bluuebunny/crossref_metadata_2025_split huggingface dataset:
The pelvis as a passageway. I. Evolution and adaptations
Authors: STEWART D. B. 
Published: August 2005

Summary.Man has an unusual pelvis, a large fetal head, and a complicated mechanism of labour. The evolution of the pelvic girdle, like that of the hind limb, is a story with some chapters still missing. In mammals the pelvis has been modified in various interesting ways to effect compromises between its locomotor function and the requirements of parturition. Among the primates, the increasing size of the fetal brain may have necessitated a change in the attitude of the head from extension to flexion as it goes through the pelvis. The distinctive shape of the hominid pelvis is probably an adaptation to bipedal gait. The birth canal has changed from a shallow bony ring to a deep curved tube, through which the mature fetal head can only pass by rotating as it descends.
Quantitative uterine histology during the menstrual cycle in relation to measured menstrual blood loss
Authors: REES MARGARET C. P. , DUNNILL M. S. , ANDERSON ANNE B. M. , TURNBULL A. C. 
Published: August 2005

Summary.Endometrium and myometrium were collected at hysterectomy from 42 women with measured menstrual blood loss (range 4–840 ml). The specimens, obtained throughout the menstrual cycle, showed no evidence of organic disease on histological examination. The volume fraction occupied by arteries at the myometrial ‐ endometrial junction, and by glandular tissue throughout the endometrium was estimated with a point counting technique. The index of volume‐to‐surface ratio of endometrial glandular tissue was examined by a combination of point counting and linear intercept methods. No correlation was found between menstrual blood loss and endometrial and myometrial arterial density, endometrial glandular density and volume‐to‐surface ratio. Consequently, meno‐rrhagia, occurring in the absence of obvious pathology, does not appear to result from an excessive number of arteries of from abnormal glandular distribution.
A functional study of platelets in menstrual fluid
Authors: REES MARGARET C. P. , DEMERS LAURENCE M. , ANDERSON ANNE B. M. , TURNBULL A. C. 
Published: August 2005

Summary.Platelets were isolated from menstrual and peripheral venous blood samples taken from nine women during the first 2 days of menstruation. The washed platelets were tested for their ability to aggregate in response to arachidonic acid, ADP, and collagen, and to metabolize arachidonic acid. Menstrual platelets differed from venous platelets in (1) failing to aggregate when challenged with aggregatory stimuli and (2) producing no appreciable cyclo‐oxygenase products from arachidonic acid as reflected in thromboxane B2 release. However, incubation of peripheral venous platelets with menstrual serum obtained from the same patients induced aggregation. The responses of menstrual and peripheral venous platelets were the same irrespective of the patients’ total menstrual blood loss. Uterine venous platelets collected during menstruation from two patients at hysterectomy aggregated normally and produced thromboxane B2.
Normal variation in the length of the follicular phase of the menstrual cycle: effect of chronological age
Authors: LENTON ELIZABETH A. , LANDGREN BRITT‐MARIE , SEXTON LYNNE , HARPER ROSEMARY 
Published: August 2005

Summary.Normal probability plots were used to analyse the distribution of follicular phase length in a population of 293 apparently ovulatory menstrual cycles from women aged between 18 and 39 years. The length of the follicular phase was defined as the interval (in days) from the onset of menstruation up to, but not including, the day of the LH peak. Follicular phase length appeared to be log‐normally distributed and graphical inspection of the probability plot suggested that the geometric mean (and 95% confidence limits) of follicular phase length in this study group was 12–9 (10–3 to 16–3) days. There was a significant decrease (P<0.001) in follicular phase length with chronological age, from 14–2 days in women aged 18–24 years to 10.4 days in women aged 40–44 years.
Two patients with complete hydatidiform mole with 46, XY karyotype
Authors: FISHER ROSEMARY A. , SHEPPARD DAVID M. , LAWLER SYLVIA D. 
Published: August 2005

