bluuebunny/crossref_metadata_2025_split huggingface dataset:
Utilisation of hormone replacement therapy in the United Kingdom
Authors: Bromley S.E. , de Vries C.S. , Farmer R.D.T. 
Published: March 2004

Objective  To determine prevalence and patterns of hormone replacement therapy (HRT) utilisation in women in the UK.Design  Prospective observational study.Setting  UK general practice.Population  Women from general practices throughout the UK.Methods  The study period was 1 January 1992 to 31 December 1998. Age‐specific prevalence was calculated for each year. Trends in prescribing patterns were described over time. A sub‐cohort of ‘new starters’ on HRT was identified to establish patterns of use, including duration of use and switching of preparations. Characteristics of the sub‐cohort were compared with a reference group of non‐HRT users.Main outcome measures  Prevalence, prescribing patterns and differences in characteristics between HRT users and non‐HRT users.Results  Among women aged 45–64, prevalence of HRT use increased from 18.6% in 1992 to 27.7% in 1998. Secular trends were observed away from prescribing combined‐sequential preparations and towards use of combined‐continuous preparations. Among the prescriptions for combined HRT products, only 4.3% contained medroxyprogesterone acetate (MPA). A total of 45.7% of women without a record of a hysterectomy and 53.8% of women with a record of a hysterectomy used HRT for at least three years. When women were partitioned by year of starting HRT, there was a trend of increasing duration of use across the seven years. Some women without a record of a hysterectomy were receiving unopposed oestrogen without progestogen supplementation.Conclusions  Within the past decade, use of HRT has increased among women in the UK with large numbers of women using HRT for long periods and treatment often tailored to the individual.
Efficacy of preemptive analgesia for wound pain after laparoscopic operations in infertile women: a randomised, double‐blind and placebo control study
Authors: Lam K.W. , Pun T.C. , Ng E.H.Y. , Wong K.S. 
Published: March 2004

Objective  To compare preemptive analgesia and preclosure analgesia in reducing wound pain after laparoscopic operation.Design  Randomised, double‐blind and placebo control.Setting  University referral centre.Population  Infertile women undergoing diagnostic laparoscopy with or without additional procedures.Methods  One hundred and forty‐four women were randomised to receive 10 mL of 1% lignocaine at the surgical sites before incision and 10 mL of normal saline before closure of incision (the preemptive group), saline before incision and lignocaine before closure of incision (the preclosure group) and saline at the surgical sites both before incision and closure of incision (the placebo group).Main outcome measures  Post‐operative wound pain measured by linear visual analogue scale and amount of analgesic use.Results  The women in the preclosure group had significantly lower pain scores at 2, 4 and 24 hours than those in the placebo group, whereas the women in the preemptive group only showed significantly lower pain scores at 2 hours than the placebo group. The pain score at 24 hours in the preclosure group was significantly lower than that in the preemptive group. There was no significant difference in the post‐operative analgesic requirement among the three groups.Conclusion  The preclosure analgesia is better than preemptive analgesia and no analgesia in reducing post‐operative wound pain.
Cervical screening in women over the age of 50: results of a population‐based multicentre study
Authors: Flannelly Grainne , Monaghan John , Cruickshank Maggie , Duncan Ian , Johnson Jane , Jordan Joe , Campbell Marion , Patnick Julietta 
Published: March 2004

Objective  It has been suggested that women over 50 with a satisfactory negative smear history are at low risk for dyskaryosis and might be suitable for withdrawal from the cervical screening programme. The objectives of this study are to document the pattern of dyskaryosis in the cervical smears of women over 50 and to relate the risk of dyskaryosis in these women to the prior smear history.Design  Available computerised smear data were analysed.Setting  Five regions in England and Scotland; Aberdeen, Dundee, Birmingham, Gateshead and Nottingham.Population All women aged 50 or over who had a satisfactory smear between 1988 and 1996.Methods  Smear results were sorted into individual smear records. The first smear after the age of 50 was identified as well as all smears before and after the age of 50.Main outcome measurements  The smear history before and after the age of 50 was determined for all women. The relative risk of dyskaryosis as well as the time to dyskaryosis was calculated for women whose raw data were available.Results  The study included 170,436 women with at least one satisfactory smear after 50. No results of previous smears were available in 90,546 (54%) of women but 36,512 (21%) of women had a satisfactory negative smear history. Women with prior dyskaryosis or borderline nuclear abnormalities (BNA) had an increased risk of dyskaryosis after the age of 50 compared with women with a negative history (RR 4.39 and 3.08 respectively). It was notable that 1.8% of women with a negative history still demonstrated subsequent dyskaryosis.Conclusions  Women with either dyskaryosis or BNA before 50 are not suitable for withdrawal from cervical screening. Well‐screened women with a negative smear history at the age 50 still have a residual risk of subsequently developing a new abnormality.
The natural history of primary dysmenorrhoea: a longitudinal study
Authors: Weissman Alicia M. , Hartz Arthur J. , Hansen Michael D. , Johnson Susan R. 
Published: March 2004

