bluuebunny/crossref_metadata_2025_split huggingface dataset:
Correlates of fatigue in critical care nurses
Authors: Ruggiero Jeanne S. 
Published: December 2003

AbstractThe purposes of this study were to examine shift‐related differences in chronic fatigue and the contributions of sleep quality, anxiety, and depression to chronic fatigue among a random nationwide sample (N = 142) of female critical care nurses. Twenty‐three percent of this sample met criteria for clinical depression. Day and night nurses did not differ in their reports of chronic fatigue. Night nurses reported more depression and poorer sleep quality than did day nurses. Regression analyses indicated that among the variables of global sleep quality, depression, and anxiety, depression and sleep quality were the most relevant to the explanation of chronic fatigue. These findings suggest the need for studies of strategies to promote sleep and improve mood in critical care nurses. © 2003 Wiley Periodicals, Inc. Res Nurs Health 26:434–444, 2003
Appraisal, coping, hardiness, and self‐perceived health in community‐dwelling spouse caregivers of persons with dementia
Authors: DiBartolo Mary C. , Soeken Karen L. 
Published: December 2003

AbstractAlthough researchers have suggested that hardiness is associated with improved outcomes in stressful situations, findings regarding its moderating effects have been mixed. Relationships among hardiness, appraisal, coping, self‐perceived health, and other antecedent variables were examined in a convenience sample of 72 community‐dwelling spouse caregivers for persons with dementia. In this descriptive correlational design, participants completed a mailed survey. Regression analyses were used to detect main and moderating effects. Antecedent variables predicted 27% of the variance in caregiver appraisal, 23% of the variance in emotion‐focused coping, and 22% of the variance in self‐perceived health. In addition to its significant main effects, hardiness functioned as a significant moderator between the set of antecedent variables and caregiver appraisal. More research is needed to support the presence of main and moderating effects of hardiness in dementia caregivers. © 2003 Wiley Periodicals, Inc. Res Nurs Health 26:445–458, 2003
Barriers and facilitators of self‐reported physical activity in cardiac patients
Authors: Yates Bernice C. , Price‐Fowlkes Tammera , Agrawal Sangeeta 
Published: December 2003

AbstractThe purpose of this study was to examine the relationships of personal factors (age and gender), barriers (symptom distress and negative well‐being), and facilitators (self‐efficacy to exercise and positive well‐being) with self‐reported physical activity in cardiac patients. Sixty‐four participants (50 men, 14 women) 6–12 months post–cardiac event participated in this study. We found that age and gender accounted for 14.7% of the variance, symptom distress and negative well‐being accounted for an additional 21.6% of the variance, and self‐efficacy accounted for the remaining 7.6% of the variance for a total of 44% of the variance in physical activity levels explained. These results suggest that personal factors and barriers are central variables, in addition to self‐efficacy, in understanding the levels of physical activity achieved by patients after a cardiac event. © 2003 Wiley‐Liss, Inc. Res Nurs Health 26:459–469, 2003
Motherhood in the context of maternal HIV infection
Authors: Sandelowski Margarete , Barroso Julie 
Published: December 2003

AbstractMetasummary and metasynthesis techniques were used to integrate findings pertaining to motherhood in 56 reports of qualitative studies conducted with HIV‐positive women. Motherhood in the context of maternal HIV infection entailed work directed toward the illness itself and the social consequences of having HIV infection in the service of two primary goals: the protection of children from HIV infection and HIV‐related stigma and the preservation of a positive maternal identity. Motherhood both intensified and mitigated the negative physical and social effects of HIV infection. HIV‐positive mothers engaged in a distinctive kind of maternal practice—virtual motherhood—to resist forces that disrupted their relationships with and ability to care for their children, as well as their identities as mothers. © 2003 Wiley‐Liss, Inc. Res Nurs Health 26:470–482, 2003
Developing risk‐adjusted 30‐day hospital mortality rates
Authors: Tourangeau Ann E. , Tu Jack V. 
Published: December 2003

