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PubMed1976

Fetal antigens associated with adenovirus 12 mouse tumors.

The fetal antigen(s) of C3H/BfB/Ki mouse tumor cells induced by adenovirus type 12 was examined by transplantation resistance, local adoptive transfer and in vitro cell-mediated microcytotoxicity tests. Mice immunized with 8 to 9-day gestation fetal cells showed weak resistance to the challenge of small numbers of tumor cells, but immunization with 13 to 14-day gestation fetal cells did not confer transplantation immunity. Local adoptive transfer of multiparous pregnant mouse spleen cells mixed with tumor cells showed a small inhibition of tumor growth in all cases, but primiparous pregnant mouse spleen cells showed a protective effect in only one of three samples. In the cell-mediated microcytotoxicity test, spleen cells taken from the fetal tissue-immunized or multiparous pregnant mice showed a cytotoxic effect to MT-2 cells (adenovirus type 12 tumor cell line) and mouse fetal cells, but not to newborn mouse kidney cells. These results strongly suggest the presence of phase-specific tumor-associated fetal antigen(s) which can evoke transplantation immunity.

Adenoviruses, Human↗
PubMed2003

Persistent mammary hyperplasia in FVB/N mice.

The inbred FVB/N mouse strain is widely used for creating transgenic mice. Over the past decade, persistent mammary hyperplasia has been detected in many multiparous FVB/N female mice sent to the University of California, Davis (UCD) Mutant Mouse Pathology Laboratory (MMPL) by a number of different laboratories. However, the experimental details concerning most specimens were not always available. To confirm these empiric findings, experiments were carried out to evaluate the mammary glands of FVB/N mice under controlled conditions. Persistent mammary hyperplasia that related to parity was found. Weeks after their first to fourth pregnancy, 10 FVB/N female mice from the Lawrence Berkeley National Laboratory (LBNL) colony were studied and the mammary glands were evaluated. The percentage of fat pad filled was estimated, using image analysis. Serum samples and the pituitary gland from other FVB/N mice from the LBNL were assayed for prolactin concentration. Multiparous FVB/N females consistently had persistent mammary hyperplasia. Four of seven females in the LBNL colony had hyperplasia after three pregnancies. A few foci of squamous nodules and sporadic carcinomas also were observed. Thus, some FVB/N females may have persistent mammary hyperplasia after three pregnancies without detectable pituitary abnormalities. Mammary carcinomas also may develop sporadically. These background phenotypes must be considered when interpreting the effect of genetic manipulation in FVB/N mice.

Animals↗
PubMedDate not supplied

Photochemotherapy in human heart transplant recipients at high risk for fatal rejection.

Heart transplant recipients in whom high levels of lymphocytotoxic antibodies directed towards a spectrum of histocompatibility antigens develop frequently represent difficult management problems. Recipients of multiple transplants and multiparous females generally form higher levels of panel reactive antibodies, which have been associated with fatal rejection episodes and accelerated graft atherosclerosis. In this study, two multiple transplant patients with preexistent high levels of panel reactive antibodies and two multiparous women who were considered at risk of sensitization were treated with a new form of immunotherapy termed photochemotherapy in addition to conventional immunosuppression. High levels of panel reactive antibodies have been reduced, and patients have suffered few rejection episodes and no infectious complications. This preliminary experience shows that the addition of photochemotherapy to conventional regimens may improve the clinical course of hypersensitized transplant patients without additional immunosuppressive risk.

Adult↗
PubMed2004

[Epidemiology, prognosis and prevention of choriocarcinoma in University Hospital of Dakar].

The objective of this study was to define epidemiological profile of choriocarcinoma in Senegal, to evaluate its prognosis and to submit a better strategy of prevention. It's a retrospective cases-control study; all choriocarcinoma diagnosed from January 1st to December 31st 2000 at Dakar University Teaching Hospital. The control were chosen among patients who had molar abortion during the same time than the cases and did not developed the pathology after at least 12 months of medical follow up. The stability of association is checked by calculating 95 confidence interval by Miettinen method, and using Chi 2 test of Pearson with a p value of 5% or Fischer test; the prognosis survival factors was compared using logrank test. Among 1098 patients with medical care follow up of post molar abortion, 61 choriocarcinoma were diagnosed with an incidence of 5.5%. The epidemiological profile is a great multipare 40 years old or more with low socio-economical status, 51% of diagnosed cases was in metastasis stage. The prognosis was marked by a complete remission in 37.7% and by global lethality in 49.2%; the average survival was about 48 months. The risk factors of choriocarcinoma among patients who had a molar abortion are represented by an age superior or equal 40 years old, high multipare and preservation of the uterus after molar abortion. To improve the prognosis we recommend to widen preventive hysterectomy indications after molar abortion among patients with risk factors of choriocarcinoma.

