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  1. 1

    New data on oral contraceptive pills and the risk of heart attack. Press release.

    World Health Organization [WHO]

    [Geneva, Switzerland], WHO, 1997 Apr 24. 3 p. (Press Release WHO/33)

    A study conducted by the UNDP/UNFPA/WHO/World Bank Special Program of Research, Development, and Research Training in Human Reproduction confirmed that young women in both developed and developing countries with no predisposing risk factors for cardiovascular disease can use oral contraceptives (OCs) without increasing their risk of acute myocardial infarction. The study was conducted in 21 centers in 12 developing and 7 developed countries and involved 369 women with acute myocardial infarction and 941 healthy controls. The duration of OC use did not affect the risk of heart attack. In OC users under 35 years who smoke and use the pill, the incidence of heart attack increases from the 3.5 cases/million woman-years recorded in nonsmoking OC users to about 40 cases/million woman-years. The risk of heart attack rises substantially, however, in OC users over 35 years of age who smoke: to 500 cases/million woman-years. The overall risk of heart attack is 10 times higher in OC users with high blood pressure than in women with normal blood pressure or non-users of OCs. The data did not reveal consistent differences in heart attack risk according to the OC's estrogen dose; there were too few OC users enrolled in the study who were using pills containing gestodene or desogestrel to permit conclusions about the relative safety of second- and third-generation OCs. These findings indicate that the minimal heart attack risk associated with OC use can be avoided by screening women for potential risk factors for such disease, especially high blood pressure, diabetes, and smoking.
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  2. 2

    World lung health: a concept that should become a reality [editorial]

    Murray JF; Enarson DA


    In May 1990 in Boston, Massachusetts, in the US, American Thoracic Society, the American Lung Association, and the International Union Against Tuberculosis and Lung Disease hosted the World Conference on Lung Health. At the end of the conference, participants adopted several resolutions calling on WHO and governmental and nongovernmental organizations to take specific actions to prevent and control lung diseases. The Conference adopted 7 resolutions pertaining to tuberculosis (TB) and AIDS, such as governments must ensure high quality care for TB and AIDS patients and strengthen TB and AIDS prevention programs. Since acute respiratory infections (ATIs), the leading cause of death in children, cause considerable suffering and death in children, the Conference asked WHO and government and nongovernment organizations to increase funding for provision, cold storage, and distribution of vaccines in developing countries, and for training care workers, and for programs to help parents recognize the signs and symptoms requiring medical attention. Other ARI-related resolutions included education about the risk and prevention of indoor air pollution and increased funding for research to develop heat-stable vaccines. Resolutions related to air pollution and health embraced tighter controls of emission of air pollutants, development of policies to protect indoor air, and more research into the hazards of indoor and outdoor air pollution. More research and gathering of accurate data on deaths and illness due to asthma were among resolutions related to asthma. Resolutions on smoking included a call for the end of all governmental support for the tobacco industry, including the import and export of tobacco products, and of all advertisements and promotions of tobacco products; for nonsmoking policies in all public places, especially health care facilities and schools; and for health workers to be societal role models by not smoking.
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  3. 3

    Women and cancer. Les femmes et le cancer.

    Stanley K; Stjernsward J; Koroltchouk V


    The primary cause of death in women in the world is cancer. In most developing countries cancer of the cervix is the most prevalent cancer. Breast cancer has this distinction in Latin America and the developed countries of North America, Europe, Australia, and New Zealand. It is also the most prevalent cancer worldwide. The most common cancer in Japan and the Soviet Union is stomach cancer. Effective early detection programs can reduce both breast and cervical cancer mortality and also the degree and duration of treatment required. In Iceland, cervical cancer mortality declined 60% between the periods of 1959-1970 and 1975-1978. Programs consist of mammography, physician breast and self examination, and Pap smear. The sophisticated early detection equipment and techniques are expensive and largely located in urban areas, however, and not accessible to urban poor women and rural women, especially in developing countries. Tobacco smoking attributes to 80-90% of all lung cancer deaths worldwide and 30% of all cancer deaths. Passive smoking increases the risk of lung cancer to 25-35% in nonsmokers who breathe in tobacco smoke. Since smoking rates of women are skyrocketing, health specialists fear that lung cancer will replace cervical and breast cancers as the most common cancer in women worldwide in 20-30 years. Tobacco use also contributes to the high incidence of oral cancer in Southern and South Eastern Asia. For example, in India, incidence of oral cancer in women is 3-7 times higher than in developed countries with the smoking and chewing of tobacco in betel quid contributing. Techniques already exist to prevent 1/3 of all cancers. If cases can be discovered early enough and adequate treatment applied, another 1/3 of the cases can be cured. In those cases where the cancer cannot be cured, drugs can relieve 80-90% of the pain.
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  4. 4

    Changing mortality patterns in men.