Summary.In a study to correlate the genetic origin of hydatidiform moles with the subsequent fate of the patients, 62 complete moles were examined for cytogenetic and/or biochemical polymorphisms. Comparisons of polymorphisms in molar tissue with those seen in white blood cells from the parents have shown that the majority of complete hydatidiform moles are androgenetic in origin and homozygous for all polymorphisms examined. Where karyotyped, these moles were found to be 46, XX. Three exceptions were found in which the molar tissue was heterozygous for enzyme polymorphisms. Cytogenetic analysis of two of these cases confirmed heterozygosity and also revealed a 46, XY karyotype which was androgenetic in origin, most likely arising by dispermy. The two patients with 46, XY complete moles have been followed up for a minimum of 9 months and neither has required treatment for persistent trophoblastic disease.
Smoking in pregnancy: effects on mother and fetus
Authors: KELLY J. , MATHEWS K. A. , O'CONOR M. 
Published: August 2005

summaryThe maternal and fetal effects of smoking tobacco or non‐tobacco cigarettes were studied in 75 pregnant patients and compared with a matched control group of 22 pregnant patients who did not smoke. The increase in maternal heart rate, maternal mean arterial pressure and fetal heart rate, and decrease in fetal heart rate ‘baseline variability’ and in fetal movements, were shown to be due primarily to the nicotine content of the cigarette.
Degradation of the coer‐releasing intrauterine contraceptive device and its significance
Authors: CHANTLER E. N. , SCOTT KRISTIN , FILHO C. ISAIA , ELSTEIN MAX , FARAGHER E. B. , LORIMER G. W. , BROUGH I. 
Published: August 2005

summaryMeasurements were made of the coer remaining on used Gravigard intrauterine contraceptive devices (lUCDs) that had been in utero for up to 40 months. The topography and composition of the surface deposits were analysed by scanning electron microscopy and energy‐dispersive X‐ray analysis. The rate of coer loss decreased exponentially from 0–42 μmol d−1 (26–7 μg d−1) upon insertion to 0‐056 μimol d−1 (3–6 μg d−1) after 26 months of use; between 27 and 40 months of use a linear release of 0–32 μimol d−1 (20–3 μg d−1) was observed. There was no correlation between this changing rate of coer loss and the pregnancy rate with the device in situ. The changes in the rate of coer loss were probably due to the growth of a surface corrosion product which, due to internal stresses, fractured after about 2 years and exposed fresh coer; this results in a progressive increase in breakage of the coer wire after 3 years. It is recommended that a coer IUCD of this type be replaced after 3 years.
A prospective study of primary cytomegalovirus infection during pregnancy: final report
Authors: GRIFFITHS P. D. , BABOONIAN C. 
Published: August 2005

summaryIn a 7‐year prospective study cytomegalovirus (CMV) was shown to infect aroximately twice as many pregnant women as did rubella virus. Fetal loss occurred in 4/26 (15%) early CMV infections which was seven‐fold higher than the rate found in controls (16/744; 2·2%). There was no evidence that fetal loss resulted from intrauterine transmission of virus. Fifty‐eight women experienced primary CMV infection and congenital infection was found in nine (20%) of the 46 infants from whom clinical samples were obtained. Transmission of virus was found in 20%, 0% and 40% in the first, second and third trimesters respectively. All babies were normal at birth but two have so far developed definite intellectual impairment attributable to cytomegalovirus infection. The mothers of both of these cases were infected after the fetus had become legally viable. We conclude that the lessons learned from studying rubella infection during pregnancy cannot be alied to cytomegalovirus; in particular, we could find no evidence that termination of pregnancy should be offered to women with early CMV infections.
Maternal diabetes and neonatal respiratory distress. I. Maturation of fetal surfactant
Authors: JAMES D. K. , CHISWICK M. L. , HARKES A. , WILLIAMS M. , TINDALL V. R. 
Published: August 2005

