Articles: disease.
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How can epidemiology contribute to understanding the cause of clinical disease? We discuss the nature of causality and the intrinsic limitations of all empirical science, including epidemiology, in establishing "proof" of causality. Our examples relate to eye disease: How the cause of blindness from retrolental fibroplasia was unravelled. How the congenital rubella syndrome was discovered as a cause of congenital cataract. How allopurinol was cleared from suspicion as a cause of cataract.
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The incidence, pathogenesis, staging, and treatment of endometriosis are reviewed, with an emphasis on pharmacologic management of this condition. Endometriosis--the presence of ectopic endometrial tissue--can be found in 15-25% of infertile women and may be found in 1-5% of all women between menarche and menopause. Although the pathogenesis of endometriosis is uncertain, the most tenable etiologic theory is a combination of celomic metaplasia and retrograde menstruation. ⋯ The most common adverse effect associated with nafarelin therapy is hot flashes. The GnRH agonist nafarelin is as effective as danazol or oral contraceptives for the treatment of endometriosis and causes fewer adverse reactions. GnRH agonists may replace danazol as the treatment of choice in patients with endometriosis.
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Tuberculosis is a major public health problem in developing countries. In recent years, a (cost-)effective intervention has been developed in the national programmes of Tanzania and other developing countries. HIV transmission in populations with a high background prevalence of tuberculosis infection will increase the incidence of tuberculosis disease substantially. World Health Organization and World Bank are currently formulating new strategies to revitalise the global efforts against tuberculosis.
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J Am Paraplegia Soc · Jul 1991
ReviewThe impact of spinal cord injury on female sexuality, menstruation and pregnancy: a review of the literature.
Spinal cord injury (SCI) results in alterations in sexual functioning. This area has been studied in depth in males; however, the literature pertaining to female sexual dysfunction after injury is sparse and focused primarily on menstruation and pregnancy. This report reviews the literature on female sexuality, menstruation and pregnancy after SCI and discusses the findings.