Objective  To describe the prevalence, severity, course and predictive factors of primary dysmenorrhoea in women of all reproductive ages.Design  Prospective mailed surveys in 1985 and 1991.Setting  University of Iowa, College of Nursing.Population  We began with a stratified sample of 996 nurses who graduated between 1963 and 1984. We analysed data from 404 women who responded to both surveys, but denied endometriosis, pelvic inflammatory disease or uterine fibroids.Methods  Participants were surveyed twice at an interval of six years (response rates 73% and 78%) regarding menstrual cycle characteristics. For analysis, dysmenorrhoea was dichotomised as none/mild or moderate/severe. We analysed predictive factors using χ2 tests and stepwise logistic regression.Main outcome measure  Severity of dysmenorrhoea. Menstrual cramps as experienced when not taking medication to prevent discomfort were rated on a four‐point scale: 0 = no dysmenorrhoea, 1 = minimal (can work, somewhat uncomfortable), 2 = moderate (can work, but quite uncomfortable) or 3 = severe dysmenorrhoea (miss work, have to be in bed).Results  In 1985, 80% of respondents were >25 years old and 60% were parous. There were few changes over six years in the prevalence of mild (51% to 53%), moderate (22% to 20%) or severe dysmenorrhoea (4% to 2%). After adjusting for dysmenorrhoea in 1985, each live birth during follow up (OR = 0.20, 95% CI = 0.08 to 0.53) and older age (OR = 0.92, 95% CI = 0.86 to 0.98) were associated with less dysmenorrhoea in 1991.Conclusions  Primary dysmenorrhoea affects most women throughout the menstrual years. Dysmenorrhoea severe enough to cause absence from work occurs in less than 5% of women. Although improvement and worsening are equally likely for all women, improvement is more likely in women who bear children.
A prospective randomised trial of atosiban versus hexoprenaline for acute tocolysis and intrauterine resuscitation
Authors: Afschar Pedram , Schöll Wolfgang , Bader Arnim , Bauer Margit , Winter Raimund 
Published: March 2004

Objective  The aim of this study was to compare the efficacy and side effect profile of atosiban with hexoprenaline when used for intrauterine resuscitation of intrapartum fetal distress.Study design  Women in labour with acute intrapartum fetal distress detected by cardiotocography were randomly assigned to receive intravenous atosiban or hexoprenaline.Setting  Department of Obstetrics and Gynecology, Karl Franzens University of Graz and General Hospital Graz, Austria.Population or sample  One thousand and four hundred and thirty‐one women with singleton pregnancy at term and cephalic presentation were enrolled in the study during October 2000 and May 2001.Methods  A prospective, randomised, pilot study with no a priori sample size calculation.Main outcome measure  Efficacy of treatment for stopping uterine contractions and the resumption of contractions determined by fetal heart rate monitoring.Results  Tocolysis was achieved in 92% (12/13) of the women receiving atosiban and 100% (13/13) of those receiving hexoprenaline. Maternal tachycardia developed in 1/13 women, receiving atosiban and 10/13 women hexoprenaline. Hypertension occurred in 1/13 on atosiban and 3/13 women on hexoprenaline. Palpitations were only reported by 10/13 women receiving hexoprenaline. Uterine contractions resumed after 8 minutes (±3) in the atosiban group and 14 minutes (±4) in the hexoprenaline group (P < 0.001).Conclusion  Atosiban and hexoprenaline were similarly effective for stopping uterine contractions. Women receiving atosiban had significantly fewer adverse events than those receiving hexoprenaline. Uterine contractions resumed more promptly in the atosiban group. Considering the low incidence of mild maternal adverse events, atosiban may be an option for acute intrapartum tocolysis for fetal distress.
For how long should oxytocin be continued during induction of labour?
Authors: Daniel‐Spiegel Etty , Weiner Zeev , Ben‐Shlomo Izhar , Shalev Eliezer 
Published: March 2004

