bluuebunny/crossref_metadata_2025_split huggingface dataset:
Simplified colposuspension: A 15‐year follow‐up
Authors: Ladwig Denise , Miljkovic‐Petkovic Ljiljana , Hewson Alan D. 
Published: January 2004

AbstractAim:  Retrospective analysis of long‐term results of a simplified ‘Burch type’ colposuspension.Methods:  A retrospective chart review, with follow‐up through postal questionnaires sent in September 2000, of all 374 patients who had a simplified colposuspension between 1985 and 1998, with additional total abdominal hysterectomy in 103 patients. Outcome measures were patient satisfaction, complications and recovery.Results:  The mean period of follow‐up was 9.2 years. Response rate to the questionnaire was 85% with 51.5% of patients very satisfied with the surgery, 17.4% moderately satisfied and 12.6% having some symptomatic relief. Complications developed in 31.3% but few were serious. Average hospitalisation was 5.8 days. The mean time to establishment of normal voiding was 58.5 h. The average length of catheterisation was 49.9 h, with only seven patients requiring prolonged catheterisation. Seventy‐four patients required additional surgery for de novo, persistent or recurring symptoms.Conclusions:  The present study provides evidence that a simplified Burch type colposuspension provides a satisfactory cure rate on long‐term follow‐up and is associated with earlier resumption of normal voiding. Transurethral drainage remains a simple and effective method of bladder management after colposuspension. The present study also confirms that many patients do need further pelvic floor surgery for later development of deficiencies in the pelvic floor.
Value of single and paired serum human chorionic gonadotropin measurements in predicting outcome of in vitro fertilisation pregnancy
Authors: Alahakoon Thushari Indika , Crittenden Jenny , Illingworth Peter 
Published: January 2004

AbstractObjectives:  To assess whether paired human chorionic gonadotropin (hCG) measurements in early pregnancy are more effective than a single measurement, in predicting the outcome for an in vitro fertilisation pregnancy.Design:  Retrospective analysis.Setting:  Westmead Fertility Centre, Westmead Hospital, Sydney, Australia.Materials and methods:  Serial hCG measurements in 143 patients at Westmead Fertility Centre, from August 1997 to April 2000, were studied retrospectively. The predictive value of single hCG measurements relative to the published assay reference ranges were evaluated. The predictive value of serial hCG levels in predicting pregnancy outcome was assessed separately. Normal daily rate of rise (ROR) of hCG was defined as the mean ROR for ongoing pregnancies ± 1 SD. Abnormal daily ROR was defined as a daily increase in hCG less than the mean ROR for ongoing pregnancies − 1 SD.Main outcome measures:  Viability of the pregnancy at 20 weeks’ gestation.Results:  An initial hCG measurement below the 5th centile reference limit for gestation has 85% (confidence interval (CI) 75–92%) positive predictive value for non‐viability, with a sensitivity of 40% (CI 33–48). Serial testing of borderline samples for ROR did not improve positive predictive value (70%: CI 50–86%) or sensitivity (30%: CI 20–43%) in identifying non‐ongoing pregnancies.Conclusions:  In assisted reproductive technologies pregnancies, comparison of a single hCG value with appropriate reference ranges enables approximately 40% of non‐viable pregnancies to be identified with a high positive predictive value. Repeated measurements did not contribute further to the predictive value.
Survey of the management of preterm labour in Australia and New Zealand in 2002
Authors: Cook Colleen‐M. , Peek Michael J. 
Published: January 2004

