bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pelvic adhesions and pelvic pain: opinions on cause and effect relationship and when to surgically intervene
Authors: Diamond M. P. , Bieber E. ,   the Adhesions Study Group.
Published: March 2003

In the absence of definitive data, we sought to determine the consensus on the contribution of adhesions to pelvic pain.Impressions about the role of adhesion location, extent, and severity of pelvic pain, were surveyed among 13 gynaecological surgeons. They were asked whether adhesions covering specific organs to a varying extent would be likely to cause pain significant enough to require pain medication, or to lead a woman to alter her normal activities, and when they would recommend surgery to reduce pelvic pain.Women with dense vascular adhesions covering all of the uterus but not the bowel or adnexal structures were thought to have a 49 ± 9% likelihood of having pelvic pain; this fell to a 34 ± 7% and 18 ± 5% likelihood of pain if 60% or 20%, respectively, of the uterus was involved with adhesions. Similar observations were made for adhesions involving the posterior cul‐de‐sac and large bowel. However, adhesions involving the anterior cul‐de‐sac were thought to be less likely to cause pain. Women with total involvement of both tubes and ovaries with dense, vascular adhesions were thought to be 60 ± 9% likely to have pelvic pain; reduction in extent of adhesions to 50% or 25% reduced the prediction of pain to 38 ± 5% and 21 ± 3%, respectively. In contrast, filmy adhesions to both tubes and ovaries, were thought to cause pain in 46 ± 9%, 26 ± 5%, and 13 ± 3% of women, respectively, according to extent. Half the surgeons said they would recommend surgery for patients with pain and dense adhesions involving 15% of both tubes and ovaries; 10 recommended surgery if it was known that adhesions involved 100% of both ovaries and tubes. Surgeons were only slightly less likely to recommend surgery for pain relief for adhesions involving either both tubes or both ovaries or for pain associated with unilateral tubal and ovarian adhesions. For bilateral tube and ovary adhesions, surgery was equally likely to be recommended for relief of pain when adhesions were cohesive and dense; for adhesions which were filmy, surgery was less likely to be recommended. For dense adhesions involving 20%, 40%, 60%, and 80% of the uterine surface, surgery was recommended by 42%, 58%, 83% and 92% of surgeons, respectively. Posterior cul‐de‐sac involvement resulted in recommendation of surgery by 50%, 83%, 92%, and 100% of surgeons, respectively; however, for corresponding amounts of anterior cul‐de‐sac adhesions, surgery was recommended by only 17%, 33%, 67%, and 75% of surgeons.(1) Adhesions are frequently considered to be a cause of pelvic pain; (2) the likelihood of discomfort is related to location, extent, and to a lesser degree, the severity of adhesions, and (3) adhesiolysis is thought to provide the potential for pain relief.
A death following hysteroscopic myomectomy
Authors: Katz Yeshayahu , Moscovici Roland , Prego George , Merzel Yosef , Kniznik Daniel , Lev Amiram 
Published: March 2003

We report a fatal outcome using 1.5% glycine as distension/irrigation fluid for hysteroscopic myomectomy.During general anaesthesia for transcervical endoscopic resection of myoma, a healthy 35‐year‐old woman developed severe pulmonary hyponatraemia and cerebral oedema, and was declared brain dead. Postmortem findings did not reveal pontine myelinolysis. Through the procedure, the net fluid absorption of 1.5% glycine was 1.6 L plus 1 L of maintenance intravenous Ringer’s lactate solution.Regional anaesthesia is recommended for hysteroscopy, since general anaesthesia may mask neurologic signs, and meticulous attention should be paid to intraoperative fluid balance.
ThermaChoice balloon endometrial ablation for menorrhagia: failure to develop and sustain operating pressures may be related to an unrecognized endometrial cancer
Authors: Onyeka Benjamin A. , Arthur Ian D. , Wilcox Frank L. 
Published: March 2003

