bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative study of single layer and conventional closure of uterine incision in cesarean section
Authors: Lal K. , Tsomo P. 
Published: April 2004

AbstractSingle layer interrupted suture closure of uterine wound incisions represent a viable choice over conventional closure since the operation not only has benefits in case of performance but also possesses a rational basis for the avoidance of ischemia of the wound, infection and hematoma formation. There is a distinct advantage of single interrupted suture closure over conventional closure because there is a substantially higher number of normal hysterograms in this group showing good integrity of the scar in the uterus.
The impact of diagnostic ultrasound on the prediction of intrauterine growth retardation in developing countries
Authors: Mahran M. , Omram M. 
Published: April 2004

AbstractThe purpose of this report is to throw light on the problem of intrauterine growth retardation in our society, and to show how this situation could be affected by the introduction of diagnostic ultrasound in our antenatal service. A series of 828 pregnant women were serially examined by ultrasound during the course of pregnancy. Among the whole series (no. 828) there were 98 growth retarded neonates (11.8%). Antenatal ultrasonic evaluation could predict 89.7% of these cases, while only 34.7% of cases could have been predicted by fundal palpation. Among the different etiological factors, maternal anemia was the most common (25%).
Homozygous sickle cell anemia at the University College Hospital, Ibadan, revisited
Authors: Osinusi B.O. , Adeleye J.A. 
Published: April 2004

AbstractThe outcome of 78 pregnancies in 47 patients with homozygous sickle cell anemia managed at the University College Hospital, Ibadan between January 1, 1975 to December 31, 1984 is reviewed. There were two maternal deaths giving a maternal mortality rate of 25 per thousand. Abortion rate was 155 per thousand. The overall perinatal mortality rate was 188 per thousand. Forty‐five percent of the babies were of low birthweight and 29% were preterm. Anemia was the commonest antenatal complication and the highest indication for hospitalization. The data were compared with previous ones from this hospital and with similar reports by other investigators outside Nigeria. A need for meticulous antenatal care and prenatal diagnosis to eliminate the homozygous sickle cell anemia is stressed.
Successful pregnancy in a renal transplant recipient taking cyclosporin A: hormonal and immunological studies
Authors: Salamalekis E.E. , Mortakis A.E. , Phocas I. , Dalamanga N. , Zourlas P.A. 
Published: April 2004

AbstractA successful pregnancy following renal allotransplantation is reported. Until now azathioprine has been used as the standard immunosuppressive agent in such cases. Because of the potential teratogenicity of azathioprine, low doses of cyclosporin A, a new immunosuppressive drug, was used in our pregnant recipient. We present the management and the outcome of the pregnancy, as well as the hormonal and immunological follow‐up.
Mortality in acute gynecology: a developing country perspective
Authors: Rogo K.O. 
Published: April 2004

AbstractOver a 20‐month period 109 deaths were recorded in the Acute Gynecology Ward, Kenyatta National Hospital, Nairobi; a rate of 5 deaths per month. Forty‐one percent of the deaths were directly attributable to pregnancy and 46% were due to malignancy (mainly cervical carcinoma). Of the dead, 12.4% were teenagers and 63% below 35 years in age. They were generally of low parity. A tragic picture is presented of death of young women in their prime from almost entirely preventable causes. The need for improved maternal care, including family planning and cytological screening for cervical carcinoma is discussed and emphasized.
Malignant degeneration of a mature ovarian teratoma
Authors: Christopherson W.A. , Councell R.B. 
Published: April 2004

AbstractMalignant components are present in 1–2% of mature teratomas (dermoid cysts) and historically have been associated with a very poor prognosis. Patients with malignant mature cystic teratomas typically are postmenopausal and may present with a rapidly enlarging tumor or systemic symptoms suggestive of malignancy. However, the diagnosis is rarely made pre‐operatively and, if the tumor is not metastatic, may not be made until the tumor is examined microscopically. Squamous cell carcinoma is the most common malignancy found in mature cystic teratomas. We present a 26‐year‐old woman with this cancer in whom the disease proved fatal. A surgical approach to patients with malignant mature teratomas is suggested. Prognostic factors and adjuvant therapy are discussed.
The need for action
Authors: Savage F. 
Published: April 2004

