PubMed Health⌕ Search

Biomedical subjects

B Ola

Publications and source records attributed to B Ola.

At least 19 recordsLinked to original sources
PubMed2006

Fetal size and growth velocity in the prediction of the large for gestational age (LGA) infant in a glucose impaired population.

OBJECTIVES: To evaluate the performances of estimated fetal weight (EFW) and fetal growth velocity (FGV) in the prediction of birth weight>95th centile amongst women with impaired glucose tolerance (IGT); the prediction of neonatal hypoglycaemia was a secondary endpoint. STUDY DESIGN: Two hundred and forty-two consecutive women (61 type 1 diabetes mellitus, 14 type 2 diabetes mellitus, 49 gestational diabetics and 118 with impaired glucose tolerance) receiving routine care at the combined diabetes/antenatal clinic, Jessop Hospital for Women, Sheffield. EFW was routinely calculated at approximately two-week intervals in the third trimester with the last EFW prior to delivery used in the analysis. FGV was calculated from two estimates of fetal weight between 21 and 35 days apart. EFW and FGV were both expressed as standard deviation (Z) scores. RESULTS: The mean gestational age at delivery was 37 weeks (range 26-40 weeks). Sixty-five (27%) infants were of birth weight>95th centile. Mean EFW Z scores were 2.7 and 0.99 for >95th and <95th centile, respectively (p<0.001). Receiver operator characteristics (ROC) curve analysis gave area under the curve 0.8; using a cut-off Z score of 1.7 (=95.5 centile), EFW has sensitivity 80% and specificity 72% in predicting an LGA neonate (likelihood ratios 2.8 and 0.27 for positive and negative test). Mean FGV Z scores were 0.85 and 0.4 for >95th and <95th centile, respectively (p>0.05); ROC curve analysis indicated no discriminatory capacity. Estimates of fetal size and growth performed poorly in the prediction of neonatal hypoglycaemia. CONCLUSION: In routine clinical practice, EFW has limited utility in the prediction of the LGA infant. FGV does not identify the LGA infant. EFW and FGV do not predict neonatal hypoglycaemia.

Anthropometry↗
PubMed2004

Ovarian cancer in Ibadan: characteristics and management.

Ovarian cancer has the highest case fatality rate among gynaecological cancers worldwide because of lack of effective screening methods and non-specific early warning symptoms with late presentation. A reinvigorated study is necessary in the developing countries because of a projected increase in its incidence. The decreasing fertility rate and increasing use of ovulation induction drugs are some of the reasons. The Ovarian Cancer Service of the Department of Obstetrics and Gynaecology, University College Hospital, Ibadan, Oyo State, Nigeria commenced the first longitudinal study of this malignancy from 1 December 1998 in order to establish a regional management and research centre. It is a questionnaire survey detailing the demography, clinical and staging laparotomy findings and histology of all confirmed cases. Twenty-one staging laparotomy and histologically confirmed ovarian cancer cases were managed from 1 December 1998 to 31 July 2002, about 1.5% of the 1387 gynaecological admissions. It is the third most common of the gynaecological cancers, representing 9.8% of the 214 cases. More than 60% of the patients were 50 years or younger. Only 19% were nulliparous, with 47.6% having had five or more deliveries. Only two patients (9.5%) had used the oral contraceptive pill, for a maximum period of 1 month. Only one patient (4.8%) had a positive family history of cancer. Abdominal swelling was the most common presenting symptom. Eighty-one per cent of the patients presented in Stages III and IV. Epithelial ovarian cancer constituted about 76.2% of the cases. Only 23.8% had adjuvant therapy, consisting of combination chemotherapy using cisplatin-based regimes. The case fatality rate 6 months after surgery was 76%. The ovarian cancer patients in this environment are younger and of higher parity than expected. The risk factors for this disease require further study.

Adolescent↗
PubMed2003

Quality of brief guidelines produced by professional bodies: a study of the 'green-top' guidelines by the UK Royal College of Obstetricians and Gynaecologists.

