Articles: disease.
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The Journal of urology · Sep 1992
Review Case ReportsFemale fertility following extracorporeal shock wave lithotripsy of distal ureteral calculi.
This study was prompted by a spontaneous abortion in a 21-year-old woman following extracorporeal shock wave lithotripsy (ESWL ) of a distal ureteral calculus. To our knowledge, it is the first clinical retrospective study on the possible adverse effects of ESWL to the female reproductive tract. We analyzed treatment data and radiation exposure of 84 women in the reproductive period, and surveyed the patients by questionnaire, to which 67 (79.8%) responded. ⋯ Overall 7 children with no malformations or chromosomal anomalies were born to 6 patients. Miscarriages were noted in 3 patients (4.5%) but they occurred at least 1 year after ESWL. Our data suggest that ESWL of lower ureteral calculi is a safe and effective procedure, and does not affect female fertility or lead to increased teratogenic risk.
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Br J Obstet Gynaecol · Sep 1992
Randomized Controlled Trial Comparative Study Clinical TrialA comparative study of the use of epoprostenol and dihydralazine in severe hypertension in pregnancy.
To compare the antihypertensive effects of epoprostenol sodium (prostacyclin) with that of dihydralazine in acute hypertensive crises of pregnancy. ⋯ The place of epoprostenol in pregnancy might be in patients with severe hypertension and tachycardia and in those requiring acute control of severe hypertension on the operating table before general anaesthesia.
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Serum samples collected from two groups in the Tari District of Southern Highlands Province were assayed for markers of hepatitis B virus (HBV) infection. 85% of women of childbearing age were found to have markers of HBV infection; 37% were positive for HBV surface antigen (HBsAg), indicative of the chronic carrier state, and 6.6% were positive for HBV e antigen (HBeAg), indicating the presence of actively replicating virus. 75% of women negative for HBsAg were positive for antibody to HBV core antigen (HBcAb), a marker of past infection. A group of children aged 6 to 18 years showed a significantly lower prevalence of markers of infection (66%) but higher rates of HBsAg positivity (46%) and HBeAg positivity (30%). Only 37% of the HBsAg-negative children in this group were positive for HBcAb. The results from this serosurvey suggest that the major route of HBV transmission in this population is horizontal, between older children, though significant transmission also occurs during the neonatal period.
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Aust J Public Health · Sep 1992
Teenage pregnancy and fertility in New South Wales: an examination of fertility trends, abortion and birth outcomes.
This paper reviews the data available in New South Wales on teenage fertility rates and pregnancy outcomes. Teenage births comprise six per cent of all births in New South Wales, but they constitute a significant public health problem because they are associated with elevated rates of adverse pregnancy outcomes, which include low birthweight, perinatal death and pre-eclampsia. Risk is concentrated in females under 18 years of age. ⋯ There are large geographic variations in teenage fertility within the state, with the highest rates in the far west of New South Wales and in western Sydney. Teenage pregnancy in New South Wales (as distinct from fertility which reflects births) cannot be assessed accurately because of the lack of information on terminations of pregnancy. However, available data suggest that teenage pregnancy rates have not increased during the 1980s.
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In Africa, blood transfusions are frequently given to treat severe paediatric anaemia. Because of the risk of HIV transmission, identification of when transfusion will reduce the risk of death for severely anaemic children has become increasingly important. For all children admitted to a Kenyan hospital from October, 1989, to October, 1990, we collected data on clinical presentation, haemoglobin (Hb), receipt of transfusion, and in-hospital survival. ⋯ Based on a combination of laboratory and clinical criteria, children with clinical signs of respiratory distress and Hb less than 4.7 g/dl who were transfused had lower morality than those who were not (OR 0.19; 95% Cl 0.09, 0.41). Among children without respiratory distress, there was no association between receipt of transfusion and mortality, irrespective of admission Hb. The frequency of blood transfusion can be reduced and survival enhanced by targeting blood to those children with severe anaemia and clinical signs of respiratory distress, and by using transfusion early in the course of hospitalisation.