bluuebunny/crossref_metadata_2025_split huggingface dataset:
Absent or hypoplastic thymus on ultrasound: a marker for deletion 22q11.2 in fetal cardiac defects
Authors: Chaoui R. , Kalache K. D. , Heling K. S. , Tennstedt C. , Bommer C. , Körner H. 
Published: May 2003

AbstractObjectiveCongenital heart defects (CHD), particularly conotruncal anomalies, may be associated with deletion of chromosome 22q11.2. Thymic aplasia or hypoplasia is known to be a typical feature in this condition. We aimed to establish (i) the prevalence of del22q11.2 in fetal CHD and (ii) whether ultrasound assessment of an absent or hypoplastic fetal thymus helps in preselection of a group who are at high risk for this deletion.Study designIn fetuses (> 16 weeks) with CHD, karyotyping and fluorescence in situ hybridization for 22q11.2 were offered and the fetal thymus was evaluated sonographically.ResultsOne hundred and forty‐nine fetuses with CHD and normal karyotype were analyzed. Seventy‐six fetuses had conotruncal anomalies. 22q11.2 deletion was present in 10 cases (6.7%), all of which had conotruncal anomalies (13.1%). Thymic hypoplasia or absence was suspected in 11 cases with conotruncal anomaly. Nine of these 11 had the deletion; two cases were false positive. One fetus with a normal‐sized thymus had deletion of 22q11.2 (sensitivity 90%, specificity 98.5%, positive predictive value 81.8%, and negative predictive value 99.2%). By subtype of cardiac anomaly, there was deletion in four of six fetuses with interruption of the aortic arch, two of four with absent pulmonary valve syndrome, three of nine with truncus arteriosus and one of 11 cases of tetralogy of Fallot. Pulmonary atresia with ventricular septal defect (n = 7), right‐sided aortic arch (n = 4), transposition of the great arteries (n = 14), double outlet right ventricle (n = 13) and other complex malpositions of the great vessels (n = 8) were not associated with the deletion.ConclusionThymic hypoplasia or aplasia may reliably be diagnosed during fetal echocardiography. The technique allows identification of a group at high risk for 22q11.2 deletion and is more specific and sensitive than by subtype of cardiac anomaly alone. Copyright © 2002 International Society of Ultrasound in Obstetrics and Gynecology
Screening for pre‐eclampsia and fetal growth restriction in twin pregnancies at 23 weeks of gestation by transvaginal uterine artery Doppler
Authors: Yu C. K. H. , Papageorghiou A. T. , Boli A. , Cacho A. M. , Nicolaides K. H. 
Published: May 2003

AbstractObjectiveTo assess the value of transvaginal uterine artery Doppler at 23 weeks of gestation in predicting the development of adverse perinatal outcomes in twin pregnancies.Patients and methodsWomen with twin pregnancies attending for routine ultrasound examination at 23 weeks in any one of seven hospitals underwent Doppler assessment of the uterine arteries. The right and left uterine arteries were identified using color flow mapping and velocity waveforms were obtained using pulsed Doppler. The mean pulsatility index (PI) of the two arteries was determined and the presence of uterine artery notching noted. Results were compared between monochorionic and dichorionic twins, and with our previously reported data from singleton pregnancies. Screening characteristics in the prediction of pre‐eclampsia, fetal growth restriction (FGR), placental abruption, fetal death and early preterm delivery were calculated.ResultsUterine artery Doppler at 22–24 weeks of gestation was performed in 360 twin pregnancies, including 324 dichorionic and 36 monochorionic diamniotic twins. Complete outcome data were available in 351 (97.5%). The mean uterine artery PI did not change significantly with gestation and there was no significant difference in mean PI between the dichorionic and monochorionic groups. However, the mean PI was significantly lower in twin pregnancies than in singletons. The pregnancy was complicated by pre‐eclampsia in 6.0% of cases, FGR below the 5th centile of both twins in 8.8%, abruption in 0.9%, intrauterine fetal death in 1.7% and early preterm delivery at less than 32 completed weeks of gestation in 5.7% of cases. The respective sensitivities of uterine artery mean PI above the 95th centile for these complications were 33.3%, 9.7%, 66.6%, 33.3% and 18.6%.ConclusionsIn twin pregnancies PI in the uterine arteries is lower than that in singleton pregnancies, but there is no significant difference between dichorionic and monochorionic twins. Doppler assessment of the uterine arteries at 23 weeks identifies a large proportion of twin pregnancies destined to develop adverse outcomes related to uteroplacental insufficiency. Copyright © 2002 International Society of Ultrasound in Obstetrics and Gynecology
Doppler assessment of the uterine circulation in the second trimester in twin pregnancies: prediction of pre‐eclampsia, fetal growth restriction and birth weight discordance
Authors: Geipel A. , Berg C. , Germer U. , Katalinic A. , Krapp M. , Smrcek J. , Gembruch U. 
Published: May 2003

