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Biomedical subjects

W Cates

Publications and source records attributed to W Cates.

At least 19 recordsLinked to original sources
PubMed2000

Abortion surveillance at CDC: creating public health light out of political heat.

In the late 1960s, states began to liberalize their abortion laws, and a new era in women's health began. Under the leadership of Jack Smith, the Centers for Disease Control and Prevention (CDC) established a voluntary abortion surveillance system that provided the first nationwide information on the numbers and characteristics of women having abortions. Studies of abortion morbidity done by the CDC revealed that suction curettage was safer than sharp curettage, local anesthesia was safer than general anesthesia, free-standing clinics were safer than hospitals, and dilation and evacuation (D&E) was safer than the alternative of labor induction for early second-trimester abortions. This evidence, which contradicted traditional medical tenets, rapidly changed the practice of abortion in the United States. CDC also established a surveillance system for abortion deaths. This demonstrated a rapid improvement in the safety of abortion in the early 1970s. Lessons learned from mortality investigations helped to change practice as well.Today, more is known about the epidemiology of abortion than any other operation in the history of medicine. In the midst of strident debate over the abortion issue, CDC abortion surveillance data have helped to guide judicial rulings, legislative actions, and Surgeon General's reports, which have supported safer choices for women of reproductive age. When medical historians of the future look back on this century, the increasing availability of safe, legal abortion will stand out as a public health triumph.

Abortion, Induced↗
PubMed1999

Estimates of the incidence and prevalence of sexually transmitted diseases in the United States. American Social Health Association Panel.

BACKGROUND: Accurate, updated estimates of the incidence and prevalence of sexually transmitted infections in the United States remain elusive. The most widely quoted number of new sexually transmitted disease (STD) cases each year is 12 million. However, this figure has not changed in more than a decade, despite improvements in detection methods and the effects of STD control programs. GOALS: To propose a system for weighing the strength of STD surveillance data and to estimate the incidence and prevalence of STDs in the United States for 1996, using the available published data. RESULTS: We estimate that more than 15 million STD infections occurred in the United States in 1996. This number exceeds the earlier estimate primarily because improved detection techniques have allowed an assessment of previously undiagnosed infections. CONCLUSIONS: Large numbers of new STDs continue to occur each year in the United States, with serious health and economic consequences. More than two thirds of our current estimate of 15 million STDs annually consists of two infections--trichomoniasis and human papillomavirus--for which we have only level III surveillance data. As the quality of our surveillance data improves, we can further refine the precision of our national estimates.

Female↗
PubMed1997

Genital Chlamydia infections in sexually active female adolescents: do we really need to screen everyone?

PURPOSE: To evaluate current Chlamydia trachomatis screening guidelines, which recommend that all sexually active female adolescents undergoing a pelvic examination be tested for chlamydial infection, and determine if instead providers should target particular subpopulations of these adolescents. METHODS: Data were collected from 148,650 sexually active females, ages 15-19 years, tested by direct immunofluorescent antibody in 160 family planning clinics from 1988-92. Trends in chlamydia prevalence by demographic, behavioral, and clinical risk factors were analyzed. Logistic regression modeling was used to identify selective screening criteria. Predictive models were developed for all years combined, as well as for the years when prevalence was highest and lowest. RESULTS: The prevalence of C. trachomatis in this population was 10%, with a 42% decrease (13.2-7.6%) over the 5-year period. Logistic regression identified nine demographic, behavioral, and clinical predictors (p < 0.0001) associated with chlamydial infections. Predictor models from the highest and lowest prevalence years varied little from the combined model. Individual year predictor models showed poor sensitivity and were similar for these 2 years. The screening criteria could not identify a group of adolescents with a prevalence less than 6%. CONCLUSIONS: Several individual risk factors were strongly associated with C. trachomatis, but no single risk factor or combination of risk factors used for selective screening could identify more than 42% of infections in our population. These findings support earlier national recommendations and the need for universal screening of sexually active female adolescents.

Adolescent↗