bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does information provided to men before a urodynamic study affect their expectation of pain?
Authors: Greenstein Alexander , Bar‐Yosef Yuval , Chen Juza , Matzkin Haim 
Published: September 2005

OBJECTIVETo evaluate the effect of a routine explanation provided to men on their expectation of pain associated with a urodynamic study (UDS).PATIENTS AND METHODSThe purpose of UDS is to reproduce patient's symptoms during the urine storage and voiding phases, and thus understand the causes of the patient's symptoms. UDS may cause discomfort and pain, mainly from the urethral instrumentation; the fear of pain related to UDS may affect the patients’ behaviour and the information provided by them, and thus may alter the conclusions drawn from the study. Routinely as with any other invasive procedures, patients are provided with an explanation about the UDS. Sixty‐three men referred for UDS in an outpatient clinic, who had not had previous UDS, were included (mean age 56.4 years, range 25–89). Of these patients, 15 had had previous instrumentation of the urethra (urethral catheterization, cystoscopy), and 14 had had a prostatectomy. One urologist provided a detailed explanation of the different stages of the UDS. Use of an anaesthetic gel, and instrumentation of the urethra and anus by an experienced urologist, were emphasized. Pain was assessed using a visual analogue pain scale three times, to provide an expected pain score (EPS) on entering the examination room, after the explanation, and the actual pain felt during the UDS.RESULTSThe mean EPS before the explanation was 4.2, significantly higher (5.17) after the explanation (P = 0.02) and the actual pain scored during the UDS was 3.76, lower than both the previous EPS. In patients who had had previous instrumentation of the urethra, the EPS after the explanation was significantly higher, at 6.06 (P < 0.05). Pain scores were not significantly different in patients after prostatectomy.CONCLUSIONSThe routine guidance provided to male patients undergoing UDS enhances their expectations of pain, especially in those who have had previous instrumentation of the urethra. As the fear of pain may alter the information provided by the patient, different strategies of providing patients with information about UDS should be devised.
Clinical observations of the effect of antidiuretic hormone on nocturia in elderly men
Authors: Ho Dong‐Ru , Lin Wei‐Yu , Wu Ching‐Fang , Shee Jia‐Jen , Huang Yun‐Ching , Chen Chih‐Shou 
Published: September 2005

OBJECTIVETo evaluate the effect of desmopressin on nocturia, based on patients’ subjective scoring of nocturia, as desmopressin is widely used to treat nocturnal enuresis and nocturnal polyuria.PATIENTS AND METHODSWe investigated a specific subgroup of 28 men with benign prostate obstruction and nocturia who were treated with desmopressin. Patients with nocturnal polyuria were excluded. All the patients were refractory to treatment with antimuscarinics or anticholinergics, e.g. oxybutynin, tolterodine, and propantheline bromide. We assessed the effect of desmopressin using a quantitative nocturia score and analysed its synergistic effect with α‐blockers.RESULTSThe mean frequency of nocturia was 6.1 before desmopressin and most (86%) patients had an improvement in nocturia within 1–12 weeks of treatment with desmopressin. There was a 43% reduction in nocturia after using desmopressin (P < 0.001). The correlation coefficient between the number of nocturnal voids and the reduction in nocturia after treatment with desmopressin was 0.756, indicating that the more severe the nocturia, the more effective was desmopressin.CONCLUSIONSDesmopressin is effective for refractory nocturia in elderly men with no nocturnal polyuria, and has limited side‐effects.
A population‐based study of the prenatal diagnosis of congenital malformation over 16 years
Authors: Richmond Sam , Atkins John 
Published: September 2005

Objective  A population‐based study of the trends in accuracy over time of prenatal diagnosis of congenital malformations.Design  A prospective study of all congenital malformations.Setting  The counties of Cleveland, Durham, North Cumbria, Northumberland and Tyne and Wear.Population  All 573,471 babies born to residents at 24 weeks of gestation or more, and all terminations for fetal abnormality, occurring between 1985 and 2000.Methods  An analysis of all congenital anomalies whether antenatally detected or diagnosed before one year of age to examine the accuracy of prenatal diagnosis and its trends over four consecutive four‐year periods.Main outcome measures  The proportion of cases where a diagnosis before birth was correctly made, wrongly made or not made in a range of important structural malformations.Results  There was a substantial improvement in the accuracy of prenatal diagnosis of all conditions reported here. However, the extent to which different conditions were diagnosed varied widely. It now exceeds 90% for anencephaly and for abdominal wall defects but is still less than 70% for diaphragmatic hernia, bladder outlet obstruction and many major skeletal defects. Termination of pregnancy for fetal malformation rose from 23 to 47 per 10,000 registrable births.Conclusion  This large prospective study provides data on the accuracy of prenatal diagnosis of a number of malformations in a geographically defined population under service conditions. Diagnostic accuracy has improved over time but may well be lower than many clinicians assume for some important conditions and may not match public expectations.
Two‐year neurodevelopmental outcome in children conceived by intracytoplasmic sperm injection: prospective cohort study
Authors: Agarwal Pratibha , Loh Sheila Kia Ee , Lim Sok Bee , Sriram Bhavani , Daniel Mary Lourdes , Yeo Seow Heong , Heng Derrick 
Published: September 2005