AbstractObjectiveTo compare singleton nomograms of the uterine circulation with previously established twin nomograms in the prediction of pre‐eclampsia, fetal growth restriction (FGR), and birth weight discordance ≥ 20% in twin gestations.MethodsThis was a retrospective analysis of maternal and perinatal data obtained from 256 dichorionic twin pregnancies. The mean uterine artery resistance index was calculated from both sides and the presence and absence of notching was recorded. Cut‐off levels for abnormal flow parameters were the 95th centile of reference ranges of either singleton or twin nomograms.ResultsAccording to twin reference values, 14.0% of patients were screen positive, compared to only 3.1% when singleton reference values were used. The sensitivity of abnormal uterine artery Doppler results defined by twin nomograms vs. singleton normograms was 36.4% vs. 18.2% for pre‐eclampsia, 26.7% vs. 9.7% for FGR, 28.9% vs. 7.9% for birth weight discordance ≥ 20%, and 26.5% vs. 10.3% for any adverse outcome, respectively.ConclusionDespite using specially constructed twin normograms, uterine artery Doppler studies in twin gestations had an overall low sensitivity in predicting adverse obstetric outcome. Negative predictive values of uterine Doppler studies in twin gestations are lower compared to those reported in unselected singleton pregnancies, i.e. maternal and fetal complications occur more frequently despite normal uterine artery waveforms. This suggests that there is an additional pathomechanism, causing pre‐eclampsia and FGR in twin gestations, that is unrelated to uteroplacental insufficiency. Copyright © 2002 International Society of Ultrasound in Obstetrics and Gynecology
Prenatal diagnosis of congenital epulis:a case report
Authors: Nakata M. , Anno K. , Matsumori L. T. , Sumie M. , Sase M. , Nakano T. , HARA H. , Imate Y. , Nakamura Y. , Kato H. 
Published: May 2003

AbstractCongenital epulis or congenital granular cell tumor, is a benign tumor that has rarely been diagnosed prenatally. We report a case of a large congenital epulis diagnosed at 26 weeks of gestation that increased in size during gestation. Color and power Doppler ultrasound examination showed marked blood flow in the tumor. The tumor could be resected completely following Cesarean section and histologically examined. We discuss the prenatal diagnosis and histogenesis of congenital epulis. Copyright © 2002 International Society of Ultrasound in Obstetrics and Gynecology
Clinically significant persistence and enlargement of an antenatally diagnosed isolated choroid plexus cyst
Authors: Becker S. , Niemann G. , Schöning M. , Wallwiener D. , Mielke G. 
Published: May 2003

AbstractIsolated choroid plexus cysts are usually diagnosed at the time of screening ultrasonography during the second trimester. While they raise the question of underlying chromosomal abnormalities, their clinical course is almost invariably benign with complete resolution often by the third trimester.We report the highly unusual case of a choroid plexus cyst diagnosed at 14 weeks of gestational age with subsequent further enlargement of the cyst,necessitating postpartum neurosurgical intervention. Copyright © 2002 International Society of Ultrasound in Obstetrics and Gynecology
Prenatal diagnosis of hypoplasia of the corpus callosum in association with non‐ketotic hyperglycinemia
Authors: Paupe A. , Bidat L. , Sonigo P. , Lenclen R. , Molho M. , Ville Y. 
Published: May 2003

