bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diabetic family history is an isolated risk factor for gestational diabetes after 30 years of age
Authors: Chan Louis Yik‐Si , Wong Shell Fean , Ho Lau Cheung 
Published: March 2003

Background. Family history of diabetes is regarded as a risk factor for gestational glucose intolerance. Most selective screening policy includes family history as an indication of oral glucose tolerance test. However, few studies had evaluated the actual incidence of glucose intolerance in this group of women.Methods. Pregnant women with oral glucose tolerance test performed for family history of diabetes over two consecutive years were identified. Receiver operating curve was used to identify the age cut‐off that give the highest sensitivity and specificity. The incidence of glucose intolerance was compared between women with age above and below this cut‐off.Results. One hundred and eighty‐seven women were identified. The age cut‐off selected was 30.5 years. In young women (age ≤ 30 years) with family history alone, the incidence of glucose intolerance is similar to that in the low risk pregnant population (12.5% and 6.3% for 8.0 mmol/L and 9.0 mmol/L cut‐off for two hour value of 75 g oral glucose tolerance test, respectively). In women aged above 30 years, the incidence of glucose intolerance raised by three fold (35.2% and 22.0% for 8.0 mmol/L and 9.0 mmol/L cut‐off, respectively).Conclusions. The risk of glucose intolerance in young women with positive family history is similar to that in the background pregnant population. Standard oral glucose tolerance test may not be necessary in this group of women if selective screening policy is adopted.
A new ultrasonographic method for evaluation of the results of anti‐incontinence operations
Authors: Yalcin Omer T. , Hassa Hikmet , Tanir Mete 
Published: March 2003

Background. To evaluate the effectiveness of a new ultrasonographic method for discrimination of successful and failed anti‐incontinence operations.Methods. Ninety‐six patients who had undergone anti‐incontinence operations for the diagnosis of pure genuine stress incontinence due to bladder neck hypermobility were evaluated by perineal ultrasonography and 1 hr standardized pad test 6, 12 and 24 months after their operations. The distances from the bladder neck to the lower tip (A) and to the posterior midpoint of symphysis pubis (B) were measured at rest and during stress. Bladder neck mobility (Mu) was obtained by two‐caliper method. After superimposing the symphysis pubis of the frozen images, the bladder neck positions at rest and during stress were plotted on an x‐y coordinate system by using computer programs and the corresponding x and y‐values (X and Y) calculated and the second bladder neck mobility (Mc) were measured on the x‐y coordinate system by computer. Unpaired and paired‐t‐tests were used for statistical analysis.Results. Ten (10.4%) patients had recurrent urinary incontinence, while 86 (89.6%) were continent 24 months after the operation. The incontinent patients had significantly longer Mu, Mc and distance B during stress and lower X and Y‐values during stress than the continent patients at the last control (P < 0.001). When the previous results were compared, the incontinent patients had significantly lower Y‐values during stress and greater Mc values beginning 6 months after the operation, while they were still continent (P < 0.01). Once present, the significant differences between the incontinent versus continent patients persisted from that point onward.Conclusions. Measurement of the bladder neck mobility on an x‐y co‐ordinate system could discriminate the failed and successful operations and predict the outcome of the surgery.
The prognostic impact of a prolonged second stage of labor on maternal and fetal outcome
Authors: Janni Wolfgang , Schiessl Barbara , Peschers Ursula , Huber Sandra , Strobl Barbara , Hantschmann Peer , Uhlmann Natalie , Dimpfl Thomas , Rammel Gerhard , Kainer Franz 
Published: March 2003