Objective  To answer the question of whether oxytocin induction of labour should be discontinued when active labour begins.Design  We enrolled patients admitted for induction of labour with oxytocin. Exclusion criteria for induction of labour included non‐vertex presentation, past history of more than one caesarean delivery, multiple pregnancies, persistent non‐reassuring fetal heart rate before induction of labour and estimated fetal weight of more than 4250 g.Setting  Department of Obstetrics and Gynecology, Ha'Emek Medical Center, Afula, Israel.Population  Patients who were admitted for induction of labour in Ha'Emek Medical Center from 1st February 1998 to 29th February 2000.Methods  Patients were randomly divided into two groups. In group A, infusion of oxytocin was incremental until 5 cm dilation and maintained at the same level from that point throughout the labour. In group B, infusion of oxytocin was incremental but was discontinued when cervical dilatation reached 5 cm. Comparison between the two groups was made using Wilcoxon rank‐sum test and Fisher's exact test.Main outcome measure  Primary outcome variable was duration from induction to delivery. The secondary outcome variables included: duration of labour stages, maximal dosage and total amount of oxytocin used, the use of analgesia, abnormalities in fetal heart rate and episodes of uterine hyperstimulation. We also recorded mode of delivery, together with maternal and neonatal outcome.Results  One hundred and four patients participated in this study. The active phase of labour was shorter in group B compared with group A, but this difference was not statistically significant (2.6 ± 2 vs 3.3 ± 2.9, P= 0.07). In group A there were six caesarean deliveries and in group B only three. No significant differences were found when the other outcome parameters were compared.Conclusions  There is no advantage in continuing oxytocin infusion after the onset of active labour.
Fetal activin A: associations with labour, umbilical artery pH and neonatal outcome
Authors: Tong Stephen , Egan Val , Wallace Euan M. 
Published: March 2004

Objective  To define the ontogeny of umbilical artery activin A at term and to evaluate activin A as a potential marker of perinatal hypoxia.Design  A cohort study.Setting  A university teaching hospital delivery suite.Population  A convenience sample of 141 term pregnancies.Methods  At delivery, umbilical artery and vein bloods were collected for blood gas measurements and subsequent measurement of activin A. Activin A levels were correlated with blood gas measurements and with labour and neonatal outcomes.Main outcome measures  Umbilical arterial activin A and pH.Results  The median (95% CI) umbilical arterial activin A level at delivery was 1.38 (1.34–1.70) ng/mL. Levels varied significantly across gestation (P= 0.03), increasing from 36 to 38 weeks, thereafter decreasing to a nadir at 41 weeks. In 60 matched samples, the median (95% CI) venous and arterial activin A levels were 0.89 (0.81–1.06) ng/mL and 1.38 (1.21–1.61) ng/mL, respectively (P < 0.0001). Mean umbilical arterial pH was 7.20 (7.06–7.38; 5–95th centiles) and was not significantly correlated with log10 activin A (r=− 0.01; P= 0.68). Compared with healthy controls, there was no difference in arterial activin A in neonates identified as having suffered significant intrapartum asphyxia (P= 0.96). Fetal activin A levels were significantly lower in cases delivered by emergency caesarean section for complications during the first stage of labour compared with cases delivered vaginally (P= 0.003).Conclusions  Umbilical artery activin A does not appear to be a sensitive marker of fetal oxygenation or of risk of hypoxic–ischaemic encephalopathy.
Biologically induced mineralization in the tree Milicia excelsa (Moraceae): its causes and consequences to the environment
Authors: Braissant Olivier , Cailleau Guillaume , Aragno Michel , Verrecchia Eric P. 
Published: March 2004

