Articles: prospective-studies.
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To identify factors associated with subsequent sexually transmitted infection (STI) (within 1 year of initial infection) due to Chlamydia trachomatis, Neisseria gonorrhoeae or Trichomonas vaginalis. ⋯ Subsequent STI frequently follow an initial STI, but there is substantial variation in the causal organism. These data suggest the importance of comprehensive STI prevention programs for adolescents rather than organism-specific interventions.
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For logistical reasons sedation studies are often carried out in elective surgical patients and the results extrapolated to the general intensive care unit (ICU) population. We question the validity of this approach. We compared the two sedation regimens used in our general ICU in a trial structured to mimic clinical practice as closely as possible. ⋯ Both regimens produced rapid onset of acceptable sedation but undersedation appeared more common with the cheaper diazepam regimen. At least 140 patients should be studied to provide evidence applicable to the general ICU population. Used alone, a sedation score may be an inappropriate outcome measure for a sedation trial.
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Br J Obstet Gynaecol · Dec 1998
Comparative StudyA comparison of medical and surgical termination of pregnancy: choice, emotional impact and satisfaction with care.
To investigate whether women having medical or surgical terminations of pregnancy differ in their emotional distress before or after the procedure. To evaluate whether choice of procedure occurs, the factors influencing type of procedure and the effect of choice on emotional responses and satisfaction with care. ⋯ Termination method did not influence emotional adjustment. Many women were not offered genuine choice of procedure. Having choice was considered very important but was unrelated to emotional distress or satisfaction with care.
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Multicenter Study Comparative Study
Adult and prenatal exposures to tobacco smoke as risk indicators of fertility among 430 Danish couples.
During 1992-1995, 430 Danish couples were recruited after a nationwide mailing of a letter to 52,255 trade union members who were 20-35 years old, lived with a partner, and had no children. The couples were enrolled into the study when they discontinued birth control, and they were followed for six menstrual cycles or until a clinically recognized pregnancy. At enrollment and each month throughout the follow-up, both partners completed a questionnaire that asked them about their smoking, alcohol consumption, and intake of caffeinated beverages. ⋯ Fecundability odds ratio for nonsmoking women exposed in utero was 0.70 (95% CI 0.48-1.03) and that for female smokers not exposed in utero was 0.67 (95% CI 0.42-1.06). Exposure in utero was also associated with a decreased fecundability odds ratio in males (0.68, 95% CI 0.48-0.97), whereas present smoking did not reduce fecundability significantly. It seems advisable to encourage smoking cessation prior to the attempt to conceive as well as during pregnancy.
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J Stroke Cerebrovasc Dis · Sep 1998
Reduced stroke risk in patients with compromised cerebral blood flow reactivity treated with superficial temporal artery to distal middle cerebral artery bypass surgery.
Extracranial-to-intracranial (EC-IC) bypass surgery for the prevention of stroke in patients with symptomatic carotid artery occlusion has nearly ended after a randomized trial showed no benefit of the procedure. Although an EC-IC bypass might benefit patients with compromised cerebrovascular hemodynamics, the randomized trial did not differentiate patients with hemodynamic from embolic etiologies. However, subsequent investigators have identified a subgroup of patients at increased stroke risk from hemodynamic compromise. ⋯ STA-MCA bypass surgery can restore cerebrovascular reserve in high-risk patients with symptomatic internal carotid artery occlusion. This was achieved with minimal perioperative complications, resulting in a subsequent reduction of stroke frequency. We suggest that the efficacy of STA-MCA bypass surgery for symptomatic carotid occlusion be re-examined prospectively using hemodynamic selection criteria.