Personal and Social Factors Influencing Age at First Sexual Intercourse

Early initiation of sexual activity is aconcern, in part because of increased risk of sexuallytransmitted diseases, including HIV, and unwantedpregnancies among young people. In this study, 241 high schoolers were administered a questionnaire toestablish the relationships between age at first sexualintercourse and personal qualities (sexual style,attractiveness, physical maturity, restraint, autonomy expectations, and attitudes to gender roles),smoking and drug use, and aspects of the social context(social activities, media impact, peer norms). Therewere few effects of sex of respondent and none in which respondents' sex impacted on age ofinitiation. Overall (and among the male sample),perceptions of greater physical maturity, greater use ofuncommon (mostly illicit) drugs, and expectations of earlier autonomy significantly differentiatedbetween early and later initiators. This group offactors tends to confirm the view that early experienceof sexual intercourse is correlated with problembehaviors and a press toward adultbehaviors. For girls, this pattern was even clearer,with use of uncommon drugs being replaced as asignificant contributor to early sexual experience byrelative lack of restraint. We conclude that the desire to achieve thetransition to adulthood at an earlier age than theirpeers constitutes a powerful incentive for young peopleto become sexually active.     

The hemodynamic effects of cell-free hemoglobin during general and epidural anesthesia

Local anesthetics inhibit edema and improve circulation in experimental burns. We evaluated the effect of topical local anesthetics on human skin burns in volunteers using computerized color analysis that allowed repeated noninvasive quantitative measurements. A standardized partial-thickness burn (1 cm2) was induced in one forearm of 10 healthy volunteers and in the opposite forearm a week later. The burned areas were treated with lidocaine/prilocaine cream (EMLA; Astra, Sweden) or a placebo cream for 1 h. The experimental skin area was photographed before and 1, 2, 4, and 12 h postburn. Digitized images were evaluated using normalized red-green-blue and Hue-Saturation-Intensity. Differences in erythema between skin treated with EMLA and placebo were not significant during the first 4 h postburn. However, 12 h postburn, a pronounced decrease in the degree of erythema was observed in EMLA-treated skin compared with placebo-treated skin. We conclude that topical local anesthetics administered for 1 h postburn significantly reduces the duration of erythema after a mild thermal injury, which suggests a potential use in clinical practice in the treatment of minor skin burns. IMPLICATIONS: Burn injury constitutes a serious type of tissue damage that activates inflammatory mechanisms, often causing pain, disfiguration, or malfunction. We treated burns using an anesthetic cream and demonstrated a reduction in burn-induced inflammation by using computer-based color image analysis.     

Trends in maternal mortality ratio among women of German and non-German nationality in West Germany, 1980-1996

BACKGROUND: Maternal mortality is a sensitive indicator for inequity in health. We describe recent trends in overall and cause-specific maternal mortality ratio among women of German and non-German nationality residing in West Germany. METHODS: Using birth and death register data for 1980-1996 we related 1067 cases of maternal death (ICD 9: 630-676) to 11.2 million live births. We assessed the effects of nationality and of marital status, a proxy for socioeconomic status, controlling for year of death and age of the mother in a Poisson regression model. RESULTS: Maternal mortality ratio in West Germany decreased from 13 per 100000 live births in 1980-1988 to 6.1 in 1989-1996. The crude relative risk for non-German nationality decreased from 1.9 (95% CI: 1.6-2.3) to 1.3 (1.0-1.7); after adjusting for age, year of death and marital status it was 1.7 (95% CI: 1.4-2.1) and 1.6 (95% CI: 1.2-2.1). Unmarried women incurred an adjusted relative risk of 1.8 (95% CI: 1.5-2.3). Non-German women experienced an excess mortality from abortions which largely disappeared in 1989-1996; concurrently, being unmarried no longer conveyed an additional risk to them. The risk status of German mothers developed unfavourably: increasing proportions are unmarried, which continues to be a marker of elevated relative risk in this group. CONCLUSIONS: Our findings suggest continuously improving accessibility and quality of obstetric services, in particular for women of non-German nationality. Still, inequity in maternal risk continues to exist. Maternal risk, however, is not determined by the simple distinction 'German' versus 'non-German'; its association with socioeconomic status extends beyond nationality.     

Volatile constituents of the dried leaves of Cassia angustifolia and C. acutifolia (Sennae folium)

The official drug Sennae folium (obtained from Cassia angustifolia and/or C. acutifolia) was found to contain small amounts of volatiles (0.047% based on dry weight) which were analyzed in detail by GC and GC/MS. More than 200 compounds could be detected, 122 of them were identified, representing about 90.7% of the peak area of the total mixture. The volatile constituents can be classified into monoterpenoids (8.8% for sample A and 34.6% for B), sesquiterpenoids (4.2% and 4.0%, respectively), phenylpropanoids (4.2%/15.2%), fatty acids and esters (54.3%/14.2%), and miscellaneous compounds (19.3%/22.7%). Apart from hexadecanoic acid which was strong in both samples (36.8%/9.7%), the occurrence of menthol, geranylacetone, and (E)-anethole is of interest.     

