PHT Sept 2014 PHT Sept 2014

Total Page:16

File Type:pdf, Size:1020Kb

PHT Sept 2014 PHT Sept 2014 In this issue > Interview: US public health guru Georges Benjamin > FPH Annual Conference: catch up on what you missed The magazine of the > Learning from the AIDS crisis in dealing with Ebola UK Faculty of Public Health www.fph.org.uk September 2014 Loud and clear The advocacy edition Public Health Today FROM THE PRESIDENT UP FRONT The magazine of the UK Faculty of Public Health www.fph.org.uk ‘Health in every News in brief September 2014 Welcome policy’ dropped from Double vaccines ‘hasten the end of polio’ Contents Using both types of polio vaccine could Welsh white paper speed up efforts to free the world of the Up Front 3 E WAS responsible for the disease, research suggests. The oral vaccine traditional environmental is leading the fight to eradicate polio, but services of water supply, trials in India show an additional injection ‘H n THE Welsh Government’s public health Stagnant incomes among the low paid – of inactivated virus boosts immunity, Interview with Georges Benjamin 4 sewage disposal, food control and hygiene; for the public white paper, Listening to you – your health actually a fall in real terms, the first according to the journal Science. health aspects of housing; for the matters, sets out wide-ranging proposals, substantial decrease since the 1960s. control and prevention of infectious including action to reduce the harms Read FPH’s response :http://bit.ly/1pcVJT4 ‘Sugar intake must be slashed further’ caused by smoking, alcohol misuse and The target to reduce sugar consumption Special feature: Advocacy 6 disease; for the maternity and child welfare clinics and their attendant health obesity, and strong practical actions that EU-US Trade agreement should be much more ambitious, health Make yourself clear 6 visitors and midwives; he was will have a positive impact on health and Most FPH members believe that experts say. The latest official advice is that responsible for the TB dispensary and the wellbeing. overwhelming international evidence sugar should account for 5% of energy Scotland’s battle to lead the world in VD clinic; then... he was in charge of The Faculty of Public Health’s (FPH) key points to a universal health service intake – down from 10%. But a study banning cheap alcohol 7 school health. Now to all this was added concern, responding to the plans, is to available to all, free at the point of need published in the BMC Public Health journal responsibility for the management of the highlight part of the preceding green paper and funded through general taxation, as said the target should be no more than 3%. Online network fighting gender local hospital. The Medical Officer of that didn’t reach the white paper: being the cheapest and most effective way stereotyping 7 Health [MOH} was at the height of his We have a choice of role models for proposals to ensure that health was built to deliver healthcare. Most of us in public Guide dog owners ‘fearful’ of cyclists into all Welsh Government policies. FPH health believe in integrating health and A charity for blind people has said guide Debate: Should your advocacy power; this was the peak of his career.” the practice of public health, most said that a framework for health in all social care; and in setting the best possible dog owners are scared of going out in organisation accept industry funding? 8 I quote here from Sidney Chave’s seminal notably Edwin Chadwick and John Snow essay on The Rise and Fall of the Medical at the national level and William Henry policies should form a central pillar of legal, regulatory and fiscal conditions to London because of cyclists. The Guide Land of the living 9 Officer of Health. I quoted it previously Duncan and his equivalents around the an eventual Welsh public health bill, promote and protect the public’s health. Dogs for the Blind Association said it had in a paper for the AGM of the Faculty of UK at the local. During my career, I have ensuring strong collaborative links That is why FPH sees the Transatlantic seen more reports from guide dog owners How a thank-you letter became Community Medicine in 1988 entitled been privileged to sit at the feet of a across different sectors, and a strategic Trade and Investment Partnership (TTIP), a who had been hit by a cyclist or come a filmscript 10 Where have all the troublemakers succession of colleagues, friends and national approach supported by local free-trade agreement under negotiation close to a collision. Rob Harris from the initiatives. between the EU and USA, as a threat to group said some visually impaired people Personal stories can shape policy 10 gone?. I lamented, with one of the citizens who have made major fathers of the Faculty of Public Health, contributions to public health and the Read FPH’s response: http://bit.ly/1nQwVAX the health and livelihoods of all the were “fearful” about going out. Girls on film 11 Huw Francis, the passing of the robust human condition. Very few have made populations involved. FPH predicts several tradition of “the breadth and richness of that contribution by remaining seated Food poverty on the increase threats to public health from TTIP: Children flock to hospital to have teeth out Many voices of health 12 n classical public health” as articulated by behind their desks. Perhaps most vivid There is known to be a gap in health It will reduce the sovereign ability of The number one reason for children of Data bombshell proves new law Sir John Simon and quoted by Huw. The has been the example of my friend circumstances