bluuebunny/crossref_metadata_2025_split huggingface dataset:
A customised birthweight centile calculator developed for a New Zealand population
Authors: McCOWAN Lesley , STEWART Alistair W. , FRANCIS Andre , GARDOSI Jason 
Published: September 2004

AbstractBackground:  Traditionally, small for gestational age is defined as birthweight <10th percentile using sex‐adjusted centile charts. However, this criterion includes constitutional variation due to maternal height, weight, ethnic group and parity.Aims:  To develop customised birthweight centiles for a New Zealand population.Methods:  National Women's Hospital database of births from 1993 to 2000 was used to identify eligible women with singleton pregnancies who had data available on the following: scan result for dating at gestation <24 weeks, maternal height and weight at booking, parity and ethnic origin. Multiple regression was used to determine the coefficients applicable to New Zealand.Results:  A total of 4707 pregnancies met the inclusion criteria comprising: European 1688 (36.0%), Maori 419 (8.9%) Samoan 506 (10.7%), Tongan 326 (6.9%), Chinese 751 (16.0%), Indian 214 (4.6%) and other 803 (17.1%). Mean term birthweight for an average nulliparous European woman was 3530 g. Babies of Maori and Indian ethnicity were on average 67 g and 150 g lighter, respectively, than European babies. Samoan, Tongan and Chinese babies were 84 g, 124 g and 101 g heavier, respectively.Conclusions:  There are significant differences in birthweight between European and the other major ethnic groups in New Zealand. They relate to maternal physiological variables, for which coefficients have been derived and incorporated into freely available software that enables improved clinical assessment of fetal and neonatal weight.
Term birthweight centiles for babies from New Zealand's main ethnic groups
Authors: McCOWAN Lesley , STEWART Alistair W. 
Published: September 2004

AbstractBackground:  There are significant differences in mean birthweights between New Zealand's main ethnic groups. Birthweight centiles developed predominantly from babies of European ethnicity may therefore not be appropriate to classify babies from other ethnic groups.Aims:  To develop ethnic specific birthweight centiles for New Zealand babies delivered at term (>37 weeks).Methods:  Births from the National Women's Hospital database from 1993 to 2000 who also had scan data at <24 weeks comprised the study population (n = 10 292). Multiple pregnancies, fetal abnormalities, stillbirths and preterm births were excluded. For six ethnic groupings, born at gestational weeks from 38 to 41, sex specific centiles were generated and smoothed.Results:  Birthweight centiles were constructed from 5203 European, 801 Maori, 825 Samoan, 577 Tongan, 1058 Chinese, 433 Indian and 1395 other ethnic group births. Mean birthweights by ethnic group were: European 3521 g, Maori 3467 g, Samoan 3691 g, Tongan 3791 g, Chinese 3418 g, Indian 3192 g and other 3466 g. Tongan and Samoan babies were significantly heavier and Indian babies were significantly lighter than babies from all other ethnic groups (P < 0.001 for all comparisons). Overall Maori babies were approximately 50 g lighter than European babies but this difference was not statistically significant (P = 0.08), whereas Chinese babies were significantly lighter with a mean birthweight 100 g less than European (P < 0.001).Conclusions:  These ethnic specific centile charts are likely to identify term babies with inappropriate growth better than population centiles generated predominantly from one ethnic group.
Clinical utility of magnetic resonance imaging and the preoperative identification of low risk endometrial cancer
Authors: LOSCO Giovanni , SYKES Peter , ANDERSON Nigel , ROBERTS Hugh , FULTON James , FRASER Hamish 
Published: September 2004