AbstractThis article describes one risk‐adjustment method useful for minimizing threats to internal validity that stem from the impact on the outcomes under investigation from patients' own characteristics and their associated risks. Mortality is the outcome used to illustrate the risk‐adjustment approach. A two‐step approach to outcomes research is suggested. The first step includes risk‐adjusting outcomes for patient characteristics by developing standard mortality rates. In the second step these risk‐adjusted standard rates can be used as dependent variables in outcomes analytic models. This article focuses on the first step. In the current study risk adjustment resulted in changes in both absolute values and rank ordering of hospital mortality rates compared to crude rates. This procedure is useful for developing risk‐adjusted outcomes with administrative data similar to those used in this study. © 2003 Wiley Periodicals, Inc. Res Nurs Health 26:483–496, 2003
Prenatal diagnosis of congenital genu recurvatum following amniocentesis complicated by leakage
Authors: Gorincour G. , Chotel F. , Rudigoz R. C. , Guibal‐Baggio A. L. , Berard J. , Pracros J. P. , Guibaud L. 
Published: December 2003

AbstractCongenital genu recurvatum (CGR) is an extremely rare condition observed at birth. It is associated with, among other malformations, genetic entities such as the Larsen syndrome. When CGR is isolated, orthopedic treatment will usually lead to a good functional prognosis. We report the first case of isolated CGR diagnosed prenatally and suspected to be a consequence of reduced amniotic fluid volume due to leakage following amniocentesis. The etiology and management options for CGR are briefly discussed. Copyright © 2003 ISUOG. Published by John Wiley & Sons, Ltd.
Single umbilical artery at 11–14 weeks' gestation: relation to chromosomal defects
Authors: Rembouskos G. , Cicero S. , Longo D. , Sacchini C. , Nicolaides K. H. 
Published: December 2003

AbstractObjectiveTo determine the possible association between single umbilical artery (SUA) at 11–14 weeks of gestation and the incidence of chromosomal abnormalities.MethodsColor flow imaging of the fetal pelvis was used to determine the number of umbilical arteries in 717 fetuses immediately before chorionic villus sampling for karyotyping at 11–14 weeks' gestation.ResultsSingle umbilical artery (SUA) was diagnosed in 21/634 (3.3%) chromosomally normal fetuses, in 5/44 (11.4%) with trisomy 21, 14/18 (77.8%) with trisomy 18 and 2/21 (9.5%) with other chromosomal defects. In the chromosomally normal group there was no significant difference in median fetal crown–rump length or nuchal translucency (NT) between those with a single and those with two umbilical arteries. In the 42 fetuses with SUA the expected number of cases of trisomy 21, estimated on the basis of maternal age, gestational age and fetal NT, was 4.7, which was not significantly different from the observed 5. The corresponding numbers for trisomy 18 were 2.0 for expected and 14 for observed (Fisher's exact test P = 0.0016).ConclusionA SUA at 11–14 weeks' gestation has a high association with trisomy 18 and other chromosomal defects. Copyright © 2003 ISUOG. Published by John Wiley & Sons, Ltd.
Relationship between placental blood flow resistance and precordial venous Doppler indices
Authors: Baschat A. A. 
Published: December 2003

AbstractObjectiveTo characterize the relationship between placental blood flow resistance and precordial venous Doppler indices in normal fetuses.MethodsThis was a prospective cross‐sectional Doppler study of uncomplicated pregnancies. Umbilical artery (UA), inferior vena cava (IVC) and ductus venosus (DV) were examined. Multiple indices were calculated for each vein and correlated with the UA pulsatility index (PI) and gestational age (GA). In addition, an arteriovenous ratio (AV ratio) between the UA PI and multiple venous indices was calculated and related to GA.ResultsIn the 237 patients studied all venous indices showed a linear relationship with the UA PI. All venous indices except the IVC preload index (PLI) had a significant positive correlation with the UA PI. Seven AV ratios were calculated and each had a linear negative relationship with GA. The relationship between UA PI and IVC pulsatility index for veins (PIV) and DV PIV remained constant throughout gestation. The AV ratio that utilized the IVC PLI and DV systolic/a‐wave ratio showed a significant decline with GA.ConclusionPlacental blood flow resistance least influences the IVC PLI while the converse is true for the PIV in both veins. A differential effect of placental afterload on various venous indices needs to be accounted for in situations of elevated placental blood flow resistance. AV Doppler ratios may be useful for this purpose. Copyright © 2003 ISUOG. Published by John Wiley & Sons, Ltd.
Oscillations of cerebrovascular resistance throughout the menstrual cycle in healthy women
Authors: Krejza J. , Siemkowicz J. , Sawicka M. , Szylak A. , Kochanowicz J. , Mariak Z. , Lewko J. , Spektor V. , Babikian V. , Bert R. 
Published: December 2003