and outcomes between rich governments to legislate to protect health, primary school age being admitted to packs a punch 13 latter went on to eavesdrop on Sir John Slobodan Lang, City Medical Officer for and poor people in the UK. The reasons for safety and the working conditions of their hospital is to have multiple teeth taken Simon reflecting in 1890 on his annual Zagreb, whose practice of public health inequalities are complex, but many people out. The number of children aged five to n Use meetings briefings and reports as MOH of the City of London extended to him standing between working families are now living in poverty It will hinder the ability of governments nine needing hospital treatment for dental hard evidence 13 from 1849 onwards: “After a lapse of so Serbian tanks and striking miners in – and do not have enough income for a to protect the environment and to prevent problems has risen by more than 3,000 in decent diet. That was the FPH’s message to global warming, by limiting regulation of the past three years, according to figures Do media campaigns improve health? 14 many years... I rejoice to remember that, Kryena and mediating. Slobodan is even in those early days, I did my best to certainly out of the mould of ‘classical the All Party Parliamentary Inquiry into industry and commerce analysed by the Health and Social Care n make clear to the commission, what public health’; there are many more from Hunger and Food Poverty, led by Frank It will interfere with national policies on Information Centre. sufferings and degradation were a wide range of backgrounds and not Field MP. The submission focused on three provision of health and social care. incurred by the masses of the labouring necessarily with public health in their job problems: Read FPH’s response to the recent Kerala plans to ban alcohol The Secret DPH’s Diary 14 n population through the conditions under title. Somebody who had a profound Increasing food poverty and increasing European Commission consultation on Authorities in the southern Indian state of which they were so generally housed in effect on my personal approach to public use of food banks – a marker of pressure TTIP: http://bit.ly/1pWQMxG Kerala have outlined plans to ban the sale courts and alleys they inhabited: not only health was the Governor of for emergency food aid and consumption of alcohol to tackle the n Volatile food prices which are proving Mark Weiss state’s drink problem. The first phase of the FPH Annual Conference 2014 15 how unwholesome were those Visagapatnam in India. Every night at the conditions, but how shamefully end of the working day, he would go increasingly hard for lower-income Policy Officer ban would see more than 700 bars and inconsistent with reasonable standards with his driver to the main station and households to manage Faculty of Public Health some shops selling alcohol shut down, of civilisation; and how vain it must be scoop up all the newly arrived children with more alcohol-free days introduced. The government aims to enforce total Books & Publications 19 to expect good social fruit from human and deposit them at the municipal life running its course under such orphanage. Clearly he was acting on an prohibition in 10 years. conditions.” Neither Sir John Simon, understanding of proactive public health. who became the country’s first Chief So we must ask “will we prove worthy Breast cancer test ‘Angelina effect’ found Referrals to breast cancer clinics more than Endnotes 20 Medical Officer, nor Edwin Chadwick, successors or are we to be reduced to president of the Board of Health, were petty clerks and bureaucratic doubled in the UK after Angelina Jolie shrinking violets. They stood up for the commissioners? The wheel turns and we announced she had had a double poor, the dispossessed and those whose are once more having to define what we mastectomy.
Recommended publications
  • A Conversation with Mervyn Susser
    VOICES Editors’ Note: VOICES is a project of the journal to provide personal, historical and scientific perspectives on the field of epidemiology, as seen through the eyes of the field’s most senior and accomplished practitioners. Subjects are selected by the Editors. Readers are welcome to nominate candidates for VOICES. A Conversation With Mervyn Susser Nigel Paneth ervyn Wilfred Susser was born September 26, 1921, in Johannesburg, South Africa. MA 1950 graduate in medicine from the University of Witswatersrand, he spent several years in community clinical work in the Alexandra Health Centre before emigrat- ing to England in 1956. In 1957, he was appointed Lecturer in social and preventive medicine at the University of Manchester, and, in 1964, Reader and Head. In 1966, he was appointed Chair of the Division of Epidemiology at Columbia University, where he founded the PhD program in epidemiology. In 1978, he stepped down from the chair to found the Gertrude H. Sergievsky Center, a Columbia research unit focused on neurologic, psychiatric, and developmental epidemiology. He also served as Editor of the American Journal of Public Health from 1992 to 1998. Dr. Susser’s research has addressed problems in mental health, child health, and the long-term consequences of exposures during pregnancy. He is also known for his work on the philosophy and goals of epidemiology, and for his active involvement in human rights. He is a member of the Institute of Medicine and the National Academy of Sciences, and is the author of 6 books. Special recognitions include the John Snow Award, presented in 1994 by the American Public Health Association.