AbstractNutrition workers speculated about why poor mothers should decide to bottle feed, when their community in the past had apparently always breastfed effortlessly and successfully. Surveys cross‐tabulated feeding methods against socioeconomic variables, but it was difficult to make use of the results. Few thought that there was anything we needed to learn about HOW to make breastfeeding succeed. There was also a tacit assumption that if you had the resources — for example if you were yourself an employed health worker — you could bottle feed safely, so there was no need to worry.
Breastfeeding as an intervention within diarrheal diseases control programs: WHO/CDD activities
Authors: Hogan R. , Martinez J. 
Published: April 2004

AbstractThe Control of Diarrhoeal Diseases Programme (CDD) at the World Health Organization (WHO) is looking at ways to prevent diarrhea and has identified breastfeeding as an important factor. CDD is studying the protective effects of exclusive breastfeeding and the morbidity and mortality risks for infants exclusively, partially, or not breastfed. CDD has identified trials of interventions for breastfeeding promotion and the evaluation of approaches for the implementation of tested interventions among its research priorities. CDD also has included breastfeeding promotion information in modules in its two management training courses. The Programme plans to monitor the effectiveness of the training and develop future activities based on that feedback.
Reliability of the patient's history in the diagnosis of urinary incontinence
Authors: Bergman A. , Bader K. 
Published: April 2004

AbstractThe reliability of a patient's history has been challenged in the preoperative evaluation of stress urinary incontinence. In this study, 122 consecutive patients referred to our Gynecology/Urology clinic were evaluated and an additional 32 control patients (continent women with no urinary symptoms) were evaluated. All patients answered a detailed 64‐item questionnaire, and all patients received a complete urodynamic evaluation. Our detailed questionnaire provided a mean positive predictive value of 80% for genuine stress incontinence and 25% for detrusor instability. The conditions leading to a false positive history suggestive of genuine stress incontinence were detrusor instability and urethral diverticulum. The conditions leading to a false positive history suggestive of detrusor instability were urethritis, unstable urethra, vaginitis and polyuria. History alone can be misleading in diagnosing urinary incontinence.
Delayed abdominal pain after outpatient endometrial biopsy in the luteal phase
Authors: Li T.C. , Cooke I.D. 
Published: April 2004

AbstractOutpatient endometrial biopsy was followed by delayed abdominal discomfort in 50% of cases. The pain started 2–3 h after the procedure, lasted for about 2 h and was described in most cases as similar to dysmenorrhoea of a moderate degree. Appropriate explanation and the use of a simple analgesic may reduce the discomfort and the anxiety with which it is associated.
Mechanism of action of gestagens
Authors: Landgren B.‐M. 
Published: April 2004

AbstractIn the mid‐1950s it was shown that ovulation can be inhibited by oral administration of progesterone or of synthetic progestogens such as norethynodrel. The idea that progestogens may interfere with fertility even when administered in doses so small, that they do not invariably inhibit ovulation was launched in the mid‐1960s by a group of Mexican investigators. Since then a large number of studies have been conducted on the mechanism of action of gestagens when used as contraceptives. The objective of this communication is to review the information collected so far on this topic.
Birth asphyxia and obstetric care in Curaçao Netherlands Antilles
Authors: Wildschut H.I.J. , Wiedijk V. , Tutein Nolthenius‐Puylaert M. 
Published: April 2004

AbstractOut of the 223 fetal and neonatal deaths that occurred on the island of Curaçao in a 2‐year period (1984–1985), 35 were due to birth asphyxia (15.7%). In order to evaluate the quality of obstetric care, the circumstances surrounding each asphyxiated death were scrutinized. On the whole, patients' compliance with antenatal care was satisfactory. However, when the woman presented in labor the attending physician or midwife often lacked information on maternal antecedents and the course of pregnancy. Inadequate intrapartum surveillance together with failure to respond appropriately to abnormalities in labor constituted the principle factors which were associated with asphyxiated deaths. In addition, asphyxial conditions during labor were often preceded by inappropriate administration of oxytocic agents.
Successful ultrasound‐guided intrauterine blood transfusion in severe non‐immune hydrops fetalis
Authors: Buckshee K. , Bhatla N. , Paul V.K. 
Published: April 2004

