1.  Title: Progestogen-only contraceptives and the risk of stroke: a meta-analysis. Author: Chakhtoura Z; Canonico M; Gompel A; Thalabard JC; Scarabin PY; Plu-Bureau G Source: Stroke; A Journal of Cerebral Circulation. 2009 Apr;40(4):1059-62. Abstract: BACKGROUND AND PURPOSE: The association between combined oral contraceptives (OC) use and increased risk of stroke has been reported. While progestogen-only contraceptives (POC) are commonly used worldwide, their impact on cardiovascular disease remains unclear. METHODS: A meta-analysis based on EMBASE and MEDLINE referenced literature corresponding to OCs marketed since 1960 was carried out. Eligible articles assessing the risk of stroke in relation to OC or POC were reviewed, and relevant studies were extracted. All types of POC and routes of administration were taken into account in the meta-analysis. RESULTS: Six case-control studies were identified. The combined odd ratio (OR) showed no increase in the risk of stroke among POC users (OR=0.96; 95% confidence interval: 0.70 to 1.31). This result was similar according to the route of administration (either implant or injectable or oral POC). CONCLUSIONS: Data from observational studies show that POC use is not associated with an increased risk of stroke. However, these results are based on limited data. Further investigations are needed in women with risk factors of stroke. Language: English Keywords: FRANCE | LITERATURE REVIEW | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | CASE CONTROL STUDIES | COMPARATIVE STUDIES | WOMEN | PREVALENCE | ORAL CONTRACEPTIVES, SIDE EFFECTS | CONTRACEPTIVE AGENTS, PROGESTIN | RISK ASSESSMENT | CEREBROVASCULAR EFFECTS | CONTRACEPTIVE IMPLANTS | INJECTABLES | Developed Countries | Europe, Western | Europe | Research Methodology | Studies | Demographic Factors | Population | Measurement | Contraceptive Safety | Safety | Public Health | Health | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Evaluation | Physiology | Biology | Contraceptive Methods Document Number: 331085 |
| 2. Title: Cerebral venous and sinus thrombosis in women. Author: Coutinho JM; Ferro JM; Canhao P; Barinagarrementeria F; Cantu C; Bousser MG; Stam J Source: Stroke. 2009 Jul;40(7):2356-61. Abstract: BACKGROUND AND PURPOSE: Little is known about the gender-specific manifestations of cerebral venous and sinus thrombosis, a disease that is much more common in women than men. METHODS: We used data of the International Study on Cerebral Vein and Dural sinus Thrombosis (ISCVT), a multicenter prospective observational study, to analyze gender-specific differences in clinical presentation, etiology, and outcome of cerebral venous thrombosis. RESULTS: Four hundred sixty-five of a total of 624 patients were women (75%). Women were significantly younger, had less often a chronic onset of symptoms, and had more often headache at presentation. There were no gender differences in ancillary investigations or treatment. A gender-specific risk factor (oral contraceptives, pregnancy, puerperium, and hormonal replacement therapy) was present in 65% of women. Women had a better prognosis than men (complete recovery 81% versus 71%l P=0.01), which was entirely due to a better outcome in female patients with gender-specific risk factors. Women without gender-specific risk factors are similar to men in clinical presentation, risk factor profile, and outcome. Logistic regression analysis confirmed that the absence of gender-specific risk factors is a strong and independent predictor of poor outcome in women with sinus thrombosis (OR, 3.7; CI, 1.9 to 7.4). CONCLUSIONS: Our study identified important differences between women and men in presentation, course, and risk factors of cerebral venous and sinus thrombosis and showed that women with a gender-specific risk factor have a much better prognosis than other patients. Language: English Keywords: GLOBAL | RESEARCH REPORT | PROSPECTIVE STUDIES | STATISTICAL REGRESSION | CLIENTS | WOMEN | CEREBROVASCULAR EFFECTS | THROMBOSIS | RISK FACTORS | SEX FACTORS | SIGNS AND SYMPTOMS | Studies | Research Methodology | Data Analysis | Program Activities | Programs | Organization and Administration | Demographic Factors | Population | Physiology | Biology | Thromboembolism | Embolism | Vascular Diseases | Diseases | Health | Population Characteristics Document Number: 342314 |
| 3. Peer Reviewed Title: Eligibility criteria in venous thromboembolism, myocardial infarction, and stroke among transdermal contraceptive system users. Author: Dore DD; Norman H; Seeger JD Source: Obstetrics and Gynecology. 2009 Jul;114(1):175. Abstract: An erratum printed in Obstetrics & Gynecology in June of 2008 corrected the stated eligibility criterion in a study of venous thromboembolism, myocardial infarction (MI), and stroke in transdermal contraceptive users reported by Cole and colleagues. Originally, it was reported that the authors excluded women with malignancies other than nonmelanoma skin cancer. The actual exclusion implemented was slightly broader: women with a neoplasm other than benign skin disorders. We applied the originally stated exclusion of women to the original study population, so that women with evidence in the claims data of malignancy other than nonmelanoma skin cancer (International Classification of Diseases, 9th revision: 140.xx-208.xx, except 173.xx) were excluded rather than the broader version actually implemented (International Classification of Diseases, 9th revision: 140.xx-239.xx, except 232.xx). There were approximately 423,000 women in the source population before application of exclusions, and 2.4% of them were excluded because of the nonmalignancy neoplasm codes used. In the originally reported case-control analysis comparing use of the transdermal contraceptive to norgestimate- containing oral contraceptives with 35 micrograms of ethinyl estradiol, the odds ratio (OR) for venous thromboembolism was 2.0 (95% confidence interval [CI] 1.0-4.1) overall and 2.4 (95% CI 1.1-5.5) after exclusion of women with high-risk factors and 2.1 (95% CI 0.3-15.5) for MI. No strokes were observed among transdermal contraceptive users. Application of the narrower exclusion criterion (consistent with the originally stated exclusion by Cole and colleagues), yielded six additional cases matched to 24 controls, leading to ORs for venous thromboembolism of 2.0 (95% CI 1.0-4.0) overall and 2.5 (95% CI 1.1-5.5) after exclusion of women with high-risk factors and 2.1 (95% CI 0.3-15.5) for MI. No strokes were observed in transdermal contraceptive users. The broader definition of neoplasm that was used for exclusion in the original analysis did not materially affect the observed association measures. This finding is consistent with the study design principle that the application of broader exclusions will lead to noticeably different estimates than application of narrower exclusions only in settings where the effect (not just the risk) among excluded participants is substantially different from what it is among included participants. (full-text) Language: English Keywords: UNITED STATES OF AMERICA | CRITIQUE | THROMBOEMBOLISM | MYOCARDIAL INFARCTION | CEREBROVASCULAR EFFECTS | CONTRACEPTIVE IMPLANTS | Developed Countries | North America | Americas | Embolism | Vascular Diseases | Diseases | Heart Diseases | Physiology | Biology | Contraceptive Methods | Contraception | Family Planning Document Number: 341716 |
