bluuebunny/crossref_metadata_2025_split huggingface dataset:
The absorption and secretion of calcium in the gastrointestinal tract of germ-free and conventional chicks
Authors: Palmer Maureen F. , Rolls B. A. 
Published: May 2005

1. The uptake, transport and secretion of calcium into the gastrointestinal tract of germ-free (GF) and conventional (CV) chicks was determined by a variety of in vivo and in vitro techniques using45Ca as a marker following a standard fast-feed regimen.2. Following an oral dose of Ca in conscious chicks, the transit time of digesta in the GF birds was appreciably faster than in the CV controls.3. Although the proportion of the Ca dose absorbed was similar in both groups of chicks, the accumulation of Ca in the intestinal wall was much greater in CV birds. Distribution of the labelled Ca in plasma and bone was similar in both groups.4. Following intravenous Ca injection in conscious chicks the Ca secretion into the intestinal lumen was similar in both groups, but the amount appearing in the gut wall was appreciably greater in CV chicks.5. There were regional differences in the ability of the gut to absorb Ca. There was a tendency for Ca uptake to be greater in the GF chicks but only in the proximal ileum did this approach significance.6. When the Ca was confined to an intestinal loop the uptake/g tissue was similar in the proximal ileum of both groups but significantly greater in the distal ileum of the GF group. Uptake/10 mm gut was similar in both groups at both the proximal and the distal site.7. It is suggested that the absence of a microbial load does not affect the ability of the enterocyte to absorb Ca but the subsequent removal of the absorbed load from the intestinal wall is appreciably slower in the CV group.
Epidermolysis Bullosa Simplex Associated With Muscular Dystrophy and Cardiac Involvement
Authors: Celik Canan , Uysal Hilmi , Heper Aylin Okcu , Karaoglan Belgin 
Published: May 2005

Abstract

We report a new clinical variant of epidermolysis bullosa simplex with muscular dystrophy (EBS-MD) that was associated with cardiac involvement. A 33-year-old patient had atrial fibrillation, pericardial effusion, and hypokinetic left ventricular cardiac walls. The muscle biopsy material revealed diffuse endomysial fibrosis and small atrophic muscle fibers with rounded contours. A positive desmin expression with abnormal localization in the subsarcolemmal groups was observed. We concluded that patients with EBS-MD should be investigated carefully when there are associated cardiac findings.
Histologic placental lesions in women with recurrent preterm delivery
Authors: Ghidini Alessandro , Salafia Carolyn M. 
Published: May 2005

Background.  The aim of this study was to evaluate whether particular placental histopathology lesions are associated with recurrent preterm birth.Methods.  We analyzed a database of 413 consecutive singleton pregnancies delivered at <32 weeks with past reproductive history available. After the exclusion of nulliparous women, the pregnancies were divided according to the obstetrical history into group 1 (n = 328), women without prior preterm delivery (PTD); group 2 (n = 49), women with one prior preterm childbirth; and group 3 (n = 36), women with ≥2 prior preterm deliveries. Demographic and clinical variables were compared among the three groups by using Kruskal–Wallis test and chi‐square test for trend. Finally, the individual placental lesions (i.e. 42 lesions of acute or chronic inflammation, uteroplacental vascular pathology, and intraplacental villous lesions) were correlated with the number of prior preterm deliveries by using regression analysis. A two‐tailed P < 0·05 was considered significant.Results.  No differences were found among the three groups in demographic or clinical variables. Regression analysis of scored placental lesions corrected for gestational age at delivery showed that the number of prior preterm deliveries was correlated only with chronic marginating choriodeciduitis (correlation coefficient = 0·13; P = 0·01) and acute choriodeciduitis (correlation coefficient = 0·14; P = 0·008).Conclusions.  Among women delivered at <32 weeks, those with prior preterm birth have histologic findings compatible with acute or chronic inflammatory involvement of the uterine cavity, suggesting that a prepregnancy endometrial infection rather than an ascending intrapregnancy pathway may be responsible for some recurrences of PTD.
Interleukin‐6 and interleukin‐8 in cervical fluid in a population of Swedish women in preterm labor: relationship to microbial invasion of the amniotic fluid, intra‐amniotic inflammation, and preterm delivery
Authors: Holst Rose‐Marie , Mattsby‐Baltzer Inger , Wennerholm Ulla‐Britt , Hagberg Henrik , Jacobsson Bo 
Published: May 2005

