RESUMEN
Forty-five per cent of first marriages in Ethiopia end in divorce within 30 years, and two-thirds of women who divorce do so within the first 5 years of marriage. This paper looks at two factors that may have an impact on the risk of divorce in Ethiopia: early age of first marriage, and childlessness within the first marriage. Data used were from the 1990 National Family and Fertility Survey conducted by the Government of Ethiopia. A total of 8757 women of reproductive age (15-49) were analysed. Life table analysis was used to determine the median age at first marriage, first birth and the median duration of marriage. Cox models were analysed to determine the differentials of divorce. The results of this analysis showed that both early age at marriage and childlessness have a significant impact on the risk of divorce. An inverse relationship was found between age at marriage and risk of divorce. Having a child within the first marriage also significantly reduced the risk of divorce. In addition, several cultural and socioeconomic variables were significant predictors of divorce.
Asunto(s)
Divorcio/etnología , Divorcio/estadística & datos numéricos , Infertilidad/etnología , Matrimonio/etnología , Matrimonio/estadística & datos numéricos , Adolescente , Adulto , Factores de Edad , Análisis de Varianza , Niño , Etiopía , Femenino , Humanos , Tablas de Vida , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Modelos de Riesgos Proporcionales , Factores de Riesgo , Factores SocioeconómicosRESUMEN
The alpha 1-antitrypsin phenotypes were determined in 47 patients with abdominal aortic aneurysms. The MM phenotype was present in 85%, the MS phenotype in 4%, the MZ phenotype in 11%, and the ZZ phenotype not present in any patients. The MZ phenotype occurred significantly more often in patients with aneurysms than would be expected in the general population. The current data would support a genetic mechanism of either autosomal-dominant or multifactorial influences but not an X-linked mechanism for families with a history of abdominal aortic aneurysms.
Asunto(s)
Aneurisma de la Aorta/genética , Fenotipo , alfa 1-Antitripsina/genética , Aorta Abdominal , HumanosRESUMEN
A prospective controlled comparison of portal-systemic (PSS) and distal splenorenal shunts (DSRS) in cirrhotic patients who had survived hemorrhage from esophagogastric varices was undertaken 5 yr ago at five hospitals by the Boston-New Haven Collaborative Liver Group. The clinical and endoscopic criteria for massive hemorrhage were satisfied in 155 patients. Thirty-four patients were excluded, primarily because of uncontrolled hemorrhage. Thirty-four were rejected because the were poor operative risks and 21 because they did not satisfy criteria. Thirteen patients refused to participate; the remaining 53 were randomized; 29 to receive PSS and 24, DSRS. The two groups were similar in clinical, laboratory, and manometric characteristics. The DSRS group was older and tended to have had more previous hemorrhages. Followup ranged from 1 to 56 months (mean 21). After PSS, which was performed by 10 different surgeons, 6 patients died during the hospital admission (21%) compared to 2 after DSRS (12%). There were 6 late deaths in the PSS group and 4 in the DSRS group. Portal-systemic encephalopathy occurred in 5 of the 23 survivors of PSS (23%), and in 6 of the 19 who survived DSRS (32%. Two patients in the PSS group bled (9%), 1 after thrombosis and 1 after stenosis of the shunt. Three patients in the DSRS group bled (16%) and all had thrombosis of the shunt. PSS was associated with an unexplained but inordinately high operative mortality. Although the DSRS was accomplished with an acceptably low operative mortality, it was associated with frequent portal-systemic encephalopathy, shunt occlusion, and recurrent hemorrhage. Similar incidences of portal-systemic encephalopathy, shunt occlusion, and recurrent hemorrhage were observed in the PSS group. More patients and longer followup are necessary to determine which of these portal decompressive procedures is superior.
Asunto(s)
Várices Esofágicas y Gástricas/cirugía , Cirrosis Hepática/cirugía , Derivación Portosistémica Quirúrgica , Derivación Esplenorrenal Quirúrgica , Ensayos Clínicos como Asunto , Várices Esofágicas y Gástricas/etiología , Femenino , Hemorragia Gastrointestinal/etiología , Hemorragia Gastrointestinal/cirugía , Humanos , Cirrosis Hepática/complicaciones , Masculino , Persona de Mediana Edad , Mortalidad , Complicaciones Posoperatorias , Estudios ProspectivosRESUMEN
The composition of fasting hepatic bile was analyzed in 63 samples from 8 patients following cholecystectomy to determine if bile was lithogenic in patients with previous cholesterol gallstones after removal of the gallbladder. Bile specimens were obtained from t-tubes over a 7-20 day study period following re-establishment of the enterohepatic circulation. Bile composition varied on a day to day basis in each patient. 18 of 63 samples were lithogenic according to criteria of Admirand and Small while 35 of 63 samples were lithogenic according to criteria of Hegardt and Dam. Variations in the composition of hepatic bile appeared related to changes in the excretion rate of bile acids. These studies demonstrate that hepatic bile may be lithogenic after cholecystectomy and indicate that factors other than sequestration of the bile acid pool in the gallbladder influence the enterohepatic circulation of bile acids and the lithogenicity of bile.