Objective  Primary outcome was to compare neurodevelopmental outcome at two years in intracytoplasmic sperm injection (ICSI) conceived children versus matched controls. Secondary outcome was to determine incidence of major congenital malformations and study perinatal outcome.Design  Prospective cohort study.Setting  Tertiary care perinatal centre over a period of 13 months.Population  Seventy‐six ICSI conceived children and 261 matched controls selected by matching for maternal age, sex, date of delivery, race, plurality and parity.Methods  Mental Development Index (MDI) and Psychometric Development Index (PDI) of the Bayley's Scale of Development (BSID‐II) and Vineland Adaptive Behaviour Scale (VABS) were used to assess the neurodevelopmental and functional outcome. The congenital malformations were classified according to ICD‐9 code.Main outcome measures  Primary outcome measure—neurodevelopmental and functional outcomes. Secondary outcome measure—congenital malformations and perinatal outcomes.Results  Neurodevelopmental and functional outcome were comparable in both groups. The mean MDI score was 92 [16] versus 90 [14] in the study and control groups respectively. Fourteen (18.4%) in the ICSI group had MDI <85 compared with 87 (33%) controls (P= 0.002). On linear regression the MDI was independently affected by plurality (P= 0.001), maternal education and socio‐economic status (P= 0.01). The study group had a lower gestation (36 [3] vs 37.1 [2] weeks; P= 0.005) and a higher incidence of prematurity <34 weeks [19 (25%)] vs [31 (12%)] P= 0.012]. Six (7.9%) of the ICSI babies and seven (2.7%) of the controls had a major congenital malformation (P= 0.05).Conclusions  Children born by ICSI pregnancies did not have an adverse neurodevelopmental outcome. The incidence of major congenital malformations in ICSI needs further evaluation.
Randomised controlled trial comparing efficacy of same day administration of mifepristone and misoprostol for termination of pregnancy with the standard 36‐ to 48‐hour protocol
Authors: Guest Jacqueline , Chien Patrick , Thomson Margaret , Kosseim Marie Louise 
Published: September 2005

Hypothesis  That a 6‐hour drug administration interval has similar efficacy and greater patient satisfaction as a 36‐ to 48‐hour interval.Sample  Four hundred and fifty patients.Methods  A two‐arm parallel design unblended randomised controlled trial in a single hospital. Eligible women up to 63 days of gestation will be invited to participate. Those willing will be randomised to either the experimental group (6 hours administration of misoprostol) or the control group (36–48 hours administration of misoprostol). All participants will take 200 mg mifepristone orally. At the time determined by study group allocation 800 μg misoprostol will be given intravaginally together with 100 mg diclofenac pr. Antibiotic prophylaxis as per the usual protocol will be given to each group. The control group will remain in hospital for 6 hours as per current policy and the study group will return home in 1 to 3 hours.Main outcome measure  Complete medical abortion without need for further misoprostol or surgical evacuation.Secondary outcomes  Duration of bleeding, side effects and acceptability based on questionnaire.Funding Source  None.
Diminished pregnancy rates in endometriosis due to impaired uterotubal transport assessed by hysterosalpingoscintigraphy
Authors: Kissler S. , Hamscho N. , Zangos S. , Gätje R. , Müller A. , Rody A. , Döbert N. , Menzel C. , Grünwald F. , Siebzehnrübl E. , Kaufmann M. 
Published: September 2005

