Articles: disease.
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Acta Psychiatr Scand · Jun 1998
Association of maternal, antenatal and perinatal complications with suicide in adolescence and young adulthood.
The aim of the present study was to investigate whether maternal, antenatal and perinatal complications are associated with adolescent or young adulthood suicide in offspring. Cases consisted of individuals, aged 15-22 years, born in New York City and committing suicide in New York City between 1985 and 1991 (n = 189). Two controls were selected for each case, constituting the hospital birth immediately preceding and following that of the case, matched with the case with regard to sex and ethnicity. ⋯ This lack of association between complications and outcome also obtained in separate analyses by sex, ethnicity, socio-economic status and age at suicide. These results fail to replicate the findings of two previous reports implicating maternal, antenatal and perinatal complications in risk of youth suicide. At present, epidemiological evidence that adverse reproductive events increase the risk for suicide in offspring remains inconclusive.
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The purpose of this study was to evaluate the diagnostic accuracy of transvaginal sonography for first trimester spontaneous abortions, thought to be incomplete or complete, in patients with postabortion bleeding or uterine cramping within 5 days of abortion. In a prospective study, 78 patients underwent transvaginal sonography to evaluate the maximum anteroposterior diameter of the uterine cavity on the long axis view and echo pattern of the retained products of conception. Patients were divided into three groups: those with a normal uterine cavity or a uterine cavity with fluid collection without echogenic foci (n = 13, group A), those with a uterine cavity containing fluid mixed with solid components (n = 38, group B), and those with a uterine cavity containing solid components (n = 27, group C). ⋯ In group C, all patients with a diameter of the uterine cavity 8 mm or greater underwent elective curettage. The overall complication and patient satisfaction rates were approximately 14% and 88%, respectively. Transvaginal sonographic findings can be used as a decision factor in the management of patients with first trimester spontaneous abortion to reduce the need for an elective curettage by approximately 58%.
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The documented history of malaria in parts of Asia goes back more than 2,000 years, during which the disease has been a major player on the socioeconomic stage in many nation states as they waxed and waned in power and prosperity. On a much shorter time scale, the last half century has seen in microcosm a history of large fluctuations in endemicity and impact of malaria across the spectrum of rice fields and rain forests, mountains and plains that reflect the vast ecological diversity inhabited by this majority aggregation of mankind. That period has seen some of the most dramatic changes in social and economic structure, in population size, density and mobility, and in political structure in history: all have played a part in the changing face of malaria in this extensive region of the world. ⋯ The task of malaria control or elimination needs to be clearly related to the basic macroeconomic process that preoccupies governments, not cloistered away in the health sector Historically malaria has had a severe, measurable, negative impact on the productivity of nations. Economic models need rehoning with political aplomb and integrating with technical and demographic strategies. Recent decades in Chinese malaria history carry some lessons that may be relevant in this context.