ABSTRACTObjective To report a case of unsuccessful balloon ablation therapy for menorrhagia in the presence of an unsuspected stage 1b endometrial cancer, in a 45‐year‐old woman with no known risk factor for endometrial cancer.Results Balloon ablation therapy in this woman was abandoned because of failure to generate and sustain enough pressure to perform the procedure. Hysteroscopy was therefore carried out, and abnormal uterine anatomy, perforation and obvious pathology were excluded. Balloon leakage or perforation was ruled out by aspiration of all the infused fluid. Endometrial curettings obtained at the time of hysteroscopy showed endometrial cancer, and at a later date the patient underwent total abdominal hysterectomy with bilateral salpingo‐oöphorectomy. The histological investigation showed a stage 1b endometrial cancer. A previous hysteroscopy performed 21 months earlier had shown no abnormality and the curettings had been histologically normal.Conclusions This case suggests that endometrial cancer with muscle invasion may result in compromised myometrial integrity, so that the level of pressure needed to carry out the ablation procedure cannot be generated and maintained.
Clinical guidelines for treating von Willebrand disease patients who are not candidates for DDAVP — a survey of European physicians
Authors: Lusher  
Published: March 2003

While certain plasma‐derived factor VIII/von Willebrand factor (FVIII/vWF) concentrates have proven to be quite useful in preventing or controlling bleeding in persons with von Willebrand disease who are not candidates for DDAVP, most of the information concerning dosage and effectiveness has been anecdotal. Additionally, the laboratory tests used to quantify vWF (the vWF:RCoF assay and collagen binding assay) are not well standardized. Thus, the US Food and Drug Administration (FDA) has been reluctant to grant licensed indication for use of these products in von Willebrand disease.This brief report describes a survey of non‐US physicians (from major centres) who are recognized experts in haemophilia and von Willebrand disease. Twenty‐four of 27 questionnaires were completed, returned and analysed. Products thought to be effective in von Willebrand disease included Haemate P®, Facteur von Willebrand®, Alphanate®, and the UK’s BPL ‘8Y’®. In calculating dosage to stop or prevent bleeding, most aim for a certain level of both FVIII and vWF:RCoF. Postoperatively, 16/24 respondents follow both of these laboratory tests once daily. Twenty‐two of 24 would follow FVIII levels once daily. It is noteworthy that FVIII assay results are generally the only test results readily available to guide the respondents’ clinical decisions.For treatment of significant mucous membrane bleeding, respondents often individualize dosage and monitoring, depending on the type, location and extent of bleeding. Gastrointestinal bleeding is generally treated more aggressively. Patient monitoring varies between merely looking for cessation of bleeding, to a battery of laboratory tests, including haemoglobin and haematocrit. Seven out of 24 would monitor BT as well.In addition to FVIII content, 22/24 respondents noted that they would find it helpful to have vWF:RCoF listed on the label, while 15/24 would like to know the vWF multimeric composition.
The treatment of intra‐articular synovitis by the use of chemical and radioactive substances
Authors: HEIM M. 
Published: March 2003

As the Chairperson of the session relating the intra‐articular use of chemical and radioactive substances it would seem appropriate to give credit to those who contributed to the recent supplement of our Journal Haemophilia. I have extracted key sentences and concepts from the contributed articles.All the papers can be found in Haemophilia, Volume 7, Supplement 2, July 2001. The title, authors and page numbers are provided [1].
Long‐term follow‐up after osteotomy for haemophilic arthropathy of the knee
Authors: Wallny T. , Saker A. , Hofmann P. , Brackmann H. H. , Nicolay C. , Kraft C. N. 
Published: March 2003

Summary.  In this study the long‐term value of corrective osteotomy around the knee was evaluated by means of clinical and radiographic parameters. Between 1974 and 1984 we performed 52 corrective osteotomies in the vicinity of the knee on patients affected by haemophilic arthropathy. Forty‐two patients (45 osteotomies) were adequately followed‐up at an average 11.6 years postoperatively. Using the clinical score of the Advisory Committee of the World Federation of Haemophilia, 38 patients showed a postoperative improvement, five remained clinically unchanged and two showed deterioration. Range of motion of the knee joint did not significantly improve postoperatively. The radiographic Pettersson score showed only a marginal decrease by an average 0.003 points at the time of follow‐up. Only one patient needed subsequent joint replacement of both knees, on the left side 13 years after osteotomy and on the right side 8 years after osteotomy.Even in cases of marked radiographic joint destruction, corrective osteotomy shows acceptable long‐term clinical results, underlining the feasibility of this management option in the treatment of haemophilic arthropathy of the knee. Although moderate cartilage degenerations in the femoropatellar complex and in the contralateral compartment can be tolerated, this therapy should primarily be contemplated for those patients where damage is unicompartmental and a corresponding axial deviation is found. Particularly the younger patient can benefit from this treatment option in that joint replacement may possibly wholly be avoided or at least postponed to a later stage of life.
Species as units of analysis in ecology and biogeography: time to take the blinders off
Authors: Riddle Brett R. , Hafner David J. 
Published: March 2003