Background.  Intrauterine infection and inflammation in women with preterm labor are related to adverse perinatal outcome. Due to its subclinical nature, a correct diagnosis depends on retrieval of amniotic fluid. Amniocentesis is, however, not performed as a clinical routine because of its invasiveness. Hypothetically, cytokines in the cervical fluid may represent an alternative diagnostic approach. The aim was to examine cervical interleukin (IL)‐6 and IL‐8 in relation to microbial invasion of the amniotic fluid, intra‐amniotic inflammation, and preterm birth in women in preterm labor.Methods.  Women with singleton pregnancies in preterm labor (<34 weeks of gestation) and intact membranes were included. Cervical (n = 91) and amniotic fluids (n = 56) were collected. Polymerase chain reaction for Ureaplasma urealyticum and Mycoplasma hominis and culture for aerobic and anaerobic bacteria were performed. IL‐6 and IL‐8 were analyzed with enzyme‐linked immunosorbent assay.Results.  Non‐lactobacillus‐dominated biota was detected in cervical secretion in 25% (22/89) and the presence of micro‐organisms in the amniotic fluid in 16% (9/56) of the patients. The presence of U. urealyticum in the cervical fluid (21/46) was associated with significantly higher levels of IL‐6 in the secretion. IL‐6 and IL‐8 were significantly higher in cervical fluid of women with intra‐amniotic infection and inflammation and in women who delivered ≤7 days and/or before 34 weeks of gestation. Cervical IL‐6 ≥ 1.7 ng/ml was related to intra‐amniotic inflammation (relative risk: 2.67; range: 1.50–4.74) and had a sensitivity, specificity, positive predictive value, and negative predictive value of 58, 83, 75, and 69%, respectively, in the identification of intra‐amniotic inflammation. Similar data were obtained for IL‐8 ≥ 6.7 ng/ml.Conclusions.  High levels of cervical IL‐6 and IL‐8 are moderately predictive of intrauterine infection/inflammation and preterm delivery.
Preterm birth in Sweden 1973–2001: Rate, subgroups, and effect of changing patterns in multiple births, maternal age, and smoking
Authors: Morken Nils‐Halvdan , Källen Karin , Hagberg Henrik , Jacobsson Bo 
Published: May 2005

Background.  The objectives of this report are to evaluate changes in the preterm birth rate in Sweden 1973–2001. Furthermore, describe the proportion of spontaneous and indicated preterm births and assess risk factors for the subgroups of preterm birth during the period from 1991 to 2001.Methods.  A population‐based register study of all births occurring in Sweden from 1973 to 2001 registered in the Swedish Medical Birth Register was designed. The analysis of subgroups was restricted to the period 1991–2001. Gestational age was calculated using last menstrual period and best estimate. Odds ratio for preterm birth related to risk factors was calculated for the subgroups' spontaneous and indicated preterm birth.Results.  After an increase in the beginning of the 1980s, the preterm birth rate has decreased from 6.3% in 1984 to 5.6% in 2001 (P < 0.0001). The proportion of multiple births born preterm of the total birth rate increased from 0.34% in 1973 to 0.71% in 2001 (P < 0.0001).Spontaneous preterm births account for 55.2% and iatrogenic preterm births for 20.2% of all preterm births. The strongest association with maternal smoking in early pregnancy was found at gestational age <28 weeks and spontaneous preterm birth [odds ratio (OR) smoking versus no smoking: 1.55, 95% confidence intervals (CI): 1.42–1.69]. The strongest association for maternal age was found between gestational age <28 weeks and indicated preterm birth (OR 5‐year increase: 1.34, 95% CI: 1.21–1.47).Conclusions.  The preterm birth rate in Sweden has decreased since the mid 1980s. The composition of different subtypes of preterm birth in a Scandinavian low‐risk population seems to be similar to populations with higher incidence of preterm birth and perinatal infections.
Biomarkers for the prediction of preterm delivery
Authors: Vogel Ida , Thorsen Poul , Curry Allison , Sandager Puk , Uldbjerg Niels 
Published: May 2005