Objective. While obstetrical management has changed significantly over years, the optimal duration of the second stage of labor still remains to be defined. The purpose of this study was to evaluate the effect of the duration of labor on fetal distress and maternal perinatal morbidity.Methods. There were 1457 consecutive patients delivered of a singleton fetus in cephalic presentation beyond the 34th week of gestation at the I. Frauenklinik, Ludwig‐Maximilians University, Munich between May 1999 and June 2000. The 257 patients (17.6%), who underwent cesarean section prior to or during labor, were excluded from the study. Of the 1200 vaginal deliveries, 1017 (84.8%) were normal spontaneous deliveries, while 183 (15.2%) were instrumentally assisted. Data were contemporaneously collected and analyzed for the presence of severe pelvic floor damage, maternal hemorrhage, maternal fever, delayed involution of the uterus, fetal acidosis and APGAR score, and the necessity for admitting the newborn to the intensive care unit (NICU). A second stage duration of > 2 hr was considered to be prolonged.Results. The mean duration of the second stage of labor was 70 min (range 2–387, SD 73 min). For 952 patients (79.3%), the second stage was less than 2 h. For 47 patients (3.9%), it exceeded 4 h. A prolonged duration of the second stage was not associated with low Apgar scores 5 and 10 min postpartum (P = 0.76 andP = 0.38, respectively), a higher incidence of umbilical artery pH levels of < 7.20 (P = 0.60), nor with an increased rate of admission to the NICU (P = 0.24). A significant increase in the rate of maternal blood loss was noted after long second stages (1.84 g/dl median difference between the intrapartum and postpartum hemoglobin level) in comparison to patients with normal duration of second stage (0.79 g/dl), both by univariate (P < 0.0001) and multivariate (P < 0.001) analysis. The incidence of third degree anal sphincter tears was significantly correlated with a prolonged duration of second stage in univariate analysis (7.7%,P = 0.001), but not in multivariate analysis after allowing for duration of the second stage, maternal age, birth weight, episiotomy, and mode of delivery (P = 0.26).Conclusion. There is no evidence that prolonged second stage of labor is a serious disadvantage to the fetus, if adequate monitoring is provided. Because the increase of maternal morbidity in patients with prolonged labor may be partially attributed to a higher rate of operative procedures in these patients, interventions should not be solely based on the elapsed time after full cervical dilatation.
Can changes in sex hormone binding globulin predict the risk of venous thromboembolism with combined oral contraceptive pills?
Authors: Odlind Viveca , Milsom Ian , Persson Ingemar , Victor Arne 
Published: March 2003

Background. Recent studies have indicated that the risk of thromboembolic disease (VTE) in users of combined oral contraceptive pills (COCs) varies not only with estrogen dose, but also with the progestogen in pills with the same estrogen dose. The aim of this article is to discuss sex hormone binding globulin (SHBG) as a marker of estrogenicity and as a surrogate indicator for the potential risk of VTE in users of COC.Material and methods. Using data from the literature, we investigated the relationship between the risk of VTE with various COCs and their effects on SHBG. We also collected data on the effects on SHBG by some combined preparations, where there are no VTE data.Results. There appears to be a relationship between the risk of VTE and the effect on SHBG. Monophasic preparations containing levonorgestrel, having the lowest risk of VTE, cause an average SHBG increase of around 50%. COCs containing desogestrel or gestodene cause an average SHBG increase of 200–300%. A preparation with cyproterone acetate, carrying a higher risk of VTE than desogestrel and gestodene, cause a 300–400% SHBG increase. With the recently developed combined preparations, there is a 150% SHBG increase with norgestimate and a 250–300% increase with drosperinone and dienogest.Conclusions. We propose that the change in SHBG with a COC could be interpreted as a measure of total estrogenicity and used as a predictor of the risk of VTE. Preparations containing drosperinone, dienogest, cyproterone acetate and norgestimate are equally or more estrogenic than the more thoroughly studied COCs, containing desogestrel or gestodene and should not be considered a safer substitute.
Patterns of depressed mood across the menopausal transition: approaches to studying patterns in longitudinal data
Authors: Woods Nancy Fugate , Mariella Anne , Mitchell Ellen Sullivan 
Published: March 2003

To date many researchers have focused on depression as a discrete episode, attempting to relate its occurrence to a transition in menopausal stage or other factors that might account for its occurrence. Characterizing change over time requires consideration of pattern or trajectory, not merely discrete events. The purposes of this paper are to:1) to explore methods for intraindividual and interindividual (group) analysis of patterns of depressed mood among midlife women2) to identify challenges for analytic strategies for understanding depressed mood as it is experienced by midlife women, with special concern for its relationship to the menopausal transition.Data from the Seattle Midlife Women's Health Study were used to illustrate approaches to intraindividual and interindividual analysis of patterns of depressed mood. For most women, menopausal transition was not a time when there was a new episode of depression. Instead, a minority of women showed evidence of becoming depressed once the transition had begun. The most prevalent pattern was that of non‐depressed mood across the years of the menopausal transition. Association of several factors with a pattern of depressed mood included life stressors, perceived poor health, and vasomotor symptoms.
Validity of a rheumatic disease diagnosis in the Medical Birth Registry of Norway
Authors: Skomsvoll Johan F. , ØStensen Monika , Baste Valborg , Irgens Lorentz M. 
Published: March 2003