| 4. Peer Reviewed Title: Maternal deaths due to eclampsia and HELLP syndrome. Author: Vigil-De Gracia P Source: International Journal of Gynecology and Obstetrics. 2009;104:90-94. Abstract: Objective: To evaluate maternal deaths associated with eclampsia, HELLP syndrome, and the concurrence of these conditions. Method: A review of Medline studies reporting maternal deaths associated with eclampsia or HELLP syndrome published in English, Spanish, and Portuguese between 1995 and June 2008. Results: A total of 304 deaths were identified: 100 due to eclampsia, 117 due to eclampsia/HELLP, and 87 associated with HELLP syndrome. Of the total deaths, 71.3% of women had seizures and 67.1% developed HELLP syndrome. In high-income countries 3.9% of deaths were due to eclampsia without HELLP syndrome, while in low-income countries this figure was 42.5% (Pb0.0001). The presence of HELLP syndrome in the women who died of eclampsia was 90.6% (29/32) in high-income countries compared with 47.6% (88/185) in low-income countries (Pb0.001). Conclusion: Concurrent eclampsia and HELLP syndrome was diagnosed in 5-6 out of 10 deaths associated with eclampsia or HELLP syndrome in this review. Language: English Keywords: GLOBAL | RESEARCH REPORT | LITERATURE REVIEW | MATERNAL MORTALITY | ECLAMPSIA | PREECLAMPSIA | CAUSES OF DEATH | HYPERTENSION | CEREBROVASCULAR EFFECTS | LIVER DYSFUNCTION | BLOOD PRESSURE | Mortality | Population Dynamics | Demographic Factors | Population | Pregnancy Complications | Diseases | Vascular Diseases | Physiology | Biology | Hemic System Document Number: 340212 |
| 5. Title: Reproductive history, oral contraceptive use, and the risk of ischemic and hemorrhagic stoke in a cohort study of middle-aged Swedish women. Author: Yang L; Kuper H; Sandin S; Margolis KL; Chen Z; Adami HO; Weiderpass E Source: Stroke; A Journal of Cerebral Circulation. 2009 Apr;40(4):1050-8. Abstract: BACKGROUND AND PURPOSE: Controversy persists as to whether oral contraceptive (OC) use and reproductive history play a role in the etiology of stroke, particularly ischemic stroke. Our aim was to investigate this question in a cohort of middle-aged Swedish women. METHODS: The Women's Lifestyle and Health Cohort Study included 49259 Swedish women, aged 30 to 49 years at baseline (1991 to 1992). Participants completed an extensive questionnaire and were traced through linkages to national registries until the end of 2004. RESULTS: Among the 45699 women included in these analyses, there were 285 cases of incident stroke during follow-up (193 ischemic stroke, 72 hemorrhagic stroke, and 20 of unknown origin). Neither ischemic nor hemorrhagic stroke risk was related to OC use, duration, or type of OC use, even among women who were smokers or hypertensive. Though not statistically significant, risk of hemorrhagic stroke was elevated in women who started using OCs after the age of 30 (Hazard Ratio [HR] 2.3, 95% CI=0.8 to 6.8) and women recommended by a doctor to stop using OC for medical reasons (2.1, 0.9 to 5.0) compared with never users. Compared with nulliparous women, parous women had a statistically significant lower risk of hemorrhagic stroke (0.5, 0.2 to 0.8), but similar association was not found for ischemic stroke (0.9, 0.5 to 1.4). CONCLUSIONS: There was no significant association of OC use with ischemic or hemorrhagic stroke, and the parity was associated with reduced risk of hemorrhagic stroke but not with ischemic stroke. Language: English Keywords: SWEDEN | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | COHORT ANALYSIS | FOLLOW-UP STUDIES | WOMEN | MIDDLE AGED ADULTS | PREVALENCE | ORAL CONTRACEPTIVES, SIDE EFFECTS | CEREBROVASCULAR EFFECTS | ORAL CONTRACEPTIVES, CONTRAINDICATIONS | PARITY | RISK FACTORS | Developed Countries | Europe, Northern | Europe | Research Methodology | Studies | Demographic Factors | Population | Adults | Age Factors | Population Characteristics | Measurement | Contraceptive Safety | Safety | Public Health | Health | Physiology | Biology | Fertility Measurements | Fertility | Population Dynamics Document Number: 331084 |
| 6. Title: Migraine and stroke: the role of oral contraceptives. Author: Allais G; Gabellari IC; Mana O; Schiapparelli P; Terzi MG Source: Neurological Sciences. 2008 May;29 Suppl 1:S12-4. Abstract: The use of oral contraceptives (OCs) confers an increased risk for ischaemic stroke (IS). This risk slightly decreases, but remains significant, if low-dose formulations are used, particularly if other risk factors, such as hypertension or smoking, are associated. Some inherited prothrombotic conditions (e.g., Factor V Leiden, G20210A prothrombin or methylenetetrahydrofolate reductase C677T polymorphism) could also greatly increase the IS risk if present in OC users. Migraine, particularly with aura, is an independent risk factor for IS, and the patient's IS risk is probably affected by other individual risk factors (e.g., age, genetic predisposition to thrombosis, presence of patent foramen ovale or enhanced platelet aggregation) which seem to be over-represented in migraine patients. IS risk among migraineurs is further increased when OCs are currently used and can become very high if associated with smoking. Consequently, in 2004 the WHO stated in its 'Medical Eligibility Criteria for Contraceptive Use' that women suffering from migraine with aura at any age should never use OCs. Moreover, since the exposure to the effects of OCs may greatly increase the IS risk in some migraine subpopulations with specific personal characteristic, testing for these risk factors may allow for more accurate stratification of the population at risk before long-term use of OCs is prescribed. Language: English Keywords: ITALY | RESEARCH REPORT | WOMEN | MIGRAINE | ORAL CONTRACEPTIVES | CEREBROVASCULAR EFFECTS | RISK FACTORS | Developed Countries | Europe, Southern | Europe | Demographic Factors | Population | Vascular Diseases | Diseases | Contraceptive Methods | Contraception | Family Planning | Physiology | Biology Document Number: 328668 |
| 7. Peer Reviewed Title: Increased risk of stroke in patients who undergo cesarean section delivery: A nationwide population-based study. Author: Lin SY; Hu CJ; Lin HC Source: American Journal of Obstetrics and Gynecology. 2008 Apr;198(4):391.e1-391.e7. Abstract: This study used a population-based dataset to determine whether (compared with vaginal deliveries), cesarean section deliveries increase the risk of postpartum stroke during the 3-, 6-, or 12-month period after delivery. This study used 1998-2003 records from the Taiwan National Health Insurance Research Database for 987,010 women with singleton deliveries from 1998-2002. Cox proportional hazard regressions were carried out to compute stroke-free survival rates between the 2 delivery modes. The regression model indicated that, compared with patients who delivered vaginally, the hazard ratio for postpartum stroke among those who delivered by cesarean section was 1.67 times greater within 3 months of delivery (95% CI, 1.29-2.16), was 1.61 times greater within 6 months of delivery (95% CI, 1.31-1.98), and was 1.49 times greater within 12 months of delivery (95% CI, 1.27-1.76). Our data indicates that cesarean section delivery is an independent risk factor for stroke. (author's) Language: English Keywords: TAIWAN | RESEARCH REPORT | COMPARATIVE STUDIES | POSTPARTUM WOMEN | CESAREAN SECTION | CEREBROVASCULAR EFFECTS | RISK FACTORS | ANESTHESIA | ECLAMPSIA | PREECLAMPSIA | Asia, Eastern | Asia | Developed Countries | Studies | Research Methodology | Puerperium | Reproduction | Obstetrical Surgery | Surgery | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Physiology | Biology | Pregnancy Complications | Diseases Document Number: 325967 |
| 8. Peer Reviewed Title: Maternal deaths due to hypertensive disorders in pregnancy. Author: Moodley J Source: Best Practice and Research Clinical Obstetrics and Gynaecology. 2008;22(3):559-567. Abstract: Hypertensive disorders of pregnancy (HDP) are one of the most common direct causes of maternal mortality worldwide. Cerebral haemorrhage is the main final cause of hypertensive deaths and probably implies that doctors are reluctant to treat sustained high blood pressure effectively during pregnancy. Maternal deaths from HDP can probably be reduced markedly by: (1) promoting antenatal care and instituting a recall system for defaulters; (2) instituting regional centres and regional obstetricians to provide advice on, or care for, women with severe pre-eclampsia; (3) educating health professionals through continuing professional education and the use of clinical guidelines of management; and (4) informing the general public on complications associated with the pre-eclampsia/eclampsia syndrome. (author's) Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | PREGNANT WOMEN | MATERNAL MORTALITY | PREGNANCY | HYPERTENSION | PREECLAMPSIA | CEREBROVASCULAR EFFECTS | BLEEDING | CAUSES OF DEATH | PREVENTION AND CONTROL | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Population Characteristics | Demographic Factors | Population | Mortality | Population Dynamics | Reproduction | Vascular Diseases | Diseases | Pregnancy Complications | Physiology | Biology | Signs and Symptoms Document Number: 326567 |
