bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multifamily psychoeducation groups (MFPG) for families of children with bipolar disorder
Authors: Fristad Mary A , Goldberg‐Arnold Jill S , Gavazzi Stephen M 
Published: March 2003

Objectives:
Multi‐family psychoeducation groups (MFPG) have been developed and tested for adults, but not for children with bipolar disorder (BPD). We present data from a pilot study of our manual‐driven MFPG treatment for families of children with mood disorders and address two questions: Do families of children with BPD and families of children with major depressive disorder/dysthymic disorder (MDD/DD): 1) differ at treatment entry?; 2) benefit equally from intervention?
Method:
A total of 35 children (n=16, BPD; n=19, MDD/DD) aged 8–11 years and their parents were randomized into immediate MFPG plus treatment as usual (TAU) or wait‐list + TAU and assessed periodically.
Results:
At baseline, there was a trend toward parents in BPD families being more knowledgeable about mood symptoms than parents in MDD/DD families (p < 0.04). Additionally at baseline, children with BPD evidenced greater mood severity historically and a trend toward more hospitalizations, day treatment, outpatient treatment, medication trials, and placement in special education classrooms than children with MDD/DD. Immediately following and 4 months post‐treatment, both BPD and MDD/DD families described having gained knowledge, skills, support, and positive attitudes during treatment. MDD/DD families increased their knowledge of symptoms to the same level as BPD families.
Conclusions:
While BPD families enter treatment with more impaired children and more extensive treatment histories, both BPD and MDD/DD families benefit from intervention. The clinical issues concerning combining families of children with bipolar and depressive spectrum illnesses in groups are discussed. Clinical impressions suggest that such combinations are clinically feasible and potentially beneficial.
Valproate, bipolar disorder and polycystic ovarian syndrome
Authors: McIntyre Roger S , Mancini Deborah A , McCann Sonia , Srinivasan Janaki , Kennedy Sidney H 
Published: March 2003

Background:  Persons with bipolar disorder are often overweight and cluster risk factors for cardiovascular disease. Some antibipolar agents adversely impact upon weight and the lipid milieu. Recent data suggest that valproic acid, a commonly prescribed mood stabilizer, may be associated with polycystic ovarian syndrome (PCOS). This adverse event has not been systematically studied in bipolar disorder.Method:  Thirty‐eight female subjects, aged 18–50 years, meeting DSM‐IV criteria for bipolar I or II disorder, in any phase of illness were evaluated. Eighteen females received valproate (sodium valproate and valproic acid) and 20 females received lithium. Patients completed questions regarding their menstrual, reproductive and medical histories. During the follicular phase they were assessed for weight, body mass index (BMI kg/m2), and changes in the reproductive endocrine milieu that included morning estradiol, progesterone, follicle‐stimulating hormone (FSH), luteinizing hormone (LH), sex‐hormone binding globulin (SHBG), androstenedione, dehydroepiandrosterone‐sulfate (DHEAS), testosterone, free testosterone, prolactin and thyroid‐stimulating hormone (TSH). The blood was also analyzed for fasting metabolic parameters which included total cholesterol (TC), high‐density lipoprotein (HDL), low‐density lipoprotein (LDL), insulin, glycosylated hemoglobin (HbA1C), insulin‐like growth factor 1 (IGF‐1), insulin‐like growth factor binding‐protein 1 (IGFBP‐1), fasting blood glucose and morning leptin.Results:  Nine (50%) of the valproate‐treated females had menstrual abnormalities versus three (15%) of the lithium‐treated females (p < 0.05). Valproate‐treated females had significantly higher levels of follicular phase androgen concentrations than lithium‐treated females (p < 0.05). Nine (50%) of females who were overweight (BMI ≥ 25 kg/m2) and with a history of menstrual irregularities also exhibited laboratory evidence of hyperandrogenism (p < 0.05). Persons receiving valproate exhibited significant increases in fasting biochemical parameters suggestive of an adverse metabolic syndrome (p < 0.05). Leptin levels were significantly elevated in the valproate‐treated females (p < 0.05).Conclusions:  In this pilot, open‐label cross‐sectional study, valproate‐treated females exhibited higher rates of menstrual abnormalities and biochemical evidence of both hyperandrogenism and adverse metabolic parameters when compared with lithium‐treated females. These preliminary data suggest that valproate may, in some predisposed females, adversely impact upon the reproductive endocrine milieu and result in aspects of the metabolic syndrome (1).
Suicide risk in bipolar patients: the role of co‐morbid substance use disorders
Authors: Dalton E Jane , Cate‐Carter Tasha D , Mundo Emanuela , Parikh Sagar V , Kennedy James L 
Published: March 2003