Clinicians ignore lengthy guidelines and prefer pocket cards and concise pamphlets. However, brevity in guidelines may lead to deficiency in quality. Our objective, therefore, was to examine the quality of brief guidelines produced by professional bodies, using those produced by the UK Royal College of Obstetricians and Gynaecologists (RCOG) as an example. We assessed all 22 'green-top' guidelines, produced by September 2002, for quality using a validated 37-item appraisal instrument. This instrument evaluated the guidelines on three dimensions, namely rigour of development, context and content and applicability. Ten (45%), 18 (82%) and five (23%) of the 22 guidelines met at least half the quality criteria for rigour of development, context and content and applicability, respectively. We conclude that the brief guidelines were deficient in several specific quality items, particularly those in the applicability dimension. Guideline developers need to achieve the higher quality standards expected of professional bodies.

Female↗
PubMed2003

Serum albumin, creatinine, uric acid and hypertensive disorders of pregnancy.

BACKGROUND: Pre-eclampsia is a form of hypertensive disorder of pregnancy. It is a common cause of both maternal and perinatal morbidity and mortality in both developed and developing countries. OBJECTIVE: To evaluate the possibility of early prediction of hypertensive disorders of pregnancy using single estimation of serum protein, creatinine and uric in serum samples of healthy primigravidae with singleton pregnancy. SETTING: University College Hospital, Ibadan. SUBJECTS: Fifty nine normortensive primigravidae. METHODS: Fifty nine healthy normotensive primigravidae with singleton pregnancy who booked for antenal care and delivered at the University College Hospital, Ibadan had single estimations of their serum albumin, creatinine and uric acid levels at booking before the 20th week of pregnancy. The women were followed up longitudinally throughout pregnancy. RESULTS: Pre-eclampsia occurred in five of the patients (21.7%), two had pregnancy induced hypertension only (8.7%) while 16 remained normotensive (69.6%). The difference in the mean serum concentration of uric acid (0.162 +/- 0.02 mmol/L) and creatinine (93.70 +/- 10.08 micromol/L) respectively were not statistically significant (p>0.05). However, the difference in the mean serum albumin levels (4.06 +/- 0.06 versus 3.71 +/- 0.33 gm/dl) was significantly higher in the pre-eclampsia group (p<0.05). The predictive performance of these tests was generally low whether alone or in combination. CONCLUSION: Single estimation of serum uric acid and creatinine levels early in pregnancy are of little value in the prediction of pre-eclampsia. A large study is recommended to properly define the value of serum albumin levels in pregnancy in the prediction of pre-eclampsia in the light of the findings of this study.

Adult↗
PubMed2002

Long term safety of fluoroscopically guided selective salpingography and tubal catheterization.

BACKGROUND: The irradiation of the ovaries of reproductive age women during fluoroscopically guided selective salpingography and tubal catheterization has raised concern about the safety of the procedure. In addition to the risk of cancer induction, which exists with the irradiation of all tissues, with the gonads, the induction of hereditary disorders is possible. The objective of this study was to estimate these risks and present them in a clinically meaningful way. METHODS: Retrospective analysis was undertaken of 366 consecutive cases of selective salpingography and tubal catheterization performed at the Birmingham Women's Hospital, UK. The radiation doses of different types of procedure were compared with the background annual radiation dose. The risks of cancer and genetic disorders induction were calculated using conversion coefficients published by the International Commission on Radiological Protection. RESULTS: The radiation dose women were exposed to during selective salpingography and tubal catheterization under fluoroscopic guidance was a fraction of the background annual radiation dose. The excess lifetime risks of cancer and hereditary disorders were in the order of four to 13 and two to six per million procedures respectively. CONCLUSIONS: The long term risks of selective salpingography and tubal catheterization under fluoroscopic guidance are low.

Adult↗
PubMed2001

Recombinant or urinary follicle-stimulating hormone? A cost-effectiveness analysis derived by particularizing the number needed to treat from a published meta-analysis.

