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实用肿瘤杂志 2012年第4期27卷 419-423页

作者：李妮娜陈磊李峥吉峰济宁医学院精神卫生学院山东济宁272000 象山县疾病预防控制中心浙江象山315700

目的定量综合评价人工流产与乳腺癌的相关性。方法通过电子资源数据库搜索1991年1月-2011年1月期间发表的人工流产和乳腺癌关系为主要内容的病例对照研究。经严格筛选后,采用RevMan 5.0软件对纳入文献进行异质性检验,计算合并的比值比... 详细信息

目的定量综合评价人工流产与乳腺癌的相关性。方法通过电子资源数据库搜索1991年1月-2011年1月期间发表的人工流产和乳腺癌关系为主要内容的病例对照研究。经严格筛选后,采用RevMan 5.0软件对纳入文献进行异质性检验,计算合并的比值比(OR)及95%置信区间(95%CI),对结果进行敏感度分析和发表偏倚分析。结果共纳入17篇文献,包括20 421例乳腺癌患者和34 261例对照。Meta分析结果显示,所纳入的资料间存在显著的异质性,故采用随机效应模型得出合并的比值比OR值及95%CI为1.28(1.06,1.54)。分层分析显示,女性人工流产1次与乳腺癌关系并无统计学意义,OR=1.05,95%CI(0.92,1.19);而≥2次人工流产可使乳腺癌发病的危险性增加,差异有统计学意义,OR=1.34,95%CI(1.03,1.75)。结论人工流产是女性乳腺癌的危险因素之一,尤其是≥2次人工流产可以增加妇女患乳腺癌的危险性。

关键词：乳腺肿瘤/外科学分析流产人工/统计学和数值数据随机分配

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Reasons for hospitalization due to abortion and pregnancy termination

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JOURNAL OF TROPICAL PEDIATRICS 1999年第1期45卷 31-36页

作者： de Souza, AI Cecatti, JG Ferreira, LOC Santos, LC Womens & Childrens Hosp IMIP Recife PE Brazil UNICAMP Sao Paulo Brazil Univ Fed Pernambuco FESP Recife PE Brazil

The aim of this study was to identify the reasons for hospitalization associated with abortion and pregnancy termination among women attending the Maternity Unit of IMIP, Recife, Brazil. In a case-control study, 230 women who were hospitalized consecutively between August 1994 and June 1995 due to causes related to pregnancy termination or abortion were chosen as cases, Four controls per case were selected randomly out of a total of 920 women who delivered at the same hospital. For each potential cause consider-ed, the odds ratio (OR) and respective 95 per cent confidence interval (CI) were calculated. Multiple logistic regression analysis was then used to control for confounders. Among all potential causes studied, those that showed significant association with pregnancy termination or abortion were: being single, absence of emotional support from partner, being a working woman, literacy up to the fourth year of school, failure of contraceptive method employed, and experience of previous pregnancies, children, and abortions.

关键词：流产人工/副作用流产人工/心理学流产人工/统计学和数值数据巴西病例对照研究住院/统计学和数值数据 Logistic模型比值比危险因素青少年成年人女(雌)性人类中年人妊娠

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CURRENT PRACTICE OF HYPOTHERMIA IN BRITISH CARDIAC-SURGERY

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BRITISH JOURNAL OF ANAESTHESIA 1975年第9期47卷 1011-1017页

作者： MACDONALD, DJF ROY INFIRM DIV ANAESTHESIA GLASGOW SCOTLAND

A questionnaire was sent to all centres of cardiac surgery in the United Kingdom, enquiring into their current use of hypothermia. Moderate hypothermia without cardio-pulmonary bypass and the Drew technique of profound hypothermia are becoming less popular, each technique being used in only two of the 30 centres which replied. Moderate hypothermia as an integral part of the cardiopulmonary bypass is used on occasions in 24 centres. Although some centres use moderate hypothermia out of habit, the main benefits from its use are considered to be the protection afforded to the myocardium and a greater safety margin in the event of technical difficulties. Profound hypothermia, usually induced by means of the pump oxygenator, followed by circulatory arrest is becoming increasingly popular for the correction of complex congenital anomalies in infants.