    [Show full text]
  • A History of Doctor and Patient AIDS Activism in South Africa, 1982-1994
    From both sides of the bed: A history of doctor and patient AIDS activism in South Africa, 1982-1994 by Mandisa Mbali A thesis submitted in partial fulfillment of the requirements for the degree of Master of Arts by Coursework in Historical Studies at the University of KwaZulu-Natal, Durban And supervised by Ms Julie Parle February 2004 Declaration I, Mandisa Mbali, hereby declare that this thesis is my own original work, has not been submitted for any degree or examination at any other university, and that the sources I have used have been fully acknowledged by complete references. Mandisa Mbali (5 th February 2004) Ms. Julie Parle (5 th February 2004) TABLE OF CONTENTS Author Declaration ........................................................................................... ii Table of Contents .............................................................................................. iii Abstract ............................................................................................................. iv Acknowledgements ............................................................................................ v Glossary ............................................................................................................. vi A Note on Sources ........................................................................................... viii Introduction ....................................................................................................... 1 Chapter One: Patient activism: AIDS, representation and the
    [Show full text]
  • You Can Download the Excerpt HERE (PDF)
    2—War, Wits, Politics, and Ruth Meets Joe JOE’S FIRST IMPRESSION of Ruth was that she and her intellectual friends at the University of the Witwatersrand were “just too big for their boots.” 29 It was 1946, Joe was just returning from the army and the Second World War, and Ruth was in the midst of her social science studies at the university. They were both engaged in political protests and actions through the Communist Party of South Africa, already committed militants and engaged intellectuals, each looking toward a life of struggle for justice and equality. Joe brought the grit and experience of the streets and the war; Ruth evoked the style and sensibility of the brilliant researcher and writer she would become. “So my life with Ruth,” Joe said later, “started off with quite a degree of political tension based on this nonsense.” 30 When Ruth First enrolled at the University of the Witwatersrand, Joe Slovo was sent to Italy by the South African Army to fight against Nazi Germany and fascist Italy. In June of 1941, Germany attacked the Soviet Union and the CPSA changed its policy of opposition to the Second World War, announcing that it would now support South African involvement in fighting against the Nazis. In addition, white members were encouraged to volunteer for military service. Because of the importance of South Africa’s corporate and imperialist con- nections to the Allies, the country officially supported the war effort. Some Afrikaners felt a much greater sympathy for Germany and viewed Great Britain as the enemy.
    [Show full text]
  • Mervyn Susser
    DOI: 10.1590/1980-5497201500040003 EDITORIAL/EDITORIAL Mervyn Susser Mauricio Gomes PereiraI Mervyn Susser, Professor Emeritus at Columbia University, School of Public Health, passed away on August 14, 2014, in his residence in New York, at the age of 92. Susser was a great friend of the Brazilians, having collaborated for many years as a member of the Editorial Board of the Brazilian Journal of Epidemiology. He had great influence on the field of Epidemiology during the second half of the 20th century, and also in the beginning of the 21st, especially with respect to the methodological and philosophycal aspects of epidemiology plus the relationship between health and society. EARLY YEARS, EDUCATION, AND RESEARCH Susser was born in South Africa on September 26, 1921, where he graduated in Medicine along with his wife, Zena Stein, his lifelong companion. They both worked at health care centers in the rural areas of the country, which had great influence on their reflections concerning the social determinants of a disease and on their active stand towards human rights. Due to political difficulties of the Apartheid, the couple emigrated to England in 1956, where Susser held a position in the Department of Preventive and Social Medicine at the University of Manchester. In 1966, he moved to the United States and became full professor and Head of Department at the Columbia University, School of Public Health, in New York. In 1978, he founded the Sergievsky Center at Columbia University, a unit for the investigation of neurological and psychiatric problems and developmental epidemiology. He retired in 1990, but remained linked to the University and to projects from numerous countries, in particular those dedicated to AIDS in Africa.
