bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prostaglandin: cervical ripening in hypertensive pregnancies
Authors: Ferrazzani Sergio , De Santis Lidia , Carducci Brigida , Caliandro Dario , De Carolis Sara , Di Simone Nicoletta , Caruso Alessandro 
Published: May 2003

Background.  To determine the outcome of cervical ripening with intracervical prostaglandin E2 (PEG2) in hypertensive and non‐hypertensive high‐risk pregnancies in terms of successful ripening, mode of delivery, time intercorring between ripening and the beginning of labor or parturition and, at least, duration of labor.Methods.  A total of 63 women with a diagnosis of hypertensive disorders were included in the study protocol. These 63 women were compared with 71 consecutive high‐risk pregnancies requiring induction of labor for maternal and/or fetal indications. Cervical ripening was performed with single or multiple doses of 0.5 mg of intracervical PGE2 gel.Results.  The rate of successful ripening was 84% for non‐hypertensive patients (60/71) and 69% (43/63) for hypertensive patients ( p < 0.03). Twenty‐four out of 63 hypertensive patients (38%) and 21 out of 71 non‐hypertensive patients (30%) ( p < 0.05) were delivered by cesarean section. After stratification of hypertensive patients, the time interval from the first PGE2 administration to the onset of labor or vaginal delivery was significantly longer for preeclamptic patients vs. non‐hypertensive patients or non‐preeclamptic hypertensive patients. There were no differences in the duration of labor.Conclusions.  Among hypertensive patients, only preeclamptic patients showed a lower rate of successful ripening and vaginal delivery if compared with non‐preeclamptic or non‐hypertensive patients; however, a vaginal delivery might be obtained in most preeclamptic patients when suitable cervical ripening was performed in the presence of clinician‐perceived urgency to delivery.
Activin B in patients with granulosa cell tumors: serum levels in comparison to inhibin
Authors: Vihko Kimmo K. , Bläuer Merja , Puistola Ulla , Tuohimaa Pentti 
Published: May 2003

Background.  Activins and inhibins are polypeptide hormones/growth factors of primarily gonadal origin. In the ovary, activins and inhibins are primarily synthesized by granulosa cells. Serum inhibin measurements have been used for the follow‐up of patients with granulosa‐cell tumors (GCT) after surgery.Methods.  We have employed a recently developed assay to study whether activin B (A) measurements can be used as a marker of progression of GCTs. Additionally, these measurements have been compared with simultaneously run inhibin measurements using a commercial assay. Serum samples of three patients suffering from GCTs (all stage Ia) were collected at primary surgery and at controls thereafter.Results.  In patient AM, serum inhibin levels have remained elevated while A levels are low; there has been no evidence of a residual tumor. In patient AR, there has been no clinical evidence of a residual tumor, and both serum A and inhibin levels have remained low. In patient PP, a residual tumor was found 6 years after primary surgery; at the time A levels were elevated, while inhibin levels remained low.Conclusion.  We introduce A as a promising new marker for postoperative follow‐up of patients suffering from GCTs.
Early and late half‐life of human chorionic gonadotropin as a predictor of persistent trophoblast after laparoscopic conservative surgery for tubal pregnancy
Authors: Billieux Marie‐Hélène , Petignat Patrick , Anguenot Jean‐Luc , Campana Aldo , Bischof Paul 
Published: May 2003

Background.  To determine if the early or late half‐lives (T0.5) of human chorionic gonadotropin (hCG) can identify patients with persistent trophoblastic activity after conservative surgery for tubal pregnancy.Design.  Prospective cohort study.Setting.  Department of obstetrics and gynecology of a university hospital.Methods.  All patients with a tubal pregnancy treated by laparoscopic salpingostomy between June 1997 and September 2000 were enrolled in the study. Postoperative sequential hCG sampling was performed at days 0, 2 (± 1) and 7 (± 2) and followed until levels were undetectable. Taking the biexponential hCG declining curve as a model, we calculated the early (days 0–2) and late (days 2–7) T0.5 hCG values.Main outcome measure.  To assess success or failure of surgical treatment.Results.  Seventy‐three patients with an ectopic pregnancy were managed by conservative surgery. Early and late T0.5 allowed us to identify 2/10 and 9/10 women, respectively, with persistent trophoblast. Late T0.5 levels revealed two patients with false‐positive values, but one patient showed a secondary increase in hCG after day 7 (false‐negative) despite a normal late T0.5.Conclusions.  Early and late half‐lives of hCG do not identify all women at risk for persistent ectopic pregnancy. To exclude persistent trophoblast, postoperative serum hCG determination should be performed until levels are undetectable.
Triage by HPV‐DNA testing: is it useful in women with persistent minor smear abnormalities?
Authors: Pisal Narendra , Sindos Michael , Chow Carl , Singer Albert 
Published: May 2003

