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L T Strauss

Publications and source records attributed to L T Strauss.

At least 37 records · Page 2Linked to original sources

Sterilization-associated deaths: a global survey.

Except for data from several geographically limited studies, little is known globally about the number and causes of death associated with surgical sterilization. To identify clinical characteristics and problems leading to deaths related to the procedures, the International Planned Parenthood Federation ( IPPF ) and the Centers for Disease Control (CDC) in the United States collaborated in a global mail survey of 4642 physicians. Usable responses were received from 1298 physicians (28%) in 80 countries. Fifty-five sterilization-associated deaths which occurred from January 1, 1980 to June 30, 1982 were reported. The most frequently reported causes of death were infection, anesthetic complications, and hemorrhage. There were some regional differences in the relative frequencies of these causes. Most cases did not involve surgical accident. The characteristics most frequently associated with the reported fatal procedures were: interval sterilizations, minilaparotomy incision, tubal ligation and general anesthesia. Most deaths were attributable to the surgical sterilization procedure.

Adolescent↗

Agreement between women's histories of oral contraceptive use and physician records.

The histories of oral contraceptive (OC) use provided by women participating in a study of hepatocellular adenoma (HCA) were compared with records obtained from their physicians. In the HCA study two memory aids were used to assist women in their recall: a calendar of significant events during a woman's lifetime to which she might relate her use of OCs and a book of colour photographs of the 90 OC preparations available up to the time of the study. Using the number of months of a woman's history which could be checked against physician records (mean for all women of 33 months) as the denominator, the highest proportion of concordance was for month-specific duration of OC use (90%) with lower agreement for duration and brand (62%) and duration, brand, and dose (54%). Agreement was better for cases than for controls.

Adult↗

A comparison of primary and secondary homicides in the United States.

In 1979, over 20,000 people in the United States were victims of homicide, but public health agencies have not yet defined their role in its prevention. Role definition might begin with differentiating various forms of homicide, so the authors used data on all homicides reported by law enforcement agencies for 1976-1979 to determine whether homicides that did not occur during the perpetration of another crime (primary homicides) differ from those that occurred during the perpetration of another crime (secondary homicides). Primary and secondary homicide rates were highest in the South and West, respectively. The relative risk for Standard Metropolitan Statistical Areas (SMSAs) compared with non-SMSAs was 2.4 for secondary homicide but only 1.3 for primary homicide. It was found that 17% of primary homicides and 3% of secondary homicides had a female offender. Primary homicides were more frequently intersexual and intraracial than were secondary homicides. Victim and offender ages were similar to one another in primary homicides and dissimilar in secondary ones. Over 75% of primary homicides involved family members or acquaintances, compared to only 24% of secondary homicides. The authors conclude that primary and secondary homicides are epidemiologically dissimilar, and they suggest that public health concern should focus on primary homicide. Prevention and intervention measures should concentrate on discussed target populations. Techniques might include stress reduction and conflict avoidance.

Adolescent↗

Complications of interval laparoscopic tubal sterilization.

In 1978, the Centers for Disease Control initiated a multicenter prospective study to assess the safety of the various female sterilizing operations and the ways in which they could be made safer. During the first 31 months, 3500 women who underwent interval laparoscopic tubal sterilization by electrocoagulation or Silastic banding without other concurrent operations were enrolled in the study. When a standard definition of complications was used, the overall rate of an intraoperative or postoperative complication was 1.7 per 100 women. Several patients factors increased the risk of complications twofold or more: diabetes mellitus, previous abdominal or pelvic surgery, lung disease, a history of pelvic inflammatory disease, and obesity. There was a fivefold difference in complication rates between procedures performed under general anesthesia and those done under local anesthesia.

Adolescent↗

Complications of abdominal and vaginal hysterectomy among women of reproductive age in the United States. The Collaborative Review of Sterilization.

Although hysterectomy was the most frequently performed major surgical procedure among women of reproductive age during the past decade, few recent studies have been conducted to determine the risk of complications. We examined data from the Collaborative Review of Sterilization, a prospective, multicenter, observational study coordinated by the Centers for Disease Control, to assess the comparative risks of complications among women undergoing hysterectomy by the abdominal and vaginal approaches. Between September, 1978, and August, 1981, 1,851 women from nine institutions were included in the study. Women who underwent vaginal hysterectomy experienced significantly fewer complications than women who had undergone abdominal hysterectomy. The difference was probably attributable to the prevalence and efficacy of prophylactic antibiotic use among the former group. Vaginal hysterectomy was associated with more unintended major surgical procedures but less febrile morbidity, bleeding requiring transfusion, hospitalization, and convalescence than abdominal hysterectomy. Vaginal hysterectomy with prophylactic antibiotics should be strongly considered for those women of reproductive age for whom either surgical approach is clinically appropriate.