AbstractAbnormalities of the corpus callosum are often associated with a poor prognosis due to the anatomical defect itself and associated anomalies that include malformations and inherited metabolic disorders. We report a case of the prenatal diagnosis of hypoplasia of the corpus callosum that was associated with non‐ketotic hyperglycinemia. Metabolic disorders are a known association with corpus callosum abnormalities and carry a dismal prognosis. A diagnosis of non‐ketotic hyperglycinemia should be considered when a fetus presents with an abnormality of the corpus callosum. A literature search reviews other inherited diseases associated with hypoplasia of the corpus callosum. Copyright © 2002 International Society of Ultrasound in Obstetrics and Gynecology
Multiple risk factors in root survivorship: a 4‐year study in Concord grape
Authors: Anderson L. J. , Comas L. H. , Lakso A. N. , Eissenstat D. M. 
Published: May 2003

Summary• Minirhizotron techniques were used to examine root lifespan inVitis labruscana(Concord grape) for roots born in four different years that varied in rainfall.• Experimental vines were given irrigation (irrigated or not) and canopy pruning treatments (minimal or balanced). Root survival was assessed from 1997 through 2000 and analysed using Cox proportional hazards regression. Model covariates included pruning, irrigation, vine yield, soil depth, root diameter, time of root birth, and numbers of neighboring roots.• Soil depth, root diameter and time of birth consistently influenced root lifespan in all years (P < 0.05). Deeper and coarser roots had longer lifespans. Roots born near bloom were shorter‐lived than roots born later in the season. Pruning and irrigation influenced root lifespan in some years but their effects seemed to vary with growing‐season environmental conditions.• These data underscore the value of long‐term studies in distinguishing factors that consistently affect root lifespan from those that change annually with environmental conditions, and emphasize the diversity in life histories of fine roots within a species.
Incorporating the views of obstetric clinicians in implementing evidence‐supported labour and delivery suite ward rounds: a case study
Authors: Deshpande Neelima , Publicover Mary , Gee Harry , Khan Khalid S. 
Published: May 2003

Abstract Objectives: To implement evidence‐supported delivery suite ward rounds using strategies to overcome barriers. Design: Qualitative case study to identify barriers and a quantitative assessment of outcomes on ward rounds. Method: After an introduction to the proposed evidence‐supported delivery suite ward round reactions were elicited from 15 clinicians. Responses were categorized into barriers related to knowledge, skills, attitudes and behaviour. Using strategies to overcome these barriers, a weekly evidence‐supported ward round was established. During patient‐centred discussions, clinical questions were formulated. Following literature searches, evidence was acquired and appraised. Results: Clinicians had limited awareness about the potential benefits of a clinical librarian's support during ward rounds. They were unsure of their skills in evidence‐based practice. There was scepticism, fear of loss of autonomy, poor motivation and resistance to change. Clinicians identified several factors that could impinge on their practice. Using appropriate strategies when evidence‐supported ward rounds were conducted, 67 questions were raised. However only seven articles were appraised in time to affect decisions on that ward round. Conclusions: Knowledge of barriers was helpful in developing plans for implementation of evidence‐supported ward rounds. The pilot study indicates the feasibility of this approach.
Non use of health information kiosks examined in an information needs context
Authors: Williams Peter , Nicholas David , Huntington Paul 
Published: May 2003

AbstractWhilst great emphasis has rightly been placed on the increased availability and use of health information, little research has been undertaken into the non use of such material, particularly with regard to electronic sources. Computer transactional log data from health information touch screen kiosks, collected as part of an ongoing Department of Health‐funded study being carried out by City University, showed that females in the 55–74 age group were particularly under‐represented as users. To explore reasons for this, in‐depth interviews were carried out with 13 non‐kiosk‐using, primary‐care out‐patients fitting this profile, at a surgery which had a kiosk that was being monitored. Subjects were interviewed at length about their information needs and information‐seeking behaviour, to determine reasons (if any) they might have had for non‐kiosk use. The study utilized an interview schedule and technique loosely based on the ‘Sense‐Making’ methodology of Brenda Dervin (Talk Presented at the International Communication Association Annual Meeting, May 1983, Dallas, Texas, USA. Available from: http://communicationsbsohio‐stateedu/sense‐making/art/artdervin83html.). Findings elicited many factors accounting for non use of the system. The first and major source of information remained the doctor, with written or other sources only being consulted where recommended or provided. There was evidence that patients wanted little more than the minimum information or instructions required to deal with their condition. Many appeared unaware of the presence of the kiosk and others assumed either that it was not for patient use or that it would not serve their needs. The methodology proved itself, with certain caveats, to be an appropriate vehicle for this kind of exploratory work.
Factors of Early Life as Predictors of Headache in Children at School Entry
Authors: Aromaa Minna , Rautava Päivi , Helenius Hans , Sillanpää Matti L. 
Published: May 2003