summaryThe phospholipid composition of amniotic fluid samples from 30 normal patients and 44 diabetic patients over the last 10 weeks of pregnancy was studied. Higher levels of phosphatidylcholine (PC) and phosphatidylinositol (PI) were found in diabetic pregnancies where there was excellent glucose control. These differences were statistically significant at 34–36 weeks. Phosphatidylglycerol (PG) aeared significantly earlier in the well controlled diabetic pregnancies. but even in the poorly controlled diabetics the levels of PC, PI and PG were comparable to those in normal pregnancies. There was no evidence of delayed aearance of fetal surfactant phospholipids in either the well or poorly controlled diabetic pregnancies. The absolute lecithin (PC)/sphingomyelin (SM) ratio in diabetic pregnancies was generally greater for any given gestational age than those in normal pregnancies. Whilst in most cases this was due to a higher PC concentration, in a few poorly controlled diabetics it was the result of a lower concentration of SM.
Treatment of severe pregnancy‐associated hypertension with the calcium antagonist nifedipine
Authors: WALTERS B. N. J. , REDMAN C. W. G. 
Published: August 2005

summaryThe calcium antagonist, nifedipine, was given orally to 21 women with acute episodes of severe hypertension during pregnancy or in the puerperium. A rapid and significant fall in blood pressure by an average of 26/20 mmHg was seen at 20 min after administration. The hypotensive effect was not significantly enhanced in those women already taking medication to lower the blood pressure. The principal side effects were headache and cutaneous flushing. No adverse fetal effects were detected. This is the first study of the use of this drug to control hypertension in pregnancy. The aarent efficacy of nifedipine justifies its further investigation in controlled trials.
Lupus anticoagulant in pregnancy
Authors: LUBBE W. F. , BUTLER W. S. , PALMER S. J. , LIGGINS G. C. 
Published: August 2005

summaryIn a group of 10 women with circulating lupus anticoagulant 25 intrauterine deaths were previously documented in the nine multigravidae. The presence of lupus anticoagulant activity was confirmed by showing prolongation of the activated partial thromboplastin time and kaolin clotting time with failure of correction of the prolongation on incubation with normal plasma. A clinical diagnosis of systemic lupus erythematosus (SLE) was made in four women. Three had deep vein thrombosis in pregnancy, one chorea gravidarum while two had only recurrent fetal losses. All the women had positive antinuclear antibody tests and blood platelet counts <175 × 109/1. Anti‐smooth muscle antibody and VDRL tests were each positive in half the patients; anti‐DNA antibody was present in two patients with clinically active SLE. In six pregnancies correction of the activated partial thromboplastin and kaolin clotting time was attempted using prednisone (40–60 mg/day); aspirin, 75 mg/day, was added. Five live infants were obtained, four by spontaneous delivery, when the restoration of the clotting abnormalities to normal was achieved. In one woman presenting with extensive deep vein thrombosis a live infant was delivered following therapeutic doses of heparin and low dose aspirin. Maternal lupus anticoagulant activity has major implications for pregnancy and should be excluded in women with a clinical suspicion of SLE, a positive antinuclear antibody test, thrombotic episodes, biologically false‐positive VDRL and unexplained late or repetitive early fetal losses.
Amoebic liver abscess in pregnancy. Case reports
Authors: MITCHELL R. W. , TEARE A. J. 
Published: August 2005

summaryAmoebic liver abscess is a rare complication of pregnancy. Two patients are described, one of whom was diagnosed at laparotomy at 28 weeks gestation, after which the pregnancy progressed normally to term. Diagnostic features and the importance of early treatment with metronidazole and aspiration or laparotomy are discussed.
Evidence‐Based Medicine and the Challenge of Low Back Pain: Where Are We Now?
Authors: Chou Roger 
Published: August 2005

