bluuebunny/crossref_metadata_2025_split huggingface dataset:
COPS—Cis/transpeptide bond conformation prediction of amino acids on the basis of secondary structure information
Authors: Pahlke Doreen , Leitner Dietmar , Wiedemann Urs , Labudde Dirk 
Published: October 2004

AbstractSummary: COPS predicts for all 20 naturally occurring amino acids whether the peptide bond in a protein is in cis or trans conformation. The algorithm is based only on secondary structure information of amino acid triplets without considering the amino acid sequence information. Conformation parameters are derived from solved 3D structures deposited in the PDB and led to propensities based on modified Chou–Fasman parameters. COPS analyses amino acid triplets taking only their respective secondary structure into consideration and upon application of a set of rules utilizing the conformation parameters, the N-terminal peptide bond conformation of the middle residue is predicted. COPS was tested on a random selection of protein datasets.Availability: The COPS program and further information are freely available from the FMP website at http://www.fmp-berlin.de/nmr/copsContact: labudde@fmp-berlin.de
Studies in Otitis Media: Children's Hospital Of Pittsburgh–University of Pittsburgh Progress Report—2004
Authors: Bluestone Charles D. 
Published: October 2004

AbstractObjectives/Hypothesis: The present Progress Report has summarized the key otitis media clinical trials and laboratory studies conducted since 1969 by investigators at the Children's Hospital of Pittsburgh–University of Pittsburgh (Pittsburgh, PA).Study Design: Review.Methods: Included in the discussion are the following: 1) studies of the epidemiology and risk factors; 2) anatomy and pathology of the eustachian tube–middle ear from human temporal bone histopathological specimens; 3) physiology and pathophysiology of the eustachian tube–middle ear in humans and animal models; 4) pathogenesis; 5) otitis media in special populations (e.g., patients with cleft palate, Native Americans, patients with Down syndrome); 6) microbiology; 7) diagnosis; 8) outcomes of randomized clinical trials that evaluated efficacy of nonsurgical and surgical methods of treatment and prevention; 9) studies of certain complications and sequelae (e.g., effect of middle‐ear effusion on hearing, early child development, and the vestibular system; chronic suppurative otitis media). Also included are relevant summary tables and 256 references.
Eugenics or empowered choice? Community issues arising from prenatal testing
Authors: Parker Malcolm H , Forbes Kevin L , Findlay Ian 
Published: October 2004

ABSTRACTThe prevention of inherited disabilities is viewed in two contrasting ways – either as enhancing reproductive choice and improving population health, or as discriminating against disabled community members. We argue that modern clinical genetics, including preimplantation genetic diagnosis (PGD), reflects a persistent and defensible desire by the community to prevent disability, rather than as increasing discrimination or threatening to produce a ‘new eugenic’ society. Screening should be presented as a distinct issue for decision‐making about the prevention or acceptance of disability, rather than as a routinely accepted component of antenatal care. The community must improve its understanding of the experiences of those who manage disability, and continue to debate the issues of discrimination, selective genetic prevention and enhancement, reproductive freedom, and eugenics.
Legal abortion in South Australia: a review of the first 30 years
Authors: Yusuf Farhat , Siedlecky Stefania 
Published: October 2004

ABSTRACTObjectivesTo review the first 30 years' experience of legal abortion in South Australia and its demographic implications.Data and methodsInformation was obtained from official abortion statistics and demographic publications of the Australian Bureau of Statistics. Standard demographic and statistical techniques of analysis were used.ResultsAfter an initial rise during the 1970s, abortion rates remained fairly constant for the next decade but have increased since 1990. The Pregnancy Advisory Centre opened in 1992, to reduce waiting times and to cater for late abortions. This resulted in an increase in abortions earlier in pregnancy and also an increase in late abortions. With the adoption of vacuum aspiration techniques and improved services, abortion is now a day‐only procedure, performed by specially trained doctors. Morbidity and mortality have been greatly reduced. Concurrent sterilisation has also declined. The increase in abortion has affected all age groups, but particularly women under 30, consistent with the national trend towards the postponement of births. After an initial rapid decline, the total pregnancy rate has risen slightly since 1990, showing changes in patterns of contraceptive use. However, this is not reflected in an increase in the total confinement rate.ConclusionOverall, contraception has had a greater effect than abortion in reducing births in South Australia. The abortion rate is still lower than in the rest of Australia as calculated from Medicare data, even though this is an underestimate because it includes only fee‐paying patients. There remains a need for continuing emphasis on better contraceptive use, including emergency contraception.
Audit of maternal and fetal outcomes in women treated for glucose intolerance during pregnancy
Authors: McIntyre H David , Begg Lisa M , Parry Annette F , Oats Jeremy 
Published: October 2004