AbstractBackground:  Magnetic resonance imaging (MRI) is reported to offer the best imaging of local disease in endometrial cancer. We audited MRI scans to identify their clinical utility, particularly in the preoperative identification of ‘low risk’ endometrial cancer (grade one or two endometrioid tumours confined to the inner half of the myometrium).Aim:  To correlate histological and MRI findings and to establish our ability to preoperatively identify women with ‘low risk’ tumours.Study design:  A retrospective audit of MRI scans in women with a new diagnosis of endometrial cancer from July 1998 to November 2002. Radiology and pathology reports and surgical staging data were extracted. Independently a team of radiologists reviewed MRI films and the findings were compared to pathology.Results:  Thirty‐nine patients were included. Only 10% of original reports contained all the clinically relevant information. On review, the sensitivity for the detection of myometrial invasion was 90%, specificity 71%, positive predictive value (PPV) 93% and negative predictive value (NPV) 63%. For the detection of deep invasion, sensitivity was 56%, specificity 77%, PPV 64% and NPV 71%. All women with grade one or two tumours having no invasion or grade one having superficial invasion detected on MRI had pathological ‘low risk’ disease.Conclusions:  Magnetic resonance imaging scans as reported offered limited clinical benefit. Attention needs to be given to MRI sequencing and reporting protocols. If the review results can be confirmed by prospective studies, MRI offers significant clinical utility in the identification of low risk patients and their surgical treatment planning.
Association of pre‐eclampsia with hyperhomocysteinaemia and methylenetetrahydrofolate reductase gene C677T polymorphism in a Turkish population
Authors: YILMAZ Hülya , ÜNLÜÇERÇI Yesim , GÜRDÖL Figen , ISBILEN Elif , ISBIR Turgay 
Published: September 2004

AbstractBackground:  Hyperhomocysteinaemia is a common finding in a wide variety of pathological conditions that exhibit endothelial disturbances. In the pathogenesis of pre‐eclampsia, endothelial cell activation or dysfunction has been proposed as a central feature, and the presence of hyperhomocysteinaemia in varying degrees has been detected. One of the known causes of hyperhomocysteinaemia is polymorphism in the methylenetetrahydrofolate reductase gene that lowers the activity of the enzyme.Aims:  In the current study, we measured plasma homocysteine concentrations in pre‐eclamptic pregnants, and searched for the altered methylenetetrahydrofolate reductase (MTHFR) gene in which the cytosine 677 was replaced by the thymine (C677T polymorphism).Methods:  The study groups consisted of 64 pre‐eclamptic and 47 normotensive healthy pregnant women in their third trimester. The C677T transition in the MTHFR gene was detected by HinfI restriction enzyme analysis and subsequent electrophoresis in a 3% agarose gel. Total homocysteine concentrations were measured by high performance liquid chromatography.Results:  The prevalence of the homozygous mutant thymine‐thymine genotype was non‐significant in the pre‐eclamptic group. Total homocysteine in the plasma of pre‐eclamptic women was found to be increased in comparison with healthy pregnant women (P < 0.001). Any influence of the allelic distribution on plasma homocysteine concentrations was not detected in either group. However, pre‐eclamptic patients bearing the non‐mutated cytosine‐cytosine genotype had significantly higher homocysteine levels than those with an uncomplicated pregnancy (P = 0.009), ruling out the possibility that the presence of a mutated allele is associated with the hyperhomocysteinaemia seen in pre‐eclamptic women.Conclusion:  In our pre‐eclamptic study population, a mild hyperhomocysteinaemia was observed. This finding seems to be a consequence of hypertension and vascular injury rather than an independent factor with a genetic origin.
Causes of late fetal death in New Zealand 1980–1999
Authors: CRAIG Elizabeth D. , STEWART Alistair W. , MITCHELL Ed A. 
Published: September 2004

AbstractBackground:  In recent years there has been an emerging interest in sudden unexplained intrauterine death.Aims:  To determine the major causes of late fetal death (LFD) in New Zealand during 1980–1999 and to document the proportion of deaths considered unexplained. In addition, to quantify the number of LFD undergoing post‐mortem during this period.Methods:  Using the Office for National Statistics (UK) hierarchical classification system, all information available on death certificates was used to assign a single cause to LFD for the period 1980–1999. Trends were analysed using logistic regression and risk factor profiles established for each cause of death. Post‐mortem rates and the characteristics of those failing to undergo post‐mortem were analysed for the period 1989–1999.Results:  LFD rates declined from 60.1 per 10 000 in 1980–1981 to 30.5 in 1998–1999. The declines were not uniform across all causes, with intrapartum deaths declining 73%, congenital anomalies 70% and antepartum asphyxia 50%. In contrast, unspecified deaths increased 1%, and with the decline in other causes of death, also increased proportionally, from 10.8% of LFD in 1980–81 to 28.1% in 1998–1999. Post‐mortem rates fell by 31% during 1989–1999, with Maori and Pacific babies and those in more deprived New Zealand Deprivation Index areas being significantly less likely to undergo post‐mortem.Conclusions:  While total LFD rates declined significantly during 1980–1999, rates of unspecified LFD remained static. Low post‐mortem rates, however, suggest that many of these deaths may be uninvestigated rather than truly unexplained. Nevertheless, the persistence of a category of death which, to date, has failed to improve with advances in obstetric technology suggests that further measures are necessary if New Zealand's LFD rates are to continue to decline.
Outcome after a cytological prediction of glandular abnormality
Authors: MITCHELL Heather S. 
Published: September 2004