| 9. Title: Thrombophilic risk factors among 16 Lebanese patients with cerebral venous and sinus thrombosis. Author: Otrock ZK; Taher AT; Shamseddeen WA; Mahfouz RA Source: Journal of Thrombosis and Thrombolysis. 2008 Aug;26(1):41-3. Abstract: Cerebral venous and sinus thrombosis (CVST) is a multifaceted disorder. The frequency of inherited and acquired thrombophilia among 16 CVST patients was evaluated. The mean age of the patients was 22.9 years. Five out of the 16 CVST patients (31.2%) showed the G1691A mutation of factor V. The frequency of the C677T methylenetetrahydrofolate reductase (MTHFR) genotype was 50% (8/16) in patients (2 of them were homozygous). Four of the patients (25%) had both factor V Leiden and MTHFR mutation. Three of the patients had positive antiphospholipid antibodies. At the time of CVST, 2 female patients were taking oral contraceptive pills. Four patients were known to have malignancies. Despite the limitation of the sample size, we identified an inherited coagulopathy at high rate in our patients. Combined inherited thrombophilia was also present in 25% of patients. This finding supports the impression of a multifactorial process leading to CVST in Lebanese patients. Language: English Keywords: LEBANON | RESEARCH REPORT | COHORT ANALYSIS | WOMEN | PREGNANCY | CEREBROVASCULAR EFFECTS | THROMBOSIS | ORAL CONTRACEPTIVES | Developing Countries | Middle East | Research Methodology | Demographic Factors | Population | Reproduction | Physiology | Biology | Thromboembolism | Embolism | Vascular Diseases | Diseases | Contraceptive Methods | Contraception | Family Planning Document Number: 328588 |
| 10. Title: Migraine with and without aura and risk for cardiovascular disease. Author: Vargas BB; Dodick DW; Wingerchuk DM; Demaerschalk BM Source: Current Atherosclerosis Reports. 2008 Oct;10(5):427-33. Abstract: Migraine, cardiovascular disease, and stroke are three highly prevalent and disabling conditions that exert a significant socioeconomic impact. The association between migraine and a twofold risk of stroke and myocardial infarction has been the topic of much debate. The mechanism underlying this link is largely unknown but may be the result of an increased prevalence of other conditions such as vasculopathies, hypercoagulable states, and patent foramen ovale seen in migraine with aura. Although many prior studies have demonstrated increased risks in women with migraine with aura, an emerging body of evidence is showing similar risks in men. These risks are further compounded with increased migraine frequency, smoking, and the use of oral contraceptive pills. Because the overall risk for stroke and myocardial infarction in migraineurs remains relatively low, recommendations at this time are limited to the modification of cardiovascular risk factors, such as smoking cessation and the avoidance of oral contraceptive pills, especially in women suffering from migraine with aura. Language: English Keywords: UNITED STATES OF AMERICA | LITERATURE REVIEW | CLINICAL RESEARCH | EPIDEMIOLOGIC METHODS | TARGET POPULATION | MIGRAINE | CARDIOVASCULAR EFFECTS | RISK FACTORS | HEART DISEASES | PREVALENCE | CEREBROVASCULAR EFFECTS | RISK BEHAVIOR | RISK REDUCTION BEHAVIOR | Developed Countries | North America | Americas | Research Methodology | Program Design | Programs | Organization and Administration | Vascular Diseases | Diseases | Physiology | Biology | Measurement | Behavior Document Number: 328945 |
| 11. Peer Reviewed Title: Performance characteristics of a rapid diagnostic test for malaria, when used to confirm cerebral malaria in children and young adults. Source: Annals of Tropical Medicine and Parasitology. 2007 Jan;101(1):85-87. Abstract: Rapid diagnostic tests (RDT) for malaria, based on the detection in blood of antigens of the malarial parasites, may serve to support a clinical diagnosis of malaria and, in certain clinical situations, may provide a faster, simpler alternative to the examination of bloodsmears for malarial parasites. Cerebral malaria, an acute encephalopathy complicating human infection with Plasmodium falciparum, is a medical emergency where prompt differential diagnosis, among patients presenting with acute encephalopathy accompanied by fever, may be life-saving. In the present, hospital-based, observational study, the performance characteristics of the Paracheck Pf test (Orchid Biomedical Systems, Verna, Goa, India), an RDT based on a two-site, sandwich immuno-assay for the detection of P. falciparum-specific histidine-rich protein 2 (HRP-2), were evaluated against bloodsmear examination. The Paracheck Pf dipsticks were used to identify the cases of cerebral malaria among the 209 subjects, all of whom had acute febrile encephalopathy (i.e. fever with altered sensorium of = 7 days' duration). The subjects were investigated as they attended one of two tertiary-care centres in the north Indian state of Uttar Pradesh: King George's Medical University (KGMU) in Lucknow, or Baba Raghav Das Medical College in Gorakhpur. (excerpt) Language: English Keywords: INDIA | SUMMARY REPORT | CHILDREN | ADULTS | EXAMINATIONS AND DIAGNOSES | MALARIA | ANTIGENS | TESTING | CEREBROVASCULAR EFFECTS | PERFORMANCE IMPROVEMENT | Asia, Southern | Asia | Developing Countries | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Parasitic Diseases | Diseases | Immunologic Factors | Immunity | Immune System | Physiology | Biology | Measurement | Research Methodology | Management | Organization and Administration Document Number: 312582 |
| 12. Peer Reviewed Title: Rectal versus intravenous quinine for the treatment of childhood cerebral malaria in Kampala, Uganda: A randomized, double-blind clinical trial. Author: Achan J; Byarugaba J; Barennes H; Tumwine JK Source: Clinical Infectious Diseases. 2007 Dec 1;45(11):1446-1452. Abstract: Although artemesinin derivatives are promising for the treatment of severe Plasmodium falciparum malaria, intravenous quinine remains the most affordable treatment. However, administration of intravenous quinine is often not feasible in rural areas in Africa because of the lack of simple equipment or trained staff. We compared the efficacy and safety of intrarectal quinine with those of intravenous quinine in the treatment of childhood cerebral malaria. In a randomized, double-blind clinical trial at Mulago Hospital (Kampala, Uganda), Uganda's national referral hospital, we studied 110 children aged 6 months to 5 years who had cerebral malaria. Patients were randomized to receive either intrarectal or intravenous quinine. Main outcome measures included parasite clearance time, fever clearance time, coma recovery time, time to sit unsupported, time to begin oral intake, time until oral quinine was tolerated, and death. Overall, there was no difference in the clinical and parasitological outcomes between the 2 groups (data are mean +or- standard deviation, intrarectal quinine group vs. intravenous quinine group): coma recovery time, 19.4 +or- 18.1 h versus 17.0 +or- 12.1 h; fever clearance time, 26.7 +or- 16.1 h versus 29.9 +or- 18.1 h; and parasite clearance time, 43.2 +or- 14.2 h versus 41.9 +or- 15.2 h. Mortality was similar in both groups; 4 of 56 patients in the intrarectal quinine group died, and 5 of 54 patients in the intravenous quinine group died (odds ratio, 1.3; 95% confidence interval, 0.3-5.2). Intrarectal quinine was well tolerated, and no major immediate adverse events occurred. Intrarectal quinine is efficacious and could be used as an alternative in the treatment of childhood cerebral malaria, especially in situations in which intravenous therapy is not feasible. (author's) Language: English Keywords: UGANDA | RESEARCH REPORT | CLINICAL TRIALS | DOUBLE-BLIND STUDIES | CHILD | MALARIA | CEREBROVASCULAR EFFECTS | ANTIMALARIAL DRUGS | TREATMENT | TIME FACTORS | CONTRACEPTIVE USE-EFFECTIVENESS | SAFETY | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Clinical Research | Research Methodology | Studies | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Parasitic Diseases | Diseases | Physiology | Biology | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Population Dynamics | Contraceptive Effectiveness | Contraception | Family Planning | Public Health Document Number: 322112 |