Background. In our population‐based study of pregnancy outcome in women with rheumatic disease we based our assessment on the Medical Birth Registry of Norway (MBRN). We evaluated the MBRN as a source of data for such epidemiologic research by assessing the validity of a diagnosis of rheumatic disease in the MBRN against a gold standard. The validity may also be interpreted as a quality indicator, reflecting an obstetrician's attention to rheumatic diseases in pregnancy.Methods. Using the mother's national identification number the MBRN was linked with local hospital databases (gold standard), which contained data of mothers with rheumatic disease. The sensitivity of the MBRN was calculated as the proportion of all cases registered locally with a diagnosis of rheumatic disease notified to the MBRN. The correctness of type differentiation was calculated as the proportion of all cases notified to the MBRN that was correct with respect to the type of rheumatic disease.Results. Among 169 mothers, 149 had a diagnosis in the MBRN, representing a sensitivity of 88.2%. Altogether, 97.3% of the diagnoses (145/149) were correct with respect to the type of rheumatic disease.Conclusion. Taken in to consideration the limitations of the study, namely the small numbers studied, we assume a rather high validity of rheumatic disease diagnoses in the MBRN, probably reflecting a high level of attention in the obstetric care for these patients.
Comparison of ultrasonography, hysteroscopy, and biopsy in the diagnosis of endometrial lesions in postmenopausal tamoxifen‐treated patients
Authors: Giorda Giorgio , Crivellari Diana , Veronesi Andrea , Perin Tiziana , Campagnutta Elio , Carbone Antonino , Scarabelli Carlo 
Published: March 2003

Background.  At present, no proven recommendations can be made for the surveillance of tamoxifen‐treated women. The aim of the present study was to evaluate ultrasonography and hysteroscopy in this setting.Methods.  Three hundred and ten postmenopausal patients using tamoxifen underwent vaginal ultrasonography, hysteroscopy, and endometrial biopsy; 274 were asymptomatic and 49 had abnormal bleeding. Ultrasonographic endometrial thickness and echotexture were recorded. Hysteroscopic endometrial appearance, presence of focal endometrial lesions and polyps were also recorded. General or selective endometrial biopsy was performed. Ultrasonographic and hysteroscopic follow up was provided.Results.  At ultrasonography, mean endometrial thickness was 10.8 mm. At hysteroscopy, cystic atrophy and suspect focal lesions were detected in 49.2% and 5.3% of women, respectively. Polyps were present in 44.8% of women; 38.9% of these polyps were missed at ultrasonography, whereas 11.4% were suspected but were not found at hysteroscopy. At biopsy, non‐atypical hyperplasia and atypical changes were found in 4.8% and 1.3% of patients, respectively. Three carcinomas were found, all in asymptomatic women. Logistic regression analysis showed that only suspect focal lesions at hysteroscopy were significantly associated with abnormal histology. With a 6‐mm cut‐off value for endometrial thickness, negative and positive predictive values for ultrasonography in detecting hyperplastic or neoplastic changes were 96% and 8%, respectively; the corresponding values for hysteroscopy were 96% and 65%. No additional carcinoma was found at follow  up.Conclusions.  No single ultrasonographic feature (echotexture and borders) is significantly associated with the detection of endometrial hyperplasia or carcinoma; hysteroscopy, although not predictive unless revealing a focal lesion, is more accurate in detecting polyps and hyperplastic changes.
Cord blood thyroid‐stimulating hormone level in twin pregnancy
Authors: Chan Louis Yik‐Si , Chiu Pui Yu , Lau Tze Kin 
Published: March 2003