Abortion, Spontaneous↗
PubMed2005

Prevalence of hysterectomy and associated factors in women Veterans Affairs patients.

OBJECTIVE: To estimate the prevalence of hysterectomy and associated factors in women veterans who access care at a Veterans Affairs medical center. STUDY DESIGN: A survey that included questions regarding hysterectomy status, demographics, medical history and validated mental health measures was mailed to 1,935 women who received care at the VA Puget Sound Health Care System between October 1996 and January 1998. RESULTS: The overall prevalence of hysterectomy was 32%, with 12% of 18-39-year-olds, 35% of 40-49-year-olds, and 57% of women 50 years old or older reporting having had a hysterectomy. In multivariable analyses, older age (OR 1.1, 95% CI 1.07-1.09), multiparity (OR 1.6, 1.14-2.2), self-reported polycystic ovary syndrome (OR 3.3, 1.81-5.9), chronic pelvic pain (OR 3.2, 2.1-4.9), irritable bowel syndrome (OR 1.8, 1.3-3.1) and premenstrual syndrome (OR 1.6, 1.1-2.3) were associated with prior hysterectomy. When factors associated with posttraumatic stress disorder in this population were omitted from the model, age (OR 1.07, 1.05-1.08), multiparity (OR 1.4, 1.0-1.9), a family history of ovarian cancer (OR 1.8, 1.2-2.8) and posttraumatic stress disorder (OR 1.4, 1.02-1.87) were associated with prior hysterectomy. CONCLUSION: The prevalence of hysterectomy may be higher among women veterans as compared with published rates for the general population and may be related to chronic pain syndromes and/or posttraumatic stress disorder.

Adolescent↗
PubMed1992

Origin of anti-idiotypic activity against anti-factor VIII autoantibodies in pools of normal human immunoglobulin G (IVIg).

Therapeutic preparations of polyspecific IgG obtained from plasma pools of a large number of normal donors (IVIg) express anti-idiotypic activity against a wide spectrum of natural and disease-associated autoantibodies. The present study investigated the origin of anti-idiotypic activity against autoantibodies to factor VIII. The neutralizing activity of pools of IgG against patients' anti-factor VIII autoantibodies was not influenced by the presence of individuals with natural anti-factor VIII antibodies among donors contributing to the pool. A higher frequency of neutralizing antibodies against anti-factor VIII autoantibodies was found in aged donors as compared with young adults and in pools of IgG from multiparous women as compared with IgG from random donors. Pooling IgG from several donors synergistically enhanced the inhibitory activity of the pools. Thus, a neutralizing activity against anti-factor VIII autoantibodies was detected in pools of IgG of as few as two to four donors of whom individually tested IgG did not exhibit inhibitory activity against anti-factor VIII autoantibodies. These observations suggest that aged donors and multiparous women may be privileged sources for the anti-idiotypic activity of IVIg against autoantibodies and emphasize that the expression of anti-idiotypic activity in IVIg results from a synergistic participation of anti-idiotypes from each donor contributing to the pool.

Adult↗
PubMed2005

[Pregnancy and delivery outcomes in women with previous cervical conization].