This structured review discusses the current literature on selected biomarkers and their ability to predict preterm delivery (PTD).Among symptomatic women, the likelihood ratio (LR+) for the prediction of PTD was found to be greater than 10 using amniotic fluid (AF) interleukin‐6 (IL‐6), AF Ureaplasma urealyticum, as well as a multi‐marker consisting of cervical IL‐6, cervical IL‐8, and cervical length (CL). The LR+ was found to be between 5 and 10 for serum C‐reactive protein (CRP). An LR+ between 2.5 and 5 was recorded for serum corticotropin‐releasing hormone (CRH), cervical fetal fibronectin (fFN), cervical IL‐6, serum relaxin, and a multi‐marker consisting of fFN and CL. CL and bacterial vaginosis (BV) both predicted PTD in women with preterm labor with an LR+ of less than 2.5.In asymptomatic women, AF U. urealyticum and a multimarker consisting of five individual markers [fFN, CL, serum alpha‐fetoprotein (AFP), serum alkaline phosphatase, and serum granulocyte colony‐stimulating factor (G‐CSF)] predicted PTD with an LR+ greater than 10. The LR+ was between 5 and 10 for serum relaxin and CL. LRs+ recorded for serum alkaline phosphatase, salivary estriol, serum CRH, serum G‐CSF, cervical IL‐6, AF IL‐6, cervical fFN, AFP, and Chlamydia all ranged between 2.5 and 5. Finally, an LR+ below 2.5 has been documented for serum ferritin, serum CRP, BV, and cervical ferritin.
Monocyte chemotactic protein‐2 and ‐3 in amniotic fluid: relationship to microbial invasion of the amniotic cavity, intra‐amniotic inflammation and preterm delivery
Authors: Jacobsson Bo , Holst Rose‐Marie , Andersson Bengt , Hagberg Henrik 
Published: May 2005

Objective.  To evaluate the presence of monocyte chemotactic protein (MCP)‐2 and MCP‐3 in cervical and amniotic fluid in women in preterm labor.Study design.  Cervical and amniotic fluid was sampled from women with singleton pregnancies (≤34 weeks) in preterm labor (n = 58).Results.  Monocyte chemotactic protein‐2 (range: 80–583 pg/ml) and MCP‐3 (range: 36–649 pg/ml) were detectable in 7/58 women in preterm labor. Monocyte chemotactic protein‐3 was found significantly more often in amniotic fluid of women delivered within 7 days (P < 0.001), <34 weeks (P = 0.002), or with intra‐amniotic inflammation (P < 0.001) and microbial invasion of the amniotic fluid (P = 0.003). Women in preterm labor had detectable levels of MCP‐2 significantly more often if they gave birth before 34 weeks of gestation (P = 0.038) or had intra‐amniotic inflammation (P = 0.042).Conclusions.  The presence of MCPs in amniotic fluid of women in preterm labor was associated with preterm birth before 34 weeks of gestation (MCP‐2 and MCP‐3), microbial invasion (MCP‐3), and inflammation (MCP‐2 and MCP‐3) of the amniotic cavity.
Progesterone supplementation for preventing preterm birth: a systematic review and meta‐analysis
Authors: Dodd Jodie M. , Crowther Caroline A. , Cincotta Robert , Flenady Vicki , Robinson Jeffrey S. 
Published: May 2005

Aim.  The aim of this study is to assess the role of progesterone in preterm birth prevention.Methods.  A MEDLINE search (from 1966 to the present; date of last search January 2005) was performed – using the key words progesterone, pregnancy, preterm birth, preterm labor, and randomized, controlled trial – in order to identify randomized, controlled trials in which progesterone (either intramuscular or vaginal administration) was compared with placebo or no treatment. Data were extracted and a meta‐analysis was performed.Results.  Seven randomized, controlled trials were identified. Women who received progesterone were statistically significantly less likely to give birth before 37 weeks (seven studies, 1020 women, RR = 0.58, 95% CI = 0.48–0.70), to have an infant with birth weight of ≤2.5 kg (six studies, 872 infants, RR = 0.62, 95% CI = 0.49–0.78), or to have an infant diagnosed with intraventricular hemorrhage (one study, 458 infants, RR = 0.25, 95% CI = 0.08–0.82).Conclusions.  For progesterone supplementation to be advocated for women at the risk of preterm birth, the prolongation of gestation demonstrated in this meta‐analysis must translate into improved infant outcomes, including a reduction in mortality. There is currently insufficient information to allow recommendations regarding the optimal dose, route, and timing of administration of progesterone supplementation.
Maternal smoking and causes of very preterm birth
Authors: Kyrklund‐Blomberg Nina B. , Granath Fredrik , Cnattingius Sven 
Published: May 2005

