bluuebunny/crossref_metadata_2025_split huggingface dataset:
Management and outcome of pregnancy in women with thrombophylic disorders and past cerebrovascular events
Authors: Soriano David , Carp Howard , Seidman Daniel S. , Schiff Eyal , Langevitz Pnina , Mashiach Shlomo , Dulitzky Motti 
Published: March 2003

Objective. To evaluate the maternal and fetal outcome in a cohort of women undergoing a subsequent pregnancy after a previous cerebrovascular event in the presence of thrombophilia.Patients. Fifteen pregnancies were followed up in 12 women with past cerebrovascular events and thrombophilic disorders. The cerebrovascular events occurred during a previous pregnancy in five patients. Six patients had a bad obstetric history including intrauterine fetal death in four cases, early onset of severe preeclampsia in two cases and one infant that was small for gestational age.The thrombophilic disorders included: anti–phospholipid syndrome, protein C, S or antithrombin III deficiencies, mutations of the methyltetrahydrofolate reductase (MTHFR). All patients received prophylactic treatment with low molecular weight heparin and low dose aspirin.Results. Thromboembolic complications occurred in four pregnancies. Postpartum complications occurred in one patient; deep vein thrombosis and pulmonary emboli after stopping anticoagulation treatment. No patient had long‐term neurologic damage. All pregnancies except one resulted in live births. (mean gestational age at delivery 36 ± 3. 7 weeks, mean birth weight 2656 ± 811 g). The one remaining pregnancy was electively terminated. There was one neonatal death due to the complications of severe prematurity in a woman with severe HELLP syndrome.Conclusion. This preliminary data suggests that women with a history of cerebrovascular events and thrombophilic disorders receiving prophylactic treatment, have a relatively favorable pregnancy outcome, however, they remain at significant risk during pregnancy further studies are necessary to determine the optimal prophylactic treatment.
Ovarian carcinoma associated with pregnancy. A review of 9 cases
Authors: Sayedur Rahman Mohammad , Al‐Sibai Mohammad Hisham , Rahman Jessica , Al‐Suleiman Suleiman Awdah , El‐Yahia Abdul Rahman , Al‐Mulhim Abdul Aziz , Al‐Jama Fathia 
Published: March 2003

Background. The purpose of this study was to review patients with ovarian cancer in pregnancy, the effectiveness of the available methods of treatment and their prognosis.Methods. A retrospective review of all women diagnosed to have cancer of the ovary associated with pregnancy who delivered at the authors' hospitals between January 1976 and December 2000. The demography, clinical presentation, time and mode of diagnosis, treatment, pregnancy outcome and maternal survival were noted.Results. The incidence of ovarian carcinoma in pregnancy in the series was 0.08/1000 deliveries. Of the 9 patients, 7 had epithelial cancers; 4 serous cystadenocarcinoma, 2 mucinous cystadenocarcinomas and one undifferentiated cancer. One patient each had dysgerminoma and granulosa cell tumor. Six patients were in FIGO stage Ia, one Ic, one IIa. One patient was in stage III. Five patients were treated by unilateral salpingo‐oophorectomy during pregnancy. Three patients had total abdominal hysterectomy, bilateral salpingo‐oophorectomy and omentectomy followed by chemotherapy. Debulking of the tumor was done in a patient in stage III with subsequent chemotherapy. This patient died 13 months from the time of diagnosis of the tumor. The overall 5‐year survival rate in the series was 78% and 100% for stage Ia.Conclusions. Association of ovarian cancer with pregnancy is a rare occurrence. Early diagnosis and appropriate treatment offers the best prognosis for the patient. The higher survival rates in the series was attributed to a larger number of patients in stage I of the disease and 2 patients with a germ cell tumor and dysgerminoma which have the best prognosis. Aggressive postoperative chemotherapy also contributed to the better outcome.
Pregnancy and the Ehlers–Danlos syndrome: a retrospective study in a Dutch population
Authors: Lind Jan , Wallenburg Henk C. S. 
Published: March 2003