Adolescent↗

Oral contraceptive during lactation: a global survey of physician practice.

The use of combined estrogen-progestogen oral contraceptives (EP-OC) by lactating women has been associated with suppression of lactation. To determine the extent to which physicians prescribe combined EP-OC for lactating women, the International Planned Parenthood Federation (IPPF) and the United States Centers for Disease Control (CDC) collaborated in a global mail survey of 3697 physicians affiliated with Family Planning Associations (FPA) in 72 countries. Usable responses were received from 831 physicians (22%) in 65 countries. The percent of clinicians who provide EP-OC to lactating women was higher in developing regions (63% or more) than in developed regions (40% or less). Patient preference was rated important more often than any other factor in the decision to prescribe EP-OC for lactating women. The percentage of clinicians who reported complaints of decreased milk production from women using EP-OC was higher (32% or more) in developing regions where breast milk is often essential to infant nutrition.

Contraception↗

Epidemiology of hepatocellular adenoma. The role of oral contraceptive use.

A case-control study of hepatocellular adenoma (HCA), a serious though nonmalignant liver tumor, was conducted by the Center for Disease Control and the Armed Forces Institute of Pathology (AFIP). Interviews with 79 women with HCA and with 220 age- and neighborhood-matched controls were completed. Limited information was obtained on nine additional patients who had died. Women with HCA and hemorrhage have a greater risk of morbidity and death than those with other symptoms. Increasing duration of OC use increases the risk of HCA. Use of OCs with high hormonal potency and age over 30 years may further increase a woman's risk of HCA. Long-term users of OCs have an estimated annual incidence of HCA of 3 to 4 per 100,000.

Adolescent↗

Fertility in psychiatric outpatients.

The fertility rates of 223 female schizophrenic outpatients and 479 female nonschizophrenic outpatients were compared to a probability sample of 300 women residing in the same geographic area, metropolitan Atlanta, and from the same social strata as the patients. Age- and race-adjusted comparisons showed that the mean number of children per woman and levels of unwanted and unplanned fertility did not differ in the different diagnostic groups. Furthermore, the rates were not lower for the psychiatric patients than for the general population. In order to reduce an important source of psychiatric morbidity, those in the mental health professions need to pay more attention to the family planning desires of their patients.

Adult↗

The association between oral contraception and hepatocellular adenoma--a preliminary report.

Women with long-term use of oral contraception (OC) are at increased risk of developing a serious, though nonmalignant, liver tumor--hepatocellular ademona (HCA)--according to a case-control study conducted by the Center for Disease Control (CDC) in collaboration with the Armed Forces Institute of Pathology (AFIP). The tumor is sometimes fatal, deaths usually being due to sudden rupture and hemorrhage. This study suggests that, in addition to long-term OC use, a women's age and the hormonal potency of the OC she uses affect her changes of developing HCA. Women 27 years old and older who have used OC with high hormonal potency for 7 or more years are at the greatest risk.

Carcinoma, Hepatocellular↗

Overview of the National Infant Mortality Surveillance (NIMS) project--design, methods, results.

The recent slowdown in the decline of infant mortality in the United States and the continued high risk of death among black infants (twice that of white infants) prompted a consortium of Public Health Service agencies to collaborate with all States in the development of a national data base from linked birth and infant death certificates. This National Infant Mortality Surveillance (NIMS) project for the 1980 U.S. birth cohort provides neonatal, postneonatal, and infant mortality risks for blacks, whites, and all races in 12 categories of birth weights. (Note: Neonatal mortality risk = number of deaths to infants less than 28 days of life per 1,000 live births; postneonatal mortality risk = number of deaths to infants 28 days to less than 1 year of life per 1,000 neonatal survivors; and infant mortality risk = number of deaths to infants less than 1 year of life per 1,000 live births.) Separate tabulations were requested for infants born in single and multiple deliveries. For single-delivery births, tabulations included birth weight, age at death, race of infant, and each of these characteristics: infant's live-birth order, sex, gestation, type of delivery, and cause of death; and mother's age, education, prenatal care history, and number of prior fetal losses at 20 weeks' or more gestation. An estimated 95 percent of eligible deaths were included in the NIMS tabulations. The analyses focus on three components of infant mortality: birth weight distribution of live births, neonatal mortality, and postneonatal mortality. The most important predictor for infant survival was birth weight, with an exponential improvement in survival by increasing birth weight to its optimum level. The nearly twofold higher risk of infant mortality among blacks was related to a higher prevalence of low birth weights and to higher mortality risks in the neonatal period for infants weighing 3,000 grams or more, and in the postneonatal period for all infants, regardless of birth weight. Regardless of other infant or maternal risk factors, the black-white gap persisted for infants weighing 2,500 grams or more.

Birth Certificates↗

Regional differences in birth weight-specific infant mortality, United States, 1980.

