published: March 2003

Abstract

In the colonization of an island by potentially interacting species both the severity of the competition between them and the length of the interval between their arrivals should affect the likelihood of the second species becoming established. Between‐island variation in priority and the interval between colonizations will depend on the dispersal rates of the two species.
We predict that early colonization should be relatively deterministic, whereas later in the colonization process both the sequence of arrivals and the interval between them will be more variable.
Possible instances of both deterministic and stochastic stages in community development are identified in the colonization of the Krakatau islands by zoochorous forest trees and large zoochorous lianes.
The effect of leukotriene‐modifier drugs on aspirin‐induced asthma and rhinitis reactions
Authors: Berges‐Gimeno M. P. , Simon R. A. , Stevenson D. D. 
Published: March 2003

SummaryBackground Leukotrienes (LTs) appear to be crucial mediators of aspirin (ASA)‐induced lower respiratory tract reactions. Therefore, it is logical to assume that leukotriene‐modifier drugs (LTMDs) might block these reactions.Objective The aim of this study was to determine whether concomitant treatment with LTMDs was associated with a reduction of ASA‐provoked lower respiratory tract reactions in patients with aspirin‐exacerbated respiratory disease (AERD), when compared to AERD patients who were not treated with LTMDs. Secondly, if ASA‐induced lower respiratory tract reactions were prevented in LTMD‐treated patients, was there then a higher prevalence of upper respiratory reactors or, alternatively, a higher prevalence of blocked reactions (‘non‐reactors’) in this group.Methods Of 271 patients suspected by history of having AERD, 96 were taking cys‐LT receptor antagonists (cys‐LTRAs) and 12 were taking zileuton at the time of oral ASA challenges. A matched control group of 163 patients was not receiving LTMDs. All subjects underwent standard oral ASA challenges. Reactions were classified as follows: classic [naso‐ocular combined with a 20% or > decline in forced expiratory volume of 1 s (FEV1)]; pure lower (20% or > decline in FEV1 without naso‐ocular); partial asthma (naso‐ocular + 15–20% decline in FEV1); upper only (naso‐ocular with < 15% decline in FEV1); negative (no reactions).Results In patients treated with cys‐LTRAs, there were significant reductions in numbers of patients with ASA‐induced bronchospastic reactions and a concomitant increase in upper respiratory reactors. There were no significant differences in mean provoking doses of ASA or the percent changes in FEV1 values in both groups. In the 12 patients receiving zileuton, no reactions to ASA (16%) were similar to the cys‐LTRA‐treated group (11%) and the control group (15%).Conclusion During oral ASA challenges, LTMD treatment appeared to shift target organ responses from both upper and lower respiratory tracts to upper tract alone. LTMD blocking of the entire respiratory tract did not appear to occur.
Subcision: a treatment for cellulite
Authors: Hexsel Dóris Maria ,   md, Mazzuco Rosemari ,   md
Published: March 2003

Abstract Background Cellulite is a common clinical condition, with few proven effective therapeutic options. Subcision is a surgical technique that is useful in treating advanced degree cellulite. This study was designed to determine the usefulness of the treatment of cellulite by subcision. Methods From January 1995 to January 1998, 232 female patients, aged 18–52 years, with cellulite on the thighs and buttocks were treated on an outpatient basis by the subcision technique. Results In the postoperative period, all the patients had pain, bruises, and hemosiderosis. An improvement in the surface depressions was observed and the patients reported a high degree of satisfaction. Conclusions This outpatient procedure is effective in the correction of surface depressions on the thighs and buttocks, clinically classified as cellulite.
Diversity, distinctiveness and conservation status of the Mediterranean coastal dung beetle assemblage in the Regional Natural Park of the Camargue (France)
Authors: Lobo Jorge Miguel , Lumaret Jean‐Pierre , Jay‐Robert Pierre 
Published: March 2003

Abstract.The Mediterranean region as a whole has the highest dung beetle species richness within Europe. Natural coastal habitats in this region are among those which have suffered severe human disturbance. We studied dung beetle diversity and distinctiveness within one of the most important coastal protected areas in the west Euro‐Mediterranean region (the regional Park of Camargue, southern France) and made comparisons of dung beetle assemblages with other nearby Mediterranean localities, as well as with other coastal protected area (Doñana National Park, Spain). Our finding showed that: (1) The species richness of coastal habitats in the Camargue is low and only grasslands showed a similar level of species richness and abundance to inland habitats of other Mediterranean localities. The unique habitats of the coastal area (beaches, dunes and marshes) are largely colonized by species widely distributed in the hinterland. (2) In spite of their low general distinctiveness, dune and marsh edges are characterized by the occurrence of two rare, vulnerable, specialized and large roller dung beetle species of the genusScarabaeus. As with other Mediterranean localities, current findings suggest a recent decline ofScarabaeuspopulations and the general loss of coastal dung beetle communities in Camargue. (3) The comparison of dung beetle assemblages between the Camargue and Doñana shows that, in spite of the low local dung beetle species richness in the Camargue, the regional dung beetle diversity is similar between both protected areas. Unique historical and geographical factors can explain the convergence in regional diversity as well as the striking divergence in the composition of dung beetle assemblages between both territories.
Investing in early detection versus intensive treatment for breast cancer: a study of the Israeli public priorities
Authors: Shmueli Amir 
Published: March 2003