Background.  The study was carried out to assess the course and outcome of pregnancies in women with the Ehlers–Danlos syndrome, with the aim of developing guidelines for assessment of risk and counseling, and for providing optimum medical and obstetric care.Methods.  A retrospective study based on data collected from members of the Dutch Association of Ehlers–Danlos patients. Pregnancies and neonatal outcomes of the affected mothers were compared with those of the nonaffected mothers who delivered an infant with Ehlers–Danlos syndrome.Results.  In a group of 46 women with Ehlers–Danlos syndrome, 128 pregnancies beyond 24 weeks gestation were evaluated and compared with 43 pregnancies of 33 nonaffected women. The main maternal complications consisted of pelvic pain and instability (26% vs. 7%). One bowel rupture was reported in a woman with Ehlers–Danlos syndrome type IV. Preterm delivery occurred in 21% of the affected mothers compared with 40% of the nonaffected women with an affected infant; the women with Ehlers–Danlos syndrome experienced postpartum hemorrhage (19% vs. 7%) and complicated perineal wounds (8% vs. 0%) more often than the unaffected women. The floppy infant syndrome was diagnosed in 13% of the affected infants and did not occur in the nonaffected neonates.Conclusion.  Pregnancy is generally well‐tolerated in women with Ehlers–Danlos syndrome, with favorable maternal and neonatal outcomes. In Ehlers–Danlos syndrome type IV it may be associated with severe maternal complications. Preconceptional counseling concerning specific possible complications and a multidisciplinary approach are recommended.
Short‐term complications after surgically induced abortions: a register‐based study of 56 117 abortions
Authors: Zhou Weijin , Nielsen Gunnar Lauge , Møller Margrethe , Olsen Jørn 
Published: March 2003

Background.  Performing an induced abortion is a rather simple medical procedure which is frequently done and side‐effects will have public health implications unless they are very rare. We estimated the incidence of side‐effects detected during the stay at the hospital and 2 weeks after the discharge. We only include side‐effects reported by clinics or hospitals.Methods.  Altogether 56 117 induced abortions performed by public hospitals in Denmark from 1980 to 1994 were analyzed in this study. The study combined results from the mandatory reporting of side‐effects to the National Induced Abortion Registry and all diagnoses reported to the Hospital Discharge Registry.Results.  Side‐effects in the form of bleeding, infections or re‐evacuation were recorded for about 5%. We found more side‐effects in teenage women and for abortions performed late in pregnancy. We found nothing to indicate that the frequency of side‐effects following an abortion changed over time.Conclusions.  About 5% have side‐effects registered by hospitals following an induced abortion. The long‐term consequences of this are not known.
Is mid‐trimester maternal serum inhibin‐A a marker of preeclampsia or intrauterine growth restriction?
Authors: D'Anna Rosario , Baviera Giovanni , Corrado Francesco , Leonardi Iolanda , Buemi Michele , Jasonni Valerio M. 
Published: March 2003

Background. To evaluate maternal serum Multiple of Median inhibin‐A in mid‐trimester blood samples of women who subsequently developed preeclampsia, gestational hypertension and intrauterine growth restriction and controls. Also, to verify whether this marker is related to these pathological conditions.Methods. Retrospective analysis of serum samples from a bank of stored serum, originally taken for Down's syndrome screening over 15–18 weeks, was performed. The sample consisted of 20 patients with gestational hypertension, 20 patients with preeclampsia, 10 patients with intrauterine growth restriction and 40 controls.Results. No statistically significant difference of inhibin‐A Multiple of Median values between the control group and the preeclamptic or gestational hypertension groups was found. There was a statistically significant elevation in the intrauterine growth restriction group in comparison with the control group, and the same was true for each subgroup of gestational hypertension and preeclampsia complicated by intrauterine growth restriction.Conclusion. Elevated maternal inhibin‐A concentrations in the second trimester are strongly associated with intrauterine growth restriction and not with preeclampsia, as previously stated.
Menopause, energy expenditure, and body composition
Authors: Poehlman Eric T. 
Published: March 2003

Objectives.The effects of menopause transition on metabolic and cardiovascular disease risk in women are unclear. It is unknown whether estrogen deficiency, aging, or a combination of both factors are independent contributors to a worsening health profile in women. We considered the effects of menopause transition and hormone replacement therapy on body composition, regional body fat, energy expenditure, and insulin sensitivity.Methods.A brief review of current literature that has considered the role of menopause transition and hormone replacement therapy on body composition, energy expenditure, and insulin sensitivity with an emphasis on longitudinal investigations.Results.Preliminary evidence suggests that natural menopause is associated with reduced energy expenditure during rest and physical activity, an accelerated loss of fat‐free mass, and increased central adiposity and fasting insulin levels. Hormone replacement therapy has been shown to attenuate these changes. Longitudinal and longer intervention studies are needed to confirm these initial findings.Conclusions.Menopause transition may represent a risky period in a woman's life, ‘triggering’ adverse metabolic and cardiovascular processes that predispose women to a greater incidence of obesity‐related comorbidities. Dietary, exercise, and hormonal interventions specifically targeted at premenopausal women may help mitigate the worsening cardiovascular and metabolic risk profile associated with menopause.
Prevalence and outcome of pregnancies in Norwegian and Swedish women with cystic fibrosis
Authors: ØDegaard Inger , Stray‐Pedersen Babill , Hallberg Karin , Haanaes Ole Christen , Storrøsten Olav Trond , Johannesson Marie 
Published: March 2003

