bluuebunny/crossref_metadata_2025_split huggingface dataset:
Self‐reported reproductive outcome and implications in relation to use of care in women in rural Zimbabwe
Authors: Nilses Carin , Nyström Lennarth , Munjanja Stephen , Lindmark Gunilla 
Published: March 2003

Background. In order to assess morbidity and health care utilization in developing countries, health interview surveys are often used. The aim of this paper is to explore morbidity, health care utilization during pregnancy and pregnancy outcome as reported by women in rural Gutu district, Zimbabwe.Methods. The study was cross‐sectional, performed 1992–93 in 12 villages selected at random. Women aged 15–44 years (n = 1213) were interviewed concerning their reproductive history, use of maternity care and complications during pregnancy/labor during their latest pregnancy.Results. The perinatal mortality rate (PMR) for all the completed pregnancies (889 women had completed 3601 pregnancies) was 23/1000 total births. The attendance rate for antenatal care was high (94%). Elevated blood pressure was the most commonly reported late pregnancy complication, and a prolonged labor, i.e. 24 h or more, the most common complication during delivery. Out of women whose latest pregnancy did not end in an early or late abortion (n = 831) the cesarean section rate was 6.3%. The PMR was 8.4/1000 for their latest pregnancy. Institutional deliveries were preferred by the majority of women, with hospital and clinic deliveries constituting 58% and 27% of deliveries, respectively, while 15% delivered at home. Long‐term complications were few, and only 14 (1.6%) women reported a current health problem, which they related to previous pregnancies.Conclusions. Antenatal attendance rate was high. The majority of women preferred institutional deliveries. Few women reported complications, which were not taken care of in the health service. Long‐term complications related to previous pregnancies were few.
Pregnancy outcome after suicide attempt by drug use: a Danish population‐based study
Authors: Flint Carolin , Larsen Helle , Nielsen Gunnar Lauge , Olsen Jørn , Sørensen Henrik Toft 
Published: March 2003

Background. It is important to study the side‐effects of drugs taken during pregnancy, however the findings are difficult to interpret because of a low exposure level, uncertainty of actual drug consumption and confounding by indication. Experience from accidental or intended drug intoxications may bypass some of these methodological shortcomings. Our aim was to examine reproductive failures and child health following a single drug overdose taken prior to or during pregnancy.Methods. Women diagnosed with a drug intoxication during pregnancy were identified in the Regional Hospital Discharge Registry of North, Jutland from 1977 to 1999 by linkage of diagnoses for abortion and delivery with diagnoses for intoxication. Hospital medical records were reviewed to obtain data on drug use, dosage, and pregnancy outcome (legally induced abortion/miscarriages/data on birth outcome). The hospitalization history of the children was followed for a mean of 9 years with a maximum of 20 years.Results. Of 122 women studied, 44 wanted an elective abortion, 17 experienced miscarriage, and 61, exposed mainly to weak analgesics and psychotropic drugs, gave birth to 62 infants. We estimated the proportion of miscarriage to be almost doubled, whereas there was no increased risk of congenital abnormalities or prematurity in women exposed to a drug overdose compared with the background population.Conclusions. A drug overdose shortly before or during pregnancy seems to be associated with a substantially increased risk of miscarriage, but there was no increase in fetal pathology at birth among fetuses surviving till birth.
Statistical techniques for the analysis of change in longitudinal studies of the menopause
Authors: Lehert P. , Dennerstein L. 
Published: March 2003

Objective. Critical review of statistical techniques used to analyze data from longitudinal studies.Method. Literature search and classification of statistical methods and their utilization evaluated against known underlying assumptions.Results. One hundred and twenty‐three papers found:1. cross‐sectional reduction of data (56%);2. multifactorial techniques (26%);3. repeated measurement analysis of variance (14%);4. other (time series and structural equation modelling) (4%).Conclusions. Cross‐sectional reduction violates underlying statistical assumptions. A simple and powerful technique is to mean values prior to and following an event such as the final menstrual period. To allow for the influence of multiple factors, linear regression is preferred to logistic regression where continuous data are available. For more information about evolution in time, more complex techniques are needed. A suitable technique is repeated measurement multivariate analysis of variance using a number of contrasts to estimate various effects. Split plot or randomized block designs cannot be recommended as they violate compound symmetry assumptions. For series involving more than 100 observations for each subject, time series and spectral analysis techniques should be considered. Structural equation modelling is recommended for examination in detail of a range of factors that may influence the studied end‐point, the presence of feedback and of latent or non‐measurable variables.
Do occult anal sphincter injuries, vector volume manometry and delivery variables have any predictive value for bowel symptoms after first time vaginal delivery without third and fourth degree rupture? A prospective study
Authors: Nazir Mohammad , Carlsen Erik , Nesheim Britt‐Ingjerd 
Published: March 2003