SummarySpecies and their geographical distributions, tabulated either from regional faunal and floral monographs or directly from natural history collections, often are used as the basic units of analysis by ecologists and biogeographers. It has been argued that in order for species to be operationally useful units for evolutionary and ecological studies, they need to be recognizable and identifiable as distinct entities. A growing body of molecular phylogeographic studies demonstrates that currently recognized species often are unreliable in their approximation of fundamental evolutionary and geographical units, leading, for example, to proposed usage of molecular‐based evolutionarily significant units in lieu of species in conservation biology. We argue that ecologists and bio‐ geographers should likewise employ evolutionarily significant units as basic units of analysis when evidence clearly indicates that a formally recognized species either fails to convey important evolutionary and geographical information (i.e. includes multiple geographically distinct evolu‐ tionary lineages) or fails to delineate a natural entity (i.e. does not represent a monophyletic set of populations). We demonstrate the limitations of current species as evolutionary, geographical, and conservation units within the ecologically well‐studied North American desert rodent assemblage. We suggest that biotic surveys should be designed to allow the efficient assembly and dissemination of molecular phylogeographic data from ecologically and biogeographically representative systems.
Global controls of forest line elevation in the northern and southern hemispheres
Authors: Jobbágy Esteban G. , Jackson Robert B. 
Published: March 2003

AbstractWe explored whether the independent evolutionary history of extratropical forests in the southern and northern hemispheres affects the temperature–elevation relationship of mountain forest lines. We compiled 115 forest line descriptions from the literature, covering the major extratropical mountain ranges of the world. We related forest line elevation to thermal regimes using mean annual temperature adjusted to sea level (MAT) and seasonal thermal amplitude (STA, mean of the warmest month minus the mean of the coldest) obtained from a global climate database.
Cetirizine and levocetirizine inhibit eotaxin‐induced eosinophil transendothelial migration through human dermal or lung microvascular endothelial cells
Authors: Thomson L. , Blaylock M. G. , Sexton D. W. , Campbell A. , Walsh G. M. 
Published: March 2003

SummaryBackgroundSeveral second‐generation antihistamines have documented anti‐inflammatory effects which appear independent of H1‐receptor blockade. We investigated the inhibitory effect of cetirizine and its active enantiomer levocetirizine on eosinophil transendothelial migration (TEM) through monolayers of normal human dermal microvascular endothelial cells (HMVEC‐d) or human lung microvascular endothelial cells (HMVEC‐l).MethodsHMVEC‐d or HMVEC‐l were grown to confluence on micropore filters in transwells inserted into a 24‐well tissue culture dish. Eosinophils were isolated by density gradient centrifugation and negative immunomagnetic selection. Untreated eosinophils or eosinophils pre‐incubated (30 min at 37 °C) with a concentration range of cetirizine or levocetirizine (10−5to 10−9 m) were added to the upper chamber of the transwell which was incubated for 60 min at 37 °C. Both spontaneous eosinophil TEM and TEM to 100 ng/mL of human eotaxin in the lower chamber were assessed.ResultsBetween 8 and 10% of the eosinophils added to the upper chamber underwent spontaneous TEM through HMVEC‐d or HMVEC‐l. The addition of eotaxin to the lower chamber enhanced eosinophil TEM through HMVEC‐d or HMVEC‐l monolayers to over 20%, i.e. an enhanced TEM of approximately 100% in each case. Pre‐incubation of eosinophils with cetirizine or levocetirizine dose‐dependently inhibited eosinophil TEM to eotaxin through both HMVEC‐d or HMVEC‐l with total inhibition of eotaxin‐induced TEM observed at 10−8 mfor HMVEC‐d and 10−7 mfor HMVEC‐l. Both drugs gave a reduced but significant inhibition of eosinophil TEM at lower concentrations. No concentration of cetirizine or levocetirizine had any significant effect on expression of CD11b, CD18 or CD49d by either resting or eotaxin‐stimulated eosinophils. Furthermore, no effect on spontaneous eosinophil TEM, or eosinophil viability was seen with any concentration of cetirizine or levocetirizine.ConclusionLevocetirizine inhibits eotaxin‐induced eosinophil TEM through both dermal and lung microvascular endothelial cells suggesting that, like cetirizine, levocetirizine has potential anti‐inflammatory effects.
Parental farming protects children against atopy: longitudinal evidence involving skin prick tests
Authors: Horak F. , Studnicka M. , Gartner C. , Veiter A. , Tauber E. , Urbanek R. , Frischer T. 
Published: March 2003