To describe regional differences in birth weight-specific infant mortality in the United States, we used data from the National Infant Mortality Surveillance project. The infant mortality risk (IMR) for the nation was 11.0 deaths per 1,000 live births. The risk (with 95 percent confidence intervals [CI]) for the four U.S. Census regions were West 9.9 (9.7 to 10.1), Northeast 10.4 (10.1 to 10.6), North Central 10.8 (10.6 to 11.0), and South 12.1 (11.9 to 12.3). In all regions, the IMR for blacks was approximately twice that of whites. Seventy-two percent of the higher IMR in the South was due to a higher proportion of black births compared with the remainder of the nation, reflecting the higher mortality rates suffered by black infants, and 28 percent to higher mortality among southern whites. The IMR for whites in the South was significantly higher than in the remainder of the nation: 9.8 versus 9.1 (relative risk = 1.09, CI = 1.06 to 1.11). Thirty-six percent of this excess in IMR was due to a higher frequency of low birth weight (less than 2,500 grams), 18 percent was due to higher IMR in infants with birth weight less than 2,500 grams, and 46 percent due to higher IMR in infants with birth weights of 2,500 g or more. Black infants born in the West had a lower risk of death than black infants in the other regions. When compared with the Northeast and South, 36 percent of the lower risk in the West among black infants was due to a lower frequency of low birth weight, 38 percent due to lower IMR in infants w'ith birth weight less than 2,500 g, and 26 percent to lower IMR in infants with birth weight of 2,500 g or more.

Birth Weight↗

Variation in state-specific infant mortality risks.

Data from the National Infant Mortality Surveillance project were used to examine the State-specific variations in infant, neonatal, and postneonatal mortality and to examine some of the factors affecting the risks of death. The infant mortality risk, defined as the risk of death before 1 year of age to an infant born in the 1980 birth cohort, in the highest risk State was nearly three times that in the lowest risk State. Mortality risk ratios of two or greater were found when comparing high and low States for overall black infant mortality risks, overall neonatal mortality, neonatal mortality risks for black and white infants examined separately, neonatal mortality risks for low birth weight infants regardless of race, and overall postneonatal mortality and postneonatal mortality for white infants. The lowest State-specific black mortality risks were higher than the highest white risks for overall infant mortality and neonatal mortality. The differences between State extremes in mortality risks are greater than the differences between the United States and the Scandinavian countries with the lowest infant mortality.

Female↗

Birth weight-specific infant mortality, United States, 1960 and 1980.

National statistics on the risk of infant mortality by birth weight were collected most recently in 1980 and 1960. (Infant mortality risk is the number of deaths of infants under 1 year of age per 1,000 live births.) In this 20-year period, the infant mortality risk (IMR) for single-delivery infants declined 53 percent, from 23.3 deaths per 1,000 live births to 11.0; 91 percent of this decline was due to lower IMRs within birth weight categories, and 9 percent was due to reduced frequency of low birth weight. The greatest reduction in neonatal mortality (under 28 days)--73 percent--occurred among infants of 1,500-1,999 grams (g) birth weight, whereas the greatest reductions in postneonatal mortality (28 days to under 1 year)--51 percent to 54 percent--occurred among infants of 3,500 g or more birth weight. Trends in IMR for black and white infants were similar, and the twofold gap between the races in IMR persisted from 1960 to 1980. For whites, reductions in the frequency of low birth weights contributed to the decline in the IMR. For blacks, the percentage of infants with birth weights of less than 1,500 g increased, and the total reduction in the IMR was attributable to lower birth weight-specific mortality risks. In some regions of the United States, failure to observe an increase in birth weight for blacks may be a reporting artifact, reflecting improved reporting of births of very small black infants in 1980. Examination of changes in perinatal mortality risks (from 20 weeks gestation to less than 28 days of life) did not suggest that infant mortality trends were substantially affected by changes in the distinction between fetal and neonatal deaths over the 20-year period. Reducing the number of low birth weight infants remains the greatest potential for future reductions in infant mortality.

Birth Weight↗

Birth weight-specific causes of infant mortality, United States, 1980.