Objective  To investigate uterotubal transport by means of hysterosalpingoscintigraphy (HSSG) in women with and without endometriosis.Design  A prospective observational study.Setting  University Hospital, Department of Obstetrics and Gynaecology, Division of Reproductive Medicine and Gynaecologic Endocrinology with 350 in vitro fertilisation (IVF)/intracytoplasmic sperm injection (ICSI) cycles and 400 intrauterine insemination (IUI) cycles/year.Population  Cases included 56 infertile women with laparoscopic proven endometriosis and patent fallopian tubes. Twenty‐two women with partners suffering from male factor infertility served as controls.Methods  A diagnostic cycle incorporating HSSG was performed. Subsequently, patients underwent either four cycles of timed intercourse (TI) or IUI in order to achieve pregnancy. If pregnancy did not occur, IVF or ICSI was performed.Main outcome measures  Evaluation of uterotubal transport capacity in women with endometriosis and healthy controls.Results  Patients suffering from endometriosis (group I) showed a significant reduction in physiologic uterotubal transport function: While 20 patients (36%) had ipsi‐ or bilateral uterotubal transport, there was pathological uterotubal transport contralateral to the dominant follicle or a complete failure of transport capacity (negative HSSG) in 36 patients (64%). In the controls (group II), transport function was significantly different: 15 of 22 patients (68%) revealed ipsi‐ and bilateral tubal demonstration, while 5 patients (22%) showed contralateral transport and 2 patients (10%) showed negative HSSG (P= 0.01). Twenty‐three pregnancies were observed (pregnancy rate: 29%). Eleven out of 14 (79%) women with ipsi‐ or bilateral tubal transport function fell pregnant by means of TI or IUI. In seven of nine patients (78%) with a failure in tubal transport, pregnancy was achieved by IVF/ICSI, despite acceptable semen parameters (P= 0.01).Conclusions  Endometriosis is significantly associated with a reduction in physiologic uterotubal transport capacity compared with controls. This resulted in diminished pregnancy rates even in women with normozoospermic partners. Therefore, IVF/ICSI may be required even when fallopian tubes are patent or semen quality is normal.
Laterality in five‐year‐olds conceived by intracytoplasmic sperm injection, standard in vitro fertilisation and natural conception: a European study
Authors: Sutcliffe A.G. , Barnes J. , Wennerholm U.‐B. , Loft A. , Tarlatzis B.C. , Ponjaert‐Kristoferson I. , Bonduelle M. 
Published: September 2005

Objective  To assess laterality in a group of European children conceived with the help of assisted reproductive therapy, or naturally conceived.Design  Prospective cohort study.Setting  Five European countries.Population  A total of 1525 five‐year‐old children divided into three groups according to conception status: naturally conceived; intracytoplasmic sperm injection (ICSI); in vitro fertilisation (IVF) group.Methods  All children were assessed using the McCarthy Scale of Children's Abilities (Motor Scale) with additional items using a comb, a spoon and an indirect measure was made of the parental handedness scores, using a questionnaire.Main outcome measures  Child handedness for drawing and writing.Results  Observed handedness did not differ significantly between natural conception, IVF and ICSI in girls or boys, except for ICSI‐conceived girls, fewer of whom were left‐handed than the naturally conceived controls, 7.0%versus 12.4% (P < 0.05), however, this was close to the population norm of 8%. The degree of parental handedness did not significantly vary in the three groups.Conclusions  Laterality, as assessed by handedness, may be marginally less common in girls conceived with assisted reproductive therapies than with children conceived naturally.
The Release Trial: a randomised controlled trial of umbilical vein oxytocin versus placebo for the treatment of retained placenta
Authors: Weeks Andrew , Mirembe Florence , Alfirevic Zarko 
Published: September 2005

Hypothesis  Intraumbilical injection of oxytocin reduces the incidence of manual removal compared with placebo in the treatment of retained placenta.Entry criteria  The women recruited will be stable haemodynamically, not bleeding vaginally, over 34 weeks of gestation and with a retained placenta for at least 30 minutes.Treatment arms  Oxytocin (50 IU) or sterile water (in identical vials) in 25 mL saline injected through an intraumbilical venous catheter.Sample size  Five hundred seventy‐two women.Primary endpoint  Need for manual removal of placenta.Centres  Initially, there will be two study sites in the UK (Liverpool and Sheffield) and five in Uganda (Mulago, Nsambia, Mengo, Rubaga and Arua).Funding  World Health Organization and WellBeing of Women.
Selective feticide in complicated monochorionic twin pregnancies using ultrasound‐guided bipolar cord coagulation
Authors: Robyr Romaine , Yamamoto Masami , Ville Yves 
Published: September 2005