Abstract:  Low back pain has long been described as a challenge for both primary care physicians and specialists. Management of low back pain has also been criticized as frequently arbitrary, inappropriate, or ineffective. Contributing factors have been an inadequate evidence base and a need for more rigorous appraisals of the available literature.Evidence‐based medicine, an approach to clinical problem solving, is predicated on the premise that high‐quality health care will result from practices consistent with the best evidence. In contrast to the traditional medical paradigm that placed a heavy reliance on expert opinion, authority, and unsystematic clinical observations, evidence‐based medicine emphasizes the need for rigorous critical appraisals of the scientific literature to inform medical decision making. Evidence‐based medicine places strong weight on the requirement for valid studies, particularly randomized controlled trials, to appropriately evaluate the effectiveness of health care interventions. Because of the rapidly increasing volume of medical literature, however, most clinicians are unable to keep up‐to‐date with all the new data. Two types of preprocessed evidence that can aid busy clinicians in medical decision making are systematic reviews and evidence‐based clinical practice guidelines. Like primary studies, systematic reviews and clinical practice guidelines must adhere to high methodologic standards to reduce error and bias.As in other areas of medicine, the approach to the management of low back pain has been positively affected by the availability of more clinical trials and better use of critical appraisal techniques to evaluate and apply research findings. In addition to more rigorous primary studies, an increasing number of high‐quality systematic reviews and evidence‐based clinical practice guidelines for low back pain are also available. Although some research gaps and methodologic shortcomings persist, the richer evidence base has greatly improved our understanding of what does and does not work for low back pain. Despite these advances, the best available evidence often does not inform everyday clinical decisions for low back pain. Nonetheless, there is widespread agreement that adherence to evidence‐based practice will help improve low back pain patient outcomes and reduce arbitrary variations in care. This article reviews basic principles of evidence‐based medicine, discusses evidence‐based medicine in the context of low back pain management, and summarizes some useful evidence‐based medicine resources.
Training effects of short bouts of stair climbing on cardiorespiratory fitness, blood lipids, and homocysteine in sedentary young women
Authors: Boreham C A G , Kennedy R A , Murphy M H , Tully M , Wallace W F M , Young I 
Published: August 2005

Objectives:To study the training effects of eight weeks of stair climbing on Vo2max, blood lipids, and homocysteine in sedentary, but otherwise healthy young women.Methods:Fifteen women (mean (SD) age 18.8 (0.7) years) were randomly assigned to control (n  =  7) or stair climbing (n  =  8) groups. Stair climbing was progressively increased from one ascent a day in week 1 to five ascents a day in weeks 7 and 8. Training took place five days a week on a public access staircase (199 steps), at a stepping rate of 90 steps a minute. Each ascent took about two minutes to complete. Subjects agreed not to change their diet or lifestyle over the experimental period.Results:Relative to controls, the stair climbing group displayed a 17.1% increase in Vo2maxand a 7.7% reduction in low density lipoprotein cholesterol (p<0.05) over the training period. No change occurred in total cholesterol, high density lipoprotein cholesterol, triglycerides, or homocysteine.Conclusions:The study confirms that accumulating short bouts of stair climbing activity throughout the day can favourably alter important cardiovascular risk factors in previously sedentary young women. Such exercise may be easily incorporated into the working day and therefore should be promoted by public health guidelines.
Measurement of scapula upward rotation: a reliable clinical procedure
Authors: Watson L , Balster S M , Finch C , Dalziel R 
Published: August 2005

Background:It is important to deal with the scapula when developing rehabilitation strategies for the shoulder complex. This requires clinical measurement tools that are readily available and easy to apply and which provide a reliable evaluation of scapula motion.Aim:To determine the reliability of the Plurimeter-V gravity inclinometer for the measurement of scapular upward rotation positions during humeral elevation in coronal abduction in a group of patients with shoulder pathology.Method:Twenty six patients were assessed in two repeat tests within a single testing session. Patients exhibiting a wide spectrum of shoulder pathology were selected. The angle of scapular upward rotation was measured during total shoulder abduction. The measurement protocol was performed twice during a single testing session by a single tester. Results of the two tests were compared and the reliability assessed by intraclass correlation coefficients (ICCs).Results:There was no significant difference in the scapula measurements taken during the two tests at each testing position. Overall, there was very good intrarater reliability (ICC  =  0.88). The ICC ranged from 0.81 (at 135°) to 0.94 (at both resting and end of total shoulder abduction range).Conclusion:The Plurimeter-V gravity inclinometer can be used effectively and reliably for measuring upward rotation of the scapula in all ranges of shoulder abduction in the coronal plane.
Effect of endurance training on lung function: a one year study
Authors: Kippelen P , Caillaud C , Robert E , Connes P , Godard P , Prefaut C 
Published: August 2005