Objective:  Bipolar disorder is associated with a high frequency of both completed suicides and suicide attempts. The primary aim of this study was to identify clinical predictors of suicide attempts in subjects with bipolar disorder.Methods:  We studied 336 subjects with a diagnosis of bipolar I, bipolar II, or schizoaffective disorder (bipolar type). The Structured Clinical Interview for DSM‐IV (SCID‐I) was administered and subsequently two expert psychiatrists established a diagnosis. Predictors of suicide attempts were examined in attempters and non‐attempters.Results:  The lifetime rate of suicide attempts for the entire sample was 25.6%. A lifetime co‐morbid substance use disorder was a significant predictor of suicide attempts: bipolar subjects with co‐morbid substance use disorders (SUD) had a 39.5% lifetime rate of attempted suicide, while those without had a 23.8% rate (odds ratio=2.09, 95% CI=1.03–4.21, χ2=4.33, df=1, p=0.037).Conclusions:  Lifetime co‐morbid SUD were associated with a higher rate of suicide attempts in patients with bipolar disorder. This relationship may have a genetic origin and/or be explained by severity of illness and trait impulsivity.
Long‐term therapy with lithium in a private practice clinic: a naturalistic study
Authors: Luby Elliot D , Singareddy Ravi Kumar 
Published: March 2003

Objective:  To document the effectiveness and vicissitudes of treating 14 bipolar patients with lithium carbonate over a combined 300 years, and an average of 21 years/patient.Methods:  Chart review of the narrative and laboratory studies of these 14 patients ranging in duration from 12 to 29 years.Results:  Lithium stabilized these bipolar patients over these periods. Only three patients required hospitalization, one because lithium was slowly tapered at her request after 6 years of mood stability, another because of non‐compliance, and a third because of co‐morbid alcohol abuse. One patient attempted suicide after lithium was tapered off. However, in some patients, there were serious side‐effects necessitating lithium discontinuation.Conclusions:  Controlled studies in psychopharmacology are obviously preferred to open‐label or naturalistic case studies. However, controlled studies are rarely conducted over long periods, and practice‐related naturalistic research can be of value, albeit anecdotal and without the use of structured rating scales. In this paper, we are reporting on 14 patients seen consistently by one psychiatrist. These patients were functional and productive at work and in family life. The patients suffered brief hypomanic or depressive episodes. Although several patients experienced serious side‐effects, lithium was continued with stable mood, while the side‐effects were managed in collaboration with other specialists.
Longitudinal distance standards of fetal growth
Authors: DI BATTISTA ELIANA , BERTINO ENRICO , BENSO LODOVICO , FABRIS CLAUDIO , AICARDI GIORGIO , PAGLIANO MARCO , BOSSI ANNA , DE BIASIO PIERANGELA , MILANI SILVANO ,   (Intrauterine and Infant Longitudinal Growth Study: IILGS)
Published: March 2003

Background. Most ultrasonographic fetal growth norms are derived from cross‐sectional data or from longitudinal data treated as coming from cross‐sectional studies, although only longitudinal models may detect particular aspects of fetal growth shape, such as peak of growth velocity.Materials and methods. The sample included 238 singleton normal pregnancies. All the fetal traits under study (biparietal diameter, occipito‐frontal diameter, head circumference, femur diaphysis length and abdomen circumference) were measured according to the classical ultrasound techniques by highly trained operators. Individual growth profiles (made up of 5 to 9 measures) were taken at regular intervals between the 12th and the 40th week. Growth norms were traced by means of a two‐stage linear model: (I) a 3‐constant fetal growth function was fitted to each individual growth profile, (II) growth centiles were based upon the weighted mean and covariance matrix of the individual growth constants.Results. Fetal growth curves show a sigmoid shape with a maximum slope (i.e. a peak growth velocity) which occurs earlier for head diameters (about 18 weeks), later for femur diaphysis length (20 weeks) and abdomen circumference (22 weeks). During intrauterine growth, all traits show a progressive increase in interindividual variability, which is more prominent for abdomen circumference.Conclusion. The mathematical model applied to a large sample of growth profiles provided a satisfactory description of the individual fetal development and its biological variability, and allowed the construction of longitudinal distance standards useful for clinical purposes.
Note
Magnetic resonance imaging compared to ultrasonography in fetal weight and volume estimation in diabetic and normal pregnancy
Authors: UOTILA JUKKA , DASTIDAR PRASUN , HEINONEN TOMI , RYYMIN PERTTI , PUNNONEN REIJO , LAASONEN ERKKI 
Published: March 2003

