Pregnancy outcomes in unicornuate uteri: a review.

Objective: To elucidate the impact of unicornuate uteri on pregnancy outcomes as evidenced by historical and contemporary studies.

Design: Publications related to unicornuate uterus were identified through MEDLINE and other bibliographic databases.

Setting: Literature review in an academic research environment.

Advantage of conservative surgical management of large ovarian neoplasms in adolescents.

Objective: To measure the postoperative size and volume of the ovary after cystectomy for a neoplasm >or=10 cm.

Design: Retrospective case series.

Setting: Academic medical center.

Does the fimbria have an embryologic origin distinct from that of the rest of the fallopian tube?

Objective: To propose a new theory describing the development of the fallopian tube fimbria.

Design: Case series report.

Setting: Metropolitan tertiary care children's hospital.

Monitoring and deterring drug-resistant malaria in the era of combination therapy.

As chloroquine and sulfadoxine-pyrimethamine (SP) are replaced by more effective artemisinin-based combination therapies (ACTs), strategies for monitoring (and, if possible, deterring) drug-resistant malaria must be updated and optimized. In vitro methods for measuring resistance will be critical for confirming and characterizing resistance to ACTs. Molecular markers are useful for tracking the emergence and dissemination of resistance and guiding treatment policy where resistance is low or moderate.

Laparoscopic oophoropexy prior to radiation for pediatric brain tumor and subsequent ovarian function.

Background: Ovarian failure has been reported to occur in female cancer survivors who had received spinal radiation as children. We aimed to determine whether laparoscopic unilateral oophoropexy prior to radiotherapy effectively preserves ovarian function.

Methods: In a retrospective analysis, the study group comprised girls, aged 18 and younger, who received spinal irradiation for a brain tumor.

Malaria treatment efficacy among people living with HIV: the role of host and parasite factors.

Identification of an effect of HIV-associated immunosuppression on response to antimalarial therapy would help guide management of malaria infection in areas of high HIV prevalence. Therefore, we conducted an observational study of people living with HIV infection in Blantyre, Malawi. Participants who developed malaria were treated with sulfadoxine-pyrimethamine (SP) and followed for 28 days.

Use of acellular human dermal allograft for vaginoplasty in Mayer-Rokitansky-Küster-Hauser syndrome: a case report.

Background: Both autologous and synthetic tissue have been used to create a neovagina in women with Mayer-Rokitansky-Küster-Hauser syndrome. Despite reports on many different techniques, the ideal method of vaginoplasty has not been firmly established.

Case: A 33-year-old woman with Mayer-Rokitansky-Küster-Hauser syndrome had been unsuccessful in using vaginal dilators for the creation of a functional vagina with the Frank technique due to pain and vulvar lichen sclerosis.

Bone density in adolescents treated with a GnRH agonist and add-back therapy for endometriosis.

Study Objective: To evaluate the bone density of adolescents with endometriosis treated with a GnRH-agonist and "add-back" therapy with norethindrone acetate.

Design: Retrospective chart review.

Setting: Pediatric gynecology clinic at a tertiary care center.

Structural requirements for the BARD1 tumor suppressor in chromosomal stability and homology-directed DNA repair.

The BRCA1 tumor suppressor exists as a heterodimeric complex with BARD1, and this complex is thought to mediate many of the functions ascribed to BRCA1, including its role in tumor suppression. The two proteins share a common structural organization that features an N-terminal RING domain and two C-terminal BRCT motifs, whereas BARD1 alone also contains three tandem ankyrin repeats. In normal cells, the BRCA1/BARD1 heterodimer is believed to enhance chromosome stability by promoting homology-directed repair (HDR) of double strand DNA breaks.

World Antimalarial Resistance Network I: clinical efficacy of antimalarial drugs.

The proliferation of antimalarial drug trials in the last ten years provides the opportunity to launch a concerted global surveillance effort to monitor antimalarial drug efficacy. The diversity of clinical study designs and analytical methods undermines the current ability to achieve this. The proposed World Antimalarial Resistance Network (WARN) aims to establish a comprehensive clinical database from which standardised estimates of antimalarial efficacy can be derived and monitored over time from diverse geographical and endemic regions.

Uterine didelphys with duplicated upper vagina and bilateral lower vaginal agenesis: a novel Müllerian anomaly with options for surgical management.

Objective: To describe a novel Müllerian anomaly and management options.

Design: Case series report.

Setting: Metropolitan tertiary care children's hospital.

Laparoscopic partial nephrectomy: single center experience with 140 patients--evolution of the surgical technique and its impact on patient outcomes.

Purpose: We analyzed the outcome of laparoscopic partial nephrectomy in 140 patients and defined the evolution of the operative technique and its impact on patient outcomes.

Materials And Methods: Preoperative tumor characteristics, intraoperative parameters (blood loss, ischemia time, complication and conversion rates) and postoperative parameters (complications, surgical margins status and followup) were compared between the initial 30 patients (group 1) and the last 110 (group 2). Statistical analysis was done using the Student t test with p <0.

Pneumocystis pneumonia in HIV-positive adults, Malawi.