ABSTRACTIroko trees (Milicia excelsa) in Ivory Coast and Cameroon are unusual because of their highly biomineralized tissues, which can virtually transform the trunk into stone. Oxalic acid (C2O4H2) and metal‐oxalate play important roles in their ecosystems. In this study, the various forms of oxalate and carbonate mineralization reactions are investigated by using scanning electron microscopy and X‐ray diffraction. Calcium oxalate monohydrate is associated with stem, bark and root tissues, whereas calcium oxalate dihydrate is found with wood rot fungi in soils, as well as in decaying wood. Laboratory cultures show that many soil bacteria are able to oxidize calcium oxalate rapidly, resulting in an increase in solution pH. In terms of M. excelsa, these transformations lead to the precipitation of calcium carbonate, not only within the wood tissue, but also within the litter and soil. We calculate that c. 500 kg of inorganic carbon is accumulated inside an 80‐year‐old tree, and c. 1000 kg is associated with its surrounding soil. Crucially, the fixation of atmospheric CO2 during tree photosynthesis, and its ultimate transformation into calcite, potentially represents a long‐term carbon sink, because inorganic carbon has a longer residence time than organic carbon. Considering that calcium oxalate biosynthesis is widespread in the plant and fungal kingdoms, the biomineralization displayed by M. excelsa may be an extremely common phenomena.
Evolutionary timing of the origins of mesophilic sulphate reduction and oxygenic photosynthesis: a phylogenomic dating approach
Authors: Blank Carrine E. 
Published: March 2004

ABSTRACTUntil recently, the deep‐branching relationships in the bacterial domain have been unresolved. A new phylogenetic approach (termed compartmentalization) was able to resolve these deep‐branching relationships successfully by using a large number of genes from whole genome sequences and by reducing long branch attraction artefacts. This new, well‐resolved phylogenetic tree reveals the evolutionary relationships between diverse bacterial groups that leave important traces in the geological record. It shows that mesophilic sulphate reducers originated before the Cyanobacteria, followed by the origination of sulphur‐ and pyrite‐oxidizing bacteria after oxygen became available in the biosphere. This evolutionary pattern mirrors a similar pattern in the Palaeoproterozoic geological record. Sulphur isotopic fractionation records indicate that large‐scale bacterial sulphate reduction began in marine environments around 2.45 billion years ago (Ga), followed by rapid oxygenation of the atmosphere about 2.3 or 2.2 Ga. Oxygenation was then followed by increasing oceanic sulphate concentrations (probably owing to pyrite oxidation and continental weathering), which then resulted in the disappearance of banded iron formations by 1.8 Ga. The similarity between the phylogenetic and geological records suggests that the geochemical changes observed on the Palaeoproterozoic Earth were caused by major origination events in the mesophilic bacteria, and that these geochemical changes then caused additional origination events, such as aerobic respiration. If so, then constraints on divergence dates can be established for many microbial groups, including the Cyanobacteria, mesophilic bacteria, mesophilic sulphate reducers, methanotrophs, several anoxygenic phototrophs, as well as for mitochondrial endosymbiosis. These dates may also help to explain a large number of other changes in the geological record of the Neoarchean and Palaeoproterozoic Earth. This hypothesis, however, does not agree with the finding of cyanobacterial and eukaryote lipids at 2.7 Ga, and suggests that further work needs to be done to elucidate the discrepancies in both these areas.
Conceptual models for burrow‐related, selective dolomitization with textural and isotopic evidence from the Tyndall Stone, Canada
Authors: Gingras Murray K. , Pemberton S. George , Muelenbachs Karlis , Machel Hans 
Published: March 2004

