Articles: disease.
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Am. J. Obstet. Gynecol. · Jan 1999
Estimates of the risk of cardiovascular death attributable to low-dose oral contraceptives in the United States.
Our purpose was to estimate the annual risk of death in the United States from cardiovascular disease attributable to low-dose combination oral contraceptives. ⋯ There is virtually no excess attributable risk of death from cardiovascular disease related to oral contraceptive use in young women. However, smokers more than 35 years of age should use a nonestrogen contraceptive.
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Bull. World Health Organ. · Jan 1999
ReviewUnsafe injections in the developing world and transmission of bloodborne pathogens: a review.
Unsafe injections are suspected to occur routinely in developing countries. We carried out a literature review to quantify the prevalence of unsafe injections and to assess the disease burden of bloodborne infections attributable to this practice. Quantitative information on injection use and unsafe injections (defined as the reuse of syringe or needle between patients without sterilization) was obtained by reviewing the published literature and unpublished WHO reports. ⋯ In conclusion, unsafe injections occur routinely in most developing world regions, implying a significant potential for the transmission of any bloodborne pathogen. Unsafe injections currently account for a significant proportion of all new hepatitis B and C infections. This situation needs to be addressed immediately, as a political and policy issue, with responsibilities clearly defined at the global, country and community levels.
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Bull. World Health Organ. · Jan 1999
Comparative StudyLong-term morbidity and mortality following hypoxaemic lower respiratory tract infection in Gambian children.
Acute lower respiratory infections (ALRI) are the main cause of death in young children worldwide. We report here the results of a study to determine the long-term survival of children admitted to hospital with severe pneumonia. The study was conducted on 190 Gambian children admitted to hospital in 1992-94 for ALRI who survived to discharge. ⋯ Children in Gambia who survive hospital admission with hypoxaemic pneumonia have a good prognosis. Survival depends more on nutritional status than on having been hypoxaemic. Investment in oxygen therapy appears justified, and efforts should be made to improve nutrition in malnourished children with pneumonia.
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Bull. World Health Organ. · Jan 1999
Clinical Trial Controlled Clinical TrialA clinical training unit for diarrhoea and acute respiratory infections: an intervention for primary health care physicians in Mexico.
In Tlaxcala State, Mexico, we determined that 80% of children who died from diarrhoea or acute respiratory infections (ARI) received medical care before death; in more than 70% of the cases this care was provided by a private physician. Several strategies have been developed to improve physicians' primary health care practices but private practitioners have only rarely been included. The objective of the present study was to evaluate the impact of in-service training on the case management of diarrhoea and ARI among under-5-year-olds provided by private and public primary physicians. ⋯ Most aspects of the case management of children with diarrhoea improved among both groups of physicians after the course; the proportion of private physicians who had five or six correct elements out of six increased from 14% to 37%: for public physicians the corresponding increase was from 53% to 73%. In ARI case management, decisions taken on antimicrobial therapy and symptomatic drug use improved in both groups; the proportion of private physicians with at least three correct elements out of four increased from 13% to 42%, while among public doctors the corresponding increase was from 43% to 78%. Hands-on training courses thus seemed to be effective in improving the practice of physicians in both the private and public sectors.
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Review Case Reports
Abdominal wall pain caused by cutaneous nerve entrapment in an adolescent girl taking oral contraceptive pills.
The etiology of chronic abdominal pain can be elusive. The diagnostic workup, therefore, often includes superfluous and expensive tests, as well as invasive procedures which do not contribute to the final diagnosis. Studies have shown that some patients suffer from prolonged pain in the abdominal wall and often are misdiagnosed and treated as having a visceral source for their complaints. ⋯ After the involved cutaneous nerve was selectively blocked by subcutaneous infiltration, the pain disappeared immediately and completely. Recognition of this apparently unusual condition can lead to gratifying results. It is proposed that oral contraceptive therapy may have caused changes in the abdominal wall which led to nerve entrapment and the ensuing severe, prolonged pain.