In a prospective study of 660 HIV-positive Malawian adults, we diagnosed Pneumocystis jirovecii pneumonia (PcP) using clinical features, induced sputum for immunofluorescent staining, real-time PCR, and posttreatment follow-up. PcP incidence was highest in patients with the lowest CD4 counts, but PcP is uncommon compared with incidences of pulmonary tuberculosis and bacterial pneumonia.

Sonographic findings of ovarian torsion in children.

Background: The clinical diagnosis of ovarian torsion is challenging and findings on pelvic sonography can be pivotal in making the correct diagnosis.

Objective: To determine the sonographic characteristics in children of surgically and pathologically proven ovarian torsion.

Material And Methods: We performed a retrospective review of the sonograms and medical records of 41 patients with surgically and pathologically proven ovarian torsion at a pediatric hospital between 1994 and 2005.

Obstructed hemivagina and ipsilateral renal anomaly (OHVIRA) syndrome: management and follow-up.

Objective: To review the experience at two large referral centers with the syndrome of obstructed hemivagina and ipsilateral renal anomaly (OHVIRA), and to review the risks, benefits, and complications of surgical management options.

Design: Retrospective case series.

Setting: Children's Hospital Boston and Brigham and Women's Hospital, Boston, Massachusetts.

The Interaction between HIV and malaria in Africa.

HIV and malaria kill millions of people every year. They share a common geographic distribution, and both cause far more disease and death in sub-Saharan Africa than they do in the rest of the world. Many epidemiologic studies have suggested that HIV and malaria coexist independently, but some recent reports describe synergistic interactions between them.

Parental decisions to abort or continue a pregnancy following prenatal diagnosis of chromosomal abnormalities in a setting where termination of pregnancy is not legally available.

Objective: To learn about parental decisions to abort or continue a pregnancy after prenatal diagnosis of chromosomal abnormalities among the population in Uruguay.

Methods: Between 1982 and 2003, 14 656 amniocentesis and 2740 chorionic villus samplings were performed in a referral Genetic Unit. Chromosomal anomalies were found in 376 cases (2.

Renal artery occlusion during nephron-sparing surgery: retrospective review of 301 cases.

Objectives: Temporary occlusion of the renal artery during nephron-sparing surgery may facilitate complete tumor resection and reduce operative bleeding. However, it may also entail a greater risk of ischemic kidney damage. In contrast, when vascular occlusion is not applied, the risk of bleeding, as well as the risk of positive margins, may be increased.

Return of chloroquine antimalarial efficacy in Malawi.

Background: In 1993, Malawi became the first country in Africa to replace chloroquine with the combination of sulfadoxine and pyrimethamine for the treatment of malaria. At that time, the clinical efficacy of chloroquine was less than 50%. The molecular marker of chloroquine-resistant falciparum malaria subsequently declined in prevalence and was undetectable by 2001, suggesting that chloroquine might once again be effective in Malawi.

Menstruation in girls and adolescents: using the menstrual cycle as a vital sign.

Young patients and their parents often are unsure about what represents normal menstrual patterns, and clinicians also may be unsure about normal ranges for menstrual cycle length and amount and duration of flow through adolescence. It is important to be able to educate young patients and their parents regarding what to expect of a first period and about the range for normal cycle length of subsequent menses. It is equally important for clinicians to have an understanding of bleeding patterns in girls and adolescents, the ability to differentiate between normal and abnormal menstruation, and the skill to know how to evaluate young patients' conditions appropriately.

Radiation rescue for biochemical failure after surgery for prostate cancer: predictive parameters and an assessment of contemporary predictive models.

Objectives: To determine pretreatment prognostic variables that predict outcome of radiotherapy for biochemical failure after prostate cancer surgery and evaluate contemporary clinical decision tools for patient selection.

Methods: Fifty patients were identified with failure after rescue radiation was defined as a confirmed rise in PSA, distant metastases, prostate cancer death, or initiation of hormonal therapy. Univariate analysis and multivariate Cox models were constructed.

Observational cohort study of HIV-infected African children.

Background: Most information about children living with HIV is based on follow up from children identified through mother-to-child transmission studies. Children identified through voluntary counseling and testing (VCT) represent a unique cohort that has not been previously described in the literature.

Methods: Children who were found to have HIV infection through VCT were offered enrollment in this study.

Adolescent endometriosis-related pelvic pain treated with acupuncture: two case reports.

Background: Chronic pelvic pain in adolescents accounts for 10% of outpatient gynecology visits, and 70% of adolescent patients whose pelvic pain is unresponsive to initial therapy have endometriosis. To date, there has been no published research investigating the use of acupuncture for adolescents with chronic pelvic pain and/or endometriosis.

Methods: This paper presents two case reports describing the impact of a course of acupuncture on adolescent girls with endometriosis-related chronic pelvic pain of more than 1 year.

The manchester-fothergill procedure as a fertility sparing alternative for pelvic organ prolapse in young women.

Although reproductive organ prolapse typically affects older, parous women, a certain population of children and adolescents, primarily adolescents with congenital spinal defects, are also at risk. The Manchester-Fothergill procedure was first performed in 1888 by Dr. Archibald Donald of Manchester, England.