To describe underlying causes of infant death by birth weight, we used data from the 1980 National Infant Mortality Surveillance project and aggregated International Classification of Diseases codes into seven categories: perinatal conditions, infections, congenital anomalies, injuries, sudden infant death syndrome (SIDS), other known causes, and nonspecific or unknown causes. Compared with heavier infants, infants with birth weights of 500-2,499 grams (g) are at increased risk of both neonatal and postneonatal death for virtually all causes. Sixty-two percent of neonatal deaths (under 28 days of life) were attributed to "conditions arising in the perinatal period," as defined using codes from the International Classification of Diseases. Prematurity-low birth weight and respiratory distress syndrome (RDS) were the leading causes of such deaths among infants with birth weights of 500-2,499 g, while birth trauma-hypoxia-asphyxia and other perinatal respiratory conditions were the leading causes among heavier infants. For all birth weight groups, congenital anomalies were the second leading cause, representing 27 percent of neonatal deaths. Although perinatal conditions caused nearly one-third of postneonatal deaths (28 days to under 1 year of life) among infants with birth weights of 500-1,499 g, for the other birth weight groups these conditions were much less important; predominant causes of postneonatal death were sudden infant death syndrome (SIDS), congenital anomalies, infections, and injuries. Black infants had a roughly twofold higher risk of neonatal and postneonatal death than did white infants for all causes except congenital anomalies, which occurred with almost equal frequency in blacks and whites. However, for infants with birth weights of 500-2,499 g, blacks had lower risks of neonatal death from RDS and congenital anomalies. Between 1960 (the latest year for which national birth weight-specific mortality statistics had been available) and 1980, SIDS emerged as a major diagnostic rubric. Otherwise, except for infections and congenital anomalies among infants with birth weights of 500-1,499 g, all causes of death declined in frequency among all birth weight groups.

Birth Weight↗

Birth weight-specific infant mortality due to congenital anomalies, 1960 and 1980.

The impact of mortality due to congenital anomalies in single-delivery births was compared in 1960 and 1980 birth cohorts; data were used from the 1960 National Center for Health Statistics national linkage of birth and death certificates and the 1980 National Infant Mortality Surveillance project. In 1960 there were 14,714 deaths due to congenital anomalies, compared with 8,674 in 1980, a 41 percent reduction. The infant mortality risk (IMR) due to congenital anomalies fell 31 percent. This is in contrast with the observed 54 percent decline in IMR due to all causes. This reduction in mortality due to congenital anomalies occurred for both whites and blacks in the postneonatal period and for whites only in the neonatal period. Changes ranged from a 1.8 percent increase for the black neonatal mortality risk to a 46.6 percent decrease for the white postneonatal mortality risk. In spite of these relative reductions, the absolute percentage of all infant deaths due to congenital anomalies had increased from 15.8 percent in 1960 to 24.1 percent in 1980. Two categories, cardiovascular and central nervous system anomalies, accounted for 72 percent of infant deaths due to congenital anomalies in 1960 and for 59 percent in 1980; cardiovascular anomalies accounted for 48 percent of all deaths due to congenital anomalies in 1960 and 40 percent in 1980. Infant mortality risks in the United States showed a 2:1 black to white ratio in both 1960 and 1980. However, for infant mortality due to congenital anomalies, the black and white mortality risks were approximately equal in both 1960 and 1980. For infants with birth weights of 500-2,499 g, the risk of neonatal mortality for blacks was less than half the risk for whites.

Birth Certificates↗

Differences in neonatal and postneonatal mortality by race, birth weight, and gestational age.

In recent decades, neonatal and postneonatal mortality rates have declined overall in the United States. Yet, the mortality rates for black infants continue to be approximately twice those for white infants. With the use of data from 45 of the 53 vital statistics reporting areas that participated in the 1980 National Infant Mortality Surveillance project, we extended previous State analyses to describe differences, nationally, in neonatal and postneonatal mortality risks for black and white infants according to gestational age and birth weight. After restricting our analysis to single-delivery infants with known and plausible combinations of gestational age of 26 or more weeks and birth weights of 500 grams (g) or more, the neonatal mortality risk (NMR)--that is, the number of deaths to infants less than 28 days of life per 1,000 live births--for black infants was 1.6 times higher than the NMR for whites. This difference was largely explained by two findings: First, although the NMR was lower for black than for white infants with gestational ages of less than 38 weeks and birth weights less than 3,000 g, that advantage was heavily outweighed by the higher percentage of such births among blacks, accounting for roughly two-thirds of the overall difference in NMR between blacks and whites. Second, most of the remaining difference in NMR was accounted for by higher NMRs among black infants with gestational ages of 38 or more weeks and birth weights of 3,000 g or more. A comparison of the lowest mortality risk for any combination of birth weight and gestational age showed that the black NMR was 1.89 times higher than the white NMR. The postneonatal mortality risk (PNMR)--PNMR equals the number of deaths to infants 28 days to less than 1 year of life per 1,000 neonatal survivors--for black infants was 2.09 times the PNMR for white infants. Black infants had higher PNMRs than white infants for nearly all combinations of birth weight and gestational age. Higher PNMRs among infants with gestational ages of 38 or more weeks and birth weights of 2,500 g or more accounted for 43 percent of the difference in PNMR between black infants and white infants. Eliminating the U.S. black-white infant mortality disparity will require not only reducing the higher frequency of prematurity and low birth weight among black infants, but also improving the survival during both the neonatal and postneonatal periods of term black infants with normal birth weights.

Birth Weight↗