Background.  This study was carried out to evaluate the efficacy of HPV‐DNA (Human Papilloma Virus) testing as a triage strategy for persistent borderline and mild cytological abnormalities.Methods.  A prospective cross‐sectional study involving 321 women registered between January and December 2001 with two smears showing borderline or mild dyskaryosis, taken 6 months apart. This study was undertaken in a colposcopy unit in a large district general hospital in central London.Results.  Three hundred and twenty‐one women referred with persistent borderline and mild dyskaryosis were recruited in this study. HPV‐DNA testing was positive in 194 women (60.4%). Histology of colposcopically directed biopsy showed CIN2/3 in 57 women (18%). Fifty‐one of these 57 women were detected by HPV‐DNA testing (sensitivity for high‐grade disease 89.5%). Specificity for high‐grade disease was 45.8%. Negative predictive value was 95.3%. Women with a positive HPV‐DNA result had a 7.2 times higher risk of having a high‐grade cervical cancer precursor lesion.Conclusion.  Negative predictive value of HPV‐DNA testing for high‐grade cervical lesion is very high. Hence, it can be used as a triage strategy for persistent borderline changes and mild dyskaryosis.
Maternal serum interleukin‐6, interleukin‐8, tumor necrosis factor‐α and interferon‐γ in preterm labor
Authors: Bahar Ahmed M. , Ghalib Hashim W. , Moosa Riyad A. , Zaki Zaki M. S. , Thomas Chet , Nabri Osman A. 
Published: May 2003

Background.  To find out whether preterm labor is associated with raised maternal serum concentrations of interleukin (IL)‐6, IL‐8, tumor necrosis factor alpha (TNF‐α) and interferon gamma (IFN‐γ) and whether the measurement of these cytokines can be used to detect early intrauterine infection in preterm labor.Methods.  Cross‐sectional study: 77 women in preterm labor, 47 controls of healthy preterm women not in labor and 19 women in term labor. The serum cytokines levels were measured by enzyme‐linked immunosorbent assay (ELISA). The newborns of women who were in labor were followed up for evidence of infection. Differences between groups were tested using analysis of variance, Student's t‐test and χ2‐test.Results.  There was no significant difference in the concentration of all the cytokines measured between the different groups. No statistical difference was found in the concentration of the cytokines between women in preterm labor with ruptured membranes and those with intact membranes. There was also no difference found in the concentration of cytokines between women whose newborns had positive bacterial culture and those with negative culture. There was a positive correlation between the concentrations of IL‐6, IL‐8 and TNF‐α.Conclusion.  Serum levels of interleukin‐6, interleukin‐8 and tumor necrosis factor‐α were not increased in preterm labor compared to normal control women. There is doubt regarding the usefulness of maternal serum measurement of these cytokines for the detection of early fetal infection in preterm labor, but this needs further evaluation.
Probability analysis for diagnosis of endometrial hyperplasia and cancer in postmenopausal bleeding: an approach for a rational diagnostic workup
Authors: Bachmann Lucas M. , Ter Riet Gerben , Clark T. Justin , Gupta Janesh K. , Khan Khalid S. 
Published: May 2003

