Articles: disease.
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Female residents of King and Ierce Counties in the state of Washington in whom endometrial cancer was diagnosed during 1975--77 were interviewed concerning prior use of oral contraceptives. Their responses were compared with those of a random sample of women from the same population. ⋯ Women who had used combined oral contraceptives had only 50 per cent of the incidence of endometrial cancer of nonusers (P = 0.05), although the protective effect was not evident among those who subsequently took menopausal estrogens for more than two years. These associations suggest that development of neoplasia in the endometrium can be extremely sensitive to hormonal factors: if an oral contraceptive, like Oracon, emphasizes the estrogenic component, promotion of cancer can result; if like combined preparations, the contraceptive emphasizes the progestational component, protection against cancer can result.
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A comparison has been made of the recent changes in coronary heart disease mortality in Australia, the USA, and in the United Kingdom (England and Wales). Sharp declines in mortality dating from 1966 in Australia and from 1968 in the USA in both sexes contrast with a persistent increase in men in England and Wales until 1972 (after which a sight fall occurred) and a consistent slight fall in women since 1950. An investigation has been made of changes in 3 major risk factors-hypertension, cigarette smoking and diet in the 3 countries in an attempt to determine to what extent such changes might correlate with the different patterns of mortality. ⋯ In Australia and the USA increases in vegetable fat consumption have occurred since 1950 with a reduction in animal fat in Australia but not in the USA. In the United Kingdom increases in vegetable fat have not been observed while there has been some increase in animal fat. It is concluded that the different patterns of coronary heart disease mortality in the 3 countries do correlate to some extent with changes in diet and cigarette smoking.
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Randomized Controlled Trial Comparative Study Clinical Trial
A randomized, single blind comparative trial of norethindrone enanthate and depo-medroxyprogesterone acetate in Bangladesh.
A randomized, single blind comparative trial of norethindrone enanthate (NET-ENT) and depo-medroxyprogesterone acetate (DMPA) was conducted in the Model Clinic, Decca, Bangladesh, to determine if there were differences in reported side effects, reasons for discontinuation and discontinuation rates of these two injectables. On all follow-up visits the proportion of women reporting no bleeding (amenorrhea) was higher for the DMPA clients compared to the NET-ENT clients. Concurrent with these findings, the proportion of women reporting irregular bleeding was consistently higher for the NET-ENT clients. ⋯ By the fourth injection, less than 15% of the clients in both drug groups still reported having regular cyclic bleeding (4 of the 26 DMPA clients and 4 of the 28 NET-ENT clients). Five of the 133 women on DMPA and 6 of the 106 women on NET-ENT became pregnant while using the injectables. At the end of one year of follow-up, 14 of the 133 DMPA and 14 of the 106 NET-ENT clients were still continuing (came back for a fifth injection).
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Perinatal epidemiologists no longer speak much of "prematurity". Instead the World Health Organization recommends that infants born before 37 completed weeks of gestation should be designated "preterm" and those of birthweight less than 2500 g "low birthweight". Both definitions have obvious drawbacks--the former because menstrual dates are often unknown or unreliable, the latter because it does not separate preterm from small-for-gestational-age infants. Whatever the classification of these small infants there is no dispute about their high mortality and morbidity; in the United Kingdom they account for over two-thirds of first-week deaths.