OBJECTIVE: The purpose of this study was to assess the effect of cervical conization on subsequent pregnancy and delivery outcomes. METHOD/STUDY DESIGN: We used a retrospective design that included the records of all women who had conization of the cervix in our department between March 1st 1993 and September 1st 2001. Loop electrosurgical excision procedure (LEEP) was performed in every woman. From the totality of records we selected the ones who subsequently got pregnant (20 patients) and determined the pregnancy and delivery events. RESULTS: 113 women in the reproductive years underwent cervical conization during this period; 45 (39.8%) were lost to follow up, 48 (42.5%) didn't get pregnant and 20 (11.7%) women achieved 21 pregnancies. Among these 21 pregnancies there were 2 (9.5%) spontaneous abortions, 2 (9.5%) voluntary terminations of pregnancies, 1 (4.8%) elective termination of pregnancy, 1 (4.8%) ectopic pregnancy, 1 (4.8%) pregnancy evolving in the first trimester at the time of the study and 14 (66.7%) term deliveries. This last group was studied with more detail. Half of the women were nulliparous and half were multiparous. There were 2 cases of threatened preterm labour, 2 gestation diabetes, 1 pregnancy induced hypertension, 1 intrauterine growth restriction, 1 macrosomic foetus, 1 premature rupture of membranes and in three cases the labour was induced. The mean time between conization and delivery was 35.75 months. All deliveries occurred between 37 and 40 weeks of gestation; 11 (78.6%) women delivered vaginally and 3 (21.4%) had caesarean section. Only one newborn weighted less than 2500 g. The mean duration of labour (active phase of the first stage and 2nd stage) was 130.92 minutes (95 minutes for multiparous and 157.5 minutes for nulliparous women). CONCLUSION: Despite the small number of cases, pregnant patients who previously underwent LEEP don't seem to be at increased risk of adverse pregnancy outcome, preterm delivery, caesarean delivery or low birth weight. There was, however, a tendency to short duration of labour.

Adult↗
PubMed2005

Effect of parity on bone mineral density among postmenopausal Saudi Arabian women.

OBJECTIVE: Osteoporosis and osteopenia among postmenopausal Saudi Arabian women are common to the extent of over 60%. Pregnancy, multiparity and prolonged lactation are suggested as factors modifying negatively in the development of osteoporosis. Earlier reports from the institution indicated a beneficial role of multiparity in postmenopausal osteoporosis (PMO). We conducted this study to measure the effect of parity on bone mineral density (BMD) measurement of lumbar spine and the upper femur. METHODS: We conducted this prospective study at King Fahd Hospital of the University, College of Medicine, King Faisal University, Dammam, Saudi Arabia, between January 2002 and June 2003. This study analyzed 256 patients who attended orthopedic clinics. The data gathered was age, duration of menopause, number of children borne, height and weight for body mass index (BMI) calculation. We excluded women with secondary osteoporosis from the study. We entered the patients orthopedic complaints in the database. We carried out the BMD measurements using Hologic total body DEXA machine. We analyzed the data using SPSS package with significance at p<0.05 and confidence interval of 95%. For final analysis, we took into consideration an average of results of the lumbar spine and hip region. RESULTS: We analyzed the available data of 256 patients. We divided the patients into 2 groups; group A with >6 children and group B with women of <5 children. In group A, there were 116 women and 140 in group B. The mean age of patients in group A was 56.81 (50-65) years SD +/- 5.19 and in group B the mean age was 58.86 years (48-76) SD +/- 7.68. The average BMI in group A was 31.95 kg/m2 and in group B it was 29.14 kg/m2. The BMD of the lumbar spine of group A was 0.850 g/cm2 (SD+/-0.112) compared to group B of 0.699 g/cm2 (SD+/-0.141), p<0.005. The BMD of the hip region of group A was 0.836 g/cm2 and that of group B patients was 0.716g/cm2 (p<0.01). In women with <5 children, 25.5 had normal BMD as compared to 47 in women with >6 children, 25.4% were osteoporotic in group A and in group B 48%. As per the World Health Organization classification 56% in group A had an increased risk of fracture as compared to 77.5% in group B women. CONCLUSION: Our results indicate that women who had borne >6 children were less osteoporotic and of low fracture risk as compared to those women who had <5 children. The BMD of the women with >6 children was statistically higher than their counterparts, and they sustain this after prolonged lactation. We believe that increased parity protects women from osteoporosis and the severity of the disease, and it is our suggestion that women with <5 children and those nulliparous, who are at increased risk of developing osteoporosis should be investigated and treated accordingly.

Absorptiometry, Photon↗
PubMed2006

Relation of parity and homocysteine to bone mineral density of postmenopausal women.