AbstractNon‐immune hydrops fetalis has varied etiology, high mortality and few known successful treatment modalities. A rare case of non‐immune fetal hydrops with severe anemia diagnosed prenatally and treated successfully by repeated ultrasound‐guided intrauterine blood transfusions is presented.
Associated leukemia and mixed gem cell tumor in a patient with gonadal dysgenesis
Authors: Kaplan S.S. , Bornstein S.G. , Christopherson W.A. , Surti U. 
Published: April 2004

AbstractA 16‐year‐old phenotypic female developed acute myeloblastic leukemia with a fulminant course very shortly after surgery and chemotherapy for a mixed germ cell tumor of the ovary. The karyotype (46, XY, 47, XY + 8) suggested de novo rather than therapy‐associated leukemia. The relationship between germ cell tumors and leukemia, their common yolk sac derivation and the role of the Y chromosome are discussed. The idea that XY gonadal dysgenesis may be familial also is discussed.
Ureteric injuries associated with gynecologic surgery
Authors: Onwudiegwu U. , Makinde O.O. , Badejo O.A. , Okonofua F.E. , Ogunniyi S.O. 
Published: April 2004

AbstractWe conducted a review of eight ureteric injuries associated with major gynecologic surgery in seven patients over an 11‐year period. Our low incidence of 0.36% is comparable with other reports. Diagnosis was made either intra‐operatively or postoperatively. Immediate ureteric repair is advocated for all injuries discovered intra‐operatively. Attention to preventive measures both before and during gynecological operations will reduce the incidence of ureteric injuries.
Repeat pregnancy associated with cardiac pacemaker
Authors: Matorras R. , Diez J. , Saez M. , Montoya F. , Aranguren G. , Rodriguez‐Escudero F.J. 
Published: April 2004

AbstractTwo pregnancies in a patient with a fixed‐rate pacemaker are reported. The first pregnancy was uneventful. The second had no maternal complications either. A moderate tachysystolia was detected during the second period. The newborn was delivered with forceps applied under spinal anesthesia. Newborn infant evolution presented no hazards, but umbilical cord analysis revealed a severe acidosis, in spite of a normal scalp analysis 45 min earlier. Epidural anesthesia is recommended for such patients.
No decline in preterm birth rate over three decades
Authors: Yan J.S. , Yin C.‐S. 
Published: April 2004

AbstractLow socioeconomic status has been associated with risk of preterm delivery. During the past 30 years, Taiwan has had tremendous economic growth and people have attained higher levels of education and living. It is thus not unreasonable to presume that the rate of preterm delivery would decline in response to these changes. The birth registry of Tri‐Service General Hospital from 1957 to 1987 was reviewed. The rate of preterm delivery remained stable over the past 30 years, unaffected by these country‐wide social changes.
Vaginal hysterectomy for the management of menstruation in mentally retarded women
Authors: Sheth S. , Malpani A. 
Published: April 2004

AbstractA personal series of 60 vaginal hysterectomies performed in nulliparous mentally retarded women is presented. This is the largest series published in the literature. The advantages of the vaginal route in performing hysterectomies in these patients is discussed and the technique is described.
Unexplained infertility: a review of diagnosis, prognosis, treatment efficacy and management
Authors: Collins J.A. , Crosignani P.G. 
Published: April 2004

AbstractThe dilemma of unexplained infertility posed by Southam in 1960 remains today: despite advances in the diagnostic assessment of infertility, many couples still have no explanation for their infertility. Even the most sophisticated evaluation of semen, ovulation and genital tract competence cannot reveal all of the possible defects in the complex process leading to conception. Because it arises from these shortcomings in our knowledge of fertilization and from our inability to utilize all of the current knowledge, unexplained infertility is a challenge for both biological and clinical research. This paper attempts to summarize some clinical issues in the management of unexplained infertility: the prevalence of the disorder, problems in the definition and possible explanations for the existence of this diagnostic category. It reviews outcome‐based clinical publications as a guide to decision‐making on what diagnostic tests to use, provides a summary of the untreated prognosis and evaluates study results that may serve as a basis for treatment decisions in this puzzling diagnostic category of infertility.
The feasibility of suppressing ovarian activity following the end of amenorrhoea by increasing the frequency of suckling
Authors: Gellén J.J. 
Published: April 2004

