Topic
Natural history
About: Natural history is a research topic. Over the lifetime, 3434 publications have been published within this topic receiving 86556 citations.
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2,783 citations
TL;DR: Efforts to determine natural history are handicapped by the primary characteristics of the disease, namely that its onset rarely is recognized and its course is prolonged exceedingly, so that at least 20% of chronically infected adults develop cirrhosis within 20 years.
1,551 citations
TL;DR: The incidence of HPV infection in sexually active young college women is high and the short duration of most HPV infections in these women suggests that the associated cervical dysplasia should be managed conservatively.
Abstract: BACKGROUND
Genital human papillomavirus (HPV) infection is highly prevalent in sexually active young women. However, precise risk factors for HPV infection and its incidence and duration are not well known.
METHODS
We followed 608 college women at six-month intervals for three years. At each visit, we collected information about lifestyle and sexual behavior and obtained cervicovaginal-lavage samples for the detection of HPV DNA by polymerase chain reaction and Southern blot hybridization. Pap smears were obtained annually.
RESULTS
The cumulative 36-month incidence of HPV infection was 43 percent (95 percent confidence interval, 36 to 49 percent). An increased risk of HPV infection was significantly associated with younger age, Hispanic ethnicity, black race, an increased number of vaginal-sex partners, high frequencies of vaginal sex and alcohol consumption, anal sex, and certain characteristics of partners (regular partners having an increased number of lifetime partners and not being in school). The median duration of new infections was 8 months (95 percent confidence interval, 7 to 10 months). The persistence of HPV for > or =6 months was related to older age, types of HPV associated with cervical cancer, and infection with multiple types of HPV but not with smoking. The risk of an abnormal Pap smear increased with persistent HPV infection, particularly with high-risk types (relative risk, 37.2; 95 percent confidence interval, 14.6 to 94.8).
CONCLUSIONS
The incidence of HPV infection in sexually active young college women is high. The short duration of most HPV infections in these women suggests that the associated cervical dysplasia should be managed conservatively.
1,453 citations
1,438 citations
TL;DR: This comprehensive review summarizes the current knowledge of the natural history of Crohn's disease in adults as reported in population-based studies that include long-term follow-up results.
832 citations