SummaryBackground There is growing evidence that the development of allergic sensitization can be influenced by environmental co‐factors. Studies showed that growing up on a farm can protect children against allergic sensitization. However, little is known whether this ‘farming effect’ can only be observed in early lifetime or whether it also plays a role in later childhood.Objective The aim of our study was to test whether a farming environment is negatively associated with a new occurrence of skin prick test (SPT) positivity in school children. As a secondary outcome we investigated whether children living on a farm lose their allergic sensitization more frequently than other children.Methods In a longitudinal design, 1150 elementary school children (mean age 7.8 years, SD 0.7) were recruited from nine different areas of Austria in 1994. A questionnaire and an SPT involving seven common aero‐allergens were performed at study entry and at follow‐up 3 years later.Results A total of 844 children, who underwent two SPTs, were included in the analyses; 15.1% of their families reported working on a farm. Adjusting for potential confounders (parental education, number of siblings, sex, family history of allergy), parental farming was inversely related to the prevalence and new occurrence of SPT positivity [no farming 12.2%, part‐time farming 6%, full‐time farming 2.2% incidence; odds ratio (OR) farming vs. non‐farming 0.34, 95% confidence interval (CI) 0.12–0.98]. Furthermore, children living in a farming environment were more likely to lose their SPT positivity during follow‐up (no farming 14.6%, part‐time farming 50%, full‐time farming 60% loss of sensitization; OR farming vs. non‐farming 8.06; 95% CI 2.05–31.75). No difference in the pattern of sensitization to specific allergens could be observed between farming and non‐farming children.Conclusion A farming environment has a strong negative effect on the development of allergic sensitization. Furthermore, the study provides evidence that atopic children living on a farm lose their SPT positivity more frequently than children from non‐farming environments.
Atopic allergy and delayed type hypersensitivity in Estonian children
Authors: Julge K. , Meriste* S. , Kemp A. , Björkstén B. 
Published: March 2003

SummaryBackground A shift in the balance ofT helper (Th) cell subsets towards a polarized Th2 population is generally accepted to occur in atopic disease, however, both Th1 and Th2 disorders have increased over the past decades in Western communities.Objective The aim of our study was to investigate delayed type hypersensitivity (DTH) response in atopic and non‐atopic children in a population with a low prevalence of allergic disorders.Methods Skin prick tests (SPT) were performed with fresh egg white and extracts of five inhalant allergens, i.e. cat, dog, house dust mite (Dermatophagoides pteronyssinus), birch and timothy, and DTH response was evaluated by Multitest® CMI in 72 Estonian 4‐ to 6‐year‐old children.Results The frequency of response to diphtheria was significantly increased in SPT‐positive children (55% vs. 26%, χ2 = 5.5; P = 0.038). The induration to diphtheria (2.4 ± 0.5 vs. 0.9 ± 0.2 mm; P = 0.004), and tetanus (3.5 ± 0.6 vs. 2.1 ± 0.3 mm; P = 0.025) was significantly greater in the SPT‐positive children. The cumulative size of induration in the positive DTH tests was significantly greater in the SPT‐positive children (9.0 ± 1.2 vs. 5.2 ± 0.6 mm, P = 0.01).Conclusion In this group of children our findings do not support the hypothesis of an immune deviation with decreased Th1 and increased Th2 responses leading to atopic disease, but rather a process of immune modulation whereby both Th1 and Th2 responses are increased in atopic subjects.
Severe respiratory syncytial virus infection in early life is associated with increased type 2 cytokine production in Gambian children
Authors: Van Der Sande M. A. B. , Kidd I. M. , Goetghebuer T. , Martynoga R. A. , Magnusen A. , Allen S. , Weber M. W. , Fielding K. L. , Marchant A. , Whittle H. C. 
Published: March 2003