Background.  The aim of this study was to determine whether there exists a correlation between anal incontinence, occult sphincter injuries, anal manometry values, and delivery variables in primiparous women after first time vaginal delivery.Methods.  Eighty‐six primigravida women were recruited for this study. Transanal ultrasonography (TAUS) and vector volume manometry (VVM) was performed and bowel symptoms were recorded at 25 weeks of pregnancy and 5 months after labor. Incontinent women at 5 months after vaginal delivery were interviewed again at 12 months.Results.  Nineteen women (25%) experienced flatus incontinence postpartum. After 12 months, only one‐third of the women were still incontinent. Fourteen women (19%) showed abnormal TAUS of the anal sphincter. Of the delivery variables, only baby head circumference was significantly associated with flatus incontinence (p = 0.01). There was no correlation between flatus incontinence or delivery variables and anal sphincter injuries; VVM values were not associated with either anal sphincter injuries or flatus incontinence at 5 months, but VVM values were negatively associated with flatus incontinence at 12 months after labor.Conclusions.  At 5 months after labor, flatus incontinence is relatively common, and is not associated with reduced VVM values. Two‐thirds of women recover from flatus incontinence during the first year. Women who had flatus incontinence persisting for a minimum of 1 year had reduced VVM values. Anal sphincter injuries as seen by TAUS are not associated with either VVM values or any delivery variable. Baby head circumference is the only delivery variable significantly associated with flatus incontinence.
Expression of the vascular endothelial growth factors B and C and their receptors in human endometrium during the menstrual cycle
Authors: Möller Björn , Lindblom Bo , Olovsson Matts 
Published: March 2003

Background.  Endometrial angiogenesis is important for bleeding control and fertility, and is believed to be regulated by angiogenic growth factors under the influence of ovarian steroids.Objective.  To document the pattern of expression of the two angiogenic growth factors, vascular endothelial growth factor (VEGF)‐B and VEGF‐C, and of their receptors, VEGFR‐1, VEGFR‐2, and VEGFR‐3, in order to investigate their possible role in the regulation of angiogenesis in normal cycling human endometrium.Material and methods.  Cryosections of endometrial biopsy specimens obtained from 17 healthy women before laparoscopic sterilization were examined by immunohistochemistry.Results.  Vascular endothelial growth factor and VEGF‐C and their receptors were all expressed in and around endometrial blood vessels, with no obvious menstrual cycle‐dependent changes in expression except for VEGFR‐2, which showed stronger expression during the early secretary phase. Stromal blood vessel density did not change significantly during the menstrual cycle.Conclusion.  The presence and pattern of expression of these angiogenic growth factors and their receptors suggest that they participate in the regulation of normal endometrial angiogenesis.
Antithrombin III activity and platelet count are more likely to decrease in twin pregnancies than in singleton pregnancies
Authors: Tsunoda Tetsuo , Ohkuchi Akihide , Izumi Akio , Watanabe Takashi , Matsubara Shigeki , Sato Ikuo , Minakami Hisanori 
Published: March 2003

Background.  It is not known whether antithrombin III activity and platelet count are more likely to decrease in women with twin pregnancies than singleton pregnancies.Methods.  We enrolled 56 consecutive women with twin pregnancies and 692 consecutive women with singleton pregnancies. Antithrombin III activity and platelet count were determined at 26–31 weeks and again at 32–40 weeks of gestation. Thrombin–antithrombin complex, and plasmin–α2 plasmin inhibitor complex were measured simultaneously in some women.Results.  In twin pregnancies, both antithrombin III activity (111 ± 8.2%) and platelet count (244 ± 60 × 109/l) at 28.6 ± 1.0 weeks decreased over time to 91 ± 12% and 205 ± 59 × 109/l, respectively, at 35.2 ± 1.2 weeks; these decreases were significantly greater than in singleton pregnancies. However, a small number of women with singleton pregnancies had a significant decrease in antithrombin III activity in the absence of preeclampsia. The serum thrombin–antithrombin complex was significantly higher in twin pregnancies than in singleton pregnancies (9.7 ± 4.2 ng/ml vs. 6.7 ± 4.4 ng/ml, respectively, p < 0.01), and this increase correlated significantly with the decrease in antithrombin III activity in twin pregnancies (r = −0.459, p < 0.001).Conclusions.  Antithrombin III activity and platelet count show a greater decrease in twin than in singleton pregnancies, perhaps due to a greater increase in thrombin generation.
Relationship between blood pressure level in early pregnancy and subsequent changes in blood pressure during pregnancy
Authors: Iwasaki Ryuhiko , Ohkuchi Akihide , Furuta Itsuko , Ojima Toshiyuki , Matsubara Shigeki , Sato Ikuo , Minakami Hisanori 
Published: March 2003

