Corrigendum for health-related quality of life and hospitalizations in chronic thromboembolic pulmonary hypertension versus idiopathic pulmonary arterial hypertension: And analysis from the Pulmonary Hypertension Association Registry.

[This corrects the article DOI: 10.1177/20458940211053196.].

[Intrepretation of elevated transaminase levels in a pregnancy after a liver transplantation]. / Interprétation d'une augmentation des transaminases lors d'une grossesse après une transplantation hépatique.

A young woman became pregnant 36 months after a liver transplant following an episode of fulminant hepatitis A. At 38 weeks gestation, she delivered by cesarean section following an isolated and moderate elevation of her transaminase enzymes, indicating rejection of the graft. This was later confirmed by liver biopsy. Following augmentation of steroid therapy her postnatal progress was good. The infant progressed quite well. This case raises the question of the management of pregnant women following liver transplantation, with elevated transaminase levels.

[Ovarian steroid cell tumors: a bilateral form]. / Tumeurs ovariennes à cellules stéroïdiennes: à propos d'une forme bilatérale.

The authors report a case of bilateral ovarian steroid cell tumour, not otherwise specified (as subclassified now by Scully). For two years a 46-year-old woman had androgenic manifestations. Only plasma testosterone level was increased. A hysterectomy with bilateral ovariectomy was performed. The first diagnosis was bilateral Leydig cell tumour, but no Reinke crystal was found. The final diagnosis was steroid cell tumour, not otherwise specified. No significant nuclear atypia or mitotic activity were found and two-year follow-up was favourable. The authors discuss the difficulty to class some ovarian tumours between Leydig cell tumour and steroid cell tumour, not otherwise specified as defined by Scully.

Women's decision making about mammography: a replication of the relationship between stages of adoption and decisional balance.

The motivational and cognitive processes of behavior change in the area of screening mammography were investigated. A total of 676 women, 40 to 79 years old, were recruited for telephone interview through random selection from designated census tracts and were asked questions that assessed mammography stage-of-adoption and decisional balance constructs from the trans-theoretical model of behavior change. Two definitions of stage of adoption were used. Analysis of covariance showed that a history of regular screening and an intention to continue having the exam were associated with a more favorable decisional balance. Results replicated a prior investigation and demonstrated the usefulness of stage of adoption and decisional balance as guides for designing stage-matched interventions to increase rates of mammography.

New autosomal recessive chondrodysplasia--pseudohermaphrodism syndrome.

Two siblings with a previously undescribed syndrome are presented. They both have severe dwarfism, antenatal in origin, with generalized chondrodysplasia, severe microcephaly with cerebellar vermis hypoplasia, a hypoplastic iris and a papillous coloboma (Coloboma of the optic disc). The first sibling has a 46,XY karyotype despite normal female internal and external genitalia. She has moderate mental retardation. Gestation of the second sibling was interrupted after antenatal diagnosis. The fetus was 46,XX and very similar to the first case.

A model for quality assessment in cervical cytology used as a screening test.

Although many reliability studies on cervical cytology have been carried out, measurements of sensitivity and specificity have rarely been made since biopsies are not often performed on patients with a negative smear result. This screening assessment was performed over 3 years, using a database of 230,167 smears from 177,051 women. It would seem that cervical cytology has a high specificity (over 99%) but a relatively low sensitivity (61%). Values for sensitivity (exceeding 95%) and specificity (exceeding 99%) for invasive carcinoma should be regarded as reasonably accurate as all incident cases of symptomatic cervical carcinoma are recorded in the Burgundy register. The sensitivity (57%) for pre-invasive lesions is underestimated while their prevalence is overestimated: the lack of organized screening leads to the loss of prevalent cases. The predictive value of a positive smear is 76% for moderate-severe dysplasia, 85% for in situ carcinoma and over 95% for invasive carcinoma.

[Luteinized cystic hyperplasia of the ovaries during pregnancy. A case report]. / Hyperplasie kystique lutéinisée des ovaires au cours de la grossesse. A propos d'un cas.

Multiple lutein cyst (MLC) and luteoma are two aspects of ovarian hyperplasia induced by high levels of human chorionic gonadotrophin (HCG). Using a case report of MLC, the authors compare it with luteoma (the anatomoclinical and pathogenic data). Luteoma are more frequent with multipara, whereas MLC are more often seen with paucipara. Maternal virilization can occur in both cases but MLC does not seem to be responsible for fetal virilization. The fetus could be protected by the placenta, thanks to increased aromatase activity and sex binding globulin production. MLC and luteoma are usually found by chance. The pathology must be known, because of their spontaneous regression after delivery. So, the attitude will be conservative under the control of biopsies.

The Breast Cancer Screening Program in Rhode Island.