Objective. To estimate fetal volume and weight in diabetic and normal pregnancy using high‐resolution magnetic resonance imaging.Methods. T1‐weighted magnetic resonance imaging was combined with semiautomatic segmentation technique. The accuracy of fetal volume estimations thus obtained was compared with conventional ultrasound‐based weight estimations in ten pregnant women with insulin‐dependent diabetes mellitus and ten women with normal pregnancy. Examinations were made within 48 hours before delivery.Results. Ultrasound‐based estimations of fetal weight showed a correlation rate of r=0.77 with the actual birth weights in the whole material, while volume determinations based on magnetic resonance imaging showed a significantly better correlation rate of r=0.95. Diabetic women did not differ from the normal pregnancy group with regard to birth weight or the accuracy of weight estimations.Conclusions. High‐resolution magnetic resonance imaging combined with semiautomatic segmentation software was found to be accurate in determining fetal volume and, consequently, better than conventional ultrasound‐based techniques in estimating fetal weight. The use of magnetic resonance imaging in fetal weight estimation may be recommended for clinical situations where an accurate weight estimate is considered essential.
Emergency cerclage in the presence of protruding membranes: is pregnancy outcome predictable?
Authors: CARUSO ALESSANDRO , TRIVELLINI CARMEN , DE CAROLIS SARA , PARADISI GIANCARLO , MANCUSO SALVATORE , FERRAZZANI SERGIO 
Published: March 2003

Background. The aim of this retrospective study is to verify whether some maternal features are related to pregnancy outcome in cases of emergency mid‐trimester cerclage when membranes are protruding through the dilated cervix.Methods. Between 1988 and 1996 twenty‐three pregnant patients with dilated cervix and protruding membranes were treated with emergency cerclage. At the time of cerclage, gestational age ranged from 17 to 27 weeks (median 22).Results. Pregnancy was prolonged from 0 to 20 weeks (median 4). Eleven living infants were born (46%); median gestational age at delivery was 25 weeks (range 21–39) and median birth weight 700 g (range 350–3980 g). Obstetric histories, white blood cell count, and vaginal‐cervical and urine cultures obtained on admission were analyzed in the two following groups: data from patients with good pregnancy outcome (live births) versus those from patients with poor outcome (stillbirths and neonatal deaths). No significant difference was found between the groups for the above mentioned maternal features.Conclusions. The possibility of 46% live births is considered a good result for mid‐trimester emergency cerclage when the membranes are protruding. Success of the procedure remains unpredictable on the basis of the maternal features investigated.
Maternal thrombocytopenia at term: a population‐based study
Authors: SAINIO SUSANNA , KEKOMÄKI RIITTA , RIIKONEN SEIJA , TERAMO KARI 
Published: March 2003

Background. Thrombocytopenia is a common problem during pregnancy and often inappropriately managed. This study aimed to assess the prevalence and causes of maternal thrombocytopenia at term with special attention to immune mechanisms of thrombocytopenia and the need for assessing fetal risks.Methods. We conducted a 1‐year population‐based surveillance study involving 4382 fullterm (at least 37 weeks' gestation) women (83.8% of the study population) and their infants from the city of Helsinki. Maternal and cord platelet counts were performed at delivery. Immune studies were performed if maternal platelet counts were less than 100×109/l; 95% confidence intervals (CIs) were calculated from the binomial distribution.Results. A total of 317 women (7.3%; 95% CI 6.5, 8.1) had platelet counts of less than 150×109/l. Most cases (81%) of maternal thrombocytopenia at term were due to gestational thrombocytopenia, which had no impact on either the mother or the fetus unless associated with some other medical or obstetric disorder. Other causes of thrombocytopenia were preeclampsia (16%) and idiopathic thrombocytopenic purpura (ITP) (3%). There was no association between maternal and fetal platelet counts: of the infants born to thrombocytopenic mothers, 2.1% had thrombocytopenia in the cord blood, which did not differ significantly from the 2.0% of thrombocytopenic infants born to non‐thrombocytopenic mothers.Conclusion. Women with gestational thrombocytopenia do not require alteration of their treatment. Fetal blood sampling is not considered necessary when thrombocytopenia is discovered unexpectedly at term.
Immunohistochemical analysis of CA125, CA19‐9, and Ki‐67 in stage III or IV endometriosis:
Authors: TOKI TOSHIHIKO , KUBOTA JUNKO , LU XIN , NAKAYAMA KUNIAKI 
Published: March 2003