Background.  It is not known whether women with high blood pressure in the first trimester are likely to exhibit a large increase in blood pressure during pregnancy.Methods.  We conducted a retrospective, longitudinal study of 1599 pregnant women, among whom 29 women (1.8%) received antihypertensive medication during pregnancy. The blood pressure levels measured during the first (7.9 ± 2.4 weeks), second (20.7 ± 1.2 weeks) and third trimesters (38.4 ± 1.7 weeks) were analyzed. The obstetric outcomes were examined in five subgroups divided according to the quintile of the first‐trimester mean arterial pressure level.Results.  The net change in blood pressure levels (third‐trimester value minus first‐trimester value) was significantly inversely correlated with the first‐trimester blood pressure levels irrespective of the use or lack of use of antihypertensive drugs. Women with the highest quintile first‐trimester mean arterial pressure had the largest body weight, exhibited a fall in blood pressure and had the smallest increase in body weight during pregnancy, and were significantly more likely to have a growth‐restricted infant.Conclusions.  Women with high initial blood pressure tended to exhibit a fall in blood pressure, whereas women with low initial blood pressure tended to exhibit a large increase in blood pressure during pregnancy. Women with high initial blood pressure and a small increase in body weight during pregnancy tended to have growth‐restricted infants.
Image analysis to improve diagnosis of exfoliation
Authors: Puska Päivi , Sassi Raija , Tarkkanen Ahti 
Published: March 2003

ABSTRACT.Purpose: To improve visualization of exfoliation material in standard colour photographs by image analysis.Methods: Standard anterior segment colour photographs taken from 17 patients with known exfoliation were subjected to film scanning with a maximum accuracy of 3175 dpi.Results: Before image scanning, visualization of exfoliation was classified as barely visible in 10 (59%) patients and clearly visible in 7 (41%) patients. After the image scanning, exfoliation material became clearly visible in 13 (76%) patients and could easily be demonstrated.Conclusion: Diagnosis of exfoliation material can be improved by standard film scanning.
Central serous chorioretinopathy following pigment epithelium detachment: fluorescein and indocyanine green angiography follow‐up
Authors: Gómez‐Ulla Francisco , Vázquez José Manuel , Rodríguez‐Cid María José , Des Julio , González Francisco 
Published: March 2003

ABSTRACT.Purpose: To evaluate the evolution from idiopathic serous pigment epithelium detachment (PED) to central serous chorioretinopathy (CSC).Methods: Fluorescein angiography (FA) and indocyanine green angiography (ICGA) were performed using the digital imaging system Topcon IMAGEnet H 1024.Results: A leakage point which later became the typical smokestack image of a CSC was found in the upper margin of the persistent PED. Dilation of the choroidal vessels under the detached neuroepithelium was also seen.Conclusions: Clinical and angiographic evidence about the relation betweeen the two entities can help us to understand CSC as a potential evolution of PED and to continue searching for the common injury of the pigment epithelium which probably is the primary event.
Screening and prevention of diabetic blindness
Authors: Stefánsson Einar , Bek Toke , Porta Massimo , Larsen Nikolaj , Kristinsson Jóhannes Kári , Agardh Elisabet 
Published: March 2003