Acta Obstet Gynecol Scand 2003; 82: 28–32. © Acta Obstet Gynecol Scand 2003Background.  Cord blood thyroid‐stimulating hormone level is elevated among neonates who undergo more perinatal stress. The aim of this study was to investigate the effect of twin pregnancy on the cord blood thyroid‐stimulating hormone level.Methods.  The study group consisted of 24 910 singleton and 543 twin neonates over a 4‐year period. The effect of twin pregnancy on the cord blood thyroid‐stimulating level was evaluated. Linear regression analysis was used to control for the effect of mode of delivery, birth weight, and infant sex.Results.  The median cord blood thyroid‐stimulating hormone levels (interquartile range) in the singletons and in the twins were 5.8mIU/l (4.2–8.6) and 5.6mIU/l (4.3–7.5), respectively. Linear regression analysis revealed no significant difference between singleton and twin cord blood thyroid‐stimulating hormone levels (p = 0.23). Cord thyroid‐stimulating hormone levels tended to be higher in second‐born twins (p = 0.08) and monochorionic twins (p = 0.097) compared with singleton neonates. Twins with more than 20% weight discordance were associated with a significantly higher cord blood thyroid‐stimulating hormone level (p = 0.035).Conclusion.  Cord blood thyroid‐stimulating hormone level is elevated in some subgroups of twins who are at higher risk of adverse perinatal outcomes. However, the overall effect of multiple pregnancy on the cord blood thyroid‐stimulating hormone level is small. Cord blood thyroid‐stimulating hormone screening for congenital hypothyroidism is also valid in twin pregnancies.
Color Doppler ultrasonography in ocular Behçet's disease
Authors: Çelebi Serdal , Akfırat Murat , Çelebi Harika , Alagöz Gürsoy 
Published: March 2003

ABSTRACT.Purpose: The aim of this prospective study was to assess the ocular hemodynamic changes in patients with Behçet's disease who had involvement of the posterior segment by color Doppler ultrasonography.Methods: The present study was carried out in 32 eyes of 24 patients with ocular Behçet's disease and 42 eyes of 21 persons as a healthy age‐matched control group. In order to detect the hemodynamic changes in ocular Behçet's disease, peak systolic and end‐diastolic velocities (PSV, EDV; cm/sec), resistive and pulsatile indices (RI, PI), and PSV/EDV ratio of central retinal artery (CRA), short posterior ciliary artery (PCA) and ophthalmic artery (OA) were determined.Results: The mean PSV and EDV (8.1±2.6 and 2.7±0.1 cm/sec, respectively) in the CRA were significantly lower in patients with Behçet's disease than in healthy controls (11.5±2.2 and 3.5±1.0 cm/sec, respectively, p<0.001). For the PCA, these values (12.7±4.2 and 4.3±1.1 cm/sec, respectively) were significantly lower in the patient group than in the control the group (18.2±4.2 and 6.1±2.5 cm/sec, respectively, p<0.001). In the patient group, a statistically significant decrease compared to the control group was detected in the mean PSV of the OA (31.8±8.2 and 35.8±0.6 cm/sec, respectively, p<0.02). However, no significant difference in the other parameters of these vessels was observed between groups.Conclusions: These results demonstrate the presence of some circulatory changes in the flow velocities of the CRA, PCA and OA in patients with Behçet's disease when compared with control subjects.
Pigmented spindle cell naevus of Reed presenting in the conjunctiva
Authors: Seregard Stefan 
Published: March 2003

ABSTRACT.Purpose: This study aimed to present the clinical and histopathological features of a pigmented spindle cell naevus (PSCN) appearing in the conjunctiva.Methods: Histopathological examination of the lesion following excision and review of the pertinent literature.Results: The features were consistent with those previously recognized in the skin as the PSCN of Reed.Conclusion: The PSCN can appear in the conjunctiva and should not be confused with conjunctival melanoma.
Results of transantral orbital decompression in patients with thyroid‐associated ophthalmopathy
Authors: Tallstedt Leif , Papatziamos Georgios , Lundblad Lars , Änggård Anders 
Published: March 2003

ABSTRACT.Purpose: To present the results of orbital decompression in patients with thyroid‐associated ophthalmopathy (TAO).Methods: Transantral orbital decompression was performed in 63 patients with TAO. In 40 patients (63%) the operation was made because of progressive ophthalmopathy not responding to medical therapy, and in 23 patients (37%) the operation was made for rehabilitative reasons. The long‐term hypesthesia engaging the infraorbital nerve was assessed with a questionnaire using a Visual Analogue Scale (VAS).Results: The mean proptosis reduction was 3.2 mm (range 0–8 mm). Twenty‐one patients had impaired visual acuity preoperatively, and 20 improved. Altogether 30 patients (40%) had worsened ocular motility postoperatively. Forty‐three patients did not have diplopia in the primary position preoperatively, and new diplopia developed in 22 of these (51%). Hypesthesia in the infraorbital nerve area was reported for half of the operated sides, but was a major cause of distress (VAS‐scoring >5) to eleven patients.Conclusions: Transantral orbital decompression is indicated in patients with progressive TAO or in patients with prominent exophthalmos, and results in a good proptosis reduction, but the risk of postoperative diplopia is significant. Postoperative hypesthesia is common but often not a major problem.
Colour Doppler imaging of the ocular circulation in diabetic retinopathy
Authors: MacKinnon Jane R. , McKillop Graham , O'Brien Colm , Swa Kenneth , Butt Zahida , Nelson Patricia 
Published: March 2003