SummaryBackground Severe respiratory syncytial virus (RSV) infection in early childhood has been associated with subsequent wheezing and atopy. The aim of this study was to test if severe RSV infection in early life was associated with an increase in type 2 cytokine production and atopy in Gambian children 5 years later.Methods A cohort of children with severe RSV infection during the first year of life (‘cases’, n = 66) and without (‘controls’, n = 122) was followed‐up at 5 years of age. Immediate hypersensitivity to common allergens, airway reactivity, serum IgE concentration and the production of IFN‐γ, IL‐5 and IL‐13 by lymphocytes activated in vitro with RSV F‐G or control antigens was determined.Results After adjustment for confounders, cases produced significantly higher concentrations of IL‐13 in response to RSV F‐G and of IL‐5 and IL‐13 in response to tuberculin. Cases were more likely to have presented with a wheezy lower respiratory tract infection in the first 3 years of life (adjusted odds ratio = 9.9; 95% CI 1.6–61.0), but not thereafter. Cases and controls had similar skin response to allergens, airway reactivity and serum IgE concentrations.Conclusion Severe RSV infection in early life is associated with a higher production of type 2 cytokines in Gambian children at 5 years of age. However this does not appear to result in increased risk of atopy or clinical allergy at that age.
Oral lichen planus: different clinical features in HCV‐positive and HCV‐negative patients
Authors: Mignogna Michele D. , Lo Muzio Lorenzo , Lo Russo Lucio ,   DDS, Fedele Stefano ,   DDS, Ruoppo Elvira ,   DDS, Bucci Eduardo 
Published: March 2003

Abstract Background Hepatitis C virus (HCV) infection induces variable dermatologic manifestations. Objective To determine whether differences exist in the clinical features and behavior of oral lichen planus (OLP) between HCV‐positive (HCV+ve) and HCV‐negative (HCV–ve) patients. Methods Two hundred and sixty three patients (156 women and 107 men), with a mean age of 55.5 years, with OLP (76 HCV+ve and 187 HCV–ve) were clinically evaluated. Previously, all local factors that could modify the clinical characteristics were removed and were monitored carefully following morphology. Results In both groups, the prevalent clinical form of OLP was the mixed form (33.1% in HCV–ve and 35.5% in HCV+ve patients), in which reticular–plaque lesions coexist with atrophic–erosive ones. The reticular form was more frequent in HCV+ve (25%) than in HCV–ve (18.7%) patients, whereas plaque lesions were more prevalent in HCV–ve (15.5%) than in HCV+ve (5.2%) patients (P < 0.01, chi‐squared test). There were no significant differences in the frequency of erosive (27.2% in HCV–ve and 27.6% in HCV+ve) and atrophic (5.3% in HCV–ve and 5.2% in HCV+ve) forms between the two groups. Conclusions Our findings show that there were statistically significant differences between OLP‐HCV–ve and OLP‐HCV+ve groups for reticular and plaque clinical forms. These findings underline the importance of liver examination in all OLP patients, including cases with mild, asymptomatic keratotic forms of the disease.
Homology, biogeography and areas of endemism
Authors: Morrone Juan J. 
Published: March 2003

Abstract.Hypotheses of biogeographic homology constitute the basis of historical biogeography. Primary biogeographic homology refers to a conjecture on a common biogeographic history, and secondary biogeographic homology refers to the cladistic test of the formerly recognized homology. Panbiogeography deals with the former, through the recognition of generalized tracks and areas of endemism, whereas cladistic biogeography deals with the latter, through the generation of general area cladograms. A historical biogeographic analysis may include both approaches, in a two‐stage analysis.