| 13. Title: Cerebral venous thrombosis and hepatic venous thrombosis during pregnancy. Author: Altunayoglu V; Turedi S; Gunduz A; Karaca Y; Akdogan RA Source: Journal of Obstetrics and Gynaecology Research. 2007 Feb;33(1):78-82. Abstract: Cerebral venous thrombosis (CVT) and Budd-Chiari syndrome (BCS) are rarely encountered thrombotic diseases of two different vascular systems. A 20-year-old woman in the 14th week of pregnancy was brought to the emergency department with complaints of sudden headache and loss of vision. Thrombosis in the left transverse and sigmoid sinus was demonstrated at MR angiography. She was diagnosed with BCS by using hepatic Doppler ultrasonography after an elevation of liver enzymes. Although CVT and BCS are rarely seen during pregnancy, they need emergency treatment because of high mortality. (author's) Language: English Keywords: TURKEY | RESEARCH REPORT | CASE STUDIES | WOMEN IN DEVELOPMENT | PREGNANT WOMEN | THROMBOSIS | CEREBROVASCULAR EFFECTS | HEPATIC EFFECTS | VASCULAR DISEASES | HEADACHE | SIGNS AND SYMPTOMS | ULTRASONICS | PHYSICAL EXAMINATIONS AND DIAGNOSES | PREGNANCY COMPLICATIONS | Developing Countries | Europe, Southeastern | Europe | Studies | Research Methodology | Economic Development | Economic Factors | Population Characteristics | Demographic Factors | Population | Thromboembolism | Embolism | Diseases | Physiology | Biology | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Examinations and Diagnoses Document Number: 315378 |
| 14. Title: Correlation of the fetal cerebellar volume with other fetal growth indices by three-dimensional ultrasound. Author: Araujo E Junior; Pires CR; Nardozza LM; Filho HA; Moron AF Source: Journal of Maternal-Fetal and Neonatal Medicine. 2007 Aug;20(8):581-587. Abstract: The objective was to verify the correlation of fetal cerebellar volume by three-dimensional ultrasound (3D US) with other indices of fetal growth in normal fetuses. This was a longitudinal prospective study involving 52 normal pregnant women between 20 and 32 weeks of gestation. The assessments of the fetal cerebellar volume were carried out at intervals of two weeks, and the method used was VOCAL (virtual organ computer-aided analysis) with a 30° rotation angle. At each assessment, the following biometric indices were evaluated using the two-dimensional method: biparietal diameter, head circumference, transverse cerebellar diameter, femur length, and estimated fetal weight. We used Pearson's correlation coefficient to evaluate the correlation between fetal cerebellar volume and these indices; we also used polynomial regression analysis with fetal cerebellar volume as the dependent variable and the other indices as the independent variable. The fetal cerebellar volume was highly correlated with gestational age (r = 0.94; p < 0.001) and with all other fetal growth indices (p < 0.001). The assessment of the fetal cerebellar volume by 3D US is an important tool to evaluate fetal growth. (author's) Language: English Keywords: BRAZIL | RESEARCH REPORT | CLINICAL RESEARCH | EVALUATION INDEXES | PROSPECTIVE STUDIES | LONGITUDINAL STUDIES | FETUS | PREGNANT WOMEN | WOMEN IN DEVELOPMENT | CEREBROVASCULAR EFFECTS | GROWTH | HEALTH STATUS INDEXES | ULTRASONICS | COMPUTERS | GESTATIONAL AGE | South America, Eastern | South America | Latin America | Americas | Developing Countries | Research Methodology | Quantitative Evaluation | Evaluation | Studies | Pregnancy | Reproduction | Population Characteristics | Demographic Factors | Population | Economic Development | Economic Factors | Physiology | Biology | Child Development | Health | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Information Processing | Information Document Number: 319651 |
| 15. Peer Reviewed Title: Validation of fetal cerebellar volume by three-dimensional ultrasonography in Brazilian population. Author: Araujo Junior E; Filho HA; Pires CR; Nardozza LM; Moron AF Source: Archives of Gynecology and Obstetrics. 2007 Jan;275(1):5-11. Abstract: The objective was to validate the prediction equation of the volume of fetal cerebellum by three-dimensional ultrasonography determined for Taiwan's population in Brazilian population. A longitudinal prospective study was performed with 52 normal pregnant women between 20 and 32 weeks. The measurement of fetal cerebellar volume was done by virtual organ computer-aided analysis (VOCAL) method, with a rotation angle of 30°. To establish the correlation of fetal cerebellar volume with gestational age, a polynomial regression analysis was performed, with cerebellar volume as dependent variable and gestational age as independent variable. To compare the prediction equation of the volume of fetal cerebellum in Taiwan's population and the equation established in this study, with the values obtained from Brazilian population (referential), we used the intraclass correlation coefficient, with the averages compared by paired Student's t test. The volume of fetal cerebellum was highly correlated with gestational age, and the best prediction equation obtained was of the second degree. The equation established in this study predicted cerebellar volumes more accurately than the equation established for Taiwan's population, since the average values of fetal cerebellar volume were more similar to the average values of reference. The equation established for Taiwan's population presented less accuracy in Brazilian population, possibly due to the strong ethnical differences between both populations. (author's) Language: English Keywords: BRAZIL | TAIWAN | RESEARCH REPORT | LONGITUDINAL STUDIES | MEASUREMENT | PREGNANT WOMEN | FETUS | CEREBROVASCULAR EFFECTS | ULTRASONICS | South America, Eastern | South America | Latin America | Americas | Developing Countries | Asia, Eastern | Asia | Developed Countries | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Pregnancy | Reproduction | Physiology | Biology | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 310910 |
16.  Peer Reviewed Title: Cerebrospinal fluid and serum biomarkers of cerebral malaria mortality in Ghanaian children. Author: Armah HB; Wilson NO; Sarfo BY; Powell MD; Bond VC Source: Malaria Journal. 2007 Nov 12;6:147. Abstract: Plasmodium falciparum can cause a diffuse encephalopathy known as cerebral malaria (CM), a major contributor to malaria associated mortality. Despite treatment, mortality due to CM can be as high as 30% while 10% of survivors of the disease may experience short- and long-term neurological complications. The pathogenesis of CM and other forms of severe malaria is multifactorial and appear to involve cytokine and chemokine homeostasis, inflammation and vascular injury/repair. Identification of prognostic markers that can predict CM severity will enable development of better intervention. Postmortem serum and cerebrospinal fluid (CSF) samples were obtained within 2-4 hours of death in Ghanaian children dying of CM, severe malarial anemia (SMA), and non-malarial (NM) causes. Serum and CSF levels of 36 different biomarkers (IL-1beta, IL-1ra, IL-2, IL-4, IL-5, IL-6, IL-7, IL-8, IL-9, IL-10, IL-12 (p70), IL-13, IL-15, IL-17, Eotaxin, FGF basic protein, CRP, GCSF, GM-CSF, IFN-y, TNF-alpha, IP-10, MCP-1 (MCAF), MIP-1alpha, MIP-1beta, RANTES, SDF-1alpha, CXCL11 (I-TAC), Fas-ligand [Fas-L], soluble Fas [sFas], sTNF-R1 (p55), sTNF-R2 (p75), MMP-9, TGF-beta1, PDGF bb and VEGF) were measured and the results compared between the 3 groups. After Bonferroni adjustment for other biomarkers, IP-10 was the only serum biomarker independently associated with CM mortality when compared to SMA and NM deaths. Eight CSF biomarkers (IL-1ra, IL-8, IP-10, PDGFbb, MIP-1beta, Fas-L, sTNF-R1, and sTNF-R2) were significantly elevated in CM mortality group when compared to SMA and NM deaths. Additionally, CSF IP-10/PDGFbb median ratio was statistically significantly higher in the CM group compared to SMA and NM groups. The parasite-induced local cerebral dysregulation in the production of IP-10, 1L-8, MIP-1beta, PDGFbb, IL-1ra, Fas-L, sTNF-R1, and sTNF-R2 may be involved in CM neuropathology, and their immunoassay may have potential utility in predicting mortality in CM. (author's) Language: English Keywords: GHANA | RESEARCH REPORT | CLINICAL RESEARCH | CHILDREN | MALARIA | CEREBROVASCULAR EFFECTS | EXCESS MORTALITY | RISK FACTORS | AUTOPSY | IMMUNOLOGICAL EFFECTS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Parasitic Diseases | Diseases | Physiology | Biology | Mortality | Population Dynamics | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Immunity | Immune System Document Number: 322718 |