    [Show full text]
  • AIDS, Representation and the Birth of Rights-Based AIDS Activism in the 1980S
    1 History/African Studies Seminar Paper: Presented on the 29th October 2003 ‘Without the luxury of time’: AIDS, Representation and the Birth of Rights-based AIDS Activism in the 1980s Mandisa Mbali “Two South African Airways stewards have died after apparently becoming the first South African victims of a rare disease which is believed to affect mainly homosexuals and drug addicts”. “’Homosexual’ disease kills SAA Staff” Argus 4th January 19831 "I say, with professional deliberation as an epidemiologist, that the epidemic presents a national emergency and should be a national political priority…Nothing less than a social movement on a national scale can hope to stem the tide…we do not have the luxury of time”. Mervyn Susser, Keynote Address, 7th Annual NAMDA National Conference, 19902 Introduction On the August 4th 2003 Treatment Action Campaign (TAC) activists marched on the first South African AIDS Conference. The singing and toyi-toying demonstrators reached the court-yard next to the entrance to the conference’s venue, Durban’s International Convention Centre, which is usually blocked off to protestors. After a few minutes, Zackie Achmat, the well-known gay rights and AIDS activist and national chairperson of the TAC took the microphone to much applause, then he outlined the rights-based case for HIV treatment access in the public health sector in South Africa.3 1 Pasted into “Scrap Book Kept by Leon Eksteen who died in August 1986. He was the 5th Capetonian to die of AIDS”. Media Scrap Books Gay Association of South Africa /Gay Association of South Africa 6010 Box.
    [Show full text]
  • The Influence of Second World War Military Service on Prominent White South African Veterans in Opposition Politics, 1939–1961
    The influence of Second World War military service on prominent White South African veterans in opposition politics, 1939–1961 By GRAEME WESLEY PLINT Thesis presented in fulfilment of the Degree Masters in Military Science (MMil) at the Faculty of Military Science of Stellenbosch University Faculty of Military Science Stellenbosch University Supervisor: Ms A Delport Co-Supervisor: Prof I.J. van der Waag March 2021 Stellenbosch University https://scholar.sun.ac.za ii DECLARATION By submitting this thesis electronically, I declare that the entirety of the work contained therein is my own, original work, that I am the sole author thereof (save to the extent explicitly otherwise stated), that reproduction and publication thereof by Stellenbosch University will not infringe any third party rights and that I have not previously in its entirety or in part submitted it for obtaining any qualification. GRAEME WESLEY PLINT Date: March 2021 Copyright © 2021 Stellenbosch University All rights reserved Stellenbosch University https://scholar.sun.ac.za iii ABSTRACT The nexus between military service and political activism is explored in this thesis. The lives of 153 politically-exposed Second World War veterans are examined. Pierre Bourdieu’s concepts of ‘Capital’ and ‘Habitus’ are used to examine the ways in which the war shaped the political views of the servicemen as well as the ways in which the ex-servicemen could leverage their war service to further their post-war political careers. An examination of the fault lines of class and culture, in pre-war, White South Africa, provided crucial insight into the initial habitus and motivation of the volunteer soldier.