OBJECTIVE: To demonstrate that particularizing pooled results of a meta-analysis can derive incremental cost effectiveness of superovulation with recombinant follicle-stimulating hormones (rFSH) vs. the highly purified urinary form (uFSH) for assisted conception. DESIGN: A retrospective study. SETTING: An assisted conception unit in the United Kingdom. PATIENT(S): One hundred forty-five fresh in vitro fertilization (IVF) and 58 fresh intracytoplasmic sperm injection (ICSI) cycles. INTERVENTION(S): rFSH vs. uFSH. MAIN OUTCOME MEASURE(S): Incremental cost-effectiveness (i.e., cost needed to treat, or CNT) and budget-impact analyses of rFSH vs. uFSH. RESULT(S): In women less than 30 years old, the clinical pregnancy rate was 37.7% (95% CI 24.8%-52.1%), the particularized number needed to treat (pNNT) was -19, and the cost needed to treat was 5070.51 pounds sterling (3660.53 pounds sterling to 7619.32 pounds sterling). For the 30- to 35-year-old age group, the clinical pregnancy rate was 29.9% (95% CI 20.0%--41.4%), the particularized number needed to treat was -24, and CNT was 7335.59 pounds stering (5284.11 pounds sterling to 10,941.22 pounds sterling). For the 36- to 40-year-old age group, the clinical pregnancy rate was 30.6.0% (95% CI 19.6%--43.7%), the particularized number needed to treat was -23.0, and the CNT was 8569.67 pounds sterling (5998.70 pounds sterling to 13,413.24 pounds sterling). CONCLUSION(S): The CNT and thus the budget impact analyses (the extra number of cycles that can be funded by the CNT) both increase directly with age of the patient, and inversely with the clinical pregnancy rate.

Adult↗
PubMed2001

Information derived from hospital coded data is inaccurate: the Birmingham Women's Hospital experience.

We tested the accuracy of coded hospital information on the Patient Administration System (PAS), a major component of the Hospital Information Support System (HISS). This is the main electronic database used for healthcare research, audit, and planning in National Health Service hospitals in the UK. The accuracy of electronic records of diagnoses, interventions and diagnosis-intervention pairs was low. (Kappa agreement statistics [k] were 0.39, 0.30, and 0.21 respectively). A major source of error arose because the databases of maternities and surgical operations were not seamlessly linked to the PAS.

Journal Article↗
PubMed2001

Should ICSI be the treatment of choice for all cases of in-vitro conception? Considerations of fertilization and embryo development, cost effectiveness and safety.

There is now considerable discussion whether intracytoplasmic sperm injection (ICSI) should be used in all cases of IVF. A critical and balanced view of the current literature is presented. The difficult question is how to identify men with apparently normal semen who are likely to fail to achieve a pregnancy using IVF. In conclusion, from both the safety and scientific viewpoint, ICSI should only be used in cases where success at IVF is regarded as unlikely.

Blastocyst↗
PubMed2001

Enhanced spontaneous locomotor activity in bovine GH transgenic mice involves peripheral mechanisms.

Clinical and experimental studies indicate a role for GH in mechanisms related to anhedonia/hedonia, psychic energy, and reward. Recently we showed that transgenic mice with general overexpression of bovine GH display increased spontaneous locomotor activity. In the present study, we investigated whether this behavioral change is owing to a direct action of GH in the central nervous system or to peripheral GH actions. A transgenic construct, containing the glial fibrillary acidic protein promoter directing specific expression of bovine GH to the central nervous system, was designed. The central nervous system-specific expression of bovine GH in the glial fibrillary acidic protein-bovine GH transgenic mice was confirmed, but no effect on spontaneous locomotor activity was observed. Serum bovine GH levels were increased in glial fibrillary acidic protein-bovine GH transgenic mice but clearly lower than in transgenic mice with general overexpression of bovine GH. In contrast to the transgenic mice with general overexpression of bovine GH, glial fibrillary acidic protein-bovine GH mice did not display any difference in serum IGF-I levels. The levels of free T(3) and the conversion of the free T(4) to free T(3) were only increased in transgenic mice with general overexpression of bovine GH, but serum corticosterone levels were similarly increased in both transgenic models. These results suggest that free T(3) and/or IGF-I, affecting dopamine and serotonin systems in the central nervous system, may mediate the enhanced locomotor activity observed in transgenic mice with general overexpression of bovine GH.

Animals↗