| Abstrakt: |
A two-semester survey was conducted to obtain information about the underutilization of postcoital contraception (PCC) in terms of fear about using it or ignorance of its existence. Among 437 students attending the women's health clinic at California State University/Fresno, 41% had had a therapeutic abortion. One hundred fifty-two, or 84.9%, of those who had had terminations were not aware of PCC. Some were not aware that they had taken a chance of becoming pregnant. It is concluded that students who have had a therapeutic abortion either were unaware of the existence of PCC or were unaware they were risking pregnancy and therefore unable to utilize PCC to avoid the need for a surgical procedure. It would appear that ignorance about the existence of PCC is a major reason for its underutilization. "Treatment of First Episodes of Genital Herpes Simples Virus Infection with Oral Acyclovir," YVONNE J. BRYSON, MARYANNE DILLON, MICHAEL LOVETT, GUILLERMO ACUNA, STEPHEN TAYLOR, JAMES D. CHERRY, B. LAMAR JOHNSON, EDWARD WIESMEIER, WILLIAM GROWDON, TERRI CREAGH-KIRK, RONALD KENNEY. We performed a double-blind placebo-controlled trial of oral acyclovir in the treatment of first episodes of genital herpes simplex virus infections in 48 young adults (31 women and 17 men). Subjects were randomized to receive either placebo or acyclovir (200 mg per dose) five times daily for 10 days; they were examined on at least eight visits until healed and at monthly visits thereafter. Acyclovir treatment, as compared with placebo, significantly reduced virus shedding, new lesion formation after 48 hours, and the duration of genital lesions in both men and women. The total duration and severity of clinical symptoms (such as pain, adenopathy, dysuria, and malaise) were significantly reduced by acyclovir in both men and women by the third and fourth day, respectively (P ≤ 0.025), as compared with placebo. No toxicity was observed. Recurrence rates have so far been similar in placebo and acyclovir recipients. Oral acyclovir treatment of first-episode genital herpes simplex virus infections is clincially effective, but it does not seem to prevent virus latency or associated recurrent disease. (New England Journal of Medicine 1983;308:916–21) "Cesarean Section: Risk and Benefits for Mother and Fetus," BEN P. SACHS, BRIAN J. McCARTHY, GEORGE RUBIN, ANTHONY BURTON, JULES TERRY, CARL W. TYLER. We studied the effects of cesarean section on neonatal mortality for breech infants and low-birth weight vertex infants using data from the Georgia neonatal surveillance network on 392,241 singleton deliveries between 1974 and 1978. The risk of neonatal death for breech infants weighing 4,000 g or less delivered vaginally was significantly higher than the risk for those delivered by cesarean section. The lower the birthweight, the higher the risk for a vaginal breech delivery. For breech infants weighing 1,000 to 2,500 g, the risk was almost 2½ times greater for a vaginal delivery v a cesarean delivery. The best outcome for high-risk vertex infants weighing 1,000 to 1,500 g was for those delivered by cesarean section in a tertiary perinatal center. An increase in the cesarean section rate may be associated with increased neonatal survival; however, the benefits must be weighed against the costs of an increased maternal mortality and morbidity. (Journal of the American Medical Association 1983;250:2157–2159) [ABSTRACT FROM AUTHOR] |