AbstractAim:  To determine current attitudes and practices regarding the suppression of preterm labour among obstetricians in Australia and New Zealand.Methods:  A questionnaire mailed to all Diplomates, Members and Fellows of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists in April 2002.Results:  A total of 813 surveys were returned – 33% (470/1412) of Fellows and Members and 11% (322/2806) of Diplomates. The response rate for Australia was 18.9% (759 of 4019) compared to 27.1% (54 of 199) from New Zealand. Routine suppression of preterm labour was attempted by 79% of respondents, primarily to prolong pregnancy for steroid administration (83%) and/or transfer (74%). The gestation for initiation of suppression ranged from 20 to 37 weeks. Tocolysis was discontinued at 32.9 ± 2.7 weeks (mean ± SD), range 24–38 weeks. The first choice drug for tocolysis was the β‐adrenergic group (73%), followed by nifedipine (21%). Maintenance tocolysis was used by 34%. Respondents were asked the percentage of women in whom suppression was attempted that achieved: (i) steroid cover – median 80% (range 10–100); (ii) prolongation of pregnancy ≥7 days – 50% (0–100); and (iii) prolongation of pregnancy to term – 10% (0–100).Conclusion:  Most respondents attempted to suppress preterm labour for steroid administration and/or transfer. However, a wide range of opinions and uncertainty was evident as to the effectiveness of tocolytic therapy in clinical management, the most appropriate drug and drug side‐effects.
Beat‐to‐Beat QT Dynamics in Healthy Subjects
Authors: Jensen Berit T. , Larroude Charlotte E. , Rasmussen Lars P. , Holstein‐Rathlou Niels‐Henrik , Hojgaard Michael V. , Agner Erik , Kanters Jørgen K. 
Published: January 2004

Background: Measures of QT dynamics express repolarization abnormalities that carry prognostic information, but the reproducibility of beat‐to‐beat QT dynamics has never been established. The QT interval is prolonged at night, but how the circadian rhythm and heart rate influence the dynamic QT measurements is still unsettled. The aims of the present study were: (1) to describe the reproducibility of beat‐to‐beat QT dynamics with respect to intrasubject, between‐subject, and between‐observer variability and (2) to describe the normal range, circadian variation, and heart rate dependence of QT dynamics. Methods: Ambulatory Holter recordings were performed three times on 20 healthy volunteers and were analyzed by two experienced cardiologists. Slope and intercept of the QT/RR regression, the variability of QT and R‐R intervals expressed as the standard deviation, and the relation between QT and RR variability expressed as a variability ratio were measured among other QT dynamics. Results: The reproducibility of all QT dynamics was good. All QT dynamics showed circadian variation when calculated on an hourly basis. The day/night variation in slope could be explained by the differences in heart rate, whereas the day/night variation in intercept was heart rate independent. Conclusion: The present study shows that reliable automatic QT measurements could be performed, encouraging further evaluation of the clinical value of QT dynamics in risk stratification of cardiac patients.
Structural, Functional and Autonomic Changes in the Cardiovascular System in Growth Hormone Deficient Patients
Authors: Erdoğan Doğan , Tükek Tufan , Aral Ferihan , Oflaz Hüseyin , Özaydin Mehmet , Kocaman Orhan , Akkaya Vakur , Gören Taner , Molvalilar Senay 
Published: January 2004

Background: Growth hormone deficiency (GHD) is known to cause higher rates of cardiovascular mortality. The purpose of the study was to analyze the structural and functional changes in the heart and investigate their relation to autonomic function as assessed with heart rate variability (HRV). Methods: Eleven untreated GHD patients (mean age 50.4 ± 10.7 years, M/F: 3/8) and 15 age‐ and sex‐matched healthy persons (mean age 45.3 ± 10.4 years, M/F: 5/10) were compared. Both groups were examined with echocardiography, HRV, and exercise testing and findings were analyzed. Results: The groups were similar in height, weight, body mass index, body surface area, systolic and diastolic blood pressure, heart rate. The GHD patients had lower exercise duration and metabolic equivalent (MET) compared to controls (7.94 ± 1.26 vs. 9.8 ± 1.9 min, P < 0.001, for MET 8.85 ± 0.86 vs. 10.7 ± 2.23, P = 0.03). On echocardiography, GHD patients had lower interventricular septum diastolic diameter (9 ± 0.89 vs. 10.7 ± 0.88 mm, P < 0.001) and posterior wall thickness (8.4 ± 0.93 vs. 9.8 ± 0.91 mm, P = 0.002), and lower left ventricle mass index (90.9 ± 20 vs. 112 ± 8 g/m2, P = 0.01). Left ventricular ejection fraction was lower in the GHD patients (57.4 ± 5.12% vs. 65.5 ± 4.1%, P < 0.001). Time and frequency domain heart rate variability parameters, SDNN, SDANN, VLF, LF ve LF/HF were lower in GHD patients compared to controls. There was a significant correlation between left ventricle diastolic diameter and LF (r = 0.62, P = 0.02). Conclusion: GHD seemed to cause decreased left ventricle mass and decreases in the sympathetic components of HRV that may have a bearing on the increased cardiovascular risk seen in these patients.
The Relationship between Plasma Endothelin‐1, Nitric Oxide Levels, and Heart Rate Variability in Patients with Coronary Slow Flow
Authors: Pekdemir Hasan , Cicek Dilek , Camsari Ahmet , Akkus M. Necdet , Cin V. Gokhan , Doven Oben , Parmaksiz H. Tuncay , Katircibasi M. Tuna , Ozcan I. Turkay 
Published: January 2004