Background.  Smoking increases the risk of preterm birth. The present study was made to elucidate the relation of smoking to causes of very preterm birth.Methods.  In a case‐control study on all very preterm births in two regions of Stockholm 1988–1992, prospectively collected data were extracted from antenatal and delivery records on smoking, other maternal characteristics, pregnancy complications, and causes of preterm birth. Cases were live single births with a gestational age of ≤32 weeks and 0 days, and controls were live singletons delivered at 37 weeks or later (n = 295, respectively). Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated with logistic regression.Results.  Compared with non‐smokers, adjusted ORs of very preterm birth among moderate smokers (1–9 cigarettes per day) and heavy smokers (≥10 cigarettes per day) were 1.4 (95% CI 0.8–2.4) and 2.9 (95% CI 1.5–5.7), respectively. Compared with non‐smokers, risk of preterm labor was increased among moderate and heavy smokers [ORs 1.9 (95% CI 1.0–3.6) and 2.6 (95% CI 1.1–1.6), respectively]. These risks remained essentially unchanged in women without an identifiable cause of preterm labor (‘idiopathic preterm labor’). Smoking was also associated with dose‐dependent increases in risks of preterm birth due to preterm premature rupture of membranes and late pregnancy bleedings. There was no association between smoking and risk of very preterm birth caused by hypertensive diseases.Conclusions.  Smoking increases the risk of very preterm birth caused by preterm labor (including idiopathic preterm labor), preterm premature rupture of membranes, and late pregnancy bleedings.
Term breech delivery in Sweden: mortality relative to fetal presentation and planned mode of delivery
Authors: Herbst Andreas 
Published: May 2005

Objectives. To compare perinatal and infant mortality in breech and cephalic presentations and between planned vaginal and cesarean section (CS) breech deliveries in Sweden.Methods. The study comprised two parts. Study A is a national cohort study for the period 1991–2001, including 22 549 breech presentations and 875 249 cephalic presentations born at ≥38 completed weeks. Study B is a case–control study, including all 164 breech deliveries with perinatal or 1‐year infant death (during 1991–1999 in Sweden) and controls.Results. Study A: Among non‐malformed infants, the total mortality rate was 0.46% in breech and 0.28% in cephalic presentations [adjusted odds ratio (OR) 1.6; 95% confidence interval 1.3–1.9]. Non‐malformed breech babies were at an increased risk of antenatal death (breech versus cephalic hazard ratio: 2.7, 2.1–3.6). The infant mortality among non‐malformed breech deliveries was higher in vaginal birth than in delivery by CS before labor (OR 2.5, 1.2–5.3). The perinatal + infant mortality among non‐malformed breech babies was higher at delivery after 39 completed weeks than at CS delivery at 38 weeks (0.53% versus 0.14%; OR 3.5, 1.9–6.4). The estimated needed number of CS to avoid one death was 400. Study B: In breech presentations without malformations, OR for perinatal or infant death was 3.1 (1.7–5.8) at planned vaginal delivery compared with planned CS delivery, and when breech presentations not diagnosed at 37 gestational weeks were excluded, OR was 3.7 (1.6–9.2).Conclusions. These large population‐based and case‐control studies both show a significant reduction of perinatal and infant mortality with planned CS in term breech pregnancy.
Radial nerve injury after general anaesthesia in the lateral decubitus position*
Authors: Tuncali B. E. , Tuncali B. , Kuvaki B. , Cinar O. , Doğan A. , Elar Z. 
Published: May 2005

SummaryA 43‐year‐old female patient underwent pyelolithotomy in the left lateral decubitus position. Her upper right arm was placed on a padded armboard. Surgery lasted for 240 min. Postoperatively, she complained of numbness of the dorsal part of her right hand and wrist drop. Neurological examination revealed hypoaesthesia of the dermatome of the right forearm and hand innervated by the radial nerve. Electromyography revealed advanced axonal degeneration of the radial nerve below the level of the elbow. Treatment with diclofenac, vitamin B and physiotherapy was started. Her symptoms improved gradually and at the 60th postoperative day, motor weakness had completely resolved. In order to prevent peri‐operative nerve injury, careful positioning of every patient on the operating table with proper padding is essential, with attention paid to time‐dependent risks. If an injury occurs, diagnosis and treatment should be started as rapidly as possible.
Long‐term outcome after 60 days of intensive care
Authors: Venker J. , Miedema M. , Strack van Schijndel R. J. M. , Girbes A. R. J. , Groeneveld A. B. J. 
Published: May 2005