    [Show full text]
  • Low Levels of Good Cholesterol May Increase Risk of Alzheimer's
    VOLUME 2 • ISSUE 1 FEBRUARY 2011 NEWS FROM THE DEPARTMENT OF EPIDEMIOLOGY MAILMAN SCHOOL OF PUBLIC HEALTH COLUMBIA UNIVERSITY 2 UPCOMING 3 PUBLICATION HIGHLIGHTS 5 BRIEF MENTIONS 6 SUBMITTED GRANTS Innovation, Page 16 7 IN THE NEWS 8 FACULTY APPOINTMENT Low Levels of 9 PROFILES 13 GIANTS AMONG US Good Cholesterol 20 FACULTY ARTICLE May Increase Risk BIBLIOGRAPHY of Alzheimer’s Low levels of high-density lipoproteins (HDL) may increase the risk of developing Alzheimer’s disease, according to a new study of elderly individuals senior authored by Dr. Jose Luchsinger, Associate Professor of Medicine and Epidemiology. Low levels of good cholesterol are very common in the U.S. and are a well-known risk factor for heart disease. But the rela- tionship between HDL and Alzheimer’s had previously been unclear, with some studies finding a connection and others not. This new study provides a more complete picture of the relationship between HDL and Alzheimer’s because the researchers followed subjects for longer than past studies. They monitored 1,130 elderly northern Manhattan residents for an average of four years, finding that those with low HDL had a 40 percent higher rate of Alzheimer’s incidence. THIS illustration shows THE damage caused BY ALZEHIMER’S DISEASE: PLAQUES, tangles, Unlike similar studies, this study includes AND THE loss OF connection BETWEEN NEURONS. a large number of African Americans and Hispanics, and its findings suggest that low HDL is linked to a high risk of Alzheimer’s in of the study suggest that researchers should focus specifically on many different ethnicities.
    [Show full text]
  • Mervyn Susser Obit ZA Sunday Times
    News ST Mainbody, 31-Aug-2014-Page 22, Cyan ST Mainbody, 31-Aug-2014- Page 22, Magenta ST Mainbody, 31-Aug-2014-Page 22, Yellow ST Mainbody, 31-Aug-2014- Page 22, Black | * 1 6 7) 4 1 - 5 Sunday Times | )KCKIJ ! " AHLO 5KIIAH )E@I ?= F=EC AH = @ MH@ A=@AH E AFE@A ECO G ' ! " At the same time, he was editor of The American Journal of Public MERVYN Susser, who has died at his Health. COMMERCIAL PERSONAL FARM FOR SALE home in Hastings on Hudson, New When HIV/Aids began spreading in PROPERTY York, at the age of 92, helped to pioneer New York in the early 1980s, he and community-based primary healthcare Stein were among the first epidemi- We wish to make contact Tired of the City? MORGANS BAY in South Africa. ologists to study it. with ROBERT E THOMAS EASTERN CAPE ’ the brother of the Late BEAUTIFUL MODERN He was one of the first doctors in the In the later 80s, they engaged quite Commercial property Charles Saxon Thomas, born world to study the ways in which frequently with ANC exiles, notably LIFESTYLE FARM IN consisting of a fitted shop, on 18 Aug 1951, who died in ) )1.- . .7 8AH= 8AI bottle store, flatlet and social, cultural and psychological fac- Nkosazana Dlamini-Zuma and Manto Mexico on 5 June 2013. EVER GROWING storage areas on 7000 sqm tors contribute to disease, and his Ts h ab ab a l a - M s i m a n g . ATTORNEYS HALSTEAD of commercial land for sale.
    [Show full text]
  • Zena Stein, Mervyn Susser and Epidemiology: Observation, Causation and Action
    © International Epidemiological Association 2002 Printed in Great Britain International Journal of Epidemiology 2002;31:34–37 CELEBRATION Zena Stein, Mervyn Susser and epidemiology: observation, causation and action George Davey Smitha and Ezra Susserb In this issue of the International Journal of Epidemiology we highlight the contributions of two pioneering self-taught epi- demiologists, Zena Stein and Mervyn Susser. Their joint paper ‘Civilization and Peptic Ulcer‘, originally published in the Lancet in 1962, appears as one of our series of reprints of important epidemiological papers, along with several commentaries. These include a reflection, 40 years on, by the original authors. A com- panion series of papers originated in an international sympo- sium held by the Mailman School of Public Health of Columbia University, New York, to mark the 80th years of both Zena and Mervyn. The event ended in a manner perhaps unusual for such an occasion: it was closed by Ahmed Kathrada, a friend of Zena and Mervyn, who was incarcerated with Nelson Mandela on Robben Island during the struggle against apartheid in South Africa. He read out a letter from Nelson Mandela to mark the occasion (Box 1). The interlocked careers of Zena and Mervyn have been described elsewhere,1 as well as in the present collection.2 The range of their work in epidemiology and public health can be appreciated from the bibliographies which we have made avail- able on the web (http://www.ije.oupjournals.org). Therefore here we will just give a brief account of their continuing contribu- tions to epidemiology and public health. For both Zena and Mervyn their work in epidemiology and public health started in South Africa and has continued to have a strong attachment to that country.