ABSTRACTObjectiveTo determine whether one should aim for glycaemia that is statistically ‘normal’ or for levels of glycaemia low enough to prevent macrosomia (if such a threshold exists) when glucose intolerance is detected during pregnancyDesignAn audit of pregnancy outcomes in women with impaired glucose tolerance in pregnancy as compared to a local age‐matched reference group with normal glucose tolerance.ResultsOur study suggests that for most patients, more intensive therapy would not have been justified. Maternal smoking appeared to convey some ‘advantages’ in terms of neonatal outcomes, with reduction in large‐for‐gestational‐age (LGA) infants and jaundice in babies of impaired glucose tolerance (IGT) mothers.ConclusionsThese observations demonstrate the importance of considering risk factors other than GTT results in analysing pregnancy outcomes, while emphasizing that ‘normalisation’ of fetal size should not be our only therapeutic endpoint. Our detailed outcome review allows us to reassure patients with GDM that with current treatment protocols, they should have every expectation of a positive pregnancy outcome.
Factors associated with success or failure in trials of vacuum extraction
Authors: Mola Glen DL , Amoa AB , Edilyong James 
Published: October 2004

ABSTRACTFailure rates for vacuum extraction of between one in 16 and one in 600 have been reported. Most studies report that unexpected failure carries a greater risk to both mother and fetus. The aim of this study was to determine factors that were likely to predict success or failure in trials of vacuum extraction.At the Port Moresby General Hospital, 59 trials of vacuum extraction were performed between 1 December 1997 and 30 November 1999. These cases were analysed according to whether vacuum extraction was achieved with more than or less than three pulls, or an alternative method of delivery was required to effect delivery.Factors that were predictive of failure were: (i) Highlands origin of the mother; (ii) longer duration of the second stage of labour; (iii) severe moulding of the fetal head; (iv) cup detachments and deflexing cup applications; and (v) operator persisting with the procedure after three pulls.The cervix being less than fully dilated when the trial was commenced was not associated with a higher risk of failure, nor was it associated with a significantly higher risk of cervical trauma.Perinatal death and serious fetal scalp trauma were associated with deflexing cup applications, making more than three pulls and failed vacuum extractions.
High‐grade vulval intraepithelial neoplasia (VIN 3): a retrospective analysis of patient characteristics, management, outcome and relationship to squamous cell carcinoma of the vulva 1989–1999
Authors: Sykes Peter , Smith Natasha , McCormick Peter , Frizelle Frank A 
Published: October 2004

ABSTRACTObjectivesTo determine patient and disease characteristics, treatment patterns and long‐term outcomes, in order to help direct management of patients with VIN 3, to examine the risk of development of cancer following a diagnosis of VIN 3 and the risk of recurrent disease requiring multiple treatment episodes, and to review patients with vulval cancer, in order to establish the relative prevalence of VIN 3 related vulval cancers.DesignRetrospective chart review of 65 consecutive patients diagnosed with VIN 3 between 1989 and 1999.Population or sampleAll patients diagnosed with VIN 3 at Christchurch Womens' Hospital (1 January 1989 to 31 December 1999) and Dunedin Public Hospital (1 January 1990 to 31 December 1999)Main outcome measuresAge at diagnosis, symptoms, medical history, disease characteristics, treatment, outcome and follow‐up.ResultsThe median age at diagnosis was 38 years. Smokers were younger than non‐smokers. Two‐thirds had associated dysplasia of the lower genital tract, 43% had high‐grade lesions. Seventy‐nine per cent were symptomatic for a median of 9.5 months. All had macroscopically visible disease. Colposcopy and histology diagnoses correlated in 72% of cases. Treatment by local excision was undertaken in 84% of cases of which 65% had involved margins. Fifty‐one per cent required further treatment, risk factors were positive margins and multifocal disease. Three developed micro‐invasive cancer.ConclusionsTreatment by local excision is both diagnostic and therapeutic. Excision may reveal micro‐invasive cancer, patients are usually symptomatic and VIN 3 has some potential to become invasive. Treated patients may develop microinvasive disease but frank invasion was not seen. The true rate of malignant progression in untreated patients remains unclear and radical surgery is rarely indicated. All patients require long‐term follow up.
Breastfeeding patterns and return to fertility in Australian women
Authors: Gross Barbara A , Burger Henry ,   the WHO Task Force on methods for the natural regulation of fertility
Published: October 2004