| 17. Peer Reviewed Title: Platelet-mediated clumping of Plasmodium falciparum -- infected erythrocytes is associated with high parasitemia but not severe clinical manifestations of malaria in African children. Author: Arman M; Raza A; Tempest LJ; Lyke KE; Thera MA Source: American Journal of Tropical Medicine and Hygiene. 2007 Nov;77(5):943-946. Abstract: Platelet-mediated clumping of Plasmodium falciparum-infected erythrocytes is an adhesive phenotype commonly found in field isolates that has previously been associated with severe malaria. Here, clumping was assessed in 131 isolates from Malian children. The clumping phenotype was seen in 6% (N = 51) of uncomplicated malaria, 24% (N = 51) of severe malaria, and 45% (N = 29) of high parasitemia non-severe malaria isolates. Multivariate analysis indicated that clumping was strongly positively associated with parasitemia (F/1,122 = 24.1, P < 0.001) but not with disease category (F/2,122 = 1.8, P = 0.17). Therefore platelet-mediated clumping in Malian P. falciparum isolates is primarily associated with high parasitemia and not with severe clinical manifestations of malaria. (author's) Language: English Keywords: MALI | KENYA | THAILAND | RESEARCH REPORT | MULTIVARIATE ANALYSIS | CHILD | MALARIA | PARASITES | PARASITIC DISEASES | CEREBROVASCULAR EFFECTS | PHYSIOLOGY | SEASONAL VARIATION | BLOOD | LABORATORY PROCEDURES | Africa, Western | Africa, Sub Saharan | Africa | Developing Countries | Africa, Eastern | Asia, Southeastern | Asia | Data Analysis | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Diseases | Biology | Population Dynamics | Hemic System | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 321809 |
| 18. Peer Reviewed Title: Malaria in rural Burkina Faso: Local illness concepts, patterns of traditional treatment and influence on health-seeking behaviour. Author: Beiersmann C; Sanou A; Wladarsch E; De Allegri M; Kouyate B Source: Malaria Journal. 2007 Aug 8;6(1):106. Abstract: The literature on health care seeking behaviour in sub-Saharan Africa for children suffering from malaria is quite extensive. This literature, however, is predominately quantitative and, inevitably, fails to explore how the local concepts of illness may affect people's choices. Understanding local concepts of illness and their influence on health care-seeking behaviour can complement existing knowledge and lead to the development of more effective malaria control interventions. In a rural area of Burkina Faso, four local concepts of illness resembling the biomedical picture of malaria were described according to symptoms, aetiology, and treatment. Data were collected through eight focus group discussions, 17 semistructured interviews with key informants, and through the analysis of 100 verbal autopsy questionnaires of children under-five diagnosed with malaria. Sumaya, dusukun yelema, kono, and djoliban were identified as the four main local illness concepts resembling respectively uncomplicated malaria, respiratory distress syndrome, cerebral malaria, and severe anaemia. The local disease categorization was found to affect both treatment and provider choice. While sumaya is usually treated by a mix of traditional and modern methods, dusukun yelema and kono are preferably treated by traditional healers, and djoliban is preferably treated in modern health facilities. Besides the conceptualization of illness, poverty was found to be another important influencing factor of health care-seeking behaviour. The findings complement previous evidence on health care-seeking behaviour, by showing how local concepts of illness strongly influence treatment and choice of provider. Local concepts of illness need to be considered when developing specific malaria control programmes. (author's) Language: English Keywords: BURKINA FASO | RESEARCH REPORT | KAP SURVEYS | RURAL POPULATION | CHILDREN | UTILIZATION OF HEALTH CARE | TRADITIONAL HEALTH PRACTICES | BELIEFS | TREATMENT | MALARIA | SIGNS AND SYMPTOMS | AUTOPSY | RESPIRATORY INSUFFICIENCY | CEREBROVASCULAR EFFECTS | ANEMIA | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Surveys | Sampling Studies | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Youth | Age Factors | Health Services | Delivery of Health Care | Health | Culture | Sociocultural Factors | Medical Procedures | Medicine | Parasitic Diseases | Diseases | Examinations and Diagnoses | Pulmonary Effects | Physiology | Biology Document Number: 319448 |
| 19. Title: Meningococcal disease and meningitis. Author: Branco RG; Amoretti CF; Tasker RC Source: Jornal de Pediatria. 2007 May;83 Suppl 2:S46-S53. Abstract: The objective was to review the literature relevant to diagnosis and management of meningococcal disease (MD). The source used was a non-systematic review of medical literature through the MEDLINE database using the terms meningococcal, septic shock, diagnosis, and treatment. Articles were selected according to their relevance to the objective of the study and according to the authors' opinion. MD is a leading cause of death due to infection in children. It progresses rapidly and a high level of suspicion is necessary for early diagnosis. Early intervention with aggressive fluid resuscitation and antibiotic therapy can significantly improve outcome. In the pediatric intensive care unit, a large amount of fluids may be required during the first few days and vasoactive drug infusions are often needed. Coagulopathy is frequent, but it has no specific treatment. The use of colloids and steroids may be beneficial, but other new therapies such as insulin and activated protein C still need further assessment. Rescue therapy with extracorporeal membrane oxygenation may be appropriate in cases complicated by severe acute respiratory distress syndrome, but not for refractory shock. Meningitis is often not diagnosed in MD because of the severity of illness and the inability to perform a lumbar puncture safely in a patient with coagulopathy, coma, or hemodynamic instability. When present, cerebral edema and altered cerebral blood flow are the main concerns. The use of osmolar solution may be necessary, but the main therapeutic intervention is to ensure adequate blood pressure for adequate cerebral perfusion. Seizures and hyponatremia should be aggressively treated. Steroids do not appear to affect outcome in meningococcal meningitis. MD is a life-threatening infection that requires early recognition and treatment. Time sensitive fluid resuscitation and antibiotic therapy are the most effective therapies for MD. Other therapies such as steroids may have a place in MD treatment but more definitive studies are necessary. (author's) Language: English Keywords: UNITED KINGDOM | LITERATURE REVIEW | CHILDREN | MENINGITIS | CAUSES OF DEATH | EXAMINATIONS AND DIAGNOSES | ANTIBIOTICS | TREATMENT | BLOOD COAGULATION EFFECTS | EDEMA | CEREBROVASCULAR EFFECTS | Developed Countries | Europe, Western | Europe | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Central Nervous System Effects | Central Nervous System | Physiology | Biology | Mortality | Population Dynamics | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Drugs | Hematological Effects | Hemic System | Signs and Symptoms | Diseases Document Number: 319429 |