Osteoporosis is a major problem in contemporary society. However, there is not enough data on multiparity and osteoporosis from developing and/or undeveloped countries on a large scale. Selection of participants in this study was aimed at the detection of bone status in healthy (normal bone mineral density) postmenopausal (n = 46, 55.3 +/- 6.7 years) and osteoporotic postmenopausal women (n: 33) of similar age. Bone mineral density (BMD) was evaluated using dual energy X-ray absorptiometry. At the DEXA evaluation, 33 women had osteoporotic (T score below -2.5) and 46 had normal BMD values. The number of pregnancies was found to range from 3 to 12 (with an overall mean of 6.7 +/- 2.5), while 2.6 +/- 1.9 (range, 1-7) were miscarriages in all of the 33 postmenopausal osteoporotic women. Serum homocysteine (t-Hcy) and urinary deoxypyridinoline (DPD) levels were significantly higher in osteoporotic postmenopausal women (11.96 +/- 3.84 micromol/L, 15.4 +/- 7.0 nM/mM cr) than in non-osteoporotic postmenopausal women (10.93 +/- 3.6 micromol/L, 10.6 +/- 9.1 nM/mM cr), p < 0.05, p < 0.01, respectively. Surprisingly, in postmenopausal osteoporotic women the homocysteine (t-Hcy) levels were positively associated with the number of deliveries (multiparity; 6.7 +/- 2.5), and positively associated with the number of curettages (2.6 +/- 1.9), r = 0.401, p < 0.038 and r = 0.520, p < 0.029, respectively. The mechanism linking serum t-Hcy to the number of pregnancies is unclear, and the relationship may only be by chance. In conclusion, the present study firstly suggests that the number of pregnancies has an effect on the t-Hcy levels. In addition, our study indicates that there is a significant negative correlation between the number of pregnancies and the lumbar spine BMD.

Absorptiometry, Photon↗
PubMed2005

[Genetic polymorphisms of GSTM1 and GSTT1 in mothers of children with isolated cleft lip with or without cleft palate].

Orofacial clefts are one of the most common developmental malformations (OMIM #119530, #119540), which aetiology is very complex and associated with both genetic and environmental factors. One of the main environmental factors increasing the risk of having a child with an oral cleft is maternal cigarette smoking. The effect of maternal smoking may be modified by genes involved in biotransformation of toxic compounds derived from tobacco. Very important role in this process is played by S-glutathione transferase M1 (GSTM1) and S-glutathione transferase T1 (GSTT1) which conjugate glutathione with xenobiotics and promote their removal from human body. The aim of this study was frequency analysis of homozygous deletion of GSTM1 and GSTT1 genes in women having infants with ororfacial clefts and in control group. In this case-control study we used DNA isolated from peripheral blood lymphocytes of 121 mothers having children with isolated cleft lip with or without cleft palate and from 80 control mothers. The common deletions of GSTM1 and GSTT1 were determined by polymerase chain reaction and agarose gel separation. The prevalence of genotype GSTM1(-)/GSTT1(-) was higher in mothers of children with cleft (6.6%) compared to controls (3.7%, p>0.05). Among multiparous mothers of children with cleft (one child with birth defect and at least 2 healthy children, mean number of children - 4) the prevalence of genotype GSTM1(+)/GSTTI(+) was significantly reduced (31.0% vs. 58.7%, p=0.011). A significantly increased risk of giving birth to a child with cleft was found in multiparous subgroup of mothers with GSTM1(-)/GSTT1(-) and GSTM1(-)/ GSTT1(+) genotypes as compared to those with GSTM1(+)IGSTT1(+) genotype (OR 6.96; 95%CI: 1.33-36.57, p<0.01 i 3.05; 95%CI: 1.153-8.05, p<0.02 respectively). We did not observe a significant correlation between smoking status, GSTM1/GSTT1 genotypes and risk of orofacial clefts. Our results suggest that homozygous deletions of GSTM1 and GSTT1 in mother genome might increase the risk of having child with cleft lip with or without cleft palate.

Child↗
PubMed2005

[Risk factors associated to ovarian cancer].