AbstractObjectivesIncreased concentration of endogenous estrogen during a typical menstrual cycle has been shown to correlate with augmentation of blood flow through the internal carotid arteries (ICAs), which may be related to changes in vascular resistance within the brain. In this study we investigated the effects of endogenous estrogen and progesterone on cerebrovascular impedance in young healthy women.MethodsThe blood flow in the ICA and the common (CCA) and external (ECA) carotid arteries was studied with duplex Doppler sonography. The resistance index (RI) was determined and correlated with plasma 17β‐estradiol concentration in 14 young healthy women throughout their menstrual cycle.ResultsThe concentration of 17β‐estradiol increased in the follicular phase of the cycle and reached a peak on day 14, whereas concentration of progesterone remained low. Along with an increase in estrogen concentration, the ICA RI had decreased from its initial level on average by 9.2% on day 13 and by 6.7% on day 14 (P < 0.05). In contrast, the trend of the ECA RI was to increase during the peak of estrogen concentration. There were no significant changes in the CCA RI or in the systolic blood pressure, heart rate, hematocrit and hemoglobin concentration through the menstrual cycle.ConclusionsEstrogen‐related augmentation of blood flow through the ICA is caused mainly by decreased cerebrovascular impedance, as shown by a decrease in the ICA RI. These changes in RI suggest that estrogen influences cerebral impedance mainly by altering the resistance of cerebral microvasculature. Copyright © 2003 ISUOG. Published by John Wiley & Sons, Ltd.
Ultrasound prediction of risk of spontaneous miscarriage in live embryos from assisted conceptions
Authors: Choong S. , Rombauts L. , Ugoni A. , Meagher S. 
Published: December 2003

AbstractObjectiveAn accurate method to predict subsequent miscarriage in live embryos has not yet been established. This pilot study aimed to determine the most discriminatory ultrasound‐based model for predicting spontaneous miscarriage after embryonic life was first detected in assisted conceptions. A method for estimating individual risk of miscarriage was developed.MethodsThis was a prospective cross‐sectional survey of 322 live singleton embryos in women from an assisted reproductive technology program. Mean sac diameter (MSD), crown–rump length (CRL), embryonic heart rate (EHR), maternal age and gestational age at the first transvaginal scan detecting embryonic life (between 42 and 62 days) were observed. These variables were included in a multivariate model for predicting spontaneous miscarriage occurring prior to 20 weeks. MSD, CRL and MSD minus CRL were assessed in univariate logistic regression analyses. The global diagnostic accuracy of each model was compared directly using receiver–operating characteristics (ROC) curves.ResultsThe multivariate model demonstrated the best ROC curve for predicting miscarriage (ROC area 0.87; 95% CI, 0.80–0.95). The separate univariate analyses had less diagnostic accuracy. In particular, MSD − CRL had a significantly smaller ROC area (0.65) than did the multivariate model (P < 0.01).ConclusionsThe most discriminatory test for predicting spontaneous miscarriage in live embryos was a multivariate model, which allows estimation of individual risk levels. Copyright © 2003 ISUOG. Published by John Wiley & Sons, Ltd.
Late onset microcephaly: failure of prenatal diagnosis
Authors: Schwärzler P. , Homfray T. , Bernard J.‐P. , Bland J. M. , Ville Y. 
Published: December 2003

AbstractWe present a case of recurrent primary developmental microcephaly of late onset, the prenatal diagnosis of which could not be achieved despite performing targeted serial ultrasound scans that revealed no obvious fetal abnormality. Serial scans for head measurements and detailed examination of the brain anatomy by both transabdominal and transvaginal sonography including color and power Doppler assessment revealed no obvious brain abnormality. Frontal lobe distance and thalamic frontal lobe distance at 36 weeks were on the 30th and 50th centiles, respectively. Growth velocity remained on the 50th centile up to 36 weeks; between 36 and 38 weeks measurements were between the 35th and 40th centiles. The infant was delivered by Cesarean section at 38 weeks on parental request. On examination after birth the head circumference was on the 9th centile, but the facies was that of a microcephalic child with a sloping forehead and neurologically he was severely abnormal. The adequacy of the normal reference ranges used is reviewed: the use of sex‐specific growth charts at 38 weeks would have demonstrated the biparietal diameter and the head circumference to be on the 20th and 15th centiles, respectively, rather than just below the 40th centile. However, even sex‐specific charts may not allow the recognition of a substantial number of affected fetuses. Copyright © 2003 ISUOG. Published by John Wiley & Sons, Ltd.
Ultrasound examination at 37 weeks' gestation in the prediction of pregnancy outcome: the value of cervical assessment
Authors: Ramanathan G. , Yu C. , Osei E. , Nicolaides K. H. 
Published: December 2003