Occupational lung cancer risk for men in Germany: results from a pooled case-control study

Occupational exposures such as crystalline silica, diesel engine exhaust, polycyclic aromatic hydrocarbons, and man-made mineral fibers are strongly suspected to increase lung cancer risk. Two case-control studies in Germany conducted between 1988 and 1996 were pooled for a joint analysis. A total of 3,498 male cases and 3,541 male population controls, frequency matched for age and region, were included in the study. The lifelong history of all jobs and industries was coded and occupational exposures were evaluated by expert rating. Odds ratios, crude and adjusted for smoking and asbestos exposure, were calculated by conditional logistic regression. Job-related evaluation showed a statistically significant increased odds ratio adjusted for smoking among farmers; forestry workers, fishermen, and livestock workers; miners and quarrymen; chemical processors; cabinet makers and related wood workers; metal producers and processors; bricklayers and carpenters; road construction workers, pipelayers and well diggers; plasterers, insulators, and upholsterers; painters and lacquerers; stationary engine and heavy equipment operators; transport workers and freight handlers; and service workers. With regard to specific occupational exposures, elevated odds ratios (OR) (95% confidence intervals (CI)) for lung cancer risk adjusted for smoking and asbestos exposure were observed for man-made mineral fibers (OR = 1.48, 95% CI 1.17, 1.88); crystalline silica (OR = 1.41, 95% CI 1.22, 1.62); diesel engine exhaust (OR = 1.43, 95% CI 1.23, 1.67); and polycyclic aromatic hydrocarbons (OR = 1.53, 95% CI 1.14, 2.04). The risk of asbestos exposure, adjusted for smoking was also increased (OR = 1.41, 95% CI 1.24, 1.60).     

The validity of continuous automated fluid monitoring during endometrial surgery: luxury or necessity?

Thirty-four consecutive women undergoing endometrial laser ablation, as a treatment of menorrhagia, were recruited to assess the validity of fluid absorption monitoring by a new continuous automated system (AquaSens). The same group of women also had monitoring of fluid absorption carried out by our standard technique of weighing. The intra-class correlation coefficient for the fluid deficit estimated by AquaSens compared to our standard technique of manually weighing the irrigation bags was 0.98 (95% CI 0.96–0.99). Aquasens therefore provides a valid and non-invasive method of continuously monitoring fluid deficit amongst patients undergoing operative hysteroscopy procedures, thereby reducing the risk of unexpected fluid absorption and its potentially fatal sequelae.     

Sorting the hype from the facts in testicular cancer: is testicular cancer related to trauma?

PURPOSE: The rate of testicular cancer is increasing. Trauma severe enough to cause testicular atrophy is a putative risk factor for testicular cancer but the epidemiological evidence is not conclusive. A population based, multicenter case-control study was performed from 1995 to 1997 to investigate potential risk factors for gonadal and extragonadal germ cell cancer. MATERIALS AND METHODS: The study was done in 5 German regions. Interviews were performed with 269 eligible male patients with a histologically verified diagnosis and 797 controls. Detailed information on medical and family history was collected at personal interviews. RESULTS: We identified a significantly elevated risk for testicular cancer in relation to testis and/or groin trauma (odds ratio 2.5, 95% confidence interval [CI] 1.51 to 4.20). After introducing a lag time by excluding reports of trauma within the last 12 months before diagnosis or interview the corresponding odds ratio was 2.1 (95% CI 1.24 to 3.61). Analysis of the circumstances and the reported types of injury allowed us to restrict the study to testis trauma specifically, which had an odds ratio of 3.49 (95% CI 1.78 to 6.81). To account for a potential reporting bias analysis was restricted to traumatic episodes for which medical attention was sought. This restriction resulted in an odds ratio of 0.70 (95% CI 0.19 to 2.63) after excluding from study trauma reports within the last 12 months. CONCLUSIONS: The results of our study do not support the hypothesis that testicular trauma is an important risk factor for testicular cancer. The possibility of recall bias should be considered.     

TP53 mutations in ovarian carcinomas from sporadic cases and carriers of two distinct BRCA1 founder mutations; relation to age at diagnosis and survival

Background  

Ovarian carcinomas from 30 BRCA1 germ-line carriers of two distinct high penetrant founder mutations, 20 carrying the 1675delA and 10 the 1135insA, and 100 sporadic cases were characterized for somatic mutations in the TP53 gene. We analyzed differences in relation to BRCA1 germline status, TP53 status, survival and age at diagnosis, as previous studies have not been conclusive.