Articles: disease.
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There is widespread criticism of medicine which contrasts with its manifest success in biotechnology. Medicine's failure to convince stems partly from the fact that its successful biotechnology distracts it from the mundane task of responding appropriately to components of commonplace sicknesses which do not stem from disease (things) or illness (symptoms) but from predicaments. Predicaments are painful social situations or circumstances, complex, unstable, morally charged and varying in their import in time and place, which are readily discernible from a good history. ⋯ The model is capable of broader application in psychiatry and medicine. Doctors should be more concerned to know about the context and background of their patients' sickness, as patients give this information very freely if asked. If patients' complaints are misunderstood then medical responses, made in good faith, may be seen as dangerous intrusions leading to a loss of trust, anger, and litigiousness.
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Patients are considered to have hypercoagulable states if they have laboratory abnormalities or clinical conditions that are associated with an increased risk of thrombosis (prethrombotic states) or if they have recurrent thrombosis without recognizable predisposing factors (thrombosis-prone). The number of specific primary hypercoagulable states that are recognized is growing. ⋯ Secondary hypercoagulable states are generally acquired disorders in patients with underlying systemic diseases or clinical conditions known to be associated with an increased risk of thrombosis: for example, malignancy, pregnancy, use of oral contraceptives, myeloproliferative disorders, hyperlipidemia, diabetes mellitus, and abnormalities of blood vessels and rheology. The complex pathophysiologic features of these secondary hypercoagulable states are discussed, and a framework is provided for the laboratory investigation and systematic clinical approach to the patient.
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A review of the literature on the health consequences of teenage pregnancy and childbirth shows remarkable similarity in findings from studies conducted in the United States, Canada, Britain, France and Sweden. In particular, results of studies conducted since 1970 have tended to indicate that the increased risk of maternal complications from pregnancy and delivery among teenagers--especially those older than 15--is associated more with socioeconomic factors than with the biological effects of age. Smaller differences in maternal mortality between teenagers and older women exist in England and Wales than in the United States and France; this finding suggests that England and Wales may have minimized the age or socioeconomic factors contributing to a difference in rates. ⋯ Studies that separate data for young teens and older teenage mothers also indicate that increased perinatal and late fetal mortality rates may occur only among very young teenage mothers. There is no evidence of an overall increase in congenital malformations among babies born to teenagers. When individual birth defects are examined, some studies have shown increased rates of cardiovascular and central nervous system malformations among the children of teenage mothers.(ABSTRACT TRUNCATED AT 400 WORDS)