ABSTRACT.Purpose: To measure blood flow velocity in the ophthalmic artery (OA) and central retinal artery (CRA) in patients with diabetic retinopathy.Subjects and Methods: 62 age‐matched subjects divided into 3 groups: non‐diabetic controls (n=17); diabetics with no clinical retinopathy or background changes (n=24); diabetics with either pre‐proliferative or proliferative retinopathy (n=21). Colour Doppler imaging was performed on supine patients by one masked observer using the Acuson 128 machine.Results: There was a statistically significant (p<0.05) decrease in both the peak systolic velocity (PSV 0.073 m/s) and end diastolic velocity (EDV 0.014 m/s) of the central retinal artery in the pre‐proliferative/proliferative group compared to the no retinopathy/background retinopathy group (PSV 0.096 m/s, EDV 0.024 m/s) and the control group (PSV 0.142 m/s, EDV 0.029 m/s). The resistance index of the ophthalmic artery was significantly increased in both the pre‐proliferative/proliferative (0.81) and the no retinopathy/background group (0.81) compared to controls (0.72).Conclusion: Reduced blood flow velocity was found in the CRA of diabetic patients and appeared to become further reduced with the progression of retinopathy. This suggests that monitoring with Colour Doppler imaging may have predictive power in identifying those at greatest risk of developing sight threatening proliferative disease. The resistance index of the OA was increased in diabetics compared to controls.
Comparative studies on pattern VECP between patients with ischemic optic neuropathy and optic neuritis
Authors: Takasoh Michihiko , Mizota Atsushi , Adachi‐Usami Emiko 
Published: March 2003

ABSTRACT.Purpose: To evaluate whether and how VECPs are useful in differentiating ION from ON.Methods: We retrospectively studied 27 patients with non‐arteritic ION and 69 patients with ON using pattern visually evoked cortical potentials (PVECPs) to 3 rev/sec stimulation (transient) and 12 rev/sec stimulation (steady‐state).Results: In patients with ION, non‐recordable responses were found in 25% of those with transient VECP and in 74% of those with steady‐state VECP. In ON patients, non‐recordable responses were found in 34% of those with transient VECP and in 64% of those with steady‐state VECP. The average peak latency of P100 component in those with ION was significantly shorter than in those with ON. The amplitude ratio (affected eye/fellow eye) of steady‐state VECP was significantly higher in those with ION than in those with ON. The amplitude ratio of P100 showed no significant differences between groups.Conclusion: The P100 peak latency of transient VECPs and the amplitude of steady‐state VECPs have the potential to differentiate between ION and ON.
Contrast sensitivity function in patients with beta‐thalassemia major
Authors: Gartaganis Sotirios P. , Zoumbos Nikolaos , Koliopoulos John X. , Mela Ephigenia K. 
Published: March 2003

ABSTRACT.Purpose: To investigate contrast sensitivity function in patients with beta‐thalassemia major, after regular transfusion and chelation therapy.Methods: We measured contrast sensitivity at four spatial frequencies in 30 patients with beta‐thalassemia major and in 30 matched normal control subjects. All subjects underwent an ophthalmic examination that included fluorescein angiography. The contrast sensitivity results from the two groups were compared between them. Patients' contrast sensitivity values were correlated to the variables age, duration of transfusion, duration of chelation therapy and serum ferritin levels, to select the important predictors.Results: Contrast sensitivity function in all beta‐thalassemic patients was significantly lower (p<0.0001) compared to the normal control subjects, for all spatial frequencies tested. The most important predictor of contrast sensitivity loss was patients' age.Conclusion: Contrast sensitivity testing can detect early changes in the visual function of beta‐thalassemic patients and should be considered as a monitor for patients under chronic transfusion‐chelation therapy.