OBJECTIVE: To determine the risk factors associated to ovarian cancer. PATIENTS AND METHODS: A case-control study was carried out including 31 women with ovarian cancer and 69 patients with benign ovarian tumors corroborated with a histopathological study. We analyzed 26 independent variables, which classification was clinic, sociodemographic and ultrasonographic. The dependent variable was ovarian cancer, and it was assigned a value of 1 if it was present and 0 if it was absent. The statistical analysis was done using a logistic regression analysis, with an alpha value of 0.05. RESULTS: The malignant tumor of epithelial cells was the most common histological variety and was seen in 22 cases (71%). There were 24 cases (77.4%) in clinical stage I at the time of the diagnosis. Out of the 26 studied variables late menarche (p = 0.02), multiparity (p = 0.02), loss of weight (p = 0.04), solid tumor (p = 0.02), mixed tumor (p = 0.02) and irregularities of the tumor (p = 0.03) were significant in the applied model. CONCLUSIONS: The sociodemographic variables associated to ovarian cancer were: late menarche and multiparity; the clinical significant variable was loss of weight; and the ultrasonographic variables were solid tumor, mixed tumor and irregularities of the tumor. A population screening program is recommended in women who are in reproductive age, and it should include a gynecological ultrasonographic scanning in order to make an opportune diagnosis of this pathology.

Case-Control Studies↗
PubMed1991

Pattern of breast cancer in Saudi females in eastern province of Saudi Arabia.

We present our retrospective analysis of malignant breast tumours seen at King Fahd University Hospital between 1982 to 1987. 1,658 Saudi nationals were admitted with different malignant conditions, out of this 69 (4.1%) females suffered from breast cancer. Majority of the patients were between the age 31-50 years and half of them presented within the first 6 months of the symptoms. All the patients were married, multiparous and had breast fed their new born. Our study suggests that the incidence of breast cancer among Saudi women is low, multiparous and breast feeding in no way gives any protection to the patients and ductal carcinoma remains the commonest histological type of breast tumour.

Adenocarcinoma, Scirrhous↗
PubMed2006

[Assessment of Bishop's pelvic score in induction of labor prognosis].

Aim of the present mixed prospective and retrospective study is to determine the prognostic significance of the 5 parameters of the pelvic score of Bishop for the continuity and the final outlet of induction of labor. Based on the given results the authors conclude that the dilatation of the cervix is a good prognostic factor for the nulliparous and bad prognostic factor for multiparous. The effacement of the cervix is significant for the outlet of the induction regardless of parity. The level of the presenting part is a valuable criterion for the nulliparous when the pelvic is well assessed but for the multiparous it has no prognostic value. The firmness of the cervix has a bad prognostic value regardless of parity. The position of the is a good prognostic factor for the outlet of the induction but has no value prognosis of the continuity of the induction.

Cervix Uteri↗
PubMed2006

Risk factors for blood transfusion during c-section in a tertiary hospital in Nigeria.

BACKGROUND: Blood and blood products are scarce in developing countries due to increasing demand and declining supply. Rational utilization of blood products is imperative and prompted this study, which identifies the risk factors for blood transfusion during C-sections in a tertiary hospital in Nigeria. MATERIAL/METHODS: This retrospective case-controlled study reviewed all C-sections in our hospital from January 1, 1998, to December 31, 2002. Clinical variables including demographic characteristics, surgical events, EBL, indication for transfusion, and the number of units transfused were recorded. RESULTS: A total of 1117 cesarean sections were performed within the study period. Sixty-three patients (5.6%) received blood transfusions. An unbooked patient was six times more likely to receive a blood transfusion during cesarean section than women who had had antenatal care (p<0.001). Grand-multiparous women were associated with intraoperative transfusion during cesarean section (p=0.004). Placental previa was significantly associated with transfusion during cesarean section (p=0.0002). Previous cesarean section was an associated factor for intraoperative transfusion at cesarean section (p=0.02). CONCLUSIONS: The factors associated with transfusion at cesarean section were lack of prenatal care, grand multiparity, previous cesarean section, and pregnancies complicated by placenta previa. These factors should be considered in the care of parturients for cesarean section, especially in developing countries.

Blood Transfusion↗
PubMed1975

Response of pituitary-adrenal axis on partal stress.