To study the main predictors of childhood preschool headache, 1443 families expecting their first child were followed from the onset of pregnancy to the child's sixth year of life. Subject selection was based on stratified randomized cluster sampling.Of the children, 14.9% (144) suffered from headache disturbing daily activities at the age of 6 years. The mother's assessment of the infant's poor health (OR 2.5, 95% Cl 1.1 to 5.8) and feeding problems (OR 1.9, 95% Cl 1.1 to 3.2) at the age of 9 months predicted later occurrence of headache. At 3 years, depression and sleeping difficulties (according to Achenbach's psychological test) and recurrent difficulties in falling asleep (OR 3.2, 95% Cl 1.5 to 7.2) were strong predictors. Headache in other family members (OR 3.5, 95% Cl 2.0 to 5.9), especially in the mother (OR 1.7, 95% Cl 1.2 to 2.4), predicted preschool headache in the child. At the age of 5 years, travel sickness (OR 2.8, 95% Cl 1.5 to 5.1), nocturnal enuresis (OR 1.8, 95% Cl 1.1 to 3.0), and the presence of long‐term disease (OR 1.8, 95% Cl 1.1 to 3.0) were strong predictors of later headache. At the same age, concentration difficulties (OR 2.3, 95% Cl 1.3 to 4.2), behavioral problems (OR 2.7, 95% Cl 1.1 to 6.4), unusual tiredness (OR 3.8, 95% Cl 1.0 to 13.5), and, conversely, high sociability (OR 1.5, 95% Cl 1.0 to 2.2) predicted headache. The three last‐mentioned psychological factors seemed to be associated with concentration difficulties at the age of 5, which was found to be the strongest predictor. The parents of child headache sufferers often became aware of the child's problems long before the emergence of headache.
Acute and delayed hemolytic transfusion reactions secondary to HLA alloimmunization
Authors: Benson Kaaron , Agosti Steven J. , Latoni‐Benedetti Gerardo E. , Leparc German F. 
Published: May 2003

BACKGROUND: HLA antibodies may be directed against HLA antigens on RBCs, but these antibodies are generally not considered to be clinically significant in transfusion practice. A case of a multiparous woman who had hemolytic transfusion reactions due to HLA‐related Bg antibodies is reported. CASE REPORT: A 37‐year‐old woman was admitted with anemia. No unexpected RBC antibodies were identified. Two group O, D+ RBC units were transfused. Ten days later she returned with hemolysis and anemia. Two more RBC units were ordered, no unexpected RBC antibodies were identified, and two crossmatch‐compatible units were issued. During the transfusion, the patient developed symptoms of an acute reaction, and the posttransfusion sample showed evidence of intravascular hemolysis. RESULTS: Repeat RBC antibody screen showed anti‐Bg. HLA antibody screen identified anti‐HLA‐A2, A28, B7, B7 cross‐reactive group (CREG). The two RBC units from the first transfusion episode and one RBC unit from the second transfusion episode were HLA incompatible with the patient. No other cause for the hemolytic reactions was identified. The patient was later successfully transfused with one RBC unit from an HLA‐compatible donor. CONCLUSION: HLA antibodies should be considered in patients with hemolytic transfusion reactions when RBC‐specific antibodies are not found to be the etiology.
Differences in the perception of blood transfusion risk between laypeople and physicians
Authors: Lee D.H. , Mehta M.D. , James P.D. 
Published: May 2003