关键词：体温心脏外科手术/方法心肺转流术心脏缺损先天性/外科学低温人工/统计学和数值数据成年人儿童人类婴儿

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Effect of pacing mode on health-related quality of life in the Canadian Trial of Physiologic Pacing

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AMERICAN HEART JOURNAL 2003年第3期145卷 430-437页

作者： Newman, D Lau, C Tang, ASL Irvine, J Paquette, M Woodend, K Dorian, P Gent, M Kerr, C Connolly, SJ Univ Toronto St Michaels Hosp Dept Med Toronto ON M5B 1W8 Canada Univ Toronto Sunnybrook & Womens Coll HSC Dept Med Toronto ON Canada Univ Ottawa Ottawa Heart Inst Dept Med Ottawa ON Canada York Univ Dept Psychol Toronto ON M3J 2R7 Canada McMaster Univ Dept Clin Epidemiol & Biostat Hamilton ON Canada Univ British Columbia St Pauls Hosp Dept Med Vancouver BC V5Z 1M9 Canada McMaster Univ Hamilton Hlth Sci Corp Dept Med Hamilton ON Canada

Background Both "physiologic" (dual-chamber or atrial only) or ventricular-pacing-only permanent pacemakers provide chronotropic competence, with unknown health-related quality of life (QOL) differences between these options. The QOL studies within the Canadian Trial of Physiologic Pacing were performed to assess whether QOL differences exist in patients randomized to these 2 pacing modes. Methods Two QOL protocols were performed: 1) a substudy of 269 patients with detailed QOL measures (The Medical Outcomes Study, Short-Form (SF-36), the Pacemaker Syndrome Scale, an activity. scale, and a pacemaker-specific scale) at baseline and 6 months after implantation;and 2) a parent study assessment of QOL in 1721 patients with a 12-item QOL instrument package (SF-6, "ladder of life," and pacemaker syndrome scale) given 6 months after implantation only. Results In the substudy, pacing was associated with an average significant (P < .05) 0.36 SD unit improvement in QOL across all domains (SF-36: 38 +/- 9 to 41 +/- 11 for physical scores, 47 +/- 11 to 52 +/- 9 for mental health scores, both P < .001). Similar improvements were seen with the pacemaker-specific scales. There were no significant differences in the absolute or relative improvement in QOL between assigned pacing modes. The parent study similarly showed no differences in QOL between pacing modalities. Presyncope occurred in 31% of-patients in the physiological pacing group, compared with 38% of the patients in the ventricular, pacing group (P < .01). No other symptoms were different between the 2 groups. Pacemaker dependency, defined,as an escape heart rate <50 beats per minute, did not influence the lack of difference in QOL scores between the 2 assigned pacing modes. Conclusion In this largest randomized assessment of QOL in patients with pacemakers, with the instruments used, there was no significant health-related QOL difference seen between "physiologic" pacing and ventricular pacing.

关键词：房室结/生理学心动过缓/治疗加拿大心脏起搏人工/方法健康状况心率/生理学心脏起搏器人工/统计学和数值数据生活质量问卷调查窦房结/生理学晕厥/治疗治疗结果老年人女(雌)性人类男(雄)性

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LONGITUDINAL STUDIES OF PREGNANCY ON THE ISLAND-OF-KAUAI, TERRITORY-OF-HAWAII .1. ANALYSIS OF PREVIOUS REPRODUCTIVE HISTORY

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AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY 1956年第1期71卷 80-96页

作者： YERUSHALMY, J BIERMAN, JM KEMP, DH CONNOR, A FRENCH, FE [a]Division of Biostatistics School of Public Health University of California Berkeley California USA [b]Division of Maternal and Child Health School of Public Health University of California Berkeley California USA [c]Division of Hospitals and Medical Care USA [d]Bureau of Maternal and Child Health Department of Health Territory of Hawaii USA

This paper provides an analysis of the previous reproductive histories of all the women on the Island of Kauai, Territory of Hawaii, who had experienced at least one pregnancy. The data for the study were obtained from all women of childbearing age taken as part of a complete enumeration of the population of the island made in conjunction with a longitudinal study which is in progress. The data have been tested for all needed indices and found reliable when obtained from women who were less than 50 years of age. Consequently the analysis is based on the information obtained from this group of women. The following findings are recorded: 1.1. The results confirm other studies on the relatively high incidence of early fetal deaths. There were more than twice as many early as late fetal deaths.2.2. The factors of order of pregnancy and age of the mother have some-what different effects on the early fetal death rate, the late fetal and neonatal mortality rates, and the postneonatal death rates. The effect of order of pregnancy is stronger for the older infants, while the age of the mother exerts a greater influence on fetal mortality.3.3. The interval between the termination of one pregnancy and the beginning of the next is associated with the survival of the offspring. The early fetal, late fetal, and neonatal mortality rates are high when the interval is short. They are at a minimum when the interval is around 2 years, and increase for longer intervals. On the other hand, postneonatal and childhood mortality rates are lower when the interval between pregnancies is longer.4.4. There is a strong association between the outcome of one pregnancy and that of the immediately preceding one. When a mother suffers a loss in the form of a fetal or infant death, the chances are increased that she will sustain a subsequent loss. This association is specific for type of loss, i.e., when a woman has had an early fetal death she is more likely to have a similar accident in a subseque