Objective.  To develop an analytical approach to estimate the probability of endometrial hyperplasia and cancer in women with postmenopausal bleeding, using a combination of patient history and tests.Methods.  A prospectively collected database of 428 postmenopausal women investigated for abnormal uterine bleeding in an outpatient rapid access clinic was used. The probability of disease was estimated using multivariable logistic regression models considering a combination of age and the use of hormone replacement therapy (HRT) and tests (ultrasound and hysteroscopy) in keeping with the actual clinical process.Results.  The prevalence or prior probability of endometrial cancer in the sample studied was 4.4%. Hysteroscopy alone performed better than ultrasound alone. In all patients, a negative hysteroscopy reduced the probability of cancer to 1.3%. In women less than 60 years of age who use HRT, a negative hysteroscopy further reduced this probability to 0.1%. Overall, a positive hysteroscopy raised the probability of cancer to 38.9%. However, in women over 60 years of age not using HRT, a positive hysteroscopy increased this probability to 59.4%. Combining ultrasound results with hysteroscopy did not meaningfully alter the diagnostic probability.Conclusion.  The combination of information obtained from patient history and tests allows generation of specific disease probabilities in postmenopausal bleeding. This type of multivariable analysis puts diagnostic information gained from history and other tests into a perspective that reflects actual clinical practice.
A systematic review of transvaginal ultrasonography, sonohysterography and hysteroscopy for the investigation of abnormal uterine bleeding in premenopausal women
Authors: Farquhar Cynthia , Ekeroma Alec , Furness Susan , Arroll Bruce 
Published: May 2003

Background.  To determine the accuracy of transvaginal ultrasonography, sonohysterography and diagnostic hysteroscopy for the investigation of abnormal uterine bleeding in premenopausal women.Design.  Systematic review of common diagnostic imaging tests.Data sources.  Relevant papers were identified through electronic searching of MEDLINE (1980 to July 2001) and EMBASE (1980 to July 2001) and manual searching of a bibliography of primary and review articles.Review methods.  Studies were selected if accuracy of transvaginal ultrasonography, sonohysterography and diagnostic hysteroscopy was compared with a reference standard and included data that could be abstracted into a two‐by‐two table in order to calculate sensitivity and specificity. Quality assessment and data extraction were performed by at least two independent reviewers. Diagnostic accuracy was determined by calculating positive and negative likelihood ratios for all intrauterine pathologies, submucous fibroids and endometrial hyperplasia.Results.  Nineteen studies met the inclusion criteria. Statistically significant heterogenenity was present between the likelihood ratios for studies of transvaginal ultrasound. A positive test result with sonohysterography diagnosed submucous fibroids with a pooled likelihood ratio of 29.7 (17.8, 49.6). A positive test result with hysteroscopy diagnosed submucous fibroids with a pooled likelihood ratio of 29.4 (13.4, 65.3), and any intrauterine pathology with a pooled likelihood ratio of 7.7 (4.3, 13.7). A negative test result with hysteroscopy for diagnosing any intrauterine pathology had a pooled likelihood ratio of 0.07 (0.04, 0.15).Conclusion.  Although there was considerable variability present between the studies, all three diagnostic tests were moderately accurate in detecting intrauterine pathology. However, sonohysterography and hysteroscopy performed better than transvaginal ultrasound in detecting submucous fibroids.
A sporadic case of von Hippel‐Lindau disease with a secondary maculopathy as the presenting sign
Authors: Kreusel Klaus‐Martin , Bechrakis Nikolaos E. , Neumann Hartmut P. H. , Foerster Michael H. 
Published: May 2003