Background. Serum levels of CA125 and CA19‐9 are often elevated in patients with endometriosis, but the clinical or biological significance of this is not well established. The aim of the present study was to compare serum and tissue levels of CA125 and CA19–9, and to examine the correlation between these levels and cell proliferation using immunohistochemical analysis in stage III or IV endometriosis.Methods. Forty‐five cases diagnosed histologically as endometriosis were analyzed (26 cases were stage III and 19 were stage IV using the revised American Fertility Society classification). The preoperative serum levels of CA125 and CA19‐9 were measured by immunoradiometric assay. Immunohistochemical analysis was performed using antibodies against CA125, CA19‐9, and Ki‐67 (a representative marker of cell proliferation).Results. The serum levels of CA125 and CA19‐9 were elevated (over the cutoff values) in 25 cases and 21 cases, respectively. There was no significant correlation between serum CA125 and serum CA19‐9 levels (correlation coefficient [ρ]=0.19). The serum CA19‐9 level correlated well with the degree of immunostaining for CA19‐9 (ρ=0.57), but not with the Ki‐67 labeling index. The serum CA125 level did not show a strong correlation with CA125 staining (ρ=0.41), but it correlated well with the Ki‐67 labeling index (ρ=0.53).Conclusions. The present study indicates that the serum CA125 level may correlate with the proliferative activity of epithelial cells in endometriotic lesions.
Factors affecting the volume of umbilical cord blood collections
Authors: YAMADA TAKASHI , OKAMOTO YUKIKO , KASAMATSU HAJIME , HORIE YOSHINORI , YAMASHITA NAOKO , MATSUMOTO KAYOKO 
Published: March 2003

Objective. Our purpose was to find factors that may help increase the number of the
HSC (
CD34+) collected from umbilical cord blood for transplantation.Study design. We assessed the effect of cesarean sections and vaginal deliveries on the volume of the umbilical cord blood collected from 155 healthy term neonates retrospectively.Results. The volume of umbilical cord blood obtained in 29 cesarean deliveries was 103.9±33.6 ml compared with 84.2±25.3 ml collected in 126 vaginal deliveries. Although the percentage of
CD34+ cells was comparable in both groups, the absolute number of
CD34+ cells was significantly higher in the cesarean section group because of the larger volume collected.Conclusions. Cesarean sections may allow collection of significantly increased volumes of umbilical cord blood and numbers of
CD34+ cells compared to vaginal deliveries.
Aims, options and outcomes in measuring maternal mortality in developing societies
Authors: BERHANE YEMANE , ANDERSSON TOBIAS , WALL STIG , BYASS PETER , HÖGBERG ULF 
Published: March 2003

Background. Effective methods for measuring maternal mortality in developing countries are important, particularly in assessing interventions aiming for safer motherhood. Here the performance of different approaches is compared in the same setting.Methods. Estimates of maternal mortality in a rural Ethiopian community are reported, made by direct observation, a case‐control approach, and the sisterhood method.Results. Adjusted estimates of MMR using these methods ranged between 440 and 665 per 100,000 live births.Conclusions. The advantages and disadvantages of the different approaches are compared, both for operational feasibility and outcome.
Combined oral contraceptives do not increase the risk of back and pelvic pain during pregnancy or after delivery
Authors: BJÖRKLUND KENNETH , NORDSTRÖM MARIE‐LOUISE , ODLIND VIVECA 
Published: March 2003