Background: Coronary slow flow (CSF) is characterized by delayed opacification of coronary arteries in the absence of epicardial occlusive disease. In this study, we aimed to determine endothelin‐1 (ET‐1), nitric oxide (NOx) levels and time domain heart rate variability (HRV) parameters in patients with CSF and relationship among these parameters. Methods: Thirty‐three patients with CSF detected in the coronary angiography (17 females; mean age 55 ± 7) and 19 patients with normal coronary flow (10 females; mean age 54 ± 11) as a control group were enrolled in the study. Patients were divided into two groups according to exercise testing as if positive (group A, n = 8) or negative (group B, n = 25). Results: Plasma ET‐1 levels were higher in the group A patients (28.7 ± 17.4 pg/ml) than that of group B (15.9 ± 10.6 pg/ml) and control group (6.0 ± 5.7 pg/ml); and higher in group B patients than that of control group (P < 0.05). Although groups A and B did not differ according to plasma NOx levels (23.4 ± 13.5 μmol/L vs. 32.8 ± 22.7 μmol/L, P > 0.05), NOx levels in group A were lower than the control group (23.4 ± 13.5 μmol/L versus 42.5 ± 15.9 μmol/L, P < 0.05). Time domain HRV parameters were decreased in all patient groups. This was more prominent in group A. Additionally, HRV parameters were negatively correlated with ET‐1 and TIMI frame counts. TIMI frame count was also significantly correlated with ET‐1 and NOx levels (r = 0.61, P < 0.0001, r =−0.30, P < 0.05). Upon intravascular ultrasonography investigation, the common finding was longitudinally extended massive calcification throughout the epicardial arteries. Mean intimal thickness was 0.50 ± 0.13 mm (group A; 0.58 ± 0.11 mm, group B 0.47 ± 0.12 mm, P = 0.029). Conclusions: The present study demonstrated that in patients with CSF, both increased plasma ET‐1, decreased plasma NOx and diffuse atherosclerosis may cause the decrease in HRV by effecting myocardial blood flow.
Increased P Wave Dispersion and Maximum P Wave Duration after Hemodialysis
Authors: Tezcan Ugur K. , Amasyali Basri , Can Ilknur , Aytemir Kudret , Köse Sedat , Yavuz Izzet , Kursaklioglu Hurkan , Işik Ersoy , Demirtaş Ertan , Oto Ali 
Published: January 2004

Background: Atrial fibrillation is a frequent arrhythmia in patients undergoing hemodialysis. The consequences of hemodialysis on P wave durations and P wave dispersion have not been fully understood. The objective of this study was to study the effect of dialysis on P wave maximum (Pmax), P wave minimum (Pmin), and P wave dispersion (Pd). Methods: We studied Pmax, Pmin, and Pd in 32 patients (17 men and 15 women, mean age 54 ± 18 years) with chronic renal failure undergoing hemodialysis. The difference between maximum and minimum P wave duration was calculated and defined as P wave dispersion (Pd= Pmax− Pmin). Results: There was a significant increase in Pmax at the end of dialysis compared to the beginning (98 ± 13 ms vs. 125 ± 12 ms, P < 0.001). Pmin did not show any significant change (71 ± 11 ms vs. 73 ± 10 ms, P = 0.42). Pd was significantly increased at the end of dialysis (27 ± 9 ms vs. 52 ± 11 ms, P < 0.001). There was a negative correlation between serum potassium, magnesium, phosphate, blood urea nitrogen, and creatinin at the end of dialysis and Pmax and Pd, respectively (P < 0.05). A weak positive correlation was found between serum calcium, bicarbonate at the end of dialysis and Pmax and Pd (P < 0.05). Conclusion: Hemodialysis ends with significant increase in P wave maximum duration and P wave dispersion, which might be responsible for the increased occurrence of atrial fibrillation in these groups of patients.
High correlation between the bacterial species in denture plaque and pharyngeal microflora
Authors: Sumi Yasunori , Kagami Hideaki , Ohtsuka Yoshiaki , Kakinoki Yasuaki , Haruguchi Yuuji , Miyamoto Hiroshi 
Published: January 2004