ABSTRACT.: Diabetic eye disease remains a major cause of blindness in the world. Laser treatment for proliferative diabetic retinopathy and diabetic macular edema became available more than two decades ago. The outcome of treatment depends on the timing of laser treatment. The laser treatment is optimally delivered when high‐risk characteristics have developed in proliferative retinopathy or diabetic macular edema and before this has significantly affected vision. Laser treatment is usually successful if applied during this optimal period whereas the treatment benefit falls sharply if the treatment is applied too late.In order to optimize the timing of laser treatment in diabetic eye disease screening programs have been established. The oldest screening program is 20 years old and several programs have been established during the last decade. In this paper the organisation and methods of screening programs are described including direct and photographic screening. The incidence and prevalence of blindness is much lower in populations where screening for diabetic eye disease has been established compared to diabetic populations without screening. Technical advantages may allow increased efficiency and telescreening.From a public health standpoint screening for diabetic eye disease is one of the most cost effective health procedures available. Diabetic eye disease can be prevented using existing technology and the cost involved is many times less than the cost of diabetic blindness.
Diclofenac drops to treat inflammation after cataract surgery
Authors: Herbort Carl P. , Jauch Arthur , Othenin‐Girard Philippe , Tritten Jean‐Jacques , Fsadni Mario 
Published: March 2003

ABSTRACT.Purpose: To compare the anti‐inflammatory effect of topical diclofenac sodium 0.1% in a fixed combination with gentamicin 0.3% to the anti‐inflammatory effect of dexamethasone phosphate 0.1% in a prospective randomized double‐masked double‐dummy study in patients undergoing cataract surgery.Setting: Trial performed from June 1991 to April 1992 at the Hôpital Jules Gonin, Department of Ophthalmology, University of Lausanne, Lausanne, Switzerland.Methods: Inclusion of patients scheduled for extracapsular cataract extraction (ECCE) with implantation of an all PMMA intraocular lens (IOL). Double‐masked comparison of post‐operative inflammation in two randomized treatment groups: (1) fixed diclofenac sodium 0.1%/gentamicin 0.3% and vehicle drops 4X/day until day 12–14 and diclofenac sodium 0.1% 3X/day until day 28. (2) dexamethasone phosphate 0.1% drops 4X/day until postoperative day 12–14 and 3X/day until day 28 and gentamicin 0.3% drops 4X/day until day 12–14. Anterior chamber flare and cells, measured by laser flare‐cell photometry, were analyzed as the primary outcomes.Results: Eighty‐seven patients were recruited, 45 being assigned to the diclofenac group and 42 to the dexamethasone control group. Diclofenac was significantly better than dexamethasone at controlling flare at day 3 (p≤0.01) and day 12–14 (p≤0.002). Mean anterior chamber cells were also significantly lower at day 12–14 (p≤0.021) and day 28 (p≤0.012). The commonest adverse event was transient punctate keratitis, which occurred in 15 diclofenac and 3 dexamethasone patients.Conclusions: While both treatments were effective at controlling post‐operative inflammation, the diclofenac‐gentamicin combination followed by diclofenac alone was significantly better at suppressing flare and cells but showed a slightly higher incidence of punctate keratitis and eye discomfort.
The luminance fall in anomaloscope examination: clinical examples
Authors: Pinckers Alfred , Uvijls André 
Published: March 2003

ABSTRACT.Purpose: The evaluation of the anomaloscope slope quotient in patients with acquired colour vision deficiency.Methods: Two patients with Stargardt's disease in combination with protanomaly and deuteranomaly, respectively, were selected and also 3 patients with a presumed dominant optic atrophy of the protan type. The anomaloscope examination was performed according to the Linksz procedure. The luminance fall was calculated as the slope quotient SQ:Y units luminance fall per X units width of the matching range.Results: The SQ of the 2 Stargardt patients was steeper than the SQ of congenital colour vision defectives, especially at the red end of the anomaloscope green‐red mixture scale, indicating pathologic scotopization superimposed on the congenital deficiency. In optic atrophy of the protan type the SQ was flatter than in congenital deficiency, indicating that this deficiency has nothing to do with congenital protan deficiency.Conclusion: Calculation of the slope quotient SQ is helpful for the diagnosis of acquired colour vision deficiency, especially when the subject also has a congenital colour vision deficiency or is supposed to have such a deficiency.
Search for autoantibodies against the HNK‐1 carbohydrate epitope in the human eye in intermediate uveitis
Authors: Uusitalo Marita , Mikkilä Helena , Karma Anni , Kivelä Tero 
Published: March 2003