Objective  To review our experience with selective feticide in complicated monochorionic (MC) twin pregnancies, using ultrasound‐guided cord coagulation with a bipolar forceps.Design  Retrospective analysis.Setting  All consecutive umbilical cord coagulations performed at our institution in the second trimester of pregnancy between November 1999 and 2003.Population  Consecutive cases of complicated MC pregnancies with an indication for selective termination.Methods  Ultrasound‐guided coagulation of the umbilical cord with a 2.5‐mm bipolar forceps under local anaesthesia.Main outcome measures  Indications, gestational age at the procedure, perinatal outcome and neonatal follow up.Results  Forty‐six patients with MC twin pregnancies underwent this procedure. Indications included twin reverse arterial perfusion sequence (n= 17), severe malformation in one twin (n= 7) and agonal presentation or cerebral anomalies of one twin in twin‐to‐twin transfusion syndrome (TTTS) after laser treatment or serial amniodrainage (n= 22). The procedure resulted in six intrauterine fetal demise (IUFD, 13%), with a rate of 41% and 3% when performed at 16–17 weeks or later, respectively (Fisher P= 0.002). Preterm rupture of the membranes (PROM) before 28 weeks and between 28 and 34 weeks occurred in 9% and 14% of the cases, respectively. All neonatal deaths (four) occurred in cases with PROM at 28 weeks or earlier. Paediatric follow up showed that all infants discharged alive but one were neurologically normal at 3–42 months, which corresponds to 70% of the 46 cases.Conclusions  This technique is effective when the natural history is likely to severely affect the development of the normal co‐twin. The overall intact survival rate was 70% and our results support justification of later surgery. Prematurity remains a significant complication of the procedure.
The temperature dependence and involvement of mitochondria permeability transition and caspase activation in damage to organotypic hippocampal slices following in vitro ischemia
Authors: Rytter Anna , Cardoso Carla M. P. , Johansson Petra , Cronberg Tobias , Hansson Magnus J. , Mattiasson Gustav , Elmér Eskil , Wieloch Tadeusz 
Published: September 2005

AbstractThe aggravating effect of hyperglycemia on ischemic brain injury can be mimicked in a model of in vitro ischemia (IVI) using murine hippocampal slice cultures. Using this model, we found that the damage in the CA1 region following IVI in the absence or presence of 40 mm glucose (hyperglycemia) is highly temperature dependent. Decreasing the temperature from 35 to 31°C during IVI prevented cell death, whereas increasing the temperature by 2°C markedly aggravated damage. As blockade of the mitochondrial permeability transition (MPT) is equally effective as hypothermia in preventing ischemic cell death in vivo, we investigated whether inhibition of MPT or of caspases was protective following IVI. In the absence of glucose, the MPT blockers cyclosporin A and MeIle4‐CsA but not the immunosuppressive compound FK506 diminished cell death. In contrast, following hyperglycemic IVI, MPT blockade was ineffective. Also, the pan‐caspase inhibitor Boc‐Asp(OMe)fluoromethyl ketone did not decrease cell death in the CA1 region following IVI or hyperglycemic IVI. We conclude that cell death in the CA1 region of organotypic murine hippocampal slices following IVI is highly temperature dependent and involves MPT. In contrast, cell death following hyperglycemic IVI, although completely prevented by hypothermia, is not mediated by mechanisms that involve MPT or caspase activation.
Inflammatory neurodegeneration induced by lipoteichoic acid from Staphylococcus aureus is mediated by glia activation, nitrosative and oxidative stress, and caspase activation
Authors: Kinsner Agnieszka , Pilotto Valentina , Deininger Susanne , Brown Guy C. , Coecke Sandra , Hartung Thomas , Bal‐Price Anna 
Published: September 2005

AbstractIn this study we investigated the mechanisms of neuronal cell death induced by lipoteichoic acid (LTA) and muramyl dipeptide (MDP) from Gram‐positive bacterial cell walls using primary cultures of rat cerebellum granule cells (CGCs) and rat cortical glial cells (astrocytes and microglia). LTA (± MDP) from Staphylococcus aureus induced a strong inflammatory response of both types of glial cells (release of interleukin‐1β, tumour necrosis factor‐α and nitric oxide). The death of CGCs was caused by activated glia because in the absence of glia (treatment with 7.5 µm cytosine‐d‐arabinoside to inhibit non‐neuronal cell proliferation) LTA + MDP did not cause significant cell death (less than 20%). In addition, staining with rhodamine‐labelled LTA confirmed that LTA was bound only to microglia and astrocytes (not neurones). Neuronal cell death induced by LTA (± MDP)‐activated glia was partially blocked by an inducible nitric oxide synthase inhibitor (1400 W; 100 µm), and completely blocked by a superoxide dismutase mimetic [manganese (III) tetrakis (4‐benzoic acid)porphyrin chloride; 50 µm] and a peroxynitrite scavenger [5,10,15,20‐tetrakis (4‐sulfonatophenyl) porphyrinato iron (III); 100 µm] suggesting that nitric oxide and peroxynitrite contributed to LTA‐induced cell death. Moreover, neuronal cell death was inhibited by selective inhibitors of caspase‐3 (z‐DEVD‐fmk; 50 µm) and caspase‐8 (z‐Ile‐Glu(O‐Me)‐Thr‐Asp(O‐Me) fluoromethyl ketone; 50 µm) indicating that they were involved in LTA‐induced neuronal cell death.
Program Report: GENECOUNTING Support Programs
Authors: Curtis D. , Knight J. , Sham P. C. 
Published: September 2005