ABSTRACTThe formation of dolomite is generally explained using models that reflect larger‐scale processes that describe the relationship between the supply and transport of Mg, and geochemical conditions that are amenable to the formation of dolomite. However, heterogeneities in the substrate, such as those made by bioturbating infauna, may play a more important role in dolomitization than has been previously considered. Burrow‐facilitated dolomitization is evident in the Ordovician Tyndall Stone (Red River Group, Selkirk Formation) of central Canada. The diagenetic fabrics present are attributed to dolomitizing fluids that both flowed through and evolved within burrow networks. Petrographic analysis suggests that two phases of dolomite formation took place. The first formed a fine‐grained, fabric‐destructive type that probably accompanied early burial; the second is a fine‐ to medium‐grained, locally sucrosic dolomite that is interpreted to have precipitated during later burial. Isotopic analysis supports the proposed paragenetic history: (1) an apparent linking of the stable isotopes 13C and 18O strongly suggests that the micrite matrix formed during very early diagenesis and was derived from seawater; (2) the initial phase of dolomitization is potentially microbially mediated, as evidenced by the enrichment of 13C; and (3) isotopic values for the second generation of dolomite reflect the mixing of ground water and resorbed early dolomite. This paper conceptualizes the physical and chemical conditions required for the formation of dolomite in association with burrow fabrics. The proposed model reveals a composite of biological and inorganic reactions that demonstrates the interdependence of sediment fabric, organic content and microbial interactions in the development of burrow‐mottled dolomitic limestone. It is suggested that where burrow‐associated dolomite occurs, it is most likely to develop in two stages: first, the byproducts of the degradation of organic material in burrows locally increase the permeability and porosity around burrow fabrics in shallow diagenetic depositional environments; and, second, the passing of burrowed media into deeper dysaerobic sediment is accompanied by the establishment of fermenting micro‐organisms whose byproducts mediate dolomitization.
Reproducibility and accuracy of automated probe measurements of gingiva and bone levels on stone casts following guided bone regeneration treatment
Authors: Van der Zee Erwin , Vogels Marie‐Faustine , Oosterveld Paul , Van Waas Marinus 
Published: March 2004

AbstractObjectives: For evidence‐based evaluation of guided bone regeneration (GBR), accurate registration of changes in gingiva and bone levels is needed. A new method is introduced and evaluated.Methods: In a clinical trial with 30 patients, alginate impressions of the surgical area including the interproximal gingiva and alveolar bone at the adjacent teeth were made in duplicate prior to and during GBR surgery, fixture installation and abutment connection. Poured in hard stone, the casts were used for repeated measurements of the level of the free gingival margin and the alveolar bone with an automated probe (Florida disc‐probe®), using the incisal edge as a fixed reference point. The reproducibility and accuracy of these measurements were evaluated by means of the Intraclass Correlation Coefficients and Generalizability Theory. The effect of treatment was evaluated by multivariate analysis of variance.Results: Generalizability Theory indicated a high accuracy of the gingiva‐ and bone‐level measurements: the Intraclass Correlation Coefficients for gingiva and bone levels were 0.99 and 0.98, respectively. The intra‐cast reproducibility was 0.09±0.07 mm (mean±SD) and the inter‐cast reproducibility was 0.10±0.09 and 0.20±0.07 mm for gingiva and bone levels, respectively. Clinical applicability is demonstrated by the fact that manova revealed on average a small but highly significant (p=0.001) effect of the staged surgical intervention on the gingiva and bone levels at the adjacent teeth.Conclusion: It is concluded that the presented method makes it possible to evaluate reproducibly and accurately changes in gingiva and bone levels for GBR studies.
Surface wear on cervical restorations and adjacent enamel and root cementum caused by simulated long‐term maintenance therapy
Authors: Rühling A. , Wulf J. , Schwahn C. , Kocher T. 
Published: March 2004

AbstractBackground: In an in vitro study, the surface wear on cervical restorations and adjacent enamel and root cementum caused by different tooth‐cleaning methods in simulated long‐term therapy was investigated.Methods: Cervical restorations of amalgam (Oralloy®), modified composite resin (Dyract®), glass‐ionomer cement (ChemFill Superior®), and composite (Tetric®) were instrumented by POL (polishing), CUR+POL (curette and polishing), US+POL (ultrasonic device with polishing) and the polishing agents Cleanic® and Proxyt® in a computer‐controlled test bench. Treatment time corresponding to a real‐time period of 5 or 10 years. Substance loss from instrumented surfaces was measured with a digital gauge. A three‐way anova was used in the statistical evaluation.Results: The results showed that POL led to slight substance loss, which was greater using Cleanic® (27 μm) than Proxyt® (5 μm). CUR+POL produced a significantly greater substance loss than did US+POL, with 186 μm versus 35 μm on glass‐ionomer cement, respectively, and 123 μm versus 18 μm, respectively, on root cementum, followed by composite (111 μm versus 27 μm, respectively), polyacid modified composite resin/compomer (89 μm versus 36 μm), amalgam (75 μm versus 19 μm), and enamel (32 μm versus 23 μm).Conclusions: As opposed to the use of US+POL or POL, substance loss on cervical restorations and especially root cementum must be expected to result from tooth‐cleaning during long‐term maintenance treatment using CUR+POL.