AbstractObjectiveTo examine the potential value of routine measurement of cervical length in singleton low‐risk pregnancies at 37 weeks of gestation in the prediction of onset and outcome of labor.MethodsCervical length was measured by transvaginal sonography at 37 weeks in 1571 singleton low‐risk pregnancies. Outcome measures were gestation at spontaneous onset of labor, post‐term delivery, duration of labor and mode of delivery.ResultsThe median cervical length at 37 weeks was 30 mm and there was a significant association between cervical length and gestation at delivery, which increased from a mean of 38 weeks for cervical length of 10 mm to 41 weeks for cervical length of 35 mm. The incidence of delivery after 40 weeks and 10 days was 296 (18.8%) and the incidence increased with cervical length at 37 weeks from 0% to 6%, 35% and 68% for respective cervical lengths of < 20, 21–30, 31–40 and 41–50 mm. In the pregnancies with spontaneous onset of labor the incidence of Cesarean section for failure to progress increased from 3.6% to 6.0%, 6.4% and 11.8% for cervical lengths of < 20, 21–30, 31–40 and 41–50 mm, respectively. In the pregnancies requiring induction for post‐term the incidence of Cesarean section for failed induction or failure to progress increased from 7.5% to 20.1% to 25.0% for cervical lengths of 21–30, 31–40 and 41–50 mm, respectively.ConclusionMeasurement of cervical length at 37 weeks can define the likelihood of spontaneous delivery before 40 weeks and 10 days and the risk of Cesarean section in those requiring induction for prolonged pregnancy. Copyright © 2003 ISUOG. Published by John Wiley & Sons, Ltd.
Prenatal diagnosis of a cleidocranial dysplasia‐like phenotype associated with a de novo balanced t(2q;6q)(q36;q16) translocation
Authors: Winer N. , Le Caignec C. , Quere M. P. , David A. , Boceno M. , Aubron F. , Joubert M. , Boog G. , Philippe H. J. , Rival J. M. 
Published: December 2003

AbstractCleidocranial dysplasia (CCD) is a congenital disorder of bone development characterized by persistently open or delayed closure of cranial sutures and wormian bones, hypoplastic and/or aplastic clavicles, wide pubic symphysis, dental anomalies and short stature. The condition is inherited as an autosomal‐dominant trait and the human CBFA1 gene has been identified as the CCD gene. We describe a prenatal form of the skeletal disorder that included clavicular hypoplasia, absence of ossification of the cranial parietal bones and very poor ossification of the frontal and pubic bones. Growth restriction affecting only the long bones was also noted. The fetal karyotype revealed an apparently de novo balanced t(2q;6q)(q36;q16) translocation. This particular form of skeletal disorder associated with the absence of family history and an apparently de novo balanced translocation led the parents to opt for termination of the pregnancy. Copyright © 2003 ISUOG. Published by John Wiley & Sons, Ltd.
Endoanal sonography in assessment of fecal incontinence following obstetric trauma
Authors: Martínez Hernández Magro P. , Villanueva Sáenz E. , Jaime Zavala M. , Sandoval Munro R. D. , Rocha Ramírez J. L. 
Published: December 2003

AbstractObjectivesFecal incontinence is a common, incapacitating and largely unrecognized medical problem and can be caused by various factors. Obstetric trauma is the most common cause of fecal incontinence secondary to trauma. We aimed to analyze the role of endoanal ultrasound in assessment of this type of fecal incontinence, and report the functional results of surgical treatment.MethodsWe reviewed the records of all 22 patients with fecal incontinence secondary to obstetric trauma who were evaluated by endoanal ultrasound and underwent surgical management in our department from April to 1997 to April 2002. Pre‐ and postoperative evaluation of the degree of incontinence was done using the incontinence score of Jorge and Wexner.ResultsThe patients had a median age of 43 (range, 29–68) years. All had vaginal deliveries, five of which (22.7%) were instrumental. Most of the patients had total fecal incontinence (solids) with preoperative incontinence score values of 15–20 (median, 18). Endoanal ultrasound confirmed structural defects in the anterior external anal sphincter alone in 16 (72.7%) patients, and both anterior external and internal sphincter defects in six (27.3%) patients. A thinned perineal body was present in all patients. All patients received surgical treatment with overlapping sphincteroplasty and there was improvement of continence in 19 (86.4%) patients with postoperative incontinence score values between 4 and 0 (median, 2).ConclusionsEndoanal sonography is an accurate method for assessing sphincter anatomy, delineating both internal and external anal sphincters. Surgical treatment of sphincter defects is associated with good outcome. Copyright © 2003 ISUOG. Published by John Wiley & Sons, Ltd.
Results of endosonographic imaging of the anal sphincter 2–7 days after primary repair of third‐ or fourth‐degree obstetric sphincter tears
Authors: Starck M. , Bohe M. , Valentin L. 
Published: December 2003