The Rhode Island Department of Health has undertaken a Breast Cancer Screening Program which incorporates assessment, policy development, and assurance functions, following the model proposed in the Institute of Medicine (IOM) report, The Future of Public Health. With the community's help, projects have been implemented to increase screening capacity with dedicated, state-of-the-art equipment, to increase screening accessibility, to publicize the need for mammography, and to minimize false test results. In the program's first 15 months, the proportion of women ages 40 and over who were screened with mammography according to current guidelines increased from 35 to 46 percent (from 38 to 49 percent among women ages 40-49; from 31 to 43 percent among women ages 50 and over), including 15 percent who received their first screening mammogram. Providers' recommendations and knowledge of screening guidelines were important in explaining first-time use. The Department plans to apply the IOM model in other program areas. Its adoption by others is urged.

A study guided by the Health Belief Model of the predictors of breast cancer screening of women ages 40 and older.

In late 1987, a total of 852 Rhode Island women ages 40 and older were interviewed by telephone (78 percent response rate) to measure their use of breast cancer screening and to investigate potential predictors of use. Predictors included the women's socioeconomic status, use of medical care, a provider's reported recommendations for screening, and the women's health beliefs about breast cancer and mammography. The Health Belief Model guided the construction of the interview questions and data analysis. Logistic regression was used to identify leading independent predictors of breast cancer screening according to contemporary recommendations: reporting that a medical provider had ever recommended a screening mammogram (odds ratio [OR] = 18.77), having received gynecological care in the previous year (OR = 4.92), having a regular source of gynecological care (OR = 2.63), having ever had a diagnostic mammogram (OR = 2.32), and perceiving mammography as safe enough to have annually (OR = 1.93). The findings suggest that programs intended to increase the use of breast cancer screening should include "inreach" and "outreach" elements; inreach to patients with established patient-provider relationships, by assuring that physicians recommend screening to all eligible patients, and outreach to all eligible women, by helping them overcome barriers to effective primary care, and by promoting mammography, emphasizing its effectiveness and safety. The findings also suggest that socioeconomically disadvantaged women, who are less likely to be screened than other women, should become special targets of inreach and outreach interventions.

[Respiratory distress syndrome in the adult and pregnancy. Hemodynamic consequences]. / Syndrome de détresse respiratoire chez l'adulte et grossesse. Conséquences hémodynamiques.

RDS in adults is an unusual complication of pregnancy. We analysed a case of adult respiratory distress syndrome during pregnancy and assessed the haemodynamic data under controlled ventilation whilst a spontaneous delivery was carried out. The rapid drop in pulmonary artery pressure and in the QS-QT complex after the delivery suggests that there may be a placental shunt which gives a too high reading for exaggeration of the left to right intrapulmonary shunt figures obtained.

[Retrocervical cystic hygroma: diagnosis, prognosis and management. A series of 13 cases]. / Hygroma kystique rétrocervical: diagnostic, pronostic et conduite à tenir. A propos d'une série de 13 cas.

Fetal cystic hygroma (CH) are congenital malformation of the lymphatic system which are seen in antenatally ultrasonography from the end of the first trimester of pregnancy. From a 13 CH retrospective study, the authors discuss the ultrasound diagnosis, the prognosis and the management of CH. In our study, CH is associated with lymphedema (69%), hydrops (46%), diminution of amniotic fluid (69%) and other abnormality (31%). In all cases a diminution or an absence of fetal movement are found. In seven cases a cytogenetic analysis are performed on amniocentesis or fetal tissues: there are five 45XO, one 47XX + 13 and one 46XX. In six cases the chromosome culture failed: two male phenotypes and two histologic appearances of chromosomic anomaly. The prognosis depends on chromosome analysis, other ultrasound abnormality and the size of CH. It is usually fatal in utero. If chromosome anomaly are found, a genetic counsel is proposed.

Mammography referral patterns among Rhode Island physicians.

In 1987, the Rhode Island Department of Health conducted a survey of Rhode Island primary care physicians to determine their attitudes and practices regarding breast cancer screening, particularly their use of clinical breast exam (CBE) and referral for screening mammography, and compared the data with information obtained from primary care physicians in the US in 1984 and 1989. The survey showed that the same percentage of Rhode Island physicians (71%) and physicians nationally (72%) agree with American Cancer Society (ACS) guidelines for breast cancer screening, but Rhode Island physicians refer for mammography (43 vs 37%) and perform CBE (97 vs 80%) according to ACS guidelines more frequently. Cost, reliability and availability were of greater concern to physicians nationally than in Rhode Island. Despite better use of breast cancer screening by Rhode Island physicians, only 43% reported referring for mammography according to guidelines. Since studies indicate that the recommendation of her physician is a key determinant of a woman's decision to have a screening mammogram, physician referral needs to increase in order to meet the Year 2000 Objectives of 80% for screening mammography for women 40 and older.