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[Poliomyelitis--Challenges for the Last Mile of the Eradication Programme] Poliomyelitis--Herausforderungen in der Endphase des globalen Eradikationsprogramms.
Gesundheitswesen). 2016 Apr; 78(4):227-9.The World Health Organisation initiated the Global Polio Eradication Initiative in the year 1988. With the large-scale application of routine and mass vaccinations in children under the age of 5 years, polio disease has become restricted to only 3 endemic countries (Afghanistan, Pakistan and Nigeria) by today. However, since the beginning of the 21st century, increasing numbers of secondary polio epidemics have been observed which were triggered through migration, political turmoil and weak health systems. In addition, there emerged serious technical (e. g., back-mutations of oral vaccine virus to wild virus) and socio-political (refusal of vaccinations in Muslim populations of Nigeria and Pakistan) problems with the vaccination in the remaining endemic countries. It thus appears questionable if the current eradiation initiative will reach its goal in the foreseeable future. (c) Georg Thieme Verlag KG Stuttgart . New York.
[Sexual abstinence or thrombosis? Comment on the controversy regarding the "third generation pill"] Enthaltsamkeit oder Thrombose? Stellungnahme zur Kontroverse um "Pille der dritten Generation".
FORTSCHRITTE DER MEDIZIN. 1995 Nov 30; 113(33):18, 20.In October 1995 the WHO published the alarming results of an international study about oral contraceptives (OCs) and the risk of venous thrombosis stating that with the use of the third generation of OCs or micropills containing gestodene and desogestrel the risk increases twofold compared with OCs containing other gestagens. However, the Zurich discussion group, composed of German and Swiss hormone researchers, declared that this statement should be taken with a grain of salt. The study reported that 3 cases of thrombosis occur for 100,000 woman years when no OCs are used. When OCs without the above two gestagens are used the incidence of thrombosis increases to 8 cases/100,000 woman years. With the use of these micropills the incidence rose to 17 cases/100,000. The experts interpretation of the differentials was that the common risk factors for thrombosis (obesity, smoking, age, and duration of OC use) were not sufficiently taken into consideration. The original higher dose OCs already produced side effects early on, such as thrombosis, stroke, and heart infarction. Therefore, in the late 1980s the introduction of the new generation of OCs with lower doses seemed to be a welcome solution. The micropill, Femovan by Schering, was put on the market containing .03 mg of ethinyl estradiol (EE) and .075 mg of gestodene, a synthetic, very effective gestagen. The Organon Company introduced another preparation (Marvelon) that contained the same dose of EE and .15 mg of desogestrel. The considerable attention to the putative higher risk of thrombosis posed by these agents was not shared by the European Drug Commission, which did not see any reason for removal of these OCs from the market. The third generation OCs also provide benefits: reduction of bleeding anomalies and cardioprotective effects. Even the increased thrombosis risk is significantly lower than the thrombosis risk posed by pregnancy, delivery, and puerperium.
[WHO Special Programme of Research, Development and Research Training in Human Reproduction (HRP). A summary] WHO Special Programme of Research, Development and Research Training in Human Reproduction (HRP). Eine zusammenfassende Darstellung.
GEBURTSHILFE UND FRAUENHEILKUNDE. 1991 Jan; 51(1):9-14.The WHO's Special Program of Research, Development, and Research Training in Human Reproduction (HRP) has been involved in a global research and development program since 1972 in the are of human reproduction with special regard to the needs of developing countries. HRP set up a worldwide network of cooperating institutes and organized task forces for carrying out priority research objectives/assignments. The goals of HRP include reducing population growth in developing countries by improving health care and by increasing the availability of contraceptives. HRP training and research activities have encompassed workshops, seminars, and training courses. Research and development have been concerned with contraceptive prevalence and use; risks of contraceptives (carcinogenicity, cardiovascular effects, and subdermal implants' side effects); the development of new and safe methods (1-2 month depot preparations; and the levonorgestrel-releasing vaginal ring); and efficacy of contraceptive methods (lactation for birth spacing and natural family planning). A multicentric study in 25 countries has examined infertility caused by infections and sexually transmitted diseases. The extension of research capacity in developing countries was enabled by long-term institutional development grants, capital grants, labor cost financing, training of scientists, and improvement of management. The social and individual determinants of family planning aims at increasing contraceptive prevalence from 11% in Africa, 24% in Southeast Asia, and 43% in Latin America to the level of industrial countries 68%. The structure and management, goal setting and priorities, international cooperation, and finances of HRP are further detailed.