AbstractOBJECTIVE: To determine the feasibility of suppressing ovarian activity by increasing the frequency of suckling episodes. METHOD: Prospective study was carried out with 19 exclusively breastfeeding volunteers. Ten subjects (experimental group) increased the suckling episodes by minimum 50% per day from the beginning of the first postpartum menses. Nine controls continued breastfeeding as before. Estradiol, progesterone, LH, FSH and prolactin were measured in blood samples, drawn twice a week up to the second postpartum menses or for 60 days, by RIA. Student's t‐test was employed. RESULT: The higher suckling frequency prevented ovulation in 7 of 10 cases examined according to the plasma progesterone concentration (<9.5 nmol/l). Significantly higher average prolactin value could also be found in the experimental group (1038 (527) munits/l vs. 518 (245) munits/l; P < 0.05). CONCLUSION: Results suggest that an earlier initiation of the increase in breastfeeding frequency may delay the resumption of ovulation. Frequent, full time lactation may reduce the risk of pregnancy.
Amoxycillin/clavulanic acid (augmentin) compared with triple drug therapy for pelvic inflammatory disease
Authors: Uri F.I. , Sartawi S.A. , Dajani Y.F. , Masoud A.A. , Barakat H.F. 
Published: April 2004

AbstractSixty Jordanian women with pelvic inflammatory disease (PID) were studied. Of these, 31 were given oral amoxycillin/clavulanic acid (augmentin) for a mean duration of 8.4 days and 29 were given a standard triple drug regimen of oral ampicillin, intramuscular gentamicin and metronidazole tablets/pessaries for a mean duration of 7.2 days. Bacterial culture (cervical and high vaginal swabs) was positive in every case, most often E. coli but sometimes more than one pathogen was isolated. No gonococci were isolated and tests for chlamydia in 16 patients (8 in each group) were negative, suggesting a dissociation between the etiology of PID and sexually transmitted disease in this Jordanian study. After 3 days of treatment, more patients in group I (augmentin) showed diminution of symptoms of pain and discharge (P ≤ 0.05) compared to group II. At the end of treatment, complete cure or satisfactory improvement was recorded in 93.1% and 92.9% of cases in the two groups, corresponding to in vitro bacterial efficacy of 90.4% and 96.5%, respectively. No serious side effects were noted in either regimen. The results of this comparative study suggest that oral amoxycillin/clavulanic acid (augmentin) may be a convenient alternative to the triple drug regimen usually administered for the treatment of pelvic inflammatory disease.
Cytokines in the peritoneal fluid of patients with endometriosis
Authors: Koyama N. , Matsuura K. , Okamura H. 
Published: April 2004

AbstractOBJECTIVE: To determine which of the various cytokines interleukin‐5 (IL‐5), interleukin‐6 (IL‐6) and interleukin‐1 (IL‐1) are important in endometriosis. METHODS: Peritoneal fluid (PF) samples were taken from 55 women at the time of either laparotomy or laparoscopy, and were examined for the levels of IL‐5, IL‐6 and IL‐1 using each cytokine specific sandwich enzyme‐linked immunosorbent assay. Thirty‐two patients had pelvic endometriosis, eight post‐pelvic inflammatory disease, four advanced cancer, three adenomyosis, three benign ovarian tumor, and other diseases. Statistical analysis was performed with the Mann Whitney test, chi‐square test or Fisher's test. RESULTS: Both IL‐5 and IL‐6 levels in PF specimens with endometriosis tended to be higher than normal, while the same specimens were mostly interleukin‐1β (IL‐1β) negative. Of great interest was the negative correlation between log (IL‐5) and IL‐6 (Fisher's test, P < 0.04). CONCLUSION: These findings support the concept that IL‐5 and IL‐6 but not IL‐1 are associated with endometriosis.
A comparison of manual vacuum aspiration (MVA) and sharp curettage in the management of incomplete abortion
Authors: Mahomed K. , Healy J. , Tandon S. 
Published: April 2004

AbstractObjectives: A prospective longitudinal study was carried out in two Harare hospitals to determine whether manual vacuum aspiration (MVA) was as safe and as effective as sharp curettage for treatment of incomplete abortion. Methods: Demographic and clinical data were collected over a 3‐month period on 589 women treated with sharp curettage for incomplete abortion ≤ 12 weeks gestation. One year later, after faculty and staff at the two hospitals were trained to use MVA, data were similarly collected on 834 women treated with MVA for incomplete abortion. Results: Based on procedure‐related complications at the time of treatment, MVA was found to be as safe as sharp curettage in treating incomplete abortion ≤ 12 weeks gestation. MVA was more effective than sharp curettage in achieving complete uterine evacuation (0% incomplete evacuations vs. 0.7%, P < 0.05). Conclusions: Given the safety and effectiveness of the MVA procedure and the potential for reducing health care costs and improving patient management, this technology should be considered by health care systems in developing countries for improving treatment of abortion complications.
Transvaginal ultrasound in threatened abortions with empty gestational sacs
Authors: Tongsong T. , Wanapirak C. , Srisomboon J. , Sirichotiyakul S. , Polsrisuthikul T. , Pongsatha S. 
Published: April 2004