Objective:To identify in a follow up study airway changes occurring during the course of a sport season in healthy endurance athletes training in a Mediterranean region.Methods:Respiratory pattern and function were analysed in 13 healthy endurance trained athletes, either during a maximal exercise test, or at rest and during recovery through respiratory manoeuvres (spirometry and closing volume tests). The exercise test was conducted on three different occasions: during basic endurance training and then during the precompetition and competitive periods.Results:During the competitive period, a slight but non-clinically significant decrease was found in forced vital capacity (−3.5%, p  =  0.0001) and an increase in slope of phase III (+25%, p  =  0.0029), both at rest and after exercise. No concomitant reduction in expiratory flow rates was noticed. During maximal exercise there was a tachypnoeic shift over the course of the year (mean (SEM) breathing frequency and tidal volume were respectively 50 (2) cycles/min and 3.13 (0.09) litres during basic endurance trainingv55 (3) cycles/min and 2.98 (0.10) litres during the competitive period; p<0.05).Conclusions:This study does not provide significant evidence of lung function impairment in healthy Mediterranean athletes after one year of endurance training.
Bone strength index in adolescent girls: does physical activity make a difference?
Authors: Greene D A , Naughton G A , Briody J N , Kemp A , Woodhead H , Corrigan L 
Published: August 2005

Background:Bone strength index (BSI) combines bone mineral and bone biomechanical properties to measure resistance to bending. This index may have greater clinical significance than the more often described markers of bone mineral content (BMC), areal density, or geometry alone and, in turn, may show a stronger relation to fracture risk. The BSI is the product of volumetric cortical bone mineral density (BMD) and cross sectional moment of inertia within a region of interest. Calculations combine dual energyxray absorptiometry and magnetic resonance imaging technologies and provide a useful, non-invasive measure of in vivo bone strength.Objectives:(a) To compare BSI in adolescent female middle distance runners and age matched controls; (b) to examine factors predictive of BSI in adolescent girls.Methods:Twenty adolescent female middle distance runners (mean (SD) age 16 (1.7) years, physical activity 8.9 (2.1) hours a week) and 20 female controls (age 16 (1.8) years, physical activity 2.0 (0.07) hours a week) were recruited. To calculate BSI, a region of interest representing 10% of the mid-distal tibia was analysed for dual energyxray absorptiometry derived BMC and was combined with bone geometry and biomechanical properties obtained by magnetic resonance imaging assessments. Potential predictors of BSI were also examined.Results:Independentttests showed that BMC (p  =  0.028), cortical bone volume (p  =  0.002), volumetric cortical BMD (p  =  0.004), cross sectional moments of inertia (p  =  0.005), and BSI (p  =  0.002) were higher in the distal tibia of athletes than of controls. The strongest predictor of BSI was hours of physical activity a week (R2 =  0.46).Conclusions:Athletes habitually exposed to high training loads displayed greater BSI at the distal tibia than controls. The results further confirm BSI as a significant and discerning marker in musculoskeletal health in adolescent girls engaged in high and low mechanical loading.
Physical activity of moderate intensity in leisure time and the risk of all cause mortality
Authors: Bucksch J 
Published: August 2005

Background:There are conflicting data about the health benefits of moderately intense physical activity.Objectives:To examine the effect of such activity on all cause mortality in a German sample of men and women.Methods:Physical activity during leisure time of 3742 men and 3445 women aged 30 to 69 was assessed in a baseline questionnaire from 1984 to 1986. The participants were observed during the follow up period until 1998 when a mortality follow up was conducted.Results:During the follow up period, 300 women and 643 men had died. The multivariate rate ratios (RR) for the volume of lifestyle activities of moderate intensity (for example, gardening, walking, cycling) compared with sedentary lifestyle showed a clearly protective dose–response relation (p for trend <0.001) in women but not in men (p for trend 0.20). Following the recommendation for health enhancing physical activity a second analysis was conducted; 2.5 hours per week taking part in physical activity of moderate intensity decreased the relative risk of overall mortality (0.65 (95% confidence interval, 0.51 to 0.82) and 0.90 (0.77 to 1.01) for women and men, respectively).Conclusions:The volume of lifestyle activities of moderate intensity in leisure time was inversely associated with all cause mortality in women but not in men. With regard to the health enhancing physical activity recommendation as a threshold, there were favourable findings only in women.