ABSTRACTObjectiveThe purpose of this study was to understand the relationship between infant feeding patterns and the return of fertility during lactation.DesignMother‐infant pairs were followed up prospectively from the first week postpartum until the return of two normal menstrual bleeds (as judged by the woman) or pregnancy.SettingThis study was conducted in the Sydney and Melbourne areas of Australia, and was part of a seven‐country research project.SampleSix hundred and twenty‐four Australian mother‐infant pairs participated in the study.MethodsFollow‐up interviews occurred in the mothers' homes every two weeks. Mothers completed a daily diary record chart of vaginal bleeding and infant feeding, and completed a detailed diary card of the time and duration of breastfeeds and the frequency and nature of all other feedings once every two weeks.Main outcome measuresThe main outcomes of the study were measured as the median duration of lactational amenorrhoea and lifetable pregnancy rate during lactational amenorrhoea.ResultsThe median duration of amenorrhoea in the Australian breastfeeding women who participated in the study was over 8.5 months. Breastfeeding was shown to be an effective method of fertility control in that no non‐contracepting, sexually active, amenorrhoeic, breastfeeding woman became pregnant in the first six months after delivery. Regular supplements commenced on average at five months and the Australian women rarely introduced non‐caloric (water), caloric (juices), or milk‐based supplements before this time.ConclusionsThis confirmed the Bellagio Consensus and the effectiveness of the Lactational Amenorrhoea Method.
Intravaginal 400 μg misoprostol for pregnancy termination in cases of blighted ovum: a randomised controlled trial
Authors: Kovavisarach Ekachai , Sathapanachai Udomsak 
Published: October 2004

SUMMARYObjectiveTo investigate the effectiveness and side effects of intravaginal misoprostol 400 micrograms compared with a placebo for facilitating complete abortion in cases of blighted ovum.DesignA prospective randomised placebo‐controlled trial.SettingRajavithi Hospital, Thailand between 1 July 1998 and 31 January 1999.SampleFifty‐four pregnant women with gestations of up to 12 weeks whose diagnosis of blighted ovum had been made by transvaginal ultrasound.MethodsThe patients were assigned randomly into two equal groups; the study group received two tablets of vaginal misoprostol (200 micrograms/tablet), and the control group received two tablets of a vaginal placebo.ResultsThe complete abortion rate was significantly higher in the women receiving misoprostol (63%) compared with those receiving the placebo (18.5%) (p < 0.05). Lower abdominal pain (74.1%) and fever (14.8%) were significantly higher in the study group than in the placebo group (22.2%) and (0%) respectively, (p < 0.05).ConclusionIntravaginal 400 μg misoprostol is significantly more effective for termination of blighted ovum than placebo, but lower abdominal pain and fever are signifcantly higher in the misoprostol group.
The absence of factor V Leiden mutation in Malays with recurrent spontaneous abortions
Authors: Yusoff Narazah Mohd , Abdullah Wan Zaidah , Ghazali Selamah , Othman Mohd Shukri , Baba Abdul Aziz , Abdullah Norazmi , Isa Mohd Nizam , Chong Chan Li 
Published: October 2004