A 36‐year‐old male presented with a drop in visual acuity in his left eye to 0.1. Ophthalmoscopy of the affected eye revealed dense, macular, lipid exudates at the posterior pole (Fig. 1) and a single peripheral capillary retinal haemangioma with only moderately enlarged draining vessels (Fig. 2). Retinal findings in the right eye were unremarkable. As the patient had reported headache, magnetic resonance tomography (MRT) of the brain was performed. This showed a single infratentorial haemangioblastoma (Fig. 3) with a solid (arrow) and cystic (arrow) component, thus allowing for a clinical diagnosis of von Hippel‐Lindau disease (VHL) (Neumann 1987). However, the subject's family history was negative for this autosomal‐dominant, multi‐tumour syndrome. Molecular genetic analysis of the VHL gene (3p25–26) by sscp (Latif et al. 1993) detected a mutation (477 C/G) in the patient's DNA (Fig. 4, lane 2), but not in his mother's or sister's DNA (Fig. 4, lanes 3 and 4; wild‐type DNA: lane 1). Although a positive family history is present in the majority of VHL cases, the disease can also present sporadically due to a de novo mutation (Richards et al. 1995; Kreusel et al. 2000). Ruthenium‐106 brachytherapy of the haemangioma (Kreusel et al. 1998) induced complete regression to a choroido‐retinal scar (Fig. 5). During 5 years of follow‐up according to current screening recommendations (Maher et al. 1990), no further haemangioma or other new VHL lesions were detected in the patient.Fundus photograph of the posterior pole of the left eye. Abundant lipid exudates are present, resembling pronounced stellate retinopathy. There is only discrete enlargement of the inferior temporal artery and vein.imageIn the temporal inferior periphery a capillary retinal hemangioma surrounded by retinal hemorrhage is present. The feeder vessels are only moderately enlarged.imageMagnetic resonance image of the patients brain showing an infratentorial hemangioblastoma with a solid (arrow) and cystic (arrow) component. The lesion was removed surgically.imageSingle‐strand polymorphism (SSCP) analysis of exon 1 of the VHL gene after amplification by polymerase chain reaction (PCR) and labelling. The patients blot (lane 2) showed an additional band (arrow) not present in the wild type DNA (lane 1) or the blot of his mother (lane 3) or sister (lane 4). Sequencing revealed an exchange of cytosine for guanine at nucleotide 477.imageFundus view after ruthenium‐106‐brachytherapy. The hemangioma shows complete regression.image
Type 1 diabetes patients with severe non‐proliferative retinopathy may benefit from panretinal photocoagulation
Authors: Lövestam‐Adrian Monica , Agardh Carl‐David , Torffvit Ole , Agardh Elisabet 
Published: May 2003

Abstract.Purpose:  To examine whether panretinal photocoagulation for severe non‐proliferative retinopathy in type 1 diabetes patients could halt the progression of retinopathy with subsequent vitreous haemorrhages and visual impairment.Methods:  During a 10‐year follow‐up study period of 344 type 1 diabetes patients, 81 subjects went through panretinal photocoagulation. Forty patients were treated for severe non‐proliferative retinopathy (age at onset of diabetes 14 ± 8 years, diabetes duration 18 + 10 years) and 41 for proliferative retinopathy (age at onset 15 ± 10 years, diabetes duration 22 + 13 years). One randomly selected eye per patient forms the basis for the study. Metabolic control, systolic and diastolic blood pressure, serum creatinine and urinary albumin levels were measured and analysed yearly during the follow‐up period.Results:  A total of 35% (14/40) of eyes treated for severe non‐proliferative retinopathy developed neovascularizations during a mean time of 2.9 ± 1.5 years. Vitreous haemorrhages were more frequent in eyes with proliferative retinopathy at treatment than in eyes with severe non‐proliferative retinopathy (12/41 versus 2/40; p = 0.007). The number of vitrectomies due to vitreous haemorrhages in eyes treated for severe non‐proliferative retinopathy tended to be lower (1/40 versus 6/41; p = 0.052). Before photocoagulation, visual acuity (VA) was similar in eyes with severe non‐proliferative retinopathy and in those with proliferative retinopathy (1.0, 0.4–1.0 versus 1.0, 0.1–1.0; median and range). Visual impairment and blindness tended to develop more often in eyes treated for proliferative retinopathy compared to those treated for severe non‐proliferative retinopathy (10/40 versus 4/40; p = 0.056). Eyes with neovascularizations at follow‐up were more often visually impaired (VA < 0.5) than eyes without neovascularizations (15/55 versus 1/26; p = 0.016).Conclusion:  In type 1 diabetes, panretinal photocoagulation may be beneficial even at the severe non‐proliferative retinopathy stage in terms of preventing vitreous haemorrhage, subsequent vitrectomy and visual impairment.
Longterm results of one‐site phacotrabeculectomy
Authors: Cagini Carlo , Murdolo Paola , Gallai Raffaella 
Published: May 2003