Objectives. To elucidate whether the duration of previous use of combined oral contraceptives (COC) is associated with disabling back or pelvic pain during pregnancy and pain persisting eight months after delivery.Methods. Questionnaires were distributed to a group of women at 36 weeks of pregnancy and eight months after their delivery. There were no exclusion criteria. Disabling pain was defined as moderate or severe pain restricting physical activity. Multiple logistic regression analysis of disabling pain during pregnancy and persistent pain after delivery comprised the duration of COC use adjusted for age, pain in a previous pregnancy and a history of back pain when not pregnant.Results. The study comprised 161 women. Pain during pregnancy was classified as disabling in 57 of the women (35%), pain in a previous pregnancy being a risk factor; odds ratio (OR) 5.0 (95% CI 2.1; 12.1), whereas no association was found with the duration of COC use. Persistent pain eight months after delivery was reported by 41 women (26%), risk factors being a history of back pain when not pregnant; OR 7.5 (2.8; 19.5), disabling pain in the recent pregnancy; OR 5.0 (1.9; 13.4), and short use of COC; 0–<1 year; OR 4.2 (1.3; 12.9), 1–<5 years; OR 4.6 (1.5; 14.4) (reference=>10 years).Conclusion. The results indicate that non‐ or short term users of COC have an increased risk of persistent pain after delivery compared to long term users. No association was found between the duration of COC use and back or pelvic pain during pregnancy.
A case‐referent study on fetal bacteremia and late fetal death of unknown etiology in Lithuania
Authors: MALECKIENE LAIMA , NADISAUSKIENE RUTA , STANKEVICIENE IRENA , CIZAUSKAS ARVYDAS , BERGSTRÖM STAFFAN 
Published: March 2003

Background. The objectives were to test the hypothesis that certain strains of microorganisms are present in fetal blood in a significant proportion of parturient women suffering unexplained third trimester fetal death, and to examine the correlation between fetal bacteremia and histologic chorioamnionitis and vasculitis.Methods. A case‐referent study was carried out on 58 pregnant women with fetal death of unknown etiology (cases) and 116 pregnant women at term (referents) with live fetuses. Cultures from maternal endocervix, amniotic fluid, placental homogenate, external ear and blood of newborns were performed in both groups. Histological examination of placentas and fetal membranes was carried out in order to identify chorioamnionitis and chorionic vasculitis.Results. Intrauterine fetal bacteremia was observed in 36% of cases and in 0% of referents (p=0.001). Escherichia coli was the most common strain, isolated in 21% of fetal blood samples in cases. Extensive histologic chorioamnionitis was observed in 50% of cases with the presence of Escherichia coli in blood of stillborns. Chorionic vasculitis was found in 67% of such cases. Positive significant correlations between isolation of the Escherichia coli from maternal endocervix, amniotic fluid, placenta, fetal ear and blood in stillborns and histological chorioamnionitis and chorionic vasculitis were observed.Conclusions. Escherichia coli bacteremia was detected in a significant proportion of stillborns suffering a third trimester prelabor death. Fetal bacteremia significantly correlated with histologic signs of inflammation in placenta and membranes. Ascending subclinical intrauterine infection may play an important role in the etiology of otherwise unexplained late prelabor fetal death.
VEGF mRNA is unaltered in decidual and placental tissues in preeclampsia at delivery
Authors: Ranheim Trine , Staff Anne Cathrine , Henriksen Tore 
Published: March 2003

Background. VEGF (vascular endothelial growth factor) is a growth factor which is central in blood vessel formation. We wanted to determine whether the mRNA levels of VEGF are altered in preeclampsia in decidual and placental tissues compared to control pregnancies.Methods. Decidua basalis was obtained by vacuum aspiration during cesarean section in 25 preeclamptic and 19 uneventful pregnancies. Placental biopsies were taken immediately after delivery. Relative mRNA levels of VEGF were quantified and compared to those of the housekeeping gene β‐actin.Results. No statistically significant differences in VEGF mRNA levels were found between the preeclampsia and the control group for either the decidual or placental tissues. Furthermore, there were no significant differences between VEGF mRNA levels in the preeclamptic and control group with respect to gestational age of the women.Conclusions. This study provides no evidence of abnormal VEGF expression at delivery in decidua basalis or placenta in pregnancies complicated by preeclampsia.