AbstractObjectivesTo describe the endosonographic image of the anal sphincter 2–7 days after delivery in women who had undergone a primary repair of an obstetric sphincter tear.MethodsForty‐eight women who had suffered a third‐ or fourth‐degree sphincter tear at delivery and had undergone primary sphincter repair were examined with endoanal sonography 2–7 days after delivery. A score from 0 to 16 was used to describe the extent of the endosonographic defects, a score of 0 indicating no defect and a score of 16 a defect > 180° involving the whole length and depth of the sphincter. Clinical information was retrieved from the delivery and operation records after the analysis of the ultrasound images and the classification of the sonographic defects had been completed.ResultsClinically, 34 (71%) women had a partial third‐degree tear, 11 (23%) had a total third‐degree tear, and three (6%) had a fourth‐degree tear. Forty‐three (90%; 95% CI, 77–97%) women had sonographic defects, all hypoechoic. Twenty‐three (54%) sonographic defects were confined to the proximal part of the anal canal and involved less than half of the length of the anal canal. Thirty (63%) defects were confined to the external sphincter. Five of nine women (56%) with an endosonographic sphincter defect score ≥ 8 had undergone primary sphincter repair by a doctor in training vs. 9 of 39 women (23%) with an endosonographic sphincter score < 8 (P = 0.05), despite the fact that 86% (12/14) of the tears sutured by doctors in training were clinically partial third‐degree tears vs. 65% (22/34) of those sutured by specialists (P = 0.15). Five (15%) of 34 women with a clinical partial third‐degree tear had an endosonographic sphincter score ≥ 8 vs. four (29%) of 14 with a clinical total third‐ or fourth‐degree sphincter tear (P = 0.26).ConclusionsMost women (90%) with a clinical third‐ or fourth‐degree obstetric sphincter tear have endosonographic sphincter defects if they are examined 2–7 days after primary repair. The extent of the endosonographic defects seems to be determined mainly by the surgical experience of the doctor performing the repair, and not by the clinical degree of the tear. Copyright © 2003 ISUOG. Published by John Wiley & Sons, Ltd.
Uterine artery blood flow velocity waveforms during uterine contractions
Authors: Li H. , Gudmundsson S. , Olofsson P. 
Published: December 2003

AbstractObjectiveNo quantitative or qualitative Doppler velocimetry classification of vascular flow resistance covering all stages of forward and reversed flows exists. The objective of this study was to characterize uterine artery (UtA) flow velocity waveforms (FVWs) obtained during an oxytocin challenge test (OCT) and compare them to FVWs in spontaneous normal labor.MethodsUterine artery Doppler velocimetry was performed during and between uterine contractions in 61 high‐risk pregnancies subjected to an OCT and in 20 normal pregnancies undergoing spontaneous labor. FVWs were classified relative to the presence of forward/absent/reversed flow during systole and diastole, and the time‐averaged flow velocity over the heart cycle.ResultsEleven different FVW classes were identified. No relationship between FVWs recorded during uterine inertia and contractions was found (P ≥ 0.2). In both groups, only forward FVWs were recorded between contractions, whereas during contractions flow reversal was more common in the OCT group (P ≤ 0.002). In cases of predominantly reversed flow, a reciprocal relationship to FVW classes recorded in the contralateral artery was found.ConclusionsUtA FVW patterns recorded during uterine contractions were not predicted by flow patterns recorded during uterine inertia. Reversal of flow direction was more common during oxytocin‐induced uterine contractions than during spontaneous contractions. In cases of predominantly reversed flow, domains of the uterus may be supplied by blood from the contralateral UtA. These observations give new insights into the circulatory dynamics of the uterus during labor, and also point to a possible vasoconstrictory effect in the UtAs of oxytocin at high concentrations. Copyright © 2003 ISUOG. Published by John Wiley & Sons, Ltd.