Abstract Objectives: The morbidity and mortality of the dependent elderly that result from aspiration pneumonia are recognized as a major geriatric health problem. Most cases of bacterial pneumonia are initiated following colonization or superinfection of the pharynx by pathogenic bacteria, followed by aspiration of pharyngeal contents. A recent study revealed that bacteria, that commonly cause respiratory infection, colonized the dentures of dependent elderly. This suggests that denture plaque may function as a reservoir of potential respiratory pathogens to facilitate colonization on the pharynx. The purpose of this study was to determine the possible correlation between denture and pharyngeal microflora. Study Design: The denture and pharyngeal bacterial flora of 50 dependent elderly were examined, and the microorganisms identified by culturing. The agreement between the bacterial species in denture plaque and pharyngeal microflora was investigated using the Kappa method. Results: The microorganism species on the dentures and pharyngeal mucosa of the subjects had an agreement rate of 68.5%. The agreement rate for each of the bacterial species of the dentures and pharynx was also demonstrated to be high. Conclusions: Dentures should be considered an important reservoir of organisations which could colonise the pharynx, and the importance of controlling denture plaque for the prevention of aspiration pneumonia cannot be overemphasized.
Validation of a Sinhalese translation of the Oral Health Impact Profile‐14 for use with older adults
Authors: Ekanayake L. , Perera I. 
Published: January 2004

Abstract Objective: To test the psychometric properties of a Sinhalese translation of the OHIP‐14 scale for use among older adults in Sri Lanka. Design: A cross‐sectional survey. The English version of the OHIP‐14 was translated in to Sinhalese, pre‐tested and subsequently administered to the subjects by a trained interviewer. Setting: Moratuwa — a densely populated urban area in the Western province of Sri Lanka. Subjects: 585 individuals aged 60 years and above. Main outcome measures: Reliability of the translated scale was assessed in terms of internal consistency using Cronbach's alpha. Construct validity was evaluated by examining the associations between perceived oral health status, perceived need for dental care and the OHIP scores. Results: Cronbach's alpha of the translated scale was 0.93. Corrected item‐total correlation coefficients ranged from 0.53–0.80. The highly significant associations between perceived oral health status, perceived need for dental care and the OHIP scores support the construct validity of the translated scale. Conclusion: The Sinhalese translation of the OHIP‐14 is a valid and reliable instrument to measure oral health related quality of life in older adults of Sri Lanka.
The influence of age and denture wear on the size of edentulous structures
Authors: Pietrokovski J , Harfin J , Levy F 
Published: January 2004

Abstract Objectives: This study was designed to evaluate the influence of age and denture use on the size of arches and residual ridges in edentulous patients. Design: At two nursing homes, maxillary and mandibular stone casts of 302 fully edentulous patients were utilized to measure the size of the arches and residual ridges, according to age and use of complete dentures. Age cohorts were divided into three groups; 60–69, 70–79, and 80–89 years old. Two hundred and forty‐nine denture wearers used complete dentures for at least 2 years before examinations. Fifty‐three non‐denture users had never worn removable prostheses. Chi‐square analysis (p<0.05) was used to establish the possible relations between the linear values and the size indexes of the ridges and arches and the two examined parameters: age and denture wear. Results: Young old patients possessed edentulous structures that were not significantly larger than elderly old patients in both the maxilla and the mandible. Non‐denture users had significantly bigger arches and ridges in both edentulous jaws than denture users. Conclusions: Young old, non‐denture users tended to have bigger residual edentulous tissues compared to elderly old patients who used complete dentures.
Temporal and seasonal variation in the occurrence of chemical incidents: Table 1
Authors: Olowokure B , Saunders P J , Dyer J A , Kibble A J 
Published: January 2004

