| 1 | Early infant male circumcision:Systematic review,risk-benefit analysis,and progress in policy显示文摘AIM To determine whether recent evidence-based United States polices on male circumcision(MC) apply to comparable Anglophone countries,Australia and New Zealand.METHODS Articles in 2005 through 2015 were retrieved from PubM ed using the keyword 'circumcision' together with 36 relevant subtopics.A further PubM ed search was performed for articles published in 2016.Searches of the EMBASE and Cochrane databases did not yield additional citable articles.Articles were assessed for quality and those rated 2+ and above according to the Scottish Intercollegiate Grading System were studied further.The most relevant andrepresentative of the topic were included.Bibliographies were examined to retrieve further key references.Randomized controlled trials,recent high quality systematic reviews or meta-analyses(level 1++ or 1+ evidence) were prioritized for inclusion.A risk-benefit analysis of articles rated for quality was performed.For efficiency and reliability,recent randomized controlled trials,metaanalyses,high quality systematic reviews and large welldesigned studies were used if available.Internet searches were conducted for other relevant information,including policies and Australian data on claims under Medicare for MC.RESULTS Evidence-based policy statements by the American Academy of Pediatrics(AAP) and the Centers for Disease Control and Prevention(CDC) support infant and later age male circumcision(MC) as a desirable public health measure.Our systematic review of relevant literature over the past decade yielded 140 journal articles that met our inclusion criteria.Together,these showed that early infant MC confers immediate and lifelong benefits by protecting against urinary tract infections having potential adverse long-term renal effects,phimosis that causes difficult and painful erections and 'ballooning' during urination,inflammatory skin conditions,inferior penile hygiene,candidiasis,various sexually transmissible infections in both sexes,genital ulcers,and penile,prostate and cervical cancer.Our risk-benefit analysis showed that benefits exceeded procedural risks,which are predominantly minor,by up to 200 to 1.We estimated that more than 1 in 2 uncircumcised males will experience an adverse foreskin-related medical condition over their lifetime.Wide-ranging evidence from surveys,physiological measurements,and the anatomical location of penile sensory receptors responsible for sexual sensation strongly and consistently suggested that MC has no detrimental effect on sexual function,sensitivity or pleasure.United States studies showed that early infant MC is cost saving.The evidence supporting early infant MC has further strengthened since the positive AAP and CDC reviews.CONCLUSION Affirmative MC policies are needed in Australia and New Zealand.Routine provision of accurate,unbiased education,and access in public hospitals,will maximize health and financial benefits. | Brian J Morris Sean E Kennedy Alex D Wodak Adrian Mindel David Golovsky Leslie Schrieber Eugenie R Lumbers David J Handelsman John B Ziegler | 2017 | World Journal of Clinical Pediatrics2017，6，1： | 2 |
| 2 | 最新进展:性传播感染显示文摘性传播疾病的发病率逐渐增高,特别是在15~25岁的人群当中。虽然,最近开发的一些筛查试验,尤其是对沙眼衣原体、单纯疱疹病毒和人乳头状瘤病毒的检测,为早期诊断和预防性传播感染及其并发症提供了新的机遇,但如何才能很好地控制性病增长的问题尚未解决。虽然这些筛查方法已用于研究,但用于临床实践仍是一个复杂的问题。本文叙述目前应用的对主要性传播性疾病的筛选试验,并讨论有关处理这些疾病的一些重要问题。 | RichardJ C Gilson Adrian Mindel 范洪伟 | 2003 | 英国医学杂志中文版2003，6，1： | 2 |
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