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  • 1
    Electronic Resource
    Electronic Resource
    A randomized controlled trial of early amniotomy (1991)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 98 (1991), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective— To determine if a policy of early amniotomy resulted in a reduction in mean labour duration when compared to a policy of conservation of the membranes.Design— A single-centre randomized controlled trial.Setting— A tertiary care teaching hospital in Alberta, Canada.Subjects— Ninety-seven term nulliparae in spontaneous labour, baby in cephalic presentation.Intervention— Early amniotomy versus intent to keep membranes intact.Main outcome measures— Interval from randomization to delivery, rate of abnormalities of fetal heart rate tracings, cord artery blood pH, Apgar scores.Results— The mean interval from randomization to delivery was 390.9 (SE 29.1) min in the amniotomy group and 442.9 (SE 34.1) min in the control group (P= 0.251). There were no differences between groups in the occurrence of fetal heart rate tracing abnormalities, nor was there a difference in the proportion of babies with abnormal Apgar scores, or abnormal cord pH (〈 7.20).Conclusion— The results of the study fail to support the long held belief that early amniotomy is an effective method for reducing labour duration.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1991.tb10316.x
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  • 2
    Electronic Resource
    Electronic Resource
    Does sweeping of the membranes reduce the need for formal induction of labour? A randomized controlled trial (1998)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 105 (1998), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective 1. To evaluate the effectiveness of sweeping of the membranes to reduce the need for a formal induction of labour; 2. to evaluate the side effects of this intervention.Design A randomised controlled clinical trial.Setting Three tertiary care hospitals of the province of Quebec, Canada.Population Two hundred women for whom non- urgent induction of labour was medically indicated.Methods Women were randomly allocated to sweeping of membranes, or vaginal examination for Bishop scoring only.Main outcome measures 1. Cumulative incidence and relative risk of induction of labour by either oxytocin, prostaglandins or amniotomy; 2. women's discomfort and side effects attributable to sweeping of the membranes.Results Women allocated to sweeping of the membranes required formal induction of labour less frequently than women in the control group, but this difference was not statistically significant (49%vs 60%, RR 0.83, 95% CI 0.64–1.07). Pain during vaginal examination and other side effects were more frequently reported by women allocated to the sweeping group.Conclusions The observed reduction in the need for formal induction of labour is smaller than in previous studies. Side effects and discomfort associated with sweeping of the membranes must be taken into account when counselling women who require induction of labour.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1998.tb09347.x
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  • 3
    Electronic Resource
    Electronic Resource
    Prostaglandin E2 vaginal gel to treat dystocia in spontaneous labour: a multicentre randomised placebo-controlled trial (2005)
    Oxford, UK and Malden, USA : Blackwell Science Ltd
    BJOG 112 (2005), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective  To test the safety and efficacy of prostaglandin E2 (PgE2) as a treatment for dystocia in spontaneous labour.Design  Randomised, double-blind, placebo-controlled trial.Setting  Multicentre study in nine university-affiliated hospitals in Canada.Population  Three hundred and thiry-two nulliparous women with spontaneous labour at term.Methods  Women who had progressed 〈2 cm of cervical dilation in the 4 hours following the diagnosis of labour were randomly assigned to receive a single dose of either 1 mg (n= 112) or 2 mg (n= 111) PgE2 vaginal gel or placebo gel (n= 109).Main outcome measures  The primary outcome was resolution of dystocia, defined as a change in cervical dilatation of 〉0.5 cm per hour in the 6 hours following gel administration. Secondary outcomes were progress of labour, uterine hyperstimulation (more than five contractions in 10 minutes or a contraction lasting more than 2 minutes), use of oxytocin, method of delivery, maternal and neonatal morbidity.Results  Dystocia resolved more often after PgE2 1 mg (49%), RR 1.53 (95% CI 1.1, 2.1) and PgE2 2 mg (49%), RR 1.5 (CI 1.1, 2.1), compared with placebo (32%). Hyperstimulation was increased after PgE2 2 mg treatment (15%), RR 5.6 (95% CI 1.7, 18), but not after PgE2 1 mg (5.4%), RR 1.9 (CI 0.50, 7.6) when compared with placebo (2.8%). There was an increase in caesarean sections performed in the second stage of labour in the PgE2 groups versus placebo. There were no differences in measures of maternal or neonatal morbidity.Conclusion  A single 1-mg dose of PgE2 vaginal gel is more effective than placebo in resolving dystocia, without increasing uterine hyperstimulation, but may be associated with an increase in the incidence of second stage caesarean section.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.2005.00484.x
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  • 4
    Electronic Resource
    Electronic Resource
    Trial of labour after caesarean section in sub-Saharan Africa: ameta-analysis (1997)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 104 (1997), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective To evaluate the safety and effectiveness of apolicy of trial of labour for women with a previous caes are an section, delivering in hospitals in sub-Saharan Africa.Design Ameta-analysis of 17 published reports. Setting Hospitals located in sub-Saharan Africa.Main outcome measures The probability of vaginal delivery, the risk of mortality and morbidity, and the risk difference for specific obstetrical condition swere computed using an approach equivalent to a random effects model.Results The proportion of women who were allowed a trial of labour ranged from 37% to 97% across reports. The probability of a vaginal delivery among these women was 69% (95% CI63–75%). Maternal mortality among all women with aprevious caesarean section was 1.9/1000 (95%CI0–4.3). Uterine rupture and scar dehiscence occurred in 2.1% (95%CI1.0–3.2). Criteria used to select women foratrial of labour appeared to have a limited impact on the probability of vaginal delivery.Conclusions In hospitals in sub-Saharan Africa a selective policy of trial of labour after a previous caesarean section has a success rate comparable to that observed in developed countries. The policy appears to be relatively safe and applicable in this context.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1997.tb11008.x