AbstractObjective: To determine whether transvaginal ultrasound criteria alone can distinguish viable from non‐viable gestational sacs at a single examination. Method: A prospective descriptive study was undertaken and analysis performed on 211 pregnancies complicated by threatened abortion and empty gestation sacs diagnosed by transvaginal ultrasound. The main outcome measure was the final diagnosis of viable or non‐viable gestation on subsequent transvaginal sonography. Results: The study shows that a single transvaginal ultrasound examination is useful in differentiating viable from non‐viable gestation sacs. The mean sac diameter (MSD) was found to be the most useful criterion for determining non‐viability. An MSD of ≥ 17 mm that lacked an embryo and an MSD of ≥ 13 mm without visible yolk sac were reliable predictors of non‐viable gestation sacs at a single examination with 100% specificity and 100% positive predictive value. An MSD ≥ 13 mm without visible yolk sac was the most sensitive criterion. Using MSD criteria, 73% of non‐viable gestations could be reliably identified without any false‐positive diagnoses. Deformed shape, low position and thin decidual reaction are strong indicators of non‐viable gestations but are not 100% accurate. There is still a significant proportion of empty sacs, where no accurate distinction between viable and non‐viable can be made according to one criterion at a single examination and in these cases serial examinations should be carried out before any active management is advocated. Conclusion: In most cases, transvaginal sonographic criteria alone can distinguish viable from non‐viable empty gestational sacs at a single examination.
Type‐IV collagenase and tissue inhibitor of metalloproteinase in ovarian cancer tissues
Authors: Takemura M. , Azuma C. , Kimura T. , Kanai T. , Saji F. , Tanizawa O. 
Published: April 2004

AbstractObjective: We examined the specific expression of gelatinase/type‐IV collagenase and tissue inhibitor of metalloproteinase (TIMP) in clinical ovarian cancer tissue. Methods: Molecular weight‐specific gelatinase/type‐IV collagenase activity was examined by sodium dodecyl sulfate (SDS)‐polyacrylamide gel electrophoresis in which substrate was included (zymography). The expression of TIMP mRNA was examined by Northern blot analysis. Results: Zymography revealed that in ovarian cancer the activity of a 92‐kDa gelatinase/type‐IV collagenase was always greater than that of a 64‐kDa gelatinase/type‐IV collagenase in contrast to the situation in the normal ovary. Northern blot analysis revealed no remarkable difference of TIMP mRNA expression between cancer and normal ovarian tissues. Conclusions: These results indicate that the higher activity of the 92‐kDa gelatinase/type‐IV collagenase enzyme, relative to that of the 64‐kDa enzyme, is involved in the malignant phenotype of ovarian cancer, while the inhibitor of these enzymes, TIMP, is distributed in a widespread fashion in the tissue, and its levels are not correlated with the malignancy.
The immediate surgical management of fresh obstetric fistulas with catheter and/or early closure
Authors: Waaldijk K. 
Published: April 2004

AbstractOBJECTIVES: To determine prospectively if the immediate surgical management of obstetric fistulas within the first 3 months by catheter and/or early closure is effective. METHODS: During a 10‐month period (August 1992 through May 1993), a total of 170 patients with an obstetric fistula of less than 3 months' duration were treated. A catheter was inserted if the fistula was necrotic, and as soon as the fistula edge was clean an early closure was performed unless the fistula had healed already. RESULTS: The fistula was closed in 156 (91.8%) of the 170 consecutive patients: with continence in 146 (93.6%), minimal/mild incontinence in 7 (4.5%) and severe incontinence in 3 (1.9%) of the closed fistulas. In 14 patients (8.2%) the fistula was not closed at first intention; however, 12 were closed at the second attempt. CONCLUSION: The immediate surgical management proved highly effective in terms of closure and continence.