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Introduction Epidemiological studies have shown that oral contraceptives carry a small but increased risk of venous thromboembolism (deep vein thrombosis and pulmonary embolism).[1] Furthermore, women who use oral contraceptives and [...]

Abstract Objectives - to establish the survival of individuals heterozygous for hereditary protein C deficiency, who have an increased risk of venous thrombotic events, and to compare it with the [...]

Back pain is one of the most frequent physical reasons people must limit their activities. Risk factors associated with the development of back pain include smoking, driving, and repetitive lifting. However, the actual causes of back pain and the natural course of the disorder are not well established, and it is difficult to predict which individuals may develop the problem. Data from a long-term health study were analyzed to improve understanding of these issues. Results from 241 women who had never had back pain and 236 women who reported both current and past back pain were used for this report. Although smoking and oral contraceptive use were associated with back pain at the start of the study, these factors did not remain significant during analysis of subjects 10 years later. Individuals who reported back pain at the start of the study were likely to have a past history of cystitis (urinary tract infection) and a current history of headaches. Body leanness and obesity were not related to back pain. Subjects who had reported recurrent back pain at the start of the study were most likely to report back pain 10 years later. Analysis indicated that pain in hip or knee on standing was the single independent predictor of continuing back pain. Few of the women with or without pain had worked outside the home so occupational factors were not analyzed. X-ray examinations were not helpful in determining subjects who were likely to have back pain. (Consumer Summary produced by Reliance Medical Information, Inc.)

Back pain is one of the most frequent causes of activity limitation. It is often difficult to determine the underlying problem during the first occurrence of back pain, and X-rays are usually not requested unless back pain persists for at least three months. However, X-rays are useful only if standards marking the natural course of spinal changes in the general population are established. No long-term studies of changes in the lumbar spine (lower back) visible by X-ray have previously been done. To determine whether osteophytes (bone spurs), degeneration of intervertebral discs (shock-absorbing discs present spinal bones), fractures related to osteoporosis (loss of bone density), or other changes visible by X-ray were associated with the development of back pain, results from a long-term medical survey were analyzed. The study included 236 women who had recurrent back pain at the start of the study and 241 women who had never had back pain when the study started. At the start of the study, almost half of women had abnormally small intervertebral spaces, indicative of disc degeneration, and this was more common in those with back pain. Women with back symptoms tended to have more discs affected. Osteophytes were equally common in symptomatic and asymptomatic women. Women with back pain tended less often to have osteoporosis. After 10 years of the study, 64 percent of women had degenerated discs, and this was still more common among women with back pain. More disc spaces were involved, and the number of women with osteophytes was almost 100 percent. The incidence of osteoporosis also increased and remained more common among those without back pain. Development of newly occurring disc degeneration was significantly related to obesity, while having a higher number of children was protective against degeneration. Further deterioration of existing degenerated discs was related to number of discs already involved, and was inversely correlated with age. The study suggests that disc degeneration may explain back pain in some middle-aged women, that osteoporosis is not related to disc degeneration, and that once established disc degeneration progresses in an independent fashion. (Consumer Summary produced by Reliance Medical Information, Inc.)

Some studies suggest that the use of oral contraceptives (OC) may protect against the development of rheumatoid arthritis (RA) in women, a joint disease characterized by inflammation of the joints, stiffness, swelling, overgrowth of cartilage tissue, and pain. The relationship between behavioral factors related to OC use and a possible preventive effect of OC on RA development was assessed. Past pregnancy, age at first pregnancy, and pregnancies with unfavorable outcomes were evaluated as possible risk factors for RA. The study included 135 young women with recently diagnosed RA and 378 women with soft tissue rheumatic disorders or osteoarthritis, a chronic joint disease characterized by destruction of joint cartilage and bone overgrowth with malformation and impairment of function. The women were studied over a period of two years. The risk of RA was decreased in women who had been pregnant, and was lower in women who had early first pregnancies as compared with women who had late first pregnancies. The risk of RA was not substantially reduced if the pregnancy had an unfavorable outcome (ending before 25 weeks gestation). The protective effect of pregnancy against the development of RA was not related to OC use, nor was it related to the presence of a specific histocompatibility antigen, HLA-DR4, a cell element that can activate an immune response, or to a family history of RA. Hormonal changes during pregnancy may influence immune responses and thereby protect against RA. (Consumer Summary produced by Reliance Medical Information, Inc.)

Studies on the relationship between the use of oral contraceptives and the onset of rheumatoid arthritis (RA) have arrived at conflicting conclusions. In studies that focused on oral contraceptive use among patients with RA, researchers noted that other behaviors, such as smoking, were not the same in patients and controls. Smoking is known to affect various systemic functions. The effects of smoking and another related behavior, alcohol consumption, on the occurrence of rheumatoid arthritis were studied in 135 young women with RA and 378 control patients with osteoarthritis or soft tissue rheumatism. Patients with RA tended to have used oral contraceptives less often before RA symptoms developed, and were less frequent users of alcohol or tobacco. Thirty-three percent of RA patients were current cigarette smokers, while 48 percent of other subjects smoked cigarettes. The risk of RA in women who smoked at least one cigarette per day was about one-half that of those who did not smoke. This effect was independent of oral contraceptive use. A similar decreased risk was found among RA patients who used alcohol, and this was also independent of cigarette smoking and oral contraceptive use. The study suggests that alcohol consumption is reduced among RA patients; this may be due to the fear of adverse drug reactions and because joint pain increases strikingly after drinking alcohol. The results also suggests that cigarette smoking may affect the occurrence of RA due to its effects on female and male hormones and on cellular and immune functions. (Consumer Summary produced by Reliance Medical Information, Inc.)