Articles: disease.
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Maternal ageing is a very important factor in aneuploidy. It is associated with an increased risk of a liveborn trisomy, especially Down's syndrome, and with a dramatic increase in trisomic conceptions, the majority of which miscarry. A total of 585 volunteer couples who were planning pregnancies participated in a prospective study of reproduction. ⋯ Use of oral contraceptives for > or = 9 years was associated with a spontaneous abortion rate of 11.3%, which is about half the rate (23%) which was found in couples who had not used the pill. However, the effect of pill taking was correlated with female age, and when age was examined as an independent factor, the reduction in miscarriage was only statistically significant in women > 30 years old, where the rate of abortion reduced from 28 to 7%. Because age-related aneuploidy in humans probably occurs as a direct or an indirect result of follicle depletion, it is proposed that the long-term use of the oral contraceptive pill protects against abortion due to aneuploidy by preserving the number of follicles.
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Infect. Dis. Clin. North Am. · Jun 1995
Mass population displacement. A global public health challenge.
Since the end of the Cold War, there has been a dramatic increase in civil conflicts resulting in approximately 50 million refugees and internally displaced civilians. The public health impact of these situations has been immense, comprising high rates of communicable diseases, elevated prevalence of acute malnutrition, and high excess mortality rates. The prevention of these adverse public health effects includes early warning and intervention; prompt supply of adequate food, water, and sanitation; measles immunization; effective management of epidemic communicable diseases; and simple and timely information systems.
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Comparative Study
Care of critically ill newborns in India. Legal and ethical issues.
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J. Natl. Cancer Inst. · May 1995
Vasectomy and prostate cancer: results from a multiethnic case-control study.
Vasectomy, a widely used form of contraception, has been associated in some studies with increased prostate cancer risk. ⋯ The findings of this study do not support previous reports of increased prostate cancer risk associated with vasectomy. However, the altered endocrine profiles of vasectomized control subjects seen in this cross-sectional comparison warrant further evaluation in longitudinal studies.
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Randomized Controlled Trial Clinical Trial
Intra-vas deferens bupivacaine for prevention of acute pain and chronic discomfort after vasectomy.
We have studied the use of intra-vas deferens local anaesthesia in 70 patients undergoing vasectomy as day-case patients. Patients were allocated randomly to either a control or treatment group. In the treatment group, 0.5% bupivacaine 1 ml or 0.9% saline 1 ml was injected into the lumen of the right or left vas deferens in a randomized blinded design. ⋯ One year after the procedure a second questionnaire was sent out asking about the presence or absence of chronic testicular discomfort, its duration and any surgical intervention required to relieve it. There were no differences between the control group and the saline side of the treatment group in VAS scores on both day 1 and day 7 after operation or in the incidence and duration of chronic testicular discomfort (mean 30 (SD 53) and 34 (50) days, respectively). The VAS scores were, however, significantly less (P < 0.005) and testicular discomfort was absent on the bupivacaine-treated side.