AbstractBackground:  The National Health and Medical Research Council of Australia Guidelines for the Management of Women with Screen Detected Abnormalities are under review. The availability of population‐based Australian data on the outcome after a cytology prediction of glandular abnormality was considered relevant to revising the recommended investigations for women with these abnormalities.Aim:  To describe the outcome of women with cytological predictions of glandular abnormalities of the cervix during 1999.Methods:  A longitudinal study using data held by the Pap Test Registers of Australia.Results:  Over a 24 month period, 70% (95% confidence interval (CI) 62–78%) of women whose cytology was reported as adenocarcinoma in situ (AIS) were confirmed as having high‐grade disease. Among women whose cytology was reported as ‘inconclusive: possible high‐grade glandular disease’, the proportion of women having high‐grade disease was 25% (95% CI 20–30%). For cytology reports of minor non‐specific change (MNSC) of glandular cells, the proportion of women having high‐grade disease was 10% (95% CI 8–12%). Cancer was diagnosed in 16%, 5% and <1% of women with index cytology reports of AIS, inconclusive and MNSC, respectively.Conclusions:  These results can be used to inform an evidence‐based approach to the investigation and management of abnormal glandular cytology reports. The results can also be used to better inform women about the significance of their abnormal cytology.
Stem cells in gynaecology
Authors: GARGETT Caroline E. 
Published: September 2004

AbstractCurrently, there is enormous interest in stem cells as a new treatment modality for regenerative medicine, commencing when human embryonic stem (hES) cells were first cultured from spare in vitro fertilisation‐derived embryos. Emerging evidence also suggests that somatic stem cells may have greater differentiation potential. Stem cell research is now in an exciting phase of development and has the potential to dramatically influence therapeutics as hES cell derivatives and/or adult stem cells are applied to regenerative medicine or to deliver gene therapy. Human ES cells show apparently limitless proliferative potential and differentiation capacity into all tissue types. Adult stem cells are rare cells, which maintain the tissue in which they reside. The challenges facing the use of hES cells and adult stem cells in medicine are highlighted and examples of their use in laboratory studies and the clinic are given. Adult stem cells have been identified in diverse tissues, including human bone marrow, breast, prostate, brain and liver. We hypothesised that adult stem cells reside in the endometrium, a highly proliferative, cyclically regenerating tissue. Our research has demonstrated, for the first time, that human endometrium contains a small population of epithelial cells (0.22%) and stromal cells (1.25%) that exhibit stem/progenitor cell behaviour in vitro; clonogenicity. The progeny in these colonies have been characterised and growth factors supporting clonogenicity identified. The goal is to examine the role of putative endometrial stem/progenitor cells in proliferative disorders of human endometrium, such as endometriosis, adenomyosis, endometrial hyperplasia and endometrial cancer, and the action of hormone‐replacement therapy on the post‐menopausal endometrium.
Maternal mortality in Australia, 1973–1996
Authors: SULLIVAN Elizabeth A. , FORD Jane B. , CHAMBERS Georgina , SLAYTOR Emma K. 
Published: September 2004