Aims:To determine whether there were temporal or seasonal patterns in the occurrence of chemical incidents reported to the West Midlands Chemical Incident Surveillance System, UK.Methods:A retrospective analysis of reports maintained on a computerised database was carried out for information received from January 1997 to December 2001.Results:Annual numbers of events increased significantly from 77 (7.5%) in 1997 to 282 (27.4%) in 2001. Compared to the average of other seasons, proportionately more incidents occurred in the summer (29.3%). Compared with the average of other days, incidents were more likely to occur on Thursdays (17.1%) and least likely on Saturdays (8.9%). When grouped together on a six hourly basis incidents were most frequent between 12 00 and 17 59 (31.1%) and least frequent between 00 00 and 05 59 (21.2%).Conclusions:The surveillance system shows that chemical incidents do not occur randomly but have marked temporal and seasonal variation. These results have implications for service provision, training, and the development of preventive strategies.
Integrating qualitative methods into occupational health research: a study of women flight attendants: Table 1
Authors: Ballard T J , Corradi L , Lauria L , Mazzanti C , Scaravelli G , Sgorbissa F , Romito P , Verdecchia A 
Published: January 2004

Aims:To identify possible work related sources of psychosocial stress in order to develop pertinent questionnaire items for a cross-sectional health survey of 3000 Italian women flight attendants, and to solicit suggestions on improving survey participation.Methods:Qualitative study in which 26 current and former women flight attendants participated: three focus groups of 6–7 participants each and six in-depth individual interviews. The session themes included positive and negative aspects of the job; relationships with colleagues, superiors, and passengers; perception of occupational risk for serious diseases; compatibility of work and family; and experiences of work related sources of stress and their effect on health. A transcript based analysis of the focus groups and interviews was used to identify emerging themes related to risk factors for mental health problems.Results:The participants indicated that mental health was a major concern. Several work related risk factors possibly related to adverse outcomes, such as depression and anxiety, were highlighted. These included isolation and solitude, fears of being inadequate partners and mothers due to job demands, passenger relationships, and lack of protection by employers with respect to workplace exposures and violent passengers. The information gained was used to develop a mental health module for inclusion in the health survey questionnaire which included questions on history of severe depression or anxiety, suicidal ideation or attempt, substance abuse, workplace sexual harassment, social support, leisure time activities, relationship with a partner, and role as mother.Conclusions:Employing qualitative methods to identify work related sources of psychosocial stress enabled development of pertinent questionnaire items for a cross-sectional epidemiological study of women flight attendants. Follow up qualitative research may be necessary in order to put the cross-sectional study findings into context and to explore actions or strategies for preventing work related health problems evidenced from the survey.
Cutaneous melanoma: hints from occupational risks by anatomic site in Swedish men
Authors: Perez-Gomez B , Pollán M , Gustavsson P , Plato N , Aragonés N , López-Abente G 
Published: January 2004

Aims:To improve knowledge of the epidemiology of melanoma by comparing occupational risks of cutaneous melanoma (CM) by anatomic site in Swedish workers.Methods:Male workers employed in 1970 and living in the country in 1960 were followed up from 1971 to 1989 using the Swedish Registers of Death and Cancer. A more specifically exposed subcohort included men reporting the same occupation in 1960 and 1970. For each location, occupational risk ratios (RRs) were extracted from Poisson regression models adjusted by age, period, town size, and geographical area. To diminish the influence of socioeconomic factors, intrasector analyses, comparing only jobs belonging to the same occupational sector, were performed. Risk patterns for different locations were compared.Results:High RRs for different sites were found among workers exposed to UV sources (dentists, physiotherapists, and lithographers), and sun exposed workers (harbour masters, and lighthouse/related work). Risk excesses were seen in fur tailors, tanners/fur dressers, patternmakers/cutters, electrical fitters/wiremen, telephone/telegraph installers/repairmen, and some glass/pottery/tile workers. Results for lower and upper limbs were significantly correlated but somewhat independent of those found in thorax, the most frequent location. Correlation between head/neck and thorax was moderate. Specific risk excesses were found for rolling mill workers in head/neck, for chimney sweeps in upper limbs, and for aircraft pilots/navigators/flight engineers in lower limbs.Conclusions:High RRs in the trunk among occupations with UV exposure from artificial sources suggest an effect not restricted to exposed sites. An unusual distribution of cases and RRs in chimney sweeps, rolling-mill, or glass/pottery/tile workers suggests local effects of exposures. The not previously reported risk excess in this job and in fur related processes, and the RR in electrical fitters and telephone/telegraph installers deserve further investigation. Disparities between locations, as RRs in thorax and limbs, may reflect differences in aetiological mechanisms.