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  • 5
    Electronic Resource
    Electronic Resource
    The spatial pattern of industrial rents and the role of distance (2005)
    Bradford, West Yorkshire [u.a.] : Emerald
    Journal of property investment & finance 23 (2005), S. 329-341 
    Details
    ISSN: 1463-578X
    Source: Emerald Fulltext Archive Database 1994-2005
    Topics: Economics
    Notes: Purpose - The objective of this paper is to re-appraise intra-urban rent models in the context of a multi-nodal landscape. Primarily, the study focuses on the early work of Alonso and, more recently, Di Pasquale and Wheaton. Although the latter use a more sophisticated approach, both models lead to similar outputs, notably a declining rent gradient from the central business district (CBD). However, throughout the twentieth century there has been a considerable process of urban industrial change. Di Pasquale and Wheaton recognise this and argue that this has led to an almost flat industrial rent gradient. Design/methodology/approach - To assess the current impact on industrial rents a hedonic rent regression model is applied which enables us to standardise for property characteristics. Findings - The results support the hypothesis that the rent gradient from the CBD for a large city is still downward-sloping, albeit very shallow. More interesting is the significance of proximity to motorway junctions. The analysis supports the hypothesis of a multi-nodal rent surface. Proximity to a motorway junction is the most important locational variable with a much steeper and negative gradient than that to the CBD, albeit over a shorter distance. Originality/value - These results imply that the draw of the CBD in terms of agglomeration economies and its accessibility to labour for a city the size of Glasgow still remains, but its attractions are much denuded with the development of a national motorway network.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1108/14635780510602408
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  • 6
    Electronic Resource
    Electronic Resource
    A cis -acting control region is required exclusively for the tissue-specific imprinting of Gnas (2004)
    [s.l.] : Nature Publishing Group
    Nature genetics 36 (2004), S. 894-899 
    Details
    ISSN: 1546-1718
    Source: Nature Archives 1869 - 2009
    Topics: Biology , Medicine
    Notes: [Auszug] Genomic imprinting brings about allele-specific silencing according to parental origin. Silencing is controlled by cis-acting regulatory regions that are differentially marked during gametogenesis and can act over hundreds of kilobases to silence many genes. Two candidate imprinting control regions ...
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1038/ng1398
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  • 7
    Electronic Resource
    Electronic Resource
    Factors predicting the acute effect of pamidronate on serum calcium in hypercalcemia of malignancy (1992)
    Springer
    Calcified tissue international 51 (1992), S. 419-423 
    Details
    ISSN: 1432-0827
    Keywords: Hypercalcemia ; Malignancy ; Bisphosphonates ; Nephrogenous cyclic adenosine monophosphate ; Tubular threshold ; Phosphate reabsorption
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine , Physics
    Notes: Summary In this study we retrospectively reviewed results of the first 9 days of treatment with pamidronate at doses of 30 mg (n=13), 45 mg (n=9), and 90 mg (n=13) in an attempt to see what factors influenced the response of serum calcium to pamidronate. The nadir of serum calcium obtained post treatment was correlated with pretreatment levels of nephrogenous cyclic adenosine monophosphate (NcAMP), the renal tubular threshold for phosphate reabsorption (TmPO4), and the renal tubular threshold for calcium reabsorption (TmCa). Using the post treatment serum calcium levels, patients were divided into “good” and “poor” responders depending on whether a normal serum calcium was obtained. Pretreatment NcAMP was significantly correlated with the magnitude of the response of serum calcium (r=0.45, P=0.0001). Pretreatment NcAMP was significantly higher in the poor responders (mean±SEM): 65.0±9.4 nmol/liter GF (poor responders) versus 29.6±6.3 (good responders), P=0.004. NcAMP as a predictor of the acute response of serum calcium showed a sensitivity of 93% and a specificity of 72%. Pretreatment TmPO4 was negatively correlated with the serum calcium response post treatment (r=-0.41, P=0.003). However, though TmPO4 tended to be lower in the poor responders, this was not statistically significant [0.65 mmol/liter GF±0.09 (poor responders) versus 0.76 mmol/liter GF±0.06 (good responders)]. As a predictor of the acute response of serum calcium, TmPO4 was less good with a sensitivity of 70% and specificity of 58%. No significant correlation was present between TmCa and the serum calcium response. A significant negative correlation was evident between NcAMP and TmPO4 (r=-0.35, P=0.003), however, no significant correlation was evident between NcAMP and TmCa or TmPO4 and TmCa. These results suggest that in a hypercalcemic patient where evidence exists for the presence in circulation of a factor with PTH-like activity (i.e., NcAMP is elevated or TmPO4 is low) the response of serum calcium to pamidronate is less good. NcAMP would appear to be a useful predictor of the response of serum calcium, whereas TmPO4 is less discriminating.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00296674
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