BACKGROUND: There is little objective evidence to support the commonly held belief that laypeople perceive blood transfusion risk differently from physicians. Acknowledging and characterizing such differences may improve risk communication. The objective of this study was to characterize how laypeople and physicians perceive the risks of blood transfusion in comparison with a wide variety of other hazards. STUDY DESIGN AND METHODS: A total of 161 laypeople and 91 physicians and medical trainees were surveyed in Kingston, Ontario, between March and August 2000. The perceived riskiness and other qualitative characteristics of blood transfusion and 9 other hazards were measured by psychometric scaling and principal components analysis. RESULTS: The overall return rate was 100 percent, with 86 percent of surveys having no missing responses. Physicians perceived the risks of blood transfusion and most other hazards to be less dreaded and severe, but also less understood and controllable than laypeople. CONCLUSION: Laypeople and physicians perceive risk differently for blood transfusion, but this perceptual gap between the groups for blood transfusion may be representative of a more generalized phenomenon that spans different types of hazards, both medical and nonmedical. Awareness of such differences may facilitate risk communication and shared decision making between physicians and their patients.
Methodologic issues in the use of bleeding as an outcome in transfusion medicine studies
Authors: Heddle Nancy M. , Cook Richard J. , Webert Kathryn E. , Sigouin Christopher , Rebulla Paolo ,   in collaboration with the Biomedical Excellence for Safer Transfusion (BEST) Working Party of the International Society for Blood Transfusion
Published: May 2003

BACKGROUND: Prophylactic platelet transfusions are given to thrombocytopenic patients to prevent bleeding. The benefit of platelet transfusions has frequently been assessed by measuring the count increment; however, more recently, an assessment of bleeding has been used because it is a more clinically relevant outcome measure. The purpose of this study was to identify platelet transfusion trigger studies that used bleeding as an outcome measure, compare and contrast methods used to document bleeding and analyze bleeding outcomes, and identify and discuss methodologic issues to consider when bleeding is used as a study outcome. STUDY DESIGN AND METHODS: A systematic search to identify platelet transfusion trigger studies was performed. Relevant articles were reviewed to identify how bleeding data was captured and analyzed, and methodologic considerations were identified. RESULTS: Seven articles meeting the predefined entry criteria were identified. Methods used to document bleeding included chart review and clinical assessment. The frequency of assessment and the type of personnel performing the assessment were variable. Four approaches to analysis were identified: descriptive; comparison of the proportions of patients having at least one bleed; comparison of patient days with bleeding expressed as a proportion of the total days at risk of bleeding; and time‐to‐event (first bleed) analysis. CONCLUSION: Methodologic issues for consideration when designing a clinical study with bleeding as the outcome measure included approaches to minimize bias in the documentation and classification of bleeding and selection of an analysis approach that is appropriate to the question being asked. The need for development of a valid and reliable bleeding scale was also identified.
A comparison of the host preference of monarch butterflies (Danaus plexippus) for milkweed (Asclepias syriaca) over dog‐strangler vine (Vincetoxicum rossicum)
Authors: Mattila Heather R. , Otis Gard W. 
Published: May 2003

AbstractObservations in the field indicate that monarch butterflies will oviposit on dog‐strangler vine, an invasive introduced species in the same family as milkweed (Asclepias spp.), the principal larval host of monarchs. The potential impact of this behaviour depends on the strength of the preference of monarch adults to oviposit on these two hosts and the relative ability of larvae to survive on each. We determined the preference for milkweed vs. dog‐strangler vine of ovipositing adults and first instar larvae in choice and no‐choice tests. We also compared the ability of larvae to consume, develop, and survive on either host. In the presence of both hosts, adults exhibited a strong preference to oviposit on milkweed over dog‐strangler vine (mean 80.7 eggs compared to 0.4 eggs over 48 h, respectively). In the absence of milkweed, adults ceased oviposition (mean 0.9 eggs in 48 h), but resumed oviposition when the dog‐strangler vine was replaced with milkweed (mean 99.1 eggs in 48 h). Given a choice between hosts over 24 h, 92% of larvae moved to milkweed leaves and consumed 3.94 cm2 of milkweed leaves compared to 2% of larvae that moved to dog‐strangler vine and consumed negligible amounts of leaf material (0.01 cm2). Without a choice, larvae on dog‐strangler vine never consumed more than mean 0.02 cm2 larva−1 in a 24‐h period, did not develop beyond the first instar, and died within 96 h. We obtained no data in support of an effect of the presence of dog‐strangler vine on monarch butterfly populations.