    Kesteloot H; Yuan X; Joossens JV

    ACTA CARDIOLOGICA. 1988; 43(2):133-9.

    Age-adjusted mortality trends among men aged 35 to 74 in developed countries are analyzed for the last 35 years using WHO data for seven selected countries. "Mortality from all causes has shown the greatest decrease in Japan and the greatest increase in Hungary. From 1970 on cardiovascular mortality demonstrates a downward trend in all countries, except in Sweden where it remains virtually unchanged and Hungary where it rises markedly. Cancer mortality shows an upward trend which levels off during the last 15 years with the exception of Hungary. Changes in dietary and smoking habits and mass treatment of hypertension offer the most plausible explanation for the observed changes." (EXCERPT)
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  5. 5

    A case-control study of ectopic pregnancy in developed and developing countries.

    Gray H

    In: Intrauterine contraception: advances and future prospects, edited by Gerald I. Zatuchni, Alfredo Goldsmith, and John J. Sciarra. Philadelphia, Pennsylvania, Harper and Row, 1985. 354-64. (PARFR Series on Fertility Regulation)

    Little data is available from developing countries on the incidence of ectopic pregnancy and the associated risk factors: pelvic inflammatory disease (PID), sexually transmitted diseases (STDs), intrauterine devices (IUDs), and abortion. To address this problem, the World Health Organization conducted a multinational case-control study between 1978 and 1980 of factors associated with ectopic pregnancy in 12 centers, 8 in developing countries and 4 in developed countries. Results suggest that risk factors are similar in women from developing and developed countries. The only exceptions were increased risks of ectopic pregnancy associated with spontaneous abortion or smoking in developing but not developed country centers. This may reflect misreporting of illegal induced abortion or postabortion complications, and behavioral differences between smoking and nonsmoking women in developing countries. All methods of contraception prevent pregnancy and so provide protection against ectopic pregnancy. This protective effect is least with the IUD, however, and accidental conceptions during IUD use or after sterilization carry an increased risk of ectopic pregnancy. With the IUD, this probably reflects both differential protection against intrauterine and extrauterine pregnancy and an increased risk of IUD-related PID resulting in tubal damage. The risk of ectopic pregnancy is also increased in women with a previous history of PID or a prior pregnancy. However, cesarean section was found to reduce the risk of ectopic gestations in all comparison groups.
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  6. 6

    Smoking control strategies in developing countries: report of a WHO Expert Committee.

    Masironi R

    World Smoking and Health. 1984 Spring; 9(1):4-6.

    An Expert Committee met in World Health Organization Headquarters in Geneva in November 1982 to discuss Smoking Control Strategies in Developing Countries. They reviewed the harmful health effects of different types of tobacco which characterized developing countries and the adverse effects of tobacco use on their economics due to smoking related diseases and higher smokers' work absenteeism. It advised on the objectives of smoking control programs, including data collection; education and information; legislation; smoking cessation; the role of medical, political, social, and religious leaders; the role of WHO, UN agencies, and nongovernmental organizations; research on smoking behavior; and evaluation of program efficacy. In addition, the Committee provided guidance on how to counteract tobacco industry arguments. More than a million people worldwide die prematurely each year because of cigarette smoking. In developed countries smoking is generally understood to cause lung cancer, coronary heart disease, chronic bronchitis, and other respiratory disorders. Major campaigns have been launched to reduce the rate of smoking. The public in most developing countries are unaware of the dangers, and no educational, legislative, or other measures are being taken to combat the smoking epidemic. The Committee called for firm steps to be taken to prevent this unnecessary modern epidemic. The incidence of tobacco related diseases is increasing in developing countries. Many of the developing countries have cigarettes on sale with high yields of tar and nicotine. Tobacco cultivation has spread to about 120 countries, becoming a substantial source of employment and creating new vested interests. Overall, the costs outweigh the "benefits." Tobacco taxes may be Politically comfortable," that is, easy to administer and generally acceptable to smokers, but these taxes do not contribute to national wealth but merely redistribute wealth. They cannot offset the economic losses caused by tobacco production and use: health service expenditures on smoking related diseases, disablement and work absenteeism, domestic and forest fires, use of scarce fule to cure tobacco, and reduced food production. Action against smoking can be inexpensive yet effective. Health warnings can be placed on cigarette packets, and legislation can be enacted to put an end to the double standards in marketing practices, whereby cigarettes of the same brand carrying health warnings in developed countries are marketed without these warnings in developing countries. Recommendations issued to governments and public health authorities in developing countries are listed.
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