Background:  As patients with cystic fibrosis now live longer, more women with cystic fibrosis wish to become mothers. We looked at the prevalence and outcome of pregnancies in women with cystic fibrosis who were alive in Norway and Sweden in the year 2000.Methods:  Women with cystic fibrosis aged 18 years and older attending cystic fibrosis centers in Norway and Sweden were included in the study. Information was obtained from medical records, interviews and questionnaires.Results:  One hundred and thirty‐two women with cystic fibrosis were included. Sixty‐one (46%) had considered or were now considering pregnancy. Forty‐six (75%) of these 61 women had already conceived. Eighty pregnancies were reported, including 12 (15%) conceived by assisted reproductive techniques. There were eight (10%) induced abortions, 11 (14%) miscarriages, and one extrauterine pregnancy. The remaining 60 (75%) pregnancies resulted in live born infants.Conclusions:  Today women with cystic fibrosis have a better chance of getting pregnant than previously reported. In this study, 75% of those who wanted to get pregnant had succeeded. Fifteen percent of pregnancies were conceived by artificial reproductive techniques. The possibility of motherhood must be considered in these patients. It is important to plan pregnancies with optimal follow up by a cystic fibrosis team.
Deliveries in maternity homes in Norway: results from a 2‐year prospective study
Authors: Schmidt Nina , Abelsen Birgit , ØIan Pål 
Published: March 2003

Background.  The study aims to report the short‐term outcome for the mothers and newborns for all pregnancies accepted for birth at maternity homes in Norway.Methods.  A 2‐year prospective study of all mothers in labor in maternity homes, i.e. all births including women and newborns transferred to hospital intra partum or the first week post partum.Results.  The study included 1275 women who started labor in the maternity homes in Norway; 1% of all births in Norway during this period. Of those who started labor in a maternity home, 1217 (95.5%) also delivered there while 58 (4.5%) women were transferred to hospital during labor. In the post partum period there were 57 (4.7%) transferrals of mother and baby. Nine women had a vacuum extraction, one had a forceps and three had a vaginal breech (1.1% operative vaginal births in the maternity homes). Five babies (0.4%) had an Apgar score below 7 at 5 min. There were two (0.2%) neonatal deaths; both babies were born with a serious group B streptococcal infection.Conclusion.  Midwives and general practitioners working in the districts can identify a low‐risk population (estimated at 35%) of all pregnant women in the catchment areas who can deliver safely at the maternity homes in Norway. Only 4.5% of those who started labor in the maternity homes had to be transferred to hospital during labor.
Initiation of lactation in women after preterm delivery
Authors: Cregan Mark D. , De Mello Thalles R. , Kershaw Daphne , McDougall Kate , Hartmann Peter E. 
Published: March 2003

Background.  Lactogenesis II describes the onset of copious milk secretion, and the success of lactogenesis II has been determined in women by measuring the changes in the composition of mammary secretion in the immediate postpartum period.Aim and methods.  Therefore, the aim of this study was to determine the success of lactogenesis II at day 5 postpartum in women expressing milk for their preterm infants (n = 22) by measuring the lactogenesis II markers (milk citrate, lactose, sodium and total protein) and comparing them with women breastfeeding full‐term infants (n = 16).Results.  There were no significant differences between the means (± SD) of the lactogenesis II markers for preterm (4.3 ± 0.7 mM; 147 ± 10 mM; 12 ± 6 mM; 14.0 ± 1.5 g/l, respectively) and term (3.4 ± 1.4 mM; 126 ± 17 mM; 30 ± 13 mM; 15.3 ± 2.5 g/l, respectively) women. However, variation about the mean was greater in preterm women (coefficient of variation for citrate, 40%; lactose, 14%; sodium, 42%; and total protein, 17%) compared with term women (17%, 7%, 33%, and 10%, respectively). All lactogenesis II markers were within 3 SD from the means for the term women and thus these women were considered to have successfully initiated their lactation. Only 18% of preterm women had all four lactogenesis II markers within 3 SD from the mean for term women. The remaining 82% of preterm women had at least one of the markers of lactogenesis II at pre‐initiation concentrations (36% had 1 marker, 32% had 2 markers, and 14% had 3 markers). Furthermore, these women had significantly lower 24‐hr milk production than those preterm women that had all four markers within 3 SD from the mean of the term women.Conclusions.  It was concluded that 82% of preterm women had a compromised initiation of lactation, and this was not uniform in all women.
Uveitis in children: Population‐based study in Finland
Authors: Päivönsalo‐Hietanen Taina , Tuominen Juhani , Matti Saari K. 
Published: March 2003