| 20. Peer Reviewed Title: Venous thromboembolism, myocardial infarction, and stroke among transdermal contraceptive system users. Author: Cole JA; Norman H; Doherty M; Walker AM Source: Obstetrics and Gynecology. 2007 Feb 1;109(2):339-346. Abstract: The objective was to estimate the incidence of venous thromboembolism, acute myocardial infarction, and ischemic stroke among transdermal contraceptive system users compared with users of norgestimate-containing oral contraceptives with 35 mcg ethinyl estradiol. We began with insurance claims data from UnitedHealthcare. We identified women exposed to the transdermal contraceptive system or norgestimate-containing oral contraceptives from April 2002 through December 2004. Outcomes were confirmed from medical records. We calculated incidence rates and age-adjusted incidence rate ratios. In a nested case-control analysis, we investigated and controlled for confounding. There were 49,048 woman-years of transdermal contraceptive system exposure and 202,344 woman-years of norgestimate-containing oral contraceptives exposure. There was a more than two-fold increase in the venous thromboembolism rate (incidence rate ratio 2.2, 95% confidence interval [CI] 1.3-3.8) among transdermal contraceptive system users (20 cases, 40.8 per 100,000 woman-years) compared with norgestimate-containing oral contraceptives users (37 cases, 18.3 per 100,000 woman-years). Acute myocardial infarction occurred in three transdermal contraceptive system users compared with seven among norgestimate-containing oral contraceptives users (incidence rate ratio 1.8, 95% CI 0.5- 6.8). No strokes occurred among transdermal contraceptive system users, whereas 10 occurred among norgestimate-containing oral contraceptives users. In the nested case-control analysis, after exclusions for high-risk factors, the odds ratio for venous thromboembolism was 2.4 (95% CI 1.1-5.5). There was a more than two-fold increase in the risk of venous thromboembolism associated with use of the transdermal contraceptive system. Acute myocardial infarction and stroke occurred too rarely to ascertain precise risk estimates. (author's) Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | COMPARATIVE STUDIES | WOMEN | THROMBOEMBOLISM | MYOCARDIAL INFARCTION | CEREBROVASCULAR EFFECTS | INCIDENCE | ORAL CONTRACEPTIVES | NORGESTIMATE | ETHINYL ESTRADIOL | HEALTH INSURANCE | ORAL CONTRACEPTIVES, SIDE EFFECTS | CONTRACEPTIVE AGENTS, SIDE EFFECTS | North America | Americas | Developed Countries | Research Methodology | Studies | Demographic Factors | Population | Embolism | Vascular Diseases | Diseases | Heart Diseases | Physiology | Biology | Measurement | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Contraceptive Agents, Estrogen | Financial Activities | Economic Factors | Contraceptive Safety | Safety | Public Health | Health Document Number: 312126 |
| 21. Title: Mother with post-partum group B Streptococcus meningitis and cerebellar abscess. Author: Ghani NA; Jaafar R; Ishak S; Zainuddin AA; Mukari SA Source: Journal of Obstetrics and Gynaecology Research. 2007 Apr;33(2):195-198. Abstract: We report the case of a 25-year-old Malay woman, admitted for preterm delivery at 35 weeks' gestation. Vaginal swab did not isolate any organism. She delivered a baby girl who developed respiratory distress syndrome, requiring ventilation. Although chest radiograph showed hyaline membrane disease with pneumonia, septic workout was negative. The mother was discharged on the next day. Seven days postpartum, the mother presented with fever and fits and was diagnosed to have meningo-encephalitis. Lumbar puncture isolated group B Streptococcus (GBS) and MRI revealed a superior cerebellar abscess. She was treated and survived the episode. This case illustrates the uncommon situation where GBS infection was confirmed via maternal septic workout rather than neonatal, although both presented with severe disease. (author's) Language: English Keywords: MALAYSIA | RESEARCH REPORT | CLINICAL RESEARCH | CASE STUDIES | WOMEN IN DEVELOPMENT | POSTPARTUM WOMEN | MENINGITIS | BACTERIAL AND FUNGAL DISEASES | CEREBROVASCULAR EFFECTS | PREMATURE BIRTH | RESPIRATORY INSUFFICIENCY | PNEUMONIA | FEVER | LABORATORY EXAMINATIONS AND DIAGNOSES | Developing Countries | Asia, Southeastern | Asia | Research Methodology | Studies | Economic Development | Economic Factors | Puerperium | Reproduction | Central Nervous System Effects | Central Nervous System | Physiology | Biology | Infections | Diseases | Pregnancy Outcomes | Pregnancy | Pulmonary Effects | Body Temperature | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 315380 |
| 22. Peer Reviewed Title: Migraine and use of combined hormonal contraceptives: A clinical review. Author: MacGregor EA Source: Journal of Family Planning and Reproductive Health Care. 2007 Jul;33(3):159-169. Abstract: Headache is a common condition affecting the majority of women at some time in their lives. Epidemiological studies of migraine also confirm that up to one-third of women will experience migraine, particularly during their fertile years. Studies suggesting that migraine in young women is associated with an increased risk ischaemic stroke have led to particular concerns regarding the additional effect of other risk factors such as use of combined oral contraceptives (COCs). This paper reviews the effect that COCs have on headache and migraine and considers the data on the risk of ischaemic stroke in COC users with migraine. This evidence will be used to support practical guidance on the management of women with migraine wishing to use COCs. Whilst the evidence presented is based on studies of COCs, there is no evidence to suggest that the effects of other combined hormonal contraceptives (CHCs) are any different. Until further data are available on the different routes of delivery, the following recommendations apply to all CHCs. (excerpt) Language: English Keywords: UNITED KINGDOM | LITERATURE REVIEW | WOMEN | ORAL CONTRACEPTIVES, COMBINED | ETHINYL ESTRADIOL | DESOGESTREL | ADMINISTRATION AND DOSAGE | RISK FACTORS | MIGRAINE | CEREBROVASCULAR EFFECTS | PROGESTERONE | CONTRACEPTIVE AGENTS, PROGESTIN | Europe, Western | Europe | Developed Countries | Demographic Factors | Population | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Estrogen | Contraceptive Agents, Female | Contraceptive Agents | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Biology | Vascular Diseases | Diseases | Physiology | Progestational Hormones | Hormones | Endocrine System Document Number: 318325 |
| 23. Peer Reviewed Title: Increasing burden of childhood severe malaria in a Nigerian tertiary hospital: Implication for control. Author: Orimadegun AE; Fawole O; Okereke JO; Akinbami FO; Sodeinde O Source: Journal of Tropical Pediatrics. 