    [Show full text]
  • Women, and HIV/AIDS 1
    AIDS, Sex, and Culture AIDS, Sex, and Culture: Global Politics and Survival in Southern Africa Ida Susser © 2009 Ida Susser. ISBN: 978-1-405-15586-1 For Philip and Jonah AIDS, Sex, and Culture Global Politics and Survival in Southern Africa Ida Susser with a contribution by Sibongile Mkhize A John Wiley & Sons, Ltd., Publication This edition fi rst published 2009 © 2009 Ida Susser Blackwell Publishing was acquired by John Wiley & Sons in February 2007. Blackwell’s publishing program has been merged with Wiley’s global Scientifi c, Technical, and Medical business to form Wiley-Blackwell. Registered Offi ce John Wiley & Sons Ltd, The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, United Kingdom Editorial Offi ces 350 Main Street, Malden, MA 02148-5020, USA 9600 Garsington Road, Oxford, OX4 2DQ, UK The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK For details of our global editorial offi ces, for customer services, and for information about how to apply for permission to reuse the copyright material in this book please see our website at www.wiley.com/ wiley-blackwell. The right of Ida Susser to be identifi ed as the author of this work has been asserted in accordance with the Copyright, Designs and Patents Act 1988. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by the UK Copyright, Designs and Patents Act 1988, without the prior permission of the publisher. Wiley also publishes its books in a variety of electronic formats.
    [Show full text]
  • Civilization and Peptic Ulcer*
    Printed in Great Britain International Journal of Epidemiology 2001;30:13–17 REPRINTS AND REFLECTIONS Civilization and peptic ulcer* Mervyn Sussera and Zena Steinb Remarkable changes have occurred in the sex and age incidence and the number of spells of sickness absence.12 As yet it does of peptic ulcer in North-West Europe. The fluctuations over not appear in statistics of the last decade from general practice the previous hundred and fifty years were studied by Jennings and from the Army, both of which showed stable rates.8–10 (1940).1 He examined the incidence of perforations, which pro- All these trends together suggest that we are observing a vide perhaps the most uniform index of the incidence of ulcers recession of the peptic-ulcer syndrome. This has affected the for the total period. His interpretation suggested that during this age-groups unequally. Since the war, mortality from gastric and period there had been three observable syndromes: perforations duodenal ulcers has declined in young men and women, of acute gastric ulcers in young women; perforations of duo- although recently it was still rising at ages over 65 (Figure 1a, b, denal ulcers in young and middle-aged men; and perforations of c, d). One possible explanation is that the fluctuations in peptic- gastric ulcers in older men.1 ulcer rates represent a cohort phenomenon, and that each Perforations began to be noted with increasing frequency at generation has carried its own particular risk of bearing ulcers the beginning of the 19th century. Half of all perforations were throughout adult life.
    [Show full text]
  • Civilization and Peptic Ulcer*
    Printed in Great Britain International Journal of Epidemiology 2001;30:13–17 REPRINTS AND REFLECTIONS Civilization and peptic ulcer* Mervyn Sussera and Zena Steinb Remarkable changes have occurred in the sex and age incidence and the number of spells of sickness absence.12 As yet it does of peptic ulcer in North-West Europe. The fluctuations over not appear in statistics of the last decade from general practice the previous hundred and fifty years were studied by Jennings and from the Army, both of which showed stable rates.8–10 (1940).1 He examined the incidence of perforations, which pro- All these trends together suggest that we are observing a vide perhaps the most uniform index of the incidence of ulcers recession of the peptic-ulcer syndrome. This has affected the for the total period. His interpretation suggested that during this age-groups unequally. Since the war, mortality from gastric and period there had been three observable syndromes: perforations duodenal ulcers has declined in young men and women, of acute gastric ulcers in young women; perforations of duo- although recently it was still rising at ages over 65 (Figure 1a, b, denal ulcers in young and middle-aged men; and perforations of c, d). One possible explanation is that the fluctuations in peptic- gastric ulcers in older men.1 ulcer rates represent a cohort phenomenon, and that each Perforations began to be noted with increasing frequency at generation has carried its own particular risk of bearing ulcers the beginning of the 19th century. Half of all perforations were throughout adult life.
    [Show full text]