ABSTRACT.Purpose: To investigate the incidence and prevalence rates of different types of uveitis in children, and to compare them with the rates in adults.Subjects and methods: For this population‐based retrospective study the medical records of all residents of the district of Turku University Hospital with a diagnosis of uveitis seen at the Eye Clinic of Turku University Hospital during the years 1980–1982 and 1988 were reviewed.Results: A total of 1122 uveitis cases were identified, and 55 (4.9%) of them were children under 16 years. The incidence per 100 000 population per year for all uveitis cases in children was 4.3 (95% confidence interval [CI], 2.2 to 6.4), and the prevalence was 27.9 (95% CI, 17.1 to 38.6), which was significantly lower compared with the rates in adults (p=0.001 for incidence and prevalence). The vast majority of children, 50 (90.9%), had anterior uveitis (AU), and the incidence and prevalence rates of AU were significantly lower than in adults (p=0.001 for incidence and prevalence). Three (5.5%) children had posterior uveitis (PU), but there was no significant difference in the incidence and only marginally significant difference in the prevalence rate of PU in children compared with the rates in adults (p=0.33 for incidence, and p=0.07 for prevalence). Only one case (1.8%) was found with intermediate and one with panuveitis, but no new cases. The commonest diagnostic groups in children were AU associated with juvenile rheumatoid arthritis, idiopathic acute anterior uveitis, and idiopathic chronic anterior uveitis. Toxoplasmic retinochoroiditis was found in all of the PU cases with the incidence 0.3, and the prevalence 1.1, which did not differ significantly from the rates in adults (p=1.0 for incidence, and p=0.48 for prevalence).Conclusion: Uveitis is rarer in children than in adults. However, in contrast to studies from tertiary referral centers, the distribution of different forms of uveitis in children in this population‐based study seems to resemble the distribution in adults.
Foveal haemorrhages in diabetic retinopathy. Clinical characteristics and visual outcome
Authors: Lahrmann Christian , Bek Toke 
Published: March 2003

ABSTRACT.Background: Haemorrhages from retinal vessels is one of the major clinical characteristics of diabetic retinopathy. Vitreous haemorrhages from retinal neovascularizations may extend to the visual axis and disturb central vision, whereas asymptomatic intraretinal haemorrhages may develop from ruptures of smaller retinal vessels. On rare occasions, however, smaller intraretinal haemorrhages may develop in the fovea, and consequently lead to a reduction in central vision. The clinical characteristics and visual outcome of these lesions have not been described in detail.Methods: Clinical data of 4724 diabetic patients (31.4% with type 1 diabetes and 68.6% with type 2 or other diabetes types) examined in the screening clinic for diabetic retinopathy at the Department of Ophthalmology, Århus University Hospital, 1993–1998 were reviewed. Patients who had had a previous foveal haemorrhage were subjected to a full ophthalmological reexamination.Results: Six eyes of six patients with type 1 diabetes had previously had a foveal haemorrhage. The lesion had resulted in a visual reduction of on the average 1.4 visual acuity steps (SD=0.5, range:1–2, n=5), and resolution of the lesion was accompanied by an increase in visual acuity of on the average 1.2 visual acuity steps (SD=0.4, range: 1–2, n=6). Four of the patients had progressed to proliferative diabetic retinopathy and had received pan‐retinal photocoagulation.Conclusions: Foveal haemorrhages in diabetic retinopathy are accompanied by a mild and transient reduction in central vision. The lesions predominate in patients with type 1 diabetes of long duration, and may indicate that retinopathy has developed into a moderate or severe stage.
Efficacy of fluconazole and liposome entrapped fluconazole for C. albicans induced experimental mycotic endophthalmitis in rabbit eyes
Authors: Gupta Suresh K. , Dhingra Narendra , Velpandian Thirumurthy , Jaiswal Jagdish 
Published: March 2003