Objective Public opinion has become one of the main inputs in setting priorities, rationing and allocating health resources. The present study focuses on the priorities of the Israeli public in allocating marginal breast cancer funds between early detection in the healthy majority of the population and intensive treatment of the sick minority in need. Design A sample of 2030 individuals representing the Israeli Jewish urban population aged 45–75 was interviewed in 1993/4. A full sit‐down interview collected information on several health related issues. Results Sixty‐one per cent chose to direct the funds to early detection efforts and 35% chose to direct the funds to treating the sick. Four per cent of the population could not decide. Higher education and better health are related to choosing early detection; religious observance is related to choosing the treatment option; and men and older persons tend, more than women and younger respondents, to be undecided. Conclusions Whilst the majority of the population tend to follow a cost‐effectiveness rationale in the marginal use of breast cancer funds, for more than a third of the population efficiency is not thus important, and they adhere to entitlement based upon a need‐equity principle in allocating health resources.
Does provision of an evidence‐based information change public willingness to accept screening tests?
Authors: Domenighetti Gianfranco , Grilli Roberto , Maggi Jenny Rose 
Published: March 2003

ObjectiveTo investigate whether the willingness of the general population to undergo a screening test of questionable effectiveness for pancreatic cancer is influenced by the quality and the extent of the information provided.DesignRandomised study.SettingSwitzerland.ParticipantsRepresentative sample (N=1000) of the general population aged over 20.InterventionsParticipants were randomly allocated into two groups (N=500 each), with one group to receive basic and the other extended quality of information. The information was presented in two hypothetical scenarios about implicit and explicit benefits and adverse events of the screening test. Response rates were, respectively, 80.2% (N=401) and 93.2% (N=466).Main outcome measuresStated willingness to undergo the screening test.ResultsOut of the 401 participants receiving the basic information scenario, 241 (60%) stated their willingness to accept the test, as compared to the 63/466 (13.5%) exposed to the extended one (P < 0.001). After adjusting for respondent characteristics through a logistic regression model, the ‘information effect’, expressed in terms of odds‐ratio (OR), shows that provision of additional information was related to a 91% (OR 0.09; 95CI: 0.07 – 0.13) relative reduction in the likelihood of accepting the screening test.ConclusionThe quality and the extent of the information provided about the implicit and explicit benefits and adverse events on hypothetical scenarios of a screening test may dramatically change the willingness of people to participate in the testing. This study suggests that provision of full information on the yield of health care interventions plays an important role in protecting the public from being exposed to procedures of questionable effectiveness.
A ‘Third Way’ for lay involvement: what evidence so far?
Authors: Pickard Susan , Smith Keri 
Published: March 2003

Aims and objectives This article considers evidence regarding lay involvement in the NHS, following the White Paper’s commitment to rebuild public confidence in an NHS ‘accountable to patients and open to the public and shaped by their views’. It looks at two aspects of lay involvement: the lay board member’s involvement in primary care group (PCG) decision‐making and the engagement of the PCG with the wider public. Methods The paper analyses data from the first sweep of the annual Tracker Survey of a sample of PCGs in England, led by the National Primary Care Research and Development Centre in collaboration with the King’s Fund between September and December 1999. It draws specifically from the postal questionnaires sent to lay members. Firstly, however, it contextualizes this data by reviewing the history of lay involvement before 1997 in the NHS and particularly in primary care. Conclusions The paper concludes that, during the first 6 months of their operation, the lay voice was faintly heard in PCGs. The lay member’s role in decision‐making at board‐level was peripheral. The majority rated their involvement in key aspects of decision‐making as low and their influence on decision‐making below that of other board members including the Chief Officer, the chair and the GP board members. Beyond the arena of the board, what little contact there was with the lay voice has taken the shape of informing rather than consulting. Mitigating factors include the early stage at which the survey was completed and the lack of precedents for lay involvement in primary care in a broad sense on which PCGs can draw.