2007 Jun;53(3):185-189. Abstract: Malaria remains an important public heath concern in Nigeria because of its impact on child and maternal health, but the contribution of severe malaria to morbidity among Nigerian children was scantly reported. This study was undertaking to document the hospital-burden of severe malaria among children in Ibadan in order to reflect on the impacts and health implications of the current malaria control strategies. A review of 6-year case records of all children admitted to the emergency ward of the University College Hospital Ibadan was carried out. Cases of severe malaria were defined as those children in whom parasitaemia were confirmed with blood film microscopy and any of the WHO case definitions for severe malaria was documented. Severe malaria cases constituted 11.3% of 16 031 admissions (2000-05) with 89.1% being children less than 5 years old. Cerebral malaria accounted for about one-fifth (19.7%) of all severe malaria cases. The yearly proportional morbidity rate from severe malaria ranged from 8.7% to 13.2% with significant increase from 2000 to 2004 (X/2 = 48.49; df = 5; P less than 0.001). Severe malaria accounted for 12.4% of all paediatric deaths with an estimated overall case fatality rate of 9.6%. Deaths from malaria were significantly associated with wasting (Z-score for weight-for-height less than or equal to 2.0), age less than 2 years, hypoglycaemia and respiratory distress. Our data demonstrated an increased trend in morbidity from severe malaria over the study period. Severe malarial anaemia was a more common complication of Plasmodium falciparum malaria than cerebral malaria in hospitalized Nigerian children and it was associated with a high number of deaths. The consequences of high rate of severe malaria may be beyond health as it also affects the economy and the developmental prospects of the country. There may therefore a need to review the current strategies for malaria control in Nigeria. (author's) Language: English Keywords: NIGERIA | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | CHILDREN | HOSPITALS | MALARIA | CEREBROVASCULAR EFFECTS | PREVALENCE | CAUSES OF DEATH | CHILD MORTALITY | BODY WEIGHT | RESPIRATORY INSUFFICIENCY | GLUCOSE METABOLISM EFFECTS | Africa, Western | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Health Facilities | Delivery of Health Care | Health | Parasitic Diseases | Diseases | Physiology | Biology | Measurement | Mortality | Population Dynamics | Pulmonary Effects | Carbohydrate Metabolic Effects | Metabolic Effects Document Number: 313545 |
| 24. Title: Millennium Development Goals: Where are we? [editorial] Author: Thomas SV Source: Annals of Indian Academy of Neurology. 2007 Jul-Sep;:[1] p. Abstract: In September 2000, the Heads of States of 147 countries put their signatures on the UN Millennium Declaration. The Millennium Development Goals (MDG) were set out based on the actions and targets proposed in the declaration, and all 192 member countries of the United Nations have agreed to achieve them by 2015. The eight goals are to: (1) eradicate extreme poverty and hunger; (2) achieve universal primary education; (3) promote gender equality and empower women; (4) reduce child mortality; (5) improve maternal health; (6) combat HIV/AIDS, malaria, and other diseases; (7) ensure environmental sustainability; and (8) develop a Global Partnership for Development.[1] Now, at the midpoint of the program, how far have we progressed? What will be the role of the Indian Academy of Neurology, and individual neurologists in this country, in achieving the MDG? Neurological disorders constitute an important component of the economic burden due to diseases. Early diagnosis and prevention of diseases and the resultant disability would move us closer to achieving these goals. (excerpt) Language: English Keywords: INDIA | CRITIQUE | PROVIDERS WITH CLIENTS | NEUROLOGIC EFFECTS | RELIGIOUS ASPECTS | DEVELOPMENT PLANS | GOALS | CEREBROVASCULAR EFFECTS | DISEASE PREVENTION | Developing Countries | Asia, Southern | Asia | Health Services | Delivery of Health Care | Health | Physiology | Biology | Religion | Sociocultural Factors | Planning | Organization and Administration | Prevention and Control | Diseases Document Number: 320752 |
| 25. Peer Reviewed Title: Combined oral contraceptive use among women with hypertension: a systematic review. Author: Curtis KM; Mohllajee AP; Martins SL; Peterson HB Source: Contraception. 2006 Feb;73(2):179-188. Abstract: Women with hypertension are at increased risk for cardiovascular events. Combined oral contraceptive (COC) use, even among low-dose users, has been associated with a small excess risk for cardiovascular events among healthy women. In this systematic review, we examined cardiovascular risks among COC users with hypertension. After searching MEDLINE for all articles published from 1966 through February 2005 relevant to COC use, hypertension and cardiovascular disease, we identified 25 articles for this review. Overall, these studies showed that hypertensive COC users were at higher risk for stroke and acute myocardial infarction (AMI) than hypertensive non-COC users, but that they were not at higher risk for venous thromboembolism (VTE). Women who did not have their blood pressure measured before initiating COC use were at higher risk for ischemic stroke and AMI, but not for hemorrhagic stroke or VTE, than COC users who did not have their blood pressure measured. (author's) Language: English Keywords: UNITED STATES OF AMERICA | NORTH CAROLINA | RESEARCH REPORT | DATA ANALYSIS | STUDIES | WHO | WOMEN | ORAL CONTRACEPTIVES, COMBINED | HYPERTENSION | THROMBOEMBOLISM | CEREBROVASCULAR EFFECTS | MYOCARDIAL INFARCTION | ORAL CONTRACEPTIVES, CONTRAINDICATIONS | CONTRACEPTIVE SAFETY | Developed Countries | North America | Americas | Research Methodology | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | Demographic Factors | Population | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Vascular Diseases | Diseases | Embolism | Physiology | Biology | Heart Diseases | Safety | Public Health | Health Document Number: 296205 |
| 26. Peer Reviewed Title: Use of combined oral contraceptives among women with migraine and nonmigrainous headaches: a systematic review. Author: Curtis KM; Mohllajee AP; Peterson HB Source: Contraception. 2006 Feb;73(2):189-194. Abstract: This systematic review examines evidence evaluating whether women with headaches who use combined oral contraceptives (COCs) have a greater risk of stroke than women with headaches who do not use COCs. We searched MEDLINE for articles published from 1966 through March 2005 relevant to headaches and COC use as risk factors for stroke. Of the 79 articles identified, nine met our selection criteria (eight reports of six observational studies plus one meta-analysis). All studies reported specifically on migraine headaches. Evidence from six case-control studies suggested that COC users with a history of migraine were two to four times as likely to have an ischemic stroke as nonusers with a history of migraine. The odds ratios for ischemic stroke ranged from 6 to almost 14 for COC users with migraine compared with nonusers without migraine. The three studies that provided evidence on hemorrhagic stroke reported low or no risk associated with migraine or with COC use. (author's) Language: English Keywords: UNITED STATES OF AMERICA | NORTH CAROLINA | RESEARCH REPORT | DATA ANALYSIS | STUDIES | WHO | WOMEN | ORAL CONTRACEPTIVES, COMBINED | MIGRAINE | HEADACHE | CEREBROVASCULAR EFFECTS | RISK FACTORS | ORAL CONTRACEPTIVES, CONTRAINDICATIONS | Developed Countries | North America | Americas | Research Methodology | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | Demographic Factors | Population | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Vascular Diseases | Diseases | Signs and Symptoms | Physiology | Biology | Contraceptive Safety | Safety | Public Health | Health Document Number: 296206 |
| 27. Title: Perinatal risk factors for neonatal intracerebral hemorrhage in preterm infants. Author: Ertan AK; Tanriverdi HA; Meier M; Schmidt W Source: European Journal of Obstetrics, Gynecology and Reproductive Biology. 