The circulating level of ACTH (by radioimmunoassay) and cortisol (by competitive protein binding) were determined at 1- to 2-hour intervals during spontaneous labor (N=8) and induced labor (N=28) and after delivery. There were no differences in ACTH levels between primiparous and multiparous women. The primiparous women displayed a higher level of cortisol throughout labor than the multiparous women, but not after delivery. After spontaneous onset of labor, ACTH levels were always lower than after elective induction of labor, while there were no differences in the levels of cortisol. The hypertensive complications of pregnancy did not affect the secretion of ACTH. In normal pregnancy the rise of cortisol during labor and after delivery was significant, but it was not significant in the group of patients with hypertensive complications.

Adrenocorticotropic Hormone↗
PubMed2006

Is vaginal breech delivery outdated for all singletons and twins? The current kaleidoscope of obstetric thinking.

The best practice for the delivery of a term breech in singleton and twin pregnancies is still controversial. We sought the opinions of obstetricians working in Ireland. A questionnaire was used to address the management of the obstetrician's "own hypothetical pregnancy" in three different scenarios. We also inquired about factors which might influence the decision on mode of delivery. The response rate was 104/174 (60%). In the scenario of a singleton fetus presenting by the breech in a nulliparous woman, 15/84 (18%) of obstetricians would chose a spontaneous vaginal delivery compared to 40/80 (50%) for a multiparous woman (p < 0.01). In the scenario of a second twin in breech presentation (nulliparous and multiparous), 75/93 (81%) would choose a spontaneous vaginal delivery. When asked about a singleton cephalic presentation, 85/91 (93%) would choose a spontaneous vaginal delivery. These decisions were influenced by concerns about perinatal morbidity [91/100 (91%)], published evidence [73/98 (75%)], the delivery doctor's inexperience [56/94 (60%)], but not by gender. Our study indicates that obstetricians in Ireland consider that there is a role for vaginal breech delivery in selected scenarios.

Attitude of Health Personnel↗
PubMedDate not supplied

Development and validation of risk scoring system for prediction of cancer cervix.

A Hospital based group matched case-control study was conducted to devise a risk scoring system for the prediction of cancer cervix at the Gynecology Clinic, Government Medical College Hospital, Nagpur, India. The study consisted of 230 cases of cancer cervix (histopathologically confirmed) and equal number of controls, group matched for age. The risk factors considered were Illiteracy, long duration of married life (>25 years), Early Menarche (<13 years), marital status (widow, separated, divorcee), multiparity (> 3), h/o abortion, h/o tobacco use, h/o passive smoking, poor genital hygiene, (grade III & IV) and low socioeconomic status. Statistical Analysis included unconditional multiple logistic regression analysis Receiver Operating Characteristic (ROC) curve analysis. The overall predictive accuracy was calculated by Wilcoxon statistic as an equivalent of area under ROC curve. Five risk factors, illiteracy, poor genital hygiene, long duration of married life, multiparity and early menarche were identified to be significantly associated with cancer cervix. These factors were given statistical weights of 13, 10, 7, 5 and 5 respectively. A total score of 21 was found to be the best cut off for prediction and the overall predictive accuracy of the risk scoring system was calculated to be 0.74(0.67 - 0.81). In case of consistent further validation using other data sets this additive risk scoring system can be used for reducing the cost of universal screening by subjecting only high-risk subjects to laboratory screening procedure (Pap smear) in population setting.

Case-Control Studies↗
PubMed1992

Randomized trial of comprehensive prenatal care for low-income women: effect on infant birth weight.

The effect of comprehensive prenatal care on birth weight was examined using a prospective randomized design. A total of 428 pregnant women were randomly assigned to comprehensive prenatal care (n = 217) or standard prenatal care (n = 211). Comprehensive care was provided by a multidisciplinary team of nurse-midwives, social workers, a nutritionist, paraprofessional home visitors, and a psychologist. Standard prenatal care consisted of medical care provided by obstetric residents. Multiple regression analysis using behavioral, demographic, and medical variables showed a strong relationship between the set of predictors and birth weight. Comprehensive care was related to higher birth weights for primiparous but not multiparous mothers. Separate analyses of variance for primiparas and multiparas similarly showed a favorable effect of comprehensive care on birth weight for primiparous but not multiparous mothers.

Birth Weight↗