Articles: disease.
-
The benefits of surgical treatment for patients with congenital heart disease in relation to pregnancy are still controversial. We studied 48 pregnant women (mean age = 25 years) with surgically-corrected congenital heart diseases (Group 1). This included 15 cyanotic diseases: Fallot's tetralogy (11 cases); Ebstein's anomaly (2 cases); transposition of the great arteries (1 case); and double outlet of the right ventricle (1 case). ⋯ Spontaneous abortion (4 vs. 10 percent), Caesarean deliveries (48 vs. 66 percent) or growth retardation (13 vs. 28 percent) did not present any significant differences between these groups. Surgical treatment in patients with heart diseases is associated with a better maternal and fetal prognosis. Therefore, surgery must be considered when counseling patients with congenital heart diseases.
-
Food production in the countries of South and South-East Asia has shown a general upward trend during the last decade. Despite the considerable increase in population in many of these countries, food production per capita in 1988-90 was significantly higher as compared to 1979-81 figures, the increase being specially marked in such countries as Vietnam, Cambodia, Indonesia, and Malaysia. Available daily calorie supply was adequate to meet the requirement. ⋯ Countries of the Region are in varying stages of developmental transition. Among the burgeoning middle classes in some of these countries there are evidences of escalation of degenerative diseases such as diabetes and coronary heart disease. With increasing life expectancy, geriatric nutritional problems will demand increasing attention.
-
The Injury Severity Score (ISS) has served as the standard summary measure of human trauma for 20 years. Despite its stalwart service, the ISS has two weaknesses: it relies upon the consensus derived severity estimates for each Abbreviated Injury Scale (AIS) injury and considers, at most, only three of an individual patient's injuries, three injuries that often are not even the patient's most severe injuries. Additionally, the ISS requires that all patients have their injuries described in the AIS lexicon, an expensive step that is currently taken only at hospitals with a zealous commitment to trauma care. We hypothesized that a data driven alternative to ISS that used empirically derived injury severities and considered all of an individual patient's injuries would more accurately predict survival. ⋯ We conclude that ICISS is a much better predictor of survival than ISS in injured patients. The use of the ICD-9 lexicon may avoid the need for AIS coding, and thus may add an economic incentive to the statistical appeal of ICISS. It is possible that a similar data driven revision of ISS using the AIS vocabulary might perform as well or better than ICISS. Indeed, the actual lexicon used to divide up the injury "landscape" into individual injuries may be of little consequence so long as all injuries are considered and empirically derived SRRs are used to calculate the final injury measure.
-
Some studies (but not all) have suggested that there may be an increase in the risk of breast cancer associated with a prior induced abortion. The risk, if present, may vary according to the duration of the pregnancy in which the abortion occurred, or to a woman's age or parity at that time. The authors conducted a case-control study of breast cancer in white women under age 45 years to address the question of breast cancer risk in relation to induced abortion, with the intention of identifying subgroups of women who might be at particularly increased risk. ⋯ There was no excess risk of breast cancer associated with induced abortion among parous women. These data support the hypothesis that there may be a small increase in the risk of breast cancer related to a history of induced abortion among young women of reproductive age. However, the data from this study and others do not permit a causal interpretation at this time; neither do the collective results of the studies suggest that there is a subgroup of women in whom the relative risk associated with induced abortion is unusually high.
-
The authors have conducted an analysis to validate a computer model that uses age-specific human immunodeficiency virus (HIV) prevalence data to estimate age-specific HIV incidence rates. Data for the analysis are from a cohort study of volunteer male workers in Bujumbura, the capital city of Burundi. Testing for HIV prevalence was conducted at baseline, and HIV-negative subjects were retested annually from 1990 to 1993 to determine rates of seroconversion. ⋯ Expected numbers of cases within age intervals did not differ significantly from observed number of cases. The authors conclude that the model proved to be successful in approximating observed incidence rates and that it is a useful tool, particularly in countries where prevalence data are available and where HIV prevalence has stabilized, which is when the underlying assumptions in the model are best met. The model provides crucial information about incidence rates that might not be evident from prevalence data alone.