Articles: adult.
-
In Western industrial countries, low back pain is one of the most frequent causes of illness. Between the 4th and 5th decades of life approximately 80% of adults complain of low back pain, lasting for fairly long periods. About 10% of this population must undergo disc surgery once during life. ⋯ CT control examinations showed clear regression in the extent of disc herniation in 15 patients, in 18 a moderate decrease, and in 9 cases the CT findings had not changed. A favorable tendency towards regression was observed in disc herniations at the level of L5-S1 and in cases showing sequestration of the disc. Herniations of the disc at higher levels between L4-5 and L3-4 or a lateral herniation, reaching the intervertebral foramen, showed on unfavorable prognosis.
-
In a retrospective cohort study of survivors of cancer and of controls, we estimated the risk of infertility after treatment for cancer during childhood or adolescence. We interviewed 2283 long-term survivors of childhood or adolescent cancer diagnosed in the period from 1945 through 1975, who were identified at five cancer centers in the United States. Requirements for admission to the study were diagnosis before the age of 20, survival for at least five years, and attainment of the age of 21. ⋯ Chemotherapy with alkylating agents, with or without radiation to sites below the diaphragm, was associated with a fertility deficit of about 60 percent in the men. Among the women, there was no apparent effect of alkylating-agent therapy administered alone (relative fertility, 1.02) and only a moderate fertility deficit when alkylating-agent therapy was combined with radiation below the diaphragm (relative fertility, 0.81). Relative fertility in the survivors varied considerably according to sex, site of cancer, and type of treatment; these factors should be taken into consideration in counseling survivors about the long-term consequences of disease.
-
The aforementioned social trends affecting women, including women in poverty, women in the labor force, and elderly women, are all ultimately related to problems of access to health care. In almost every age group, women use more health and medical services. Women are hospitalized more often, although their stays in hospitals tend to be shorter. ⋯ As the field of women's health expands and receives more emphasis, the data reflecting the experiences of large groups of women will have to be collected and analyzed ever more carefully. Information collected should include physiologic, psychosocial, and economic factors that together affect the health status of women. These data may then be used to guide health policy decision making, as well as provide a basis for health promotion and disease prevention interventions with individual clients.
-
In 1985 cholera has been a serious problem in the horn of Africa, particularly affecting the many famine victims and refugees in that region. In this paper the history of cholera in Africa is briefly summarized, as is the background to the current refugee situation in eastern Sudan. A cholera epidemic involving 1,175 cases in two adjacent refugee camps in eastern Sudan is described. ⋯ The relationship between cholera and malnutrition is explored and hypochlorhydria is suggested as the main reason for the increased susceptibility to cholera among malnourished populations. It was observed that severely malnourished adults and children appeared to nave less severe diarrhoea with their cholera, presumably because of reduced mucosal surface area and poor enterocyte function. Finally possible means of aborting cholera epidemics are discussed.