Abstract.Purpose:  To evaluate results of one‐site phacotrabeculectomy and intraocular lens (IOL) implantation.Methods:  A retrospective study of a consecutive series of 62 eyes with cataract and glaucoma, which underwent primary one‐site phacotrabeculectomy with IOL implantation. Mean follow‐up time was 28 ± 12.3 months (range 12–46 months).Results:  Preoperative mean intraocular pressure (IOP) (25.1 ± 8.6 mmHg) dropped significantly, to 16.4 ± 1.3 mmHg 1 year after surgery (p < 0.01). Mean logMAR best corrected visual acuity (VA) improved significantly from 0.74 ± 0.49 to 0.22 ± 0.28 (p < 0.01). The most common complications were fibrinous exudation (10%) and choroidal detachment (6%). In two eyes (3%) we successfully performed scleral flap revision to achieve IOP control.Conclusion:  One‐site combined surgery was a safe and effective procedure with good IOP control and visual rehabilitation.
Visual prognosis in immunocompetent patients with herpes zoster ophthalmicus
Authors: Zaal M. J. W. , Völker‐Dieben H. J. , D'Amaro J. 
Published: May 2003

Abstract.Purpose:  To determine the normal spectrum of ocular complications and associated visual outcome in patients with herpes zoster ophthalmicus.Methods:  This prospective observational cohort study included 73 immunocompetent adults with herpes zoster ophthalmicus, referred by their general practitioners within 7 days of skin rash onset. The follow‐up period was 6 months. All patients received a 7–14‐day course of systemic aciclovir treatment combined with longterm application of a lubricating ophthalmic ointment as long as the corneal epithelium was affected. Topical corticosteroids were strictly avoided in the acute phase of ocular disease. Acquired visual loss scores at 1, 2 and 6 months were based on best corrected visual acuity (BCVA) level and evaluation of the ophthalmological history and findings.Results:  Ophthalmic herpes zoster led to a variety of transient inflammatory reactions within the anterior eye segment of the involved side in 46 patients (63%), but did not seriously compromise their ultimate visual outcome. Mild to moderate visual loss, with corrected VA between 0.3 and 0.8, was found in 17 patients at 1 month (23%), in 10 patients at 2 months (14%) and in seven patients at 6 months follow‐up (10%). None of the patients developed visual loss with a corrected VA of less than 0.3.Conclusion:  Functional vision was retained in all ophthalmic zoster patients referred to the ophthalmologist in the acute phase of the disease by vigorous antiviral treatment and adequate prevention of corneal exposure.
Capillary haemangioma of the eyelids and orbit: a clinical review of the safety and efficacy of intralesional steroid
Authors: O'Keefe Michael , Lanigan Bernadette , Byrne Sinead A. 
Published: May 2003

Abstract.Purpose:  To describe the presenting features, investigations, treatment and outcome of a series of patients with capillary haemangioma of the eyelids and orbit.Methods:  A retrospective analysis of 21 patients, presenting between the years 1985 and 2000. Effectiveness of treatment was determined by final visual acuity and cosmetic result.Results:  Lesions were more common in females and the upper eyelid was a definite site of predilection. A total of 87.5% of lesions presented within 6 weeks of birth. Intralesional steroid injections were received by 79% of patients. Amblyopia was a definite complication. No local or systemic complications were associated with intralesional steroid injection. Surgery and laser treatment were reserved for persistent lesions.Conclusion:  Early recognition and prompt treatment with intralesional steroid prevents early occlusion amblyopia, but follow‐up and management of refractive amblyopia with glasses and patching is necessary in the longer term. In this series, intralesional steroid proved to be a safe effective treatment.
Eales' disease in Inuit: Report of four cases
Authors: Moldow Birgitte , La Cour Morten 
Published: May 2003

Abstract.Purpose:  To report four cases of Eales' disease in Inuit from Greenland diagnosed within a 6.5‐year period. There are no previous reports on Eales' disease among Greenlanders.Methods:  Four younger Inuit, three males and one female, were diagnosed with Eales' disease based on fundus changes and exclusion of possible differential diagnoses. Several studies point to a possible relation between Eales' disease and tuberculosis (TB); examination of possible exposure to TB was part of the clinical investigation.Results:  Retinal changes made panretinal laser photocoagulation necessary in all cases. Four eyes in three patients were vitrectomized. Three patients received oral corticosteroid treatment. The final visual outcome was relatively good, with a visual acuity below 6/60 (3/36) in only one vitrectomized eye. All patients had been exposed to TB.Conclusion:  Eales' disease seems to be rather common in the small population of Inuit (56 000) in Greenland. Attention is required to ensure diagnosis and appropriate treatment, including laser photocoagulation, leading to a reasonably good prognosis.