ABSTRACTObjectivesThe objectives of this study were to investigate the prevalence of factor V Leiden mutation in Malay women with recurrent spontaneous abortion and to clarify the contribution of the factor V Leiden mutation to recurrent miscarriages in these women.DesignA prospective case control study between June 1999 and April 2000.SettingHospital University Science of Malaysia, Kubang Kerian, Kelantan, and Maternal and Child Health Clinic, Pasir Mas, Kelantan, Malaysia.SamplesA total of 46 Malay women with a history of three or more first or second trimester miscarriages were studied. The control group consisted of 46 parous women without obstetric complications.MethodsDiagnosis of factor V Leiden mutation was made by examination of factor V Leiden allele product following Mnl I digestion of factor V Leiden alleles amplified by polymerase chain reaction.ResultsNone of the 46 women with recurrent spontaneous abortion carried the mutation. Also, we found no subject carrying the factor V Leiden alleles in the control group.ConclusionThese results suggest that that there is no association between the factor V Leiden mutation and recurrent spontaneous abortion in the Malay population.
The anatomy of the perineal membrane: its relationship to injury in childbirth and episiotomy
Authors: Hudson Christopher N , Sohaib Syed A , Shulver Helen M , Reznek Rodney H 
Published: October 2004

ABSTRACTBackgroundEpisiotomy during childbirth, intended to protect the anal sphincter, may fail to do so. Furthermore damage to the anal sphincter complex may occur without complete perineal tear.We hypothesise that these particular injuries may occur due to posterior displacement of the anus leading to distraction of the anal sphincter complex from an anterior attachment to the perineal membrane. However, the anatomical basis for this has not been well defined.ObjectiveTo investigate the relationship between the anal sphincter and the perineal membrane. Materials and methods High‐resolution MRI scans of a female cadaver perineum were performed. The imaging findings were correlated with the anatomical structure identified on dissection and histological examination.ResultsThe perineal membrane was easily identified on MR imaging. Fibres from the perineal membrane could be seen to attach to the anal sphincter complex at the apex of the perineal body. This was confirmed on histological examination and was a deeper layer than that of the decussation of the superficial transverse perineal muscle with the superficial part of the external anal sphincter.ConclusionThe upper ano‐rectal canal and apex of the perineal body have demonstrable attachment to the free margin of the perineal membrane postero‐lateral to the lower vagina. This attachment would resist posterior displacement of the anal canal.
A retrospective cohort study comparing microwave endometrial ablation with levonorgestrel‐releasing intrauterine device in the management of heavy menstrual bleeding
Authors: Henshaw Richard , Coyle Christy , Low Stephanie , Barry Christopher 
Published: October 2004

ABSTRACTObjectiveTo compare microwave endometrial ablation (MEATM) with a levonorgestrel‐releasing intrauterine device (Mirena®) in the management of heavy menstrual bleeding.DesignA retrospective cohort study.SampleThirty‐nine women were treated with MEATM and 23 women with Mirena®, in the South East Regional Health Service of South Australia during 1998 to 2001; the mean duration of follow‐up was 14.6 months.Main outcome measuresPrimary measures include acceptability of the treatment process, effectiveness of the treatment, and satisfaction with outcomes. Secondary measures included side effects, complications and quality of life (using the SF‐36).ResultsAcceptability of the treatment process and satisfaction with outcomes was very high for both procedures. Each treatment led to a statistically significant reduction in menstrual bleeding (p < 0.0001) and dysmenorrhoea scores (p < 0.002).ConclusionsThere were no statistical differences between the two treatments for any of the primary or secondary outcome measures assessed. The treatments seem equally effective in the management of heavy menstrual loss.
Laparoscopic diagnosis of endometriosis
Authors: Wood Carl , Kuhn Raphael , Tsaltas Jim 
Published: October 2004

ABSTRACTObjectiveTo consider and explain the possibility of difficulties in diagnosis of endometriosis at previous laparoscopy.DesignRetrospective patient record review.SettingThe Endometriosis Care Centre of Australia and the private practices of authors.SampleTwo hundred and fifteen patients with clinical evidence of endometriosis examined laparoscopically between March 1999 and May 2001.Main outcome measuresConfirmation of endometriosis by histological biopsy.ResultsEndometriosis was confirmed in 168 of the 215 women. Of these women 38 had a previous negative laparoscopy within 12 months of the current laparoscopy.ConclusionsIt is possible that in some of the patients, who previously had a negative laparoscopy, endometriosis was not recognised. Possible reasons for difficulty in diagnosis have been identified and techniques to improve diagnosis suggested.This retrospective study was performed to consider and explain the possibility of difficulties in diagnosis of endometriosis at previous laparoscopy.
Total laparoscopic hysterectomy: a new option for removal of the large myomatous uterus
Authors: O'Shea Robert T , Cook Jennifer R , Seman Elvis I 
Published: October 2004