ABSTRACT.Purpose: To study the efficacy of intravitreally injected plain and liposome encapsulated fluconazole in the doses of 100 and 200 Ψg in Candidal endophthalmitis in rabbit eyes.Method: Endophthalmitis was induced by injecting Candida albicans (1000 CFU/0.1 ml). Seventy two hours after inoculation, plain and liposome encapsulated fluconazole (REVs) were injected. At day 16 sterility was studied using vitreous culture.Results: In the 100 & 200 Ψg plain fluconazole group, vitreous sterility was seen in 62.5% and 75%, respectively. In the liposome entrapped fluconazole a culture sterility of 25% and 50% for 100 Ψg and 200 Ψg, respectively, was seen.Conclusion: Plain fluconazole in the dose of 100 and 200 Ψg was equally effective against Candidal endophthalmitis in rabbits, but a failure of 25–37.5% of the eyes to respond, discourages one from using fluconazole as a sole therapy. Liposome entrapped fluconazole was found to be inferior to plain fluconazole in this model.
Palpebral myiasis in a Danish traveler caused by the human bot‐fly (Dermatobia hominis)
Authors: Bangsgaard Regitze , Holst Bengt , Krogh Erik , Heegaard Steffen 
Published: March 2003

ABSTRACT.Purpose: To demonstrate a case of palpebral myiasis caused by Dermatobia hominis in a Dane traveling in the Brazilian rain forest.Methods: Surgical removal and histological examination.Results: Within three weeks after returning from the Brazilian rain forest, the patient developed a localized swelling of the left upper eyelid and follicular conjunctivitis. A funnel containing a larva was found between the cilia. The larva was excised together with surrounding inflammatory tissue.The clinical findings as well as zoological and pathological examinations indicated a case of palpebral myiasis caused by Dermatobia hominis.The larva was removed in its third stage four weeks from symptom debut.Conclusions: Infestation with Dermatobia hominis should be suspected when itching and red swelling of the lid are present in patients who have been to Central and South America.
Allergic Conjunctivitis and Contact Lenses: Experience with Olopatadine Hydrochloride 0.1% Therapy
Authors: Brodsky M. 
Published: March 2003

ABSTRACT.Objective: The efficacy of Patanol®, a topically applied anti‐allergic agent, was evaluated in a group of patients with allergic conjunctivitis due to contact lens wear (GROUP I) and a group comprised of seasonal allergic conjunctivitis patients, vernal conjunctivitis patients and atopic keratoconjunctivitis patients (GROUP II).Methods: One drop of Patanol® was administered to each eye twice daily. Signs and symptoms were assessed 7, 14, and 28 days after initiation of drug therapy.Results: Itching/burning, tearing, hyperemia and papillary reaction were reduced to scores of 0/1 (absent/mild) in 85%, 90%, 81% and 62%, respectively, of GROUP I patients at Day 28. The allergic conditions in GROUP II patients also improved with Patanol® treatment. Itching/burning, tearing, hyperemia and papillary reactions were absent/mild in 60%, 76%, 96% and 90%, respectively, of these patients at Day 28.Conclusion: Patanol® treatment effectively and rapidly alleviated the signs and symptoms of allergic conjunctivitis due to contact lens wear as well as vernal conjunctivitis, atopic keratoconjunctivitis and the common seasonal allergic conjunctivitis. Patanol® allowed allergic patients to be more comfortable while permitting them to continue using contact lenses.
Latent proliferative sickle cell retinopathy in sickle cell trait
Authors: Mehta J. S. , Whittaker K. W. , Tsaloumas M. D. 
Published: March 2003

ABSTRACT. Purpose: To describe a patient with sickle cell trait who developed latent proliferative sickle cell retinopathy after mild blunt trauma.Method: Case Report. A 20‐year‐old man with unilateral Stage 3 sickle retinopathy associated with an ischaemic ridge presenting three years after the initial mild blunt ocular trauma.Results: Fundus examination of the left eye showed an ischaemic ridge delineating avascular from vascular retina. Fluorescein angiography of the left eye showed an avascular peripheral retina and multiple sea fan neovascularization. Blood studies showed him to be Hb AS.Conclusions: In our patient the proliferative changes were the result of his initial mild trauma associated with an increase in the intraocular pressure. The latent development of the sea‐fan neovascularization associated with an ischaemic ridge is unusual. Advice about potential complications to patients with Hb AS after ocular trauma is advocated.