AbstractWe describe a suite of programs which enhance the usability of GENECOUNTING, a program for estimating haplotype frequencies in unrelated subjects. The programs, called RUNGC, SCANASSOC, COMPGR, SCANGROUP and LDPAIRS, carry out likelihood ratio tests and permutation tests to detect differences in haplotype frequencies between cases and controls,or between predefined groups, and output likely haplotype assignments and tables of linkage disequilibrium statistics between all pairs of markers in a dataset.
Age of First Faint in Patients with Vasovagal Syncope
Authors: SHELDON ROBERT S. , SHELDON AARON G. , CONNOLLY STUART J. , MORILLO CARLOS A. , KLINGENHEBEN THOMAS , KRAHN ANDREW D. , KOSHMAN MARY‐LOU , RITCHIE DEBBIE ,   for the Investigators of the Syncope Symptom Study and the Prevention of Syncope Trial
Published: September 2005

Introduction: Understanding whether vasovagal syncope is a lifelong disorder might shed insight into its physiology and affect management strategies. Accordingly, we determined the age of the first syncopal spell in adult patients who sought care for syncope. Methods and Results: Patients were 42 ± 18 years old with 64% women. They had had a median 8 syncope spells (interquartile range [IQR]: 4, 20) with a median frequency of 1.0 syncopal spells per year. The range of syncopal spells was 1–3,375, and the range of duration of history of syncope was 0.003–70 years. The first syncopal spell occurred at ages 0–81 in a skewed distribution, with a marked mode age of 13 years, a median age of 18 years (IQR 12, 37), and a mean age of 26 ± 20 years. The distributions were statistically indistinguishable across countries (P = 0.50), among Canadian regions (P = 0.69), and between the studies (P = 0.49). The same modal values were seen in males and females, and in patients <40 and ≥40 years old. However, patients ≥40 years had median ages of onset older than patients <40 years (36 ± 23 vs 17 ± 8 years). Patients had a recalled history of syncopal spells of median duration of 10 years (IQR: 2, 23), with a range of 0.003–70 years. An age of onset <44 years was 86% accurate for vasovagal syncope. Conclusion: The most common age at which vasovagal syncope first presents is 13 years, and patients remain at risk of syncope for many years. Lifelong coping strategies may be desirable.
The Impact of Cardiac Resynchronization Therapy on Ventricular Tachycardia/Fibrillation: An Analysis from the Combined Contak‐CD and InSync‐ICD Studies
Authors: McSWAIN ROBERT L. , SCHWARTZ ROBERT A. , DeLURGIO DAVID B. , MERA FERNANDO V. , LANGBERG JONATHAN J. , LEÓN ANGEL R. 
Published: September 2005

Objectives: To determine the potential influence of cardiac resynchronization therapy (CRT) on the frequency and types of ventricular arrhythmia (VA) in patients with an indication for the implantable cardioverter‐defibrillator (ICD), we performed a retrospective electrogram (EGM) analysis of stored VA events from the two largest CRT‐ICD trials. Background: Previous reports suggest that CRT might promote polymorphic VT (PVT), while a beneficial effect of CRT on ventricular function might reduce the frequency of monomorphic VT (MVT). Theoretically, a balanced effect produces no change in overall VA. Methods: We analyzed stored EGMs from patients in the Contak‐CD and Insync‐ICD studies receiving appropriate therapy for VA. EGM inspection distinguishes MVT and PVT using morphologic criteria rather than cycle length classification alone. Results: Of 1,041 subjects entering the two trials, 880 were randomized CRT (N = 439) or control (N = 441). We were able to analyze 840 EGMs in 150 patients with VA, including 678 MVT episodes and 162 PVT episodes. These events were distributed among 68 patients with active CRT (390 MVT vs 111 PVT) and 82 patients assigned to control (288 MVT compared to 51 PVT). The apparent increase in PVT episodes in the CRT group is not significant and can be explained by a disproportionate number of episodes in a few patients. We were unable to identify clinical variables predictive of PVT during CRT. Conclusions: CRT is not associated with a measurable increase in the incidence of PVT, or in a reduction in MVT in the combined InSync‐ICD and Contak‐CD populations.