SummaryPatients with a long stay in the intensive care unit because of chronic critical illness consume many resources, and yet their outcome may be poor. We evaluated the long‐term outcome of patients spending more than 60 days in the intensive care unit. We performed a retrospective cohort and prospective follow‐up study of 78 patients staying more than 60 days in the 19–26 bed mixed intensive care unit of a university hospital from November 1995 to January 2003. The mortality in the intensive care unit was 38%; at 1 and 5 years it was 56% and 67%, respectively. Advanced age, prior pulmonary disease, long duration of renal replacement therapy, a low oxygenation ratio and platelet count and high Simplified Acute Physiology Score II and Sequential Organ Failure Assessment scores on day 60 influenced long‐term mortality. A Simplified Acute Physiology Score II of 50 or a Sequential Organ Failure Assessment score of 8 or higher was associated with 100% mortality during follow‐up. The overall 5‐year survival rate of 33% suggests that prolonged intensive care may be worth the effort in certain patients.
The influence of the military on civilian uncertainty about modern anaesthesia between its origins in 1846 and the end of the Crimean War in 1856
Authors: Metcalfe N. H. 
Published: May 2005

SummaryExamination of primary and secondary sources suggests that the military did not significantly help establish the position of modern anaesthesia in society until evidence and experience from the Crimean War was obtained and disseminated.
Methylthioninium chloride: pharmacology and clinical applications with special emphasis on nitric oxide mediated vasodilatory shock during cardiopulmonary bypass
Authors: Faber P. , Ronald A. , Millar B. W. 
Published: May 2005

SummaryVasodilatory shock after cardiopulmonary bypass is a common complication requiring treatment with high doses of inotropes and prolonged stays in the intensive care unit. The vasodilatory shock is initiated by an inflammatory response to the extracorporeal circuit. The inflammatory response results in endothelial synthesis and release of nitric oxide resembling the clinical features observed in vasodilatory shock caused by septicaemia. During vasodilatory shock, the inhibition of nitric oxide synthase and the nitric oxide/cyclic guanylyl monophosphate pathway is an attractive adjunct to therapy with traditional inotropes. Methylthioninium chloride inhibits nitric oxide/cyclic guanylyl monophosphate mediated vasodilation and can successfully be used as a supplement in the treatment of vasodilatory shock associated with cardiopulmonary bypass. The application of methylthioninium chloride in septicaemia has not produced comparable positive clinical results.
A physiologically‐based early warning score for ward patients: the association between score and outcome*
Authors: Goldhill D. R. , McNarry A. F. , Mandersloot G. , McGinley A. 
Published: May 2005

SummaryWe analysed the physiological values and early warning score obtained from 1047 ward patients assessed by an intensive care outreach service. Patients were either referred directly from the wards (n = 245, 23.4%) or were routine critical care follow‐ups. Decisions were made to admit 135 patients (12.9%) to a critical care area and limit treatment in another 78 (7.4%). An increasing number of physiological abnormalities was associated with higher hospital mortality (p < 0.0001) ranging from 4.0% with no abnormalities to 51.9% with five or more. An increasing early warning score was associated with more intervention (p < 0.0001) and higher hospital mortality (p < 0.0001). For patients with scores above one (n = 660), decisions to admit to a critical care area or limit treatment were taken in 200 (30.3%). Scores of all physiological variables except temperature contributed to the need for intervention and all variables except temperature and heart rate were associated with hospital mortality.
Delayed haemolytic transfusion reaction and hyperhaemolysis complicating peri‐operative blood transfusion in sickle cell disease
Authors: McGlennan A. P. , Grundy E. M. 
Published: May 2005

SummaryWe present a case of delayed haemolytic transfusion reaction and hyperhaemolysis syndrome in a patient with sickle cell disease. A 32‐year‐old woman with a history of sickle cell disease was scheduled for total hip replacement. She was transfused pre‐operatively and suffered a delayed haemolytic transfusion reaction. Postoperatively the patient continued to haemolyse, despite the use of antigen compatible blood, suggesting that she had developed hyperhaemolysis syndrome following her delayed haemolytic transfusion reaction. Although rare, both conditions must be borne in mind when dealing with patients who have undergone multiple transfusions.
Direct thrombin inhibitors: pharmacology and clinical relevance
Authors: Kam P. C. A. , Kaur N. , Thong C. L. 
Published: May 2005

SummaryAlthough heparin has been a cornerstone of treatment for the prevention of thrombosis, it is limited by its adverse effects and unpredictable bioavailability. Direct thrombin inhibitors are a novel class of drugs that have been developed as an effective alternative mode of anticoagulation in patients who suffer from heparin‐induced thrombocytopaenia, and for the management of thromboembolic disorders and acute coronary syndromes. The main disadvantages of the direct thrombin inhibitors are the lack of an antidote or readily available clinical monitoring. The mechanism of action, the properties of direct thrombin inhibitors and their potential to replace currently available anticoagulants are reviewed.