2006 Jul;127(1):29-34. Abstract: The objective was to investigate the perinatal factors related to neonatal intracerebral hemorrhage (ICH) and possibly to define obstetric and perinatal risk factors. All medical records of women who delivered in the period from 1 January 1991 to 1 January 2000 were reviewed for intracerebral hemorrhages in infants born between 24 and 34 weeks of gestation and treated in the postnatal period. Sixty infants with ICH (Group I) and 60 infants without ICH (Group II, matched controls) were determined for comparison. Obstetrical parameters and risk factors and perinatal outcome parameters were evaluated and statistically analyzed. Neonatal intracerebral hemorrhage prevalence was 0.8% (60/7635 births). Betamethasone administration was significantly less in Group I than in Group II (27% versus 46%). Although Doppler-sonography of the middle cerebral artery was performed in a minority of the cases, it showed a significant tendency of lower resistance indices (brain sparing) in the intracerebral hemorrhage group (66.7% versus 21.1%). Postnatally, infants with intracerebral hemorrhage showed a significantly more often umbilical arterial acidosis (18% versus 10%), a greater base deficit, lower median 5 min Apgar scores (6 and 8, respectively for Groups I and II), and a lower thrombocyte count (Group I 190,000 ± 76,000 µ1, and Group II 227,000 ± 96,000 µ1). Infants in Group I were more often (93% versus 76%) and longer (26.7 ± 30.5 days versus 15.4 ± 11.7 days) dependent on ventilatory support than infants in Group II. Mortality rate in Group I (35%) was significantly higher compared to Group II (17%). Antenatal Doppler sonography in predicting intracerebral hemorrhage in preterm infants should be investigated in large scale prospective studies. Postnatal low pH-values (pH < 7.1) and a base deficit of more than -16 mmol/L in the umbilical artery, low Apgar scores and thrombocytopenia are associated with a neonatal intracerebral hemorrhage and prophylaxis with corticosteroids reduces the risk for it. A higher neonatal mortality and morbidity, including neurological and neuromotoric dysfunctions is expected in this clinical entity. (author's) Language: English Keywords: GERMANY | RESEARCH REPORT | RETROSPECTIVE STUDIES | INFANT, PREMATURE | BLEEDING | RISK FACTORS | CEREBROVASCULAR EFFECTS | EXAMINATIONS AND DIAGNOSES | ULTRASONICS | Developed Countries | Europe, Central | Europe | Studies | Research Methodology | Infant | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Signs and Symptoms | Diseases | Biology | Physiology | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 303057 |
| 28. Title: Stroke and HIV -- causal or coincidental co-occurrence? [editorial] Author: Modi G; Modi M; Mochan A Source: South African Medical Journal. 2006 Dec;96(12):1247-1248. Abstract: Stroke is responsible for a large part of the global burden of disease. Worldwide in 1990 it was the second commonest cause of mortality, causing approximately 4.4 million deaths. Two-thirds of these deaths occurred in less developed countries. In South Africa in 2001 it was the fourth leading reported natural cause of mortality. HIV infection has in the wake of our pandemic become a leading cause of death and dread disease, with an estimated 15% of the population being infected. A co-occurrence of these two illnesses is therefore expected. The debate rests with regard to whether or not there is a causal relationship. The first suggestion that there is an association between HIV and stroke came from autopsy and case series from the USA. These were followed by population studies to determine the risk of this association. The first of these was a study from KwaZulu-Natal (KZN) that found an HIV prevalence of 16% in a young stroke population. The prevalence of HIV in that region at that time was also 16%, suggesting that there was no significant increase in the risk of stroke associated with HIV infection. In another population-based study from Baltimore, USA, the incidence of stroke in persons with AIDS was 0.2% per year. In this study AIDS was found to confer an adjusted relative risk of 13.7 for ischaemic stroke (IS) and 25.5 for intracerebral haemorrhage (ICH), indicating that AIDS is strongly associated with both IS and ICH. A criticism directed at this study has been that only patients meeting the Centers for Disease Control (CDC) definition of AIDS were included. In a study from Germany on 772 HIV-infected patients, a prevalence of 1.2% for stroke and an annual incidence rate for IS of 216/100 000 population was reported. The prevalence was highest in young adult patients with advanced HIV infection. This latter finding has been consistently observed in studies reporting on the association between HIV and stroke. The results in this regard thus appear to be inconclusive but favour an increased stroke risk, at least with advanced HIV/AIDS. (excerpt) Language: English Keywords: SOUTH AFRICA | LITERATURE REVIEW | PERSONS LIVING WITH HIV/AIDS | YOUTH | CEREBROVASCULAR EFFECTS | RISK FACTORS | ANTIRETROVIRAL DRUGS | SIDE EFFECTS | LABORATORY EXAMINATIONS AND DIAGNOSES | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Persons Living With HIV/AIDS | HIV Infections | Viral Diseases | Diseases | Age Factors | Population Characteristics | Demographic Factors | Population | Physiology | Biology | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Examinations and Diagnoses Document Number: 318424 |
| 29. Title: Maternal outcome in HELLP syndrome requiring intensive care management in a Turkish hospital. Author: Osmanagaoglu MA; Osmanagaoglu S; Ulusoy H; Bozkaya H Source: Sao Paulo Medical Journal. 2006;124(2):85-89. Abstract: Maternal mortality, presented as a ratio, measures obstetric risk per 100,000 live births and has been defined internationally as the total number of deaths of women during pregnancy or within 42 days after the end of pregnancy. Pregnancy-related hypertensive disorders are the main cause of maternal mortality in most countries. Data from developed countries show maternal mortality of about 0.1% due to preeclampsia, in which the majority of cases were complicated by the HELLP syndrome (hemolysis, elevated liver enzymes and low platelet count). Despite the development of tertiary care facilities, intensive care and advanced blood banking techniques, maternal and neonatal deaths continue to occur in association with HELLP syndrome. The reported maternal mortality due to HELLP syndrome ranges from 0% to 24%. In this present study our aim was to determine maternal morbidity and mortality among women with HELLP syndrome who required transfer for critical care. (excerpt) Language: English Keywords: TURKEY | RESEARCH REPORT | CLINICAL RESEARCH | LONGITUDINAL STUDIES | PREGNANT WOMEN | WOMEN IN DEVELOPMENT | EMERGENCY SERVICES | PREGNANCY OUTCOMES | PREGNANCY COMPLICATIONS | RENAL EFFECTS | HEPATIC EFFECTS | PREECLAMPSIA | ANESTHESIA | EMBOLISM | CEREBROVASCULAR EFFECTS | Developing Countries | Europe, Southeastern | Europe | Research Methodology | Studies | Population Characteristics | Demographic Factors | Population | Economic Development | Economic Factors | Health Services | Delivery of Health Care | Health | Pregnancy | Reproduction | Diseases | Urogenital Effects | Urogenital System | Physiology | Biology | Treatment | Medical Procedures | Medicine | Vascular Diseases Document Number: 316312 |
| 30. Title: Cerebral malaria owing to Plasmodium vivax: case report. Author: Ozen M; Gungor S; Atambay M; Daldal N Source: Annals of Tropical Paediatrics. 2006 Jun;26(2):141-144. Abstract: Cerebral malaria is a diffuse encephalopathy associated with seizures and status epilepticus which can occur in up to one-third of children with severe malaria, particularly that caused by Plasmodium falciparum. We report a unique case of P. vivax infection complicated by status epilepticus. A 4-year-old boy was admitted to the emergency outpatient clinic with intractable seizures for the previous hour. During resuscitation, two episodes of left-focal tonic convulsions occurred and he received phenytoin. Because of a history of P. vivax infection in the family 3 months previously, a blood slide for malaria was undertaken. Thin blood smears demonstrated P. vivax. He was treated with chloroquine and primaquine. An initial EEG was normal but after 3 months of follow-up a second EEG showed generalised epileptic activity. Rarely, cerebral malaria is a presenting complication or occurs during the course of P. vivax infection. In endemic areas such as Turkey, the possibility of cerebral malaria should be considered. (author's) Language: English Keywords: TURKEY | RESEARCH REPORT | CASE STUDIES | CLINICAL RESEARCH | CHILD, MALE | MALARIA | CEREBROVASCULAR EFFECTS | CENTRAL NERVOUS SYSTEM EFFECTS | COMPLICATIONS | DRUGS | PARASITE CONTROL | Developing Countries | Europe, Southeastern | Europe | Studies | Research Methodology | Child | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Parasitic Diseases | Diseases | Physiology | Biology | Central Nervous System | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Public Health Document Number: 302147 |
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