Thyroid dysfunction in the first 20 wk of pregnancy may result in fetal loss and dysplasia and some congenital malformations.

Introduction Although the new classification of premature ejaculation (PE) has been proposed by Waldinger et al., there have been few studies investigating the four PE syndromes in China. Aims We investigated the prevalence and factors associated with the complaint of PE and the four PE syndromes in Anhui province, China. Methods Between September 2011 and September 2012, subjects were selected from five cities in Anhui province, China. They participated in this survey by completing a detailed verbal questionnaire regarding their demographic data and medical and sexual history. Men with PE complaint were diagnosed as lifelong PE (LPE), acquired PE (APE), natural variable PE (NVPE), or premature-like ejaculatory dysfunction (PLED). Main Outcome Measures PE complaint was divided into four PE syndromes. Anxiety, depression, and erectile dysfunction were independently assessed by the self-rating anxiety/depression scale and the international index of erectile function-5, respectively. Results Of the 3,016 men evaluated, 25.80% complained of PE. The distribution of the four PE syndromes in men with PE complaint was in the order of NVPE (44.09%), PLPE (24.81%), APE (18.77%), and LPE (12.34%). Patients with PE complaint were older and more likely to smoke, had more comorbidities, and a higher body mass index (BMI) than patients without the complaint (P < 0.001 for all). Similar findings were also observed in patients with APE compared with other PE patients (depression P = 0.012, cardiovascular P = 0.003, others P < 0.001). In addition, the rates of counseling by a doctor in men with LPE and APE were higher than those in men with NVPE and PLED (P < 0.001). Conclusion The prevalence of PE complaint in male population of Anhui province, China, was 25.80%, with the highest PE syndromes being NVPE and PLPE. Patients with PE complaint or APE were older and more likely to smoke, had more comorbidities, and a higher BMI.

Objective We aimed to determine the burden of bacillary dysentery in China, its cross-regional variations, trends in morbidity and mortality, the causative bacterial species and antimicrobial resistance patterns. Methods We extracted and integrated governmental statistics and relevant medical literature published from 1991 to 2000. Data were also collected from one general hospital each for the six provinces and Jin-an district, Shanghai, representative of six geographical regions and a modern city. Findings In 2000, 0.8-1.7 million episodes of bacillary dysentery occurred of which 0.5 to 0.7 million were treated at health-care facilities and 0.15-0.20 million patients were hospitalized. The highest morbidity and mortality rates were among the youngest and oldest age groups. Bacillary dysentery peaked during the summer months. The major causative species was Shigella flexneri (86%) and the predominant S. flexneri serotype was 2a (80%). About 74-80% of Shigella isolates remained susceptible to fluorinated quinolones. Conclusion We conclude that while morbidity and mortality due to bacillary dysentery has decreased considerably in China in the past decade due to increasing access to affordable health care and antibiotics, a considerable burden exists among the youngest and oldest age groups and in regions with low economic development. We suggest that while a vaccine would be effective for short-and medium-term control of bacillary dysentery, improved water supply, sanitation, and hygiene are likely to be required for long-term control.Bulletin of the World Health Organization 2006;84:561-568.Voir page 567 le résumé en français. En la página 567 figura un resumen en español. IntroductionGlobally, morbidity and mortality due to diarrhoea has decreased from 4.6 million deaths in 1982 to 3.3 million in 1992 to 2.5 million in 2003.1-3 A review published in 1999 reported that bacillary dysentery caused by Shigella species (S. flexneri, S. sonnei, S. boydii, and S. dyse e enteriae) remains a major source of diarr r rhoea, especially in developing countries. It also reported that of the 164.7 million episodes of shigellosis (Shigellarrelated diarrhoea) occurring worldwide each year, 163.2 million were in developing countries; however, the review included sparse data from China. 5 Even so diarrhoeal diseases remain an important public health problem. A crossrsectional survey conducted in 1988 estimated that of the 84 million diarrhoeal episodes that ocr r curred in China annually, 25% affected children less than five years of age. The survey also found that Shigella is one of the principle etiologic organisms for diarrhoea.6 A live oral Shigella vaccine which was developed and produced in China in 1997 reportedly provides 60-70% protection against S. flexneri 2a and S. sonnei infections. 7A continuing analysis of the disease burden of bacillary dysentery would be required for effective treatment and prevention policies, health prioritization debates, and cost-benefit assessments to enable rational decisions on research, ...

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