ABSTRACT.Purpose: Molecules bearing the immunogenic HNK‐1 epitope are present in the inner connective tissue layer and epithelia of the ciliary body. We investigated whether autoantibodies to these molecules can be detected in patients with intermediate uveitis, which affects the ciliary body.Methods: Serum was collected from 9 patients with intermediate uveitis, and from 6 controls with idiopathic iritis and 3 controls with sarcoid uveitis, representing nongranulomatous and granulomatous uveitis, respectively. The sera were used as polyclonal antibodies to immunostain 3 formalin‐fixed, paraffin‐embedded normal human donor eyes by the avidin‐biotinylated peroxidase complex method.Results: No immunostaining in the ciliary body could be detected using the sera from patients with intermediate uveitis or from the controls. Serum within blood vessels was nonspecifically immunolabelled with the secondary anti‐human antiserum.Conclusion: No autoantibodies against the HNK‐1 epitope or other antigens of the ciliary body could be demonstrated in patients with intermediate uveitis. It is unlikely that such autoantibodies against the HNK‐1 epitope have a role in intermediate uveitis.
Secondary glaucoma in patients with juvenile rheumatoid arthritis‐associated iridocyclitis
Authors: Foster C. Stephen , Havrlikova Katerina , Baltatzis Stefanos , Christen William G. , Merayo‐Lloves Jesus 
Published: March 2003

ABSTRACT.Purpose: The prevalence and management of glaucoma were evaluated in patients with juvenile rheumatoid arthritis (JRA)‐associated iridocyclitis.Methods: The records of 69 patients with JRA‐associated iridocyclitis were reviewed.Results: Twenty‐nine (42%) of these patients had secondary glaucoma or ocular hypertension. Glaucoma was controlled with topical treatment in only 7 of the 41 affected eyes (17%); systemic carbonic anhydrase inhibitor therapy resulted in control of another 8 eyes. Surgery controlled all but one of the remainder.Conclusion: Glaucoma is a common complication of JRA‐associated iridocyclitis. It results from prolonged, inadequately treated intraocular inflammation and in some instances, from steroid use. Medical and surgical therapy for the glaucoma associated with JRA‐uveitis is challenging and incompletely effective. We suspect that a more aggressive approach to the treatment of JRA‐associated uveitis, earlier in the course of the disease may reduce this vision robbing contribution to the process.
Skin Tests and Cutaneous Anergy in Children with Ocular Allergy
Authors: Bremond‐Gignac Dominique , Beydon Nicole , Laroche Laurent 
Published: March 2003

ABSTRACT.Purpose: To evaluate skin tests with clinical ocular allergy and to compare cutaneous hypersensitivity and seasonal allergic conjunctivitis in children.Case‐report: A 10‐year‐old girl presented a typical seasonal allergic conjunctivitis, never treated and the onset occurred one year before. She was skin tested for the allergy. Complete blood tests were also performed. An ocular treatment was given: olopatadine over 45 days.Results: She showed a complete cutaneous anergy including histamine and codeine controls. Radioallergosorbent tests (RAST) found numerous great positivity to different allergens. Within 30 days under ocular treatment, she recovered completely from symptoms and clinical signs.Conclusion: Clinical typical seasonal ocular allergy in children with cutaneous anergy should be explored further or at least treated. Cutaneous hypersensitivity should be evaluated more precisely with a larger study comparing results in general allergy and in ocular allergy where the anergy seems to be more frequent.
Is it mandatory to treat amblyopia prior to surgery in esotropia?
Authors: Dadeya Subhash , Ms Kamlesh 
Published: March 2003

ABSTRACT. Purpose: To determine whether presence of amblyopia has any influence on the outcome of motor and sensory success in cases of esotropia.Methods: 100 patients were taken for this study. Patients were divided into two groups of 50 each. Amblyopia was fully treated in group I and patients in group II underwent surgery before full treatment of amblyopia. Motor success (±10 PD of orthophoria) was assessed three months after surgery and at the child’s most recent visit by comparing the motor alignment at 6 meter and 0.33 meter distance using accommodative target in primary position. Sensory success was assessed by comparing the frequency of detectable stereoacuity.Results: There was no significant difference in motor success (84% vs 75%) and sensory success (55% vs 50%) whether amblyopia was fully treated or partially treated.Conclusion: It is not mandatory to treat ambloypia prior to surgery, unless it is a case of infantile esotropia with moderate amblyopia and amblyopia therapy is continued post operatively.