ABSTRACTThis is the first report of a series of women who underwent total laparoscopic hysterectomy (TLH) to remove a large myomatous uterus weighing more than 390 g. The case history notes of 21 women undergoing TLH in both the private and public sectors of Flinders Endogynaecology were studied.The mean uterine weight was 534.7 g (390‐1022 g). The mean operating time was 155.0 ± 56.1 minutes and mean blood loss was 297.6 mL (50‐1000 mL). The mean hospital stay was 3.2 ± 1.0 days. The two complications were a post‐operative deep venous thrombosis (DVT) and an estimated blood loss of 1000 mL in separate cases.Total laparoscopic hysterectomy is a low morbidity procedure offering a new option for the removal of the large myomatous uterus and avoidance of abdominal hysterectomy.
Human parvovirus B19 infection in pregnancy: should screening be offered to the low‐risk population?
Authors: Fean Wong Shell , Yee Chan Fung , Cincotta Robert B , Tilse Martin 
Published: October 2004

ABSTRACTHuman parvovirus B19 infection during pregnancy can result in fetal hydrops and death. Intra‐uterine transfusion in hydropic fetuses affected by the virus can reduce perinatal deaths. Up to 33% of women with this infection are asymptomatic. In view of the significant adverse outcomes, the role of routine screening among low‐risk pregnant women is discussed.
Hypertension in pregnancy: do consensus statements make a difference?
Authors: Davis Gregory K , Homer Caroline SE , Brown Mark A 
Published: October 2004

ABSTRACTObjectives(i) To document variation in management of hypertension in pregnancy; (ii) to determine whether this variation falls within current management guidelines; and (iii) to make recommendations for developing future guidelines.DesignQuestionnaire‐based survey.SettingAustralia and New Zealand.PopulationAll specialist obstetricians.MethodsQuestionnaires were sent to 1198 obstetricians in Australia and New Zealand. Those returned by respondents currently in obstetric practice were analysed. Information was obtained on their current clinical practices relating to the diagnosis and management of hypertension in pregnancy.ResultsOf 1198 obstetricians surveyed, 973 (81%) replied. Of these, 686 (71%) were responsible for obstetric care. Considerable variation in practice was found, particularly in relation to the measurement of blood pressure, the determination of hypertension and significant proteinuria, and the decision to institute antihypertensive drug treatment. The recommendations of the Australasian 1993 Consensus Statement appeared to have had little influence. There has been a striking increase in the use of magnesium sulphate for the prevention of convulsions in preeclampsia.ConclusionsThere is significant variation in management of hypertensive pregnancies that differs from current guidelines although it is not known whether this diversity adversely affects clinical outcomes. Until further outcome evidence is available, consensus statements may be better confined to basic aspects of management for which there is high level evidence.
Evaluation of restaging in clinical stage 1A low malignant potential ovarian tumours
Authors: Land Russell , Perrin Lew , Nicklin James 
Published: October 2004

ABSTRACTObjectiveThis study was undertaken to evaluate whether restaging clinical stage 1A low malignant potential (LMP) tumours previously incompletely staged in a non‐gynaecology oncology centre yields useful information for management and prognosis.MethodsA retrospective chart review was undertaken of all patients with LMP tumours treated at the Queensland Centre for Gynaecological Cancer (QCGC) from 1982–2000.ResultsFifty‐six (69%) of the 81 patients referred with a provisional stage 1A diagnosis underwent a second operation for staging purposes. Four (7%) out of the 56 patients who underwent restaging had their tumours upstaged. A single patient out of the 25 patients who did not undergo restaging had disease recurrence and died as a result. The mean follow‐up for all patients in the study was 60 months.ConclusionIt is hard to justify routine surgical restaging for patients with a LMP ovarian tumour apparently confined to a single ovary. At the very least, hundreds of patients with clinical stage 1A tumours will need to be restaged before a single patient will have data that will change management. Consequently the morbidity of routine restaging is difficult to justify for such a small clinical gain.