AbstractAims:  Maternal mortality has declined dramatically over the past 30 years in developed countries. This retrospective study aims to provide an epidemiological overview of maternal deaths in Australia between 1973 and 1996.Methods:  Data were abstracted from national maternal mortality data collection and triennial reports for the period 1973–1996 for women who died from pregnancy‐related causes while pregnant or within 42 days of a pregnancy being delivered or terminated. Deaths were restricted to those classified as direct or indirect maternal deaths. Maternal mortality age‐specific mortality ratios were calculated. The leading causes of death were examined.Results:  Of the 584 deaths, 363 were direct and 221 indirect. The leading causes of direct death were pulmonary embolism (18.4%) and hypertensive disorders (16.3%). Cardiovascular disease accounted for 41% of indirect deaths. The maternal mortality ratio declined from 12.7 deaths per 100 000 confinements in 1973–1975 to 6.2 in 1991–1993, and was 10.0 for the entire 24‐year period. For women aged 40–44 years the ratio declined from 165.1 to 14.2 between 1973 and 1996. The ratio for Indigenous mothers was three times higher than for non‐Indigenous mothers, being 34.8 in the most recent triennium 1994–1996.Conclusions:  Although maternal deaths are rare in Australia, apparent health inequality persists with Indigenous mothers continuing to have a higher risk of maternal death. While mortality in traditionally higher risk women aged > 40 years has declined, women with morbid cardiovascular disease continue to be over‐represented in the deaths. The comparatively high rate of deaths from pulmonary embolism needs to be addressed.
Behavioral Symptoms in Residential Care/Assisted Living Facilities: Prevalence, Risk Factors, and Medication Management
Authors: Gruber‐Baldini Ann L. , Boustani Malaz , Sloane Philip D. , Zimmerman Sheryl 
Published: September 2004

Objectives: To examine the prevalence, correlates, and medication management of behavioral symptoms in elderly people living in residential care/assisted living (RC/AL) facilities.Design: Cross‐sectional study.Settings: A stratified random sample of 193 RC/AL facilities in four states (Florida, Maryland, New Jersey, North Carolina).Participants: A total of 2,078 RC/AL residents aged 65 and older.Measurement: Behavioral symptoms were classified using a modified version of the Cohen‐Mansfield Agitation Inventory. Additional items on resistance to care were also examined.Results: Approximately one‐third (34%) of RC/AL residents exhibited one or more behavioral symptoms at least once a week. Thirteen percent exhibited aggressive behavioral symptoms, 20% demonstrated physically nonaggressive behavioral symptoms, 22% expressed verbal behavioral symptoms, and 13% resisted taking medications or activities of daily living care. Behavioral symptoms were associated with the presence of depression, psychosis, dementia, cognitive impairment, and functional dependency, and these relationships persisted across subtypes of behavioral symptoms. Overall, behavioral symptoms were more prevalent in smaller facilities. More than 50% of RC/AL residents were taking a psychotropic medication, and two‐thirds had some mental health problem indicator (dementia, depression, psychosis, or other psychiatric illness).Conclusion: Integrating mental health services within the process of care in RC/AL is needed to manage and accommodate the high prevalence of behavioral symptoms in this evolving long‐term setting.
The Maryland Assisted Living Study: Prevalence, Recognition, and Treatment of Dementia and Other Psychiatric Disorders in the Assisted Living Population of Central Maryland
Authors: Rosenblatt Adam , Samus Quincy M. , Steele Cynthia D. , Baker Alva S. , Harper Michael G. , Brandt Jason , Rabins Peter V. , Lyketsos Constantine G. 
Published: September 2004

