[A birth rate study, 1977].
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Biomedical subjects
Publications and source records attributed to O Meirik.
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The systemic absorption and the plasma concentrations of chloroquinaldol have been determined after local application of one vaginal tablet of Sterosan. A peak plasma concentration of 33 ng/ml was determined 12 h after application. A mean absorption of 6.0% of the applied dose was estimated.
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In a well defined geographical area with only one hospital, the incidence of upper urinary tract stone was found to be 180 per 100 000 inhabitants, a figure not substantially higher than that reported more than 30 years ago. The male/female ratio was 3.6:1. The mean frequency of recurrence was 40% and the mean frequency of infection 12%. Hyperparathyroidism was found in 1.4% of all cases. Thirty-five per cent of the patients required hospital treatment and 19% needed operation. Renal pelvic stone was more common in the female (22%) than in the male (8.5%) patients. Spontaneous passage of stone occurred in 87.5% of the men and in 81.5% of the women. No seasonal variation in the onset of acute pain was demonstrable.
Cardiovascular risks have been a concern since combined oral contraceptives (OCs) were first introduced. In the past four years new, mostly reassuring information on the safety of modern, low oestrogen dose OCs has become available. However, in 1995 the new information showed higher venous thromboembolism (VTE) risk for OCs containing desogestrel and gestodene compared with levonorgestrel- or norethindrone-containing OCs. The controversial responses by national authorities, their scientific and public health merits were hotly debated and many considered the differences in risk small and resulted from bias and/or confounding. We discuss these arguments and conclude they lack empirical support or cannot account for the 2-fold increased risk. The risk of ischaemic stroke and myocardial infarction (MI) associated with low oestrogen dose OCs are very small in women without cardiovascular risk factors, while increased risk of haemorrhagic stroke is confined to women >35 years of age. Applying the most recent risks to models of OC-attributable events and deaths, OC-attributable mortality in women <35 years is estimated to be <3 per million users annually, rising to about 10 per million users annually among smokers. In the context of external cause mortality (about 90 per million women of reproductive age annually in the UK) such risks appear small. Over the age of 35 years, OC-attributable mortality is a more important concern, particularly among smokers. In the absence of any appreciable OC-attributable mortality in young healthy women, the additional VTE risk for third compared with second generation OCs should be considered when women choose which OC to use.