Choices: contraception, pregnancy, birth, and abortion

This article discusses the issues of contraception, pregnancy, birth and abortion. It puts these issues in a context for health care professionals in the state of Georgia. Currently the US is last in the developed world in contraceptive use, further, when we do use contraceptive, we have the highest failure rate of any developed nation. Annually there are 600,000 unwanted pregnancies in the US just from the failure of oral contraceptives. In 1985 there were 3.7 million live births and 1.5 million legal abortions. This is indicative of how poorly we use contraceptive technology. Currently Georgia has one of the highest rates of teenage pregnancy. Considering only Medicaid, AFDC, and Food Stamps, the state of Georgia spends $11,600 on each teen pregnancy for the first year. The author's final conclusion is that a well funded birth control program, that included sexual education, would be the best way to avoid unwanted pregnancies which cost the state money and put women in a position to chose abortion. This type of program has proven to be successful in Sweden and the Netherlands. The abortion issue would no be as important if there were significantly less unwanted pregnancies.     

神经调控技术的过去、现在和未来

神经调控技术是当前发展最快的医学领域之一,调控技术种类激增,适应症不断拓展,全球已有数十万脑功能性疾病患者从中获益,但也存在诸多不足,如神经调控机制尚不完全清楚,神经调控的最佳靶点长期存有争议,缺乏可靠的疗效预测指标及术后程控模式繁琐、效率低等。相信随着医工技术的不断发展进步及脑功能性疾病神经网络机制的逐渐揭示,未来神经调控技术将不断向个体化、精准化、智能化的方向飞速发展。本文将回顾神经调控技术的发展历史,并就其应用现状及未来发展进行总结和述评。     

Thrombolysis: past, present, and future

Management of myocardial infarction evolved because of understanding of underlying disease processes and clinical trials of "chemical" and "mechanical" clot dissolution that reduced in-hospital mortality. Meta-analysis comparing these treatment strategies marginally favours angioplasty. Current European Society of Cardiology guidelines propose primary angioplasty as the preferred therapeutic option but few units in the UK can offer angioplasty on demand as a designated "heart attack centre". Thrombolysis will continue as it is widely available and training needs and costs less than angioplasty. Community thrombolysis should be made available for those patients who do not wish for such aggressive intervention or as a prelude to transfer time to a heart attack centre distant from a triage hospital.