Objectives: To obtain a direct estimate of the prevalence of dementia and other psychiatric disorders in residents of assisted living (AL) in Central Maryland, and their rates of recognition and treatment.Design: Comprehensive review of history and cognitive and neuropsychiatric evaluations using widely accepted instruments in a randomized cohort of AL residents, stratified by facility size. An expert multidisciplinary consensus panel determined diagnoses and appropriateness of treatment.Setting: Twenty‐two (10 large and 12 small) randomly selected AL facilities in the city of Baltimore and seven Maryland counties.Participants: One hundred ninety‐eight volunteers who were residents of AL, 75% were aged 80 and older, and 78% were female. Potential participants were randomly chosen by room number. There was a 67% participation rate.Measurements: Overall rate of dementia, noncognitive active psychiatric disorders, and recognition and adequate treatment of dementia and psychiatric disorders, as determined by consensus panel.Results: Two‐thirds (67.7%) of participants had dementia diagnosable according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (81% small facilities and 63% large). Family or caregivers recognized 78% to 80% of dementias. Seventy‐three percent of dementias were adequately evaluated, and 52% were adequately treated. Of the 26.3% of participants who had an active noncognitive psychiatric disorder, 58% to 61% were recognized and 52% adequately treated.Conclusion: Dementia and psychiatric disorders are common in AL and have suboptimal rates of recognition and treatment. This may contribute to morbidity and interfere with the ability of residents to age in place.
Chlamydia Pneumoniae Seropositivity and Cardiovascular Risk Factors: The InCHIANTI Study
Authors: Blanc Pierluigi , Corsi Anna Maria , Gabbuti Andrea , Peduzzi Cecilia , Meacci Francesca , Olivieri Fabiola , Lauretani Fulvio , Francesco Mazzotta , Ferrucci Luigi 
Published: September 2004

Objectives: To assess the prevalence of Chlamydia pneumoniae (CP) seropositivity and test the hypothesis that CP infection (CPI) is associated with cardiovascular (CV) risk factors and levels of inflammatory biomarkers.Design: Cross‐sectional survey.Setting: Representative sample of the residents of Greve in Chianti and Bagno a Ripoli, two small towns located in the Chianti geographic area (Tuscany, Italy).Participants: A total of 1,304 (age‐range: 20–103, 79% aged≥65) participants of the InCHIANTI study.Measurements: CP seropositivity was assessed using immunofluorescence. Previous CPI was defined as immunoglobulin (Ig) G ≥1/16 and <1/256, and recent CPI was defined as IgG ≥1/512 or IgM ≥1/16. Inflammatory markers included interleukin (IL)‐6, soluble IL‐6 receptor (sIL‐6r), tumor necrosis factor‐alpha (TNF‐α), IL‐1β, IL‐1 receptor antagonist (IL‐1ra), iron, ferritin, and C‐reactive protein (CRP). CV risk factors included smoking, body mass index (BMI), lipid profile, and hypertension.Results: The prevalence of CP seropositivity was 75%, increased with age, and was higher in men than in women (P<.01). CPI was not associated with IL‐1β, IL‐1ra, iron, ferritin, CRP, BMI, lipids, and smoking. After adjusting for age and sex, previous or recent CPI was associated with higher TNF‐α (P<.01), IL‐6 (P<.03), sIL‐6R (P<.01), and hypertension (P<.02). In additional age and sex‐adjusted models, the associations between CPI and TNF‐α, IL‐6, sIL‐6r, and hypertension appeared to be mutually independent.Conclusion: CP seropositivity is highly prevalent in the older population and is a significant, independent correlate of hypertension and circulating levels of TNF‐α, IL‐6, and sIL‐6r.
Longitudinal Study of Determinants of Dependence in an Elderly Population
Authors: Paterson Donald H. , Govindasamy Devin , Vidmar Marjan , Cunningham David A. , Koval John J. 
Published: September 2004

Objectives: To describe those factors, from the host of initial measures in ambulatory, independent older men and women, that were determinants of becoming dependent over an 8‐year follow‐up.Design: Initial measures in a cohort of independent older adults were used in logistic regression to describe the determinants of becoming dependent at the 8‐year follow‐up.Setting: London, Ontario.Participants: Three hundred seventy‐three men and women aged 55 to 86.Measurements: Initial variables included body size, presence of chronic disease, maximal oxygen uptake (VO2max), strength, flexibility, walking pace, and leisure time physical activity.Results: An 8‐year follow‐up of 297 participants identified 43 as dependent. Logistic regression showed age, presence of disease, and VO2max (cardiorespiratory fitness) at baseline to have significant odds ratios related to the outcome of becoming dependent. Controlling for other factors, a lower VO2max increased the odds of dependence by 14% for each mL/kg·min.Conclusion: Lower cardiorespiratory fitness was a significant determinant of becoming dependent in an 8‐year follow‐up of older adults. Initiatives to encourage physical activity in older adults should emphasize exercise, such as brisk walking, to maintain or improve cardiorespiratory fitness.