关键词：流产人工/统计学和数值数据生物统计学夏威夷婴儿/统计学和数值数据纵向研究生育史生命统计女(雌)性人类妊娠

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Seasonal variations in sexual activity and their implications for sexual health promotion

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JOURNAL OF THE ROYAL SOCIETY OF MEDICINE 1999年第2期92卷 60-64页

作者： Wellings, K Macdowall, W Catchpole, M Goodrich, J Univ London London Sch Hyg & Trop Med Dept Publ Hlth & Policy Sexual Hlth Programme Hlth Promot Res Unit London WC1E 7HT England Publ Hlth Lab Serv Ctr Communicable Dis Surveillance London NW9 5EQ England Hlth Educ Author London WC1H 9TX England

Although seasonal variations in births are observed in all human populations, the links between calendar events and sexual activity have received little attention in relation to health promotion and service provision. We have plotted various relevant data--routinely collected data for births within and outside of marriage, abortions, sexually transmitted infections, human immunodeficiency Virus tests and condom sales figures--by calendar period. The trends point consistently to an increase in sexual activity and unsafe sex occurring at or around the Christmas period, and a longer but less pronounced subsidiary period of increased sexual activity and unsafe sex coinciding with the summer vacation. We conclude that seasonal patterns of sexual activity have implications for provision of sexual health services and for the timing and targeting of sexual health promotional interventions.

关键词：流产人工/统计学和数值数据出生率避孕套/统计学和数值数据避孕/统计学和数值数据 HIV感染/诊断健康促进婚姻季节性行为性传播疾病/流行病学性传播疾病/预防和控制女(雌)性人类男(雄)性

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Trajectories of fetal loss in the Czech Republic

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DEMOGRAPHY 1999年第3期36卷 327-337页

作者： Carlson, E Hoem, JM Rychtarikova, J Univ S Carolina Dept Sociol Columbia SC 29208 USA Univ Stockholm Demog Unit S-10691 Stockholm Sweden Charles Univ Fac Sci Dept Demog & Geodemog Prague Czech Republic

Using data for 555,038 pregnancies conceived in the Czech Republic in 1987-1990, we show that pronounced differences in fetal survival in the middle trimester of pregnancy by marital status, educational level, and labor force attachment become much smaller at full term;survival differences by age at conception and number of previous deliveries show relatively constant proportional hazards throughout gestation. Social inequalities in postpartum life chances have been documented previously, but we show that similar inequalities exist before birth.

关键词：流产人工/统计学和数值数据流产自然/流行病学方差分析捷克共和国/流行病学数据收集教育就业死胎/流行病学孕龄私生婚姻状况母亲年龄产次危险因素社会经济因素青少年成年人女(雌)性人类婴儿新生妊娠

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Complications of unsafe abortion in sub-Saharan Africa: A review

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HEALTH POLICY AND PLANNING 1996年第2期11卷 117-131页

作者： Benson, J Nicholson, LA Gaffikin, L Kinoti, SN JOHNS HOPKINS UNIV PROGRAM INT EDUC REPROD HLTH BALTIMORE MD USA CENT & SO AFRICA COMMONWEALTH REG HLTH COMMUNITY ARUSHA TANZANIA

The Commonwealth Regional Health Community Secretariat undertook a study in 1994 to document the magnitude of abortion complications in Commonwealth member countries. The results of the literature review component of that study, and research gaps identified as a result of the review, are presented in this article. The literature review findings indicate a significant public health problem in the region, as measured by a high proportion of incomplete abortion patients among all hospital gynaecology admissions. The most common complications of unsafe abortion seen at health facilities were haemorrhage and sepsis. Studies on the use of manual vacuum aspiration for treating abortion complications found shorter lengths of hospital stay (and thus, lower resource costs) and a reduced need for a repeat evacuation. Very few articles focused exclusively on the cost of treating abortion complications, but authors agreed that it consumes a disproportionate amount of hospital resources. Studies on the role of men in supporting a woman's decision to abort or use contraception were similarly lacking. Articles on contraceptive behaviour and abortion reported that almost all patients suffering from abortion complications had not used an effective, or any, method of contraception prior to becoming pregnant, especially among the adolescent population;studies on post-abortion contraception are virtually nonexistent. Almost all articles on the legal aspect of abortion recommended law reform to reflect a public health, rather than a criminal, orientation. Research needs that were identified include: community-based epidemiological studies;operations research on decentralization of post-abortion care and integration of treatment with post-abortion family planning services;studies on system-wide resource use for treatment of incomplete abortion;qualitative research on the role of males in the decision to terminate pregnancy and use contraception;clinical studies on pain control medications

关键词：流产不全/流行病学流产不全/死亡率流产人工/死亡率流产人工/统计学和数值数据流产合法非洲撒哈拉沙漠以南/流行病学细菌感染/经济学细菌感染/流行病学细菌感染/病因学避孕行为出血/经济学出血/流行病学出血/病因学妇产科医院/标准手术后并发症/流行病学公共卫生妇女卫生保健服务/经济学妇女卫生保健服务/组织和管理妇女卫生保健服务/标准女(雌)性人类男(雄)性妊娠

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The potential role of contraception in reducing abortion

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STUDIES IN FAMILY PLANNING 2000年第3期31卷 193-202页

作者： Bongaarts, J Westoff, CF Populat Council Policy Res Div New York NY 10021 USA Princeton Univ Princeton NJ 08544 USA

This study Examines the potential role of further increases in contraceptive prevalence and effectiveness in reducing abortion rates. The model used in this analysis links the abortion rate to ifs direct determinants, including couples' reproductive preferences, the prevalence and effectiveness of contraceptive practice to implement these preferences, and the probability of undergoing an abortion to avoid an unintended birth when a contraceptive fails or is not used. An assessment of the tradeoff between contraception and abortion yields estimates of the decline in the total abortion rate that would result from an illustrative increase of 10 percentage points in prevalence. This effect varies among societies, primarily because the tendency to obtain an abortion after an unintended pregnancy varies. For example, in a population with an abortion probability of 0.5, a 10 percentage-point increase in prevalence would avert approximately 0.45 abortions per woman, assuming contraception is 95 percent effective. If all unintended pregnancies were aborted, this Effect would be three times larger. Eliminating all unintended pregnancies and subsequent abortions would require a rise in contraceptive prevalence to the level at which all fecund women who do not wish to become pregnant practice contraception that is 100 percent effective. A procedure is provided for estimating this "perfect" level of contraceptive prevalence.

关键词：流产人工/统计学和数值数据流产人工/发展趋势生育间隔避孕/统计学和数值数据避孕/发展趋势家庭特征生育力朝鲜模型理论妊娠不想要的患病率概率青少年成年人女(雌)性人类中年人妊娠

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Sexual behaviour and contraception among unmarried adolescents and young adults in Greater Accra and Eastern regions of Ghana

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JOURNAL OF BIOSOCIAL SCIENCE 2000年第4期32卷 495-512页

作者： Agyei, WKA Biritwum, RB Ashitey, AG Hill, RB Norfolk State Univ Sch Liberal Arts Norfolk VA 23504 USA Ghana Med Sch Dept Community Hlth Accra Ghana Morgan State Univ Inst Urban Res Baltimore MD 21239 USA

A fertility survey of unmarried adolescents and young adults (953 males and 829 females) in Greater Accra and Eastern regions of Ghana revealed that a substantial proportion of the respondents were sexually experienced. Overall, 66.8% of the males and 78.4% of the females were sexually experienced. The mean ages ( +/- SD) of the males and females were 15.5 +/- 2.5 and 16.2 +/- 2.0 years, respectively. Most respondents claimed to have received adequate information on reproductive health and sexually transmitted diseases (STDs), including AIDS. However, 20% and 30% of the respondents in peri-urban and rural areas, respectively, did not know that a girl could get pregnant the first time she has sexual intercourse. The incidence of pregnancy among the unmarried female respondents was relatively high (37%), and was higher in urban than in rural areas. Approximately 47% of those who had ever been pregnant reported that they had had an abortion. Levels of contraceptive awareness were high (98.2% among males and 95.5% among females) but many still engaged in unprotected sexual relations. The most commonly used methods were the condom and the pill. The main reasons given for non-use were that they did not think about contraception, were concerned about the safety of contraceptives, and partner objection. These findings point to the need for targeting of unmarried adolescents and young adults with information on reproductive health and family planning to increase their awareness of the risks of pregnancy, STDs and HIV infection.

关键词：流产人工/统计学和数值数据避孕行为加纳健康知识态度实践妊娠率性教育性行为青少年成年人女(雌)性人类男(雄)性妊娠

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